Open-uterine surgery to repair spina bifida, or ‘fetal surgery of open neural tube defects,’ has generated questions throughout its history—and continues to do so in a variety of contexts. As clinical ethics consultants who worked (Mark J. Bliton) and trained (Virginia L. Bartlett) at Vanderbilt University—where the first successful cases of open-uterine repair of spina bifida were carried out—we lived with these questions for nearly two decades. We worked with clinicians as they were developing and offering the procedure, with (...) researchers in refining and studying the procedure, and with pregnant women and their partners as they considered whether to undergo the procedure. From this experience in the early studies at Vanderbilt, we learned that pregnant women and their partners approach the clinical uncertainty of such a risky procedure with a curious and unique combination of practicality, self-reflection, fear, and overwhelming hope. These early experiences were a major contributing factor to the inclusion of an ethics-focused interview in the informed consent process for the Management of Myelomeningocele Study (MOMS) trial study design. (shrink)

Bruno and Arora (2018) present a range of important ethical issues emerging from the development of procedures for uterine transplant (UT). They approach those issues by drawing on parallels to oth...

Despite increased attention to the question of how best to evaluate clinical ethics consultations and emphasis on external evaluation, there has been little sustained focus on how we, as clinicians, make sense of and learn from our own experiences in the midst of any one consultation. Questions of how we evaluate the request for, unfolding of, and conclusion of any specific ethics consultation are often overlooked, along with the underlying question of whether it is possible to give an accurate account (...) of clinical ethics consultants’ experience as experienced by ethics consultants. Before the challenge of submitting one’s accounts or case reports for review and evaluation from others, there is an underlying challenge of understanding and evaluating our own accounts. To highlight this crucial and deeply challenging dimension of actual clinical ethics practice, we present an account of a complex consultation, explicitly constructed to engage the reader in the unfolding experience of the consultant by emphasizing the multiple perspectives unfolding within the consultant’s experience. Written in script format, the three perspectives presented—prototypical clinically descriptive account; didactically reflective and self-evidentiary account often seen in journal presentations; highly self-critical reflective account emphasizing uncertainties inherent to clinical ethics practice—reflect different manners for responding to the ways actual clinical involvement in ethics consultation practice accentuates and refocuses the question of how to understand and evaluate our own work, as well as that of our colleagues. (shrink)

Against the background assumptions that knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service. These evaluations were collected through (...) a quality assessment effort at our institution. Drawing from the qualitative elements of our survey instrument, we describe unexpected variations among the requests for ethics consultation and the retrospective reports from those colleagues making the requests. Focusing on just one aspect – the reason for request – raised several core questions about how we should evaluate those retrospective reports, what could be learned from the differences that we were now encountering, and what we could learn about the process of evaluating our practices. Working through these questions, we suggest several issues to consider in ongoing efforts to describe and evaluate clinical ethics consultation: the role of time and memory in evaluating retrospective evaluations, the importance of attending to the language of moral shift or disruption with which our colleagues describe their experiences, and how to understand the role of ethics consultation in creating ‘moral space’ for colleagues to process their moral experiences. (shrink)

Since the concept of the living wills emerged nearly 50 years ago, there have been practical challenges in translating the concept of an advance directive into documents that are clinically useful across various healthcare settings and among different patient populations and cultures. Especially, challenging has been the reliance in most ADs on pre-selected “choices” about specific interventions which either revolve around broad themes or whether or not to utilize particular interventions, both of which about most laypersons know little and, more (...) importantly, lacking context, prove to be of limited meaningfulness. Moreover, whether by foundational frame, decade-long misunderstanding in medicine and bioethics, or different societal customs, these ADs present decision-making responsibility for initiating, continuing, or withdrawing medical interventions as a patient responsibility—creating a burden for which most patients are unprepared—and hence reducing healthcare providers’ responsibility to mere technical application or customer service. At our institution, significant efforts have focused on embracing the unique and complementary responsibilities of patients and physicians for enabling appropriate plans of care. This includes re-structuring our AD form to more accurately represent patient’s values as the frame within which physicians are responsible for determining appropriate care. Rather than specifying interventions, the AD makes patients responsible for specifying what matters to them as well as what they value in terms of function, interaction, and level of acceptable burden, thus providing clear goals for clinicians to pursue—or when goals are not reachable by available medical interventions, to acknowledge and allow for logical shifts to what may be achieved, including, in end of life contexts, care focused on respect and dignity. (shrink)

“If philosophy is essentially this activity of questioning and responding, that is, dialogue…” ∼ R.M. Zaner (The Way of Phenomenology)“Not to philosophize is to philosophize still.” E. Lévinas (“Go...

Volume 19, Issue 10, October 2019, Page 43-46.

In Galatians, Paul points to a God who reaches out to all of humankind in Jesus Christ. It is not what we work but what God works in us that shapes faithful Christian living.

Without question, preaching can profit immensely from the literary and imaginative construal of biblical texts. To affirm this, however, is not to say that preachers can therefore dispense with doing their historical-critical homework.

Clinical ethics consultants (CECs) work in complex environments ripe with multiple types of expectations. Significantly, some are due to the perspectives of professional colleagues and the patients and families with whom CECs consult and concern how CECs can, do, or should function, thus adding to the moral complexity faced by CECs in those particular circumstances. We outline six such common expectations: Ethics Police, Ethics Equalizer, Ethics Superhero, Ethics Expediter, Ethics Healer or Ameliorator, and, finally, Ethics Expert. Framed by examples of (...) requests for ethics consultation that illustrate each kind, along with brief descriptions, we argue that while these expectations ought to be resisted for clear and practical reasons, they also create opportunities for CECs to articulate, educate, and ultimately be responsible to the professional demands of clinical ethics work. Recognizing, acknowledging, and at times resisting those expectations thus become key activities and responsibilities in the performance of ethics consultation. (shrink)

Furthermore, adults with decision-making capacity, including pregnant women, can currently accept interventions with moderate net risks for themselves in other settings (e.g., open f...

W. H. Auden, the sometimes Greta Garbo of twentieth-century poetry, once told Stephen Spender that he liked America better than England because in America one could be alone. Further, in his introduction to The Criterion Book of Modern American Verse Auden remarked that while in England poets are considered members of a “clerkly caste,” in America they are an “aristocracy of one.” Certainly it does seem to be the individual poet—Whitman, Williams, Olson, Plath, O’Hara, Ginsberg—who has altered the landscape of (...) American poetry and prosody, not the group. And most American literary “movements,” as Robert Creeley has pointed out, are simply comprised of a few people who on occasion drink together, and who are as likely as not to end the evening in violent argument over an aesthetic or political point. Yet the notion of schools or movements remains, in mainstream historical criticism at least, a vital one. How many introductions to anthologies of American poetry, for example, continue to use such rubrics as the Transcendentals, the Populists, the Black Mountain poets, the Beats, the New York group? And while established poets often rebel from any sense that they are part of a larger community, which by definition is self-limiting, they are often complicit in their initial categorization. For poets as well as critics the idea of a school is often a useful fiction serving as both a kind of protective hothouse and a platform for getting a hearing.The most recent “group” of American poets—the first since the anthology wars of the early sixties really to be of more than passing interest and perhaps to be actually capable of bringing about a major shift of attention in American poetry and poetics—is the so-called “Language” school. Individual volumes by poets often considered part of this group number well into three figures now and there have been important journals and anthologies produced in a serious and sustained fashion by these writers. Yet in part because of what seems the essentially hermetic character of the project , there has been little notice of this activity by academic critics or reviewers.1 What I’d like to do here is briefly map a few major aspects of the territory, describing some of the practical and theoretical questions which seem to occupy many of these writers in their ongoing critique of the “workshop poem.” 1. Two important exceptions are discussions of some of this work in Stephen Fredman, Poet’s Prose: The Crisis in American Verse and Marjorie Perloff’s review “The Word as Such: L=A=N=G=U=A=G=E Poetry in the Eighties,” American Poetry Review 13 : 15-22. All further references to Perloff’s article, abbreviated “WS,” will be included in the text. For a discussion of the various Language poetry journals and anthologies, see my chapter “American Poetry, 1940s to the Present” in American Literary Scholarship: An Annual/1983, ed. Warren French , pp. 349-74. Lee Bartlett, an associate professor of English, has directed the University of New Mexico’s creative writing program for five years. Coeditor of the critical journal American Poetry, his Talking Poetry: Conversations in the Workshop with Contemporary Poets will be published this fall. Currently he is writing a biography of William Everson. (shrink)

Recovering Reason: Essays in Honor of Thomas L. Pangle is a collection of essays composed by students and friends of Thomas L. Pangle to honor his seminal work and outstanding guidance in the study of political philosophy. These essays examine both Socrates' and modern political philosophers' attempts to answer the question of the right life for human beings, as those attempts are introduced and elaborated in the work of thinkers from Homer and Thucydides to Nietzsche and Charles Taylor.

This volume brings together four papers by Peter Achinstein, Peter Geach, Wesley Salmon, and J. L. Mackie. Achinstein's paper Is "The Object of Explanation"; Geach's is "Teleological Explanation"; Salmon's is "Theoretical Explanation"; and Mackie's is "Ideological Explanation." /// This review summarizes each author's claims.

Following the publication of his magnum opus L’être et l’événement (Being and Event) in 1988, Alain Badiou has been acclaimed as one of France’s greatest living philosophers. Since then, he has released a dozen books, including Manifesto for Philosophy, Conditions, Metapolitics and Logiques des mondes (Logics of Worlds), many of which are now available in English translation. Badiou writes on an extraordinary array of topics, and his work has already had an impact upon studies in the history of philosophy, the (...) history and philosophy of science, political philosophy, aesthetics, psychoanalysis, and ontology. This volume takes up the challenge of explicating, extending and, in many places, criticising Badiou’s stunningly original theses. Above all, the essays collected here put Badiou’s concepts to the test in a confrontation with the four great headings that he himself has identified as essential to our humanity: science, love, art and politics. Many of the contributors have already been recognised as outstanding translators of and commentators on Badiou’s work; they appear here with fresh voices also destined to make a mark. (shrink)

Abstract:Comparatively few studies have analyzed the social behavior of multinational corporations (MNCs) at a cross-national level. To address this gap in the literature, we propose a “transnational” model of corporate social responsibility (CSR) that permits identification of universal domains, yet incorporates the flexibility and adaptability demanded by international research. The model is tri-dimensional in that it juxtaposes: 1) Bartlett and Ghoshal’s (1998, 2000) typology of MNC strategies (multinational, global, “international,” and transnational); 2) the three conceptual domains of CSR (human (...) rights, labor, and the environment) proposed by the UN Global Compact (Compact 2003); and 3) Zenisek’s (1979) description of three CSR perspectives (ideological, societal, and operational). The end result is a multidimensional typology that permits the organization and development of empirical CSR research in an international setting. (shrink)

Abstract:Comparatively few studies have analyzed the social behavior of multinational corporations (MNCs) at a cross-national level. To address this gap in the literature, we propose a “transnational” model of corporate social responsibility (CSR) that permits identification of universal domains, yet incorporates the flexibility and adaptability demanded by international research. The model is tri-dimensional in that it juxtaposes: 1) Bartlett and Ghoshal’s (1998, 2000) typology of MNC strategies (multinational, global, “international,” and transnational); 2) the three conceptual domains of CSR (human (...) rights, labor, and the environment) proposed by the UN Global Compact (Compact 2003); and 3) Zenisek’s (1979) description of three CSR perspectives (ideological, societal, and operational). The end result is a multidimensional typology that permits the organization and development of empirical CSR research in an international setting. (shrink)

This is the first collection dedicated to presenting research directly influenced by the innovative and groundbreaking ideas of the eminent linguist Ruqaiya Hasan. The collection offers an insight into the breadth and depth of Hasan's distinctive linguistic approaches and theoretical concerns. The chapters cover areas such as verbal art, context of situation, semantic networks, cohesive harmony, text structure and literacy education, contributed by well-known scholars in the field such as M.A.K. Halliday, Geoffrey Williams, David Butt, Donna Miller, Wendy L. Bowcher, (...) Tom Bartlett and Margaret Berry. The volume contains an interview with Ruqaiya Hasan by David Butt and Jennifer Yameng Liang, and a section in which the contributors describe their connection and/or history with Ruqaiya Hasan and her work. This book is of particular value to scholars and students working in sociolinguistics, literary criticism, stylistics, functional linguistic theories, literacy pedagogy, social semiotics, multimodality and applied linguistics. (shrink)

Turkey has passed the import substitution economic model to a new model of the economy called open out since 1980. Along with the neoliberal policies implemented, the process of integration with the global economy has begun. The incomes of the religious people who cannot be excluded from the effects of this articulation also increased and their consumption behaviors has changed. On the other hand, some transport elements, especially the media, have enabled consumption codes to reach different segments. The new values (...) emerged in this process also caused transformations in individual consumption trends. In this study, the "Scale of Consumption Dynamics" (SCD) was developed in order to identify the trends of consumption of devotees and to find out how they changed. Quantitative research approach was adopted in the study and the datas were collected by face-to-face survey technique. The individuals included in our sample were selected by quota sampling. In this study, an expression pool was created as a result of literature review, expert opinion consultation, brainstorming with academicians and observations. The validity and reliability analysis of the scale was made using different statistics through the SPSS program. As a result of these steps, the dimensions of the scale consisting of 16 items and 3 dimensions are called "showy consumption", "wasteful consumption" and "religious priority consumption". Summary: The first studies on consumption history and sociology belong to Marx, Weber, Veblen and Simmel. In these studies consumption is examined as a part of production process and consumption forms were investigated as a social class aspect. Consumption phenomenon was later studied under critical approach (Frankfurt School) with Adorno, Max Horkheimer, Herbert Marcuse and Erich Fromm’s theories. Theorists at Frankfurt School study how social structure steers individuals to consumption. After the 1970’s, the meaning of consumption phenomenon has changed. There are studies by Jean Baudrillard, Mike Featherstone, George Ritzer, and Zygmunt Bauman on changing phenomenon of consumption. It is widely believed that modern consumption phenomenon was originated in the USA after the World War II. After the war Keynesian economic policies and Fordist consumption forms later influenced other Western nations. After 1950’s and 1960’s mass consumption was initiated in the USA and except very poor sections of the nations, other social classes, it started to spread out in Europe, the USA, and other countries. In 1970’s and 1980’s, it has merged with individuals’ identity definitions. After 1980’s in Turkey a new economic policy instead of import substitution was adopted. In application along with neo liberal policies, Turkey started to integrate to the rest of the World. Religious people as well influenced these changes and their incomes have increased along with their consumption habits. In addition to media, some other forms of communication channels have carried new consumption habits to other sections of the society. With the increased effects of mass communication media, new social sections have emerged and their cultural characteristics have become the norms of the whole society. A new values created in this process also transformed the consumption habits. In this article, in order to assess consumption habits of religious people as it is now and to understand which direction these habits evolve, Consumption Dynamics Scale (CDS) has been developed. Scales are widely used when a researcher tries to identify and measure respondents’ feelings and ideas on a subject matter. There are different scales used in social sciences such as Thurstone, Likert, Guttman, and Bogardus that are among the most widely used ones. A Likert Type scale has been used in this study. In the first phase of the study and pilot study 5 point Likert scale and in the second phase of the study 10 point Likert scales was used to collect the data. We could not come across with any study in the literature on investigating consumption characteristics Dynamics of individuals with a formal religious education. In the study, quantitative research method has been adopted and the research data has been collected with face to face administration of the survey instrument. The scale development phase lasted about 6 months from August, 2016. Based on 3% error rate, we determined to sufficient sample size as 516, yet we reached 600 individuals and end up with 563 usable responses. Sample has been determined with quota sampling methodology. We formed a pool of statements based on literature review, expert opinion, brain storming with academicians. 49 questions have been selected from the question pool where 93 questions were found, then they are merged, some questions are changed or totally eliminated and final 30 questioned questionnaires made ready for pilot study. Two pilot studies have been carried out. In the first pilot study, 47 people are reached and 30 questions with Likert scales have been administered. In the second phase of the study, 10 point Likert scales with 57 questions has been given to 54 individuals. After pilot studies, data was analyzed with SPSS 20 version and 32 questioned final survey instrument has been formed. In order to check sufficiency of data set for Factor Analysis Kaisser-Meyer-Olkin (KMO) test and the relationships among variables Bartlett test were used. Sample composed of 563 responses revealed significant results (3358,808, p=0,000) and KMO test revealed (KMO=0,812) value. After expletory factor analysis, factor loading less than 0,40 were deleted from the scale. Hence the final structure is composed of 29 questions with 8 different factors. The reliability of scales were calculated with Cronbach Alfa analysis separately for each dimension. After reliability analysis, items with 0,60 and less reliability score were taken out from the scales. Finally 16 items were made up 3 dimensions namely “ostentatious consumption”, “wasteful consumption”, and “religious priority consumption”. The items in Factor 1 are related with luxury, fashion and statue, in Factor 2 desire to make more shopping, purchase without need, advertisement and showcase, and factor 3 religious sensitive reference focus and religion first purchasing are decided as appropriate names. Based on the analysis, measurement was decided valid and sound. Therefore, this study is believed to contribute significantly to the existing literature. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...