Communication and Conflict Management Training for Clinical Bioethics Committees Content Type Journal Article Pages 341-349 DOI 10.1007/s10730-009-9116-7 Authors Lauren M. Edelstein, Johns Hopkins Medicine’s Howard County General Hospital 5755 Cedar Lane Columbia MD 21044 USA Evan G. DeRenzo, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Elizabeth Waetzig, Change Matrix Inc. 485 Maylin St. Pasadena CA 91105 USA Craig Zelizer, Georgetown University Department of Government 3240 Prospect St. Washington, D.C. NW 20057 USA Nneka O. (...) Mokwunye, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4. (shrink)

Previous studies have shown cognitive task performance to be affected by tinnitus severity, but also that the literature is conflicted. This study sought to identify neuroticism as a possible confound, since severe tinnitus distress is associated with higher levels of neuroticism. A total of 78 participants undertook two cognitive tasks. It was found that when undertaking a Stroop paradigm, controlling for neuroticism rendered previously significant results not significant. It was also found that neuroticism was not a significant covariate for a (...) change blindness task. Gender, age, anxiety, and depression were all controlled for, and future implications for the literature discussed. (shrink)

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new “spaces” for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for “clinical ethics conflict coaching” can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

IPCC SPECIAL REPORT ON CLIMATE CHANGE AND LAND (SRCCL) -/- Chapter 3: Climate Change and Land: An IPCC special report on climate change, desertification, land degradation, sustainable land management, food security, and greenhouse gas fluxes in terrestrial ecosystems.

This essay, which is the editor's introduction to part 1 of a multipart symposium on quietism, also constitutes his call for symposium papers. The symposium is meant be comprehensive. It is described as political and broadly cultural as well as religious, and in religious terms is said to cover not only the Catholic and Protestant quietisms (most properly so called) of the late seventeenth and eighteenth centuries, but also the proto-quietisms of the medieval Western church and reputedly quietist aspects of (...) the Gnostic, Eastern Orthodox, early Hasidic, Shi'ite, Jain and other Indic, Taoist, and Zen religious traditions. This introduction emphasizes the secular approaches, mostly antipolitical or postphilosophical, that wear the adjective “quietist” metaphorically, including the postmodern currents that Martha Nussbaum has named “hip quietism” and the “minimalist” philosophical version developed by Wittgenstein and some of his successors, notably Richard Rorty. This introduction concludes with attention to Rorty's late essay “Naturalism and Quietism,” then with a dedication of the entire symposium to Rorty's memory. (shrink)

Curbside ethics consultations occur when an ethics consultant provides guidance to a party who seeks assistance over ethical concerns in a case, without the consultant involving other stakeholders, conducting his or her own comprehensive review of the case, or writing a chart note. Some have argued that curbside consultation is problematic because the consultant, in focusing on a single narrative offered by the party seeking advice, necessarily fails to account for the full range of moral perspectives. Their concern is that (...) any guidance offered by the ethics consultant will privilege and empower one party’s viewpoint over—and to the exclusion of—other stakeholders. This could lead to serious harms, such as the ethicist being reduced to a means to an end for a clinician seeking to achieve his or her own preferred outcome, the ethicist denying the broader array of stakeholders input in the process, or the ethicist providing wrongheaded or biased advice, posing dangers to the ethical quality of decision-making. Although these concerns are important and must be addressed, we suggest that they are manageable. This paper proposes using conflict coaching, a practice developed within the discipline of conflict management, to mitigate the risks posed by curbside consultation, and thereby create new spaces for moral discourse in the care of patients. Thinking of curbside consultations as an opportunity for clinical ethics conflict coaching can more fully integrate ethics committee members into the daily ethics of patient care and reduce the frequency of ethically harmful outcomes. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

In the past two to three decades health behavior scientists have increasingly emphasized affect-related concepts (including, but not limited to emotion) in their attempts to understand and facilitate change in important health behaviors, such as smoking, eating, physical activity, substance abuse, and sex. This article provides a narrative review of this burgeoning literature, including relevant theory and research on affective response (e.g., hedonic response to eating and drug use), incidental affect (e.g., work-related stress as a determinant of alcohol use), affect (...) processing (e.g., anticipated regret for illicit sex or skipping an exercise session), and affectively charged motivation (e.g., cigarette craving). An integrative dual-processing framework is presented that suggests pathways through which affect-related concepts may interrelate to influence health behavior. (shrink)

Theories of embodied cognition hypothesize interdependencies between psychological well-being and physical posture. The purpose of this study was to assess the feasibility of objectively measuring posture, and to explore the relationship between posture and affect and other patient centered outcomes in breast cancer survivors with persistent postsurgical pain over a 12-week course of therapeutic Qigong mind-body training. Twenty-one BCS with PPSP attended group Qigong training. Clinical outcomes were pain, fatigue, self-esteem, anxiety, depression, stress and exercise self-efficacy. Posture outcomes were vertical (...) spine and vertical head angles in the sagittal plane, measured with a 3D motion capture system in three conditions: eyes open, eyes open relaxed and eyes closed. Assessments were made before and after the Qigong training. The association between categorical variables was measured by Cramer’s V. In the EO condition, most participants who improved in fatigue and anxiety scales also had better vertical head values. For the EOR condition, a moderate correlation was observed between changes in vertical head angle and changes in fatigue scale. In the EC condition, most of the participants who improved in measures of fatigue also improved vertical head angle. Additionally, pain severity decreased while vertical spine angle improved. These preliminary findings support that emotion and other patient centered outcomes should be considered within an embodied framework, and that Qigong may be a promising intervention for addressing biopsychosocially complex interventions such as PPSP in BCSs. (shrink)

Using covariant derivatives and the operator definitions of quantum mechanics, gauge invariant Proca and Lehnert equations are derived and the Lorenz condition is eliminated in U(1) invariant electrodynamics. It is shown that the structure of the gauge invariant Lehnert equation is the same in an O(3) invariant theory of electrodynamics.

Listening to someone from some distance in a crowded room you may experience the following phenomenon: when looking at them speak, you may both hear and see where the source of the sounds is; but when your eyes are turned elsewhere, you may no longer be able to detect exactly where the voice must be coming from. With your eyes again fixed on the speaker, and the movement of her lips a clear sense of the source of the sound will (...) return. This ‘ventriloquist’ effect reflects the ways in which visual cognition can dominate auditory perception. And this phenomenological observation is one what you can verify or disconfirm in your own case just by the slightest reflection on what it is like for you to listen to someone with or without visual contact with them. (shrink)

In today's complex business world, the question of business ethics is increasingly gaining importance as managers and employees face numerous ethical dilemmas in their jobs. The ethical climate in the Turkish business environment is also at a critical stage, and the business community as a whole is troubled by ethical problems. This study attempts to determine the effect of individual, managerial and organizational factors on the ethical judgments of Turkish managers, and to evaluate the ethical perceptions of these managers. The (...) findings of this study reveal that the ethics score, the measure of ethical judgment, of Turkish managers differs significantly only with respect to gender and that female managers have higher ethics score than male managers. Other individual, managerial and organizational factors considered in this study do not have any significant effect on the ethical judgments of the managers. A comparative analysis between female and male managers in terms of their ranking of the eleven ethical business scenarios, ranking of the sixteen unethical acts, ranking of the factors influencing managers to engage in unethical practices, and ranking of the various parties to whom a company is socially responsible enables the researchers to enlighten the subject of business ethics in Turkey. (shrink)

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)

Do we directly perceive physical objects? What is the significance of the qualification ‘directly’ here? Austin famously denied that there was a unique interpretation by which we could make sense of the traditional debate in the philosophy of perception. I look here at Thompson Clarke’s discussion of G. E. Moore and surface perception to answer Austin’s scepticism.

[R. M. Sainsbury] Evans argued that most ordinary proper names were Russellian: to suppose that they have no bearer is to suppose that they have no meaning. The first part of this paper addresses Evans's arguments, and finds them wanting. Evans also claimed that the logical form of some negative existential sentences involves 'really' (e.g. 'Hamlet didn't really exist'). One might be tempted by the view, even if one did not accept its Russellian motivation. However, I suggest (...) that Evans gives no adequate account of 'really', and I point to unclarities in Wiggins's similar, but distinct, attempt to use 'really' in the logical form of true negative existentials. /// [David Wiggins] Evans was not wrong (I maintain) to say that the senses of genuine proper names invoke and require objects. Names in fiction or hypothesis mimic such names. Pace Evans, Sainsbury and free logicians, proper names are scopeless. (Evans's 'Julius' is not a name.) Names create a presumption of existential generalization. In sentences such as 'Vulcan does not really exist', that presumption is bracketed. The sentence specifies by reference to story or report a concept identical with Vulcan and declares it be really uninstantiated. (The sentence, which partakes of play, is a kind of palimpsest.) It is explained why this second level view of 'exists' is to be preferred. (shrink)

When we dream, it is often assumed, we are isolated from the external environment. It is also commonly believed that dreams can be, at times, accurate, convincing replicas of waking experience. Here I analyse some of the implications of this view for an enactive theory of conscious experience. If dreams are, as described by the received view, “inactive”, or “cranially envatted” whilst replicating the experience of being awake, this would be problematic for certain extended conscious mind theories. Focusing specifically on (...) Alva Noë’s enactive view, according to which the vehicles of perceptual experience extend beyond the brain, I argue that dreams are a quandary. Noë’s view is that dreaming is consistent with enactivism because even if dreams are inactive and shut off from the external environment, they are not “full-blown” perceptual consciousness, and also, there is some reason to reject the inactive claim. However, this view rests on an unjustified and reductive account of dreams which is not supported... (shrink)