When intensive care for newborns was introduced thirty years ago its primary goal was to improve the rates of survival of sick and premature infants. Medicine has been successful in attaining this goal; however, as more infants survive, the cost of intensive care and the additional cost of services and care for handicapped survivors continue to escalate. In order to curb the increasing cost of newborn intensive care, heightened initiatives directed at the prevention of premature births will be necessary.

Theoretical arguments regarding the effect of corporate social responsibility (CSR) on firm liability risk are abundant; however, empirical evidence about this relationship is scarce. We investigate the relationship between CSR and the personal liability risk of a firm’s directors and officers. We argue that companies with better CSR performance represent a better underwriting risk for directors’ and officers’ (D&O) insurance providers and, therefore, have a lower cost of insurance. Our results show that firms with better CSR performance are more likely (...) to purchase D&O insurance and have a lower premium-to-coverage ratio, known as the insurance rate-on-line. We also show that this risk-reduction effect is stronger for firms that operate in a high-risk environment and have higher sales growth. These results provide evidence that CSR can be used as a risk management tool to mitigate liability risk and suggest which firms benefit most from this effect. (shrink)

Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses’ assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The (...) results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers. (shrink)

A theoretical reconstruction of Lu Jiuyuan's view of the nature of human beings and their world is offered. Rejecting the widespread effort to distinguish among such concepts as xing ("human nature"), xin ("heart-mind"), and li ("pattern"), Lu regarded all such concepts as ultimately having the same referent, namely the inherent capability of humans and all things to produce and maintain order and, consequently, existence. Most often using the terms li and xin, Lu regarded li as the patterns of all activities, (...) events, and things of human society and the world. Real in the sense of belonging to actual human experience, these patterns enabled the world to exist to the fullest. Li or these patterns were opposed to disorder (luan), and thus li is called a concept of the "social real.". (shrink)

In Chinese philosophy’s encounter with modernity and feminist discourse, Neo-Confucianism often suffered the most brutal attacks and criticisms. In “Neo-Confucians and Zhu Xi on Family and Woman: Challenges and Potentials,” Ann A. Pang-White investigates Song Neo-Confucians’ views (in particular, that of Zhu Xi) on women by examining the Classifi ed Conversations of Zhu Xi (Zhuzi Yulei), the Reflections on Things at Hand (Jinsi Lu), Further Reflections on Things at Hand (Xu Jinsi Lu), and other texts. Pang-White also takes a close (...) look at the Song law regarding women’s property rights and the Song educational system. Surprisingly,Zhu exhibited a level of flexibility, though still limited, on these subjects. He was particularly adamant about the importance of women’s education. In addition, even though he opposed the social practice and women’s ownership of dowry (seeing it as a form of commercializing marriage), he did not absolutely oppose women’s property rights. However, his normative and philosophical view on the male/yang and female/yin relationship was less satisfactory. At one place, he used it to illustrate gender equity; at another place, he defended female subordination. Zhu’s social-political teaching on women’s role could benefit from a more consistent development of his metaphysics of li-qi and yin-yang, which can bring new insight to the contemporary feminist “essentialist versus non-essentialist” debate on sex and gender. (shrink)

In Chinese philosophy’s encounter with modernity and feminist discourse, Neo-Confucianism often suffered the most brutal attacks and criticisms. In “Neo-Confucians and Zhu Xi on Family and Woman: Challenges and Potentials,” Ann A. Pang-White investigates Song Neo-Confucians’ views (in particular, that of Zhu Xi) on women by examining the Classified Conversations of Zhu Xi (Zhuzi Yulei),the Reflections on Things at Hand (Jinsi Lu), Further Reflections on Things at Hand (Xu Jinsi Lu), and other texts. Pang-White also takes a close look at (...) the Song law regarding women’s property rights and the Song educational system. Surprisingly, Zhu exhibited a level of flexibility, though still limited, on these subjects. He was particularly adamant about the importance of women’s education. In addition,even though he opposed the social practice and women’s ownership of dowry (seeing it as a form of commercializing marriage), he did not absolutely oppose women’s property rights. However, his normative and philosophical view on the male/yang and female/yin relationship was less satisfactory. At one place, he used it to illustrate gender equity; at another place, he defended female subordination. Zhu’s social-political teaching on women’s role could benefit from a more consistent development of his metaphysics of li-qi and yin-yang , which can bring new insight to the contemporary feminist “essentialist versus non-essentialist” debate on sex and gender. (shrink)

A User's Guide to Melancholy takes Robert Burton's encyclopaedic masterpiece The Anatomy of Melancholy (first published in 1621) as a guide to one of the most perplexing, elusive, attractive, and afflicting diseases of the Renaissance. Burton's Anatomy is perhaps the largest, strangest, and most unwieldy self-help book ever written. Engaging with the rich cultural and literary framework of melancholy, this book traces its causes, symptoms, and cures through Burton's writing. Each chapter starts with a case study of melancholy - from (...) the man who was afraid to urinate in case he drowned his town to the girl who purged a live eel - as a way into exploring the many facets of this mental affliction. A User's Guide to Melancholy presents in an accessible and illustrated format the colourful variety of Renaissance melancholy, and contributes to contemporary discussions about wellbeing by revealing the earlier history of mental health conditions. (shrink)

Ann Whittle offers a fresh approach to questions about whether our actions are free and whether we are morally responsible for them. She argues that the answers to these questions depend on the contexts in which we make claims about our abilities and our control over our actions.

_Examines how violence has been conceptually and rhetorically put to use in continental social theory._.

Rape, claims Ann J. Cahill, affects not only those women who are raped, but all women who experience their bodies as rapable and adjust their actions and self-images accordingly. Rethinking Rape counters legal and feminist definitions of rape as mere assault and decisively emphasizes the centrality of the body and sexuality in a crime which plays a crucial role in the continuing oppression of women.

_This illuminating account of contemporary American Buddhism shows the remarkable ways the tradition has changed over the past generation_ The past couple of decades have witnessed Buddhist communities both continuing the modernization of Buddhism and questioning some of its limitations. In this fascinating portrait of a rapidly changing religious landscape, Ann Gleig illuminates the aspirations and struggles of younger North American Buddhists during a period she identifies as a distinct stage in the assimilation of Buddhism to the West. She observes (...) both the emergence of new innovative forms of deinstitutionalized Buddhism that blur the boundaries between the religious and secular, and a revalorization of traditional elements of Buddhism, such as ethics and community, that were discarded in the modernization process. Based on extensive ethnographic and textual research, the book ranges from mindfulness debates in the Vipassana network to the sex scandals in American Zen, while exploring issues around racial diversity and social justice, the impact of new technologies, and generational differences between baby boomer, Gen X, and millennial teachers. (shrink)

This book explores the ethical implications of managing uncertainty in clinical decision-making during the COVID-19 pandemic. It develops an ethics of clinical uncertainty that brings together insights from the clinical and biomedical ethical literatures. The book sets out to recognize the central role uncertainty plays in clinical decision-making and to acknowledge the different levels, kinds, and dimensions of clinical uncertainty. It also aims to aid clinicians and patients in managing clinical uncertainty, and to recognize the ethical duty they have to (...) manage clinical uncertainty. The book addresses four ethical duties related to clinical uncertainty: (1) the duty to advance the welfare of those in clinical medicine, (2) to respect the rights of those in clinical medicine, (3) to promote just access to health care, and (4) to care for one another in clinical medicine. These duties took on select urgency during the COVID-19 pandemic because clinical risk assessments about COVID-19 were limited, we were asked to give informed consent in the context of limited and changing knowledge, the pandemic unearthed myriad problems about the distribution of health care, and the pandemic raised questions about how we care for each other in medicine. An Ethics of Clinical Uncertainty will appeal to scholars, advanced students, and medical professionals working in philosophy of medicine, biomedical ethics, clinical medicine, nursing, public health care, and gerontology. (shrink)

Although moral distress is now a well-recognized phenomenon among all of the healthcare professions, few evidence-based strategies have been published to address it. In morally distressing situations, the “presenting problem” may be a particular patient situation, but most often signals a deeper unit- or system-centered issue. This article describes one institution’s ongoing effort to address moral distress in its providers. We discuss the development and evaluation of the Moral Distress Consultation Service, an interprofessional, unit/system-oriented approach to addressing and ameliorating moral (...) distress. (shrink)

Examines how violence has been conceptually and rhetorically put to use in continental social theory.

The causal theory of properties is standardly combined with a realist's ontology of universals or tropes. In this paper, I consider an uncharted alternative – a nominalist causal theory of properties. I discuss advantages and disadvantages of the resulting theory of properties, and explore the Rylean understanding of causal powers that emerges.

Agrifood scholars commonly adopt “a matter of fact way of speaking” to talk about the extent of neoliberal rollout in the food sector and the viability of “alternatives” to capitalist food initiatives. Over the past few decades this matter of fact stance has resulted in heated debate in agrifood scholarship on two distinct battlegrounds namely, the corporate food regime and the alternative food regime. In this paper I identify some of the limitations of speaking in a matter of fact way (...) and of focusing on capitalist and neoliberal economies as the yardstick by which to assess all food economy initiatives. Using stories of bananas in Australia and the Philippines I advocate for a new mode of critical inquiry in food scholarship that focuses on matters of concern. Following Bruno Latour I use the term critical inquiry to refer to research methods and thinking practices that multiply possible ways of being and acting in the world. The new mode of critical inquiry I propose centers on enacting three broad research matters of concern. These are gathering and assembling economic diversity human actancy and nonhuman actancy. I argue that through becoming critical minds in the Latourian sense researchers can play a key role in enacting economic food futures in the Anthropocene. (shrink)

I consider a grand, yet neglected proposal put forward by Shoemaker—a functionalist theory of all properties. I argue that two possible ways of developing this proposal meet with substantial objections. However, if we are prepared to endorse an ontology of tropes, one of these functionalist analyses can be developed into an original and informative theory of properties.

Detecting contract cheating in written submissions can be difficult beyond direct plagiarism detectable via technology. Successfully identifying potential cases of contract cheating in written work such as essays and reports is largely dependent on the experience of assessors and knowledge of student. It is further dependent on their familiarity with the patterns and clues evident in sections of body text and reference materials to identify irregularities. Consequently, some knowledge of what the patterns and clues look like is required. This paper (...) documents how to identify some of the patterns and clues observed in essay and report submissions. Effective assessment design with specific contextual requirements make irregularities easier to detect and interpret. The irregularities identified were confirmed as instances of contract cheating through conversations held with postgraduate students. An essential element of the conversations was the evidence presented for discussion. Irregularities were noted on a pro-forma specifically developed for this purpose. Patterns identified include misrepresented bibliographic data, inappropriate references, irrelevant material and generalised text that did not address the assessment question or grading criteria. The validated patterns formed the basis of identifying potential instances of contract cheating in later submissions. Timely conversations with students before the end of semester are essential to determining whether the patterns and clues link to poor knowledge of academic writing conventions or classified as contract cheating necessitating the application of appropriate penalties under institutional policies and procedures. (shrink)

In their report in this supplement on research regulatory systems, Barbara Bierer and Mark Barnes note that, when research misconduct has been detected but not yet proven, the individual with institutional responsibility for oversight of research misconduct investigations “may determine that notification of relevant journals or professional societies and correction or full retraction of implicated papers or presentations is appropriate. In those cases, even when a finding of research misconduct per se has not been made or has not been explicitly (...) stated, the journal, professional society, and their readers or members may draw their own conclusions as to what led to the retraction or correction.” This statement highlights an aspect of the reviewed regulatory schemes that creates vulnerability for institutions of higher education subject to the regulations: while, as the authors suggest, it may be “appropriate” to notify third parties (that is, journals, professional societies, and other academic institutions) of suspected research misconduct, there is no regulatory obligation to provide such a notification, and, in fact, providing early (or any) notification is contrary to the confidentiality provisions of the research misconduct regulations. Moreover, the institution—and individuals acting on behalf of the institution—may face legal exposure for notifying outside entities. (shrink)

This is a ground-breaking study of the way educated people were trained to think in Renaissance Europe. As Ann Moss demonstrates, the commonplace-book of quotations which every schoolboy of the period was taught to use opens a window on to the manner in which attitudes were structured, a moral consensus was established, and styles of writing evolved. Printed Commonplace-Books and the Structuring of Renaissance Thought is much more than an account of humanist classroom practice: it is a major work of (...) cultural history. (shrink)

BackgroundLiterature on issues relating to comprehension during the process of obtaining informed consent (IC) has largely focused on the challenges potential participants can face in understanding the IC documents, and the strategies used to enhance comprehension of those documents. In this review, we set out to describe the factors that have an impact on comprehension and the strategies used to enhance the IC process in sub-Saharan African countries.MethodsFrom November 2021 to January 2022, we conducted a literature search using a PRISMA (...) tool. We searched electronic databases (PubMed, EMBASE, EBSCOHOST) to identify relevant peer reviewed studies. We then reviewed the references of these articles to find additional literature that might have been missed through the initial search. We were particularly interested in full text articles in English that focused on the IC process in SSA published between 2006 and 2020. We included systematic reviews, and studies from Western and Asian countries that included data about SSA. We excluded articles that focused on medical interventions and studies that did not require IC.ResultsOut of the 50 studies included most were multi-country (n = 13) followed by single country studies in South Africa (n = 12); Kenya, Tanzania, Uganda (n = 5) each; Gambia, Ghana and Nigeria (n = 2)each ; and one each for Botswana, Malawi, Mali, Mozambique. We identified three areas of focus: (1) socio-cultural factors affecting IC; (2) gaps in the ethical and legal frameworks guiding the IC process; and (3) strategies used to improve participants’ understanding of IC.ConclusionOur review showed wide recognition that the process of achieving IC in SSA is inherently challenging, and there are limitations in the strategies aimed at improving comprehension in IC. We suggest that there is a need for greater flexibility and negotiation with communities to ensure that the approach to IC is suited to the diverse socio-cultural contexts. We propose moving beyond the literal translations and technical language to understanding IC comprehension from the participants’ perspectives and the researchers’ views, while examining contextual factors that impact the IC process. (shrink)

Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

This volume brings the first English translation of the Confucian classics Four Books for Women, with extensive commentaries, to the English-speaking world. Written by women for women's education, this work provides an invaluable look at the tradition of Chinese women's writing, education, history, and philosophy, from the 1st to the 16th century.

In this first part, Matthew Lipman offers the reader a glimpse at the thought processes that resulted in Philosophy for Children and, in so doing, ...

While there is an extensive subfield in sociology studying the sources, content, and consequences of collective memory, the study of future projections has been much more fragmentary. In part, this has to do with the challenge of measurement; how do you measure something that has not happened yet? In this article, I argue that future projections can be studied via their externalizations in attitudes, narratives, performance, and material forms. They are particularly evident in what I call “sites of hyperprojectivity,” that (...) is, sites of heightened, future-oriented public debate about possible futures. As a pilot project, I examine contending narratives about possible futures in the online documents of the United Nations Conference on Sustainable Development and the accompanying “People’s Summit,” held in Rio de Janeiro in June 2012. I propose a framework for studying how public interventions into debates about “sustainable futures” and the “green economy” differ on various dimensions of projectivity, including their temporal reach, attention to contingency and causality, and network mapping of future actors. I present a preliminary analysis at the level of narrative and grammar, by analyzing the use of predictive, imperative, and subjunctive verb forms in both programmatic and oppositional texts. I close with a discussion of how different genres of future projection might be put to analytical use in studying processes of interest to social scientists, such as coalition formation, institution building, political mobilization, and policy change. (shrink)

AI has numerous applications and in various fields, including the military domain. The increase in the degree of autonomy in some decision-making systems leads to discussions on the possible future use of lethal autonomous weapons systems (LAWS). A central issue in these discussions is the assignment of moral responsibility for some AI-based outcomes. Several authors claim that the high autonomous capability of such systems leads to a so-called “responsibility gap.” In recent years, there has been a surge in philosophical literature (...) around the concept of responsibility gaps and different solutions have been devised to close or bridge these gaps. In order to move forward in the research around LAWS and the problem of responsibility, it is important to increase our understanding of the different perspectives and discussions in this debate. This paper attempts to do so by disentangling the various arguments and providing a critical overview. After giving a brief outline of the state of the technology of LAWS, I will review the debates over responsibility gaps using three differentiators: those who believe in the existence of responsibility gaps versus those who do not, those who hold that responsibility gaps constitute a new moral problem versus those who argue they do not, and those who claim that solutions can be successful as opposed to those who believe that it is an unsolvable problem. (shrink)

The notion of virtue in general, and courage in particular, has had a hard time integrating itself into the everyday lexicon of bioethics. Following the lead of enlightenment moral philosophy, which concentrates on the theory of right action as opposed to the ancient Greeks' emphasis on the development of good character, bioethics, with some notable exceptions, has tended to relegate consideration of the virtues to the sidelines of moral argument. Recently, however, there have been calls for the necessity of “moral (...) courage” in the context of clinical ethics. As nurses, physicians, and other health care professionals confront a variety of moral contexts in which the virtue of courage is invoked to "do the right thing," stand up for patients' rights, and uphold the ethical standards of their professions, they are increasingly reminded of their moral duty to exhibit courage in the face of institutional obstacles to the proper care of their patients. For example, a nurse's hesitation to approach a physician to request increased sedation for an agitated patient out of fear of retaliation is represented in one article as a lack of courage.In this paper we offer a critical assessment of such invocations of courage. While we find courage to be an indispensable virtue in some challenging contexts, in other settings we find invocations of courage to be both an unfortunate endorsement of an oppressive status quo that can divert attention from the real problems and an undesirable and potentially destructive strategy within health care institutions whose goal is medically excellent and morally good clinical practice. As we shall argue, a call to virtuousness is not always virtuous. (shrink)

Contemporary neo-Aristotelians disagree about whether Aristotle’s work can contribute to rather than compete with or replace modern political theories, particularly theories that take individual rights seriously. In his Nature, Justice, and Rights in Aristotle’s Politics, Fred Miller says “yes.” In After Virtue, drawing on Aristotle to provide an alternative to what he sees as the moral bankruptcy on which modern political theories rest, Alasdair MacIntyre says “no.” However, I maintain—as does Miller (though on somewhat different grounds)—that MacIntyre is mistaken to (...) think that Aristotelianism and modern political theories are entirely at odds with one another. They are mostly reconcilable, a position I call the ‘compatibility thesis.’ An implication of this is that Aristotle’s thought, especially concerning the common advantage, can clarify and strengthen modern political theories that regard individuals (not the state or society) as morally primary and that advocate protecting them equally via rights under the rule of law. (shrink)

Since 1992, institutions accredited by The Joint Commission have been required to have a process in place that allows staff members, patients, and families to address ethical issues or issues prone to conflict. While the commission's expectations clearly have made ethics committees more common, simply having a committee in no way demonstrates its effectiveness in terms of the availability of the service to key constituents, the quality of the processes used, or the outcomes achieved. Beyond meeting baseline accreditation standards, effective (...) ethics resources are requisite for quality care for another reason. The provision of care to the sick is a practice with profound moral dimensions. Clinicians need what Margaret Urban Walker has called “moral spaces,” reflective spaces within institutions in which to explore and communicate values and ethical obligations as they undergird goals of care. Walker proposed that ethicists needed to be concerned with the design and maintenance of these moral spaces. Clearly, that concern needs to extend beyond ethicists to institutional leaders. This essay uses Walker's idea of moral space to describe individuals and groups who are actual and potential ethics resources in health care institutions. We focus on four requisite characteristics of effective resources and the challenges to achieving them, and we identify strategies to build them. In our view, such moral spaces are particularly important for nurses and their colleagues on interprofessional teams and need to be expanded and strengthened in most settings. (shrink)

The engagement of the Catholic Church with the post-World War II international human rights project has been marked from the beginning by strong support coupled with pointed reminders of larger issues left unaddressed. In the 1990s, when the Universal Declaration of Human Rights came under assault from many directions, the Catholic Church was the strongest institutional defender of the entire body of principles in that historic document. Today, with the human rights project in crisis, its future may well hinge on (...) how its defenders deal with problems to which Church leaders have repeatedly called attention. Prominent among these is the question of what happens to freedom when man “goes off in search of an illusory freedom apart from truth itself ”(John Paul II, Veritatis splendor, n. 1). (shrink)

Background:Intensive care unit nurses are providing care to COVID-19 patients in a stressful environment. Understanding intensive care unit nurses’ sources of distress is important when planning interventions to support them.Purpose:To describe Canadian intensive care unit nurse experiences providing care to COVID-19 patients during the second wave of the pandemic.Design:Qualitative descriptive component within a larger mixed-methods study.Participants and research context:Participants were invited to write down their experiences of a critical incident, which distressed them when providing nursing care. Thematic analysis was used (...) to analyze the data.Ethical considerations:The study was approved by the ethics committee at the researchers’ university in eastern Canada.Results:A total of 111 critical incidents were written by 108 nurses. Four themes were found: (1) managing the pandemic, (2) witness to families’ grief, (3) our safety, and (4) futility of care. Many nurses’ stories also focused on the organizational preparedness of their institutions and concerns over their own safety.Discussion:Nurses experienced moral distress in relation to family and patient issues. Situations related to insufficient institutional support, patient, and family traumas, as well as safety issues have left nurses deeply distressed.Conclusion:Identifying situations that distress intensive care unit nurses can lead to targeted interventions mitigating their negative consequences by providing a safe work environment and improving nurses’ well-being. (shrink)

This essay reevaluates the widespread assumption that Paul modified a Jewish apocalyptic two-age dualism framework in light of Christ’s resurrection and offers an alternative explanation: that God’s salvific goal is not the new age, but Christ. The present age and Christ are mutually exclusive realities. Moreover, believers’ sin, suffering, and physical death are not signs of the overlap of the ages, but fit life in union with Christ.