BackgroundSex and gender influence individuals’ psychology, but are often overlooked in psychological science. The sex and gender equity in research guidelines provide instruction for addressing sex and gender within five sections of a manuscript.MethodsWe examined whether the 89 journals published by the American Psychological Association provide explicit instruction for authors to address sex and gender within these five sections. Both authors reviewed the journal instructions to authors for the words “sex,” and “gender,” and noted explicit instruction pertaining to these five (...) sections.ResultsOnly 8 journals instructed authors to address sex/gender within the abstract, introduction, and/or methods sections. No journals instructed authors to address sex and gender in the results or discussion sections.ConclusionThese journals could increase sex/gender equity and improve the reproducibility of psychological science by instructing authors to follow the SAGER guidelines. (shrink)

T. A. Cavanaugh's Hippocrates' Oath and Asclepius' Snake: The Birth of the Medical Profession articulates the Oath as establishing the medical profession's unique internal medical ethic - in its most basic and least controvertible form, this ethic mandates that physicians help and not harm the sick. Relying on Greek myth, drama, and medical experience (e.g., homeopathy), the book shows how this medical ethic arose from reflection on the most vexing medical-ethical problem -- injury caused by a physician -- and (...) argues that deliberate iatrogenic harm, especially the harm of a doctor choosing to kill (physician assisted suicide, euthanasia, abortion, and involvement in capital punishment), amounts to an abandonment of medicine as an exclusively therapeutic profession. The book argues that medicine as a profession necessarily involves stating before others what one stands for: the good one seeks and the bad one seeks to avoid on behalf of the sick, and rejects the view that medicine is purely a technique lacking its own unique internal ethic. It concludes noting that medical promising (as found in the White Coat Ceremony through which U. S. medical students matriculate) implicates medical autonomy which in turn merits respect, including honoring professional conscientious objections. (shrink)

This chapter contains sections titled: Two Views of Authenticity Being a Real Father Notes.

T. A. Cavanaugh defends double-effect reasoning, also known as the principle of double effect. DER plays a role in anti-consequentialist ethics, in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect. This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, applied ethics, and moral theology. It will also interest legal and public policy (...) scholars. (shrink)

Two complementary debates of the turn of the nineteenth and twentieth century are examined here: the debate on the legitimacy of hypotheses in the natural sciences and the debate on intentionality and ‘representations without object’ in philosophy. Both are shown to rest on two core issues: the attitude of the subject and the mode of presentation chosen to display a domain of phenomena. An orientation other than the one which contributed to shape twentieth-century philosophy of science is explored through the (...) analysis of the role given to assumptions in Boltzmann’s research strategy, where assumptions are contrasted to hypotheses, axioms, and principles, and in Meinong’s criticism of the privileged status attributed to representations in mental activities. Boltzmann’s computational style in mathematics and Meinong’s criticism of the confusion between representation and judgment give prominence to an indirect mode of presentation, adopted in a state of suspended belief which is characteristic of assumptions and which enables one to grasp objects that cannot be reached through direct representation or even analogies. The discussion shows how assumptions and the movement to fiction can be essential steps in the quest for objectivity. The conclusion restates the issues of the two debates in a contemporary perspective and shows how recent developments in philosophy of science and philosophy of language and mind can be brought together by arguing for a twofold conception of reference.Keywords: Assumption; Hypothesis; Description; Mode of presentation; Ludwig Boltzmann; Alexius Meinong. (shrink)

Federal law under the Individuals with Disabilities in Education Improvement Act stipulates that services provided to students with diagnosed disabilities must be individualised based on the as...

In Being and Time, Heidegger claims that the history of the concept of time bears an Aristotelian stamp. In this paper, I dispute that claim. Instead, I argue that the history of the concept of time is primarily Augustinian. To support this claim, I demonstrate that Augustine’s theory of time is a quantitative theory of time, while Aristotle’s theory of time is a qualitative theory of time. Since most theories of time in the tradition are quantitative, it seems unlikely that (...) they derived any significant influence from Aristotle’s theory, as Heidegger claims. But there are significant parallels to Augustine’s theory. This is true for both of the major theories of time: those found in Classical Mechanics and those found in Kant. I close with some speculation as to why Heidegger makes the claim he does concerning the history of the concept of time. (shrink)

HIV stigma, a social-medical problem, continues to confound researchers and health professionals, while undermining outcomes. Empathy may reduce stigma; its absence may predict stigma. This research investigates: How does Kafka’s _Metamorphosis_ advance understandings of HIV stigma in medical health education? _Metamorphosis_ amplifies the sociological-relational mechanisms fostering HIV stigma. It offers a multi-disciplinary, responsive space for ethical, humanistic and clinical inquiry to meet: enabling students to consider how social structures shape health inequities, moral, social experience, and their professional identity within. _Metamorphosis_ (...) may ultimately promote medical health humanities’ social mission—allowing literature to unfold such revelations towards greater equity in health. (shrink)

The way metrologists conceive of measurement has undergone a major shift in the last two decades. This shift can in great part be traced to a change in the statistical methods used to deal with the expression of measurement results, and, more particularly, with the calculation of measurement uncertainties. Indeed, as we show, the incapacity of the frequentist approach to the calculus of uncertainty to deal with systematic errors has prompted the replacement of the customary frequentist methods by fully Bayesian (...) procedures. The epistemological ramifications of the Bayesian approach merge with a deep empiricist mood tantamount to an “epistemic turn”: measurement results are analysed in terms of degrees of belief, and central concepts such as error and accuracy are called into question. We challenge the perspective entailed by this epistemic turn: we insist on the centrality of the concepts of error and accuracy by underlining the intentional character of measurement that is intimately linked to the process of correction of experimental data. We further circumvent the difficulties posed by the classical analysis of measurement by stressing the social rather than the epistemic dimension of measurement activities. (shrink)

In November 2018, the practice of health care ethics consultation crossed a major threshold when 138 candidates took the inaugural Healthcare Ethics Consultant Certification Examination. This accomplishment, long in the making, has had and continues to have both advocates and critics. The Healthcare Ethics Consultant Certification Commission, a functionally autonomous body created and funded by the American Society for Bioethics and Humanities, was charged with overseeing creation of the certification process, developing the exam, and formulating certification standards and policies to (...) assess candidates’ qualifications. In this essay, as members of the commission, we describe the process of developing, administering, and scoring the certification examination as well as the historical context and the outlook for certification. By detailing the decisions and actions of the commission, we aim to provide a transparent account of the commission's efforts to develop a psychometrically sound, reliable, and secure examination through a deliberative, fair, and data‐driven process. (shrink)

We describe the ethics consultation service (ECS) at the Cleveland Clinic and report on its activities over a 24-month period in which 478 consultations were performed. To our knowledge, this is the largest case series of ethics consultations reported to date. Established more than 25 years ago, the ECS at the Cleveland Clinic is staffed by multiple consultants with advanced training in bioethics. Several of these ethicists work closely with specialized clinical units and research departments, where they participate in multidisciplinary (...) meetings and provide specialized assistance. This combination of historical experience, large numbers of consultation requests, and specialized clinical ethicists suggests that the experience at the Cleveland Clinic may be helpful to ethicists and others who may be considering how to structure and sustain a vibrant ECS. Our results highlight the diversity of activities performed by a high-volume ECS at a tertiary care facility. Our hope in sharing the inner workings of the ECS at the Cleveland Clinic is to promote dialogue on common practices and approaches across medical institutions that support ethics consultation. (shrink)

Systems of units still fail to attract the philosophical attention they deserve, but this could change with the current reform of the International System of Units. Most of the SI base units will henceforth be based on certain laws of nature and a choice of fundamental constants whose values will be frozen. The theoretical, experimental and institutional work required to implement the reform highlights the entanglement of scientific, technological and social features in scientific enterprise, while it also invites a philosophical (...) inquiry that promises to overcome the tensions that have long obstructed science studies. (shrink)

A number of common and generally noncontroversial practices in the care of patients at the end of life lead to their deaths. For example, physicians honor a patient's refusal of medical intervention even when doing so leads to the patient's death. Similarly, with a patient's or surrogate's consent, physicians administer sedatives in order to relieve pain and distress at the end of life, even when it is known that doing so will cause the patient's death. In contemporary U.S. public policy, (...) these practices are accepted as ethical and legal while physician-assisted suicide (PAS) isrejected in current U.S. law and public policy. Some think, however, that if one accepts practices that are known to lead to a patient's death, then one cannot reasonably reject a patient's request for a lethal dose of medication so that she may kill herself (PAS). (shrink)

It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients’ medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees (...) in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation. (shrink)

Itself a topic of constant comment, the Internet's implications for healthcare remain unclear even while its boundaries incessantly expand. The WorldWide Web and allied technologies such as telephony are clearly permanent fixtures of our world. These technologies have changed our ways of life and demonstrate further dynamic capacities to do so. They speak of what we shall be, but know not.

Proponents commonly justify the legalization of physician-assisted suicide (PAS) in terms of a patient's wanting to die (autonomy) and the patient's having a medically established good reason for suicide. These are the common elements of the standard justification offered for the legalization of PAS. In what follows, I argue that these two conditions exist in significant tension with one another, operating according to distinct dynamics that render the justification for PAS an unstable basis for public policy. Moreover, no natural connection (...) keeps these two criteria united. Indeedthe two elements of the justification oppose and threaten to exclude one another. Thus, the PAS justification is too labile a basis for sound public policy. (shrink)

The authors work in a variety of clinical ethics consultation services (CECSs) that employ a range of methods and approaches. This article discusses the approach to ethics consultation at the Center for Medical Ethics and Health Policy at Baylor College of Medicine and describes the development and transformation of the authors’ CECSs. It discusses how one CECS shifted from a nascent program with only fifty consultations a year to a vibrant, heavily staffed service with five hundred ethics consultations a year.

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...) implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: train-the-trainer, local capacity-building, circuit-riding, and consolidated accountability. We note each model’s benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations. (shrink)

The philosophical significance attached to the construction of systems of units has traditionally been confined to the notion of convention, while their adoption was considered to be the exclusive province of the history and sociology of science. Against this tradition, a close articulation between history, philosophy, and sociology of science is needed in order to analyse the recent reform of the International system of units. In the new SI, units are redefined on the basis of certain fundamental constants of nature, (...) established by physical theories, whose values are fixed without uncertainty. The purpose of this article is to show that the redefinition of SI units, far from being a convention, involves a holistic reconstruction of our concepts of quantities from accepted theoretical laws. Fixing the values of the defining constants stabilizes these laws within the framework of physics through a twofold adjustment procedure that ensures both a semantic coordination between theory and world and an intersubjective coordination between human agents required by social activities. This double adjustment implies a treatment of uncertainties that results in closely entwining the pursuit of truth as correspondence and truth as coherence which turn out to be complementary, thus highlighting the anthropological underpinnings of scientific realism. (shrink)

Since its foundation, militant democratic arguments have underpinned an enforced secularism in Turkey. The 2002 election of the AKP, described as a “moderate Islamist party”, has challenged Turkey’s secular identity. In the more than twelve years since the AKP has been in power, Turkey’s political landscape has experienced significant changes, with periods of extensive democratic reforms punctuated by regression in certain areas, notably freedom of expression and the right to protest. State repressive measures coupled with Recep Tayyip Erdoğan’s reluctance to (...) exit the political stage have been the focus of much commentary and analysis. This article argues, however, that under AKP rule the Kurdish issue – critical to ensuring the normalization of politics and democratization in Turkey – has been brought in from the political cold and assesses the creation and role of the HDP, a Kurdish political party that is endeavoring to situate itself in the mainstream of Turkey’s political landscape. We posit that the HDP can be viewed as the offspring of this “democratic opening,” a project that was meant to ensure a radical transformation of the Kurdish issue in Turkey. Through analysing the historical trajectory of both AKP and HDP and the militant democratic arguments that led to their predecessors’ exclusion from the public sphere, this article engages with the key question of the extent to which the AKP’s treatment of the Kurdish issue has provided a vehicle for broader democratisation and facilitated a reconsideration of the Kurdish question in Turkey. (shrink)

The guest editors would like to thank the University of Paris and the ENSA Paris-Val de Seine for having provided premises to successfully host the 2018 "Measurement at the Crossroads" conference in Paris.Our thanks extend to our funding sources: the conference was made possible thanks to the generous support of the Institut Humanités, Sciences et Sociétés, the SPHERE laboratory and the Laboratoire Matériaux et Phénomènes Quantiques of the University of Paris, the department of History and Philosophy of Science of the (...) University of Paris, the Laboratoire National de métrologie et d'Essais, and the University of Geneva.We would like to thank the many people who contributed to the organization of... (shrink)

T. A. Cavanaugh defends double-effect reasoning (DER), also known as the principle of double effect. DER plays a role in anti-consequentialist ethics (such as deontology), in hard cases in which one cannot realize a good without also causing a foreseen, but not intended, bad effect (for example, killing non-combatants when bombing a military target). This study is the first book-length account of the history and issues surrounding this controversial approach to hard cases. It will be indispensable in theoretical ethics, (...) applied ethics (especially medical and military), and moral theology. It will also interest legal and public policy scholars. (shrink)

Developing a care plan in a critical care context can be challenging when the therapeutic alliance between clinicians and families is compromised by anger. When these cases occur, clinicians often turn to clinical ethics consultants to assist them with repairing this alliance before further damage can occur. This paper describes five different reasons family members may feel and express anger and offers concrete strategies for clinical ethics consultants to use when working with angry families acting as surrogate decision makers for (...) critical care patients. We reviewed records of consults using thematic analysis between January 2015 and June 2016. Each case was coded to identify whether the case involved a negative encounter with an angry family. In our review, we selected 11 cases with at least one of the following concerns or reasons for anger: perceived or actual medical error, concerns about the medical team’s competence, miscommunication, perceived conflict of interest or commitment, or loss of control. To successfully implement these strategies, clinical ethics consultants, members of the medical team, and family members should share responsibility for creating a mutually respectful relationship. (shrink)

Patients who enter the health care system for acute care may become “permanent” patients of the hospital when a lack of resources precludes discharge to the next level of post-acute care. Legal, professional, and ethical norms prohibit physician and acute care hospital “dumping” of these patients. However, limitless use of hospital resources for indefinite stays is untenable. In the absence of hospital policy addressing this specific issue, the availability of financial support will be determined by health care professionals' willingness to (...) advocate for the patient and negotiate with hospital administrators and the ability and willingness of administrators to authorize the use of hospital resources. We propose five mid-level ethical principles to guide advocacy and administrative decision-making about provision of financial support for post-acute care for those patients who cannot afford it. We use two actual, de-identified cases to illustrate how these principles can be used to make reasoned, consistent decisions about the provision of post-acute financial support. (shrink)

Patients who enter the health care system for acute care may become “permanent” patients of the hospital when a lack of resources precludes discharge to the next level of post-acute care. The care of these patients contributes to the rising costs of health care and will remain largely unaffected by the Affordable Care Act. For example, some resources may be available for treatment of undocumented persons, but Medicaid enrollment is unavailable for this population. Even where patients have access to Medicaid, (...) it takes up to three months between applying for and actually receiving Medicaid benefits. During that time, patients may be ready for hospital discharge. However, post-acute care facilities have no financial incentive or legal obligation to accept patients with no insurance or only pending Medicaid coverage. (shrink)

Despite the interpersonal nature of family meetings and the frequency in which they occur, the clinical ethics literature is devoid of any rich descriptions of what clinical ethicists should actually be doing during family meetings. Here, we propose a framework for describing and understanding “transitioning” facilitation skills based on a retrospective review of our internal documentation of 100 consecutive cases wherein a clinical ethicist facilitated at least one family meeting. The internal documents were analyzed using qualitative methodologies, i.e., “codes”, to (...) identify emergent themes. We identified four different transitioning strategies clinical ethicists use to reach a meaningful resolution. These transitioning strategies serve as a jumping-off point for additional analyses, future research, evaluating clinical ethics consultation, and overall performance improvement of a consultation service. (shrink)

The clinical ethicist met with Ms. H to clarify what information she wants and does not want to know. First, she wants to receive any treatment that could prolong her life, regardless of how the treatment affects her ability to engage in activities of daily living. Second, she wants to be included in the decision‐making process as much as possible, as long as clinicians use only “positive” language. Ms. H considers the words “dying,” “chemotherapy,” “radiation,” and “cancer” to be “bad (...) words.” For conversations in which these words cannot be avoided, she wants her clinicians to talk to her son. Her desired engagement includes hearing about risks, benefits, and alternatives to treatments if clinicians use only “positive” language. Finally, she says that she rarely sees doctors and that she is “very scared” of hospitals, despite exhibiting a comfortable demeanor.Should clinicians honor Ms. H's waiver of specified information and, if so, to what degree? (shrink)

In their article “Structuring a Written Examination to Assess ASBH Health Care Ethics Consultation Core Competencies” (2014), White, Jankowski, and Shelton argue that a written examination to evalu...