The case of a dying baby with is one of the most difficult in pediatric ethics. I have been involved in several such cases and they are extremely challenging for all parties, especially the parents. With the luxury of being an I will comment on this case from the perspective of when it first began and at the end point described in the narrative.

This paper explores the relationship between teaching and consulting in clinical ethics teaching and the role of the ethics teacher in clinical decision-making. Three roles of the clinical ethics teacher are discussed and illustrated with examples from the authors' experience. Two models of the ethics consultant are contrasted, with an argument presented for the ethics consultant as decision facilitator. A concluding section points to some of the challenges of clinical ethics teaching.

Personality-disordered individuals of certain types tend to exhibit behaviors that cause particular problems for the Ethics and Compliance (E&C) function inorganizations. This paper defines personality-disordered individuals and focuses on three types that might create such problems: the psychopath, the narcissist, and the obsessivecompulsive personality. We provide a working hypothesis about the problems that they may cause in organizations and then report the results of an exploratory study of E&C personnel. The paper concludes with recommendations for managers and for future research.

Bullying in organizations is receiving more attention by managers, public policy makers, and scholars. This paper adds to the literature by examining how the culture of an organization may influence the frequency and types of bullying behavior that are predicted to occur. We develop propositions and examine measurement instruments in preparation for an empirical study.

Workplace bullying is defined as repeated, malicious, and health-endangering mistreatment of an employee by one or more other employees. Workplace bullying has been associated with negative outcomes for the individual being bullied and for the organization in which such actions take place. This paper explains the nature, frequency, and costs of workplace bullying in the context of organizational culture, ethical culture, and organizational moral development. We also propose ways that organizations can and should deal with this increasingly common behavior.

Physicians traditionally have been given role-specific obligations to promote the well-being of their individual patients, one patient at a time. They are not expected to be concerned with how health care is best allocated between patients, or with how health-care allocations compare to other social goods and services. The assumption seems to be that our society’s health-care allocation should be the cumulative result of individual clinical decisions made on behalf of individual patients. In this view, physicians are the gatekeepers of (...) health-care allocation, because they are responsible for making clinical decisions about prescriptions and admissions to health-care institutions and other services. But they should... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bedside VoicesJacqueline J. GloverThis issue of Narrative Inquiry in Bioethics features ten stories of Certified Nursing Assistants (CNAs) who work primarily in long-term care. This is a voice of direct care at the bedside that is not often heard. The addition of these stories in the literature is long overdue and I am honored to be asked to comment. There is much to learn from these bedside caregivers. All (...) of these stories reflect the deep struggle to be respected as a member of the health care team. But I also hear the pain of being caught in the tension between the desire to be skilled, qualified, and professional and the desire to be present in a way that emphasizes service, caring and common human touch. My commentary is informed by my experience in Rural Bioethics and my work at the Center for Bioethics and Humanities at the University of Colorado which has a commitment to Interprofessional Education. The CNAs' stories reveal much that they share with other health care professionals, but also some unique features that can teach us much.CommonalitiesSelf Care and Being Cared ForThe voice of the CNA is a voice that is echoed in a way by all health care professionals. Each of the stories bears witness to the need to take care of yourself and to be cared for in order to be able to continue to care for others. Leilani Roseberry writes "This unresolved grief and constant exposure to dying and death had me looking at every day, even every moment, through the eyes of a dying person. This is an emotion that is very difficult to put into words." She continues elsewhere, "I believe that if I had grief support opportunities available to me in my professional life, my level of care and compassion would have been much more resilient from the very beginning of my work as a CNA. Instead, only after sorting through emotions affecting my personal life and learning they were a compilation of what I experienced professionally, only then have I become much more resilient in the face of grief and mourning." Danny Reed writes, "Caregivers benefit from the same thing patients and residents do: genuine kindness. Take care of the caregivers because one day they will be all you have left in the world." And from James Bradley, "The work itself can be very draining, but to beat the stress of it, you can follow all the usual stuff like going for walks, playing with your kids, watch TV etc. The best advice though is to, as far as possible, leave the work behind when you walk off at the end of your shift. That may be the hardest thing to do but it is the only way to retain the correct professional approach."Self care can certainly be about boundaries and stress management. Health care institutions, including professional schools, increasingly have wellness programs (Johnson, 2000). It was once thought that [End Page 159] professional and emotional distance was necessary to maintain healthy relationships and avoid burn out. But current thinking seems to indicate the opposite. If a health care professional views his or her work only in terms of tasks to be performed without some connection to the meaning of what he or she is doing for the patient as a human being, that person is more likely to burn out (Halpern, 2003). Bradley's use of "correct professional approach" prompted me to think beyond wellness and health to the need to nurture meaning in one's work. The CNAs' essays are filled with the call to recognize the deeper meaning of their work. Tracy Dudzinski writes, "Most people think anyone can do this job. I thought that myself, twelve years ago. But now I know that it takes someone special. Direct care workers do not do this work because they are getting rich. They do it because they love the work and because it is the right thing to do. This is the hardest job I have ever done but it is also the most rewarding job I have ever done."There is increasing attention to the use of reflective writing in... (shrink)

Medical decision making on behalf of unrepresented patients is one of the most challenging ethical issues faced in clinical practice. The legal environment surrounding these patients is equally complex. This article describes the efforts of a small coalition of interested healthcare professionals to address the issue in Colorado. A brief history of the effort is presented, along with discussion of the legal, ethical, practical, and political dimensions that arose in Colorado’s effort to address decision making for unrepresented patients through an (...) extension of the existing Colorado Medical Treatment Decision Act (CRS 15-18). A discussion of lessons learned in the process is included. (shrink)

Volume 19, Issue 7, July 2019, Page 66-67.

In 2016, the Colorado legislature passed an amendment to Colorado’s medical proxy law that established a process for the appointment of a physician to act as proxy decision maker of last resort for an unrepresented patient (Colorado HB 16-1101: Medical Decisions For Unrepresented Patients). The legislative process brought together a diverse set of stakeholders, not all of whom supported the legislation. Following passage of the statutory amendment, the Colorado Collaborative for Unrepresented Patients (CCUP), a group of advocates responsible for initiating (...) the legislative process, coordinated a unique effort to engage these stakeholders in the creation of a set of voluntary guidelines to assist facilities and individual careproviders in the implementation of policies and procedures enabled by the statute. This article delineates the questions and concerns of stakeholders, describes how those issues were addressed within the guidelines, and proposes additional opportunities for research to assess the impact of the legislation in Colorado. (shrink)

At a time when there is general speculation about civilization, or civilizations, as well as on what the relationships are between Western and other civilizations, it is logical to try to define precisely what the men of ancient Greece thought about the question, since Western civilization owes so much to them.It may be that they did not think about it at all, or at least they thought nothing that could be expressed in modern terms. The fact is that ancient Greece (...) did not have a word for civilization: the French and English words come from Latin, not from Greek, while the first examples given in French and English dictionaries are the privileged example of Greece, “the civilization of Greece.” Did the Greeks use a paraphrase? Or a different word? If we consult a English-Greek dictionary we are surprised to see that the word given for “civilized” is hèmeros) that is, “docile,” “tamed.”. (shrink)

Public health agencies regularly survey randomly selected anonymous students to track drug use, sexual activities, and other risk behaviors. Students are unidentifiable, but a recent project that i...

Volume 20, Issue 10, October 2020, Page W4-W7.

Discussion of the ethics of forgoing medically provided nutrition and hydration tends to focus on adults rather than infants and children. Many appellate court decisions address the legal propriety of forgoing medically provided nutritional support of adults, but only a few have ruled on pediatric cases that pose the same issue.The cessation of nutritional support is implemented most commonly for patients in a permanent vegetative state ). An estimated 4,000 to 10,000 American children are in the permanent vegetative state, compared (...) to 10,000 to 25,000 adults. Yet the dearth of literature, case reports, and court decisions suggests that physicians and families of pediatric patients stop medically provided nutrition or seek court orders much less frequently. (shrink)

A belief that high school students have the cognitive ability to analyze and assess moral choices and should be encouraged to do so but have rarely been helped to do so was the motivation for developing Exploring Bioethics, a six-module curriculum and teacher guide for grades nine through twelve on ethical issues in the life sciences. A multidisciplinary team of bioethicists, science educators, curriculum designers, scientists, and high school biology teachers worked together on the curriculum under a contract between the (...) National Institutes of Health and Education Development Center, a nonprofit research and development organization with a long history of innovation in science education. At the NIH, the Department of Bioethics within the Clinical Center and the Office of Science Education within the Office of the Director guided the project.Our overarching goal for Exploring Bioethics was to introduce students to bioethics as a field of inquiry and to enable them to develop ethical reasoning skills so they could move beyond “gut reactions” to more nuanced positions. (shrink)

This Open Access book addresses the age-old problem of infinite regresses in epistemology. How can we ever come to know something if knowing requires having good reasons, and reasons can only be good if they are backed by good reasons in turn? The problem has puzzled philosophers ever since antiquity, giving rise to what is often called Agrippa's Trilemma. The current volume approaches the old problem in a provocative and thoroughly contemporary way. Taking seriously the idea that good reasons are (...) typically probabilistic in character, it develops and defends a new solution that challenges venerable philosophical intuitions and explains why they were mistakenly held. Key to the new solution is the phenomenon of fading foundations, according to which distant reasons are less important than those that are nearby. The phenomenon takes the sting out of Agrippa's Trilemma; moreover, since the theory that describes it is general and abstract, it is readily applicable outside epistemology, notably to debates on infinite regresses in metaphysics. (shrink)

This book asks not only how the study of white-collar crime can enrich our understanding of crime and justice more generally, but also how criminological ...

'This is a book to which the attention of students of art theory and criticism, and all those interested in the important application of psychoanalysis to other ...

Advanced directives and living wills have improved our ability to dictate end-of-life care, but even these cannot guarantee that we will be allowed the dignity of a natural death. Designed by two sisters-one a doctor, one a lawyer-and drawing on their decades of experience, the five-step Compassion Protocol outlined in A Better Way of Dying offers a simple and effective framework for leaving caretakers concrete, unambiguous, and legally binding instructions about your wishes for your last days. Meant for people in (...) every walk of life-from the elderly, to those in the early stages of mentally degenerative diseases like Alzheimer's, to healthy young people planning for an unpredictable future-this book creates space for a discussion we all must have if we wish to ensure comfort and control at the end of our lives.." -- from publisher's website. (shrink)

This study investigates the use of specific educative features for supporting the teaching of nature of science during read-alouds of elementary science trade books. Educative features are components of educative curriculum materials that aim to increase teachers’ content knowledge and support effective instructional practices. Understanding how teachers use specific educative features is important for the future design of curriculum materials that can be used to improve teachers’ views of NOS in tandem with changing their teaching practices. Qualitative data from teacher (...) interviews and observations of read-alouds were used to determine which educative features teachers used and how effective they were perceived as being. Results indicate that teachers varied in their use of educative features and tended to focus on the ones that addressed specific teaching moves as opposed to those that supported understanding why the curriculum was developed as it was. Based on these findings, recommendations for future research that highlights the importance of all educative features are provided. (shrink)

One might be inclined to assume, given the mouse donning its cover, that the behavior of interest in Nicole Nelson's book Model Behavior (2018) is that of organisms like mice that are widely used as “stand-ins” for investigating the causes of human behavior. Instead, Nelson's ethnographic study focuses on the strategies adopted by a community of rodent behavioral researchers to identify and respond to epistemic challenges they face in using mice as models to understand the causes of disordered human behaviors (...) associated with mental illness. Although Nelson never explicitly describes the knowledge production activities in which her behavioral geneticist research subjects engage as “exemplary”, the question of whether or not these activities constitute “model behavior(s)”—generalizable norms for engaging in scientific research—is one of the many thought-provoking questions raised by her book. As a philosopher of science interested in this question, I take it up here. (shrink)

What about honesty? -- History of honesty in society -- Honesty and the Constitution -- Honesty in society today.

Warum und wie genau darf zu Hause oder auf einer Theaterbühne anders gehandelt werden, als im Büro; wie verändert sich die Bedeutung von Worten, je nachdem wo, von wem und wie sie gesagt werden? Warum und mit welchen Mitteln versuchen wir, höflich zu sein, und inwiefern sind wir von unangemessenem Verhalten anderer bedroht? Welches Weltwissen benötigen Beobachter, um beurteilen zu können, wann Verhalten als angemessen oder unangemessen einzustufen ist? Im vorliegenden Band untersuchen die Beitragenden das Phänomen sozialer Angemessenheit unter anderem (...) aus philosophischer, sozialpsychologischer, soziologischer, kulturtheoretischer, linguistischer und anthropologischer Perspektive. Dabei werden insbesondere Bedingungen und Auswirkungen, Merkmale sowie Wandlungs- und Entstehungsprozesse sozialer Angemessenheit thematisiert. Die Herausgebenden Jacqueline Bellon M.A. promoviert an der TU Darmstadt und arbeitet als Philosophin, Kultur- und Sozialwissenschaftlerin. Dr. Bruno Gransche ist Philosoph am Institut für Technikzukünfte (ITZ) des Karlsruher Instituts für Technologie (KIT). Sebastian Nähr-Wagener M.A. ist wiss. Mitarbeiter am Institut für Technikzukünfte (ITZ) des Karlsruher Instituts für Technologie (KIT). (shrink)

This book presents an analysis of masculinity construction in a large corpus of women’s magazines, adopting a feminist Critical Stylistic approach to reveal how men are talked about and ‘sold’ to women as part of a successful performance of hegemonic femininity. This novel approach identifies women’s magazines as sites of ‘lad culture’ that perpetuate ideologies more commonly associated with the ‘laddism’ of male-targeted media. It examines how stereotypical images of men as naturally aggressive and obsessed with sex are promoted, as (...) well as considering some of the ways in which women’s magazines contribute to the social construction of normative understandings of gender and sexuality more broadly. This engaging work will offer fresh insights to students and scholars of Discourse Analysis, Sociolinguistics, Corpus Linguistics, Stylistics, and Gender and Communication Studies. (shrink)

In his correspondence, John Locke described his close friend Damaris Masham as ‘a determined foe to ecclesiastical tyranny’ and someone who had ‘the greatest aversion to all persecution on account of religious matters.’ In her short biography of Locke, Masham returned the compliment by commending Locke for convincing others that ‘Liberty of Conscience is the unquestionable Right of Mankind.’ These comments attest to Masham’s personal commitment to the cause of religious liberty. Thus far, however, there has been no scholarly discussion (...) of the tolerationist ethic underlying Masham’s 1705 publication, Occasional Thoughts. In this chapter, I argue that Masham’s work appeals to three common tolerationist principles of her time: the idea that the authorities should not use coercion and penalties as ways of imposing religious beliefs on others; the view that God requires human beings to attain salvation through their own efforts, and not by blindly following the dictates of the state-established religion; and the idea that the granting of liberty of conscience helps to ensure the peace and stability of political society. I show that Masham goes further than her tolerationist contemporaries by arguing that together these principles imply that a woman’s intellectual education—or the conscious cultivation of a woman’s ability to reflect critically on her religious beliefs—is vital for the good of the commonwealth. (shrink)

In this rich and detailed study of early modern women's thought, Jacqueline Broad explores the complexity of women's responses to Cartesian philosophy and its intellectual legacy in England and Europe. She examines the work of thinkers such as Mary Astell, Elisabeth of Bohemia, Margaret Cavendish, Anne Conway and Damaris Masham, who were active participants in the intellectual life of their time and were also the respected colleagues of philosophers such as Descartes, Leibniz and Locke. She also illuminates the continuities (...) between early modern women's thought and the anti-dualism of more recent feminist thinkers. The result is a more gender-balanced account of early modern thought than has hitherto been available. Broad's clear and accessible exploration of this still-unfamiliar area will have a strong appeal to both students and scholars in the history of philosophy, women's studies and the history of ideas. (shrink)

Ian Hacking instigated a revolution in 20th century philosophy of science by putting experiments (“interventions”) at the top of a philosophical agenda that historically had focused nearly exclusively on representations (“theories”). In this paper, I focus on a set of conceptual tools Hacking (1992) put forward to understand how laboratory sciences become stable and to explain what such stability meant for the prospects of unity of science and kind discovery in experimental science. I first use Hacking’s tools to understand sources (...) of instability and disunity in rodent behavioral neuroscience. I then use them to understand recent grass-roots collaborative open science initiatives aimed at establishing stability in this research area and tease out some implications for unity of science and kind creation and discovery in cognitive neuroscience. -/- . (shrink)

Abstract: In this paper, I respond to James Sterba’s recent book ‘Is a Good God Logically Possible?’ I show that Sterba concludes that God is not logically possible by ignoring three important issues: (a) the different functions of leeway indeterminism (and the political freedom presupposed by it) and autonomy (the two are very different things, even though both go under the name of freedom), (b) the differences in the conditions of agency in God and in creatures, (there is non-parity in (...) how each must apply the single moral law), and (c) the non-parity between our knowledge and God’s. I provide a brief summary of Sterba’s arguments, and I develop the following points: 1. Sterba’s argument against a Free-Will Defense hinges on his conflation of political freedom and autonomy; 2. Sterba’s crucial premise for his argument against soul-making theodicies (namely, that the “Pauline Principle” should be applied univocally across God and creatures) is false; 3. Sterba’s arguments against skeptical theism depend on his assumption that our knowledge is comparable to that of God. In each case, Sterba either does not recognize non-parity between God and creatures or does not recognize the difference between the profane (e.g., political matters) and the sacred, (e.g., spiritual matters having to do with the inner nature of the soul’s development). (shrink)

Acclaimed theorist and social scientist Donna Jeanne Haraway uses the work of pioneering developmental biologists Ross G. Harrison, Joseph Needham, and Paul Weiss as a springboard for a discussion about a shift in developmental biology from a vitalism-mechanism framework to organicism. The book deftly interweaves Thomas Kuhn's concept of paradigm change into this wide-ranging analysis, emphasizing the role of model, analogy, and metaphor in the paradigm and arguing that any truly useful theoretical system in biology must have a central (...) metaphor. (shrink)

In United States ex rel. Quirk v. Madonna Towers, Inc., the U.S. Court of Appeals for the Eighth Circuit held that the failure of a skilled nursing facility's executives to seek a legal opinion regarding a billing practice they considered valid did not meet the definition of knowingly presenting a false claim for payment to the federal government under the False Claims Act. Alleging that the facility that provided care to his aunt fraudulently submitted claims to Medicare for services provided (...) free of charge, the appellant brought this case qui tam on behalf of the federal government under the FCA.The FCA was passed by the legislature in an effort to punish and deter fraud against the federal government. It provides financial incentives for private individuals to come forward with information about fraudulent activity. (shrink)

A critic of utilitarianism, in a paper entitled “Innocence and Consequentialism” Laing argues that Singer cannot without contradicting himself reject baby farming (a thought experiment that involves mass-producing deliberately brain damaged children for live birth for the greater good of organ harvesting) and at the same time hold on to his “personism” a term coined by Jenny Teichman to describe his fluctuating (and Laing says, discriminatory) theory of human moral value. His explanation that baby farming undermines attitudes of care and (...) concern for the very young, can be applied to babies and the unborn (non-persons on his view) and contradicts positions that he adopts elsewhere in his work. (shrink)

As citizens, we hold certain truths to be self-evident: that the rights to own land, marry, inherit property, and especially to assume birthright citizenship should be guaranteed by the state. The laws promoting these rights appear not only to preserve our liberty but to guarantee society remains just. Yet considering how much violence and inequality results from these legal mandates, Jacqueline Stevens asks whether we might be making the wrong assumptions. Would a world without such laws be more just? (...) Arguing that the core laws of the nation-state are more about a fear of death than a desire for freedom, Jacqueline Stevens imagines a world in which birthright citizenship, family inheritance, state-sanctioned marriage, and private land ownership are eliminated. Would chaos be the result? Drawing on political theory and history and incorporating contemporary social and economic data, she brilliantly critiques our sentimental attachments to birthright citizenship, inheritance, and marriage and highlights their harmful outcomes, including war, global apartheid, destitution, family misery, and environmental damage. It might be hard to imagine countries without the rules of membership and ownership that have come to define them, but as Stevens shows, conjuring new ways of reconciling our laws with the condition of mortality reveals the flaws of our present institutions and inspires hope for moving beyond them. (shrink)

As citizens, we hold certain truths to be self-evident: that the rights to own land, marry, inherit property, and especially to assume birthright citizenship should be guaranteed by the state. The laws promoting these rights appear not only to preserve our liberty but to guarantee society remains just. Yet considering how much violence and inequality results from these legal mandates, Jacqueline Stevens asks whether we might be making the wrong assumptions. Would a world without such laws be more just? (...) Arguing that the core laws of the nation-state are more about a fear of death than a desire for freedom, Jacqueline Stevens imagines a world in which birthright citizenship, family inheritance, state-sanctioned marriage, and private land ownership are eliminated. Would chaos be the result? Drawing on political theory and history and incorporating contemporary social and economic data, she brilliantly critiques our sentimental attachments to birthright citizenship, inheritance, and marriage and highlights their harmful outcomes, including war, global apartheid, destitution, family misery, and environmental damage. It might be hard to imagine countries without the rules of membership and ownership that have come to define them, but as Stevens shows, conjuring new ways of reconciling our laws with the condition of mortality reveals the flaws of our present institutions and inspires hope for moving beyond them. (shrink)

Despite its centrality in the philosophy of cognitive science, there has been little prior philosophical work engaging with the notion of representation in contemporary NLP practice. This paper attempts to fill that lacuna: drawing on ideas from cognitive science, I introduce a framework for evaluating the representational claims made about components of neural NLP models, proposing three criteria with which to evaluate whether a component of a model represents a property and operationalising these criteria using probing classifiers, a popular analysis (...) technique in NLP (and deep learning more broadly). The project of operationalising a philosophically-informed notion of representation should be of interest to both philosophers of science and NLP practitioners. It affords philosophers a novel testing-ground for claims about the nature of representation, and helps NLPers organise the large literature on probing experiments, suggesting novel avenues for empirical research. (shrink)