While the bioethics literature demonstrates that the field has spent substantial time and thought over the last four decades on the goals, methods, and desired outcomes for service and training in bioethics, there has been less progress defining the nature and goals of bioethics research and scholarship. This gap makes it difficult both to describe the breadth and depth of these areas of bioethics and, importantly, to gauge their success. However, the gap also presents us with an opportunity to define (...) this scope of work for ourselves and to help shape the broader conversation about the impact of academic research. Because of growing constraints on academic funding, researchers and scholars in many fields are being asked to demonstrate and also forecast the value and impact of their work. To do that, and also to satisfy ourselves that our work has meaningful effect, we must understand how our work can motivate change and how that change can be meaningfully measured. In a field as diverse as bioethics, the pathways to and metrics of change will likewise be diverse. It is therefore critical that any assessment of the impact of bioethics research and scholarship be informed by an understanding of the nature of the work, its goals, and how those goals can and ought to be furthered. In this paper, we propose a conceptual model that connects individual bioethics projects to the broader goals of scholarship, describing the translation of research and scholarly output into changes in thinking, practice, and policy. One of the key implications of the model is that impact in bioethics is generally the result of a collection of projects rather than of any single piece of research or scholarship. Our goal is to lay the groundwork for a thoroughgoing conversation about bioethics research and scholarship that will advance and shape the important conversation about their impact. (shrink)

Although ethics is an essential component of undergraduate medical education, research suggests current medical ethics curricula face considerable challenges in improving students’ ethical reasoning. This paper discusses these challenges and introduces a promising new mode of graduate and professional ethics instruction for overcoming them. We begin by describing common ethics curricula, focusing in particular on established problems with current approaches. Next, we describe a novel method of ethics education and assessment for medical students that we have devised, the Medical Ethics (...) Bowl. Finally, we suggest pedagogical advantages to MEBs when compared to other ethics curricula. (shrink)

Organ procurement presents several ethical concerns (from what constitutes acceptable criteria for death to issues involved in specifically designating to whom an organ can be given), but none is more central than the concern for what are appropriate means for acquiring organs. The following discussion attempts a different perspective on the issue of organ procurement by arguing that, rather than appealing to our charitable consciences or our pocketbooks, relinquishing our organs after death in this day and age is, in fact, (...) obligatory for most people. Each of us is pressed by the growing demand for our organs should we die ?rightly,? and that desperate need has risen to such a level that not to release our organs for transplantation would constitute a serious moral wrong. (shrink)

Introduction to healthcare ethics committees / D. Micah Hester and Toby Schonfeld -- Brief introduction to ethics and ethical theory / D. Micah Hester and Toby Schonfeld -- Ethics committees and the law / Stephen Latham -- Cultural and ...

Berkowitz and Garrett (2020) raise important arguments in favor of consent for apnea testing used in determining death by neurological criteria (DNC); and yet, a fundamental consideration is left u...

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...

Although there are many different moral arguments concerning the use of Best Interests in neonatal decision-making, there seems in practice a firm commitment to application of the concept. And yet, there is still little reflection given by practitioners about what employing a Best Interest determination means in infant care. The following lays out a comprehensive taxonomy of interest-sources in order to provide for more robust considerations of what constitutes best interests of/for neonates.

The paper by Dupras and Bunnik is a useful addition to the literature on privacy in regards to datasets of human tissue/materials. In particular, the paper addresses import...

This paper attempts to defend pragmatic approaches to bioethics against detractors, showing how particular critics have failed or succeeded. The paper divides bioethics from a pragmatic point of view into three groups. The first group is called "bioethical pragmatism" that will be represented by two book-chapters from the anthology, Pragmatic Bioethics . The second group is called "clinical pragmatism" championed by Fins, Baccetta, and Miller. Finally, a third group, which has roots in the legal tradition, has been called "freestanding pragmatism" (...) and is portrayed by Grey, Posner, and Wolf. Each group has been criticized in journal articles, and, in turn, this paper critiques some of the (mis)understandings put forth by Tollefsen, Jansen, and Arras about the capabilities and status of pragmatism in bioethical discussions. Finally, it concludes with cautionary notes about pragmatic bioethics in hopes that pragmatists will learn from their own insights about the human condition and the discipline of bioethics. (shrink)

Responding to research indicating unsettling results with regard to the ability of University students to recognize and reflect on questions of morality, this paper aims to discuss these issues and to introduce a promising mode of ethics instruction for overcoming such challenges. The Curricular Ethics Bowl (CEB) is a method of ethics education and assessment for a wide range of students and is a descendent of the Medical Ethics Bowl (MEB) (Merrick et al., “Introducing the Medical Ethics Bowl”). We seek (...) in this article to show the similarities of CEB to MEB and to distinguish this model from the Intercollegiate Ethics Bowl (ICEB) sponsored by the Association for Professional and Practical Ethics (Landenson 2001). The CEB institutionalizes this mode of ethics education at the program, rather than at the individual course level, and shows advantages over other ethics curricula. (shrink)

Every one of us will die, and the processes we go through will be our own - unique to our own experiences and life stories. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions, healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so that (...) their dying processes embody their life stories. He discusses three types of end-of-life patient populations - adults with decision-making capacity, adults without capacity, and children - to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients. (shrink)

Responding to research indicating unsettling results with regard to the ability of University students to recognize and reflect on questions of morality, this paper aims to discuss these issues and to introduce a promising mode of ethics instruction for overcoming such challenges. The Curricular Ethics Bowl (CEB) is a method of ethics education and assessment for a wide range of students and is a descendent of the Medical Ethics Bowl (MEB) (Merrick et al., “Introducing the Medical Ethics Bowl”). We seek (...) in this article to show the similarities of CEB to MEB and to distinguish this model from the Intercollegiate Ethics Bowl (ICEB) sponsored by the Association for Professional and Practical Ethics (Landenson 2001). The CEB institutionalizes this mode of ethics education at the program, rather than at the individual course level, and shows advantages over other ethics curricula. (shrink)

The term community in ethics and bioethics traditionally has been used to designate either a specific kind of moral relationship available to rational agents or, in contrast, the context in which any sense of rational agency can even be understood. I argue that bioethics is better served when both selves and community are expressed through a more processive language that highlights the functional character of such concepts. In particular, I see the turn to processive community in bioethics as a turn (...) towards method, contextualization, and narrative. In clinical practice, such a processive account demands that bioethics concentrate on methods of developing healthy dialogue and deeper understanding from within the problematic situation rather than trying to fix problems using ethical tools developed from outside the present situation. Community, I argue, is in and of the interactive processes of inquiry itself. Such inquiry, such communitying, requires that we engage individual patients in context; it demands more than simply gaining their permission or mere consent; it demands developing a supportive environment for participation. (shrink)

Ethics networks have emerged over the last few decades as a mechanism for individuals and institutions over various regions, cities and states to converge on healthcare-related ethical issues. However, little is known about the development and nature of such networks. In an effort to fill the gap in the knowledge about such networks, a survey was conducted that evaluated the organizational structure, missions and functions, as well as the outcomes/products of ethics networks across the country. Eighteen established bioethics networks were (...) identified via consensus of three search processes and were approached for participation. The participants completed a survey developed for the purposes of this study and distributed via SurveyMonkey. Responses were obtained from 10 of the 18 identified and approached networks regarding topic areas of: Network Composition and Catchment Areas; Network Funding and Expenses; Personnel; Services; and Missions and Accomplishments. Bioethics networks are designed primarily to bring ethics education and support to professionals and hospitals. They do so over specifically defined areas—states, regions, or communities—and each is concerned about how to stay financially healthy. At the same time, the networks work off different organizational models, either as stand-alone organizations or as entities within existing organizational structures. (shrink)

The essays in this collection address different aspects of Dewey's philosophy of logic, from his work at the beginning of the twentieth century to the culmination of his logical thought in the 1938 volume, Logic: The Theory of Inquiry.

Children like Baby G, born with complex chronic medical conditions that compromise function in the long term, are an increasing presence in tertiary-level neonatal intensive care units. The parents and health-care providers of these children are faced with profoundly difficult decisions. Whether severe congenital anomalies with poor prognosis are diagnosed antenatally or are discovered at the time of birth, the issues are vexing, and the impact decisions will have on everyone in the family is profound. What should such decisions be (...) based upon? What values and principles might guide the decision-making process? What moral justifications allow for pursuing.. (shrink)

In response to Anne L. Dalle Ave and David M. Shaw, we agree with their general argument but emphasize a moral risk of HIV disclosure in deceased donation cases: the risk of relational rupture. Because of the importance that close relationships have to our sense of self and our life plans, this kind of rupture can have long-ranging implications for surviving loved ones. Moreover, the now-deceased individual cannot participate in any relational mending. Our analysis reveals the hefty moral costs that (...) disclosure can bring, which should influence what information is given to wouldbe donors and how organ procurement coordinators approach these conversations. (shrink)

Disease and injury creates a break between the individual and the community which compromises the individual's status within the community as well as the integrity of the self as a “product” of social interaction. Our “everyday” activities are called into question since our ability to fulfill obligations and to achieve many of our ends is diminished through the weakening of our bodies. In light of this account of disease, healing is about restoring the individual to a state of vital functioning, (...) and vital functioning entails communal participation. As John Dewey points out, health as “living healthily” can be understood only in context of each patient's pursuits which are always social and communal. But, if living in community with others is the end-in-view for medical encounters, it too must be implicated in the means to that end. A patient who is given the opportunity to participate as a member of the health care community has already begun within the medical encounter itself to live healthily. It follows, then, that we must work to promote new attitudes within health care towards aiding in the effective agency and participation of patients in their healing process – i.e., we must see community as healing. (shrink)

This CQ department is dedicated to bringing noted bioethicsts together in order to debate some of the most perplexing contemporary bioethics issues. You are encouraged to contact department editor, D. Micah Hester, UAMS/Humanities, 4301 W. Markham St. #646, Little Rock, AR 72205, with any suggestions for debate topics and interlocutors you would like to see published herein.

_Offering a new edition of Dewey’s 1916 collection of essays_ This critical edition of John Dewey’s 1916 collection of writings on logic, _Essays in Experimental Logic—_in which Dewey presents his concept of logic as the theory of inquiry and his unique and innovative development of the relationship of inquiry to experience—is the first scholarly reprint of the work in one volume since 1954. _Essays in Experimental Logic, _edited by D. Micah Hester and Robert B. Talisse, uses the authoritative texts from (...) the _Collected Works of John Dewey, 1882–1953_ and includes as well articles from leading journals representing various contemporary schools of philosophy that criticized Dewey’s experimentalism. Culling materials from six volumes of the chronologically arranged _Collected Works_, this single-volume edition of _Essays_ marks a crucial point in Dewey’s intellectual development: one in which Dewey critically engages idealistic and intuitionist theorists and lays the groundwork for his mature theory of inquiry. The text includes a new introduction by renowned Dewey scholar Tom Burke that places _Essays_ in philosophical and historical context. In addition to the original essays, _Essays in Experimental Logic_ also features five critical essays by Dewey’s contemporaries, including Bertrand Russell, Wendell T. Bush, R. F. Alfred Hoernlé, H. T. Costello, and C. S. Peirce. (shrink)

Ross’s argument against the best interest standard (BIS) makes a clear case for the problems of the BIS, and she also notes challenges with such notions as the harm principle. In light of these critiques, Ross champions her longstanding pediatric moral norm for decision making, constrained parental autonomy (CPA). This article argues that while Ross’s critique of the traditional accounts of the BIS is correct, her solution still raises some concerns. As such, I offer the “reasonable interests standard” as a (...) way of addressing what I see as weaknesses in both the BIS and CPA. (shrink)

Leading Harvard philosophy professor William Ernest Hocking , author of 17 books and in his day second only to John Dewey in the breadth of his thinking, is now largely forgotten, and his once-influential writings are out of print. This volume, which combines a rich selection of Hocking's work with incisive essays by distinguished scholars, seeks to recover Hocking's valuable contributions to philosophical thought.

This CQ department is dedicated to bringing noted bioethicists together in order to debate some of the most perplexing contemporary bioethics issues. You are encouraged to contact “The Great Debates” department editor, D. Micah Hester, UAMS/Humanities, 4301 W. Markham St., #646, Little Rock, AR 72205, with any suggestions for debate topics and interlocutors you would like to see published herein.

The American Journal of Bioethics, Volume 11, Issue 8, Page 44-45, August 2011.

Born at 24 weeks gestation, Baby G now lies in a neonatal intensive care unit two months post-birth. He has pulmonary hypoplasia, congenital scoliosis, and swallowing issues that will require placement of a feeding tube, and bowel dystonia that interferes with his ability to absorb feedings. Shortly after birth, he experienced a cardiopulmonary arrest and now has obvious neurological impairments. As a result of incomplete development of his lungs and severe chronic lung disease, he cannot breathe on his own. Because (...) of his chronic respiratory failure, tracheostomy and long-term assisted ventilation was offered as an option that would allow him to be discharged from the acute care setting. However, his congenital.. (shrink)

This CQ department is dedicated to bringing noted bioethicsts together in order to debate some of the most perplexing contemporary bioethics issues. You are encouraged to contact department editor, D. Micah Hester, UAMS/Humanities, 4301 W. Markham St. #646, Little Rock, AR 72205, with any suggestions for debate topics and interlocutors you would like to see published herein.

In April of 2001 I published a brief commentary in the journal Academic Medicine questioning the current character and functioning of the National Residency Matching Program. The purpose of the article was to stimulate a rethinking of process. At 50 years old, the environment through which the match operates has changed, and as such I thought it time to ask ourselves whether or not the match, its algorithm, and, more important, the values it manifests might well need an overhaul.