This exploratory qualitative study investigated how doctoral students reported their personal and professional interaction experiences that they believed might facilitate or impede their academic pursuits in biomedical research. We collected 19 in-depth interviews with doctoral students in biomedical research from eight universities, and we based our qualitative analytic approach on the work of Miles and Huberman. The results indicated that among different sources and types of interaction, academic and emotional interactions from family and teachers in various stages essentially affected students’ (...) persistence in the biomedical science field. In addition, co-mentorship among peers, departmental environment, and volunteer experiences were other essential factors. This study also found related experiences among women and underrepresented minority students that were important to their academic pursuit. (shrink)

This study takes its shape around two fundamentally opposed ways of understanding the discipline of history. The one regards historical inquiry as capable of discovering "what really happened" in the human past and considers historical truth to be a matter of the correspondence between historical accounts and the past as it actually was. The other regards historical inquiry as actually constructing the human past by its methods of interpreting evidence and considers historical truth to be a matter of the internal (...) coherence of historical accounts and their compatibility with the evidence upon which they are based. My thesis is that neither the "Discovery Theory" nor the "Construction Theory" offers a satisfactory analysis of history. I offer an alternate theory which regards the concepts of correspondence and coherence as complementary and mutually necessary to such an analysis. ;The primary material of this study is to be found in two recent books, Jack Meiland's Scepticism and Historical Knowledge and Leon Goldstein's Historical Knowing , which attempt systematically to defend a Construction Theory of history. These two defenses are particularly interesting because they are grounded in very different epistemological orientations. Meiland approaches the subject from a logical positivist point of view; Goldstein takes a perspective an idealist or phenomenologist would appreciate. ;I begin in Chapter 1 with a brief historical sketch of the way the Construction Theory has evolved out of criticisms of the Discovery Theory. In Chapter 2 I argue against Meiland's claim that there cannot be present evidence of past events. Here I consider the nature and the role of general correlation principles in history. In Chapter 3 I argue against Meiland's use of the positivist Verifiability Criterion to prove that historical statements are meaningless. My claim is that historical statements are indirectly verifiable in principle. In Chapter 4 I develop Goldstein's theory of historical verification and support his view that the concept of coherence plays the major role in this process. In Chapter 5 I argue against Goldstein's theory of historical reference and develop the claim that verified historical statements must be regarded as referring to the past. In Chapter 6 I return to Meland in order to consider the relevance of the concept of correspondence to the analysis of historical reference. ;In Chapter 7 I attempt to define the middle ground between the two theories by developing the idea of historical truth. I argue that the concept of coherence is an indispensable part of the analysis of historical verification, that the concept of correspondence is indispensable to the understanding of historical reference, and that both are involved in the notion of historical meaningfulness. (shrink)

Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the authors describe an exemplar of (...) Elizabeth Barrett's “Power as Knowing Participation in Change” theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes “power as freedom” instead of “power as control.” This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings. (shrink)

The Patient Self-Determination Act (PSDA) requires hospitals to ask patients upon admission whether they have an advance directive. Although the PSDA has received extensive criticism, little attention has been paid to the cost of the law, either during its legislative course or following its implementation. Nonetheless, several tangible and intangible costs are associated with the PSDA. Such costs may be incurred by different parties. This paper examines the costs and benefits of the PSDA and illustrates the extent of some of (...) its tangible costs. The incremental start-up cost for one institution's response to the PSDA is estimated to be $49,304 ($1.31 per admission) and the total implementation cost of the program to be $114,528. In addition, the national incremental start-up cost for hospitals to implement the PSDA is estimated to be between $43,625,114 and $101,569,922. Finally, the potential implications of the PSDA for future governmental health care ethics regulation are discussed. (shrink)

A critical essay on St. Augustine's social and political thought. In describing Augustine, the author captures the essence of the man in these words: "Genius he had in full measure... he is the master of the phrase or the sentence that embodies a penetrating insight, a flash of lightning that illuminates the entire sky; he is the rhetorician, the epigrammist, the polemicist, but not the patient, logical systematic philosopher.".

In this thesis, Semantics, Meta-Semantics, and Ontology, I provide a critique of the method of truth in metaphysics. Davidson has suggested that we can determine the metaphysical nature and structure of reality through semantic investigations. By contrast, I argue that it is not semantics, but meta-semantics, which reveals the metaphysically necessary and sufficient truth conditions of our claims. As a consequence I reject the Quinean criterion of ontological commitment. In Part I, chapter 1, I argue that the metaphysically primary truth (...) bearers are not propositions, but rather concrete representations, either beliefs or sentences. I show, in chapter 2, that we can give sense to a truth predicate applying to sentences, given a truth operator and quantification into sentence position. I argue that this strategy does not commit us to the existence of propositions serving as truth bearers. In Part II I argue that although we must assign semantic values to sentences and/or predicates, the meaningfulness of these expressions is not thereby explained. In chapter 3 I articulate Davidson’s problem of predication and his solution, but argue that he was wrong to attribute this solution to Tarski. In chapter 4 I examine the semantics of modal languages; I conclude that although they require semantic values for predicates and/or sentences we should be instrumentalists about these theories. In Part III I consider the relationship between truth and existence. In chapter 5, I defend Pluralism about truth: in some domains of discourse, I claim, semantic reference plays a merely instrumental role in explaining truth. In chapter 6, I show that Hume’s Principle, which is committed by the Quinean criterion to the existence of numbers, can be true even though numbers do not exist. In doing so, I appeal to meta-semantic and diachronic considerations. In the conclusion I compare my views on ontology and commitment to Jody Azzouni’s; and in the appendix I suggest how one might pursue diachronic linguistics. (shrink)

In a number of influential articles published since 1972, Dorothy Grover has developed the prosentential theory of truth. Brought together and published with a new introduction, these essays are even more impressive as a group than they were as single contributions to philosophy and linguistics. Denying that truth has an explanatory role, the prosentential theory does not address traditional truth issues like belief, meaning, and justification. Instead, it focuses on the grammatical role of the truth predicate and asserts that (...) “it is true” is a prosentence, functioning much as a pronoun does. Grover defends the theory by indicating how it can handle notorious paradoxes like the Liar, as well as by analyzing some English truth-usages. The introduction to the volume surveys traditional theories of truth, including correspondence, pragmatic, and coherence theories. It discusses the essays to come and, finally, considers the implications of the prosentential theory for other theories. Despite the fact that the prosentential theory dismisses the “nature of truth” as a red herring, Grover shows that there are important aspects of traditional truth theories that prosentential theorists have the option of endorsing. (shrink)

Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without (...) prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources. (shrink)

The arguments of Stoffregen & Bardy for studying perception based on the global array are intriguing. This theory can be examined in nonhuman species using nonverbal tasks. We examine how monkeys master a skill that incorporates a two-dimensional/three-dimensional interface. We feel this provides excellent support for Stoffregen & Bardy's theory.

This paper provides a methodological schema for interpreting Hume's Dialogues concerning Natural Religion that supports the traditional thesis that Philo represents Hume's views on religious belief. To understand the complexity of Hume's ‘naturalism’ and his assessment of religious belief, it is essential to grasp the manner in which Philo articulates a consistently Humean position in the Dialogues.

The human resource manager treads a fine line in seeking to reconcile the values of the organisation with professional values about the ethical management of people. This paper seeks to explore this ambiguity. The research findings suggest that the extent to which HR professionals can influence organisational ethics is dependent on the culture and structure of the organisation, as well as on the status and credibility of the HR specialists themselves. In the main there is little evidence that their influence (...) is significant. (shrink)

Benedict Spinoza is feted as the philosopher par excellence of the popular democratic multitude by Antonio Negri and others. But Spinoza himself expresses a marked ambivalence about the multitude in brief asides, and as for his thoughts on what he calls “the rule of multitude,” that is, democracy, these exist only as meager fragments in his unfinished Tractatus Politicus or Political Treatise. This essay addresses the problem of Spinoza’s multitude. First, I reconstruct a vision of power that is found in (...) the Ethics but that tends to be overlooked in the scholarly literature: power is not just sheer efficacy or imposition of will, but rather involves a capacity for being-affected; I call this the conception of power as sensitivity. The second part of my argument shows how, given Spinoza’s emphatic political naturalism, the conception of power as sensitivity can be extended to his political philosophy to shed light on what Spinoza calls potentia multitudinis, or “the power of the multitude”—a term found solely in the Political Treatise and nowhere else in his oeuvre. This juxtaposition reveals significant qualifications to the liberatory potential of the multitude currently claimed in the scholarly literature. (shrink)

I argue that the suppositional view of conditionals, which is quite popular for indicative conditionals, extends also to subjunctive or counterfactual conditionals. According to this view, conditional judgements should not be construed as factual, categorical judgements, but as judgements about the consequent under the supposition of the antecedent. The strongest evidence for the view comes from focusing on the fact that conditional judgements are often uncertain; and conditional uncertainty, which is a well-understood notion, does not function like uncertainty about matters (...) of fact. I argue that the evidence for this view is as strong for subjunctives as it is for indicatives. (shrink)

Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding (...) awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

This paper reports on the findings of the first stage of a research project that experiments with the use of laddering technique in an attempt to enhance understanding of the influence of values in the behaviour of HRM professionals. Laddering has been chosen because it allows flexible, systematic investigation of aspects of ethics and people management which have hitherto been difficult to clarify. It also provides the opportunity to undertake both qualitative and quantitative analysis of the data obtained. The research (...) design incorporates two phases – a questionnaire and a laddering interview; it involves a sample of respondents drawn from HRM practitioners participating in the CIPD Professional Qualification Scheme. In comparing the results obtained from each phase of the research, it is clear that the laddering interviews have enabled more detailed information to be elicited and more specific goals to be identified. The authors believe that laddering can provide valuable additional insight into ethical practice, behaviour and goals. (shrink)

There has been a long debate on whether demonstratives are directly referential as Kaplan originally argued, or indirectly referential like a definite description. I propose a new analysis of demonstratives that combines intuitions from both direct and indirect approaches. The demonstrative is analyzed as an indirectly referential expression with a binary maximality operator that takes two arguments, where the second argument can be a deictic pointing, an anaphoric index, or a relative clause. Direct reference is encoded not in the meaning (...) of the demonstrative but in the meaning contributed by the pointing gesture, thus capturing both direct and indirect uses. I further propose that some pronouns in English function as demonstratives, realizing the binary structure and competing with the demonstrative. The main advantages of this proposal include (a) deriving the distribution of pronominal and adnominal demonstratives systematically; (b) capturing the unique interaction that demonstratives have with a pointing gesture; and (c) locating English demonstratives against a larger, cross-linguistic picture. (shrink)

There are differences in caregivers’ literacy and health literacy levels that may affect their ability to consent to children participating in clinical research trials. This study aimed to explore the effectiveness, and caregivers’ understandings, of the process of informed consent that accompanied their child’s participation in a dental randomized control trial (RCT). Telephone interviews were conducted with a convenience sample of ten caregivers who each had a child participating in the RCT. Pre-tested closed and open-ended questions were used, and the (...) findings were produced from an inductive analysis of the latter and a descriptive analysis of the former. Participants had limited understanding of the purpose of the RCT and rated the readability of the consent form more highly than they rated their understanding of the research. All felt that informed consent was vital, but some caregivers had not read the consent documents. Some caregivers enrolled their child in the RCT because they trusted the researchers, and the majority wanted to improve dental care for children. The informed consent process was not always effective despite high readability of the informed consent documents. Researchers must consider the health literacy of the study group, and actively engaging with caregivers to achieve meaningful informed consent may be challenging. Future research could explore participants’ perspectives of informed consent in populations with low health literacy and assess whether an underlying expectation not to comprehend health-related information may be a barrier to informed consent. (shrink)

Drawing on accounts of the author's personal responses while undertaking a qualitative study on the norms governing the relationship between nurses and mothers, it is argued that such responses, rather than being seen as a source of bias, have the potential to be a source of insight and interpretation in the research. This paper tells the ‘inside’ story of previously published research that was ‘sanitized’ by the omission of any reference to die researcher's subjective responses. The recognition of such researcher (...) responses has implications for how research is supervised and presented. (shrink)

The scientific validity of racial categories has been the subject of debate among population geneticists, evolutionary biologists, and physical anthropologists for several decades. After World War II, the rejection of eugenics, which had supported sterilization laws and other destructive programs in the United States, generated a compelling critique of the biological basis of race. The classification of human beings into distinct biological “races” is a relatively recent invention propped up by deeply flawed evidence and historically providing the foundation of racist (...) ideology and inequities of power. Social scientists’ conclusion that race is socially constructed was confirmed by genomic studies of human variation, including the Human Genome Project, showing high levels of genetic similarity within the human species. Some scholars came to believe that the science of human genetic diversity would replace race as the preeminent means of grouping people for scientific purposes. (shrink)