Measuring outcomes using quantitative analytic methods is the hallmark of scientific research in healthcare. For clinical ethics support services (CESS), tangible outcome metrics are lacking and literature examining CESS quality is limited to evaluation of single cases or the influence on individual healthcare professional’s perceptions or behaviour. This represents an enormous barrier to implementing and evaluating ethics initiatives to improve quality. In this context, Kok _et al_ propose a theoretical framework for how moral case deliberation (MCD) can drive quality at (...) an organisational-level, termed _morisprudence_ 1. By offering mechanistic insights into how MCD can lead to organisational learning and quality improvement (QI), they provide a roadmap for actionable items to measure quality. As conceptualised, _morisprudence_ follows accumulation of organisational practical wisdom from a repertoire of ‘paradigmatic’ MCDs, aiding identification of patterns of morally important features. Here, there are parallels between healthcare professionals’ clinical judgement, where past experience... (shrink)

Ethical climate (EC) has been broadly described as how well institutions respond to ethical issues. Developing a tool to study and evaluate EC that aims to achieve sustained improvements requires a contemporary framework with identified relevant drivers. An extensive literature review was performed, reviewing existing EC definitions, tools and areas where EC has been studied; ethical challenges and relevance of EC in contemporary paediatric intensive care (PIC); and relevant ethical theories. We surmised that existing EC definitions and tools designed to (...) measure it fail to capture nuances of the PIC environment, and sought to address existing gaps by developing an EC framework for PIC founded on ethical theory. In this article, we propose a Paediatric Intensive Care Ethical Climate (PICEC) conceptual framework and four measurable domains to be captured by an assessment tool. We define PICEC as the collective felt experience of interdisciplinary team members arising from those factors that enable or constrain their ability to navigate ethical aspects of their work. PICEC both results from and is influenced by how well ethical issues are understood, identified, explored, reflected on, responded to and addressed in the workplace. PICEC encompasses four, core inter-related domains representing drivers of EC including: (1) organisational culture and leadership; (2) interdisciplinary team relationships and dynamics; (3) integrated child and family-centred care; and (4) ethics literacy. Future directions involve developing a PICEC measurement tool, with implications for benchmarking as well as guidance for, and evaluation of, targeted interventions to foster a healthy EC. (shrink)

Evolutionary theory guides an investigation of foster parent selection in two northern Thai villages with different biosocial environments: one village has high levels of labour migration and divorce, and growing numbers of parental death due to HIV/AIDS, while the other village has lower migration, divorce and parental mortality levels. Focus groups examine mothers motivations and ideals regarding foster caretaker selection, and quantitative family surveys examine real fostering outcomes: specifically, the laterality (matrilateral versus patrilateral) and genetic distance of the foster caretakers (...) of all ever-fostered children in these two villages. As predicted, in environments of high marital stability and paternity certainty, parents seem to prefer close genetic kin from either side as foster parents for their children. In low marital stability and paternity certainty environments, parents trust their own lateral kin, regardless of genetic distance, over close genetic kin from the other side. The striking exception to this pattern, however, occurs in the case of parental death, in which case children are fostered to the deceased parents sex or other factors. In general, the foster parents for girls are selected with more care, reflecting the daughter/female preference expected in traditionally matrilineal, matrilocal societies. An ordered decision-making pathway for foster parent selection is proposed, taking into consideration the key factors of (a) the circumstances driving the fostering decision, (b) the gender of the child, (c) the gender of the key decision-making parent, and (d) the degree of marital and population fluidity (and subsequent paternity certainty) in the village. (shrink)

In this paper, we discuss the conduct of an interview that was done as a demonstration of the character of interviews in hermeneutic research. This interview was conducted within the context of a graduate course on hermeneutics and involved one of the course professors and a volunteer doctoral student in the class. Although the interview did not occur within a research study, the content of the interview is genuine and not fabricated or acted. Offering the course in an online platform (...) of Zoom allowed for the opportunity to record it and, as a result, we are able to discuss it as well as offer a link to the viewing of the actual interview. Keywords Hermeneutic research, interviewing, Gadamerian philosophical hermeneutics. (shrink)

Al aproximarse el cuadragésimo aniversario de la política oficial Canadienese de multiculturalidad, reexaminamos los cambios en las premisas, promesas y procesos de la educación multicultural. Si bien dicha política puede estar en crisis en un mundo repleto de medidas de seguridad post-11 de septiembre, o considerarse obsoleta en una norteamérica supuestamente “post-racial”, aún florece una “multiculturalidad de base” cuyo potencial no ha sido plenamente aprovechado, sobre todo en las relaciones vividas en los espacios urbanos. Al respecto presentamos el análisis de (...) una encuesta cuantitativa de 942 alumnos matriculados en los grados 10 y 11, en 10 escuelas ubicadas en contextos urbanos en 5 provincias de Canadá. El estudio ofrece una medida de su “literacidad multicultural,” identifica las lagunas y fortalezas de los programas de estudio, al mismo tiempo que demuestra que el conocimiento multicultural se ha nutrido informalmente, teniendo como fuente la familia o comunidad, o bien que se ha adquirido por medio de la cultura popular y los medios de comunicación. Nuestros hallazgos plantean la necesidad de proseguir con estudios cualitativos sobre el tema y sobre los cambios curriculares necesarios para deconstruir epistemologías autoritarias y eurocéntricas, y desarrollar enfoques inclusivos y pluralistas de una ciudadanía activa. (shrink)

Human behavioral ecology (HBE) began as an attempt to explain human economic, reproductive, and social behavior using neodarwinian theory in concert with theory from ecology and economics, and ethnographic methods. HBE has addressed subsistence decision-making, cooperation, life history trade-offs, parental investment, mate choice, and marriage strategies among hunter-gatherers, herders, peasants, and wage earners in rural and urban settings throughout the world. Despite our rich insights into human behavior, HBE has very rarely been used as a tool to help the people (...) with whom we work. This article introduces a special issue of Human Nature which explores the application of HBE to significant world issues through the design and critique of public policy and international development projects. The articles by Tucker, Shenk, Leonetti et al., and Neil were presented at the 104th annual meeting of the American Anthropological Association (AAA) in Washington, D.C., in December 2005, in the first organized session of the nascent Evolutionary Anthropology Section (EAS). We conclude this introduction by summarizing some theoretical challenges to applying HBE, and ways in which evolutionary anthropologists can contribute to solving tough world issues. (shrink)