Organizations comprise many social communities which arguably contribute to organizational knowledge creation. Two of these are the widely discussed community of practice and the lesser known micro-community of knowledge. Within such organizational communities collegial relationships are formed and maintained, norms and expectations learned, experiences shared, and ideas articulated and developed. The quality of collegial relations fostered by such communities, together with the importance of productive dialogue, have been identified as key components in organizations with the capability for ongoing innovation. Although (...) communities of practice have long been recognized as contexts for both learning and the development of collegial relations, little attention has been paid to micro-communities of knowledge. Using examples from a micro-community of knowledge found in a small New Zealand-based IT company, I demonstrate the ways in which participants ‘do collegiality’ towards establishing relational engagement. An example of collegial interaction in a community of practice is provided by way of contrast. The article concludes by arguing that despite being two distinct interactional contexts, the repertoire of relational skills required and the potential for social learning through participation in these two kinds of communities renders them not only complementary, but tightly interdependent. (shrink)

The Aristotelian concept of habituation is receiving mounting and warranted interest in educational circles, but has also been subject to different lines of interpretation and critique. In this article, I bring forward Aristotle's words on habituation, and then clarify the two lines of interpretation that have developed in the contemporary philosophical literature. I argue that the mechanical interpretation contains an intellectualist bias and then argue a cognitivist view that positions habituation as the only method appropriate to cultivating the starting points (...) of the ethical life. I contend, contrary to the popular view, that the starting points are non-discursive and not subject to explanation, and thus require the non-discursive method of habituation. I conclude with some thoughts for moral education that answer critiques of habituation concerning the role of reasoning and critical independence of students. (shrink)

The potential for genetic engineering of enhancements to complex human traits has been the subject of vigorous debate for a number of years. Most of the discussion has centered on the possible moral consequences of pursuing enhancements, especially those that might affect complex behaviours and components of personality. Little has been written on the actual process of implementing this technology. This paper presents a ‘thought experiment’ about the likely form of final preclinical testing for a technology to enhance intelligence as (...) a prototypical multiplex trait. The significance and the potential dangers of implementing enhancements in humans, especially to highly valued traits such as intelligence, would mandate a thorough programme of testing in animals, including non-human primates such as chimpanzees. The implications this would have for researchers, society and, most importantly, the animals themselves are discussed, and the paper concludes with a suggestion for a morally justifiable approach to resolve the tragic question of what to do with research animals who have a cognitive capacity that is close to that of humans. (shrink)

Periodic and unexpected shortages of drugs, biologics, and even medical devices have become commonplace in the United States. When shortages occur, hospitals and clinics need to decide how to ration their available stock. When such situations arise, institutions can choose from several different allocation schemes, such as first-come, first-served, a lottery, or a more rational and calculated approach. While the first two approaches sound reasonable at first glance, there are a number of problems associated with them, including the inability to (...) make fine, individual patient-centered decisions. They also do not discriminate between what kinds of patients and what types of uses may be more deserving or reasonable than others. In this article I outline an ethically acceptable procedure for rationing drugs during a shortage in which demand outstrips supply. (shrink)

For many years a debate has raged over what constitutes futile medical care, if patients have a right to demand what doctors label as futile, and whether physicians should be obliged to provide treatments that they think are inappropriate. More recently, the argument has shifted away from the difficult project of definitions, to outlining institutional policies and procedures that take a measured and patient-by-patient approach to deciding if an existing or desired intervention is futile. The prototype is the Texas Advance (...) Directives Act, but similar procedures have been widely implemented both with and without the protection of the law. While this method has much to recommend it, there are inherent moral flaws that have not received as much discussion as warranted. Because these strategies adopt a semblance of procedural justice, it is assumed that the outcomes of such proceedings will be both correct and fair. In this paper, I argue that there are three main irremediable defects in the policy approach: there is the potential for arbitrary decision-making about futility in specific cases; there are structural, pre-ordained consequences for ethnic minorities who would be disproportionately affected by the use of these procedures; and the use of rationing justifications to support the use of these policies. These flaws detract so much from any benefit that could be derived that they make such strategies more harmful than helpful. (shrink)

As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for (...) ineffective, inappropriate and prolonged interventions. In 1980 LaFollette called for the licensing of prospective parents, basing his argument on the harm they can do to vulnerable people. In this paper, I apply his arguments to surrogate decision-makers for cognitively incapacitated patients, rhetorically suggesting that we require potential surrogates to qualify for this position by demonstrating their ability to make reasonable and rational decisions for others. I employ this theoretical approach to argue that the loose criteria by which we authorize surrogates’ generally unchallenged power should be reconsidered. (shrink)

The ongoing revolution in molecular genetics has led many to speculate that one day we will be able to change the expression or phenotype of numerous complex traits to improve ourselves in many different ways. The prospect of genetic enhancements has generated heated controversy, with proponents advocating research and implementation, with caution advised for concerns about justice, and critics tending to see the prospect of genetic enhancements as an assault on human freedom and human nature. Both camps base their arguments (...) on the unquestioned assumption that the science will realize either their dreams or nightmares. In this paper, I show that their beliefs are based upon two fundamental mistakes. First, they are based upon an unwarranted reliance in a genetic determinism that takes for granted that the traits that we might most want to enhance, like intelligence, aggression, shyness, and even athletic ability, can be causally directed by specific genes. In so doing, character descriptions are reified to be concrete and discrete entities, in this case, genes. Second, they have accepted on faith that there is, or will be, a science to translate their hopes or worries into reality when, in fact, that is unlikely to occur because of the irreducible complexity of phenotypic expression. (shrink)

Patient and family demands for the initiation or continuation of life-sustaining medically non-beneficial treatments continues to be a major issue. This is especially relevant in intensive care units, but is also a challenge in other settings, most notably with cardiopulmonary resuscitation. Differences of opinion between physicians and patients/families about what are appropriate interventions in specific clinical situations are often fraught with highly strained emotions, and perhaps none more so when the family bases their desires on religious belief. In this essay, (...) I discuss non-beneficial treatments in light of these sorts of disputes, when there is a clash between the nominally secular world of fact- and evidence-based medicine and the faith-based world of hope for a miraculous cure. I ask the question whether religious belief can justify providing treatment that has either no or a vanishly small chance of restoring meaningful function. I conclude that non-beneficial therapy by its very definition cannot be helpful, and indeed is often harmful, to patients and hence cannot be justified no matter what the source or kind of reasons used to support its use. Therefore, doctors may legitimately refuse to provide such treatments, so long as they do so for acceptable clinical reasons. They must also offer alternatives, including second opinions, as well the option of transferring the care of the patient to a more accommodating physician or institution. (shrink)

The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. However, (...) there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care—resources in scarce supply in the area—I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the reso.. (shrink)

The current outbreak of Ebola virus infection in West Africa continues to spread. Several patients have now been treated in the United States and preparations are being made for more. Because of the strict isolation required for their care, questions have been raised about what diagnostic and therapeutic interventions should be available. I discuss the ethical challenges associated with caring for patients in strict isolation and personnel wearing bulky protective gear with reduced dexterity and flexibility, the limitations this may place (...) on available treatments and the permissibility of consequent departures from the standards of care. Restricting access to some interventions such as surgery requiring an operating room, advanced imaging, etc. is reasonable due to concern for protecting other patients, visitors and staff. Cardiopulmonary resuscitation is a special case and the implications for withholding this intervention in situations where it may be desired is discussed, especially with respect to those patients who have suspected, but not proven, infection. These same restrictions are also considered under conditions where there are scarce resources and thus limited numbers of patients may receive care. While it is to be hoped that there is only limited and sporadic infection with Ebola virus in the US, careful thought must be given to the care of these patients under the unusual circumstances demanded by their isolation. I argue that an altered standard of care is reasonable and ethically acceptable under certain conditions. (shrink)

Rationing is an unavoidable mechanism for reining in healthcare costs. It entails establishing cutoff points that distinguish between what is and is not offered or available to patients. When the resource to be distributed is defined by vague and indeterminate terms such as “beneficial,” “effective,” or even “futile,” the ability to draw meaningful boundary lines that are both ethically and medically sound is problematic. In this article, I draw a parallel between the challenges posed by this problem and the ancient (...) Greek philosophical conundrum known as the “sorites paradox.” I argue, like the paradox, that the dilemma is unsolvable by conventional means of logical analysis. However, I propose another approach that may offer a practical solution that could be applicable to real-life situations in which cutoffs must be decided (such as rationing). (shrink)

Abstract:The number of patients with organ failure who could potentially benefit from transplantation continues to exceed the available supply of organs. Despite numerous efforts to increase the number of donors, there remains an enormous mismatch between demand and supply. Large numbers of people still die with potentially transplantable organs remaining in situ, most frequently as a result of family objections. I argue that there are no persuasive moral arguments against mandated organ retrieval from all dead individuals who meet clinical criteria. (...) However, because of continuing endemic prejudice in United States society and its healthcare system and the distrust this engenders, I conclude that proceeding with a policy of compulsory organ retrieval, even if morally unobjectionable, would not be warranted. (shrink)

Behavioral genetics has as its goal the discovery of genes that play a significant causal role in complex phenotypes that are socially relevant such a parenting, aggression, psychiatric disorders, intelligence, and even race. In this article, I present the stories of the discoveries of three such important phenotypes: maternal nurturing behavior and the c-fosB gene; intelligence and phenylketonuria ; and pair-bonding and monogamy and show that the reality is considerably more complex than often portrayed. These accounts also lay bare some (...) fundamental misconceptions of this field in which genes hold a privileged place and inherently subjective phenomena are mistakenly objectified. (shrink)

The current Ebola virus epidemic in Western Africa appears to be spiraling out of control. The worst-case projections suggested that the unchecked spread could result in almost 1.4 million cases by the end of January 2015 with a case fatality rate of at least 50%. The United States and European nations have begun to respond in earnest with promises of supplies, isolation beds, and trained health care personnel in an effort to contain the epidemic and care for the sick. However, (...) there is neither a vaccine nor specific treatment for Ebola infection, and therapy is ideally centered on supportive care. I have previously argued that the provision of palliative care is obligatory during an overwhelming health catastrophe, notably pandemic influenza. Since affected Ebola patients have best outcomes with technologically advanced intensive care—resources in scarce supply in the area—I suggest that the only acceptable approach to large numbers of very sick, dying, and suffering Ebola patients who overwhelm the resources available to successfully manage them is effective palliative care. However, this could hasten death in this vulnerable population and hence, while ethically and medically justifiable, is not without social risk. (shrink)

Tied to the apron strings of the church -- Researcher, teacher, philosopher -- Philosophical discourse -- Interpretation, objectivity and nonsense -- Unitary experience and philosophical life -- Philosophical discourse as spiritual exercise -- Philosophy as life and as a quest for wisdom -- From Socrates to Foucault : a long tradition -- Inacceptable? -- The present alone is our happiness.

Tied to the apron strings of the church -- Researcher, teacher, philosopher -- Philosophical discourse -- Interpretation, objectivity and nonsense -- Unitary experience and philosophical life -- Philosophical discourse as spiritual exercise -- Philosophy as life and as a quest for wisdom -- From Socrates to Foucault : a long tradition -- Inacceptable? -- The present alone is our happiness.

One of the most influential historians of ancient philosophy of the past half-century, Pierre Hadot was adept at using ancient philosophers to illuminate the relevance of their ideas to contemporary life. This new edition of _The Present Alone is Our Happiness_, which has been significantly revised and expanded to include two previously untranslated essays, is an ideal introduction to some of Hadot's more scholarly work. In it, we discover that to be an Epicurean is not merely to think like one; (...) it is to adopt a way of living where limiting desires is the condition for happiness. Being an Aristotelian, similarly, is to choose a life that involves contemplation, and being a Cynic is to follow Diogenes in his refusal of quotidian convention and the mentality of ordinary people. If so many ancient philosophers founded schools, Hadot explains, it was precisely because they were proposing how to live life on a daily basis. We learn here that the history of philosophy has been something more than just that of a discourse. The founding texts of Greek philosophy, after all, were notes taken from oral exercises undertaken in concrete circumstances and contexts, most often a dialogue between students and specific interlocutors who meant to shed light on their students' real existence. The immense contribution of this book, which also traces Hadot's own personal itinerary in a touching manner, is to remind us, through direct language and numerous examples, what the theoretical aspect of philosophy often masks: its vital and existential dimensions. (shrink)

In this book of brilliantly erudite and precise discussions, Pierre Hadot explains that for the Ancients philosophy was not reducible to the building of a theoretical system: it was above all a choice about how to live one's life. One of the most influential historians of ancient philosophy in the world today, Hadot is adept at using ancient philosophers to illuminate the relevance of their ideas to contemporary life. In this book, which is an ideal introduction to Hadot's more scholarly (...) _What is Ancient Philosophy?_, we learn that to be an Epicurean is not merely to think like one; it is to adopt a way of living where limiting desires is the condition for happiness. Being an Aristotelian, similarly, is to choose a life that involves contemplation, and being a Cynic is to follow Diogenes in his refusal of quotidian convention and the mentality of ordinary people. If so many Ancient philosophers founded schools, Hadot explains, it was precisely because they were proposing how to live life on a daily basis. We learn here that the history of philosophy has been something more than just that of a discourse. The founding texts of Greek philosophy, after all, were notes taken from oral exercises undertaken in concrete circumstances and contexts, most often a dialogue between students and specific interlocutors who meant to shed light on their students' real existence. The immense contribution of this book, which also traces Hadot's own personal itinerary in a touching manner, is to remind us, through direct language and numerous examples, what the theoretical aspect of philosophy often masks: its vital and existential dimensions. (shrink)

The susceptibility of online learning to cheating behavior remains a contentious and unresolved issue. A cross-sectional explanatory research design was utilized to test the hypothesized factors influencing academic cheating in online learning. Our study involved 562 participants, selected through a non-probability sampling technique, who were surveyed using online questionnaires designed to measure the identified factors. We tested the hypotheses by utilizing path analysis through the partial least square regression approach within the SMART-PLS software. The demographics such as gender and age (...) of the students, along with the roles of teachers and school administration significantly influenced the students’ instances of self-reported academic cheating. The students’ attitude toward academic cheating emerged as an important factor in predicting cheating behaviors. The paper concludes with recommendations for future research explorations into other potential factors that may contribute to academic dishonesty in online learning. (shrink)

Genetic determinism labels the morally problematical claim that some socially significant traits, traits we care about, such as sexual orientation, gender roles, violence, alcoholism, mental illness, intelligence, are largely the results of the operation of genes and not much alterable by environment, learning or other human intervention. Genetic determinism does not require that genes literally fix these socially significant traits, but rather that they constrain them within narrow channels beyond human intervention. In this essay we analyze genetic determinism in light (...) of what is now known about the inborn error of metabolism phenylketonuria , which has for so long been the poster child ‘simple’ argument in favor of some form of genetic determinism. We demonstrate that this case proves the exact opposite of what it has been proposed to support and provides a strong refutation of genetic determinism in all its guises. (shrink)

Establishing biotic borders was part and parcel of empire building. The question of which kinds of biological species were permitted to make their way into North American and West European territories shaped transregional border control in the imperial age. Biotic borders were intensely biocultural in that stereotypes around race and ethnic differences shaped them. Drawing on examples from the history of white ants (also known as termites) in the American and British empires, this essay argues that insects had a sustained (...) and global presence in modern imperial imaginations of borders and frontiers. (shrink)

Le but de cet article est double. Il s’agit d’abord d’introduire un nouveau corpus de français oral numérisé, accessible sans restriction sur le web. CFPP2000 (Corpus du français parlé parisien des années 2000), qui comporte actuellement 500 000 mots alignés à l’oral au tour de parole, est constitué par un ensemble d’interviews conversationnelles sur les quartiers de Paris d’une à deux heures qui ont été réalisées en dyades ou le plus souvent en triades. L’article envisage l’influence pour la constitution du (...) corpus du but que nous nous étions fixé au départ, faciliter l’étude de la variation à l’oral pour le français parisien « commun ». Il aborde le choix des informateurs qui découle de cet objectif, les conduites d’entretien qui ont été adoptées. Il envisage ce qu’apporte la transcription d’entretiens relativement longs qui permet d’atténuer l’opposition entre analyse quantitative et analyse qualitative, ainsi que les précautions à prendre dans l’interprétation des résultats. Dans un deuxième temps, l’article présente les métadonnées, les concordanciers et les outils statistiques qui viennent enrichir le corpus et mentionne quelques travaux qu’il a permis de mener, tantôt en syntaxe de l’oral, tantôt autour de problèmes de variation morphologique. (shrink)

Le but de cet article est double. Il s’agit d’abord d’introduire un nouveau corpus de français oral numérisé, accessible sans restriction sur le web. CFPP2000 (Corpus du français parlé parisien des années 2000), qui comporte actuellement 500 000 mots alignés à l’oral au tour de parole, est constitué par un ensemble d’interviews conversationnelles sur les quartiers de Paris d’une à deux heures qui ont été réalisées en dyades ou le plus souvent en triades. L’article envisage l’influence pour la constitution du (...) corpus du but que nous nous étions fixé au départ, faciliter l’étude de la variation à l’oral pour le français parisien « commun ». Il aborde le choix des informateurs qui découle de cet objectif, les conduites d’entretien qui ont été adoptées. Il envisage ce qu’apporte la transcription d’entretiens relativement longs qui permet d’atténuer l’opposition entre analyse quantitative et analyse qualitative, ainsi que les précautions à prendre dans l’interprétation des résultats. Dans un deuxième temps, l’article présente les métadonnées, les concordanciers et les outils statistiques qui viennent enrichir le corpus et mentionne quelques travaux qu’il a permis de mener, tantôt en syntaxe de l’oral, tantôt autour de problèmes de variation morphologique. (shrink)

Technological advances in veterinary medicine have produced considerable progress in the diagnosis and treatment of numerous diseases in animals. At the same time, veterinarians, veterinary technicians, and owners of animals face increasingly complex situations that raise questions about goals of care and correct or reasonable courses of action. These dilemmas are frequently controversial and can generate conflicts between clients and health care providers. In many ways they resemble the ethical challenges confronted by human medicine and that spawned the creation of (...) clinical ethics committees as a mechanism to analyze, discuss, and resolve disagreements. The staff of the North Carolina State University Veterinary Hospital, a specialty academic teaching institution, wanted to investigate whether similar success could be achieved in the tertiary care veterinary setting. We discuss the background and rationale for this method, as well as the approach that was taken to create a clinical ethics committee. (shrink)

__Preparing Teachers for Deeper Learning _answers an urgent call for teachers who educate children from diverse backgrounds to meet the demands of a changing world._ In today’s knowledge economy, teachers must prioritize problem-solving ability, adaptability, critical thinking, and the development of interpersonal and collaborative skills over rote memorization and the passive transmission of knowledge. Authors Linda Darling-Hammond and Jeannie Oakes and their colleagues examine what this means for teacher preparation and showcase the work of programs that are educating for (...) deeper learning, equity, and social justice. Guided by the growing knowledge base in the science of learning and development, the book examines teacher preparation programs at Alverno College, Bank Street College of Education, High Tech High’s Intern Program, Montclair State University, San Francisco Teacher Residency, Trinity University, and University of Colorado Denver. These seven programs share a common understanding of how people learn that shape similar innovative practices. With vivid examples of teaching for deeper learning in coursework and classrooms; interviews with faculty, school partners, and novice teachers; surveys of teacher candidates and graduates; and analyses of curriculum and practices, _Preparing Teachers for Deeper Learning _depicts transformative forms of teaching and teacher preparation that honor and expand all students’ abilities, knowledges, and experiences, and reaffirm the promise of educating for a better world. (shrink)

The Institute of Medicine and the American Heart Association have issued a “call to action” to expand the performance of cardiopulmonary resuscitation in response to out-of-hospital cardiac arrest. Widespread advertising campaigns have been created to encourage more members of the lay public to undergo training in the technique of closed-chest compression-only CPR, based upon extolling the virtues of rapid initiation of resuscitation, untempered by information about the often distressing outcomes, and hailing the “improved” results when nonprofessional bystanders are involved. We (...) describe this misrepresentation of CPR as a highly effective treatment as the fetishization of this valuable, but often inappropriately used, therapy. We propose that the medical profession has an ethical duty to inform the public through education campaigns about the procedure's limitations in the out-of-hospital setting and the narrow clinical indications for which it has been demonstrated to have a reasonable probability of producing favorable outcomes. (shrink)

Over the last 80 years, a major goal of medical educators has been to improve the quality of applicants to medical school and, hence, the resulting doctors. To do this, academic standards have been progressively strengthened. The Medical College Admission Test (MCAT) in the United States and the undergraduate science grade point average (GPA) have long been correlated with success in medical school, and graduation rates have been close to 100 percent for many years. Recent studies have noted that some (...) doctors having difficulties in practice were found to have had similar problems while in school. In this essay, we present a brief historical account of attitudes and approaches to admissions requirements, then discuss basic broad areas of accomplishment in clinical practice: academic mastery, clinical acumen, and professionalism. We then review data that suggest that lack of competency can often be detected very early in a student’s career and may or may not be immune to remediation efforts. We end with a recommendation for a course of action that upholds and fulfills the profession’s social responsibility. This will be a moral argument, defending an aggressive but equitable approach to maintaining both public accountability and trust. (shrink)

What characteristics or attributes of a healthcare decision qualify it as acceptable to those who are empowered to judge it as adequate and hence suitable to either proceed (or not) with a recommen...

L’article permet de préciser quelques spécificités du corpus CFPP2000 et montre à partir de l’exemple des interrogatives indirectes (percontatives) comment ce corpus peut contribuer à une description de ce que nous appelons « la langue commune ». Dans un premier temps, nous rappelons les choix qui ont présidé à la confection du CFPP2000. Puis nous examinons les types d’interrogatives indirectes qui apparaissent dans le CFPP2000, avec des fréquences variées. Les interrogatives indirectes selon la norme grammaticale dominent. Cependant les interrogatives indirectes (...) en « est-ce que » sont bien représentées et elles apparaissent chez des locuteurs de toutes les origines sociales montrant que le corpus CFPP2000 ne se confond pas avec ce standard des grammaires. En revanche, les percontatives in situ sont très rares et plusieurs indices montrent qu’il s’agit encore de formes stigmatisées. (shrink)

Human allografts for life-threatening organ failure have been demonstrated to be lifesaving and are now considered to be standard of care for many conditions. Transplantation of non-vital anatomic body parts has also been accomplished. Hand transplantation after limb loss in adults has been shown to offer some promising benefits in both functional and psychological measures in preliminary studies. It has been suggested to expand eligibility criteria to include minors, with one such operation having already been performed. With this in mind, (...) we examine the current state of hand transplantation research in the context of available alternatives. We examine the ethics of carrying out these operations in minors, including under the protections of clinical research. We argue that children should not be considered for this surgery due to the substantial risks of immunosuppressive medication, the likelihood that the graft will need to be replaced during the patient’s lifetime and the lack of significant compensatory advantages over modern prosthetics. (shrink)

Over the last century, and especially since the publication of the Belmont Report in 1978, respect for persons, as exemplified by respect for autonomous decision-making, has become a central tenet in the practice of medicine. The authority of cognitively competent adults to make their own healthcare decisions is enshrined in both law and practice in most advanced industrialized nations. The right to consent to or to refuse medical interventions is virtually absolute, but is contingent on the provision of materially relevant (...) information about the benefits and burdens or risks of the proposed treatment as well as the freedom from coercion by others, especially healthcare personnel. This power also extends to the kinds, amounts and details of the proposed intervention, including the option to decline to hear anything, if one so chooses, assuming that this is a rational choice. This respect transfers to other competent individuals who are authorized as surrogates to decide for those who have temporarily or permanently lost the capacity to make their own healthcare decisions. (shrink)