In healthcare, it should be a primary requirement that we define accurately what we are trying to do. The necessity for this intensifies when we are under stress, a part of which is caused by increased technological ingenuity outstripping the general ability to pay for it. Dealing with human beings and their problems, we are person and event oriented; our creed has always been and is the best that can be done for an individual, at a point in time. Increasingly, (...) we must modify this traditional approach by viewing episodic care of the individual as a part of two continua, of the individual in relation to their life span, and of the individual in relation to the community and healthcare system to which all belong. We are not skilled or practised in defining our overall aims. (shrink)

The Michigan Department of Community Health stores almost 4 million dried blood spot specimens in the Michigan Neonatal Biobank. DBS are collected from newborns under a mandatory public health program to screen for serious conditions. At 24 to 36 hours of age, a few drops of blood are taken from the baby’s heel and placed on a filter paper card. The card is sent to the state public health laboratory for testing. After testing, MDCH retains the spots indefinitely for the (...) personal use of the patient and also, pursuant to a 2000 law, for possible research. (shrink)

Ethics consultants and critical care clinicians reflect on Seattle’s early experience as the United States’ first epicenter of COVID-19. We discuss ethically salient issues confronted at UW Medicin...

Reydon and Scholz raise doubts about the Darwinian status of organizational ecology by arguing that Darwinian principles are not applicable to organizational populations. Although their critique of organizational ecology’s typological essentialism is correct, they go on to reject the Darwinian status of organizational populations. This paper claims that the replicator-interactor distinction raised in modern philosophy of biology but overlooked for discussion by Reydon and Scholz provides a way forward. It is possible to conceptualize evolving Darwinian populations providing that the inheritance (...) mechanism is appropriately specified. By this approach, adaptation and selection are no longer dichotomized, and the evolutionary significance of knowledge transmission is highlighted. (shrink)

Understanding the causes of maize landrace loss in farmers’ field is essential to design effective conservation strategies. These strategies are necessary to ensure that genetic resources are available in the future. Previous studies have shown that this loss is caused by multiple factors. In this longitudinal study, we used a collection of 93 maize landrace accessions from Morelos, Mexico, and stored at the International Maize and Wheat Improvement Center (CIMMYT) Maize Germplasm Bank, to trace back to the original 66 donor (...) families after 50 years and explore the causes for why they abandoned or conserved their seed lots. We used an actor-centered approach, based on interviews and focus group discussions. We adopt a Multi-Level Perspective framework to examine loss as a process, accommodating multiple causes and the interactions among them. We found that the importance of maize landrace cultivation had diminished over the last 50 years in the study area. By 2017, 13 families had conserved a total of 14 seed lots directly descended from the 1967 collection. Focus group participants identified 60 accessions that could still be found in the surrounding municipalities. Our findings showed that multiple interconnected changes in maize cultivation technologies, as well as in maize markets, other crop markets, agricultural and land policies, cultural preferences, urbanization and climate change, have created an unfavorable environment for the conservation of maize landraces. Many of these processes were location- and landrace-specific, and often led to landrace abandonment during the shift from one farmer generation to the next. (shrink)

Building on more than two decades offeminist analysis of the family, this article takes a neoinstitutionalist approach to examine some of the ways that sex, gender, and sexual orientation intersect in lesbianheaded two-parent families, affecting how they construct their roles as mothers. Institutionalist theory tends to de-emphasize how actors deliberately construct social arrangements such as parenting roles within the family. The authors' analysis of interviews from 14 lesbian mothers remedies this deficiency by focusing both on how they draw upon and (...) transform institutionalized scripts, practices, and understandings of family roles and relations. Their findings reveal how these mothers reinscribed gendered understandings while simultaneously challenging heteronormative ones in their efforts to construct and maintain socially viable two-parent families. (shrink)

ACESSO À JUSTIÇA: DELINEAMENTOS GERAIS E ANÁLISE NO PROJETO DE NOVO CÓDIGO PROCESSUAL CIVIL.

In an earlier article published in this journal I challenge Reydon and Scholz’s (2009) claim that Organizational Ecology is a non-Darwinian program. In this reply to Reydon and Scholz’s subsequent response, I clarify the difference between our two approaches denoted by an emphasis here on the careful application of core Darwinian principles and an insistence by Reydon and Scholz on direct biological analogies. On a substantive issue, they identify as being the principal problem for Organizational Ecology, namely, the inability to (...) identify replicators and interactors “ of the right sort” in the business domain; this is also shown to be easily addressed with reference to empirical studies of business populations. (shrink)

This paper examines the need for standards to resolve ethical conflicts related to qualitative, on-line research. Practitioners working in the area of qualitative research gauged the breadth and depth of this need. Those practitioners identified several key ethical issues associated with qualitative on-line research, and felt that there should be a common ethics code to cover issues related to Internet research. They also identified challenges associated with the profession's acceptance of a unified code. The paper concludes by offering guidance in (...) developing and implementing such a code. (shrink)

Competent patients’ refusals of nursing care do not yet have the legal or ethical standing of refusals of life-sustaining medical therapies such as mechanical ventilation or blood products. The case of a woman who refused turning and incontinence management owing to pain prompted us to examine these situations. We noted several special features: lack of paradigm cases, social taboo around unmanaged incontinence, the distinction between ordinary versus extraordinary care, and the moral distress experienced by nurses. We examined this case on (...) the merits and limitations of five well-known ethical positions: pure autonomy, conscientious objection, paternalism, communitarianism, and feminism. We found each lacking and argue for a ‘negotiated reliance’ response where nurses and others tread as lightly as possible on the patient’s autonomy while negotiating a compromise, but are obligated to match the patient’s sacrifice by extending themselves beyond their usual professional practice. (shrink)

The term "code of conduct" includes any code where a significant part of the content consists of ethical principles. This volume sets out in alphabetical order the organizations in the UK that have drawn up professional codes of conduct. Each entry either reproduces the code verbatim or summarizes its content. The introduction considers the development of codes, their growth in numbers, their purpose, and current trends. Annotation copyrighted by Book News, Inc., Portland, OR.

This paper examines the need for standards to resolve ethical conflicts related to qualitative, on-line research. Practitioners working in the area of qualitative research gauged the breadth and depth of this need. Those practitioners identified several key ethical issues associated with qualitative on-line research, and felt that there should be a common ethics code to cover issues related to Internet research. They also identified challenges associated with the profession's acceptance of a unified code. The paper concludes by offering guidance in (...) developing and implementing such a code. (shrink)