This discussion examines the emergence of professional codes of ethics, influences that shape contemporary midwifery ethics, and the adequacy of codes to actualize values embedded in the midwifery ethics discourse. It considers the traditions of professional practice, the impact of institutionalization on health care, the application of a code of practice as a recent addition to those traditions, and the strengths and weaknesses of codes of ethics as models for ethical responses. That is, it sets out to articulate and deconstruct (...) existing frames of ethical response. The ethics of strangers (normative theory and abstract principles) are rejected as inadequate, and the ethics of intimates (feminist-relational ethics) are proposed as a more adequate guide for well-woman centred midwifery practice. (shrink)

Practitioners’ ethical orientation and responses vary between practice settings. Yet, currently, the ethics for midwifery practice that is explicit in the literature and which provides the ideals of socialization into practice, is that of bio(medical)ethics. Traditional bioethics, developed because of World War II atrocities and increased scientific research, is based on moral philosophy, normative theory, abstract universal principles and objective problem solving, all of which focus on right and wrong ‘action’ for resolving dilemmas. They exclude context and relationship. Personal narratives (...) of mothers and midwives contest the appropriateness of these accepted values and systems for childbirth because they induce conflict between work-place/service provider ethics and personal/professional midwifery ethics. In contrast to the disembedded and disembodied approach of biomedical ethics, an ethically adequate response in midwifery practice resonates more with the ethics of intimates, such as feminist virtue ethics. (shrink)

ABSTRACT:We focus on the core institution of the capital market and the institutional work of professional service firms that provide ratings on corporate issuers, initially in a bid to maintain this institution, which suffered when those involved relied solely on information from the issuers themselves. Through our analysis we identify a new type of decoupling—complicit decoupling. Complicit decoupling evolves over time, beginning with the creation of a new practice, here corporate ratings as a form of policing work, which emerges to (...) help to maintain a core institution. This practice is then adopted, implemented and later becomes decoupled. Exposure does not undermine the legitimacy of the practice because external actors collude in the ‘window dressing’ and, because it has become normalized, only partial repairs are enacted. It is by nature field-level institutional work, benefiting the majority of the field and inherently involves a violation of promise keeping. We conclude with implications for managers and behavioral ethics researchers. (shrink)

Business Ethics: A European Review, EarlyView.

In light of recent emphasis on K-12 scientific modeling, it is important to understand how students’ models and beliefs about modeling shape shared classroom practices, and how, in turn, shared classroom practices influence individual students’ practices. We use co-operative action to consider the ways in which sedimented practices and artifacts become part of the substrate for students’ later actions ). Lemke :273–290, 2000) and Goodwin describe and provide illustrative examples of the accumulative nature of transformation of materials and practices. However, (...) these examples range in scale from minutes to hours, and there is less guidance about applying these perspectives to consider the transformation of practices longitudinally. In this study, we find that co-operative action is a powerful framework for analyzing classroom practices. We show that new practices rippled through the classroom along three dimensions: immediate transformation, longitudinal reuse and transformation, and transformation through interaction with other practices. These findings confirm that students’ models and practices become part of the substrate for later enactments of practice, and that these practices develop co-operatively and accumulatively within the classroom. Thus, co-operative action provides a unique lens on student progress that complements learning progressions by considering the social dimension of the development of practices. We propose that the extent to which students’ practices are able to sediment into the substrate of shared classroom practices is an important indicator of the health of the classroom as a scientific community. (shrink)

Receiving a diagnosis of cancer can be devastating. Cancer continues to be one of the most feared diagnoses, and experiencing pain is a major fear for people diagnosed with cancer. Cancer pain is complex in aetiology and can be acute or chronic and can be caused by various compression, ischaemic, neuropathic or inflammatory processes. Many people with cancer will experience excruciating pain, which is often underreported and undertreated. The reasons for this are complex and include various factors including fears and (...) beliefs held by patients. Cognitive factors are important modulators of pain and the appraisals, meanings and beliefs that people have in relation to illness, cancer, and pain, have implications in regard to help-seeking behaviours and the coping strategies people adopt. Cancer pain can impact a range of psycho-social factors across its course. Cancer pain relates to higher rates of psychological distress, anxiety and low mood, and the perception of pain intensity is, in turn, influenced by psychological factors. Cancer pain can negatively affect psychological health, and psycho-social factors can affect the pain experience. It has been suggested that people with a life-limiting illness experience ‘total pain’, and this can encompass psychological, social, practical, spiritual domains. Research demonstrates that cancer is predominantly an illness affecting older people, yet there is a higher risk of under-treated pain in this age group and there is a paucity of research into the subjective experiences of older people managing their cancer pain. Many older people are required to self-manage cancer pain at home as outpatients, due to drivers to keep people out of inpatient care, such as the high healthcare costs of inpatient treatment, and patients wanting to manage their illness, and die, at home. Our own research into this area found that the self-management of cancer pain involves a sequential and temporal process, which centres on perceptions of control. We describe how the older people in our study experienced a perceived loss of control, followed by a sense of gaining control over pain through various experience of certain internal and external factors. The assessment and treatment of physical pain should be done in combination with assessment and treatment of psycho-social and spiritual pain, and interventions for cancer pain need to focus on increasing positive affect and reducing helplessness. No person should suffer with poorly controlled pain and we argue for the need for further research in this area to ensure adequate treatment for all.Clinical Implications: Assessment and treatment of physical pain in people with cancer needs to be conducted in combination with assessment and treatment of psycho-social issues and spiritual pain. Psychological and behavioural approaches have strong evidence supporting their efficacy for reducing cancer pain. Interventions should target helplessness and focus on increasing positive affect through positive psychological states including fighting spirit and resilience. Person-centred interventions that focus on helping people with the search for meaning may help those with cancer pain derive positive benefits. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

BackgroundWe conducted a survey to identify what types of health/medical research could be exempt from research ethics reviews in Australia.MethodsWe surveyed Australian health/medical researchers and Human Research Ethics Committee members. The survey asked whether respondents had previously changed or abandoned a project anticipating difficulties obtaining ethics approval, and presented eight research scenarios, asking whether these scenarios should or should not be exempt from ethics review, and to provide comments. Qualitative data were analysed thematically; quantitative data in R.ResultsWe received 514 responses. (...) Forty-three per cent of respondents to whom the question applied, reported changing projects in anticipation of obstacles from the ethics review process; 25% reported abandoning projects for this reason. Research scenarios asking professional staff to provide views in their area of expertise were most commonly exempted from ethics review ; scenarios involving surplus samples and N-of-1 studies were most commonly required to undergo ethics review. HREC members were 26% more likely than researchers to require ethics review. Need for independent oversight, and low risk, were most frequently cited in support of decisions to require or exempt from ethics review, respectively.ConclusionsConsiderable differences exist between researchers and HREC members, about when to exempt from review the research that ultimately serves the interests of patients and the public. It is widely accepted that evaluative research should be used to reduce clinical uncertainties—the same principle should apply to ethics reviews. (shrink)

We propose a friendly amendment to integrative experiment design (IED), adversarial-collaboration IED, that incentivizes research teams from competing theoretical perspectives to identify zones of the design space where they possess an explanatory edge. This amendment is especially critical in debates that have high policy stakes and carry a strong normative-political charge that might otherwise prevent free exchange of ideas.

On June 11, 1963, in a dramatic gesture that caught the nation's attention, Governor George Wallace physically blocked the entrance to Foster Auditorium on the University of Alabama's campus. His intent was to defy Attorney General Nicholas Katzenbach, sent on behalf of the Kennedy administration to force Alabama to accept court-ordered desegregation. After a tense confrontation, President Kennedy federalized the Alabama National Guard and Wallace backed down, allowing Vivian Malone and James Hood to become the first African Americans to enroll (...) successfully at their state's flagship university. That night, John F. Kennedy went on television to declare civil rights a "moral issue" and to commit his administration to this cause. That same night, Medgar Evers was shot dead. In The Schoolhouse Door, E. Culpepper Clark provides a riveting account of the events that led to Wallace's historic stand, tracing a tangle of intrigue and resistance that stretched from the 1940s, when the university rejected black applicants outright, to the post-Brown v. Board of Education era. We are there in July 1955 when Thurgood Marshall and lawyers at the NAACP Legal Defense Fund win for Autherine Lucy and "all similarly situated" the right to enroll at the university. We are in the car with Lucy in February 1956 as university officials escort her to class, shielding her from a mob jeering "Lynch the nigger," "Keep 'Bama white," and "hit the nigger whore." Clark exposes the many means, including threats and intimidation, used by university and state officials to discourage black applicants following the Lucy episode. And he explains how University of Alabama president Frank Anthony Rose eventually cooperated with the Kennedy administration to ensure a smooth transition toward desegregation. We also witness Robert Kennedy's remarkable face-to-face plea for Wallace's cooperation and the governor's adamant refusal: "I will never submit voluntarily to any integration in a school system in Alabama." As Clark writes, Wallace's carefully orchestrated surrender would leave the forces of white supremacy free to fight another day. And the Kennedys' public embrace of the civil rights movement would set in motion a political transformation that changed the presidential base of the Democratic party for the next thirty years. In these pages, full of courageous black applicants, fist-shaking demonstrators, and powerful politicians, Clark captures the dramatic confrontations that transformed the University of Alabama into a proving ground for the civil rights movement and gave the nation unforgettable symbols for its struggle to achieve racial justice. (shrink)

Participants in clinical research sometimes view participation as therapy or exaggerate potential benefits, especially in phase I or phase II trials. We conducted this study to discover what methods might improve cancer patients’ understanding of early-phase clinical trials. We randomly assigned 130 cancer patients from three U.S. medical centers who were considering enrollment in a phase I or phase II cancer trial to receive either a multimedia intervention or a National Cancer Institute pamphlet explaining the trial and its purpose. Intervention (...) participants were 32 times more likely to believe that the trial’s purpose was to examine safety and 60 % less likely to believe they would experience long-term benefit or cure. There was no difference in enrollment decision. However, while patients’ understanding of the trial’s purpose improved and expectations of long-term benefit diminished, half the respondents still believed they would experience long-term benefit or cure from participation. Therefore, we conclude that multimedia interventions such as this one may help oncologists to explain the risks and benefits of early-phase cancer trials in a way that patients can more easily understand, helping them to make more informed decisions about participation. But further research into other factors that influence patients’ beliefs about the outcome of enrollment is needed, both to modify the interventions and to determine how malleable patient beliefs are. (shrink)

This paper provides a brief comparative overview of the development of the reproductive sciences especially in agriculture in the UK and the US. It begins with the establishment by F. H. A. Marshall in 1910 of the boundaries that framed the reproductive sciences as distinct from genetics and embryology. It then examines how and where the reproductive sciences were taken up in agricultural research settings, focusing on the differential development of US and UK institutions. The reproductive sciences were also pursued (...) in medical and biological settings, and I discuss how the intersections among all three allowed the circulation of both ideas and scientists’ careers. Across the twentieth century, scientific leadership in the reproductive sciences alternated between the UK and US, and these patterns are elucidated. I conclude with thoughts on future research that might emphasize the elaboration of industrialization processes in agriculture and new capacities to transform both reproductive processes and their products—life itself—as biopower comes to be more ambitiously understood as extending across all species. (shrink)

High-spin states have been studied in Pr-135(59), populated through the Cd-116(Na-23,4n) reaction at 115 MeV, using the Gammasphere gamma-ray spectrometer. The negative-parity yrast band has been significantly extended to spin similar to 45 (h) over bar and excitation energy 21.5 MeV, showing evidence for several rotational alignments. The positive-parity yrast band of Ce-135(58), populated through the p4n channel of this reaction, was also populated to spin similar to 38 (h) over bar and excitation energy 18 MeV. Cranking calculations indicate that (...) these nuclei are soft with respect to the triaxiality parameter gamma and that several competing nuclear shapes occur at high spin. (shrink)

Changes in global patterns of grain production have affected the profitability of commercial, cash-crop agriculture in North America. The current financial crisis has highlighted a perceived conflict between the priorities of (1) strengthening net farm profit, (2) maintaining the productive potential of the land base, (3) enhancing the health and cohesiveness of the agricultural community, and (4) addressing societal demands for safe foodstuffs. Reducing input costs by reducing the need for privately owned machinery can minimize the scale-dependence of agricultural practices, (...) as illustrated with examples involving silage and intensively managed pasture in Ontario. This approach could improve farming opportunities for nontraditional, part-time farmers, and at the same time, create a niche for professional custom operators and managers. Enhancing the viability of nontraditional farm operations, a historically neglected component of the farming community, as well as commercial farms is viewed as one approach to sustaining and improving both the agricultural land base and the agricultural community. Applying resource-extensive rather than resource-intensive approaches to forage management reveals that these apparently divergent priorities are, in fact, interlocking pieces of the same puzzle. (shrink)

In this conceptual article, we argue that defining corporate social responsibility and corporate social irresponsibility as opposite constructs produces a lack of clarity between responsible and irresponsible acts. Furthermore, we contend that the treatment of the CSR and CSI concepts as opposites de-emphasizes the value of CSI as a stand-alone construct. Thus, we reorient the CSI discussion to include multiple aspects that current conceptualizations have not adequately accommodated. We provide an in-depth exploration of how researchers define CSI and both identify (...) and analyze three important gray zones between CSR and CSI: the role of harm and benefit, the role of the actor and intentionality, and the role of rectification. We offer these gray zones as factors contributing to the present lack of conceptual clarity of the term CSI, as a concept in its own right, leading to difficulties that researchers and managers experience in categorizing CSI acts as distinct from CSR. (shrink)

In this target article by Morain and Largent (2023), the authors focus on an investigator’s duty to patient-subjects specifically regarding incidental or collateral findings within the context of e...