Background: Physicians sometimes are asked by co-workers for prescriptions to deal with their medical problems. These “hallway” requests typically occur outside a formal doctor-patient relationship. There are professional guidelines on serving as physician for family members and friends, but no guidelines address writing prescriptions for co-workers. The frequency of these requests and the factors physicians consider in responding to them have not been examined.Objectives: To obtain data on the frequency of these requests and physicians’ attitudes and practices in responding to (...) them, and to explore the ethical considerations in writing prescriptions for co-workers.Design: A survey was administered to all physician faculty and residents in an academic department of internal medicine. The questions included whether the respondent had ever been asked for a prescription by a co-worker and how often the respondent had received such requests and written such prescriptions in the previous three months. Respondents also were asked to rate how likely they would be to write such a prescription in 15 hypothetical scenarios.Results: Of the 113 respondents who completed surveys, 68 percent reported having been asked for a prescription by a co-worker. Among those who had ever been asked, 59 percent had been asked one or more times during the previous three months and 88 percent had ever written such a prescription. Also, 88 percent of all respondents stated they were “very likely” or “likely” to write the prescription in one or more of the hypothetical scenarios.Conclusions: Most physicians in our sample had been asked for prescriptions by co-workers, and most had written such prescriptions. Many respondents indicated a willingness to write such prescriptions in a variety of scenarios, despite the absence of a formal doctor-patient relationship. Further discussion of the ethical considerations in writing prescriptions for co-workers is needed. (shrink)

IntroductionThe objectives of this study are to assess and compare differences in the intensity, frequency, and overall severity of moral distress among a diverse group of healthcare professionals.MethodsParticipants from within Baylor Health Care System completed an online seven-point Likert scale (range, 0 to 6) moral distress survey containing nine core clinical scenarios and additional scenarios specific to each participant’s discipline. Higher scores reflected greater intensity and/or frequency of moral distress.ResultsMore than 2,700 healthcare professionals responded to the survey (response rate 18.14 (...) percent); survey respondents represented multiple healthcare disciplines across a variety of settings in a single healthcare system. Intensity of moral distress was high in all disciplines, although the causes of highest intensity varied by discipline. Mean moral distress intensity for the nine core scenarios was higher among physicians than nurses, but the mean moral distress frequency was higher among nurses. Taking into account both intensity and frequency, the difference in mean moral distress score was statistically significant among the various disciplines. Using post hoc analysis, differences were greatest between nurses and therapists.ConclusionsMoral distress has previously been described as a phenomenon predominantly among nursing professionals. This first-of-its-kind multidisciplinary study of moral distress suggests the phenomenon is significant across multiple professional healthcare disciplines. Healthcare professionals should be sensitive to situations that create moral distress for colleagues from other disciplines. Policy makers and administrators should explore options to lessen moral distress and professional burnout that frequently accompanies it. (shrink)

Since 1984, the philosophy for children (p4c) Hawai‘i movement, a partnership between the University of Hawai‘i at Mānoa (UHM) and Hawai‘i’s public schools, has experienced success in creating a more philosophical schooling experience. UHM’s Uehiro Academy for Philosophy and Ethics in Education supports this movement by offering a ‘Philosopher in Residence’ who aids teachers in bringing philosophical inquiry into practice (Lukey 2013). Philosophers in Residence continue to support p4c Hawai‘i at Kailua High School, Waimānalo Intermediate and Elementary School, and Waikīkī, (...) Ka‘elepulu, and Sunset Beach Elementary Schools. As the movement grows, we continually ask, how can we support teachers in making p4c a ‘living and reliable educational option’ (Lipman 1988, p. vii) with limited resources? One solution is the philoSURFER Internship Project, where pre-college students intern with university Philosophers in Residence and assist kindergarten through to ninth grade teachers in ‘doing’ philosophy with students. Kailua High School started their first philoSURFERS cohort in the fall of 2015, and Sunset Beach Elementary School adapted the model and had their first cohort of philoSURFERS in the fall of 2021. Since 2015, 151 philoSURFERS have supported over 65 teachers and thousands of students at eight schools to engage in philosophical inquiry. The aim of this academic reflection is to share the lessons the five authors and project coordinators have learned over the last eight years of this school-university partnership for other organisations interested in utilising pre-collegiate students as catalysts for making philosophy an integral aspect of our schools. (shrink)

Developing Global Health Programming: A Guidebook for Medical and Professional Schools , edited by Jessica Evert, Paul Drain, and Thomas Hall, is reviewed. In spite of some editorial shortcomings, the book is a terrific aggregation of resources and reflections on the state of global health education that leaves readers with a multitude of useful and diverse tools, as well as directions about where to find additional ones.

The existing literature in medical ethics does not serve the practical needs of medical students and trainees very well. Medical students or junior doctors often have their own set of ethical concerns and the dilemmas that arise are generally beyond their direct control. The editors have addressed the gap in the literature by compiling a series of case studies from around the world and inviting an international team of leading ethicists and clinicians to comment on them. This volume includes over (...) 80 actual cases that cover the range of possible problems a medical trainee may encounter on the ward. (shrink)

Uno de los ejes que atraviesa la obra de Arturo Andrés Roig es la cuestión del sujeto. La filosofía, dice, "se trata de una meditación en la que no sólo interesa el conocimiento, sino también el sujeto que conoce … en su realidad humana e histórica" (Roig, 1981, 9). Justamente por su referencia a esa realidad humana e histórica, el filosofar no es ajeno al modo de habitar el hombre en el mundo. En otras palabras, el universo del discurso filosófico (...) hace referencia a un universo de lo real histórico. En esa tensión se juega la praxis filosófica, que si ha de ser liberadora, requiere la tematización tanto de la "subjetividad" como de la "morada". Al hilo de estas cuestiones trazamos un itinerario filosófico de Arturo Andrés Roig que lleva el propósito de servir de introducción al presente Dossier de la Revista Estudios de Filosofía Práctica e Historia de las Ideas, el cual se realiza como homenaje y afectuoso recuerdo de quien fuera su director. One axis that runs through the work of Arturo Andrés Roig is the question of the subject. Philosophy, he says, "is a matter of a meditation in which it is concerned not only the knowledge, but also the subject that knows… in his human and historical reality" (Roig, 1981, 9). Precisely because of this reference to human and historical reality, philosophizing is not strange to the man´s way of living in the world. In other words, the universe of the philosophical discourse In other words, the universe of the philosophical discourse refers to a universe of historical reality. It is in this tension where the philosophical praxis is played, which if it must be liberating, requires to question about both, "subjectivity" and "residing". In line with these issues we draw up a philosophical itinerary of Arturo Andrés Roig which has the purpose of serving as the introduction to the present Dossier of the Estudios de Filosofía Práctica e Historia de las Ideas academic journal, which is held in honor and loving memory of its former Director. (shrink)

This article examines the findings of an empirical study of law students from the Singapore Management University on their internship experiences at private law firms. As internships are frequently undertaken by law students, it is necessary for stakeholders to understand their impact on the values and ideals of law students in relation to the law and legal practice. This article seeks to increase the consciousness of law school educators, lawyers, and the professional bar about how law firm internships are (...) contributing to the making of future lawyers, so as to facilitate the reflection by these parties as to their roles in shaping future lawyers. (shrink)

Resumen La literatura universal, se encuentra poblada de arquetípicos que comparten una condición de desamparo y marginalidad, siendo la literatura realista de la segunda mitad del siglo XIX la que constata y da cuenta de su condición. En un mismo sentido, también la Biblia presenta un sinnúmero de personajes similares, marcando un punto de inflexión al llamarlo bienaventurados. Así pues, el presente estudio bíblico-literario, se centra en el arquetipo de la “viuda pobre”, sosteniendo dicha ficción literaria es una clave interpretativa (...) de la realidad, a la luz de la teoría literaria de la Estética de la Recepción. El articulo estudia la “viuda pobre” como un imaginario cultural y estableciendo la recepción de dicho imaginario en los cuentos “El Chiflón del diablo” y “El pago” del escritor chileno Baldomero Lillo, demostrando cómo el dialogo entre cultura y Biblia representa un aporte a la comprensión de determinadas ficciones literarias como categorías antropológicas.Universal literature is crowded by archetypical characters who share abandonment and marginalization conditions, being second half 19,h century realistic literature that confirms and exposes those conditions. In that sense, The Holy Bible presents a number of those characters. Resides, it highlights a turning point, hence, The Beatitudes point out: “Blessed are the poor in spirit, for theirs is the kingdom of heaven”. Thus, the following biblical-literary study, centered in the “Poor widow” archetype, aims to the establishment of literary fiction as interpretative key of reality, under Wolfgang Iser Aesthetics Reception's theory as its methodology. The objective aims to postulate “Poor Widow” as a Cultural imaginary, and finally to establish the reception of that imaginary within the stories “El Chiflón del Diablo” and “El Pago” by the chilean writer Baldomero Lillo, demonstrating that the dialog between culture and The Holy Bible represents a contribution to some literary fiction s as anthropological categories. (shrink)

BackgroundIn Morocco, medical research ethics training was integrated into the medical curriculum during the 2015 reform. In the same year, a law on medical research ethics was enacted to protect individuals participating in medical research. These improvements, whether in the reform or in the enactment of the law, could positively impact the knowledge of these researchers and, consequently, their attitudes and practices regarding medical research ethics. The main objective of this work is to assess Moroccan physicians’ knowledge, attitudes, and practices (...) at the beginning of their careers (interns and residents) in medical research ethics.Patients and methodsThis is a multicenter cross-sectional study conducted in 2021 among Moroccan physicians. Three scores were created and validated to assess physicians’ level of knowledge, attitudes, and practices regarding research ethics. A descriptive analysis was carried out, followed by a univariate analysis and a multivariate analysis using multivariate binary logistic regression to study the factors associated with the different calculated scores.ResultsA total of 924 physicians were included in the study, with an average age of 27.8 ± 2.2 years. 40.7% had a high medical research ethics knowledge score, and 68.8% had good attitudes. These two scores were positively associated with age and were statistically higher in residents and in physicians who had received training in medical research ethics during their medical curriculum. Only 29,9% of physicians who had participated in research studies had adequate practices with medical research ethics. This score was statistically higher in residents and in physicians who had heard about research ethics.ConclusionA genuine introduction to ethics in the medical curriculum is essential to enhance researchers’ knowledge, attitudes, and practices. This, in turn, can lead to an increase in both the quantity and quality of research conducted in Morocco. (shrink)

This article describes the findings of a mixed method literature review that examined the perceptions of elderly patients and residents of a good nurse in nursing homes, hospitals and home care. According to elderly patients and residents, good nurses are individuals who have the necessary technical and psychosocial skills to care for patients. They are at their disposal, promptly recognising the patients' needs. Good nurses like their job and are sincere and affectionate. They are understanding and caring. They do not (...) hesitate to enter into a trust-based relationship with their patients. Knowing and understanding how elderly patients and nursing home residents perceive ‘the good nurse’ is crucial for providing quality care and for promoting better patient outcomes in geriatric care. (shrink)

This article describes the findings of a mixed method literature review that examined the perceptions of elderly patients and residents of a good nurse in nursing homes, hospitals and home care. According to elderly patients and residents, good nurses are individuals who have the necessary technical and psychosocial skills to care for patients. They are at their disposal, promptly recognising the patients' needs. Good nurses like their job and are sincere and affectionate. They are understanding and caring. They do not (...) hesitate to enter into a trust-based relationship with their patients. Knowing and understanding how elderly patients and nursing home residents perceive ‘the good nurse’ is crucial for providing quality care and for promoting better patient outcomes in geriatric care. (shrink)

Background Doctors are increasingly faced with end-of-life decisions. Little is known about how medical students approach euthanasia. The objective of this study was to evaluate, among medical students and residents, the view on euthanasia and its variants; correlate such a view with empathy and religiosity/spiritualism; and with the stages of medical training in Brazil. Methods This is an exploratory cross-sectional study using an online questionnaire to be filled out on a voluntary basis among medical students and residents, consisting of: socio-demographic (...) data, an empathy questionnaire and questions with elaborate clinical cases that typify situations of the variants of euthanasia. Results From 1550 invitations, 273 volunteer participants responded (17.6%). The percentages of strong agreement/agreement on the concepts were: passive euthanasia (72.9%); active euthanasia (22.3%), orthothanasia (90.1%), dysthanasia (18.7%), assisted suicide (33%) and sedation (82.8%). Passive euthanasia, active euthanasia, dysthanasia and assisted suicide showed greater refusal with increasing length of medical training. Religious belief and degree of empathy did not significantly influence the opinion about the concepts. Strong agreement/agreement were: passive euthanasia (72.9%); active euthanasia (22.3%), orthothanasia (90.1%), dysthanasia (18.7%), assisted suicide (33%) and sedation (82.8%). Conclusions Passive euthanasia, active euthanasia, dysthanasia and assisted suicide showed greater refusal with increasing length of medical training. The external validation of our findings relies on the distinct legal, cultural, and religious frameworks found across various countries. (shrink)

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% of (...) respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

Background Studies have shown that medical students and residents believe that their ethics preparation has been inadequate for handling ethical conflicts. The objective of this study was to determine the self-perceived comfort level of medical students and residents in confronting clinical ethics issues. Methods Clinical medical students and residents at the University of Maryland School of Medicine completed a web-based survey between September 2009 and February 2010. The survey consisted of a demographic section, questions regarding the respondents’ sense of comfort (...) in handling a variety of clinical ethics issues, and a set of knowledge-type questions in ethics. Results Survey respondents included 129 medical students (response rate of 40.7%) and 207 residents (response rate of 52.7%). There were only a few clinical ethics issues with which more than 70% of the respondents felt comfortable in addressing. Only a slight majority (60.8%) felt prepared, in general, to handle clinical situations involving ethics issues, and only 44.1% and 53.2% agreed that medical school and residency training, respectively, helped prepare them to handle such issues. Prior ethics training was not associated with these responses, but there was an association between the level of training (medical students vs residents) and the comfort level with many of the clinical ethics issues. Conclusions Medical educators should include ethics educational methods within the context of real-time exposure to medical ethics dilemmas experienced by physicians-in-training. (shrink)

Physician assistants (PAs), nurse practitioners (NPs), and medical residents constitute an increasingly significant part of the American health care workforce, yet patient assent to be seen by nonphysicians is only presumed and seldom sought. In order to assess the willingness of patients to receive medical care provided by nonphysicians, we administered provider preference surveys to a random sample of patients attending three emergency departments (EDs). Concurrently, a survey was sent to a random selection of ED residents and PAs. All respondents (...) were to assume the role of patient when presented with hypothetical clinical scenarios and standardized provider definitions. Despite presumptions to the contrary, ED patients are generally unwilling to be seen by PAs, NPs, and residents. While seldom asked in practice, 79.5% of patients fully expect to see a physician regardless of acuity or potential for cost savings by seeing another provider. Patients are more willing to see residents than nonphysicians. (shrink)

Migration and Islamic Ethics, Issues of Residence, Naturalization and Citizenship addresses how Islamic ethical and legal traditions can contribute to current global debates on migration and displacement; how Islamic ethics of muʼakha, ḍiyāfa, ijāra, amān, jiwār, sutra, kafāla, among others, may provide common ethical grounds for a new paradigm of social and political virtues applicable to all humanity, not only Muslims. The present volume more broadly defines the Islamic tradition to cover not only theology but also to encompass ethics, customs (...) and social norms, as well as modern political, humanitarian and rights discourses. The first section addresses theorizations and conceptualizations using contemporary Islamic examples, mainly in the treatment of asylum-seekers and refugees; the second, contains empirical analyses of contemporary case studies; the third provides historical accounts of Muslim migratory experiences. (shrink)

This article argues that because racial inequalities are embedded in American society, as well as in medicine, more evidence-based investigation of the effects and implications of affirmative action is needed. Residency training programs should also seek ways to recruit medical students from underrepresented groups and to create effective mentorship programs.

This article critically examines the relationship between shared residence and contact after the breakdown of the parents’ relationship. It examines the background to the government’s main emphasis on methods of monitoring, facilitating and enforcing contact as the most efficacious method of proceeding in respect of the law reform agenda, focussing particularly on the potential impact of punitive enforcement measures on primary carers, usually mothers. The article sets the discussion within its wider cultural context in respect of fathers’ rights claims that (...) family law currently favours mothers, and shows how recent legal developments constitute part of a package to manage post-separation relationships between parent and children. It also examines some of the emerging case law to show how the judiciary is using shared residence orders and transfer of residence to deal with protracted and very difficult contact disputes, and in ways which were not anticipated when shared residence orders were first introduced. Drawing on feminist legal commentaries the argument will be made that the use of transfer of residence and shared residence orders in these disputes is extremely worrying, especially in light of the growing body of empirical research which heralds caution. The article will conclude by suggesting that far from favouring mothers, both the law reforms and the case law effectively construct mothers as integral to the problem of contact. They are treated as the site of and solution to the ‚problem’ of contact, and the means of dealing with the problem is by increasingly punitive measures which are inappropriate in a family law context. At the same time non-residential fathers who do not uphold contact escape legal sanctions. (shrink)

Using Shanghai Tennis Masters as an example, this study seeks to explore the psychic income associated with major sports events hosting and whether the psychic income would predict the attitudes of local residents toward events hosting. In addition, the moderating effect of sport involvement on the relationship between psychic income and attitude is also tested. In this study, a questionnaire survey is adopted. The structured questionnaire was developed based on 4 parts, including the demographics of the residents, involvement in the (...) sport event, psychic income from the sport event, and their attitudes toward the sports event, there were 47 items in total. Data were collected from the local residents of Shanghai, as a result, 1,302 valid questionnaires were collected. A series of statistical analyses were conducted by using SPSS25.0 and AMOS 24.0 to examine the reliability and validity of the scales and to test the hypotheses. The results showed that the event has brought a significant level of psychic income to the local community, and the perceived psychic income would predict the attitudes of the residents toward the event hosting. The moderating effect of sports involvement on the relationship between psychic income and attitude is also confirmed. (shrink)

Developing residents’ communication skills has been a goal of residency training programmes since the Accreditation Council for Graduate Medical Education codified it as a core competency. In this article, a case that features problematic communication between a generalist and specialist physician is drawn upon, and it is suggested how their communication might become open and effective through a practice of reason exchange. This is a practice of giving reasons, listening to reasons given by others, evaluating reasons and deciding which (...) particulars of situations constitute reasons to act and reasons how to act. Drawing on recent literature in teaching communication to radiology residents, it is proposed that practices of reason exchange are part of the skill set generally referred to as “negotiation skills” that should be cultivated in all residents. Particularly, in cases in which generalist and specialist physicians disagree about the reasons to do something, not do something or do something this way or that way, how well physicians are trained to practice reason exchange depends on whether they can communicate effectively and negotiate disagreement collegially. (shrink)

Background Caring behaviour is critical for nursing quality, and the clinical internship environment is a crucial setting for preparing nursing students for caring behaviours. Evidence about how to develop nursing students’ caring behaviour in the clinical environment is still emerging. However, the mechanism between the clinical internship environment and caring behaviour remains unclear, especially the mediating role of moral sensitivity and the moderating effect of self-efficacy. Research objective This study aimed to examine the mediating effect of moral sensitivity (...) and the moderating function of self-efficacy on the association between the clinical internship environment and caring behaviours. Research design A cross-sectional design used acceptable validity scales. The hypothesised moderated mediation model was tested in the SPSS PROCESS macro. Participants and research context This survey collected data from 504 nursing students in an internship at a teaching hospital in Changsha, China. Ethical considerations This study was pre-approved by the ethics committee of the medical school (No. E2022210). Informed consent was obtained from all students. Results The clinical internship environment ( B = 0.450, 95% CI = [0.371, 0.530]) and moral sensitivity ( B = 1.352, 95% CI = [1.090, 1.615]) had positive direct effects on nursing students' caring behaviours. Clinical internship environment also indirectly influenced students’ caring behaviours via moral sensitivity ( B = 0.161, 95% CI = [0.115, 0.206]). In addition, self-efficacy played a moderating role between the clinical internship environment and caring behaviours ( B = 0.019, 95% CI = [0.007, 0.031]), as well as the relationship between the clinical internship environment and moral sensitivity ( B = 0.006, 95% CI = [0.003, 0.010]). Conclusion Moral sensitivity mediates the effect of the clinical internship environment on caring behaviour, and self-efficacy strengthens both direct and indirect effects. This study emphasises the importance of self-efficacy in developing moral sensitivity and caring behaviours in nursing students. (shrink)

Resident Evil is a multidimensional, multimedia universe. The essays written for this volume will focus on this particular zombie manifestation and its significance in popular culture, cover a wide range, and discuss numerous issues. Among them are game theory, the idea of silence as well as memory, the connection to iconic stories, posthumanism and much more.

I get a steady stream of enquiries about internships and a growing stream of enquiries about the possibility of doing a PhD with me. I don't answer letters from people who say they have read my home page and really want to work with me and then reveal by what they write that they have NOT read my web page and know nothing about my work. I cannot take on internship students but..

Residence of unauthorized immigrants is a stable feature of the Global North’s liberal democracies. This article asks how liberal-democratic policymakers should respond to this phenomenon, assuming both that states have incontrovertible rights and interests to assert control over immigration and that unauthorized residence is nevertheless an entrenched fact. It argues that a set of liberal-democratic commitments gives policymakers strong reason to implement both so-called ‘firewall’ and ‘regularization’ policies, thereby protecting unauthorized immigrants’ basic needs and interests and officially incorporating many of (...) them in society. It then explains that the background imperative of immigration control creates a dilemmatic tension between these policies, as regularization is envisaged alongside the removal of the ineligible, which is in turn hindered by the implementation of firewalls. This creates a dilemma between the pursuit of two policy goals that are both underwritten by the same value commitments. Though it cannot be entirely dissolved, I argue that the best way to mitigate this dilemma is to design regularization policy in a way that leaves only a small number of unauthorized immigrants subject to removal. (shrink)

BackgroundDuring the COVID-19 outbreak in 2020, national governments took restrictive measures, such as a visitors ban, prohibition of group activities and quarantine, to protect nursing home residents against infections. As ‘safety’ prevailed, residents and close relatives had no choice but to accept the restrictions. Their perspectives are relevant because the policies had a major impact on them, but they were excluded from the policy decisions. In this study we looked into the moral attitudes of residents, close relatives and volunteers regarding (...) the restrictions in retrospect, and what moral lessons they considered important.MethodsWe conducted 30 semi-structured interviews with residents and close relatives and one focus group meeting with volunteers working in nursing homes. Data were transcribed verbatim and analyzed inductively. Subsequently, three Socratic dialogue meetings with residents, close relatives and volunteers were organized in which first analysis outcomes were discussed and dialogues were fostered into moral lessons for future pandemics. Outcomes were combined with moral theory following an empirical bioethics design. ResultsCritical perspectives regarding the COVID-19 restrictions grew in time. Various moral values were compromised and steered moral lessons for our future. The participants recognized three moral lessons as most important. First, constructing tailored (well-balanced) solutions in practice is desirable. Second, proper recognition is needed for the caring role that close relatives fulfill in practice. Third, a responsive power distribution should be in place that includes all stakeholder perspectives who are affected by the restrictions. DiscussionComparing the results with moral theory strengthens the plea for inclusion of all stakeholder groups in decision-making processes. To further concretize the moral lessons, tailored solutions can be realized with the use of moral case deliberations. Proper recognition includes actions addressing moral repair and including counter-stories in the debate. Responsive power distribution starts with providing clear and trustworthy information and including all perspectives. (shrink)

Training in ethics and professionalism is a fundamental component of residency education, yet there is little empirical information to guide curricula. The objective of this study is to describe empirically derived ethics objectives for ethics and professionalism training for multiple specialties. Study design is a thematic analysis of documents, semi-structured interviews, and focus groups conducted in a setting of an academic medical center, Veterans Administration, and community hospital training more than 1000 residents. Participants were 84 informants in 13 specialties (...) including residents, program directors, faculty, practicing physicians, and ethics committees. Thematic analysis identified commonalities across informants and specialties. Resident and nonresident informants identified consent, interprofessional relationships, family interactions, communication skills, and end-of-life care as essential components of training. Nonresidents also emphasized formal ethics instruction, resource allocation, and self-monitoring, whereas residents emphasized the learning environment and resident-attending interactions. Conclusions are that empirically derived learning needs for ethics and professionalism included many topics, such as informed consent and resource allocation, relevant for most specialties, providing opportunities for shared curricula and resources. (shrink)

Dispersal of individuals from their natal communities at sexual maturity is an important determinant of kin association. In this paper we compare postmarital residence patterns among Pumé foragers of Venezuela to investigate the prevalence of sex-biased vs. bilateral residence. This study complements cross-cultural overviews by examining postmarital kin association in relation to individual, longitudinal data on residence within a forager society. Based on cultural norms, the Pumé have been characterized as matrilocal. Analysis of Pumé marriages over a 25-year period finds (...) a predominant pattern of natalocal residence. We emphasize that natalocality, bilocality, and multilocality accomplish similar ends in maximizing bilateral kin affiliations in contrast to sex-biased residential patterns. Bilateral kin association may be especially important in foraging economies where subsistence activities change throughout the year and large kin networks permit greater potential flexibility in residential mobility. (shrink)

Although the moral foundations of voting rights regulations have been the subject of widespread scrutiny, there is one aspect of the debate which has gone largely unquestioned and is currently accepted in every state’s actual voting rights regulations. This is the requirement of prior residence, which stipulates that immigrants are granted the right to vote only once they have lived in the host country for a certain period of time. It is this requirement I call into question in this paper. (...) Taking up the most plausible justifications for this requirement, I aim to put substantial pressure on its moral acceptability by arguing that it is not directly grounded by any of the principles that are currently defended as a means to determine the demos, nor a proxy for some other morally relevant feature, nor a warrantor for abilities held to be significant for the right to vote. (shrink)

This article assesses an assumption pervasive in one strain of arguments in favor of stringent immigration controls. The assumption affirms that—for the case of regular admissions—to a certain extent states are permitted to prioritize the interests of their citizens and residents by issuing exclusionary immigration policies (call this the priority assumption). Using the normative methodology of applied international ethics, I suggest some broad constraints to this priority assumption that have a bearing on justifications for current practical immigration policy in Europe, (...) North America, and beyond. I do so by redefining borders as domestic-international institutions that open up borders not only to (internal) standards of justice but also to standards of international legitimacy. (shrink)

Self-regulation, or the ability to effectively manage emotions and behavior, is a critical skill to develop in early childhood. Children living in a context of economic hardship are at an increased risk for developing self-regulation difficulties. However, few studies have comprehensively examined how multiple aspects of the caregiving environment, including fathers’ parenting and coparenting quality, may contribute to child self-regulation. Thus, this study applied a family systems perspective to examine whether coparenting and resident and non-resident fathers’ reports of parenting quantity (...) and quality were associated with observations of children’s self-regulation. Participants were drawn from the Embedded Developmental Study of the Three-City Study, a longitudinal study of children and families facing economic hardship. At Wave 1, when children were 2–4 years old, reports of parenting and coparenting were obtained. At Wave 2, when children were 3–6 years old, children participated in a snack delay and gift wrap task, which assessed their self-regulation. Multi-group path analyses indicated that resident fathers’ harsh parenting at Wave 1 predicted decreased levels of self-regulation at Wave 2. Non-resident fathers’ reported hours of involvement at Wave 1 predicted greater levels of self-regulation at Wave 2. Additionally, supportive coparenting among families with a non-resident father predicted greater self-regulation. Supportive coparenting was not associated with child self-regulation in families with a resident father. The implications for research focused on facilitating positive father–child relationships in diverse family contexts are discussed. (shrink)

BackgroundThe emphasis on ethics and professionalism in medical education continues to increase. Indeed, in the United States the ACGME will require residency programs to include professionalism training in all curricula by 2007. Most courses focus on cases generated by the course instructors rather than on cases generated by the trainees. To date, however, there has been no assessment of the utility of these two case discussion formats. In order to determine the utility of instructor-generated cases (IGCs) versus resident-generated cases (...) (RGCs) in ethics and professionalism training, the author developed an innovative course that included both case formats. The IGCs were landmark cases and cases from the experience of the course instructors, while the RGCs were selected by the residents themselves. Residents were then surveyed to assess the strengths and weaknesses of each format.ResultsOf twenty-two second and third year residents, fourteen completed surveys (response rate 64%). Residents were nearly evenly split in preferring RGCs (38%), IGCs (31%), or not preferring one to the other (31%). 29% stated that they learn more from the RGCs, 21% stated that they learn more from the IGCs, and 50% stated that they did not find a difference in their learning based on format. In general, residents surveyed prefer a mix of formats. Residents tended to find the RGCs more relevant and interesting, and felt the IGCs were necessary to ensure adequate breadth of cases and concepts.ConclusionBased on our relatively small sample at a single institution, we believe that educators should consider incorporating both instructor-generated and resident-generated cases in their ethics and professionalism curricula, and should evaluate the utility of such a model at their own institution. Further work is needed to illuminate other potential improvements in ethics and professionalism education. (shrink)

To achieve the goals of ethics education, students must have oportunities to develop both moral capacities (imagination, responsibility, and perseverance) and intellectual capacities (critical thinking). This article contends that service-based learning represents an important opportunity for integrative ethics education. It describes a program of leadership internships at North Central College in Naperville, Illinois, in which faculty members conduct a for-credit reflection seminar with students involved in service internships. The seminar is based upon student-written cases about ethical issues they face in (...) their work settings. (shrink)

Democratic theory offers robust resources in order to defend the claim that noncitizens are, in many cases, entitled to the right to vote in their place of residence, regardless of their citizenship. On this, Avner de Shalit and I are in broad agreement. But the route we take to justify this right rests on substantially different argumentation: whereas I believe that residence is necessary and sufficient to justify the right to vote at the municipal and, more controversially, at the national (...) level, de Shalit believes that noncitizens must also intend to reside in a city over the longer term in order to merit the right to vote on city matters. I will argue that this focus on intention is dangerous for the most vulnerable of city dwellers, who are most in need of the right to vote, even if only at the city level. In particular, I argue that the only way that the right to vote can play its protective role is if it is available to migrants on the basis of residence, regardless of their stated intention. (shrink)

This study examined knowledge of sea lions for both residents and tourists on San Cristóbal Island in the Galápagos, a famous nature tourism destination. Participants obtained through convenience and snowball sampling answered questionnaires about their knowledge of sea lions. Participants with higher education received higher overall scores, but participants’ education and age influenced answers on only a few questions. Residents and tourists obtained comparable overall scores, exhibiting extensive knowledge of sea lion behavior and life history. Whether participants were residents or (...) tourists influenced answers to several questions, but when only participants with 13 years of education or more were examined, few differences in answers remained between residents or tourists. Participants’ broad knowledge of sea lions may be attributed to the items of knowledge tested, participants’ motivations for travel to the Galápagos, and the fact that sea lions are an engaging and ubiquitous animal. (shrink)