This paper summarizes the consequences of safety and health inattentiveness, and reviews four primary dangers in the workplace. In addition, perspectives of employee health and safety are presented from industry and academia which provide the basis for a strong recommendation to include safety and health issues in business school curricula.

Mental time travel is defined as projecting the self into the past and the future. Despite growing evidence of the similarities of remembering past and imagining future events, dominant theories conceive of these as distinct capacities. I propose that memory and imagination are fundamentally the same process – constructive episodic simulation – and demonstrate that the ‘simulation system’ meets the three criteria of a neurocognitive system. Irrespective of whether one is remembering or imagining, the simulation system: acts on the same (...) information, drawing on elements of experience ranging from fine-grained perceptual details to coarser-grained conceptual information and schemas about the world; is governed by the same rules of operation, including associative processes that facilitate construction of a schematic scaffold, the event representation itself, and the dynamic interplay between the two ; and is subserved by the same brain system. I also propose that by forming associations between schemas, the simulation system constructs multi-dimensional cognitive spaces, within which any given simulation is mapped by the hippocampus. Finally, I suggest that simulation is a general capacity that underpins other domains of cognition, such as the perception of ongoing experience. This proposal has some important implications for the construct of ‘MTT’, suggesting that ‘time’ and ‘travel’ may not be defining, or even essential, features. Rather, it is the ‘mental’ rendering of experience that is the most fundamental function of this domain-general simulation system enabling humans to re-experience the past, pre-experience the future, and also comprehend the complexities of the present. (shrink)

The purpose of this study is to explore with more rigor and detail the role of social norms in tax compliance. This study draws on Cialdini and Trost’s (The Handbook of Social Psychology: Oxford University Press, Boston, MA, 1998) taxonomy of social norms to investigate with more specificity this potentially decisive (Alm and McKee, Managerial and Decision Economics, 19:259–275, 1998) influence on tax compliance. We test our research hypotheses regarding the direct and indirect influences of social norms using a hypothetical (...) compliance scenario with 174 experienced taxpayers as participants. Factor analysis of the social norm questions successfully identified four distinct social norm constructs, in line with Cialdini and Trost (1998). Results of the path analysis show that individuals’ standards for behavior/ethical beliefs (personal norms) as well as the expectations of close others (subjective norms) directly influence tax compliance decisions, whereas general societal expectations (injunctive norms) and other individuals’ actual behavior (descriptive norms) have an indirect influence. This shows that social norms have important direct as well as indirect influences on tax compliance behavior. We also investigate a number of attitudinal variables that may be related to social norms and taxpayer compliance. The results of this study further clarify the important role that social norms have with regard to taxpayers’ compliance behavior. (shrink)

This paper proposes that the philosophy of Bernard Lonergan can provide insight into the challenge of integrating nursing theory, research and practice. The author discusses Lonergan's work in regard to reflective understanding, authenticity and the human person as a subject of consciously developing unity. This is followed by a discussion of two key elements in Lonergan's work that relate to nursing: the subject–object challenge of nursing inquiry and common sense vs. scientific knowledge. The author suggests that integration of nursing theory, (...) science and practice may be achieved through self-transcendence. (shrink)

One important sense of 'global ethics' concerns the applied ethical issues arising in the context of economic globalisation. This article contends that we are beginning to witness the economic commodification and, concomitantly, the globalisation, of human tissue and the human genome. Policy-makers and local research ethics committees need to be aware that the relevant ethical questions are no longer confined to their old national or subnational context. A shift from questions of personal autonomy and identity can therefore be expected-towards the (...) more problematic issues of justice, exploitation and distribution. Here we can learn from the distinctions drawn in legal philosophy, such as the notion of property as a 'bundle' of rights, from which we may choose rights favouring the interests of vulnerable populations. We may also wish to apply the distinctions drawn by Calabresi and Melamed between pure property rules, modified alienability rules, and pure non-property regimes. Global ethics also concerns issues of value disparity across cultures, directing our attention to the moral beliefs of indigenous peoples, for example, whose DNA or tissue is increasingly of commercial importance. In examining case examples from Tonga and Aotearoa/new Zealand, I will consider the impact of indigenous belief systems and of neo-colonialism on indigenous peoples' perceptions of Western researchers. It is clear that many indigenous peoples reject both the pure property system and any modifications, insisting on a pure non-property regime. How can they then be protected in a globalised market system that so far favours the opposite end of the spectrum? (shrink)

Policies promoted and adopted for allocating ventilators during the COVID-19 pandemic have often prioritised healthcare workers or other essential workers. While the need for such policies has so far been largely averted, renewed stress on health systems from continuing surges, as well as the experience of allocating another scarce resource—vaccination—counsel revisiting the justifications for such prioritisation. Prioritising healthcare workers may have intuitive appeal, but the ethical justifications for doing so and the potential harms that could follow require careful analysis. Ethical (...) justifications commonly offered for healthcare worker prioritisation for ventilators rest on two social value criteria: instrumental value, also known as the ‘multiplier effect’, which may preserve the ability of healthcare workers to help others, and reciprocity, which rewards past usefulness or sacrifice. We argue that these justifications are insufficient to over-ride the common moral commitment to value each person’s life equally. Institutional policies prioritising healthcare workers over other patients also violate other ethical norms of the healthcare professions, including the commitment to put patients first. Furthermore, policy decisions to prioritise healthcare workers for ventilators could engender or deepen existing distrust of the clinicians, hospitals and health systems where those policies exist, even if they are never invoked. (shrink)

The predominant conception of the status of race is that race is a social construction. But what does it mean to say that a group, racially defined, is a social construct? How we understand the process of constitution and related identities is important beyond the conceptual reality or non-reality that defines the group. To this end, this dissertation explores two models of group constitution employed by Jean-Paul Sartre, the first from Anti-Semite and Jew, which bases group constitution and identity on (...) the gaze of the dominant Other, and the second from his later work, Critique of Dialectic Reason, Vol.1, which places the group as a prominent facilitator of history that produces itself in the domain of the Other. Both models show that the existence of group and group identity are constructed and as a result both reject claims of essentialism that may be ascribed to the group. However, I argue that the more nuanced conception of the social construction of the group, found in the Critique, envisages a more complex and dynamic account of group formation and identification, an account that acknowledges the need for group identities particularly among those who are historically oppressed as members of a group. ;My dissertation attempts to reconcile two fundamental and distinct approaches to race---ontology and experience---through what I hope the reader will appreciate as a series of dialogues between Sartre and various interlocuters. These interlocuters include contemporary authors such as Ian Hacking, K. Anthony Appiah, and Naomi Zack whose works refer to some aspect of Sartrean thought. Additionally, I explore textual dialogues between Sartre and both Maurice Merleau-Ponty and Frantz Fanon, existentialists authors themselves, whose works provide insights into the possibilities and problems that Sartre faced in his attempts to attend to colonialism, racism, race and class consciousness, individual and group freedom. Thus, a secondary goal of this dissertation is to show Sartre's continued relevance to our contemporary discourse of race in particular and contemporary philosophy in general. (shrink)

Ethical decision making is a core part of the work of social work and human service practitioners, who confront with regularity dilemmas of duty of care; confidentiality, privacy and disclosure; choice and autonomy; and distribution of increasingly scarce resources. This article details the development and application of the Inclusive Model of Ethical Decision Making, created in response to growing awareness of the complexities of work in both public and private sectors. The model rests on four key platforms that are constructed (...) from important foundational values and principles. These platforms are: Accountability, Consultation, Cultural Sensitivity and Critical Reflection, and underlie the dynamic five-step process that uses a reflective yet pragmatic approach to identify and analyze all relevant aspects of an ethical dilemma. The article begins by exploring the anatomy of an ethical dilemma, including the identification of competing ethical principles. It then moves on to highlight the different points in a decision-making process where difficulties typically arise for practitioners who may confront problems of interpretation of ethical codes, lack of access to needed resources and supports, or who may find themselves bound by legal or organizational restrictions. It is argued that this model has useful application for both social work education and practice. (shrink)

Previous studies have shown that misperceptions and illusory experiences can occur if sensory stimulation is withdrawn or becomes invariant even for short periods of time. Using a perceptual deprivation paradigm, we created a monotonous audiovisual environment and asked participants to verbally report any auditory, visual or body-related phenomena they experienced. The data (analysed using a variant of interpretative phenomenological analysis) revealed two main themes: (1) reported sensory phenomena have different spatial characteristics ranging from simple percepts to the feeling of immersion (...) in a complex multisensory environment and (2) the active contribution of the perceiver where participants report engaging in exploratory processes even when there is nothing to find. Detailed analysis of the qualitative data further showed that participants who reported more perceptual phenomena were more likely to report internal bodily sensations, move more during the experiment and score higher on the Revised Hallucination Scale than those reporting fewer percepts explicitly linking perceptual deprivation to somatic phenomena. The results demonstrate how the variety of sensory experiences induced by perceptual deprivation can give further insight into the factors mediating conscious awareness and may suggest ways in which the brain imposes meaning on the environment under invariant sensory conditions. (shrink)

Available from UMI in association with The British Library. ;Typically we maintain two incompatible standards towards right action and good character, and the tension between these polarities creates the paradox of moral luck. In practice we regard actions as right or wrong, and character as good or bad, partly according to what happens as a result of the agent's decision. Yet we also think that people should not be held responsible for matters beyond their control. ;This split underpins Kant's assertion (...) that only the good will is securely good, that its goodness is impervious to outcome ill-luck. Some commentators, such as Martha Nussbaum and to some extent Bernard Williams, think that this simply writes off the paradox. Williams asserts that the paradox is insoluble, and that its inescapability threatens the notion of agent responsibility. In contrast Thomas Nagel argues that agents' most cherished projects may be indeed be subject to luck, but that does not mean that their deepest motivations are moral. This, I suggest, is one of several means whereby we might limit the effect of the paradox without denying that the tension exists. But I also argue that it is wrong to accuse Kant of ignoring the paradox. ;Ethical consequentialists, on the other hand, appear to have no problem with moral luck, because the paradox depends on a dichotomy between the outside world and the locus of moral worth in the individual agent. But this turns out not to be true. The problem of moral luck is not some strange Kantian fixation, but a general dilemma: a variant on what Nagel terms "the problem of excess objectivity" which cuts across all of ethics and metaphysics. ;Retaining a broadly Kantian notion of agent-responsibility, but limiting what agents are responsible for, requires us to delineate the realm of ethics more narrowly than has been done by those who believe that the rational and/or prudential are coterminous with the ethical. This strategy for minimising the paradox's impact is explored in two areas from medical ethics, the allocation of scarce medical resources and informed consent, and two from public policy, secrecy and nuclear deterrence. Throughout, the analysis seeks to test Nagel's maxim that the best we can hope for is to act in such a manner that we would not have to revise our opinion of how we should have acted once the consequences of our actions become apparent. (shrink)

Social workers frequently encounter ethical dilemmas in their daily practice. This paper examines the utility of hierarchies of ethical principles as tools for ethical decision making. Because of limited research on this topic, the degree of agreement on ordering of ethical principles is unknown. This paper presents illustrative data that suggest variability in individual hierarchies and priorities, which may depend on the circumstances of a situation. Recommendations for using hierarchies of ethical principles in social work education and practice are discussed (...) and a detailed example of how different hierarchies may lead to making different decisions is provided. (shrink)

In this article, I argue for the value of participatory methodologies, in research with children, which aims to privilege their epistemologies and living experiences in relation to the nature of self. Researching self with children raises questions about the mainstream materialist paradigm which holds hegemony over most academic disciplines – and, importantly, over the life worlds of everyday people. Children’s experiences of self, others and the world challenge the dominant materialist paradigm, requiring investigation into other metaphysical models of reality, that (...) may have more explanatory power than materialism. I address this by appealing to a body of scholarship referred to as ‘postmaterialist’. Reauthoring our nature as human beings carries an increasing importance and urgency in the face of current ecological, economical and health crises. I argue that any research, which seeks to facilitate social transformation through everyday people, needs to begin by asking ontological questions about the nature of the self - the subject of experience who holds and reports epistemological authority over their subjective experiences. (shrink)

Barzykowski and Moulin's view on involuntary autobiographical memory focuses on automatic activation of representations and inhibitory control mechanisms. We discuss how and when a known neural mechanism – pattern completion – may result in involuntary autobiographical memories, the types of cues that may elicit this phenomenon and consider interactions with future-oriented cognition.

In lieu of an abstract, here is a brief excerpt of the content:The Eleatic BergsonDonna Jones (bio)Suzanne Guerlac. THINKING IN TIME: AN INTRODUCTION TO HENRI BERGSON. Ithaca: Cornell UP 2006. [TT]In her Thinking in Time: An Introduction to Henri Bergson Suzanne Guerlac reminds her readers that the metaphysician has indeed been the subject of many hatreds, as the Bergsonist Gilles Deleuze once noted. But from this taut philosophical study one cannot easily make out any possible grounds for enmity; nor were (...) any expressed in the special Bergson issue of Modern Literary Notes edited by Guerlac. In this short review essay I shall voice some of that historic criticism, especially in regard to the social and political implications of his thought. Guerlac’s study may also win its own opponents for its sharp criticisms of Deleuze’s interpretations of Bergson and (in her reading) comically machinic view of life [TT 176–87]. This alone makes the book worth reading; it is also exhaustively researched, and I cannot remember learning as much from the footnotes of any other book.Bergson is presented here as a great metaphysician on the nature of time and space, the philosophical father of nonlinear science, and a theorist of concrete and affective individuality. Rejecting implicitly Leszek Kolakowski’s reading of two Bergsons, Guerlac presents him as neither a cosmologist who opposes life and matter nor an existentialist who retrieves consciousness by opposing time to space. Nor does he emerge as a systematic thinker in this study. In the last chapter Guerlac offers a dizzying defense of Bergson for providing the philosophical basis for cultural studies of the qualitative irreducibility of affectual states, the metaphysics of chaos theory, the critique of artificial intelligence, and the rudiments of an aesthetic theory of digital art and virtual reality.All of this follows from the epochal significance of Bergson’s metaphysical distinction between time and space as carefully grounded in the most advanced physics of his time. Guerlac does not discuss in any detail Bergson’s vitalist critiques of Darwinian biology in Creative Evolution, the work through which the metaphysical arsonist fired the modernist imagination in diverse, contradictory, and at times violent ways.1 Nor does she explore the occult and mystical themes that run throughout Bergson’s work and informed his personal and professional associations.In fact, Guerlac writes: “An explicit appeal to the social values of mystical experience in this study [The Two Sources of Morality and Religion] appeared to vindicate those who had criticized Bergson all along for being simply a mystic. And yet the title of the work, and the basis for the notion of closed and open societies, derive from scientific, not mystical discourse. They refer us to an opposition between closed and open systems in Sadi Carnot’s theories of thermodynamics” [TT 9]. Yet Bergson bases the opposition [End Page 21] between closed and open societies not in thermodynamics but in sociobiology. Having sociobiological reasons to believe in the power of the myths of closed morality on the human mind—groups that had instilled loyalty through myth and ritual had been more successful in the course of evolutionary history; that is, humans susceptible to myth have been successful in a positivist Darwinian sense—he called for the cooptation of such susceptibility by those myths and rituals that instilled loyalty to humanity as such. Humanity could dynamically extend the scope of sociability rather than follow the roles and customs that maintained a closed society in static equilibrium. Though Bergson would later courageously risk pneumonia to stand as an old man in the cold rain to register as a Jew in Vichy France, he claimed in this last book from 1932 that the only complete inspiration for universal openness could be found in Christian mysticism and mythology [Two Sources 227]. He explicitly criticized the insularity of the Judaic religion (and caricatured Eastern forms of mysticism). In other words, Bergson put his faith in Christian mystics alone and thus invited the charge of having laid the foundation for mystical and intolerant leadership.Bergson’s universal humanism also crashed on the limits of colonial racism. In considering closed primitive societies, Bergson called attention to missionary stories full of detailed accounts of childish and monstrous deeds. He implored his... (shrink)

This inquiry illustrates how Peirce’s Energetic Interpretant facilitates consciousness-raising between sign users. Because it forces attention and progression of action, the Energetic Interpretant highlights perfective aspectual characteristics, namely atomistic/punctual cause-effect sign relations by featuring junctures between events: beginning, middle, end. For example, the stops and starts of events are influenced by the nature of the action, in addition to the agent’s idiosyncratic preferences and predilections. The Thirdness underlying it further perpetuates the punctual component present in action relations, operational when effort (...) produces resistance against an opposing force. Because effort can materialize physically, or internally, it demonstrates the continued primacy of Peirce’s categories in fostering certain consequences. Energetic Interpretants can inhibit, i.e., attention to one stimulus, while ignoring another. Nonetheless, consciously inhibiting/resisting a force introduces control beyond the self—another’s reflections upon the conscious acts of an agent. This influence between interlocutors satisfies Peirce’s maxim of a “common place to stand”, demonstrating mutual comprehension of the sign’s proper effect. In fact, Energetic Interpretants may result in an effect of such proportion upon either or both interlocutors that a habit-change materializes. As such, Energetic Interpretants epitomize the perfectivity exercised by particular efforts, intimating the likelihood of their discursive success. Inherent in punctual events is the element of surprise, which ultimately hastens the kind of habit-change especially exhibited in Peirce’s double consciousness —self talking to self or other. (shrink)

The authors analyze results of a survey of members of the Columbia University Graduate School of Business classes of 1953–1987 in order to assess the potential effectiveness of firms' ethics training programs. Results suggest that such training has a positive effect, but that relatively few firms provide such programs (about one-third of the respondents worked for firms with such programs). Although the sample is not representative of American employees and managers generally, the results suggest that it may be worthwhile for (...) firms to provide formal ethics training to their employees. (shrink)

One effect of late capitalism – the commodification of practically everything – is to knock down the Chinese walls between the natural and productive realms, to use a Marxist framework. Women's labour in egg extraction and ‘surrogate’ motherhood might then be seen as what it is, labour which produces something of value. But this does not necessarily mean that women will benefit from the commodification of practically everything, in either North or South. In the newly developing biotechnologies involving stem cells, (...) the reverse is more likely, particular given the shortage in the North of the egg donors who will be increasingly necessary to therapeutic cloning.Although most of the ethical debate has focused on the status of the embryo, this is to define ethics with no reference to global or gender justice. There has been little or no debate about possible exploitation of women, particularly of ovum donors from the South. Countries of the South without national ethics committees or guidelines may be particularly vulnerable: although there is increasing awareness of the susceptibility of poorer countries to abuses in research ethics, very little has been written about how they might be affected by the enormously profitable new technologies exploiting human tissue. Even in the UK, although the new Medical Research Council guidelines make a good deal of the ‘gift relationship’, what they are actually about is commodification. If donors believe they are demonstrating altruism, but biotechnology firms and researchers use the discourse of commodity and profit, we have not ‘incomplete commodification’ but complete commodification with a plausibly human face. (shrink)

The question, what makes a clinician a healer? may evoke the image of a devoted physician paying a critically important home visit at the end of a long day or the image of an astute nurse—steadfast, empathic, anticipating the patient's needs before they become apparent to others. But health care is no longer provided by lone doctors or nurses. In the modern health care system, multiple professionals must work together to provide safe and effective care. The moral nature of healing (...) has not changed. But what is required of clinicians to facilitate healing has. To be a healer today, a clinician must be a good team player. Medical students have opened our eyes to this new reality. Building on their observations, we articulate a view that, over and above the role of teamwork in providing technically appropriate care and preventing errors, health care requires teamwork to promote healing. Being a good team player is now a moral imperative because it makes an essential contribution to healing. (shrink)

Although their doctrinal propositions differ significantly, process theology and evangelical theology may find common cause by considering convergences of method. These possibilities are currently limited by underlying assumptions about authority and openness to novelty that characterize the opposing camps. The methodology of Karl Barth holds out the promise of reinvigorating evangelical theology through an appreciation of his willingness to consider novel conclusions that spring from familiar premises. Likewise, process theology should emulate Barth’s passion for the historical doctrines of the Christian (...) faith and the rich resources of scripture. In lieu of the divisions created by the categories of authority and obedience, process and evangelical thinkers alike can reorient themselves toward shared sources in terms of fidelity and loyalty, and therein find common ground. (shrink)

Whether intentional suppression of an unpleasant or unwanted memory reduces the ability to recall that memory subsequently is a contested issue in contemporary memory research. Building on findings that similar processes are recruited when individuals remember the past and imagine the future, we measured the effects of thought suppression on memory for imagined future scenarios. Thought suppression reduced the ability to recall emotionally negative scenarios, but not those that were emotionally positive. This finding suggests that intentionally avoiding thoughts about emotionally (...) negative episodes may inhibit representations of those memories, progressively reducing their availability to recall. (shrink)

We review the Nuffield Council on Bioethics 2018 report on germline gene editing and show how its shortcomings are part of an increasingly permissive climate among elite scientists that may well have emboldened the Chinese 'CRISPR babies' experiment. Without a robust and meaningful airing of the perils of human germline modification, these views are likely to encourage additional, more mainstream moves in the same dangerous direction.

The feminist movement may seek democratization on a global scale, but women are still hampered by a democratic deficit in terms of economic and political power. On the other hand, global feminist networks and new expanded forms of non-territorial political space do appear to be increasing democratic participation for women.

A ‘should’ question normally signals work for an ethicist but this ethicist’s task is complicated by the normative dimension of all the chapters in this volume. Each author was asked to come up with three recommendations from their own subject area – ’should’ statements deriving from the ‘is’ analysis that they present. If those prescriptions cover the relevant topics, what more is there for an ethicist to do? I have had a personal interest in obstetricians’ relationship with ‘older women’ since (...) being classified as an ‘elderly primigravida’ at the superannuated age of 26 years. Apart from that, however, what original contribution can I make? The convenors of the 56th RCOG Study Group gave me plentiful suggestions – perhaps a little too plentiful: How should the RCOG approach its constituencies, medical ethics, regulation and its relationship to government and the rest of the medical profession, i.e. the NHS and the market, vested interests, individuals or consumers, families, the unborn, doctors, drug companies, surrogacy, the unborn, trafficking, global adoption, law, research? I have to admit this was just too much for me. Instead, I want to argue for what may seem a self-evidently simple point. The RCOG describes its mission as ‘setting standards to improve women’s health’ – presumably all women. In the 6 years that I have served on the RCOG Ethics Committee, however, we have almost always been concerned with that minority of the female population who are of reproductive age. (shrink)

Although the term commodification is sometimes criticised as imprecise or overused, in fact it has a complex philosophical ancestry and can never be used too much, because the phenomena that it describes are still gaining ground. The issues that commodification raises in relation to reproductive technologies include whether it is wrong to commodify human tissues generally and gametes particularly, and whether the person as subject and the person as object can be distinguished in modern biomedicine. This chapter examines three areas (...) in which commodification is a serious concern for important reproductive technologies: the sale of eggs for IVF and research, the banking of umbilical cord blood, and the use of gestational surrogates both domestically and internationally. Sales of human eggs for IVF or research are frequently disguised as “gifts”, which conceals the very real bodily risks and harms associated with ovarian hyperstimulation and egg harvesting undergone by egg “donors.” Umbilical cord banking is a fast-growing industry, with donated cord blood trading globally at very high prices; women who consent to banking of cord blood ostensibly for the potential future benefit of their child may not be informed of the likelihood that it will be traded in commercial markets or that the method used for harvesting may increase risks of jaundice in their babies. Commercial surrogacy also exploits altruism but in addition involves wrongful sale of babies, particularly in the international context. In each example, the commodification of women’s reproductive labour is masked by the manner in which ‘the lady vanishes’ under a gift model, ignoring the true economic value of their labour. (shrink)

Research on gender inequality has posited the importance of gender discrimination for women’s experiences at work. Previous studies have suggested that gender stereotyping and organizational factors may contribute to discrimination. Yet it is not well understood how these elements connect to foster gender discrimination in everyday workplaces. This work contributes to our understanding of these relationships by analyzing 219 discrimination narratives constructed from sex discrimination cases brought before the Ohio Civil Rights Commission. By looking across a variety of actual work (...) settings, the analysis sheds light on the cultural underpinnings and structural contexts in which discriminatory actions occur. The analyses reveal how gender stereotyping combines in predictable ways with sex composition of workplaces and organizational policies, often through interactional dynamics of discretionary policy usage, to result in discrimination. The findings suggest the importance of cultural, structural, and interactional influences on gender discrimination. (shrink)

Diabco Corporation, consisting of both domestic and international operations, aspires to be a world class company. Assumption of that status requires Diabco to develop a profile as a responsible member within the world community. Attributing morality to a corporation may seem somewhat inappropriate because it is merely an artificial entity. Yet, a corporation is only as ethical as its agents. At a minimum, Diabco must meet legal requirements, but the development of moral responsibility requires a conscious effort by all corporate (...) agents to avoid harming others. To appraise the company''s moral condition, the authors constructed the premise that Diabco conducted a comprehensive moral audit. Although the concept of a moral audit is still a relatively undeveloped appraisal activity, the purpose of the study is to demonstrate the desirability, feasibility, and possible inadequacies of such an endeavor. (shrink)

Over the past decade, genetic tests have become available for a wide variety of disorders. As a result we are able to predict, with some degree of certainty, whether or not an individual will develop such diseases as breast cancer, Huntington's disease, polycystic kidney disease, and familial adenomatous polyposis. The ability to predict disease poses several unique ethical considerations for clinical decisionmaking regarding the provision of genetic testing. Patients must be able to comprehend the complexities of genetic testing and the (...) potential meaning of the results. Patients must consider the emotional, social, and economic consequences of revelations regarding their risk status. Also, obtaining information on risk status may have implications for persons other than the individual seeking genetic testing. (shrink)

BackgroundHealth research funding agencies are placing a growing focus on knowledge translation (KT) plans, also known as dissemination and implementation (D&I) plans, in grant applications to decrease the gap between what we know from research and what we do in practice, policy, and further research. Historically, review panels have focused on the scientific excellence of applications to determine which should be funded; however, relevance to societal health priorities, the facilitation of evidence-informed practice and policy, or realizing commercialization opportunities all require (...) a different lens.DiscussionWhile experts in their respective fields, grant reviewers may lack the competencies to rigorously assess the KT components of applications. Funders of health research—including health charities, non-profit agencies, governments, and foundations—have an obligation to ensure that these components of funding applications are as rigorously evaluated as the scientific components. In this paper, we discuss the need for a more rigorous evaluation of knowledge translation potential by review panels and propose how this may be addressed.ConclusionWe propose that reviewer training supported in various ways including guidelines and KT expertise on review panels and modalities such as online and face-to-face training will result in the rigorous assessment of all components of funding applications, thus increasing the relevance and use of funded research evidence. An unintended but highly welcome consequence of such training could be higher quality D&I or KT plans in subsequent funding applications from trained reviewers. (shrink)

Echo phonology was originally proposed to account for obligatory coordination of manual and mouth articulations observed in several sign languages. However, previous research into the phenomenon lacks clear criteria for which components of movement can or must be copied when the articulators are so different. Nor is there discussion of which nonmanual articulators can echo manual movement. Given the prosodic properties of echoes (coordination of onset/offset and of dynamics such as speed) as well as general motoric coordination of various articulators (...) in the human body, we expect that the mouth is not the only nonmanual articulator involved in echo phonology. In this study, we look at a fixed set of lexical items across 36 sign languages and establish that the head can echo manual movement with respect to timing and to the axis/axes of manual movement. We propose that what matters in echo phonology is the visual percept of temporally coordinated movement that repeats a salient movement property in such a way as to give the visual impression of a copy. Our findings suggest that echoes are not obligatory motor couplings of two or more articulators but may enhance phonological distinctions that are otherwise difficult to see. (shrink)

This paper addresses the nurse manager's role regarding chemically-dependent nurses in the workplace. The manager may intervene by: terminating the contract of the impaired colleague; notifying a disciplinary committee; consulting with a counselling committee; or referring the impaired nurse to an employee assistance programme. A dilemma may arise about which of these interventions is ethically the best. The ethical theories relevant to nursing involve ethical relativism, utilitarianism, Kantian ethics, Kohlberg's justice, and Gilligan's ethic of care. Nurse managers first need to (...) understand these theories in order to clarify their own perceptions and attitudes towards chemical dependency, and then satisfactorily resolve this ethical dilemma. Education and social learning are routes to a better understanding of chemical dependency and to broadening the ethical dimensions of nurse managers. (shrink)

Over the past decade, genetic tests have become available for a wide variety of disorders. As a result we are able to predict, with some degree of certainty, whether or not an individual will develop such diseases as breast cancer, Huntington's disease, polycystic kidney disease, and familial adenomatous polyposis. The ability to predict disease poses several unique ethical considerations for clinical decisionmaking regarding the provision of genetic testing. Patients must be able to comprehend the complexities of genetic testing and the (...) potential meaning of the results. Patients must consider the emotional, social, and economic consequences of revelations regarding their risk status. Also, obtaining information on risk status may have implications for persons other than the individual seeking genetic testing. (shrink)

Developmental coordination disorder is a neurodevelopmental disorder that significantly impairs a child’s ability to learn motor skills and to perform everyday activities. The cause of DCD is unknown; however, evidence suggests that children with DCD have altered brain structure and function. While the cerebellum has been hypothesised to be involved in developmental coordination disorder, no studies have specifically examined cerebellar structure in this population. The purpose of our study was to examine cerebellar differences in children with DCD compared to typically-developing (...) children. Using voxel-based morphometry, we assessed cerebellar morphology in children 8–12 years of age. Forty-six children were investigated using high resolution T1-weighted images, which were then processed using the spatially unbiased atlas template of the cerebellum and brainstem toolbox for a region of interest-based examination of the cerebellum. Results revealed that children with DCD had reduced grey matter volume in several regions, namely: the brainstem, right/left crus I, right crus II, left VI, right VIIb, and right VIIIa lobules. Further, Pearson correlations revealed significant positive associations between the total motor percentile score on the Movement Assessment Battery for Children-2 and regions that had reduced grey matter volume in our cohort. These findings indicate that reductions in cerebellar grey matter volume are associated with poorer motor skills. Given the cerebellum’s involvement in internal models of movement, results of this study may help to explain why children with DCD struggle to learn motor skills. (shrink)

A dilemma exists when a doctor is faced with a child or young person who refuses medically indicated treatment. The Gillick case has been interpreted by many to mean that a child of sufficient age and intelligence could validly consent or refuse consent to treatment. Recent decisions of the Court of Appeal on a child's refusal of medical treatment have clouded the issue and undermined the spirit of the Gillick decision and the Children Act 1989. It is now the case (...) that a child patient whose competence is in doubt will be found rational if he or she accepts the proposal to treat but may be found incompetent if he or she disagrees. Practitioners are alerted to the anomalies now exhibited by the law on the issue of children's consent and refusal. The impact of the decisions from the perspectives of medicine, ethics, and the law are examined. Practitioners should review each case of child care carefully and in cases of doubt seek legal advice. (shrink)

Accounting professionals play an important role in the generation and auditing of financial statements and, given their understanding of business processes, may be relied upon in the development of organizations’ ethical infrastructures (i.e., the formal aspects of an organization’s ethical environment that are explicitly under the control of the organization). Thus, understanding and improving the work environments of accounting professionals is crucial to improving organizational ethical culture and reducing fraud. In this study, we extend prior research that documents the prevalence (...) of ethical infrastructure programs by assessing how accounting professionals, a key employee group, perceive their organizations’ ethical infrastructures. In addition, we examine whether perceptions of the effectiveness of the ethical infrastructure and professional autonomy influence accountants’ ethical judgments. Based on the responses of 378 CPAs in the United States, we find the perceived state of the ethical infrastructure across accounting work environments—both public accounting firms and other organization types—is relatively strong. However, of the five ethical infrastructure components we examine (i.e., ethics code, ethics training, ethics-based punishments and incentives, ethics reporting system, and ethics review system), only 35% of respondents indicate that their organizations have more than three of these components. Importantly, we find that perceived ethical infrastructure effectiveness and professional autonomy influence both perceptions of the ethical culture and the ethical judgments of accounting professionals. We also contribute to practice by highlighting opportunities for improvement in ethics training formats, ethics-based incentives, and ethics review systems. (shrink)

Research about the Olympic Games has primarily focused on preparing athletes for competition. Less attention has been paid to the post-Olympic-phase and athlete well-being during this time. This study explored Australian Olympic athletes’ experiences following the conclusion of the 2016 Rio Olympic Games, including the factors that may have contributed to or challenged their well-being during this time. Eighteen athletes participated in semi-structured interviews and thematic analysis revealed that when Olympic performance appraisal met prior expectations, when athletes planned for a (...) return to work or study, and when support from a variety of sources was readily available, this positively influenced athletes’ well-being during the POP. When these factors were not in place, more challenging post-Games experiences were present, and well-being was compromised. The findings contribute to the broader literature on elite athlete well-being and at an applied level, may be used to inform targeted programs that focus on supporting athletes after an Olympic campaign. (shrink)

Background:Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives, setting, and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced (...) by nurses in traditional patient-care settings.Research objectives:The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice.Research design:The study utilized a qualitative descriptive design with individual interviews.Participants and research context:Participating nurses self-identified as having experienced ethical challenges during screening. The majority were Caucasian, female, and worked in outpatient settings. Approximately 50% had > 10 years of research experience.Ethical considerations:The human subjects review board approved the study. Written informed consent was obtained.Findings:Predominant themes were revealed: the inability to provide a probable good, or/do no harm, and dual obligations. The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship.Discussion:Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science.Conclusion:Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

Little research has explored the possible effects of government institutions in emerging economies on ethical reviews of multinational research. We conducted semi-structured, in-depth telephone interviews with 15 researchers, Research Ethics Committees personnel, and a government agency member involved in multinational HIV Prevention Trials Network research in emerging economies. Ministries of Health or other government agencies often play pivotal roles as facilitators or barriers in the research ethics approval process. Government agency RECs reviewing protocols may face particular challenges, as they can (...) lack resources, be poorly organized, have inconsistent review processes and limited expertise, and use differing definitions of national interests, including upholding national reputation and avoiding potential exploitation and stigma of the country's population. The MOH/governmental review body may be affected by power dynamics and politics in study reviews; may consider issues both related and unrelated to research ethics as understood elsewhere; and may prioritize particular diseases, treatments, or interventions over other topics/types of research. Poor communication and deeply-rooted tensions may exist between sponsor and host countries, impeding optimal interactions and reviews. Investigators must understand and plan for the potential effects of governmental agencies on multinational collaborative research, including preserving adequate time for agency review, and contacting these agencies beforehand to address issues that may arise. Better understanding of these issues can aid and advance appropriate global scientific collaboration. (shrink)

BackgroundEvolving medical technology, advancing biomedical and drug research, and changing laws and legislation impact patients’ healthcare options and influence healthcare practitioners’ (HCPs’) practices. Conscientious objection policy confusion and variability can arise as it may occasionally be unclear what underpins non-participation. Our objective was to identify, analyze, and synthesize the factors that influenced HCPs who did not participate in ethically complex, legally available healthcare.MethodsWe used Arksey and O’Malley’s framework while considering Levac et al.’s enhancements, and qualitatively synthesized the evidence. We searched (...) Medline, CINAHL, JSTOR, EMBASE, PsychINFO, Sociological Abstracts, and ProQuest Dissertations and Theses Global from January 1, 1998, to January 15, 2020, and reviewed the references of the final articles. We included articles written in English that discussed the factors that influenced physicians and registered nurses (RNs) who did not participate in end-of-life (EOL), reproductive technology and health, genetic testing, and organ or tissue donation healthcare areas. Using Covidence, we conducted title and abstract screening, followed by full-text screening against our eligibility criteria. We extracted the article’s data into a spreadsheet, analyzed the articles, and completed a qualitative content analysis using NVivo12.ResultsWe identified 10,664 articles through the search, and after the screening, 16 articles were included. The articles sampled RNs (n = 5) and physicians (n = 11) and encompassed qualitative (n = 7), quantitative (n = 7), and mixed (n = 2) methodologies. The care areas included reproductive technology and health (n = 11), EOL (n = 3), organ procurement (n = 1), and genetic testing (n = 1). One article included two care areas; EOL and reproductive health. The themed factors that influenced HCPs who did not participate in healthcare were: (1) HCPs’ characteristics, (2) personal beliefs, (3) professional ethos, 4) emotional labour considerations, and (5) system and clinical practice considerations.ConclusionThe factors that influenced HCPs’ who did not participate in ethically complex, legally available care are diverse. There is a need to recognize conscientious objection to healthcare as a separate construct from non-participation in healthcare for reasons other than conscience. Understanding these separate constructs will support HCPs’ specific to the underlying factors influencing their practice participation. (shrink)

If the task of a post-Cartesian psychoanalysis is understood as one of exploring the patterns of emotional experience that organize subjective life, one can recognize that this task is pursued within a framework of delimiting assumptions concerning the ontology of the person. In this paper, we discuss these assumptions as they have emerged in the thinking of four major philosophers on whom we have drawn: Søren Kierkegaard, Friedrich Nietzsche, Ludwig Wittgenstein, and Martin Heidegger. Our purpose in what follows is to (...) describe essential ideas of these various thinkers and to identify the formative personal contexts within which their key insights into human life took form. By psychologically contextualizing philosophical assumptions, we hope to make progress toward discerning the particularization of scope that may be associated with these assumptions, and hence to begin a further opening up of the horizons of understanding that inevitably encircle psychoanalytic inquiry. (shrink)

Around 96 percent of children with hearing loss are born to parents with intact hearing, who may initially know little about deafness or sign language. Therefore, such parents will need information and support in making decisions about the medical, linguistic, and educational management of their child. Some of these decisions are time-sensitive and irreversible and come at a moment of emotional turmoil and vulnerability (when some parents grieve the loss of a normally hearing child). Clinical research indicates that a deaf (...) child’s poor communication skills can be made worse by increased level of parental depression. Given this, the importance of reliable and up-to-date support for parents’ decisions is critical to the overall well-being of their child. In raising and educating a child, parents are often offered an exclusive choice between an oral environment (including assistive technology, speech reading, and voicing) and a signing environment. A heated controversy surrounds this choice, and has since at least the late 19th century, beginning with the International Congress on the Education of the Deaf in Milan, held in 1880. While families seek advice from many sources, including, increasingly, the internet, the primary care physician (PCP) is the professional medical figure the family interacts with repeatedly.The present article aims to help family advisors, particularly the PCP and other medical advisors in this regard. We argue that deaf children need to be exposed regularly and frequently to good language models in both visual and auditory modalities from the time hearing loss is detected and continued throughout their education to ensure proper cognitive, psychological, and educational development. Since there is, unfortunately, a dearth of empirical studies on many of the issues families must confront, professional opinions, backed by what studies do exist, are the only option. We here give our strongly held professional opinions and stress the need for improved research studies in these areas. (shrink)

Background Escalating levels of obesity place enormous and growing demands on Health care provision in the (U.K.) United Kingdom. Resources are limited with increasing and competing demands upon them. Ethical considerations underpin clinical decision making generally, but there is limited evidence regarding the relationship between these variables particularly in terms of treating individuals with obesity. Research aim To investigate the views of National Health Service (NHS) clinicians on navigating the ethical challenges and decision making associated with obesity management in adults (...) with chronic illness. Research design A cross-sectional, multi-site survey distributed electronically. Participants A consensus sample of nurses, doctors, dietitians and final year students in two NHS Trusts and two Universities. Ethical considerations Ethical and governance approvals obtained from a National Ethics Committee (11NIR035), two universities and two teaching hospitals. Results Of the total ( n = 395) participants, the majority were nurses (48%), female (79%) and qualified clinicians (59%). Participants strongly considered the individual to have primary responsibility for a healthy weight and an obligation to attempt to maintain that healthy weight if they wish to access NHS care. Yet two thirds would not withhold treatment for patients with obesity. Discussion While clinicians were clear about patient responsibility and obligations, the majority prioritised their duty of care and would not invoke a utilitarian approach to decision making. This may reflect awareness of obesity as a multi-faceted entity, with responsibility for support and management shared amongst society in general. Conclusions The attitudes of this sample of clinicians complemented the concept of the health service as being built on a principle of community, with each treated according to their need. However limited resources challenge the concept of needs-based decisions consequently societal engagement is necessary to agree a pragmatic way forward. (shrink)

Some of the most difficult clinical ethics consultations involve patients who have both medical and mental health needs, as these cases can result in considerable moral distress on the part of the bedside staff. In this article we examine the issues that such consults raise through the illustrative example of a particular case: several years ago our ethics consultation service received a request from a critical care attending physician who was considering a rarely performed psychosurgical intervention to address intractable and (...) life-threatening agitation and aggression in an adolescent patient for whom standard treatments had proven unsuccessful. We consider strategies that may be useful in addressing not only the ethical dilemmas or the clinical problems, but also the emotional, social, and moral distress that arise in delivering care in such complex cases, in which standard routine practices of care have been exhausted. In addition, we explore the processes that led to this situation and suggest ways to promote early recognition and intervention for similar cases in the future. (shrink)

BackgroundPast research shows that physicians experience high ill-being but also high well-being.ObjectiveTo shed light on how medical faculty’s experiences of their job demands and job resources might differentially affect their ill-being and their well-being with special attention to the role that the work-life interface plays in these processes.MethodsQualitative thematic analysis was used to analyze interviews from 30 medical faculty at a top research hospital in Canada.FindingsMedical faculty’s experiences of work-life conflict were severe. Faculty’s job demands had coalescing effects on their (...) stress, work-life conflict, and exhaustion. Although supportive job resources helped to mitigate the negative effects of job demands, stimulating job resources contributed to greater work-life conflict, stress, and exhaustion. Thus, for these medical faculty job resources play a dual-role for work-life conflict. Moreover, although faculty experienced high emotional exhaustion, they did not experience the other components of burnout. Some faculty engaged in cognitive reappraisal strategies to mitigate their experiences of work-life conflict and its harmful consequences.ConclusionThis study suggests that the precise nature and effects of job demands and job resources may be more complex than current research suggests. Hospital leadership should work to lessen unnecessary job demands, increase supportive job resources, recognize all aspects of job performance, and, given faculty’s high levels of work engagement, encourage a climate that fosters work-life balance. (shrink)

Working the night shift can be fraught and experienced as demanding and, yet, is often dismissed as babysitting. Few researchers have explored the social and cultural meanings of night nursing, including storytelling rituals. In 2019, a narrative study was undertaken. The aim was to explore the stories recalled by nurses about working night shifts. Thirteen Australian nurses participated. Data were gathered using the Biographical Narrative Interview Method, and narrative analysis produced forty stories and three themes: strange and challenging experiences; colleagues (...) can be mentors (or not); and textbook knowledge is only part of what is needed on night shift. Nursing students who engage with these stories may come to understand the challenges of the night shift, and the valuable work that nurses engage in throughout a 24‐hr period, work that involves adept psychosocial and interpersonal skills alongside technical and physical competence. (shrink)

This experimental writing piece by the Earth Unbound Collective explores the ethical, political and pedagogical challenges in addressing climate change, activism and justice. The provocation Earth Unbound: the struggle to breathe and the creative thoughts that follow are inspired by the contagious energy of what Donna Haraway calls response-ability or the ability to respond. This energy ripples through monthly reading groups and workshops organised by this interdisciplinary collective that emerged organically in January 2020.

This commentary argues that Donna Haraway’s still remarkable ‘Manifesto for Cyborgs’ provided one of the first windows on the invention of a different kind of world, one in which environments figure and bodily registers expand. In her attention to bioscience she was clearly one of the first to remark on these developments. But, or so I argue, she may have underestimated their generality and their grip, not least because of the comparatively light imprint of the economy and space to (...) be found in her work. (shrink)

This article explores the queer qualities of feminist scientist Donna Haraway's ‘A Cyborg Manifesto’. In the first part, the article investigates the similarities between ‘A Cyborg Manifesto’ and the ideas circulating in queer theory, including the hybridity of identity, and the disruption of totalizing social categories such as ‘Gay man’ and ‘Woman’. In the second part, it is argued that ‘A Cyborg Manifesto’ evinced a decolonial feminist form of queerness. The article references the African-American, Chicana and Asian-American feminist sociology, (...) theory, literature and history that ‘A Cyborg Manifesto’ takes up. The article does not wish to position Haraway's white-authored text as an authoritative voice on decolonial feminist queerness, instead arguing for the role of ‘A Cyborg Manifesto’ as a bibliographical work that readers may reference in their exploration of decolonial feminist beginnings of queer theory. (shrink)

Donna Haraway, one of the premier feminist science theorists of our generation, is a trained biologist who has used a menagerie of creatures—the cyborg, the vampire, OncoMouse™, and primates—as markers to analyze the intersections among nature, culture, gender, and science. Her writing about these creatures is unique: dense, circling around, doubling back to move forward. This book, a conversation with Thyrza Nichols Goodeve, uses a more informal voice to discuss the intellectual, professional, geographical, and personal influences that shaped Haraway's (...) singular vision.A most surprising influence is the Catholicism of her upbringing—she was schooled by nuns and considered becoming a medical missionary. Although she no longer adheres to the tenets of the religion, Haraway attributes her linking of the figurative and the material to an indelible impression of the Eucharist. Place has also been defining: Denver, where she grew up, as a borderland; California, as a blend of agriculture and technology, populated by “Californios” , as the location of the history of consciousness program of the University of California at Santa Cruz, where she was appointed to the first position in feminist theory in the United States and where she has trained multitudes of students, both graduates and undergraduates.Haraway's background in the life sciences permeates this conversation. Architecture and its emergence in embryonic development stimulated her initial interest in biology, and the title How Like a Leaf stems from Haraway's attempt to compare her own structure to that of a leaf. Biology, with all of its subdisciplines, is the foundation for her analysis of nature‐culture, using one to inform the other. “We live intimately ‘as’ and ‘in’ a biological world” , but it is a world that is historically contingent on and tied to culture. Her theory is relational, seeking to challenge boundaries, requiring responsibility for their construction, and taking in all views, simultaneously. The multiple perspectives occur horizontally and vertically, from miniatures to aggregates, zooming between them.A large portion of this slim book discusses Haraway's adult personal ties, which, like her writing, also are unique. Goodeve claims that these relationships show how Haraway “lives the theory she writes and teaches” , but Haraway does not explicitly endorse this idea, saying that the relationships were only possible at a particular point in time. Without linking them to the body of work, the assertions run the risk of resembling gossip. The conversation is stilted at times, the flow interrupted when Goodeve quotes material from other writers whom Haraway does not immediately acknowledge as influential. A complete bibliography of Haraway's writings, easily accessible citations for works discussed during the talks, and more careful copyediting would have been helpful. Readers of this book will also find worthwhile dialogue between Haraway and Constance Penley and Andrew Ross .Those who come to this book looking for the canvas on which Haraway has painted an uncommon picture of our world will be enlightened. Those who come looking for clues to unravel the density of the words in her texts may be disappointed. But who would want directions for reading Haraway? Part of the joy is finding something new each time we read an essay “with passion and irony, where passion is as important as irony”. (shrink)