The Coalition of Immokalee Workers (CIW) has successfully combated modern-day slavery by transforming the ways that over a dozen major brands, including Taco Bell, Subway, and Wal-Mart, manage their supply chains. The CIW’s efforts over more than 20 years have effectively stopped enslavement practices, including abuses such as wage theft and peonage indebtedness. We conducted a field ethnography, interviews, and archival analyses to understand this success. We find that the CIW employs a decentered, egalitarian, and ensemble approach to their multiplicities (...) of alliances by collectively “animating” themselves and their partners through ensemble leadership. This combination of alliances, along with worker-driven monitoring, brings life to the CIW motto “We are all leaders.” Translating this motto into daily practice is how the CIW virtually eradicates enslavement practices in corporate supply chains. (shrink)

Effective documentation is considered a core competency for clinical ethics consultation. Ethics consultants within the Cleveland Clinic in Cleveland, Ohio, observed variation in the formatting of ethics chart notes across consultants and realized that this formatting was based on their own views of effectiveness. To minimize variation and optimize the readability and understandability of ethics chart notes for end users, a team undertook a quality improvement project to assess the formatting preferences of healthcare professionals who rely on ethics consultation notes. (...) The team developed three sample templates and conducted interviews with stakeholders to understand their preferences. A single standardized template was developed based on the preferences that emerged, which all consultants on the ethics consultation service then utilized. In the first five months of implementation, the percentage of end user respondents marking the highest Likert scale option on a post-consultation survey regarding whether the ethics consultation service provided helpful documentation increased from 60 percent to 72 percent compared to the same five-month period in the year prior. (shrink)

Background: Despite procedural innovations and increasing numbers of uterus transplant attempts worldwide, the perspectives of uterus transplant (UTx) trial participants are lacking. Methods: We conducted a mixed-methods study with women with absolute uterine factor infertility (AUFI). Participants included women who had previously contacted the Cleveland Clinic regarding the Uterine Transplant Trial and met the initial eligibility criteria for participation. In-depth interviews were conducted in conjunction with FertiQoL, a validated and widely used tool to measure the impact of infertility on the (...) quality of life of infertility patients. Results: All (n = 19) rated their overall health as good; some experienced grief and social isolation. AUFI is a life-framing experience that influences acceptance by family, partners, peers, and one’s self. UTx is a means to gain control of reproductive autonomy. UTx allows family-building and the ability to play an active role in prenatal health and well-being. Establishing and maintaining a supportive relationship is a key issue of AUFI and when considering UTx. Risks of UTx are perceived relative to risks to self/child/family posed by adoption/surrogacy. Participants had no overall preference regarding living or deceased donor. Conclusions: The ways in which women with AUFI conceptualize this condition in their lives and choices around UTx and participating in a study of the procedure are multifaceted and textured. These perspectives are critical to understanding its ethical, legal, and social implications. (shrink)

Despite an abundance of academic conferences, clinical ethicists lacked a forum to share innovative practices with peers and to generate solutions to common challenges. Organizers of the first Clinical Ethics Un-Conference developed a working event centered on active participation and problem solving through peer learning, with the goal of improving realworld practice. Registrants included 95 individuals from 64 institutions. Attendees were surveyed immediately after the Un-Conference, and again eight months later. After eight months, 85 percent (n = 33/39) of the (...) survey respondents reported that they found the event “highly impactful” or “some-what impactful” to their clinical practice, and 23 attendees reported that they had implemented ideas or projects inspired by the event. Three sets of best practice guidelines and four white papers were published from the event. As the field of clinical ethics continues to advance and evolve, this working event format offers an innovative, disruptive alternative to a traditional conference format and may serve as a model for future efforts aimed at improving real-world clinical ethics practice. (shrink)

Despite the growing routinization of prenatal diagnosis, little research has examined men's roles in this reproductive arena or these technologies' possibilities for reinforcing or transforming gender roles and relations. The authors analyze male partners' participation in the amniocentesis decisions of Mexican-origin women at high risk for problems, drawing on interviews with 157 women and 120 of their male partners. The primary aim is to explore whether the normalization of prenatal testing poses a threat to women's autonomy in this decision arena. (...) The findings challenge critics of new reproductive and genetic technologies who assume that these technologies inherently represent male attempts to control women's bodies and the processes of reproduction. In contrast, the authors find many couples try to balance their desire to share equally in parenting responsibilities while maintaining the woman's ultimate control over her body and decisions associated with it. (shrink)

Por un lado, el libro aborda la problemática educativa que enfrentan estudiantes mexicanos indocumentados en las universidades de los Estados Unidos. Por el otro lado, se aborda la atención específica (escolar, académica y administrativa) que la Universidad de Guadalajara (México), ofrece a los estudiantes migrantes retornados de los Estados Unidos.

_Migration and the Education of Young People 0_–_19_ investigates migration from a number of perspectives to consider the changing dynamics of society within different countries. Examining the data associated with global migration by focusing on case studies from a wide range of countries, it provides detailed and balanced coverage of this politically sensitive topic to explore the educational needs of migrant young people, the impact of large-scale migration to and from countries and the policy challenges that individual countries face when (...) ensuring adequate provision for migrant young people within their education systems. Chapters cover: The reasons why people might move Social and emotional learning in Britain: a tool to guard against cultural pollution? Migration into a global city: the economic and educational success of London Latvian people on the move and the impact on education People’s movement – Greece Return migration in Lithuania: incoming challenges for children’s education The United States, Latin America, immigration and education Tanzanian street children: victims, ordinary lives or extraordinary survivors? This book explores the changing social dynamics through an extensive range of case studies and will be an essential resource for students taking undergraduate and postgraduate courses in education, sociology and international relations. (shrink)

Volume 20, Issue 6, June 2020, Page 75-77.

Cet article traite d’un mythe cosmogonique où un dragon mapuche, le Kai Kai Filu, appartenant à la Patagonie argentine et chilienne, est signalé comme le responsable du déluge, de la montée des eaux et de la formation des golfes, îles et autres accidents géographiques. Un suivi du mythe montre qu’avec les frontières dressées entre ces deux pays, les populations originaires se sont fragmentées ainsi que leurs récits millénaires. Le résultat est que l’Argentine présente un mythe segmenté, plus proche des mythes (...) occidentaux et le sud du Chili nous raconte une version plus ancienne, faisant basculer le sens de la figure du dragon et sa forme dans un glissement symbolique significatif. Ce mythe vit de manière permanente et apparaît dans de nombreuses narrations locales, narrations qui vont témoigner de la vitalité du mythe : il change et se renouvelle selon les mouvements de la terre et les tsunamis qui se succèdent dans cette région du Sud. Les versions s’enrichissent quand les changements des structures économiques bouleversent la vie des habitants et que de nouveaux éléments apparaissent dans les contes populaires, revigorisant le mythe originel. (shrink)

Mabel Cooper and Gloria Ferris lived in St Lawrence's Hospital one of the large learning disability institutions which were built round the edges of London. In this paper, Mabel and Gloria share their memories of three nurses at St Lawrence's, supported by Jane Abraham and in this process reveal a number of ethical issues that remain relevant today.

The final published book by Nobel Prize-winning author and philosopher Henri Bergson (1859-1941), La pensée et le mouvant (translated here as The Creative Mind), is a masterly autobiography of his philosophical method. Through essays and lectures written between 1903 and 1923, Bergson retraces how and why he became a philosopher, and crafts a fascinating critique of philosophy itself. Until it leaves its false paths, he demonstrates, philosophy will remain only a wordy dialectic that surmounts false problems. With masterful skill and (...) intensity, Bergson shows that metaphysics and science must be rooted in experience for philosophy to become a genuine search for truth. And in the quest for unanswered questions, the spiritual dimension of human life and the importance of intuition must be emphasized. A source of inspiration for physicists as well as philosophers, Bergson's introduction to metaphysics reveals a philosophy that is always on the move, blending man's spiritual drive with his mastery of the material world. (shrink)

AbstractDuring the Covid-19 pandemic, ethicists and researchers proposed human challenge studies as a way to speed development of a vaccine that could prevent disease and end the global public health crisis. The risks to healthy volunteers of being deliberately infected with a deadly and novel pathogen were not low, but the benefits could have been immense. This essay is a history of the three major efforts to set up a challenge model and run challenge studies in 2020 and 2021. The (...) pharmaceutical company Johnson and Johnson, the National Institutes of Health in the United States, and a private-public partnership of industry, university, and government partners in Britain all undertook preparations. The United Kingdom’s consortium began their Human Challenge Programme in March of 2021.Beyond documenting each effort, the essay puts these scientific and ethical debates in dialogue with the social, epidemiological, and institutional conditions of the pandemic as well as the commercial, intellectual, and political systems in which medical research and Covid-19 challenge studies operated. It shows how different institutions understood risk, benefit, and social value depending on their specific contexts. Ultimately the example of Covid-19 challenge studies highlights the constructedness of such assessments and reveals the utility of deconstructing them retrospectively so as to better understand the interplay of medical research and research ethics with larger social systems and historical contexts. (shrink)

Decisions about continuing or terminating a pregnancy touch on profound, individualized questions about bodily integrity, reproductive autonomy, deeply held values regarding one's capacity for parenthood, and, in the case of a high-risk pregnancy, the risks one is willing to take to have a baby. So far as possible, reproductive decisions are made between a patient, in some cases her partner, and her medical provider. However, this standard framework cannot be applied if the patient lacks decision-making capacity. In this essay, we (...) discuss one such case that came before our clinical ethics team. We describe the challenges of respecting a patient's reproductive preferences when the patient cannot share what those preferences are, and we argue that decisions regarding reproductive health care should not be treated with exceptionalism. Rather, they should proceed under the normal processes of surrogate decision-making, including the application of substituted judgment. This approach enables us to take the patient's values into account when considering the questions implicated in reproductive health care, just as we do for other kinds of health care decisions in which a patient's deeply held values are salient. (shrink)

Presentación del Dossier: Feminismos y posthumanismo.

Las confesiones de Tauber han recorrido varios continentes desde el año 1997 y aseguraría que han sido leídas por muchos médicos. Tienen características que las hacen muy atractivas para las personas que hemos elegido la medicina como parte de nuestra vida: historias clínicas y relatos de la práctica profesional. Y, además y sobre todo, el autor se empeña en diagnosticar y curar el cuerpo herido y el alma enferma de la Medicina, planteándose con pasión todas las posibilidades que ofrezcan esperanza. (...) Hay búsqueda de causas, de hipótesis explicativas, de referencias ilustradas y humanistas y del auxilio de los que más saben. Todo para llegar a un diagnóstico y a un plan terapéutico: alivio de los síntomas, posibilidades de curación o de regeneración saludable para favorecer el buen funcionamiento presente y futuro. Ya no será igual, pero no tiene porqué ser peor. El tratamiento y la rehabilitación serán duros y todavía son experimentales, pero están bien fundamentados. .. (shrink)

Volume 20, Issue 3, March 2020, Page 39-41.

With the increasing professionalization of clinical ethics, some hospitals and health systems utilize both ethics committees and professional clinical ethicists to address their ethics needs. Drawing upon historical critiques of ethics committees and their own experiences, the authors argue that, in ethics programs with one or more professional clinical ethicists, ethics committees should be dissolved when they fail to meet minimum standards of effectiveness. The authors outline several criteria for assessing effectiveness, describe the benefits of a model that places primary (...) responsibility for ethics work with professional clinical ethicists—the PCE-primary model, and offer suggestions for alternative ethics program structures that empower healthcare professionals to contribute to ethics work in ways more tailored to their strengths and skills while minimizing the shortcomings of ethics committees. (shrink)

El pueblo mapuche, pueblo originario del Sur de América --Chile--, posee un sistema de comunicación propio articulado a una visión mítico-simbólica y sacralizada del mundo, condición que implica una diversidad de códigos y lenguajes que operan integradamente para la comunicación entre las diferentes dimensiones y entidades que componen este cosmos. La irrupción de occidente ha incidido en la transformación de la práctica tradicional de este pueblo debido al proceso de dominación hegemónica que ha buscado desarticularlo, ante el cual el pueblo (...) mapuche, desde la segunda mitad del siglo XX, implementa diversas estrategias tendientes a recuperar su territorio y autonomía cultural. Este trabajo sostiene que una de las principales estrategias contrahegemónicas es la creación de un macrosistema de comunicación intercultural que responde a un proceso metacognitivo complejo sustentado en distintas fases y niveles de elaboración epistémica. Con el propósito de dar cuenta de este proceso este trabajo se centra en el estudio de uno de sus subsistemas: el artístico, desde el cual se describen y reflexionan los territorios y fronteras simbólicas que se generan respecto del sistema de comunicación occidental. The Mapuche people in southern Chile, South America, have a system of communication organized upon a sacred mythical symbolic view of the world, a condition that implies a diversity of codes and languages working altogether to communicate in the different dimensions and entities that integrate this cosmos. Irruption of the western world and its hegemonic dominance have influenced and transformed these people’s culture, trying to break it apart. Since the second half of the 20th century, Mapuche people have developed varied strategies to recover their land and cultural autonomy. The present paper holds that one of the main strategies against this hegemony is the creation of a macro system of intercultural communication, which derives from a complex metacognitive process supported by different phases and epistemic elaboration levels. This paper focuses on one of those systems: the artistic one, from which we describe the land areas and symbolic borders produced in relation to the western communication system. (shrink)

Propelling Clinical Ethics Forward: A Working Unconference was held from 28-29 April 2022 in Atlanta, Georgia. The event, the third installment in an ongoing series of Clinical Ethics Unconferences, brought together 77 individuals from 40 institutions to exchange innovative practices and collaborate to address issues facing the field of clinical ethics. In this article the authors highlight the five major themes that emerged from the 2022 Unconference, including: (1) tackling new and old problems in clinical ethics practice; (2) evolving models (...) of clinical ethics structure and delivery; (3) defining the scope of clinical ethics work; (4) addressing racism, ableism, and underrepresentation in clinical ethics work; and (5) collecting and utilizing data effectively. The authors also reflect on what was learned from the first three Unconferences and offer suggestions for future Unconferences. (shrink)