Catholic health care has long been a key place where the Church embodies its social doctrine. However, the moral methodology that shapes Catholic bioethics relies on an act-based approach to decision making, which is rooted in the pre–Vatican II manualist tradition, focusing primarily on clinical issues related to the beginning and end of life. This essay argues that given the doctrinal status of Catholic social thought, Catholic bioethics must revisit its scope and methodology. It proceeds in three steps: a meta-analysis (...) of traditional Catholic bioethics, validating the claim made above; an overview of the limited literature published since 1980 engaging Catholic bioethics and CST; and a map of a Catholic bioethics informed by CST generated from a dual starting point. The essay concludes by focusing on both the places where marginalized persons encounter Catholic health care and the ethical issues presented, including race, health care disparities, immigration status, and gender inequality, as well as the interrelated perspective of the common good, expanding the array of issues to include environmental degradation, unions, health care financing, and more. (shrink)

Catholic health care is one of the key places where the church lives Catholic social teaching (CST). Yet the individualistic methodology of Catholic bioethics inherited from the manualist tradition has yet to incorporate this critical component of the Catholic moral tradition. Informed by the places where Catholic health care intersects with the diverse societal injustices embodied in the patients it encounters, this book brings the lens of CST to bear on Catholic health care, illuminating a new spectrum of ethical issues (...) and practical recommendations from social determinants of health, immigration, diversity and disparities, behavioral health, gender-questioning patients, and environmental and global health issues. (shrink)

MENDENHALL TJ, BERGE JM, HARPER P, GREENCROW B, LITTLEWALKER N, WHITEEAGLE S and BROWNOWL S. Nursing Inquiry 2010; 17: 359–372 The Family Education Diabetes Series (FEDS): community‐based participatory research with a midwestern American Indian communityIndigenous people around the globe tend to struggle with poorer health and well‐being than their non‐indigenous counterparts. One area that this is especially evident is in the epidemic of diabetes in North America’s American Indians (AIs) – who evidence higher prevalence rates and concomitant disease‐related complications (...) than any other racial/ethnic group. As researchers and AI communities work together to transcend conventional top‐down, service‐delivery approaches to care, community‐based participatory research is beginning to show promise as a way to partner contemporary biomedical knowledge with the lived‐experience, wisdom, and customs of Indigenous people. This study describes the Family Education Diabetes Series (FEDS) as an example of such effort, and highlights pilot findings assessing its value and impact across key diabetes‐relevant variables. Following 36 intervention participants across baseline, 3‐month, and 6‐month time periods, data show significant improvements in weight, blood pressure, and metabolic control (A1c). Strengths and limitations of this investigation are presented, along with suggestions about how to further advance and empirically test the work across other Indigenous communities. (shrink)

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does supported decision-making really entail? One compelling framework is Anita Silvers and Leslie Francis’ mental prosthesis account, which envisions supported decision-making as a process in which trustees act as mere appendages for the patient’s will; the trustee provides the cognitive tools the patient requires to realize her conception of her own good. We argue that supported decision-making would be better understood (...) as a collaborative process, giving patients with intellectual disabilities the opportunity to make decisions in a respectful relationship with trusted others. We offer an alternative account of supported decision-making where the primary constraint is to protect the patient from domination by the trustee. This is advantageous in its preservation of the prospects for genuine collaboration, for the mental prosthesis approach ultimately reinforces a problematic ideal of isolated patient self-determination. (shrink)

We show that without assuming completeness or continuity, a strongly independent preorder on a possibly infinite dimensional convex set can always be given a vector-valued representation that naturally generalizes the standard expected utility representation. More precisely, it can be represented by a mixture-preserving function to a product of lexicographic function spaces.

A mixture preorder is a preorder on a mixture space (such as a convex set) that is compatible with the mixing operation. In decision theoretic terms, it satisfies the central expected utility axiom of strong independence. We consider when a mixture preorder has a multi-representation that consists of real-valued, mixture-preserving functions. If it does, it must satisfy the mixture continuity axiom of Herstein and Milnor (1953). Mixture continuity is sufficient for a mixture-preserving multi-representation when the dimension of the mixture space (...) is countable, but not when it is uncountable. Our strongest positive result is that mixture continuity is sufficient in conjunction with a novel axiom we call countable domination, which constrains the order complexity of the mixture preorder in terms of its Archimedean structure. We also consider what happens when the mixture space is given its natural weak topology. Continuity (having closed upper and lower sets) and closedness (having a closed graph) are stronger than mixture continuity. We show that continuity is necessary but not sufficient for a mixture preorder to have a mixture-preserving multi-representation. Closedness is also necessary; we leave it as an open question whether it is sufficient. We end with results concerning the existence of mixture-preserving multi-representations that consist entirely of strictly increasing functions, and a uniqueness result. (shrink)

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

These studies examined whether having thoughts related to an event before it occurs leads people to infer that they caused the event— even when such causation might otherwise seem magical. In Study 1, people perceived that they had harmed another person via a voodoo hex. These perceptions were more likely among those who had first been induced to harbor evil thoughts about their victim. In Study 2, spectators of a peer’s basketball-shooting performance were more likely to perceive that they had (...) influenced his success if they had first generated positive visualizations consistent with that success. Observers privy to those spectators’ visualizations made similar attributions about the spectators’ influence. Finally, addi- tional studies suggested that these results occur even when the thought-about outcome is viewed as unwanted by the thinker and even in field settings where the relevant outcome is occurring as part of a live athletic competition. (shrink)

This paper has both theoretical and practical ambitions. The theoretical ambitions are to explore what would constitute both effective and ethical treatment of Autism Spectrum Disorder.1 However, the practical ambition is perhaps more important: we argue that a dominant form of Applied Behavior Analysis, which is widely taken to be far-and-away the best “treatment”2 for ASD, manifests systematic violations of the fundamental tenets of bioethics. Moreover, the supposed benefits of the treatment not only fail to mitigate these violations, but they (...) often exacerbate them. Warnings of the perils of ABA are not original to us—autism advocates have been ringing this... (shrink)

BackgroundThe U.S. Food and Drug Administration traditionally has kept confidential significant amounts of information relevant to the approval or non-approval of specific drugs, devices, and biologics and about the regulatory status of such medical products in FDA’s pipeline.ObjectiveTo develop practical recommendations for FDA to improve its transparency to the public that FDA could implement by rulemaking or other regulatory processes without further congressional authorization. These recommendations would build on the work of FDA’s Transparency Task Force in 2010.MethodsIn 2016-2017, we convened (...) a team of academic faculty from Harvard Medical School, Brigham and Women’s Hospital, Yale Medical School, Yale Law School, and Johns Hopkins Bloomberg School of Public Health to develop recommendations through an iterative process of reviewing FDA’s practices, considering the legal and policy constraints on FDA in expanding transparency, and obtaining insights from independent observers of FDA.ResultsThe team developed 18 specific recommendations for improving FDA’s transparency to the public. FDA could adopt all these recommendations without further congressional action.FundingThe development of the Blueprint for Transparency at the U.S. Food and Drug Administration was funded by the Laura and John Arnold Foundation. (shrink)

A casual comment by a student alerted the authors to the existence and prevalence of Internet-based paraphrasing tools. A subsequent quick Google search highlighted the broad range and availability of online paraphrasing tools which offer free ‘services’ to paraphrase large sections of text ranging from sentences, paragraphs, whole articles, book chapters or previously written assignments. The ease of access to online paraphrasing tools provides the potential for students to submit work they have not directly written themselves, or in the case (...) of academics and other authors, to rewrite previously published materials to sidestep self-plagiarism. Students placing trust in online paraphrasing tools as an easy way of complying with the requirement for originality in submissions are at risk in terms of the quality of the output generated and possibly of not achieving the learning outcomes as they may not fully understand the information they have compiled. There are further risks relating to the legitimacy of the outputs in terms of academic integrity and plagiarism. The purpose of this paper is to highlight the existence, development, use and detection of use of Internet based paraphrasing tools. To demonstrate the dangers in using paraphrasing tools an experiment was conducted using some easily accessible Internet-based paraphrasing tools to process part of an existing publication. Two sites are compared to demonstrate the types of differences that exist in the quality of the output from certain paraphrasing algorithms, and the present poor performance of online originality checking services such as Turnitin® to identify and link material processed via machine based paraphrasing tools. The implications for student skills in paraphrasing, academic integrity and the clues to assist staff in identifying the use of online paraphrasing tools are discussed. (shrink)

This article investigates the use of favors by managers of BRIC firms to accomplish business goals, the ethicality of which should be determined by the moral reasoning in these countries rather than from a developed country perspective. We define a favor as an exchange of outcomes between individuals, typically utilizing one's connections, that is based on a commonly understood cultural tradition, with reciprocity by the receiver typically not being immediate, and its value being less than what would constitute bribery within (...) that cultural context. This exchange normally takes place between and among members of networks, and may involve a network outsider contacted by a network insider on behalf of another insider. We see the giver and receiver of the favor, as well as network insiders and outsiders, as stakeholders. Additionally, society could also be considered to be a stakeholder since the practice of using favors generally inhibits the development of legitimate, strong formal institutions, since the use of favors in emerging economies is rooted in cultural traditions that we view as informal institutions. Furthermore, we assert that the practice of using favors can lead to bribery which harms society as a stakeholder both morally and economically. We posit that BRIC-country managers' behaviors stem from informal, culturally based practices—jeito in Brazil, blat/sviazi in Russia, jaan-pehchaan in India, and guanxi in China. We utilize institutional theory to explain why favors are relied upon, and ISCT to support the argument that the use of favors in environments like the BRICs is generally considered ethical. (shrink)

Circadian rhythm abnormalities in bipolar disorder have led to a search for genetic abnormalities in circadian "clock genes" associated with BD. However, no significant clock gene findings have emerged from genome-wide association studies. At least three factors could account for this discrepancy: complex traits are polygenic, the organization of the clock is more complex than previously recognized, and/or genetic risk for BD may be shared across multiple illnesses. To investigate these issues, we considered the clock gene network at three levels: (...) essential "core" clock genes, upstream circadian clock modulators, and downstream clock controlled genes. Using relaxed thresholds for GWAS statistical significance, we determined the rates of clock vs. control genetic associations with BD, and four additional illnesses that share clinical features and/or genetic risk with BD. Then we compared the results to a set of lithium-responsive genes. Associations with BD-spectrum illnesses and lithium-responsiveness were both enriched among core clock genes but not among upstream clock modulators. Associations with BD-spectrum illnesses and lithium-responsiveness were also enriched among pervasively rhythmic clock-controlled genes but not among genes that were less pervasively rhythmic or non-rhythmic. Our analysis reveals previously unrecognized associations between clock genes and BD-spectrum illnesses, partly reconciling previously discordant results from past GWAS and candidate gene studies. (shrink)

Rare copy number variants have a prominent role in the aetiology of schizophrenia and other neuropsychiatric disorders. Substantial risk for schizophrenia is conferred by large CNVs at several loci, including microdeletions at 1q21.1, 3q29, 15q13.3 and 22q11.2 and microduplication at 16p11.2. However, these CNVs collectively account for a small fraction of cases, and the relevant genes and neurobiological mechanisms are not well understood. Here we performed a large two-stage genome-wide scan of rare CNVs and report the significant association of copy (...) number gains at chromosome 7q36.3 with schizophrenia. Microduplications with variable breakpoints occurred within a 362-kilobase region and were detected in 29 of 8,290 patients versus 2 of 7,431 controls in the combined sample. All duplications overlapped or were located within 89 kilobases upstream of the vasoactive intestinal peptide receptor gene VIPR2. VIPR2 transcription and cyclic-AMP signalling were significantly increased in cultured lymphocytes from patients with microduplications of 7q36.3. These findings implicate altered vasoactive intestinal peptide signalling in the pathogenesis of schizophrenia and indicate the VPAC2 receptor as a potential target for the development of new antipsychotic drugs. © 2011 Macmillan Publishers Limited. All rights reserved. (shrink)

In the first Critique Kant introduced the analytic/synthetic distinction and illustrated it with theoretical propositions. As his main aim in that work was to justify synthetic a priori propositions, Kant was able to bring his central questions into relief and discuss the methodology of their solution by contrasting synthetic propositions, such as: “Every event has a cause” with analytic propositions, such as: “Every effect has a cause.” Consequently, few commentators have any difficulty in stating as propositions the propositions Kant is (...) justifying in the first Critique or in pointing out the difficulty of justifying such propositions. (shrink)

We present an abstract social aggregation theorem. Society, and each individual, has a preorder that may be interpreted as expressing values or beliefs. The preorders are allowed to violate both completeness and continuity, and the population is allowed to be infinite. The preorders are only assumed to be represented by functions with values in partially ordered vector spaces, and whose product has convex range. This includes all preorders that satisfy strong independence. Any Pareto indifferent social preorder is then shown to (...) be represented by a linear transformation of the representations of the individual preorders. Further Pareto conditions on the social preorder correspond to positivity conditions on the transformation. When all the Pareto conditions hold and the population is finite, the social preorder is represented by a sum of individual preorder representations. We provide two applications. The first yields an extremely general version of Harsanyi's social aggregation theorem. The second generalizes a classic result about linear opinion pooling. (shrink)

Objective To determine the public's understanding of and views about a range of ethical issues in relation to death and dying. Design Random, digit-dialling, telephone interview Setting Ireland. Participants 667 adult individuals. Results The general public are unfamiliar with terms associated with end-of-life care. Although most want to be informed if they have a terminal illness, they also value family support in this regard. Most of the respondents believe that competent patients have the right to refuse life-saving treatment. Most also (...) (mistakenly) believe that families, either alone or with physicians, have the authority to make decisions about starting or stopping treatment for incompetent patients. Most Irish people are more concerned about the quality of their dying than death itself. Religious commitment is important to most Irish people, and this impacts on their views about medical treatment and care at the end of life. Conclusions The study paints a picture of a general public that is not very comfortable with or informed about the processes of dying and death. Great sensitivity is required of health professionals who must negotiate the timing and the context of breaking of bad news with patients and families. Educational interventions, public and organisational policies and legislation need to address the uncertainty that surrounds the role of professionals and families in making decisions for dying patients. (shrink)

This essay places More's Sadness of Christ in the ancient genre of consolatio. Arising out of Socrates’ use of philosophy as a means of consolation in the Phaedo, the genre was epitomized in Boethius’ Consolation of Philosophy. In the genre, philosophy, with the help of poetry and rhetoric, provides moral remedies to suffering man with the hope of reordering his passions, intellect, and will to their true good. In other words, the genre of consolatio is philosophy's attempt to provide a (...) solution to the moral problem of evil. Thomas More's Sadness of Christ is a Christian version of this ancient genre. While appropriating philosophical principles and images, More recasts those principles and images in the light of faith, and gives the Christian martyr's proper preparation for death and suffering by reordering his passions and intellect to their proper good through consolation in prayer and meditation on the sufferings of Christ. (shrink)

The ontological foundation of the modern world view based on irreconcilable dichotomies has held hegemonic status since the dawn of the scientific revolution. The post‐modern critique has exposed the inadequacies of the modern perspective and challenged the potential for any narrative to adequately ground a vision for the future. This paper proposes that the philosophy of Beatrice Bruteau can support a foundation for a visionary world view consistent with nursing's respect for human dignity and societal health. The author discusses the (...) key concepts of Bruteau's perspective on societal evolution based on an integrated study of science, mathematics, religion, and philosophy. This perspective is discussed as a foundation to move beyond the dichotomous influence of the modern world view and the deconstructive critique of the post‐modern perspective. The author suggests spiritual evolution and a participatory consciousness as an ontological foundation for a cosmology congruent with nursing's social mandate. (shrink)

The article offers a proposal about natural law inquiry in terms of knowledge attendant in the practices of a craft. We begin by discussing Aristotle’s analogical use of crafts in considering knowledge of ethics and politics in the Nicomachean Ethics. We inquire further into craft as a way of knowing by consulting the works of psychologist Mihaly Csikszentmihalyi and sociologist Richard Sennett. The framework of a craft is connected to moral realism through an analysis of works by Iris Murdoch and (...) Simone Weil. Finally we provide a proposal for natural law inquiry in relation to the embodied and embedded nature of craft. (shrink)

In 1932, as America struggled to overcome the great economic depression and Hitler was taking power in Germany, Dewey issued a challenge to teachers. Based upon what he viewed as the principle by which to judge "the processes of education, formal and informal," he urged teachers to embrace the following goal: "Education should create an interest in all persons in furthering the general good, so that they will find their own happiness realized in what they can do to improve the (...) conditions of others" (LW 7: 243).In setting this challenge to teachers, Dewey has in mind helping students develop their character in two ways. First, teachers should nurture students' sensitivity to the impact of their speech and actions .. (shrink)

Life together : moral reasoning in theological context -- Pilgrim's progress : virtues and the goal of the journey -- The imitation of Christ : issues along the way.

Summary 1. Ecologists and conservation biologists consider many issues when designing a field study, such as the expected value of the data, the interests of the study species, the welfare of individual organisms and the cost of the project. These different issues or values often conflict; however, neither animal ethics nor environmental ethics provides practical guidance on how to assess trade-offs between them. -/- 2. We developed a decision framework for considering trade-offs between values in ecological research, drawing on the (...) field of ecological ethics. We used a case study of the population genetics of three frog species, in which a researcher must choose between four methods of sampling DNA from the study animals. We measured species welfare as the reduction in population growth rate following sampling, and assessed individual welfare using two different definitions: (i) the level of suffering experienced by an animal, and (ii) the level of suffering combined with loss of future life. -/- 3. Tipping the tails of tadpoles ranked as the best sampling method for species welfare, while collecting whole tadpoles and buccal swabbing of adult frogs ranked best for the first and second definitions of individual welfare, respectively. Toe clipping of adult frogs ranked as the worst sampling method for species welfare and the first definition of individual welfare, and equal worst for the second definition of individual welfare. -/- 4. When considering species and individual welfare simultaneously, toe clipping was clearly inferior to the other sampling methods, but no single sampling method was clearly superior to the other three. Buccal swabbing, collecting tadpoles and tail tipping were all preferred options, depending on the definition of individual welfare and the level of precision with which we assessed species welfare. -/- 5.Synthesis and applications. The decision framework we present can be used by ecologists to assess ethical and other trade-offs when planning field studies. A formal decision analysis makes transparent how a researcher might negotiate competing ethical, financial and practical objectives. Defining the components of the decision in this way can help avoid errors associated with human judgement and linguistic uncertainty. (shrink)

The relationship between corporate social responsiveness and profitability is investigated in a sample of corporate directors. The findings show there is no relationship between the level of director social responsiveness and corporate profitability. The implications of these results are discussed, especially as they relate to concerns about corporate governance.

Nel Noddings claims that there is an important normative element in happiness. For support, she points to the Aristotelian idea of the eudaimonic life, a concept that is often translated into English as ‘the happy life’. However, in light of the wide divergence between the Aristotelian view of eudaimonia as a life of virtuous activity and most contemporary psychologists’ and lay people’s view of happiness as subjective wellbeing, the authors of this article believe that Noddings’s merging of the two has (...) several shortcomings. Aside from ambiguity and confusion, it encourages us to deny that, given the human condition, we must sometimes choose between happiness as pursuit of positive emotion and personal satisfaction and happiness as pursuit of the common good and the virtuous life. (shrink)