Over the past decade, we have witnessed some early signs of progress in the battle against international bribery and corruption, a problem that throughout the history of commerce had previously been ignored. We present a model that we then use to assess progress in reducing bribery. The model components include both hard law and soft law legislation components and enforcement and compliance components. We begin by summarizing the literature that convincingly argues that bribery is an immoral and unethical practice and (...) that the economic harm it causes falls most heavily on those least able to absorb it. The next section summarizes the main provisions of anti-bribery legislation including the Foreign Corrupt Practices Act (FCPA), the Organization for Eco nomic Development's Convention on Combating Bribery of Foreign Officials in International Business Transactions, the United Nations Convention Against Corruption and the laws of selected countries. We conclude this section with a discussion of the "moral imperialism" argument for not imposing Western laws and values on other cultures. The next section focuses on the roles played by NGOs including Transparency International (TI), the World Economic Forum (WEF), and the International Chamber of Commerce. We review trends in enforcement and prosecution, including a review of the United States' enforcement processes, mechanisms for cross-border legal assistance, a discussion of the distinctive nature of FCPA cases, and an assessment of what the future holds for enforcement. The final section focuses on compliance processes for corporations aimed at reducing the risk of FCPA and related violations. This section also addresses the ethics of gift giving and "grease" payments. The article concludes with a summary and suggestions for further research. Throughout the article, we reference important bribery cases and include comments from several authorities who are on the front lines of the battle against international bribery. (shrink)

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...) implementing system-wide ethics consultation services. Specifically, we identify four models for organizing, developing, and enhancing ethics consultation activities within a system created through acquisitions: train-the-trainer, local capacity-building, circuit-riding, and consolidated accountability. We note each model’s benefits and challenges. To our knowledge, this is the first paper to consider the broader landscape of issues affected by consolidation. We anticipate that clinical ethicists, volunteer consultants, and hospital administrators will benefit from our recommendations. (shrink)

Volume 19, Issue 11, November 2019, Page 42-44.

Archéologie d'un même geste d'exclusion dont l'internement social de la folie et l'internement métaphysique de la déraison sont les effets, l'Histoire de la folie à l'âge classique décide de voir en Descartes le théoricien de cet acte violent de fondation de la raison occidentale. Après avoir exposé la polémique Foucault — Derrida, nous nous proposons, d'une part, d'identifier la « positivité » propre au discours foucaldien de la période « archéologique » et, d'autre part, de reprendre à notre compte la (...) lecture de Descartes. Nous espérons alors montrer que le « coup de force » cartésien ne vise nullement à exclure la folie mais, au contraire, à forger rationnellement la fiction d'un monde qui serait sans ordre. Le monde sensible devient le lieu d'un simulacre, et ce qui le rend fascinant c'est la catastrophe imaginaire qu'il y a derrière, savoir la nature peut-être irrationnelle de l'univers. C'est de la nécessité de cette fiction que le sujet pensant va pouvoir émerger comme le lieu de la critique.Being an archeology which, in a single excluding movement, produces the social confinement of madness and the metaphysical confinement of un-reason, The History of Madness in the Classical Age decides to see in Descartes the theoretician of this violent act of foundation of Western reason. After a presentation of the Foucault — Derrida polemic, the attempt is made, on the one hand, to identify the "positivity" proper to the Foucauldian discourse of the "archeological" period and, on the other hand, to re-read Descartes in a new light. One hopes to show that the Cartesian "revolution" in no way attempts to exclude madness but, on the contrary, to forge rationally the fiction of a world which would be without order. The sense world becomes the world of appearances, and what makes it fascinating is the imaginary catastrophe behind it, the knowledge of theperhaps irrational nature of the universe. It is by the necessity of this fiction that the thinking subject is going to be able to emerge as the place where the critique occurs. (shrink)

L’exemple espagnol de Podemos montre comment sortir positivement des limites de l’horizontalité du mouvement, à la fois si riche et infructueuse, et comment agencer un geste politique d’autoconstitution, d’organisation et de représentation. Ce passage de l’horizontalité à la verticalité, de l’agitation et de la résistance du mouvement vers le travail de gouvernement pose non seulement des questions de spatialité, mais surtout des questions de temporalité, de durée. L’important passe par la (re)création d’un flux de mouvement politique, un système ouvert de (...) gouvernance depuis le bas qui maintient unis mouvement et gouvernement – par le débat constituant constant et par une extension de ce débat aux citoyens. (shrink)

A Pulitzer Prize–winning dance critic teaches us to appreciate—and enact—grace in every dimension, from the physical to the emotional. Grace has long been taught as essential to civilized living. The Three Graces—goddesses of charm, beauty, and creativity—exemplify ease and harmony with one another and the world around them. But what has happened to this simple, marvelous concept of being at ease in the world? With warmth, humor, and an ever-perceptive eye, Sarah L. Kaufman sifts the graceful from the graceless, celebrating (...) heart-catching moments of physical elegance in sports, movies, dance, fashion, and music; rare sightings of celebrity grace; the secrets of gracious hosts; and grace found unexpectedly, in the kitchen of a high-end restaurant and among strippers in a basement bar. Kaufman’s thought-provoking reflections on these physical and social acts of grace offer hope for even the clumsiest, most awkward among us. Guided by the muse of Cary Grant (with further inspiration from Smokey Robinson, Roger Federer, Nelson Mandela, Margot Fonteyn, Amy Purdy, Beyoncé, and others), Kaufman illuminates the importance of grace in the small moments of everyday life. In The Art of Grace, she inspires us to walk taller, spend time on unnecessary kindnesses, and celebrate the grace notes in our lives and those of others. (shrink)

Ce volume collectif accompagne, à quelques mois d’intervalle, la publication de l’édition critique des textes consacrés par Bentham à l’Australie (_Panopticon versus New South Wales and other writings on Australia_) chez UCL Press sous la direction de Tim Causer et Philip Schofield. Les versions numériques des deux ouvrages sont disponibles en accès ouvert sur le site de l’éditeur. Bentham consacre un premier essai au système pénal en Australie en 1791, à peine six ans après le début des déportations de prisonniers (...) vers la nouvelle colonie carcérale. Il s’oppose sans relâche à cette politique et tente de démontrer que son propre projet de prison panoptique est à la fois plus efficace et moins coûteux pour punir les criminels et conduire à leur réforme. En 1801, au moment où le ministère rejette définitivement la construction du panoptique près de Londres, Bentham érige les colonies australiennes en symboles de la corruption de la constitution et de la malhonnêteté des membres du gouve... (shrink)

The epistemology of modality has focused on metaphysical modality and, more recently, counterfactual conditionals. Knowledge of kinds of modality that are not metaphysical has so far gone largely unexplored. Yet other theoretically interesting kinds of modality, such as nomic, practical, and ‘easy’ possibility, are no less puzzling epistemologically. Could Clinton easily have won the 2016 presidential election—was it an easy possibility? Given that she didn’t in fact win the election, how, if at all, can we know whether she easily could (...) have? This paper investigates the epistemology of the broad category of ‘objective’ modality, of which metaphysical modality is a special, limiting case. It argues that the same cognitive mechanisms that are capable of producing knowledge of metaphysical modality are also capable of producing knowledge of all other objective modalities. This conclusion can be used to explain the roles of counterfactual reasoning and the imagination in the epistemology of objective modality. (shrink)

Lack of guidance and regulation for authorizing medical cannabis for conditions involving the health and neurodevelopment of children is ethically problematic as it promulgates access inequities, risk-benefit inconsistencies, and inadequate consent mechanisms. In two virtual sessions using participatory action research and consensus-building methods, we obtained perspectives of stakeholders on ethics and medical cannabis for children and youth. The sessions focused on the scientific and regulatory landscape of medical cannabis, surrogate decision-making and assent, and the social and political culture of medical (...) cannabis. We found that evidence-gathering and data dissemination, pressures on clinical relationships, and the lack of integration of culturally diverse perspectives and Indigenous knowledges were key areas of concern. Participants emphasized the importance of utilizing adaptive study designs, highlighted the importance of trust-building between clinicians, patients and caregivers, and discussed barriers including historical and ongoing stigmatization of medical cannabis. We conclude that continued public consultation and strength-based research that integrate diverse perspectives are critical steps forward. (shrink)

This article surveys recent developments in the epistemology of modality.

It is widely assumed that sense perception cannot deliver knowledge of nonactual (metaphysical) possibilities. We are not supposed to be able to know that a proposition p is necessary or that p is possible (if p is false) by sense perception. This paper aims to establish that the role of sense perception is not so limited. It argues that we can know lots of modal facts by perception. While the most straightforward examples concern possibility and contingency, others concern necessity and (...) impossibility. The possibility of a perceptual route to some modal knowledge is not as radical as it may at first sound. On the contrary, acknowledging it has benefits. (shrink)

This essay examines the work of Nancy Fraser and Seyla Benhabib, two philosophers who have demonstrated that feminist theorists can usefully draw upon both postmodernism and the critical theory tradition, with which Fraser and Benhabib are more clearly associated. I argue that each theorist claims the universal ideals and normative judgements of modernism, and the contextualism, particularity, and skepticism of postmodernism. I do this by revisiting each of their positions in the now well-known Feminist Contentions exchange, by examining the diverse (...) ways in which they reconcile universalism and difference, and by exploring each theorist's critique of the Habermasian public sphere. (shrink)

This paper examines "moderate modal skepticism", a form of skepticism about metaphysical modality defended by Peter van Inwagen in order to blunt the force of certain modal arguments in the philosophy of religion. Van Inwagen’s argument for moderate modal skepticism assumes Yablo's (1993) influential world-based epistemology of possibility. We raise two problems for this epistemology of possibility, which undermine van Inwagen's argument. We then consider how one might motivate moderate modal skepticism by relying on a different epistemology of possibility, which (...) does not face these problems: Williamson’s (2007: ch. 5) counterfactual-based epistemology. Two ways of motivating moderate modal skepticism within that framework are found unpromising. Nevertheless, we also find a way of vindicating an epistemological thesis that, while weaker than moderate modal skepticism, is strong enough to support the methodological moral van Inwagen wishes to draw. (shrink)

Developing a simple test to identify swiftly neonates with sepsis who carry the genetic variant which means that one dose of the recommended antibiotic, gentamicin, will cause the child to become profoundly deaf looks like an admirable objective. The baby needs antibiotics and needs them within 1 hour of admission to the neonatal intensive care unit. Conventional genetic tests take much longer to yield results. The test being trialled produces results in 25 min; a baby who carries the variant can (...) be treated with a different antibiotic. All the test requires is a gentle swab of the baby’s inner cheek. Babies can be treated for potentially fatal sepsis without the risk that the drugs designed to save their lives will cost them their hearing. Parents and healthcare staff are relieved of worry—a great idea? PALOH is not a trial of the safety or efficacy of the test, only to assess how feasible it will be to carry out this test in a busy NICU, without disrupting the care of the baby. A tiny painless ‘scrape’ will take a sample of DNA—what’s the fuss about? Several other invasive and painful procedures will be carried out without a fuss.1 The problem is DNA. Genetic information must be safeguarded from falling into the wrong hands. In section 45 of Human Tissue Act 2004, Parliament legislated to prohibit non-consensual DNA testing.1 It fits uncomfortably in a statute designed to regulate retention and uses of human material, after revelations that organs and tissue from the …. (shrink)

The COVID-19 pandemic put a large burden on many healthcare systems, causing fears about resource scarcity and triage. Several COVID-19 guidelines included age as an explicit factor and practices of both triage and ‘anticipatory triage’ likely limited access to hospital care for elderly patients, especially those in care homes. To ensure the legitimacy of triage guidelines, which affect the public, it is important to engage the public’s moral intuitions. Our study aimed to explore general public views in the UK on (...) the role of age, and related factors like frailty and quality of life, in triage during the COVID-19 pandemic. We held online deliberative workshops with members of the general public. Participants were guided through a deliberative process to maximise eliciting informed and considered preferences. Participants generally accepted the need for triage but strongly rejected ‘fair innings’ and ‘life projects’ principles as justifications for age-based allocation. They were also wary of the ‘maximise life-years’ principle, preferring to maximise the number of lives rather than life years saved. Although they did not arrive at a unified recommendation of one principle, a concern for three core principles and values eventually emerged: equality, efficiency and vulnerability. While these remain difficult to fully respect at once, they captured a considered, multifaceted consensus: utilitarian considerations of efficiency should be tempered with a concern for equality and vulnerability. This ‘triad’ of ethical principles may be a useful structure to guide ethical deliberation as societies negotiate the conflicting ethical demands of triage. (shrink)

Challenges to the exercise of the basic socio-economic rights of half the global population give rise to some of the most pressing issues today. This timely book focuses on world poverty, providing a systematic exposition of the evolving legal responsibility of the international community of states to cooperate in addressing the structural obstacles that contribute to this injustice. This book analyzes the approach, contribution, and current limitations of the international law of human rights to the manifestations of world poverty, inviting (...) the reader to rethink human rights, and, in particular, the framing of responsibilities that are essential to their contemporary protection. (shrink)

Debates regarding clinical ethicists’ scope of practice are not novel and will continue to evolve. Rapid changes in healthcare delivery, outcomes, and expectations have necessitated flexibility in clinical ethicists’ roles whereby hospital-based clinical ethicists are expected to be woven into the institutional fabric in a way that did not exist in more traditional relationships. In this article we discuss three emerging roles: the ethicist embedded in the interdisciplinary team, the ethicist with an expanded educational mandate, and the ethicist as a (...) therapeutic presence in the patient care space. Such expanded capacities offer more robust, positive contributions to institutional culture, stakeholders’ relationships, and patient-centered care. (shrink)

Emerging from the intersection of the virtual world with the real."--BOOK JACKET.

Miller synthesizes Karen Horney's model of submission, aggression and withdrawal, Jean Baker Miller's concept of relational being, Julia Kristeva's idea of psychic space, and Kelly Oliver's notions on social support to advance a penetrating analysis of the fiction of Paule Constant.

For healing the land and human relationships to land are a step toward healing a troubled relationship, borne of a history, which is painful for native people and shameful for settlers. Protection...

This exploratory study investigates the divergent ways that people make sense of their own charisma. Through in-depth, semi-structured qualitative interviews with people who self-identified as charismatic (_n_ = 11), findings reveal that self-identified charismatic people hold divergent views regarding (1) who they believe benefits from their charisma (self or others), (2) how they believe they came to be charismatic (developed or innate), (3) how they experience self-confidence (self-conscious or self-assured), and (4) how they manage rejection (preparation or resilience). Taken together, (...) these divergent views reflect at least two charisma profiles—what we term _opportunistic charisma_ (i.e., charisma employed for personal gain) and _humanistic charisma_ (i.e., charisma employed to empower others)—with implications for humanistic management theory and practice. (shrink)

Prisoners are legally categorized as a vulnerable group for the purposes of medical research, but their vulnerability is not limited to the research context. Prisoner-patients may experience lower standards of care, fewer options for treatment, violations of privacy, and the use of inappropriate surrogates as a result of their status. This case study highlights some of the ways in which a prisoner-patient’s vulnerable status impacted the care he received. The article argues the following: (1) Prisoner-patients are entitled to the same (...) quality of care as all other patients, and healthcare providers should be vigilant to ensure that the stigma of incarceration does not influence care decisions. (2) Options for treatment should reflect what is most medically appropriate in the hospital or other healthcare setting, even when not all treatments would be available in the correctional setting. (3) The presence of guards at the bedside requires that additional measures be taken to protect the privacy and confidentiality of prisoner-patients. (4) When endof-life decisions must be made for an incapacitated patient, prison physicians are not well placed to act as surrogate decision makers, which heightens the obligations of the healthcare professionals in the hospital to ensure an ethically supportable process and outcome. Therefore, healthcare professionals should provide extra protection for those prisoner-patients who do not have decision-making capacity, by utilizing a robust process for decision making such as those used for incapacitated patients without surrogates, rather than relying solely on prison physicians as surrogates. (shrink)

Displays of eye movements may convey information about cognitive processes but require interpretation. We investigated whether participants were able to interpret displays of their own or others' eye movements. In Experiments 1 and 2, participants observed an image under three different viewing instructions. Then they were shown static or dynamic gaze displays and had to judge whether it was their own or someone else's eye movements and what instruction was reflected. Participants were capable of recognizing the instruction reflected in their (...) own and someone else's gaze display. Instruction recognition was better for dynamic displays, and only this condition yielded above chance performance in recognizing the display as one's own or another person's. Experiment 3 revealed that order information in the gaze displays facilitated instruction recognition when transitions between fixated regions distinguish one viewing instruction from another. Implications of these findings are discussed. (shrink)

Thought experiments provide a conspicuous case study for epistemologists of the imagination. Galileo’s famous thought experiment about falling stones is a central example in the debate about how thought experiments in science work. According to a standard interpretation, the thought experiment poses a challenge to an Aristotelian principle about falling bodies that conceives of bodies in an extremely liberal way. This chapter argues that this interpretation is implausible and then shows how the thought experiment might present a challenge to a (...) principle that conceives of bodies in a less permissive, more plausible way. The new interpretation of the thought experiment relies on a distinction between two ways of imagining Galileo’s experiment, one of which requires Aristotelians to temporarily ignore their belief in the principle under challenge. It is suggested that the distinction tracks an increasingly familiar distinction among dual-process theories in psychology: ‘intuitive’ and ‘reflective’ imagination. In order for Aristotelians to appreciate the thought experiment’s challenge to their theory, they are expected to use their intuitive imagination and not just their reflective imagination. (shrink)

An increasing number of scientists and doctors are concerned that new laws are inhibiting ethical research. This paper argues that this is not the case. Laws do not inhibit medical progress. Misunderstanding the law may do so.

Sider (2011, 2013) proposes a reductive analysis of metaphysical modality—‘(modal) Humeanism’—and goes on to argue that it has interesting epistemological and methodological implications. In particular, Humeanism is supposed to undermine a class of ‘arguments from possibility’, which includes Sider's (1993) own argument against mereological nihilism and Chalmers's (1996) argument against physicalism. I argue that Sider's arguments do not go through, and moreover that we should instead expect Humeanism to be compatible with the practice of arguing from possibility in philosophy.

Assertions about metaphysical modality play central roles in philosophical theorizing. For example, when philosophers propose hypothetical counterexamples, they often are making a claim to the effect that some state of affairs is possible. Getting the epistemology of modality right is thus important. Debates have been preoccupied with assessing whether imaginability—or conceivability, insofar as it’s different—is a guide to possibility, or whether it is rather intuitions of possibility—and modal intuitions more generally—that are evidence for possibility claims. The dissertation argues that the (...) imagination plays a subtler role than the first view recognizes, and a more central one than the second view does. In particular, it defends an epistemology of metaphysical modality on which someone can acquire modal knowledge in virtue of having performed certain complex imaginative exercises. (shrink)