The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...) actual patient care, remains unclear. This study investigates the extent to which Ontario’s health regulatory colleges have provided explicit written guidance to members related to the importance of patient-centred care. It also explores applied and theoretical explanations that may further our understanding of why patient-centred care has not been more fully embraced. Findings reveal that guidance provided by Ontario’s health regulatory colleges varies widely. Institutional barriers and the choice of policy tools for disseminating government preferences may hinder full implementation of the principles of patient-centred care. More fully understanding the role health regulatory colleges’ play in facilitating the implementation of health policy will contribute positively to dialogue and to efforts to achieve positive health system reforms. (shrink)

The philosophy of patient-centred care has become widely embraced but its implementation is dependent on interrelated factors. A factor that has received limited attention is the role of policy tools. In Ontario, one method government can use to promote healthcare priorities is through health regulatory colleges, which set the standard of practice for health professionals. The degree to which government policy in support of patient-centered care has influenced the direction provided by health regulatory colleges to their members, and ultimately impacted (...) actual patient care, remains unclear. This study investigates the extent to which Ontario’s health regulatory colleges have provided explicit written guidance to members related to the importance of patient-centred care. It also explores applied and theoretical explanations that may further our understanding of why patient-centred care has not been more fully embraced. Findings reveal that guidance provided by Ontario’s health regulatory colleges varies widely. Institutional barriers and the choice of policy tools for disseminating government preferences may hinder full implementation of the principles of patient-centred care. More fully understanding the role health regulatory colleges’ play in facilitating the implementation of health policy will contribute positively to dialogue and to efforts to achieve positive health system reforms. (shrink)

This article investigates the influence of innovation on the relationship between corporate strategy and social issues. Specifically, we employ firm-level data for a large sample of U.K. companies drawn from a diverse range of industrial sectors to investigate, given innovation, the determinants of both the probability that the innovation brings reduced environmental impacts and/or improved health and safety, and the strength of this effect. In this connection, we find evidence of a dichotomy between product and process innovations, and roles for (...) firm size, industrial sector, a foreign market presence, access to various information sources (e.g. universities and government research organisations) and the extent to which activities are constrained by regulation. Furthermore, we find a tendency for the influences of many of these factors to vary between older and newer firms. (shrink)

Disruptions in theory of mind faculties and the ability to relate to an intersubjective reality are widely thought to be crucial to schizophrenic symptomology. This paper applies a cognitive linguistic framework to analyze spontaneous perspective-taking in two corpora of stories told by people with a schizophrenia diagnosis. We elicited natural narrative language use through life story interviews and a guided storytelling task and analyzed the linguistic construal of viewpoint in these stories. For this analysis, we developed a reliable and widely (...) applicable viewpoint model that allows for the categorization and quantification of speakers’ linguistic presentation and navigation of spatiotemporal domains. We found that our participants skillfully presented, navigated and embedded different narrative viewpoints through a variety of linguistic viewpoint devices. They presented complex viewpoints of other people in both the here-and-now of the interaction and the there-and-then of a narrative, and made use of transition markers to demarcate spatiotemporal discourse domains. We found no differences in viewpoint variables when comparing their guided stories to a control group. If problems with intersubjectivity are indeed an essential part of schizophrenia, an explanation of how this group can take on and navigate complex linguistic viewpoints in natural narrative interaction is called for. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

United Nations (UN) leaders suggest that the world is not on track to meet the Sustainable Development Goals (SDGs) by 2030. The purpose of this paper is to explore whether the SDGs provide a valuable platform to call for a basic income (BI) globally. Adopting a critical historical studies approach, the article traces the evolution of ‘development’, including the UN decades of development, the Millennium Development Goals, and the SDGs. It subsequently describes the structural adjustment and poverty reduction efforts by (...) the World Bank and International Monetary Fund, and then outlines why the SDG framework may be helpful in advancing a BI. We argue that as climate-related disasters increase, a BI will be vital in providing a modicum of security in an increasingly unstable world. Calls for BI must be anchored to a broader change agenda that recognizes the causes of poverty and income inequality, and seeks their dismantling and redress. (shrink)

Background Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture. Methods To identify key ethical considerations (...) arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers. Results After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals. Conclusions The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies. (shrink)

Our study presents an overview of the issues that were brought forward by participants of a moral case deliberation (MCD) project in two elderly care organizations. The overview was inductively derived from all case descriptions (N = 202) provided by participants of seven mixed MCD groups, consisting of care providers from various professional backgrounds, from nursing assistant to physician. The MCD groups were part of a larger MCD project within two care institutions (residential homes and nursing homes). Care providers are (...) confronted with a wide variety of largely everyday ethical issues. We distinguished three main categories: ‘resident’s behavior’, ‘divergent perspectives on good care’ and ‘organizational context’. The overview can be used for agendasetting when institutions wish to stimulate reflection and deliberation. It is important that an agenda is constructed from the bottom-up and open to a variety of issues. In addition, organizing reflection and deliberation requires effort to identify moral questions in practice whilst at the same time maintaining the connection with the organizational context and existing communication structures. Once care providers are used to dealing with divergent perspectives, inviting different perspectives (e.g. family members) to take part in the deliberation, might help to identify and address ethical ‘blind spots’. (shrink)

The growth of global value chains (GVCs) and the emergence of novel forms of value chain governance pose two questions for normative business ethics. First, how should we conceptualize the relationships between members of a GVC? Second, what ethical implications follow from these relationships, both with respect to interactions between GVC members and with respect to achieving broader transnational governance goals? We address these questions by examining the emergence of transnational eco-labeling as an increasingly prominent form of GVC governance that (...) is redefining the relationship between nominally independent firms. On the first question, we argue that GVCs occupy a middle ground between intrafirm and interfirm transactions, thereby posing a challenge to theoretical frameworks that attempt to apply ethical standards based on transaction types. On the second question, we argue that this unique institutional status leads to a range of novel ethical considerations and dilemmas for GVC members. Lead firms, their suppliers, and third-party standard-setters all confront new ethical quandaries when third-party eco-labeling is introduced to a GVC. The nature of these quandaries means that, while GVCs may be well-positioned to serve as instruments of transnational governance, they are frequently not well-oriented to do so. Our analysis marks an initial attempt to map the ethical considerations that apply to members of a GVC, and in doing so, places the literature on normative business ethics and transnational governance in a closer conversation. (shrink)

This paper explores how horses are represented in the discourses of "natural horsemanship" , an approach to training and handling horses that advocates see as better than traditional methods. In speaking about their horses, NH enthusiasts move between two registers: On one hand, they use a quasi-scientific narrative, relying on terms and ideas drawn from ethology, to explain the instinctive behavior of horses. Within this mode of narrative, the horse is "other" and must be understood through the human learning to (...) communicate and through appropriate training. On the other hand, NH enthusiasts—like many horse owners—seek to emphasize partnership. In this type of discourse, people portray their horses as almost human. The tensions between these two ways of talking about horses reflect contradictory ideas about control versus freedom in relating to horses, especially as related to emotions expressed by caregivers about their relationships with horses. (shrink)

Surprisingly little has been written about hedged assertion. Linguists often focus on semantic or syntactic theorizing about, for example, grammatical evidentials or epistemic modals, but pay far less attention to what hedging does at the level of action. By contrast, philosophers have focused extensively on normative issues regarding what epistemic position is required for proper assertion, yet they have almost exclusively considered unqualified declaratives. This essay considers the linguistic and normative issues side-by-side. We aim to bring some order and clarity (...) to thinking about hedging, so as to illuminate aspects of interest to both linguists and philosophers. In particular, we consider three broad questions. 1) The structural question: when one hedges, what is the speaker’s commitment weakened from? 2) The functional question: what is the best way to understand how a hedge weakens? And 3) the taxonomic question: are hedged assertions genuine assertions, another speech act, or what? (shrink)

Many readings of the Parable of the Labourers in the vineyard want to treat the owner as representing God. Knowledge of actual agricultural practices relating to the management of vineyards suggest, on the contrary, that the details of the parable obstruct an easy identification of the owner with God, and that he displays unusual behaviour not only by paying all the labourers the same wage, but by his very intervention in the hiring process. The conclusion reached is that the parable (...) constructs the vineyard owner, typically one of the nouveau riche who lived in cities, not only as a ‘good employer’ but also, contrary to expectation, as a patron who intervened well beyond the strict norms of economic exchange. (shrink)

Recreational Drugs European Network (ReDNet) project aims to use the Psychonaut Web Mapping Project database (Psychonaut Web Mapping Group, 2009) containing novel psychoactive compounds usually not mentioned in the scientific literature and thus unknown to clinicians as a unique source of information. The database will be used to develop an integrated ICT prevention approach targeted at vulnerable individuals and focused on novel synthetic and herbal compounds and combinations. Particular care will be taken in keeping the health professionals working directly with (...) young people showing problematic behaviors regularly updated in terms of novel compounds and combinations as well. A user-friendly project website will be developed aimed primarily at delivering the information/prevention approaches, but will also be a way of communicating with project partners and relevant stakeholders (e.g. thematic forum facilities, instant messages, blogs, video chat, wikiblog, newsletters distributed via mailing list). The website will support various ICT prevention tools, including an SMS alert service. Different areas and sections will be aimed specifically at the different target groups. -/- . (shrink)

Charles Taylor in A Secular Age (2007) reopened the debate about the possibility of “reenchantment,” presupposing that “enchantment” once existed, but got lost, such that we arrived at a state of “disenchantment.” However, the no longer marginal debate on the possibility of a “re-enchantment,” is in my view chaotic and lacks precise definitions. In this article the author tries to clarify the concepts involved and put some order in the debate and investigate the possibilities for a kind of re-enchantment. Firstly, (...) she discloses enchantment, disenchantment, and reenchantment as factors in an intellectual scheme, rather than as concepts describing an historical reality. Secondly, she shows that these terms are not applicable to epoque defining sociocultural constellations, a common conviction, defended by Taylor too, which has awkward ideology-related implications. Finally, she points out, in an analysis inspired by Ricoeur, that it rather is the domain of the individual life where the loss and the recovering of enchantment may take place, in a dynamic between the individual and the “call of reality,” having the enchanting capacity to inspire possible lives and give our lives its beacons. (shrink)

As humans, we frequently engage in mental time travel, reliving past experiences and imagining possible future events. This study examined whether similar factors affect the subjective experience associated with remembering the past and imagining the future. Participants mentally “re-experienced” or “pre-experienced” positive and negative events that differed in their temporal distance from the present , and then rated the phenomenal characteristics associated with their representations. For both past and future, representations of positive events were associated with a greater feeling of (...) re-experiencing than representations of negative events. In addition, representations of temporally close events contained more sensorial and contextual details, and generated a stronger feeling of re-experiencing than representations of temporally distant events. It is suggested that the way we both remember our past and imagine our future is constrained by our current goals. (shrink)

This book analyzes the sociopolitical sensibilities of Black aesthetics in society by examining the historical and political context in which Black aesthetics emerged; analyzing various Black aesthetic perspectives that speak to social justice; exploring the interpretive conditions necessary to perceive Black aesthetics as a language of social justice.

Beschouwing vanuit een orthodox-christelijk perspectief.

Value Sensitive Design (VSD) is a design methodology developed by Batya Friedman and Peter Kahn (2003) that brings in moral deliberations in an early stage of a design process. It assumes that neither technology itself is value neutral, nor shifts the value-ladennes to the sole usage of technology. This paper adds to emerging literature onVSD for autonomous weapons systems development and discusses extant literature on values in autonomous systems development in general and in autonomous weapons development in particular. I identify (...) opportunities, such as public debates, and threats, such as the classified nature of the design process, for VSD in autonomous weapons development. This paper contributes to academic debates about the non-neutrality of technology by pointing out that values have been and can be explicitly designed into autonomous systems. It is informative for policy makers and designers who are tasked with developing actual autonomous weapons or policies around such systems, as they learn about an established design methodology that is sensitive to societal concerns and industry needs and that can be applied to autonomous weapons systems. (shrink)

Recent policy developments in the area of livestock husbandry have suggested that, from the perspective of optimizing animal welfare, new animal husbandry systems should be developed that provide opportunities for livestock animals to be raised in environments where they are permitted to engage in “natural behavior.” It is not known whether consumers regard animal husbandry issues as important, and whether they differentiate between animal husbandry and other animal welfare issues. The responsibility for the development of such systems is allocated jointly (...) between farmers, regulators, different actors in the food chain, and consumers. This research focuses on understanding consumer attitudes and preferences regarding the development and introduction of such systems, to ensure that they are acceptable to consumers as well as producers, regulators, and scientists. Consumer perceptions of animal welfare and animal husbandry practices were evaluated using quantitative consumer survey, which focused on two animal husbandry issues – farmed pigs and farmed fish. Following pilot work, 1000 representative Dutch consumers were sampled about their attitudes to either pig or fish husbandry. The results indicated that consumers think about animal welfare in terms of two broad categories related to their health and living environment, but do not think about welfare issues at a more detailed level. Greater concern was expressed about the welfare of pigs compared to fish. Consumer trust in labeling also emerged as an important issue, since consumers need to trust different food chain actors with responsibility for promoting animal welfare, and are reluctant to consider the details of animal husbandry systems. As a consequence, a transparent, enforceable, and traceable monitoring system for animal welfare friendly products is likely to be important for consumers. (shrink)

This book is about feminism, its critics, and its possible directions for change. The nine chapters raise questions about theories of sexual difference, power, justice and history. A central theme concerns the prospects for combining feminist with other, non-feminist, political perspectives.