Volume 20, Issue 4, May 2020, Page 76-78.

Good listening is an essential element in the provision of quality healthcare (Attree 2001). Good listening also supports accurate diagnosis, patient adherence to medical recommendations, and stron...

Empirical bioethics research has become an established field of study, with its own unique goals, vocabulary, and methods, and wi...

The adoption of codes of ethics or values statements is intended to guide everyday decisions, as well as to influence the perceptions of external stakeholders. Questions have emerged in the literature about whether the effort to substantively direct decision-making in an organization is marginalized by the more obvious symbolic role of values statements. Here the perceived impact of values statements on decision-making in organizations is explored, and a number of positive effects observed. Respondents report that values statements create positive externalities (...) providing guidelines for decision-making, increasing accountability, and clarifying expectations. Yet, both cynicism and perceived management hypocrisy emerged in the survey, which together had strong negative effects on the perceived decision-making impact of values statements. Finally, positive external effects are almost never mentioned by respondents who give their firms high marks on the quality of values statement development, training, and implementation. Yet, such external effects get significantly greater representation in the comments of respondents who report less substance in their firms’ values statement development and implementation processes. In all, the results suggest that the substantive and symbolic roles of values statements are not independent and that external symbolism without internal legitimacy may in the long-run be problematic. (shrink)

Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff seem important, especially (...) where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record. (shrink)

Rereading Renée C. Fox's “A Sociological Perspective on Organ Transplantation and Hemodialysis,” published in 1970, one is likely to be struck more by continuity than by change. The most pressing of the social, policy, and ethical concerns that Fox raised remain problematic fifty years later. We still struggle with scientific and clinical uncertainty, with the boundary between experimentation and therapy, and with the cost of organ replacement therapies and disparities in how they are allocated. We still have an imperfect understanding (...) of transplant immune responses. We still debate when a potential donor “actually” dies, and we still seem to think better empirical criteria could harmonize the diverse religious, cultural, and socioeconomic values of patients, providers, third‐party payers, and policy‐makers. Organ transplantation was for Fox both a particular case unfolding in time and an entryway for discussing the difficult moral questions presented by many new medical technologies in a context of high demand and limited resources. (shrink)

Although universal schooling has been adopted as a goal by international organizations, bilateral aid agencies, national governments, and non-profit organizations, little sustained international attention has been devoted to the purposes or goals of universal education. What is universal primary and secondary education intended to accomplish? This book, which grew out of a project of the American Academy of Arts & Sciences, offers views from Asia, Africa, Europe, North America and South America on the purposes of universal education while considering diverse (...) cultures, religions, and professions. It is the first book in which renowned authors from around the world have proposed, considered, and debated goals of basic and secondary education, engaging in a constructive dialogue on one of the most pressing issues facing education today. (shrink)

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The experiences of individuals with intersex conditions include considerable abuse at the hands of medical personnel. Despite changes in expert opinion about full disclosure of the nature of each patient’s condition and recommendations to defer cosmetic surgical interventions, we do not know how much actual practice has changed over several decades. Moreover, discrepancies continue between the views of who have these conditions and medical practitioners, especially about preventing cancer and retaining gonads for the purpose of providing “natural” hormone production. We (...) have insufficient data to resolve these different perspectives. (shrink)

Volume 19, Issue 7, July 2019, Page 69-71.

Antiphon is often criticized for confusing two distinct species of responsibility, causal and moral. Insofar as this distinction is fundamental to any mature legal or ethical theory, Antiphon appears at best naïve, at worst dishonest. I argue that a careful analysis of his second tetralogy reveals that Antiphon was well aware of the distinction and the rationale for recognizing it. However, Antiphon questions whether the distinction can be so easily made in every case, and he suggests that the inadequacy of (...) the distinction might have radical implications for traditional ideas at the core of the Greek legal system. In short, Antiphon's second tetralogy gives us yet another reason to question whether the sophists were as philosophically unsophisticated as we are often led to believe. (shrink)

It was the spring of 2020 when the email came to our inboxes—a memo from our Institutional Review Board informing us that we were approved to begin conducting our pragmatic clinical trial with a wa...

At the forefront of international concerns about global legislation and regulation, a host of noted environmentalists and business ethicists examine ethical issues in consumption from the points of view of environmental sustainability, economic development, and free enterprise.

How does one committed to the claims of Christ and a biblical story of redemption live Christianly and navigate the competing worldviews encountered in everyday medical practice? Adopting the practical conceptual framework promoted by Reformed Christian philosopher and theologian Albert Wolters, we argue for an all-encompassing biblical understanding of God’s cosmic redemption plan for the entire creation order in contrast to a more typical sacred/secular duality. We then apply the concepts of structure and direction, drawn from a pretheological understanding of (...) human life drawn from the Scripture, to a semi-fictional case study in discerning Christian faithfulness in everyday mundane aspects of medicine. Our subsequent analysis seeks to render an interpretation of what it means to live life consistent with that worldview when confronted with challenges like those presented in the case. (shrink)

Darwin himself suggested the idea of generalizing the core Darwinian principles to cover the evolution of social entities. Also in the nineteenth century, influential social scientists proposed their extension to political society and economic institutions. Nevertheless, misunderstanding and misrepresentation have hindered the realization of the powerful potential in this longstanding idea. Some critics confuse generalization with analogy. Others mistakenly presume that generalizing Darwinism necessarily involves biological reductionism. This essay outlines the types of phenomena to which a generalized Darwinism applies, and (...) upholds that there is no reason to exclude social or economic entities. (shrink)

Sociologists who use in-depth interview methods have become sensitized to the ways that race-ethnicity and class can form barriers to rapport with respondents, but the question of gender has been largely unexamined. This article compares data from two independently conducted in-depth interview studies of male nurses: one by a female researcher and one by a male researcher. Observed differences in how the men in the samples framed their responses to questions in the two studies are discussed. It is argued that (...) in-depth interviewers can and should become sensitized to respondents' negotiation of the gendered context of the interaction, but the existing proscriptions against cross-gender research are challenged. (shrink)

Biological evolution provides a creative fount of complex and subtle adaptations, often surprising the scientists who discover them. However, because evolution is an algorithmic process that transcends the substrate in which it occurs, evolution’s creativity is not limited to nature. Indeed, many researchers in the field of digital evolution have observed their evolving algorithms and organisms subverting their intentions, exposing unrecognized bugs in their code, producing unexpected adaptations, or exhibiting outcomes uncannily convergent with ones in nature. Such stories routinely reveal (...) creativity by evolution in these digital worlds, but they rarely fit into the standard scientific narrative. Instead they are often treated as mere obstacles to be overcome, rather than results that warrant study in their own right. The stories themselves are traded among researchers through oral tradition, but that mode of information transmission is inefficient and prone to error and outright loss. Moreover, the fact that these stories tend to be shared only among practitioners means that many natural scientists do not realize how interesting and lifelike digital organisms are and how natural their evolution can be. To our knowledge, no collection of such anecdotes has been published before. This paper is the crowd-sourced product of researchers in the fields of artificial life and evolutionary computation who have provided first-hand accounts of such cases. It thus serves as a written, fact-checked collection of scientifically important and even entertaining stories. In doing so we also present here substantial evidence that the existence and importance of evolutionary surprises extends beyond the natural world, and may indeed be a universal property of all complex evolving systems. (shrink)

This is the first book to offer the best essays, articles, and speeches on ethics and intelligence that demonstrate the complex moral dilemmas in intelligence collection, analysis, and operations. Some are recently declassified and never before published, and all are written by authors whose backgrounds are as varied as their insights, including Robert M. Gates, former Director of the Central Intelligence Agency; John P. Langan, the Joseph Cardinal Bernardin Professor of Catholic Social Thought at the Kennedy Institute of Ethics, Georgetown (...) University; and Loch K. Johnson, Regents Professor of Political Science at the University of Georgia and recipient of the Owens Award for contributions to the understanding of U.S. intelligence activities. Creating the foundation for the study of ethics and intelligence by filling in the gap between warfare and philosophy, this is a valuable collection of literature for building an ethical code that is not dependent on any specific agency, department, or country. (shrink)

In "Frailty Triage: Is Rationing Intensive Medical Treatment on the Grounds of Frailty Ethical?," Wilkinson (2021) argues that the use of frailty scores in ICU triage does not necessarily involve discrimination on the basis of disability. In support of this argument, he claims, “it is not the disability per se that the score is measuring – rather it is the underlying physiological and physical vulnerability." While we appreciate the attention Wilkinson explicitly pays to disability in this piece, we find the (...) distinction between disability and underlying vulnerability untenable both theoretically and practically. In this peer commentary, we begin with a brief overview of research in philosophy of disability concerning the meaning of the concept itself. We argue that this research demonstrates that many forms of disability do not involve underlying vulnerabilities, and, furthermore, that Wilkinson equivocates between "disability" understood as a medical category vs. "disability" understood as a feature of lived experience. We reject Wilkinson’s distinction on these grounds and offer further considerations to avoid disability discrimination in emergency and crisis standards of care contexts. (shrink)

ABSTRACT As a classical philologist, Nietzsche was extremely familiar with the work of many ancient Greek writers. It is well known that Nietzsche made a practice of identifying with and praising ancient thinkers with whom he felt a kinship. It is worth investigating, then, whether Nietzsche's mention of Hippocrates in D signals a sustained interest in the so-called father of medicine. I argue that there is no evidence that Nietzsche paid special attention to Hippocrates or the Hippocratic corpus. Instead, Nietzsche's (...) curious allusion to Hippocrates is likely influenced in part by his reading of the Comtean positivist Émile Littré. Finally, I argue that if Nietzsche is consciously “Hippocratic” at all, he is so in virtue of the “medical posture” he adopts in D, where Nietzsche's remarks suggest his mission is to relieve humankind of the psychological suffering caused by morality. (shrink)

Given a countable model of set theory, we study the structure of its generic multiverse, the collection of its forcing extensions and ground models, ordered by inclusion. Mostowski showed that any finite poset embeds into the generic multiverse while preserving the nonexistence of upper bounds. We obtain several improvements of his result, using what we call the blockchain construction to build generic objects with varying degrees of mutual genericity. The method accommodates certain infinite posets, and we can realize these embeddings (...) via a wide variety of forcing notions, while providing control over lower bounds as well. We also give a generalization to class forcing in the context of second-order set theory, and exhibit some further structure in the generic multiverse, such as the existence of exact pairs. (shrink)

While many commentators have remarked on Nietzsche’s admiration for the Greek historian Thucydides, most reduce the affinity between the two thinkers to their common commitments to “political realism” or “scientific naturalism.” At the same time, some of these same commentators have sought to minimize or dismiss Nietzsche’s enthusiasm for the Greek sophists. We do not deny the importance of realism or naturalism, but we suggest that, for Nietzsche, realism and naturalism are rooted in a rejection of moral absolutism and its (...) leading advocates, Socrates and Plato. Through careful exegesis of crucial sections from Daybreak, we show that, as early as 1880 (if not earlier), Nietzsche regarded the agonistic, anti-absolutist stance of the sophist Protagoras as an indispensable model both for Thucydides’s history and for his own philosophy. (shrink)

There have been recent concerns about an “epidemic of loneliness” during the pandemic, given the pervasiveness of loneliness in the population and its harmful effects on health and well-being. Therefore, it is important to establish the correlates of loneliness. The purpose of the current study was to explore how loneliness relates to a construct termed mattering, which is the feeling of being important to other people. Mattering was assessed with multiple measures in the current study (e.g., mattering in general, fears (...) of not mattering, and mattering to peers). A sample of 172 female psychology undergraduate students aged 18–25 years completed self-report measures of general mattering, mattering to peers, anti-mattering, fear of not mattering, and state and trait loneliness. As predicted, lower levels of both general mattering and mattering to peers were associated with higher state loneliness. Higher feelings of anti-mattering (feelings of being invisible and insignificant to others) and fears of not mattering were associated with greater trait loneliness, as well as a reduced sense of mattering to friends. The findings illustrate that feeling as though one does not matter to others (i.e., feeling insignificant and unimportant) is associated with increased state and trait loneliness among young women. Implications are discussed for loneliness theory and how these results can enhance both clinical understanding and practice. (shrink)