Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

There has been much interest in group judgment and the so-called 'wisdom of crowds'. In many real world contexts, members of groups not only share a dependence on external sources of information, but they also communicate with one another, thus introducing correlations among their responses that can diminish collective accuracy. This has long been known, but it has-to date-not been examined to what extent different kinds of communication networks may give rise to systematically different effects on accuracy. We argue that (...) equations that relate group accuracy, individual accuracy, and group diversity are useful theoretical tools for understanding group performance in the context of research on group structure. In particular, these equations may serve to identify the kind of group structures that improve individual accuracy without thereby excessively diminishing diversity so that the net positive effect is an improvement even on the level of collective accuracy. Two experiments are reported where two structures are investigated from this perspective. It is demonstrated that the more constrained network outperforms the network with a free flow of information. (shrink)

In recruitment, promotion, admission, and other forms of wealth and power apportion, an evaluator typically ranks a set of candidates in terms of their competence. If the evaluator is prejudiced, the resulting ranking will misrepresent the candidates’ actual rankings. This constitutes not only a moral and a practical problem, but also an epistemological one, which begs the question of what we should do—epistemologically—to mitigate it. In a recent paper, Jönsson and Sjödahl in [Episteme 14:499–517, 2017], argue that the epistemic problem (...) can be fruitfully addressed by way of a novel statistical method that changes the products of biased behaviour, i.e. the rankings themselves, rather than the biased persons. Jönsson and Sjödahl’s pioneering proposal is a both a welcome addition to the literature on implicit bias, due the problems with existing implicit bias interventions [see e.g. Lai et al. in J Exp Psychol Gen 143:1765–1785; J Exp Psychol Gen 145:1001–1016, 2014; 2016; Forscher et al. in J Person Soc Psychol 117:522–559, 2019] but also to the literature on prejudice more generally, where many proposed prejudice-reduction strategies enjoy less than adequate empirical support [Paluck and Green in Ann Rev Psychol 60:339–367, 2009]. Their proposal, however, needs supplementation in two ways: the circumstances that must hold in order for it to work needs to be refined, and their claim that it works as intended in these circumstances needs to be validated. We argue that four of Jönsson and Sjödahl’s method’s presumed presuppositions can be weakened, but needs to be supplemented by two additional assumptions, overlooked by Jönsson and Sjödahl. Moreover, we demonstrate that the method does work as intended by way of a statistical simulation. (shrink)

In recruitment, promotion, admission, and other forms of wealth and power apportion, an evaluator typically ranks a set of candidates in terms of their perceived competence. If the evaluator is prejudiced, the resulting ranking will misrepresent the candidates’ actual ranking. This constitutes not only a moral and a practical problem, but also an epistemological one, which begs the question of what we should do – epistemologically – to mitigate it. The article is an attempt to begin to answer this question. (...) I first explore the presuppositions that must obtain for individual interventions to likely yield positive epistemological effects in ranking situations. I then compare these with the corresponding presuppositions of a novel, ‘post hoc’ approach to deprejudicing due to Jönsson and Sjödahl (Episteme 14(4):499–517, 2017), which does not attempt to change evaluators but attempts to increase the veracity of the rankings they produce after the fact (but before the rankings give rise to discriminatory effects) using statistical methods. With these two sets of presuppositions in place, I describe the limitations imposed by each presupposition on its intervention, compare presuppositions across the two kinds of interventions, and conclude that the two kinds of interventions importantly complement each other by having fairly disjoint, but non–conflicting, presuppositions. The post hoc intervention can thus complement an individual intervention (and vice versa) in situations where both are applicable (by adding further increases in veracity), but also by applying to situations where that intervention is not applicable (and thereby increase veracity in situations beyond the reach of that intervention). (shrink)

We propose a coherence account of the conjunction fallacy applicable to both of its two paradigms. We compare our account with a recent proposal by Tentori et al. : 235–255, 2013) that attempts to generalize earlier confirmation accounts. Their model works better than its predecessors in some respects, but it exhibits only a shallow form of generality and is unsatisfactory in other ways as well: it is strained, complex, and untestable as it stands. Our coherence account inherits the strength of (...) the confirmation account, but in addition to being applicable to both paradigms, it is natural, simple, and readily testable. It thus constitutes the next natural step for Bayesian theorizing about the conjunction fallacy. (shrink)

The Enlightenment is generally painted as a movement of ideas and society lasting from the late seventeenth to the early nineteenth century, but this book argues that the Enlightenment is an essential component of modernity itself and in fact can be seen to have lasted from the late sixteenth century to the present day. In the course of the study, Martin Davies offers an original world-view and a critique of some recent interpretations of the Enlightenment.

Explores the moral dimensions of the current global role of the U.S. military.

Metagenomics bears upon all aspects of microbiology, including our understanding of mitochondrial and eukaryote origin. Recently, ribosomal protein phylogenies show the eukaryote host lineage – the archaeal lineage that acquired the mitochondrion – to branch within the archaea. Metagenomic studies are now uncovering new archaeal lineages that branch more closely to the host than any cultivated archaea do. But how do they grow? Carbon and energy metabolism as pieced together from metagenome assemblies of these new archaeal lineages, such as the (...) Deep Sea Archaeal Group (including Lokiarchaeota) and Bathyarchaeota, do not match the physiology of any cultivated microbes. Understanding how these new lineages live in their environment is important, and might hold clues about how mitochondria arose and how the eukaryotic lineage got started. Here we look at these exciting new metagenomic studies, what they say about archaeal physiology in modern environments, how they impact views on host‐mitochondrion physiological interactions at eukaryote origin. (shrink)

_Reflections on, and analysis of, ethical issues facing military service in the United States._.

Explores the moral dimensions of the current global role of the U.S. military.

Volume 18, Issue 4, December 2019, Page 353-353.

Volume 19, Issue 1, April-May 2020, Page 76-76.

Just peacemaking proposes that it is a creative "third way" between just war and pacifism for Christian engagement with international affairs. It claims that its proposals result from the convergence of a number of important characteristics of the contemporary international scene that cumulatively make this a "kairos" for novel and creative modes of reflection and action. Further, it claims to offer workable and realistic counsel for action in the contemporary world of international relations. This paper critically assesses both claims. It (...) reviews various interpretations of the direction of contemporary international affairs and raises some cautions about too enthusiastic an embrace of just peacemaking's vision of cooperative internationalism. It then focuses specifically on situations that invite intervention in the name of humanitarian concerns. There, the author finds some elements of just peacemaking to be an important supplement to the capabilities of military forces to intervene effectively and to transition successfully to nation-building activities that are necessary if intervention is to have a lasting positive effect. (shrink)

Volume 18, Issue 3, October 2019, Page 261-262.

Volume 18, Issue 2, July 2019, Page 164-164.

The extant marketing literature provides little guidance for theory development or practice with regard to questions of ethical conformity and the resulting market response. To begin to bridge this research gap, we advance a theoretical framework of ethical conformity in marketing, appealing to marketing ethics, management strategy, and sociological foundations. We set the stage for our theoretical arguments by considering the role of normative expectations related to marketing practices and behaviors held by societal constituents. Against this backdrop, we propose drivers (...) of conformity in marketing, including practices consistent with both overconformity and underconformity. The framework allows us to advance testable research propositions by which questions of ethical conformity may be explored. We conclude by suggesting additional future research needed to develop the domain, specifically in the form of empirical inquiries uncovering firm strategic decisions with ethical implications. (shrink)

While consensus exists among many practitioners of ethics consultation about the need for and identification of core competencies and standards, there has been virtually no attempt to determine how these competencies and standards are best taught and assessed. We believe that clinical ethics consultation has reached a state of sufficient maturity that expert practitioners can evaluate those who are new to the field. We will outline several steps that can facilitate the creation of a certification process for clinical ethics consultants, (...) assuring the competency and quality of consultation for the patients, families, and healthcare professionals who utilize ECSs. (shrink)

Thinking about the Enlightenmentlooks beyond the current parameters of studying the Enlightenment, to the issues that can be understood by reflecting on the period in a broader context. Each of the thirteen original chapters, by an international and interdisciplinary team of contributors, illustrates the problematic legacy of the Enlightenment and the continued ramifications of its thinking since the eighteenth century. Together, they consider whether modernity can see its roots in the intellectual revolution of the seventeenth and eighteenth centuries. The collection (...) is divided into six sections, preceded by a comprehensive introduction to the field and the most recent scholarship on the period. Across the sections, the contributors consider modern day encounters with Enlightenment thinking, including Kant's moral philosophy, the conflict between reason and faith, the significance of the Enlightenment of law and the gender inequality that persisted throughout the eighteenth century. By examining specific encounters with the problematic results of Enlightenment concerns, the contributors are able to illuminate and offer new perspectives on topics such as human nature, race, politics, gender and rationality. Drawing from history, philosophy, literature and anthropology, this book enables students and academics alike to take a fresh look at the Enlightenment and its legacy in the modern world. (shrink)

Holistic theories of meaning have, at least since Dummett’s Frege: The Philosophy of language, been assumed to be problematic from the perspective of the incremental nature of natural language learning. In this essay I argue that the general relationship between holism and language learning is in fact the opposite of that claimed by Dummett. It is only given a particular form of language learning, and a particular form of holism, that there is a problem at all; in general, for all (...) forms of holism, and irrespective of how language learning is understood, semantic holism is conducive to language learning. The paper has three main parts. In the first, I demonstrate with the use of a simple formal system, that the form of holism that generates the problem that Dummett draws attention to is really decomposable into three distinct components, each of which is necessary for the problem to arise. In the second part, I demonstrate that even Dummett’s strong form of holism is compatible with one natural way in which to understand the incremental nature of language learning. In the third part, I outline the reasons why all forms of holism are conducive to language learning and offer two ways in which this general fact can be spelled out precisely. I end the paper by addressing some possible objections, and in doing so I draw attention to some affinities between semantic holism and the principle of compositionality, a semantic principle which has long been assumed to be conducive to language learning. (shrink)

Reflections on, and analysis of, ethical issues facing military service in the United States.

In their invocations of the Muses the early epic poets use indifferently verbs meaning ‘tell’, ‘speak of’ and the verb which we normally translate as ‘sing’ When they refer directly to their own performance they may use the non-committalμνήσομαι, or ἐρέω, ἐνισπεῖνbut more often it isάείδω, ἄρχομ ἀείδεινor something of the sort; and they will pray for goodἀοιδήor hope for reward from it. We cannot make a distinction between two styles of performance, one characterized asἀείδειν the other as ἐνέπεινthe Iliad (...) beginsμῆνιν ἄειδε θεάbut later hasἔσπετε νῦν μοι Μοῦσαι;Hesiod moves straight fromχαίρετε τέκνα Διός, δότε δ᾿ ἱμερόεσσαν ἀοιδήνtoεἴπατε δ᾿ ὡς... ταῦτά μοι ἔσπετε Μοῦσαι... καὶ εἴπατε; the author of the Hymn to Pan beginsἔννεπε Μοῦσαand endsἴλαμαι δέ σ᾿ ἀοιδῇ... καὶ σεῖο καὶ ἄλλης μνήσομ᾿ ἀοιδῆς. (shrink)

Although military personnel are required to follow all legal orders, morally the traditional contract between soldier and state rests on shared assumptions about the purposes for which national militaries will and will not be used.

We congratulate Fox and her colleagues (2007) for contributing to the published empirical literature on ethics consultation in United States hospitals. Their study demonstrates the continued wide v...

Martin Davies draws parallels between Herz's personal life and Prussian politics and culture to make sense of the end of the eighteenth century when Enlightenment tradition and Romantic thought coincided.

Conflicts of interest. None to report. Despite widespread acceptance in the United States of neurological criteria to determine death, clinicians encounter families who object, often on religious grounds, to the categorization of their loved ones as “brain dead.” The concept of “reasonable accommodation” of objections to brain death, promulgated in both state statutes and the bioethics literature, suggests the possibility of compromise between the family’s deeply held beliefs and the legal, professional and moral values otherwise directing clinicians to withdraw medical (...) interventions. Relying on narrative to convey the experience of a family and clinical caregivers embroiled in this complex dilemma, the case analyzed here explores the practical challenges and moral ambiguities presented by the concept of reasonable accommodation. Clarifying the term’s meaning and boundaries, and identifying guidelines for its clinical implementation, could help to reduce uncertainty for both health care professionals and families and, thereby, the incremental moral distress such uncertainty creates. (shrink)

Name der Zeitschrift: Klio Jahrgang: 97 Heft: 1 Seiten: 313-318.