First published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

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)

In a special issue of this journal, a range of authors addressed the critical problem of difference in bioethics. To what extent do class, culture, ethnicity, and race affect the ethical decisions that patients and professionals must make in a medical context? Those arguing for an understanding of cultural influences in bioethical decisionmakingtypically argue from the perspective of individual case studies to demonstrate the importance of these social constructs. Others, like Erika Blacksher, however, worry that this approach will obscure the (...) uniqueness of individual decisionmakng patterns, allowing all persons of a single group to be aggregated as if their class, cultural construct, or religious affiliation were the single motive element in their medicolegal decisionmaking. There is, she cautions, a risk of misuse if a professional care provider reflexively assumes individual patient or surrogate reactions on the basis of ethnicity or culture. (shrink)

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We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Recent reforms of the Common Agricultural Policy have led to much discussion of the European multifunctional model of agriculture in both policy and academic circles. Accordingly, European agriculture provides numerous social and environmental benefits and as a result should be supported through a system of payments which directly target those benefits. The agri-environmental measures specified under pillar II of the Common Agricultural Policy are supposed to exemplify the multifunctional model of agriculture, and the macro-level debates surrounding the introduction and evolution (...) of these measures have been the subject of much scholarly research. However, very little research has been conducted into how the actors responsible for implementing these measures at the local level react to the macro-level definitions and interpretations of agri-environmental problems and their solution. This article examines the specific case of the Rural Environmental Protection Scheme in Ireland, focusing on how this scheme is viewed by diverse actors (farmers, government officials, and environmentalists) in the environmentally sensitive area known as the Burren, how these views complement or contradict the narrative of multifunctional agriculture promoted at the EU level of governance, and how this narrative is mediated by a national agri-environmental policy community. Results suggest the need to consider how policy narratives and instruments prominent at the macro-global level of governance enter into the life-worlds, cultures, and ecologies of a variety of actors at the national and local levels of governance, and in the process are reinterpreted, resisted, and transformed. (shrink)

We argue that analyses of civil religious ideologies in civil rights contention must include the interplay of both movement and countermovement ideologies and must recognize the ways in which such discourse amplifies conflict as well as serves as a basis for unity. Based on in-depth interviews, archival research, and content analysis of civil religious language, this article examines how priestly and prophetic civil religious discourses, and the infusion of Black power ideologies, provided significant and dynamic resources for both movement and (...) countermovement ideologies during periods of civil rights contention in Cairo, Illinois, especially from 1969 to 1972. We compare the ways in which Cairo’s civil rights leaders mobilized prophetic versions of civil religion, and concomitantly, how white countermovement organizations used a priestly civil religion. On the prophetic side the themes of “equality,” “freedom,” “justice,” and the “right to revolt” against worldly socio-political arrangements were employed. On the priestly side, the theme of “law” and “order” was played up, with a secondary theme that connected religious acquiescence to worldly power with God’s will. The former rhetoric saw calls for economic and employment integration within God’s will and the nation’s destiny. The latter rhetoric contrasted civil rights claims as essentially “un-American.”. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

To call attention to and motivate action on ethical issues in business or society, messengers often criticize groups for wrongdoing and ask these groups to change their behavior. When criticizing target groups, messengers frequently identify and express concern about harm caused to a victim group, and in the process address a target group by criticizing them for causing this harm and imploring them to change. However, we find that when messengers criticize a target group for causing harm to a victim (...) group in this way—expressing _singular concern_ for the victim group—members of the target group infer, often incorrectly, that the messenger views the target group as less moral and unworthy of concern. This inferred lack of moral concern reduces criticism acceptance and prompts backlash from the target group. To address this problem, we introduce _dual concern_ messaging—messages that simultaneously communicate that a target group causes harm to a victim group and express concern for the target group. A series of several experiments demonstrate that dual concern messages reduce inferences that a critical messenger lacks moral concern for the criticized target group, increase the persuasiveness of the criticism among members of the target group, and reduce backlash from consumers against a corporate messenger. When pursuing justice for victims of a target group, dual concern messages that communicate concern for the victim group _as well as_ the target group are more effective in fostering openness toward criticism, rather than defensiveness, in a target group, thus setting the stage for change. (shrink)

Attention Restoration Theory proposes that exposure to natural environments helps to restore attention. For sustained attention—the ongoing application of focus to a task, the effect appears to be modest, and the underlying mechanisms of attention restoration remain unclear. Exposure to nature may improve attention performance through many means: modulation of alertness and one’s connection to nature were investigated here, in two separate studies. In both studies, participants performed the Sustained Attention to Response Task before and immediately after viewing a meadow, (...) ocean, or urban image for 40 s, and then completed the Perceived Restorativeness Scale. In Study 1, an eye-tracker recorded the participants’ tonic pupil diameter during the SARTs, providing a measure of alertness. In Study 2, the effects of connectedness to nature on SART performance and perceived restoration were studied. In both studies, the image viewed was not associated with participants’ sustained attention performance; both nature images were perceived as equally restorative, and more restorative than the urban image. The image viewed was not associated with changes in alertness. Connectedness to nature was not associated with sustained attention performance, but it did moderate the relation between viewing the natural images and perceived restorativeness; participants reporting a higher connection to nature also reported feeling more restored after viewing the nature, but not the urban, images. Dissociation was found between the physiological and behavioral measures and the perceived restorativeness of the images. The results suggest that restoration associated with nature exposure is not associated with modulation of alertness but is associated with connectedness with nature. (shrink)

Curricular and co-curricular civic engagement activities and programs are analyzed in terms of their capacity to contribute to a common set of outcomes associated with nurturing civic-minded graduates: academic knowledge, familiarity with volunteering and nonprofit sector, knowledge of social issues, communication skills, diversity skills, self-efficacy, and intentions to be involved in communities. Different programs that promote civic-mindedness, developmental models, and assessment strategies that can contribute to program enhancement are presented.

Why civility matters -- It starts with you!: developing self-awareness -- Do what you say and say what you mean: personal and professional integrity -- Good fences make great neighbors: building professional relationships -- Working in the salad bowl: the importance of teamwork -- Eliminate gossip and bullying: the bully-free workplace pledge -- You can't always get what you want: conflict resolution -- Taking it to the extreme: dealing with extreme incivility -- Paving the path to civility: the next step.

“Public health is directly shaped by war, conflict, and capitalism, yet exploring the connections between these processes remains neglected in scholarship and policymaking arenas.” This chapter five lede by social work professors Scott Harding and Kathryn Libal could serve as the epigraph to the entire volume. War and Health is edited by two prominent researchers from Brown University’s Watson Institute Costs of War Project, which seeks a meaningful aggregation of the actual cost of wars, especially those of the new (...) millennium. The volume presents significant findings from nineteen researchers at various institutions, including culturally competent anthropologists. The result is a deep exegesis of syndemics—or synergistic epidemics—that endanger the health of all combatants and civilians. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)