Background/purpose:Research from other disciplines demonstrates that ethical position, idealism, or relativism predicts ethical decision-making. Individuals from diverse cultures ascribe to various religious beliefs and studies have found that religiosity and culture affect ethical decision-making. Moreover, little literature exists regarding undergraduate nursing students’ ethical position; no studies have been conducted in the United States on students’ ethical position, their self-identified culture, and intrinsic religiosity despite an increase in the diversity of nursing students across the United States.Participants and Research Context Objectives:The study’s (...) two aims were to determine the relationship of self-identified culture, religiosity, and ethics position of undergraduate nursing student and whether students’ level of education and past ethics courses taken related to idealism. Two hundred and twelve volunteer undergraduate students participated.Research design:A descriptive cross-sectional study was designed for participants who completed the Ethical Position Questionnaire, The intrinsic subscale of the Religious Orientation Scale, and a Demographic, Cultural, Ethnicity Form. To test the five hypotheses, analyses included t-tests, correlations, and ANOVA.Ethical Considerations:The study was approved by the Institutional Review Board at Adelphi University.Results:Idealism and intrinsic religiosity were significantly related. Differences were observed for intrinsic religiosity and idealism for cultural identity and cultural dimensions such as parents’ place of birth, and if participants were US born. Students’ level of education or participation in past courses on ethics did not influence idealism.Conclusions:The study’s findings were similar to most of the research from other disciplines on culture, ethics position, and religiosity. Generic courses on ethics taken prior to clinical work may not assist nursing students in integrating principles into complex ethical dilemmas. Self-identified culture, religion, and intrinsic religiosity related to ethics position; completing ethics courses and level of education, juniors compared with seniors, did not influence idealism. Faculty should consider integrating students’ culture, religious orientation, and ethics position into teaching ethics for all levels of nursing education. (shrink)

BackgroundCervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status. Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like ‘equity’. Equity is a poorly defined and understood concept. We aimed to explain experts’ perspectives on how cervical screening programs might justifiably respond to ‘the underscreened’.MethodsThis paper reports (...) on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing.ResultsMost experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines.ConclusionsExperts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to ‘improving equity’ taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage. (shrink)

Background The world is threatened by future pandemics. Vaccines can play a key role in preventing harm, but there will inevitably be shortages because there is no possibility of advance stockpiling. We therefore need some method of prioritising access. Main text This paper reports a critical interpretative review of the published literature that discusses ethical arguments used to justify how we could prioritise vaccine during an influenza pandemic. We found that the focus of the literature was often on proposing different (...) groups as priorities. Different reasons were often suggested as a means of justifying such priority groupings. We suggest that much of the literature, wrongly, assumes that we are able to plan priority groups prior to the time of a particular pandemic and development of a particular vaccine. We also point out the surprising absence of various issues from the literature. Conclusions The literature proposes a wide range of ways to prioritise vaccines, focusing on different groups and ‘principles’. Any plan to use pandemic vaccine must provide justifications for its prioritisation. The focus of this review was influenza pandemic vaccines, but lessons can be learnt for future allocations of coronavirus vaccine, if one becomes available. (shrink)

In 1958, economist A. W. Phillips published an article describing what he observed to be the inverse relationship between inflation and unemployment; subsequently, the "Phillips curve" became a central concept in macroeconomic analysis and policymaking. But today's Phillips curve is not the same as the original one from fifty years ago; the economy, our understanding of price setting behavior, the determinants of inflation, and the role of monetary policy have evolved significantly since then. In this book, some of the top (...) economists working today reexamine the theoretical and empirical validity of the Phillips curve in its more recent specifications. The contributors consider such questions as what economists have learned about price and wage setting and inflation expectations that would improve the way we use and formulate the Phillips curve, what the Phillips curve approach can teach us about inflation dynamics, and how these lessons can be applied to improving the conduct of monetary policy. ContributorsLawrence Ball, Ben Bernanke, Oliver Blanchard, V. V. Chari, William T. Dickens, Stanley Fischer, Jeff Fuhrer, Jordi Gali, Michael T. Kiley, Robert G. King, Donald L. Kohn, Yolanda K. Kodrzycki, Jane Sneddon Little, Bartisz Mackowiak, N. Gregory Mankiw, Virgiliu Midrigan, Giovanni P. Olivei, Athanasios Orphanides, Adrian R. Pagan, Christopher A. Pissarides, Lucrezia Reichlin, Paul A. Samuelson, Christopher A. Sims, Frank R. Smets, Robert M. Solow, Jürgen Stark, James H. Stock, Lars E. O. Svensson, John B. Taylor, Mark W. Watson. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Pragmatist Philosophy of History by Marnie BinderPiers H. G. StephensA Pragmatist Philosophy of History Marnie Binder. Lexington Books, 2023.Looking at current scholarship and opinion in American philosophy, one can easily conclude that there has been much more work done on studying the history of pragmatist philosophy than there has been on what pragmatist philosophy can give to the study of history. Ever since the resurrection of interest (...) in pragmatism in the late twentieth century, we have seen a range of publications offering new interpretations for the ideas of the classical pragmatists, as well as important new applications for philosophical pragmatism and the moving to center stage of historically sidelined individuals and groups. What we have seen relatively little of, however, aside from a 2016 symposium in the European Journal of Pragmatism and American Philosophy, is sustained engagement with the question of what a classically pragmatist approach to historical inquiry might contribute, entail, or imply. It is this important niche in the ecosystem of American philosophy that Marnie Binder's A Pragmatist Philosophy of History seeks to partially fill in.Binder, who is perhaps best known for her past writings on José Ortega y Gasset, is at pains from the start to indicate both the humility and the utility of her project. As befits the tradition, there are no grandiose philosophical pretensions here, with the "goal in presenting a pragmatist philosophy of [End Page 112] history" merely being "to add another apparatus to the toolkits of the philosopher and the historian," an extra perspective that is "meant to complement other methodologies" (xi; emphasis in original), as she explains in her introduction. At the same time, pragmatism can offer something distinctive, firstly through asking the pragmatic question of what difference is meant by the accepting of particular presumed facts as being true, and secondly, being able to better understand why certain historical details have relevance, value, and meaning for us as a result of answering the first question. A pragmatist philosophy of history is helpful then, Binder maintains, as it "is in a unique position to bridge the speculative analytic divide" (xiii), and her approach to doing this is to draw upon the resources found in the works of a succession of the familiar classical pragmatists, building toward a synthesis and a cashing out of insights in her concluding reflections.Structurally the work consists of an explanatory introduction followed by six chapters, each dedicated to a particular pragmatist and their insights, leading finally to an extended concluding section drawing the component parts together and answering possible objections to the project. Pragmatism, as Binder recognizes, is seldom thought of as a historically orientated philosophy, but she argues that for each of these thinkers—William James, John Dewey, F. C. S. Schiller, Charles Sanders Peirce, George Herbert Mead, and Jane Addams—there is at least the germ of a philosophy of history that can be unearthed and developed, eventually helping to inform understanding of what is needed to bring a pragmatist ethics into practical reality, the last of which is manifested primarily by Addams. Thus, the treatment of William James in chapter 1 homes in on James's psychological insights into the way that experienced reality forms a temporal continuum; our consciousness necessarily selects from the experiences of the past, ascribing interpretations and assuming levels of facticity and relevance, since no individual can know all the facts or select among them with perfect impartiality. The continuum will be one that speaks to the inquirer's concerns with accuracy, practicality, meaningfulness, and coherence, as all knowledge comes about through temporal processes, and since past events are continuously added to and can be continuously reinterpreted, it can have no real or ultimate beginning or end. Accordingly, for a Jamesian pragmatist account, the "continuum of history is the way in which we construct a meaning for history of the connected past experiences with the present and in view of the future—this is what we call 'history'" (7; emphasis in original), and Binder draws upon José Medina's recent work to further illuminate how such history can and will be continuously critically reconstructed. In addition, she observes, such reconstruction [End Page... (shrink)

For several decades historians of science have interrogated the relationship between empire and science, largely focusing on European imperial powers. At the same time, scholars have sought alternatives to an early diffusionist model of the spread of modern science, seeking to capture the multi-directional and dialogic development of science and its institutions in most parts of the globe. The papers in this special issue illuminate these questions with added attention to particular claims about the exceptionalism – or not – of (...) Islamic societies’ approach to science, modernity and politics. Each contribution centres individuals and groups who engaged with science theoretically or practically, taking seriously their analytical categories and how they understood and grappled with the social, economic and intellectual transformations happening around them. Collectively, these studies make the case for Middle Eastern and Ottoman history as useful sites for furthering our field's understanding of processes of the globalization of science and how authority, politics and science have been and continue to be interconnected. (shrink)

In the absence of a well articulated conceptual framework for nursing ethics, this article argues for a theory of applied ethics - casuistics - used within a clinical reasoning model, to analyse the complicated issues presented in three cases involving adolescents receiving treatment for abuse through a rural alternative learning centre. The clinical nurse specialist, as an independent practitioner within the community, is presented with many ethical challenges arising from cultural diversity. The inherent independent nature of such practice environments combined (...) with the pluralism which exists in today's multicultural society demands that professional nurses working in these circumstances develop and utilize an ethical framework for the analysis of patient care in situations that involve moral conflict. (shrink)

Since 2000, 11 human uterine transplantation procedures (UTx) have been performed across Europe and Asia. Five of these have, to date, resulted in pregnancy and four live births have now been recorded. The most significant obstacles to the availability of UTx are presently scientific and technical, relating to the safety and efficacy of the procedure itself. However, if and when such obstacles are overcome, the most likely barriers to its availability will be social and financial in nature, relating in particular (...) to the ability and willingness of patients, insurers or the state to pay. Thus, publicly funded healthcare systems such as the UK9s National Health Service (NHS) will eventually have to decide whether UTx should be funded. With this in mind, we seek to provide an answer to the question of whether there exist any compelling reasons for the state not to fund UTx. The paper proceeds as follows. It assumes, at least for the sake of argument, that UTx will become sufficiently safe and cost-effective to be a candidate for funding and then asks, given that, what objections to funding there might be. Three main arguments are considered and ultimately rejected as providing insufficient reason to withhold funding for UTx. The first two are broad in their scope and offer an opportunity to reflect on wider issues about funding for infertility treatment in general. The third is narrower in scope and could, in certain forms, apply to UTx but not other assisted reproductive technologies (ARTs). The first argument suggests that UTx should not be publicly funded because doing so would be inconsistent with governments’ obligations to prevent climate change and environmental pollution. The second claims that UTx does not treat a disorder and is not medically necessary. Finally, the third asserts that funding for UTx should be denied because of the availability of alternatives such as adoption and surrogacy. (shrink)

In the past decade, numerous ethical frameworks have been developed to support public health decision‐making in challenging areas. Before the COVID‐19 pandemic began, members of the authorship team were involved in research programmes, in which the development of ethical frameworks was planned, to guide (a) the use of new technologies for emerging infectious disease surveillance; and (b) the allocation of scarce supplies of pandemic influenza vaccine. However, as the pandemic evolved, significant practical challenges emerged that led to our questioning the (...) value of these frameworks. We now believe that a normative instrument, such as a framework, cannot adequately or reliably provide the ethical guidance that needs to be incorporated into public health decision‐making during natural disasters or infectious disease emergencies. Recently it has been suggested that there are potentially more dynamic, flexible, and effective ways to navigate decisions involving complex considerations entailed in policies and practices during a public health emergency. In this paper, we first outline the key functions of a public health ethics framework, before describing why we believe it would not be fit for purpose during a crisis. We end by considering whether proposed alternative methods to promote ethical public health decision‐making goals have the potential to meet these objectives. (shrink)

Annotation. Informed by recent developments in literary criticism and social theory, this book addresses the presumption that nature exists independent of culture and, in particular, of language.

Various deficits in the cognitive functioning of people with autism have been documented in recent years but these provide only partial explanations for the condition. We focus instead on an imitative disturbance involving difficulties both in copying actions and in inhibiting more stereotyped mimicking, such as echolalia. A candidate for the neural basis of this disturbance may be found in a recently discovered class of neurons in frontal cortex, 'mirror neurons' (MNs). These neurons show activity in relation both to specific (...) actions performed by self and matching actions performed by others, providing a potential bridge between minds. MN systems exist in primates without imitative and ‘theory of mind’ abilities and we suggest that in order for them to have become utilized to perform social cognitive functions, sophisticated cortical neuronal systems have evolved in which MNs function as key elements. Early developmental failures of MN systems are likely to result in a consequent cascade of developmental impairments characterised by the clinical syndrome of autism. (shrink)

The COVID-19 pandemic has led a number of countries to introduce restrictive ‘lockdown’ policies on their citizens in order to control infection spread. Immunity passports have been proposed as a way of easing the harms of such policies, and could be used in conjunction with other strategies for infection control. These passports would permit those who test positive for COVID-19 antibodies to return to some of their normal behaviours, such as travelling more freely and returning to work. The introduction of (...) immunity passports raises a number of practical and ethical challenges. In this paper, we seek to review the challenges relating to various practical considerations, fairness issues, the risk to social cooperation and the impact on people’s civil liberties. We make tentative recommendations for the ethical introduction of immunity passports. (shrink)

Jebb in outlining the differences between ancient and modem oratory maintains that while modern orators try to give the impression that their speeches are extempore, the Greeks polished their speeches with fastidious care and were not ashamed to admit laboured preparation. This view, which is widely held, needs considerable qualification. The purpose of this article is.

Departing from the sociological dual process model that divides thoughts into automatic and unconscious, or deliberate and conscious occurrences, this book draws on empirical cases to demonstrate the existence of 'automatic deliberation'. Through research into the ways in which people address difficult subjects, such as death and dying, paedophilia, and career decision-making, the author sheds light on a mode of thinking which is both habitual and effortful, displaying a combination of habituated understandings and conscious deliberation. Advancing a blended view of (...) cognition by which individuals draw on schemas and frames to think through complex topics, this volume will appeal to sociologists and psychologists with interests in cognition and the ways in which we make decisions. (shrink)

Background This paper examines the degree of agreement among simple dichotomous self-report, validated screening results, and biochemical screening results of prenatal alcohol and other drug use among pregnant women. Method Secondary analysis was conducted on a cohort of pregnant women 16 years or older, presenting for prenatal care in the greater Cape Town, South Africa. Dichotomous verbal screening is a standard of care, and pregnant patients reporting alcohol and other drug use in dichotomous verbal screenings were asked to engage in (...) screening using the Alcohol Smoking and Substance Involvement Screening Test and urinalysis. Results Significant agreements between dichotomous and ASSIST scores were observed. A higher rate of self-reported alcohol use was detected, relative to urine screening with a predictive value of 34.9; while underreporting of illicit substance use was observed with an overall predictive value of 50.0. Conclusion Dichotomous verbal screening was considered valid after comparison with the ASSIST; however, combined use with urine screenings can be recommended especially for identifying illicit substance use in order to accurately detect alcohol and other drug use in pregnancy, so that women can be identified and referred for appropriate interventions where needed. (shrink)