The aim of this article is to explore the complex forms of knowledge involved in diagnostic and interventional decision making by comparing the processes in medicine and nursing, including nurse practitioners. Many authors assert that the practice of clinical decision making involves the application of theoretical knowledge (acquired in the classroom and textbooks) as well as research evidence, upon concrete particular cases. This approach draws on various universal principles and algorithms to facilitate the task. On the other hand, others argue (...) that this involves an intuitive form of judgement that is difficult to teach, one that is acquired principally through experience. In an exploration of these issues, this article consists of three sections. A clarification of terms commonly used when discussing decision making is provided in the first section. In the second section, an epistemological analysis of decision making is presented by examining several perspectives and comparing them for their use in the nursing and medical literature. Bunge's epistemological framework for decision making (based on scientific realism) is explored for its fit with the aims of medicine and nursing. The final section presents a discussion of knowledge utilization and decision making as it relates to the implications for the education and ongoing development of nurse practitioners. It is concluded that Donald Schön's conception of reflective practice best characterizes the skilful conduct of clinical decision making. (shrink)

The purpose of this paper is to examine the various discourses, particularly the dominant instrumental and economic discourses that have brought the phenomena of the nurse practitioner into being. It is proposed that NPs have been constituted as an object of nature and therefore understood metaphorically as a tool or instrument within the health care system to be used efficiently and effectively. Heidegger's philosophical analysis of the question concerning technology is used to argue that our current ways of knowing the (...) NP through these discourses, with their emphasis on calculative logic, have resulted from our modern view of the essence of technology. It is also argued that there is now a need to shape our horizons concerning the NP in new and different ways. There is a need to engage in dialogical forms of research in order to evoke the richness and depth of what it means to be an NP, that is, to reveal the other modes of expression by which we define ourselves, understand others and nursing. (shrink)

This study draws on Kohlberg''s Cognitive Moral Development Theory and Hofstede''s Culture Theory to examine whether cultural differences are associated with variations in ethical reasoning. Ethical reasoning levels for auditors from Australia and China are expected to be different since auditors from China and Australia are also different in terms of the cultural dimensions of long term orientation, power distance, uncertainty avoidance and individualism. The Defining Issues Tests measuring ethical reasoning P scores were distributed to auditors from Australia and China (...) including Hong Kong and The Chinese Mainland. Results show that auditors from Australia have higher ethical reasoning scores than those from China, consistent with Hofstede''s Culture Theory predictions. (shrink)

Benjamin Libet has argued that electrophysiological signs of cortical movement preparation are present before people report having made a conscious decision to move, and that these signs constitute evidence that voluntary movements are initiated unconsciously. This controversial conclusion depends critically on the assumption that the electrophysiological signs recorded by Libet, Gleason, Wright, and Pearl are associated only with preparation for movement. We tested that assumption by comparing the electrophysiological signs before a decision to move with signs present before a decision (...) not to move. There was no evidence of stronger electrophysiological signs before a decision to move than before a decision not to move, so these signs clearly are not specific to movement preparation. We conclude that Libet’s results do not provide evidence that voluntary movements are initiated unconsciously. (shrink)

The idea that our conscious decisions determine our actions has been challenged by a report suggesting that the brain starts to prepare for a movement before the person concerned has consciously decided to move . Libet et al. claimed that their results show that our actions are not consciously initiated. The current article describes two experiments in which we attempted to replicate Libet et al.'s comparison of participants' movement-related brain activity with the reported times of their decisions to move and (...) also the reported times of their decisions of which hand to move. We also looked at the distribution of participants' reports over time to evaluate an alternative explanation of Libet et al.'s results. Although the Readiness Potential was usually present before all of the decisions to move, consistent with the findings of Keller and Heckhausen and Libet et al. , we found that many reported decision times were before the onset of the Lateralized Readiness Potential, which measures hand-specific movement preparation. The latter finding is consistent with the conclusion that the LRP always started after the conscious decision to move. We conclude that even though activity related to movement anticipation may be present before a conscious decision to move, the cortical preparation necessary for the movement to happen immediately may not start until after the conscious decision to move. (shrink)

On the morning of Friday, June 24, 2022, over half of the population of the United States was stripped of a fundamental constitutional right. And, within minutes, the reverberations of the Supreme...

Introduction -- The significance of story -- Morphogenic fields -- The universe story and Christian story -- Morphic resonance : two stories converge -- The "kingdom of God" -- Emerging capacities -- Meditation -- The power of intention -- The fields converge -- A field of compassion -- Manifesting a field of compassion -- Engaging the grace we imagine.

In this article we explore the role of data custodians in establishing and maintaining social licence for the use of personal information in health research. Personal information from population‐level data collections can be used to make significant contributions to health and medical research, but this use is dependent on community acceptance or a social licence. We conducted semi‐structured interviews with data custodians across Australia to better understand data custodians’ views on their roles and responsibilities. This inductive, thematic analysis of the (...) interview data focuses on three factors that contribute to social licence – reciprocity, non‐exploitation and the public good. While the data custodians interviewed did not explicitly frame their role in the context of social licence, their descriptions of their roles and responsibilities clearly indicated that they did have some role to play in building and maintaining social licence. (shrink)

The mental patients' liberation movement, which started in the early 1970s, is a political movement comprised of people who have experienced psychiatric treatment and hospitalization. Its two main goals are developing self-help alternatives to medically-based psychiatric treatment and securing full citizenship rights for people labeled "mentally ill." The movement questions the medical model of "mental illness," and insists that people who have been labeled as "mentally ill" speak on their own behalf and not be represented by others who claim to (...) speak "for" them. The movement has developed its own philosophy, and operates a variety of self-help and mutual support programs in which ex-patients themselves control the services that are offered. Despite obstacles, the movement continues to grow and develop. (shrink)

Biobanks for long-term research pose challenges to the legal and ethical validity of consent to participate. Different models of consent have been proposed to answer some of these challenges. This paper contributes to this discussion by considering the meaning and value of consent to participants in biobanks. Empirical data from a qualitative study is used to provide a participant view of the consent process and to demonstrate that, despite limited understanding of the research, consent provides the research participants with some (...) level of control and a form of self determination that they value. Participation is framed as a moral act of a responsible citizen providing reinforcement of self identity. Consent symbolizes the trust invested in researchers and research institutions to use the biobank for the public good. The paper argues that consent continues to play an important role in biobank participation and that a participant view should inform proposals to modify consent processes. (shrink)

Harm reduction initiatives such as the distribution of naloxone have been crucial in saving lives during the opioid crisis in North America. Despite these efforts, today’s drug supply contaminated...

Business and society researchers, as well as practitioners, have been critiqued for ignoring those with less voice and power often referred to as “fringe stakeholders.” Existing methods used in B&S research often fail to address issues of meaningful participation, voice and power, especially in developing countries. In this article, we stress the utility of visual participatory research methods in B&S research to fill this gap. Through a case study on engaging Ghanaian cocoa farmers on gender inequality issues, we explore how (...) VPR methods may be used by researchers to achieve more inclusive, and thus more credible, stakeholder research that can improve decision making within businesses. Furthermore, we argue that ingrained social and environmental problems tackled by B&S research and the unique context in which they occur may open up new opportunities to develop participatory visual methods for social change. (shrink)

(1999). The lessons and messages of the holocaust as conveyed through Yom Hashoah (holocaust day) commemorations in selected Australian Jewish communities, 1945–1996. The European Legacy: Vol. 4, Postmodern Fascism, pp. 54-71.

There is little doubt that Corporate Social Responsibility (CSR) is now a global concept and a prominent feature of international business, with its practice localised and differing across countries. Despite the growing body of research focussing on CSR in developing countries, there is dearth research on CSR institutionalisation in African countries. Drawing on institutional theory (IT), this article examines the focus and form of CSR practice of companies in Kenya. It is evident from our findings that the nature and orientation (...) of CSR differ across companies with operations only in Kenya and those headquartered abroad or with international operations. Significantly, firm-related drivers such as public relations and performance, as well as global institutional pressures explain the focus and form of CSR in Kenya. This article concludes that for the institutionalisation of CSR in Kenya, attention must be paid to conditions that stifle CSR uptake such as lack of government regulations, and the government's capacity and commitment to enforce regulation. The establishment of functional CSR institutions and a vibrant civil society that advance civil regulation ought to be encouraged. (shrink)

This book undertakes an extensive study of the constellation of two eminent thinkers of post-idealism for the first time. The contributions in this volume analyze the relationship between Schopenhauer and Kierkegaard systematically and historically from a number of thematic perspectives: metaphysics and ethics, freedom and original sin, existential philosophy and the theory of suffering, art and aesthetics, religion and science. The book also goes into Kierkegaard s explicit disagreement with Schopenhauer and last but not least discusses the conflicting poles of (...) idealism and modernity. The volume is rounded off by a first complete and annotated German translation of the notes on Schopenhauer, which Kierkegaard wrote in his late journals.". (shrink)

The growing global prominence of Chinese state-owned enterprises brings new dimensions to our understanding of multi-national corporations and human rights issues. This article constructs a three-level framework that enables the mapping of transnational, national, and intra-organizational human rights pressures, and uses this framework to identify and analyze the human rights that Chinese SOEs report concern with. The analysis provided suggests that while China’s most global SOEs are subject to transnational pressures to respect all human rights, such pressures appear outweighed by (...) those encouraging them to concentrate on only some human rights within their national and intra-organizational environment. The article concludes by identifying a number of ways in which our conceptual framework and empirical findings can inform future research. (shrink)

From a twenty-first century partnership between bioethics and neuroscience, the modern field of neuroethics is emerging, and technologies enabling functional neuroimaging with unprecedented sensitivity have brought new ethical, social and legal issues to the forefront. Some issues, akin to those surrounding modern genetics, raise critical questions regarding prediction of disease, privacy and identity. However, with new and still-evolving insights into our neurobiology and previously unquantifiable features of profoundly personal behaviors such as social attitude, value and moral agency, the difficulty of (...) carefully and properly interpreting the relationship between brain findings and our own self-concept is unprecedented. Therefore, while the ethics of genetics provides a legitimate starting point - even a backbone - for tackling ethical issues in neuroimaging, they do not suffice. Drawing on recent neuroimaging findings and their plausible real-world applications, we argue that interpretation of neuroimaging data is a key epistemological and ethical challenge. This challenge is two-fold. First, at the scientific level, the sheer complexity of neuroscience research poses challenges for integration of knowledge and meaningful interpretation of data. Second, at the social and cultural level, we find that interpretations of imaging studies are bound by cultural and anthropological frameworks. In particular, the introduction of concepts of self and personhood in neuroimaging illustrates the interaction of interpretation levels and is a major reason why ethical reflection on genetics will only partially help settle neuroethical issues. Indeed, ethical interpretation of such findings will necessitate not only traditional bioethical input but also a wider perspective on the construction of scientific knowledge. (shrink)

Courtin, Judy As a young girl in the 1960s, I attended a Catholic boarding school. The nuns could be scary. When they walked the wintry and un-illuminated corridors of the convent, their knee-length rosary beads jangled against their ankle-length black habits.

Recent advances in the brain sciences have dramatically improved our understanding of brain function. As we find out more and more about what makes us tick, we must stop and consider the ethical implications of this new found knowledge. This ground-breaking book on the emerging field of neuroethics answers many pertinent questions, such as: What makes monitoring and manipulating the human brain so ethically challenging? Will having a new biology of the brain through imaging make us less responsible for our (...) behavior and lose our free will? Should certain brain scan studies be disallowed on the basis of moral grounds? A distinguished group of contributors from a wide range of fields make this an invaluable introduction to neuroethics. (shrink)

This article explores how the shift from print to electronic calendars materializes and exacerbates a distinctively quantitative, “spreadsheet” orientation to time. Drawing on interviews with engineers, I argue that calendaring systems are emblematic of a larger design rationale in Silicon Valley to mechanize human thought and action in order to make them more efficient and reliable. The belief that technology can be profitably employed to control and manage time has a long history and continues to animate contemporary sociotechnical imaginaries of (...) what automation will deliver. In the current moment we live in the age of the algorithm and machine learning, so it is no wonder, then, that the contemporary design of digital calendars is driven by a vision of intelligent time management. As I go on to show in the second part of the article, this vision is increasingly realized in the form of intelligent digital assistants whose tracking capacities and behavioral algorithms aim to solve life’s existential problem—how best to organize the time of our lives. This article contributes to STS scholarship on the role of technological artifacts in generating new temporalities that shape people’s perception of time, how they act in the world, and how they understand themselves. (shrink)

The handbook contains more than 50 chapters by leaders from around the world and a broad range of sectors of academia and clinical practice spanning the ...

Recent advances in the brain sciences have dramatically improved our understanding of brain function. As we find out more and more about what makes us tick, we must stop and consider the ethical implications of this new found knowledge. Will having a new biology of the brain through imaging make us less responsible for our behavior and lose our free will? Should certain brain scan studies be disallowed on the basis of moral grounds? Why is the media so interested in (...) reporting results of brain imaging studies? What ethical lessons from the past can best inform the future of brain imaging? These compelling questions and many more are tackled by a distinguished group of contributors to this volume on neuroethics. The wide range of disciplinary backgrounds that the authors represent, from neuroscience, bioethics and philosophy, to law, social and health care policy, education, religion and film, allow for profoundly insightful and provocative answers to these questions, and open up the door to a host of new ones. The contributions highlight the timeliness of modern neuroethics today, and assure the longevity and importance of neuroethics for generations to come. (shrink)

Aim: Explore nurses’ values and perceptions regarding the practice of medical aid in dying. Background: Medical aid in dying is becoming increasing legal in the United States. The laws and American Nurses Association documents limit nursing involvement in this practice. Nurses’ values regarding this controversial topic are poorly understood. Methodology: Cross-sectional electronic survey design sent to nurse members of the American Nurses Association. Inductive thematic content analysis was applied to open-ended comments. Ethical Considerations: Approved by the institutional review board (#191046). (...) Participants: 1213 nurses provided 3639 open-ended comments. More than 80% of participants self-identified as white 58% held a graduate degree; and half were of Christian faith. Results: Values ranged on a continuum expressed through four themes: “Honoring Patient Autonomy without Judgment,” “Honoring with Limitations,” “Not until...,” and “Adamantly against.” Some felt it was a duty to honor the patients’ wishes, set aside own beliefs, and respect patients’ choices often with a spiritual connotation. Nurses held concerns about the process, policy, potential psychological harm, legal risk, and the need to learn more about MAID. Nurse who were adamantly against MAID associated the practice with murder/suicide and against religious beliefs. Disparate values were expressed about changing the MAID legislation to allow patient support with taking MAID medications and allowing MAID via advance directive. Conclusions: Nurses desire more education on MAID. There is not one universally held position on the nurse’s role during MAID. Healthcare policy/standards need to accommodate the wide variation in nurses’ values. Implications: Nurses desire education regarding their role in MAID. Nurses are encouraged to participate in policy discussions as the practice becomes increasingly legal. Managers need to expect that nurses, patients, and families will need psychological support to participate in MAID. Careful construction of policy/standards is needed to minimize conflict, moral distress, and psychological harm amongst nurses. Further research is needed. (shrink)

This paper reports the results of a survey completed by 565 human resource professionals in the Canadian provinces of Alberta and Saskatchewan. The major result suggests that individuals who are more dependent on their employing organizations are more likely to comply with organizational pressures to behave unethically. Factor analysis of our dependent measure of ethical organizational behavior suggested that two distinct constructs were being tapped; furthermore, different variables were found to predict each. The potential for conceptualizing unethical organizational behavior as (...) multidimensional is discussed. (shrink)

This paper reviews major structural drivers of place-based health disparities in the context of Canada, an industrialized nation with a strong public health system. Likelihood that the COVID-19 pandemic will facilitate rejuvenation of Canada’s northern and remote areas through remote working, advances in online teaching and learning, and the increased use of telemedicine are also examined. The paper concludes by identifying some common themes to address healthcare disparities for northern and remote Canadian residents.

Very young children occasionally commit scale errors, which involve a dramatic dissociation between planning and control: A child's visual representation of the size of a miniature object is not used in planning an action on it, but is used in the control of the action. Glover's planning–control model offers a very useful framework for analyzing this newly documented phenomenon.

Corporate community involvement is often regarded as means of development in developing countries. However, CCI is often criticised for patronage and insensitivity both to context and local priorities. A key concern is the extent of 'community participation' in corporate social decision-making. Community participation in CCI offers an opportunity for these criticisms to be addressed. This paper presents findings of research examining community participation in CCI governance undertaken by Magadi Soda Company in Kenya. We draw on socio-political governance and interaction theories (...) to examine the institutionalisation of participatory decision-making and its impact on changing governing roles and social action in CCI over time. (shrink)

This discussion is grounded in Aristotelian–Thomistic realism and takes the position that nursing is a practical science. As an exposition of the title statement, distinctions are made between opinion and truth, and the speculative, productive and practical sciences. Sources of opinion and truth are described and a discussion follows that truth can be achieved through knowing principles and causes of the natural kind behind phenomena. It is proposed that humans are the natural kind behind nursing phenomena. Thus, human nature provides (...) proper principles (the truth) of nursing practice. (shrink)

Changes in attitude toward intellectual property are covered here.