Genomic research projects that collect tissues from deceased organ and tissue donors must obtain the authorization of family decision makers under difficult circumstances that may affect the authorization process. Using a quasi-experimental design, the Ethical, Legal, and Social Issues (ELSI) substudy of the Genotype-Tissue Expression (GTEx) project compared the recall and understanding of the donation authorization process of two groups: family members who had authorized donation of tissues to the GTEx project (the comparison group) and family members who had authorized (...) organ and tissue donations in years previous, who subsequently participated in two different mock-authorization processes that mimicked the GTEx authorization process (the intervention groups). Participants in the comparison and intervention groups were matched on key demographic characteristics.We found that participants in the intervention groups who experienced a mock-authorization process demonstrated better recall of the tissue donation request than members of the comparison group. Our data indicate that the stress associated with the loss of a loved one limited the ability of family members to recall details about the GTEx project. However, we found a similar lack of knowledge in both the comparison and the intervention group participants, suggesting lack of knowledge may be due to the complexity and unfamiliarity of the information presented to them during the authorization process. We discuss these findings in the context of everyday clinical decision making in cognitively challenging conditions. (shrink)

Early in the COVID-19 pandemic there was widespread concern that healthcare systems would be overwhelmed, and specifically, that there would be insufficient critical care capacity in terms of beds, ventilators or staff to care for patients. In the UK, this was avoided by a threefold approach involving widespread, rapid expansion of critical care capacity, reduction of healthcare demand from non-COVID-19 sources by temporarily pausing much of normal healthcare delivery, and by governmental and societal responses that reduced demand through national lockdown. (...) Despite high-level documents designed to help manage limited critical care capacity, none provided sufficient operational direction to enable use at the bedside in situations requiring triage. We present and describe the development of a structured process for fair allocation of critical care resources in the setting of insufficient capacity. The document combines a wide variety of factors known to impact on outcome from critical illness, integrated with broad-based clinical judgement to enable structured, explicit, transparent decision-making founded on robust ethical principles. It aims to improve communication and allocate resources fairly, while avoiding triage decisions based on a single disease, comorbidity, patient age or degree of frailty. It is designed to support and document decision-making. The document has not been needed to date, nor adopted as hospital policy. However, as the pandemic evolves, the resumption of necessary non-COVID-19 healthcare and economic activity mean capacity issues and the potential need for triage may yet return. The document is presented as a starting point for stakeholder feedback and discussion. (shrink)

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid (...) spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans. (shrink)

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid (...) spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans. (shrink)

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

REIMER‐KIRKHAM S, SHARMA S, PESUT B, SAWATZKY R, MEYERHOFF H and COCHRANE M. Nursing Inquiry 2012; 19: 202–212 Sacred spaces in public places: religious and spiritual plurality in health careSeveral intriguing developments mark the role and expression of religion and spirituality in society in recent years. In what were deemed secular societies, flows of increased sacralization (variously referred to as ‘new’, ‘alternative’, ‘emergent’ and ‘progressive’ spiritualities) and resurgent globalizing religions (sometimes with fundamentalist expressions) are resulting in unprecedented plurality. These shifts (...) are occurring in conjunction with increasing ethnic diversity associated with global migration, as well as other axes of difference within contemporary society. Democratic secular nations such as Canada are challenged to achieve social cohesion in the face of growing religious, spiritual and ethnic diversity. These challenges are evident in the high‐paced, demanding arena of Health care. Here, religious and spiritual plurality enter in, sometimes resulting in conflict between medical services and patients’ beliefs, other times provoking uncertainties on the part of healthcare professionals about what to do with their own religiously or spiritually grounded values and beliefs. In this paper, we present selected findings from a 3‐year study that examined the negotiation of religious and spiritual pluralism in Health care. Our focus is on the themes of ‘sacred’ and ‘place’, exploring how the sacred – that which is attributed as special and set apart as it pertains to the divine, transcendence, God or higher power – takes form in social and material spaces in hospitals. (shrink)

Essays in Memory of Richard Helgerson: Laureations brings together new essays by leading literary scholars of the British and European middle ages and early modern period who have been influenced by the groundbreaking scholarship of Richard Helgerson. The contributors evince the ongoing impact of Helgerson's work in critical debates including those of nationalism, formal analysis, and literary careerism.

The individual self and its critics -- The individualist assumptions of bioethical frameworks -- The genetic self is the connected self -- The failures of individual ethics in the genetic era -- The communal turn -- Developing alternatives: benefit sharing -- Developing alternatives: trust -- The ethical toolbox part one: recognising goods and harms -- The ethical toolbox part two: applying appropriate practices -- Possible futures.

All athletes experience victory and defeat, but how many truly learn from the experience of sport? For ancient Greek philosophers, sport was an integral part of education. Today, athletics programs remain in schools, but we face a growing gap between the modern sports experience and enduring educational values. This book seeks to bridge that gap by advocating a philosophical approach to the sports experience. Combining issues and ideas from traditional philosophy with contemporary analyses of sport and applied "thinking activities," this (...) book invites athletes to learn about life from their experience of sport. The text works its way from internal reflection to social interaction by addressing four important topics: self-discovery, responsibility, respect, and citizenship. This sequence is important because authentic self-knowledge is an essential foundation for effectively dealing with the personal and social challenges faced by philosophical athletes. Reid discusses specific issues such as violence, racism, and performance-enhancing drugs in their relevant contexts, although philosophical athletes focus on the big picture, approaching each issue from a complete vision of themselves, their moral commitments, and their social roles. Athletes as diverse as the teenage college recruit and the aging weekend-warrior will gain insight into their sports experience and into their lives. This philosophical approach maximizes what we can learn from sport and gives us the best chance for leading better lives because of it. (shrink)

This study investigates the hypothesis that the advantage corporate social performance (CSP) yields in attracting human resources depends on the degree of job choice possessed by the job seeking population. Results indicate that organizational CSP is positively related to employer attractiveness for job seekers with high levels of job choice but not related for populations with low levels suggesting advantages to firms with high levels of CSP in the ability to attract the most qualified employees.

Virtue ethics and virtue epistemology shift the focus of evaluation from thin concepts to thick ones. Simon Blackburn has argued that a shift to thick ethical concepts dooms us to talking past one another. I contend that virtue epistemologists can answer Blackburn's objection, thus salvaging genuine disagreement about the epistemically thick. Section I introduces the standard cognitivist and non-cognitivist analyses of thick concepts. Section II argues that thick epistemic concepts are subject to combinatorial vagueness. I contend that virtue epistemologists share (...) vague concepts of intellectual virtue and open-mindedness. Section III addresses Allan Gibbard's worry that appealing to vagueness exacerbates the problem. I conclude that for genuine disagreement to occur, the parties must (1) share vague concepts; and (2) agree on the goals of their conceptual analyses. (shrink)

McTaggart famously argued that time is unreal. Today, almost no one agrees with his conclusion.1 But his argument remains thelocus classicusfor both the A–theory and the B-theory of time. I want to show how McTaggart's argument provided the impetus for both of these opposing views of the nature of time. I will also present and defend what I take to be the correct view of the nature of time.

Douglas proposes a new ideal in which values serve an essential function throughout scientific inquiry, but where the role values play is constrained at key points, protecting the integrity and objectivity of science.

Much of the discussion of Naive Realism about veridical experience has focused on a consequence of adopting it—namely, disjunctivism about perceptual experience. However, the motivations for being a Naive Realist in the first place have received relatively little attention in the literature. In this paper, I will elaborate and defend the claim that Naive Realism provides the best account of the phenomenal character of veridical experience.

This study examines the similarities and differences in pre- and post-Sarbanes-Oxley corporate ethics codes and codes of conduct using the framework of structuration theory. Following the passage of the Sarbanes-Oxley (SOX) legislation in 2002 in the United States, publicly traded companies there undertook development and revision of their codes of ethics in response to new regulatory requirements as well as incentives under the U.S. Corporate Sentencing Guidelines, which were also revised as part of the SOX mandates. Questions that remain are (...) whether these new or revised codes are effective means of communicating changed ethical foci and attitudes in organizations. Centering resonance analysis (CRA) is used to identify differences and similarities across time and industries by analyzing word networks of 46 pre- and post-SOX corporate codes of ethics. Analyses focus on content and structure of generated word networks as well as resulting factors that emerged from the texts. Results are interpreted from the structuration perspective that content and structure of codes are constrained and enabled by system structures while they function to produce and reproduce those structures. Results indicate that corporate codes of ethics are formal discourses of ethics, laws, and control. Code structure has changed across time, with an increased emphasis on compliance in post-SOX codes. Implications for research and practice are discussed in light of findings. (shrink)

This classic, provocative introduction to classical metaphysical questions focuses on appreciating the problems, rather than attempting to proffer answers.

The Exchange of Words is a philosophical exploration of human testimony, specifically as a form of intersubjective understanding in which speakers communicate by making themselves accountable for the truth of what they say. This account weaves together themes from philosophy of language, moral psychology, action theory, and epistemology, for a new approach to this basic human phenomenon.

Many have argued that moral judgment is driven by one of two types of processes. Rationalists argue that reasoned processes are the source of moral judgments, whereas sentimentalists argue that emotional processes are. We provide evidence that both positions are mistaken; there are multiple mental processes involved in moral judgment, and it is possible to manipulate which process is engaged when considering moral dilemmas by presenting them in a non-native language. The Foreign-Language Effect is the activation of systematic reasoning processes (...) by thinking in a foreign language. We demonstrate that the FLE extends to moral judgment. This indicates that different types of processes can lead to the formation of differing moral judgments. One implication of the FLE is that it raises the possibility that moral judgments can be made more systematic, and that the type of processing used to form them might be relevant to normative and applied ethics. (shrink)

Animal welfare has a long history of disregard. While in recent decades the study of animal welfare has become a scientific discipline of its own, the difficulty of measuring animal welfare can still be vastly underestimated. There are three primary theories, or perspectives, on animal welfare - biological functioning, natural living and affective state. These come with their own diverse methods of measurement, each providing a limited perspective on an aspect of welfare. This paper describes a perspectival pluralist account of (...) animal welfare, in which all three theoretical perspectives and their multiple measures are necessary to understand this complex phenomenon and provide a full picture of animal welfare. This in turn will offer us a better understanding of perspectivism and pluralism itself. (shrink)

The present era of biological annihilation lends significant urgency to the need to radically reconfigure human-animal-nature relations along more ethical lines and sustainable trajectories. This article engages with largely post-humanist scholarship to offer up an in-depth qualitative analysis of a set of semi-structured interviews, conducted in August 2017-2018 with 26 radical environmental activists (REAs) from a variety of movements. These activists are posited as contemporary manifestations of the 'post-anthropocentric paradigm shifts' that challenge traditional notions of human separateness from - and (...) superiority to - the nonhuman world. However, despite being broadly categorised as post-humanist or post-anthropocentric in their efforts to deconstruct hierarchical and dualistic constructions of the human-animal-nature relationship, considerable variations abound in terms of who and what REAs value and on what basis. The article concludes with a brief discussion of the nature of REAs' post-anthropocentric sensibilities and mobilisations, and considers implications for the development of more ethical modes of human-animal-nature relationality that value and respect the irreducible alterity of nonhuman others. (shrink)

The paper argues for the centrality of believing the speaker (as distinct from believing the statement) in the epistemology of testimony, and develops a line of thought from Angus Ross which claims that in telling someone something, the kind of reason for belief that a speaker presents is of an essentially different kind from ordinary evidence. Investigating the nature of the audience's dependence on the speaker's free assurance leads to a discussion of Grice's formulation of non-natural meaning in an epistemological (...) light, concentrating on just how the recognition of the speaker's self-reflexive intention is supposed to count for his audience as a reason to believe P. This is understood as the speaker's explicitly assuming responsibility for the truth of his statement, and thereby constituting his utterance as a reason to believe. (shrink)

In colonial states and settings, constitutional arrangements are often forged within contexts that serve to maintain structural racism against Indigenous people. In 2013 the New Zealand government initiated national conversations about the constitutional arrangements in Aotearoa. Māori leadership preceded this, initiating a comprehensive engagement process among Māori in 2010, which resulted in a report by Matike Mai Aotearoa which articulated a collective Māori vision of a written constitution congruent with te Tiriti o Waitangi by 2040.This conceptual article explores the Matike (...) Mai Aotearoa report on constitutional transformation as a novel means to address structural racism within the health system as a key domain within the constitutional sphere. Matike Mai suggests alternative conceptual structural formations through its focus on the kāwanatanga, the relational and the tino rangatiratanga sphere. This framework is informed by a range of Indigenous ethical values such as tikanga, belonging, and balance that can usefully inform the redesign of the health sector.We assert that constitutional transformation and decolonization are potentially powerful ethical sources of disruption to whiteness and structural racism. We argue that, to eliminate entrenched health disparities, change processes need to be informed by the Indigenous inspirations expressed in the Matike Mai report. (shrink)

In the first section of this paper, after briefly arguing for the assumption that experiential content is propositional, I’ll distinguish three interpretations of the claim that experience has content (the Mild, Medium, and Spicy Content Views). In the second section, I’ll flesh out Naïve Realism in greater detail, and I’ll reconstruct what I take to be the main argument for its incompatibility with the Content Views. The third section will be devoted to evaluation of existing arguments for the Mild Content (...) View (the arguments from accuracy and appearing), and the development of what I take to be a stronger argument (the argument from belief generation). In the final section, I’ll identify a flaw in the argument for the incompatibility of Naïve Realism with the Content Views, which opens the door to a reconciliation. (shrink)

In his seminal work, Emotional Intelligence, Daniel Goleman suggests that the common view of human intelligence is far too narrow and that emotions play a much greater role in thought, decision-making and individual success than is commonly acknowledged. The importance of emotion to human experience cannot be denied, yet the relationship between law and emotion is one that has largely been ignored until recent years. However, the last two decades have seen a rapidly expanding interest among scholars of all disciplines (...) into the way in which law and the emotions interact, including the law's response to emotion and the extent to which emotions pervade the practice of the law. In The Emotional Dynamics of Law and Legal Discourse a group of leading scholars from both sides of the Atlantic explore these issues across key areas of private law, public law, criminal justice and dispute resolution, illustrating how emotion infuses all areas of legal thought. The collection argues for a more positive view of the role of emotion in the context of legal discourse and demonstrates ways in which the law could, in the words of Goleman, become more emotionally intelligent. (shrink)

Between 1992 and 1996, a small number of women in the UK were forced by the courts to undergo caesarean section against their expressed refusal. Analysis of the reported cases reveals the blanket assumption of maternal incompetence and the widespread use of thinly veiled coercion. Such attitudes and practices are themselves frequently compounded by inadequate communication. Medical discretion in such problematic cases seems to err on the side of safety and so appears to favour the life of the fetus over (...) maternal autonomy. Despite current policy’s placement of the pregnant woman at the centre of maternity care, obstetricians’ concerns appear to lie more with the unborn fetus. In other words, there seems to be a point at which the value of fetal life begins to outweigh, not so much the life of the woman, but her right to self-determination, her plans and her choices. While it is important to acknowledge that these court ordered caesareans represent an unusual extreme within contemporary maternity care in this country, that they have happened brings into sharp relief some of the stereotypical assumptions about women. These are assumptions that underlie much of current medical practice and may compromise or disempower women in other ways during their experience of pregnancy and labour. Using the first and last of the six reported cases as contextual illustrations, this article focuses on the complex interplay of processes that have brought the medical profession to a position in which their own self-conviction and determination to do what they believe is best for their patients has resulted in gross denial of women’s autonomy and the use of the law to override pregnant women’s refusal of consent. (shrink)

In this volume Rorty offers a Deweyan account of objectivity as intersubjectivity, one that drops claims about universal validity and instead focuses on utility for the purposes of a community. The sense in which the natural sciences are exemplary for inquiry is explicated in terms of the moral virtues of scientific communities rather than in terms of a special scientific method. The volume concludes with reflections on the relation of social democratic politics to philosophy.

Pretense is generally thought to constitutively involve imagination. We argue that this is a mistake. Although pretense often involves imagination, it need not; nor is it a kind of imagination. The core nature of pretense is closer to imitation than it is to imagination, and likely shares some of its motivation with the former. Three main strands of argument are presented. One is from the best explanation of cross‐cultural data. Another is from task‐analysis of instances of pretend play. And the (...) third concerns the different ways in which pretense (especially childhood pretense) and imagination impact one's evaluative/affective systems. (shrink)