The Hill Burton Act, which was signed into law in 1946 and ended in 1997, was one of the most significant forces that shaped the health care system we have today. Providing grants and loans for the construction and expansion of hospitals across the country, it required beneficiary hospitals to give some amount of uncompensated care to the poor and uninsured in return.The act not only led to our health care system's current emphasis on the acute‐care hospital as the primary (...) site of health care delivery, but it also had a profound effect on nursing, fully involving the profession in an acute‐care world. The act created jobs for nurses at an unprecedented level. There are over 3.4 million nurses in the United States, and in 2013, 63 percent of all nurses worked for hospitals. Nursing education continues to emphasize acute care, despite the calls for shifting the curriculum to more community‐based content and experiences that focus on health promotion and wellness for individuals, families, and communities. It is my premise that the nursing profession and all who profess to be committed to promoting health have a moral obligation to help the nation adopt a Hill‐Burton Act of the twenty‐first century that will focus on building healthy communities, supporting families in ways that promote health, and helping individuals to live healthier lives. This would require a shift in resources from a costly health care system to investing in community development, whether job creation, building safe places to play and exercise, providing access to affordable and nutritious foods, advancing the quality of education, or other approaches to addressing and improving the social determinants of health. Making this kind of investment would speak to the principles of beneficence, least harm, and justice, particularly for socioeconomically stressed communities. (shrink)

In Britain, substantial cuts in police budgets alongside controversial handling of incidents such as politically sensitive enquiries, public disorder and relations with the media have recently triggered much debate about public knowledge and trust in the police. To date, however, little academic research has investigated how knowledge of police performance impacts citizens’ trust. We address this long-standing lacuna by exploring citizens’ trust before and after exposure to real performance data in the context of a British police force. The results reveal (...) that being informed of performance data affects citizens’ trust significantly. Furthermore, direction and degree of change in trust are related to variations across the different elements of the reported performance criteria. Interestingly, the volatility of citizens’ trust is related to initial performance perceptions, and citizens’ intentions to support the police do not always correlate with their cognitive and affective trust towards the police. In discussing our findings, we explore the implications of how being transparent with performance data can both hinder and be helpful in developing citizens’ trust towards a public organisation such as the police. From our study, we pose a number of ethical challenges that practitioners face when deciding what data to highlight, to whom, and for what purpose. (shrink)

In his 1991 book ‘Consciousness Explained', Daniel Dennett presents his “Multiple Drafts” model of consciousness. Central to his theory is the rejection of the notion of ‘qualia'; of the existence of the purported ‘qualitative character' of conscious experience that many argue rules out the possibility of a purely materialist theory of mind. In eliminating qualia from his theory of consciousness, Dennett claims to be following in the footsteps of Wittgenstein, who also had much to say regarding the nature of ‘private' (...) experience. In this paper I reject this claim and argue that the elimination of qualia plays no part in Wittgenstein's radical understanding of conscious experience. S. Afr. J. Philos. Vol.24(1) 2005: 33-43. (shrink)

A growing literature addresses the ethical implications of electronic surveillance at work, frequently assigning ethical priority to values such as the right to privacy. This paper suggests that, in practice, the issues are sociologically more complex than some accounts suggest. This is because many workplace electronic technologies not designed or deployed for surveillance purposes nevertheless embody surveillance capacity. This capacity may not be immediately obvious to participants or lend itself to simple deployment. Moreover, because of their primary functions, such systems (...) embody a range of other features which are potentially beneficial for those utilising them. As a result, more complex ethical dilemmas emerge as different desired goods compete for priority in the decision-making of individuals and groups. From a sociological point of view this raises interesting questions about the way ethical dilemmas arise in the context of the ongoing social relationships of work. The paper explores these issues using data from a study of the development and implementation of a computerised instructional package in a maternity setting. This medical setting illustrates clearly how seeking to assign ethical priority to a particular concern, such as the right to privacy, cannot but oversimplify the real day to day dilemmas encountered by participants. At the same time,the example of the instructional package demonstrates that it is difficult to predict in advance what ethical issues will be raised by technologies that almost always turn out to have a range of capabilities beyond those envisaged in their original design specification. (shrink)