The clinical ethicist met with Ms. H to clarify what information she wants and does not want to know. First, she wants to receive any treatment that could prolong her life, regardless of how the treatment affects her ability to engage in activities of daily living. Second, she wants to be included in the decision‐making process as much as possible, as long as clinicians use only “positive” language. Ms. H considers the words “dying,” “chemotherapy,” “radiation,” and “cancer” to be “bad (...) words.” For conversations in which these words cannot be avoided, she wants her clinicians to talk to her son. Her desired engagement includes hearing about risks, benefits, and alternatives to treatments if clinicians use only “positive” language. Finally, she says that she rarely sees doctors and that she is “very scared” of hospitals, despite exhibiting a comfortable demeanor.Should clinicians honor Ms. H's waiver of specified information and, if so, to what degree? (shrink)

Responding to Randall and Gibson''s (1990) call for more rigorous methodologies in empirically-based ethics research, this paper develops propositions — based on both previous ethics research as well as the larger organizational behavior literature — examining the impact of attitudes, leadership, presence/absence of ethical codes and organizational size on corporate ethical behavior. The results, which come from a mail survey of 149 companies in a major U.S. service industry, indicate that attitudes and organizational size are the best predictors of ethical (...) behavior. Leadership and ethical codes contribute little to predicting ethical behavior. The paper concludes with an assessment of the relevant propositions, as well as a delineation of future research needs. (shrink)

This book applies Augustine's thought to current questions of teaching and learning. The essays are written in an accessible style and is not intended just for experts on Augustine or church history.

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Biomedical Informatics: We Are What We Publish", written by Peter L. Elkin, Steven H. Brown, and Graham Wright. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the Elkin et al. paper. In subsequent issues the discussion can continue through letters to the editor.

Though the philosopher will undoubtedly find this study too elementary for many of his purposes, the student of literature and the generally interested reader will be delighted by this rich source of reference material. Published under the general editorship of Mortimer J. Adler by the Institute for Philosophical Research, The Idea of Love has one of the most accessible formats of the Concepts in Western Thought Series. Preliminary chapters explain critical notions used in later schematizations of various figures, and relate (...) in neat topical divisions controversies about natural and supernatural human love. Next, illustrative chapters present different authors according to whether they hold that love can be either acquisitive or benevolent desire, is only acquisitive desire, must include benevolence, is wholly or primarily judgment. Two final divisions which overlap these give judgmental aspects of wholly and primarily tendential conceptions of love. Expositions within each of these divisions both justify the classification and adequately develop particular sub-themes. In toto, more than forty philosophers, writers, theologians, and psychologists receive a fairly extensive treatment, including generous citations, while brief references are also made to minor figures. Among those given major consideration are Plato, Augustine, Aristotle, Cicero, Aquinas, Dante, Kierkegaard, Kant, Freud, Jung, and William James ; Plotinus, Andreas Capellanus, Stendhal, Schopenhauer, Santayana, Darwin, Rousseau, Spinoza, Leibniz ; Adam Smith, Hegel, C. S. Lewis, Ortega Y Gasset, Erich Fromm ; Descartes, Hume, Locke, and Pascal. The work is indexed and supplemented by a seven-page bibliography.--C. M. R. (shrink)

(1984). Reading Accuracy as a Function of Teaching Strategy, Personality and Word Complexity in Seven‐year‐old Children. Educational Studies: Vol. 10, No. 3, pp. 263-272.

BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

At least four different frameworks — psychiatric, cognitive, functional and decision-making — are used in the evaluation of competence, all of which remain more or less unrelated in the literature. In the first section of this paper we consider various meanings of competence, in order to arrive at a definition of the term relevant to the medical and legal setting. Patient or client competence, we conclude, refers to the practical abilities that individuals employ in pursuing their own autonomous goals in (...) life. We then show how a systematic categorization of these practical abilities — which we call a taxonomy of practical judgment — allows us to show when the traditional frameworks for the evaluation of competence may or may not be useful in the evaluation of a particular competence.In the final section we explore some of the normative considerations underlying the taxonomy. For instance, competence is not only related to intrinsic abilities but to resources available in the community. Here we touch on questions related to the fair distribution of community resources. (shrink)

Over-time variability characterizes not only individual-level emotions, but also group-level emotions, those that occur when people identify with social groups and appraise events in terms of their implications for those groups. We discuss theory and research regarding the role of emotions in intergroup contexts, focusing on their dynamic nature. We then describe new insights into the causes and consequences of emotional dynamics that flow from conceptualizing emotions as based in group membership, and conclude with research recommendations.

Plagiarism is a serious, yet widespread type of research misconduct, and is often neglected in developing countries. Despite its far-reaching implications, plagiarism is poorly acknowledged and discussed in the academic setting, and insufficient evidence exists in Latin America and developing countries to inform the development of preventive strategies. In this context, we present a longitudinal case study of seven instances of plagiarism and cheating arising in four consecutive classes of an Epidemiology Masters program in Lima, Peru, and describes the implementation (...) and outcomes of a multifaceted, “zero-tolerance” policy aimed at introducing research integrity. Two cases involved cheating in graded assignments, and five cases correspond to plagiarism in the thesis protocol. Cases revealed poor awareness of high tolerance to plagiarism, poor academic performance, and widespread writing deficiencies, compensated with patchwriting and copy-pasting. Depending on the events’ severity, penalties included course failure and separation from the program. Students at fault did not engage in further plagiarism. Between 2011 and 2013, the Masters program sequentially introduced a preventive policy consisting of: intensified research integrity and scientific writing education, a stepwise, cumulative writing process; honor codes; active search for plagiarism in all academic products; and a “zero-tolerance” policy in response to documented cases. No cases were detected in 2014. In conclusion, plagiarism seems to be widespread in resource-limited settings and a greater response with educational and zero-tolerance components is needed to prevent it. (shrink)

We report specific heat and μSR measurements on Th and/or B substituted UBe13. The specific heat data show that either Th or B substitution reduces the Kondo temperature TK and increases the entropy at the superconducting transition by almost 20%, indicating an enhanced density of states. However, whereas μSR shows clear evidence for magnetic correlations for Th substitutions, no magnetism is observed for B substitutions. The enhanced specific heat jump in the B-substituted material is associated with a change in the (...) superconducting properties as TK is reduced. (shrink)

While research has focused on why certain entrepreneurs elect to create innovative solutions to social problems, very little is known about why some social entrepreneurs choose to scale their solutions while others do not. Research on scaling has generally focused on organizational characteristics often overlooking factors at the individual level that may affect scaling decisions. Drawing on the multidimensional construct of moral intensity, we propose a theoretical model of ethical decision making to explain why a social entrepreneur’s perception of moral (...) intensity of the social problem, coupled with their personal desire for control, can significantly influence scaling decisions. Specifically, we propose that higher levels of perceived moral intensity will positively influence the likelihood of scaling through open as opposed to closed modes in order to achieve greater speed and scope of social impact. However, we also propose this effect will be negatively moderated by a social entrepreneur’s higher levels of desire for control. Our model has implications for research and practice at the interface of ethics and social entrepreneurship. (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)

BackgroundPublic Safety Personnel are routinely exposed to human suffering and need to make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event or situation that conflicts with personal values can potentially lead to the development of moral injury. Common stressors associated with moral injury include betrayal, inability to prevent death or harm, and ethical dilemmas. Potentially psychologically traumatic event exposures and post-traumatic stress disorder can be comorbid with moral injury; however, moral injury (...) extends beyond fear to include spiritual, cognitive, emotional or existential struggles, which can produce feelings of severe shame, guilt, and anger.ObjectiveThis scoping review was designed to identify the extant empirical research regarding the construct of moral injury, its associated constructs, and how it relates to moral distress in firefighters, paramedics, and police officers.MethodsA systematic literature search of peer-reviewed research was conducted using databases MEDLINE, EMBASE, APA PsychInfo, CINHAL PLUS, Web of Science, SCOPUS, and Google Scholar. Included studies were selected based on the inclusion criteria before being manually extracted and independently screened by two reviewers.ResultsThe initial database search returned 777 articles, 506 of which remained after removal of duplicates. Following review of titles, abstracts, and full texts, 32 studies were included in the current review. Participants in the articles were primarily police officers, with fewer articles focusing on paramedics and firefighters. There were two studies that included mixed populations. Most studies were qualitative and focused on four topics: values, ethical decision-making, organizational betrayal, and spirituality.ConclusionPublic safety organizations appear to recognize the experience of moral distress or moral injury among public safety personnel that results from disconnects between personal core values, formal and informal organizational values, vocational duties, and expectations. Further research is needed to better understand moral distress or moral injury specific to public safety personnel and inform training and treatment in support of public safety personnel mental health. (shrink)

Cultural effects can influence the results of causal genetic analyses, such as Mendelian randomisation, but the potential influences of culture on genotype–phenotype associations are not currently well understood. Different genetic variants could be associated with different phenotypes in different populations, or culture could confound or influence the direction of the association between genotypes and phenotypes in different populations.

This study examines the socioeconomic and familial background of Irish Catholic priests born between 1867 and 1911. Previous research has hypothesized that lack of marriage opportunities may influence adoption of celibacy as part of a religious institution. The present study traced data from Irish seminary registries for 46 Catholic priests born in County Limerick, Ireland, using 1901 Irish Census returns and Land Valuation records. Priests were more likely to originate from landholding backgrounds, and with landholdings greater in size and wealth (...) than the local average. Priests were found to originate from families with more sons than the national average, but with similar numbers of daughters. These findings are discussed in relation to competition for resources and lineage survival strategies. (shrink)

This volume explores the role of some of the most prominent twentieth-century philosophers and political thinkers as teachers. It examines what obstacles they confronted as teachers and how they overcame them in conveying truth to their students in an age dominated by ideological thinking.

This book undertakes a multifaceted and integrated examination of biometric identification, including the current state of the technology, how it is being used, the key ethical issues, and the implications for law and regulation. The five chapters examine the main forms of contemporary biometrics–fingerprint recognition, facial recognition and DNA identification– as well the integration of biometric data with other forms of personal data, analyses key ethical concepts in play, including privacy, individual autonomy, collective responsibility, and joint ownership rights, and proposes (...) a raft of principles to guide the regulation of biometrics in liberal democracies. Biometric identification technology is developing rapidly and being implemented more widely, along with other forms of information technology. As products, services and communication moves online, digital identity and security is becoming more important. Biometric identification facilitates this transition. Citizens now use biometrics to access a smartphone or obtain a passport; law enforcement agencies use biometrics in association with CCTV to identify a terrorist in a crowd, or identify a suspect via their fingerprints or DNA; and companies use biometrics to identify their customers and employees. In some cases the use of biometrics is governed by law, in others the technology has developed and been implemented so quickly that, perhaps because it has been viewed as a valuable security enhancement, laws regulating its use have often not been updated to reflect new applications. However, the technology associated with biometrics raises significant ethical problems, including in relation to individual privacy, ownership of biometric data, dual use and, more generally, as is illustrated by the increasing use of biometrics in authoritarian states such as China, the potential for unregulated biometrics to undermine fundamental principles of liberal democracy. Resolving these ethical problems is a vital step towards more effective regulation. (shrink)

Abstract:What makes a leader ethical? This paper critically examines the answer given by developmental theory, which argues that individuals can develop through cumulative stages of ethical orientation and behavior (e.g. Hobbesian, Kantian, Rawlsian), such that leaders at later developmental stages (of whom there are empirically very few today) are more ethical. By contrast to a simple progressive model of ethical development, this paper shows that each developmental stage has both positive (light) and negative (shadow) aspects, which affect the ethical behaviors (...) of leaders at that stage. It also explores an unexpected result: later stage leaders can have more significantly negative effects than earlier stage leadership. (shrink)

Integrated developmental and elemental information in teeth provide a unique framework for documenting breastfeeding histories, physiological disruptions, and neurotoxicant exposure in humans and our primate relatives, including ancient hominins. Here we detail our method for detecting the consumption of mothers’ milk and exploring health history through the use of laser ablation‐inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS) mapping of sectioned nonhuman primate teeth. Calcium‐normalized barium and lead concentrations in tooth enamel and dentine may reflect milk and formula consumption with minimal modification during (...) subsequent tooth mineralization, particularly in dentine. However, skeletal resorption during severe illness, and bioavailable metals in nonmilk foods, can complicate interpretations of nursing behavior. We show that explorations of the patterning of multiple elements may aid in the distinction of these important etiologies. Targeted studies of skeletal chemistry, gastrointestinal maturation, and the dietary bioavailability of metals are needed to optimize these unique records of human health and behavior. (shrink)

Abstract:What makes a leader ethical? This paper critically examines the answer given by developmental theory, which argues that individuals can develop through cumulative stages of ethical orientation and behavior (e.g. Hobbesian, Kantian, Rawlsian), such that leaders at later developmental stages (of whom there are empirically very few today) are more ethical. By contrast to a simple progressive model of ethical development, this paper shows that each developmental stage has both positive (light) and negative (shadow) aspects, which affect the ethical behaviors (...) of leaders at that stage. It also explores an unexpected result: later stage leaders can have more significantly negative effects than earlier stage leadership. (shrink)