While the bioethics literature demonstrates that the field has spent substantial time and thought over the last four decades on the goals, methods, and desired outcomes for service and training in bioethics, there has been less progress defining the nature and goals of bioethics research and scholarship. This gap makes it difficult both to describe the breadth and depth of these areas of bioethics and, importantly, to gauge their success. However, the gap also presents us with an opportunity to define (...) this scope of work for ourselves and to help shape the broader conversation about the impact of academic research. Because of growing constraints on academic funding, researchers and scholars in many fields are being asked to demonstrate and also forecast the value and impact of their work. To do that, and also to satisfy ourselves that our work has meaningful effect, we must understand how our work can motivate change and how that change can be meaningfully measured. In a field as diverse as bioethics, the pathways to and metrics of change will likewise be diverse. It is therefore critical that any assessment of the impact of bioethics research and scholarship be informed by an understanding of the nature of the work, its goals, and how those goals can and ought to be furthered. In this paper, we propose a conceptual model that connects individual bioethics projects to the broader goals of scholarship, describing the translation of research and scholarly output into changes in thinking, practice, and policy. One of the key implications of the model is that impact in bioethics is generally the result of a collection of projects rather than of any single piece of research or scholarship. Our goal is to lay the groundwork for a thoroughgoing conversation about bioethics research and scholarship that will advance and shape the important conversation about their impact. (shrink)

The behavior of some nightlife-setting patrons would be unacceptable in workplaces or public settings and could cause distress to other patrons. This quantitative study determined 381 young Australian’s descriptive and personal norms regarding four types of sexual behavior. Participants’ personal norms were that these behaviors are wrong, but they reported that the behaviors are common in a nightlife setting. Behaviors such as these could theoretically be prevented by modifying patrons’ descriptive norms with evidence that their beliefs are contrary to individuals’ (...) personal norms of acceptable behavior in nightlife settings. (shrink)

Hester Goodenough Gelber is Associate Professor of Religious Studies, Stanford University.

The main purpose of this study was to map school leaders? perceptions concerning the cooperation of the leadership team, the distribution of leadership functions and participative decision?making, and to asses their relative weight in terms of predicting school leaders? job satisfaction. Also, the effect of demographical and structural school variables (i.e. seniority, job experience, school size, size of the leadership team, school type) on school leaders? job satisfaction was examined. A sample of 130 school leaders of 46 large secondary schools (...) completed a self?report questionnaire. The study results indicated that school leaders are highly satisfied with their job. Multiple regression analysis revealed that job satisfaction was significantly related to the cooperation of the leadership team and the school type. The amount of formal distribution of leadership functions and participative decision?making of teachers in the school policy did not have a significant influence on school leaders? job satisfaction. (shrink)

Originally published in 1773 in two volumes, and now reissued here together in one, this work by the writer Hester Chapone, a renowned proponent of female education, contains advice delivered in the form of letters to her niece. The first volume deals primarily with matters of religion and morality, while the second volume addresses questions of behaviour and schooling. Unusually for self-improvement books of this era, Chapone recommends that a young woman should have a rigorous education in a wide (...) variety of subjects, including ancient history and geography, as well as instruction in ladylike deportment and mastery of household matters. She exhorts young ladies to avoid vanity and other vices through devoted study of scripture, and writes of the importance of choosing worthy and sensible friends who can be trusted to offer good advice. Chapone's posthumously published works, in two volumes, are also reissued in this series. (shrink)

This CQ department is dedicated to bringing noted bioethicsts together in order to debate some of the most perplexing contemporary bioethics issues. You are encouraged to contact department editor, D. Micah Hester, UAMS/Humanities, 4301 W. Markham St. #646, Little Rock, AR 72205, with any suggestions for debate topics and interlocutors you would like to see published herein.

This CQ department is dedicated to bringing noted bioethicists together in order to debate some of the most perplexing contemporary bioethics issues. You are encouraged to contact “The Great Debates” department editor, D. Micah Hester, UAMS/Humanities, 4301 W. Markham St., #646, Little Rock, AR 72205, with any suggestions for debate topics and interlocutors you would like to see published herein.

Several months ago, I was walking down the hallway outside our medical school faculty offices and a colleague stopped me to ask a question. He phrased his query in the context of a case that raised ethical issues for him, and he asked me to respond. I obligingly offered my opinion given the details he presented, ending my comments with the phrase, To this he kindly shot back, To be honest, this question caught me off guard. Though his particular dilemma (...) was relatively well-trod territory for many bioethicists, I had done little research on the issue and could not immediately render a response to his latter query. (shrink)

Cultural competence has become a ubiquitous and unquestioned aspect of professional formation in medicine. It has been linked to efforts to eliminate race-based health disparities and to train more compassionate and sensitive providers. In this article, I question whether the field of cultural competence lives up to its promise. I argue that it does not because it fails to grapple with the ways that race and racism work in U.S. society today. Unless we change our theoretical apparatus for dealing with (...) diversity to one that more critically engages with the complexities of race, I suggest that unequal treatment and entrenched health disparities will remain. If the field of cultural competence incorporates the lessons of critical race scholarship, however, it would not only need to transform its theoretical foundation, it would also need to change its name. (shrink)

Although there are many different moral arguments concerning the use of Best Interests in neonatal decision-making, there seems in practice a firm commitment to application of the concept. And yet, there is still little reflection given by practitioners about what employing a Best Interest determination means in infant care. The following lays out a comprehensive taxonomy of interest-sources in order to provide for more robust considerations of what constitutes best interests of/for neonates.

Organ procurement presents several ethical concerns (from what constitutes acceptable criteria for death to issues involved in specifically designating to whom an organ can be given), but none is more central than the concern for what are appropriate means for acquiring organs. The following discussion attempts a different perspective on the issue of organ procurement by arguing that, rather than appealing to our charitable consciences or our pocketbooks, relinquishing our organs after death in this day and age is, in fact, (...) obligatory for most people. Each of us is pressed by the growing demand for our organs should we die ?rightly,? and that desperate need has risen to such a level that not to release our organs for transplantation would constitute a serious moral wrong. (shrink)

Patient organizations increasingly play an important role in health care decision-making in Western countries. The Netherlands is one of the countries where this trend has gone furthest. In the literature some problems are identified, such as instrumental use of patient organizations by care providers, health insurers and the pharmaceutical industry. To strengthen the position of patient organizations government funding is often recommended as a solution. In this paper we analyze the ties between Dutch government and Dutch patient organizations to learn (...) more about the effects of such a relationship between government and this part of civil society. Our study is based on official government documents and existing empirical research on patient organizations. We found that government influence on patient organizations has become quite substantial with government influencing the organizational structure of patient organizations, the activities these organizations perform and even their ideology. Financing patient organizations offers the government an important means to hold them accountable. Although the ties between patient organizations and the government enable the former to play a role that can be valued as positive by both parties, we argue that they raise problems as well which warrant a discussion on how much government influence on civil society is acceptable. (shrink)

Since the decade of the 1970s, and particularly since the first successful test-tube baby in 1978, the development and use of assisted reproductive technologies have grown exponentially. Would-be parents—including those in so-called traditional male-female marriages, unmarried adults, postmenopausal women, and same-sex partnerships—who just over 20 years ago had no recourse for their fertility issues can now pursue their desires to have children with at least a partial, if not, total, genetic and/or biological relationship. Ovulation-stimulating medications, artificial insemination using the sperm (...) of a husband or unrelated donor, in vitro fertilization with embryo transfer, intracytoplasmic sperm injection, and gamete and zygote intrafallopian transfers are but a few of a host of treatment options ranging in complexity, invasiveness, and expense. And on the horizon are genetic techniques such as cloning—which was once considered “pure” science fiction but in 1997 became what some call an inevitability, with the development of mammalian cloning in the form of the now-famous Dolly the sheep. (shrink)

In April of 2001 I published a brief commentary in the journal Academic Medicine questioning the current character and functioning of the National Residency Matching Program. The purpose of the article was to stimulate a rethinking of process. At 50 years old, the environment through which the match operates has changed, and as such I thought it time to ask ourselves whether or not the match, its algorithm, and, more important, the values it manifests might well need an overhaul.

This paper attempts to defend pragmatic approaches to bioethics against detractors, showing how particular critics have failed or succeeded. The paper divides bioethics from a pragmatic point of view into three groups. The first group is called "bioethical pragmatism" that will be represented by two book-chapters from the anthology, Pragmatic Bioethics . The second group is called "clinical pragmatism" championed by Fins, Baccetta, and Miller. Finally, a third group, which has roots in the legal tradition, has been called "freestanding pragmatism" (...) and is portrayed by Grey, Posner, and Wolf. Each group has been criticized in journal articles, and, in turn, this paper critiques some of the (mis)understandings put forth by Tollefsen, Jansen, and Arras about the capabilities and status of pragmatism in bioethical discussions. Finally, it concludes with cautionary notes about pragmatic bioethics in hopes that pragmatists will learn from their own insights about the human condition and the discipline of bioethics. (shrink)

Introduction to healthcare ethics committees / D. Micah Hester and Toby Schonfeld -- Brief introduction to ethics and ethical theory / D. Micah Hester and Toby Schonfeld -- Ethics committees and the law / Stephen Latham -- Cultural and ...

Governments are increasingly inviting patient organizations to participate in healthcare policymaking. By inviting POs that claim to represent patients, representation comes into being. However, little is known about the circumstances under which governments accept POs as patient representatives. Based on the analysis of relevant legislation, this article investigates the criteria that self-help organizations, a special type of PO, must fulfil in order to be accepted as patient representatives by governments in Austria and Germany. Thereby, it aims to contribute to the (...) discussion on the role of governments in steering SHOs. There are different degrees of regulation. Governments in both countries not only formulate explicit criteria for SHOs with respect to patient representation but also guide SHOs representing patients through implicit criteria for associations. We discuss the findings against concepts of responsiveness, authorization, and accountability. Our findings indicate that governmental steering is not negative per se as indicated by previous research but—depending on legislative criteria—can promote transparency and democratic quality in patient representation. (shrink)

Ross’s argument against the best interest standard (BIS) makes a clear case for the problems of the BIS, and she also notes challenges with such notions as the harm principle. In light of these critiques, Ross champions her longstanding pediatric moral norm for decision making, constrained parental autonomy (CPA). This article argues that while Ross’s critique of the traditional accounts of the BIS is correct, her solution still raises some concerns. As such, I offer the “reasonable interests standard” as a (...) way of addressing what I see as weaknesses in both the BIS and CPA. (shrink)

Far from being in disarray, American private and public colleges and universities are stronger academically than ever before but the vast majority desperately need institutional financial support.

In this paper I use William James's understanding of significance in life to show that for certain patients euthanasia and assisted suicide can be importantly meaningful acts that family, friends, and health care professionals must acknowledge and even, at times, aid in bringing to fruition. Dying with meaning is transformative. It reshapes the lives of others that are left behind, giving to their lives new groundings by engaging them in the meaning of dying for us. For the patient, dying with (...) meaning takes the seemingly formless void in the abyss of death and gives it a significant purpose in the last stages of life itself; it turns potential nothingness into actual significance. To the extent that we outsiders do not help the dying, we condemn terminally ill patients to a meaningless existence until they die. (shrink)

A K-12 curriculum guide for philosophy and ethics.

The term community in ethics and bioethics traditionally has been used to designate either a specific kind of moral relationship available to rational agents or, in contrast, the context in which any sense of rational agency can even be understood. I argue that bioethics is better served when both selves and community are expressed through a more processive language that highlights the functional character of such concepts. In particular, I see the turn to processive community in bioethics as a turn (...) towards method, contextualization, and narrative. In clinical practice, such a processive account demands that bioethics concentrate on methods of developing healthy dialogue and deeper understanding from within the problematic situation rather than trying to fix problems using ethical tools developed from outside the present situation. Community, I argue, is in and of the interactive processes of inquiry itself. Such inquiry, such communitying, requires that we engage individual patients in context; it demands more than simply gaining their permission or mere consent; it demands developing a supportive environment for participation. (shrink)

In Bester’s article (2018) challenging the use of the harm principle and advocating sole reliance on the use of a best interest standard (BIS) in pediatric decision-making, we believe that the auth...

_Offering a new edition of Dewey’s 1916 collection of essays_ This critical edition of John Dewey’s 1916 collection of writings on logic, _Essays in Experimental Logic—_in which Dewey presents his concept of logic as the theory of inquiry and his unique and innovative development of the relationship of inquiry to experience—is the first scholarly reprint of the work in one volume since 1954. _Essays in Experimental Logic, _edited by D. Micah Hester and Robert B. Talisse, uses the authoritative texts (...) from the _Collected Works of John Dewey, 1882–1953_ and includes as well articles from leading journals representing various contemporary schools of philosophy that criticized Dewey’s experimentalism. Culling materials from six volumes of the chronologically arranged _Collected Works_, this single-volume edition of _Essays_ marks a crucial point in Dewey’s intellectual development: one in which Dewey critically engages idealistic and intuitionist theorists and lays the groundwork for his mature theory of inquiry. The text includes a new introduction by renowned Dewey scholar Tom Burke that places _Essays_ in philosophical and historical context. In addition to the original essays, _Essays in Experimental Logic_ also features five critical essays by Dewey’s contemporaries, including Bertrand Russell, Wendell T. Bush, R. F. Alfred Hoernlé, H. T. Costello, and C. S. Peirce. (shrink)

Scholars have explored the influence of the field of cybernetics on scientific thought and disciplines. However, from the inception of the field, ‘‘cyberneticians’’ had explicitly envisioned applications reaching beyond the purview of scientific disciplines; cybernetics was remarkable for its portability and potential application in a wide variety of contexts. This article explores connections between cybernetics and experimental music from 1950-1980, which was a period of experimentation with electronic techniques in recording, composition, and sound production and manipulation. Examples include musicians, engineers, (...) instrument builders, composers, and scientists in collaboration with musicians who invoked cybernetic themes in their work. These uses of cybernetics were more diverse than accounts of cybernetics within the sciences suggest, presenting a major difficulty in addressing cybernetics as a homogeneous or monolithic discourse. In particular, cybernetic discourse in music often exhibited themes of openness and indeterminacy, rather than the ‘‘command and control’’ of the ‘‘closed world.’’. (shrink)

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Explores the avant-garde history of twentieth-century Europe through the lifestyle and music of the Sex Pistols.

Every one of us will die, and the processes we go through will be our own - unique to our own experiences and life stories. End-of-Life Care and Pragmatic Decision Making provides a pragmatic philosophical framework based on a radically empirical attitude toward life and death. D. Micah Hester takes seriously the complexities of experiences and argues that when making end-of-life decisions, healthcare providers ought to pay close attention to the narratives of patients and the communities they inhabit so (...) that their dying processes embody their life stories. He discusses three types of end-of-life patient populations - adults with decision-making capacity, adults without capacity, and children - to show the implications of pragmatic empiricism and the scope of decision making at the end of life for different types of patients. (shrink)