Moral distress is a well-documented phenomenon for health care providers (HCPs). Exploring HCPs’ perceptions of participation in moral distress interventions using qualitative and quantitative methods enhances understanding of intervention effectiveness. The purpose of this study was to measure and describe the impact of a two-phased intervention on participants’ moral distress. Using a cross-over design, the project aimed to determine if the intervention would decrease moral distress, enhance moral agency, and improve perceptions about the work environment. We used quantitative instruments and (...) explored participants’ perceptions of the intervention using semi-structured interviews. Participants were from inpatient settings, within three major hospitals of a large, urban healthcare system in the Midwest, United States. Participants included nurses (80.6%) and other clinical care providers. Using generalized linear mixed modeling we assessed the change in each of the outcome variables over time controlling for groups. Interviews were audiotaped and professionally transcribed. The written narratives were coded into themes. The change in scores on study instruments trended in the desired direction however did not meet statistical significance. Qualitative interviews revealed that intervention effectiveness was derived from a combination of learning benefits, psychological benefits, and building community that promoted moral agency. Findings demonstrate a clear link between moral distress and moral agency and suggest that Facilitated Ethics Conversations can enhance the work environment. Findings provide insight for developing evidenced-based approaches to address moral distress of hospital nurses. (shrink)

The use of brain imaging technology as a common tool of research has spawned concern and debate over how investigators should respond to incidental fndings discovered in the course of research. In this article, we argue that investigators have an obligation to respond to incidental fndings in view of their entering into a professional relationship with research participants in which they are granted privileged access to private information with potential relevance to participants' health. We discuss the scope and limits of (...) this professional obligation to respond to incidental fndings, bearing in mind that the relationship between investigators and research participants differs fundamentally from the doctor-patient relationship. (shrink)

My topic is authenticity in or perhaps as painting, not the authenticity of paintings; I know next to nothing about the problem of verifying claims of authorship. I am interested in another kind of genuineness and fraudulence, the kind at issue when we say of a person that he or she is false, not genuine, inauthentic, lacks integrity, and, especially when we say he or she is playing to the crowd, playing for effect, or is a poseur. These are not (...) quite moral distinctions (no one has a duty to be authentic), but they are robustly normative appraisals, applicable even when such falseness is not a case of straight hypocrisy but of lack of self-knowledge or of self-deceit. (A person can be quite sincere and not realize the extent of her submission to the other’s expectations and demands.) This sort of appraisal also has a long history in post-Rousseauist reflections on the dangers of uniquely modern forms of social dependence, and they are prominent worries in the modern novel. (shrink)

The rise of the phenomenon of virtue ethics in recent years has increased at a rapid pace. Such an explosion carries with it a number of great possibilities, as well as risks. This volume has been written to contribute a multi-faceted perspective to the current conversation about virtue. Among many other thought-provoking questions, the collection addresses the following: What are the virtues, and how are they enumerated? What are the internal problems among ethicists, and what are the objections and replies (...) to contemporary virtue ethics? Additionally, the practical implications following from the answers to these questions are discussed in new and fascinating research. Fundamental concepts such as teleology and eudaimonism are addressed from both a historical and dialectical approach. This tome will contribute not only to providing further clarity to the current horizons in virtue ethics, but also to the practical conclusion following from the study: to challenge the reader toward a greater pursuit of the virtuous life. (shrink)

Staff reported paranormal experiences in connection with the outpatient Medical Assistance in Dying room at the hospital. This case study reports on staff experiences and illustrates how the Ethics team’s role expanded to deal with this novel situation by facilitating an interdisciplinary response.

Increasingly, medical educators integrate art-viewing into curricular interventions that teach clinical observation—often with local art museum educators. How can cross-disciplinary collaborators explicitly connect the skills learned in the art museum with those used at the bedside? One approach is for educators to align their pedagogical approach using similar teaching methods in the separate contexts of the galleries and the clinic. We describe two linked pedagogical exercises—Visual Thinking Strategies (VTS) in the museum galleries and observation at the bedside—from “Training the Eye: (...) Improving the Art of Physical Diagnosis,” an elective museum-based course at Harvard Medical School. It is our opinion that while strategic interactions with the visual arts can improve skills, it is essential for students to apply them in a clinical context with faculty support—requiring educators across disciplines to learn from one another. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 25.2 (2001) 233-250 [Access article in PDF] Narrative Theory and Function: Why Evolution Matters Michelle Scalise Sugiyama I It may seem a strange proposition that the study of human evolution is integral to the study of literature, yet that is exactly what this paper proposes. The reasons for this are twofold. Firstly, the practice of storytelling is ancient, pre-dating not only the advent of writing, but (...) of agriculture and permanent settlement as well. Secondly, narrative is ultimately a product of the mind, which in turn is the product of a long history of evolution by natural selection. Thus, an understanding of why and how humans create and consume narrative requires an understanding of (1) features of ancestral environments and (2) features of the mind that made the emergence of this phenomenon possible.There can be little doubt that narrative emerged in human prehistory. Language, an obvious prerequisite for storytelling, is likely to have emerged by at least 50,000 and possibly 250,000 years ago, depending upon whether one places one's trust in archaeological or anatomical evidence. 1 The most reasonable estimate is offered by Geoffrey Miller, who points out that, given its universality, the language faculty must have emerged by the time ancestral Homo sapiens began migrating out of Africa approximately 100,000 years ago. 2 Although the oldest known written narrative (The Epic of Gilgamesh) dates back only 5,000 years, the written literary traditions of many ancient cultures are known to be rooted in longstanding oral traditions. 3 The fact that many modern foraging peoples have rich and complex oral traditions further suggests that the emergence of narrative is not linked to the development of agriculture 10,000 years ago. Moreover, other forms of symbolic expression, such as the cave paintings, Venus figurines, and engraved bone [End Page 233] and antler that have been found at various sites throughout Europe, date back approximately 30,000 years, and rock paintings in Australia may date back even farther. 4 Since humans were physiologically capable of speech long before they began producing these artifacts, storytelling is likely to be at least as ancient as these other representational forms. Indeed, one scholar situates the "dawn of the oral tradition" within this period (Pfeiffer, p. 189). Given, then, that modern humans (Homo sapiens sapiens) have been in existence for approximately 100,000 years 5 and are the only hominid species or subspecies known for certain to exhibit storytelling behavior, we can safely say that oral narrative is a product of our hunting-and-gathering past, likely to have emerged between 30,000 and 100,000 years ago.The universality of narrative is further testimony to its being an ancient cognitive phenomenon. Literate or not, all known cultures, past and present, practice storytelling. 6 Moreover, all normally developing humans acquire the ability to process and generate stories: studies of Western children indicate that the ability to tell stories emerges spontaneously between the ages of two-and-a-half and three, and children as young as thirty months can distinguish between narrative and non-narrative uses of language. 7 In contrast to reading, writing, and arithmetic, no special education is required for narrative competence to develop, nor is there any evidence that oral literacy is acquired through contact with other cultures; although subject matter is often exchanged between groups, the practice of storytelling itself arises independently among even the most isolated peoples. Nor does any type of culture have a monopoly on narrative sophistication: the stories of hunter-horticulturalist societies are no less observant, insightful, or artful than those of agrarian or industrial societies.As with language, narrative takes the same basic form across cultures, which David Bordwell and Kristin Thompson define as "a chain of events in cause-effect relationship occurring in time." Given the preponderance of human agents in narrative, most narrative theorists would probably modify this barebones description to include character (usually understood to have a human psychology), goal-oriented action, and resolution. Frank Kermode, for example, defines the "proprieties" of narrative as "connexity, closure, and character," and John... (shrink)

In this collection of provocative essays, historians and literary theorists assess the influence of Michel Foucault, particularly his History of Sexuality, on the study of classics. Foucault's famous work presents a bold theory of sexuality for both ancient and modern times, and yet until now it has remained under-explored and insufficiently analyzed. By bringing together the historical knowledge, philological skills, and theoretical perspectives of a wide range of scholars, this collection enables the reader to explore Foucault's model of Greek culture (...) and see how well his interpretation accounts for the full range of evidence from Greece and Rome. Not only do the essays bring to light the assumptions, ideas, and practices that constituted the intimate lives of men and women in the ancient Mediterranean world, but they also demonstrate the importance of the History of Sexuality for fields as diverse as Greco-Roman antiquity, women's history, cultural studies, philosophy, and modern sexuality. The essays include "Situating The History of Sexuality" (the editors), "Taking the Sex Out of Sexuality: Foucault's Failed History" (Joel Black), "Incipit Philosophia" (Alain Vizier), "The Subject in Antiquity after Foucault" (Page duBois), "This Myth Which Is Not One: Construction of Discourse in Plato's Symposium" (Jeffrey S. Carnes), "Foucault's History of Sexuality: A Useful Theory for Women?" (Amy Richlin), "Catullan Consciousness, the 'Care of the Self,' and the Force of the Negative in History" (Paul Allen Miller), "Reversals of Platonic Love in Petronius' Satyricon" (Daniel B. McGlathery), and an essay from Dislocating Masculinity (Lin Foxhall). (shrink)

A startling look at one of this century's most influential philosophers, the book chronicles every stage of Foucault's personal and professional odyssey, from his early interest in dreams to his final preoccupation with sexuality and the nature of personal identity.

Este trabajo surge a partir de la investigación general de las técnicas hidropónicas teniendo en cuenta sus ventajas y desventajas para de esta forma poder encontrar aquel factor determinante a través de una comparación de técnicas hidropónicas que permitan clasificarlas y escoger la mejor opción que genere menos impacto ambiental negativo y demuestre ser más productivo en los entornos urbanos. Adicionalmente, un factor determinante en las ciudades es su espacio limitado por lo que la mejor opción también deberá incluir un (...) óptimo manejo del espacio que permita a casi cualquier individuo poder aplicarlos desde su entorno sin recurrir a excesivas modificaciones. Como principal resultado se escogió a la Hidroponía recirculante como método predominante por los excelentes resultados que se obtienen con relación a los demás, adicionalmente, este puede ser fácilmente aplicado en los ambientes urbanos por su versatilidad y buen manejo de recursos. Palabras Clave: Hidroponia, ambiente, urbano, comparativa, técnicas, cultivo. Referencias [1]J. López, «La producción hidropónica de cultivos,» IDESIA, vol. 36, nº 2, pp. 139-141, 2018. [2]J. Lee, A. Rahman, J. Behrens, C. Brennan, B. Ham, H. Seok Kim, C. Won, S. Yun, H. Azam y M. Kwon, «Nutrient removal from hydroponic wastewater by a microbial consortium,» New Biotechnology, vol. 41, pp. 15-24, 2018. [3]H. Ku, C. Tiong, A. Suresh y B. Ong, «“Active” hydroponic greenhouse system to kick-start and augment reforestation program through carbon sequestration e an experimental and theoretical feasibility study,» Journal of Cleaner Production, vol. 129, pp. 637-646, 2016. [4]J. Beltrano y D. Gimenez, Cultivo en hidroponía, Buenos Aires: Universidad de la Plata, 2015. [5]L. Ramírez, M. Pérez, P. Jiménez, H. Giraldo y E. Gómez, «Evaluación preliminar de sistemas acuapónicos e hidropónicos en cama flotante para el cultivo de orégano,» Revista Facultad de Ciencias Básicas, vol. 7, nº 2, pp. 242-259, 2011. [6]S. Hosseinzadeh, D. Testai, M. BKheet y J. De Graeve, «Degradation of root exudates in closed hydroponic systems using UV/H2O2: Kinetic investigation, reaction pathways and cost analysis,» Science of the Total Environment, vol. 1, pp. 1-9, 2019. [7]N. Camarena, A. Rojas y M. Santos, «Fluoride bioaccumulation by hydroponic cultures of camellia,» Chemosphere, vol. 136, pp. 56-62, 2015. [8]W. Wang, Y. Ma, L. Fu, Y. Cui y M. Yaqoob, «Physical an mechanical properties of hydroponic lettuce for automatic harvesting,» Informatión processing in agriculture, vol. 1, pp. 2214-3173, 2020. [9]M. Zárate, Manual de Hidroponia, Coyoacán: Universidad Autónoma de Mexico, 2014. [10]S. Magwaza, L. Magwaza, A. Odindo y C. Buckley, «Partially treated domestic wastewater as a nutrient source for tomatoes grown in a hydroponic system: effect on nutrientabsorption and yield,» Heliyon, vol. 6, nº 12, pp. 2405-8440, 2020. [11]C. ARANO, «Hidroponía: Algunas paginas de historia,» Tecnología de Producción, nº 58, pp. 24-32, 2007. [12]G. Guzmán, Hidroponia en Casa: Una actividad familiar, Costa Rica: Ministerio de Agricultura y ganaderia, 2004. [13]J. Gilsanz, HIDROPONIA, Montevideo : Unidad de Comunicación y Transferencia de Tecnología, 2007. [14]C. Miller, «El debate de hidroponia orgánica: Perspectivas norteamericanas sobre si la producción hidropónica merece ser certificada como orgánica.,» Productores de Hortalizas, nº 6, pp. 36-38, 2017. [15]A. Herrera, «Manejo de la solución nutritiva en la producción de tomate en hidroponía,» Terra Latinoamericana, vol. 17, nº 3, pp. 221-229, 1999. [16]C. Espinal y D. Matulić, «Recirculating Aquaculture Technologies,» Biomedical and Life Sciences, pp. 35-76, 2020. [17]H. Resh, «Técnicas de cultivo con flujo laminar de nutrientes,» de Cultivos Hidroponicos, España, Mundi-Prensa, 2001, pp. 35-37. [18]P. Blanca y L. Teresa, «Sistemas recirculantes y su interés en el cutlivo de ornamentales,» Tecnología de producción, nº 35, pp. 34-36, 2006. [19]C. Magán, «Recirculación de las soluciones nutritivas, Manejo y Control Microbiologico,» InfoAgro, nº 2, pp. 1-2, 2016. [20]S. Goddek, A. Joyce, B. Kotzen y M. Dos-Santos, «Aquaponics and Global Food Challenges,» Aquaponics Food Production Systems. Springer, vol. 1, nº 1, pp. 3-17, 2019. [21]S. G. Verdoliva, D. Gwyn Jones, A. Detheridge y P. Robson, «Controlled comparisons between soil and hydroponic systems reveal increased water use efficiency and higher lycopene and β-carotene contents in hydroponically grown tomatoes,» Scientia Horticulturae, pp. 3002-4238, 2020. [22]A. Chaudhry y V. Mishra, «A Comparative Analysis of Vertical Agriculture Systems in Residential Apartments, » de 2019 Advances in Science and Engineering Technology International Conferences, Dubai, United Arab Emirates, United Arab Emirates, 2019. [23]T. Mazhar, G. Jianmin, L. Imran, S. Kashif, Q. Waqar, S. Sher y C. Jiedong, «Modern plant cultivation technologies in agriculture under controlled nvironment: a review on aeroponics,» Journal of Plant Interactions, vol. 13, nº 1, pp. 338-352, 2012. [24]K. Janiak, A. Jurga, J. Kuźma, W. Breś y M. Muszyński, «Surfactants effect on aeroponics and important mass balances of regenerative life support system – Lettuce case study,» Science of the Total Environment, vol. 718, nº137324, pp. 1-12, 2020. [25]F. Rahman, I. Jahan, R. Biplob, N. Farhin y J. Uddin, «Automated Aeroponics System for Indoor Farming using Arduino,» de 2018 Joint 7th International Conference on Informatics, Electronics & Vision and 2018 2nd International Conference on Imaging, Vision & Pattern Recognition, Kitakyushu, Japan, 2018. [26]M. Caldeyro Stajano, «La Hidroponía Simplificada como Tecnología apropiada, para implementar la Seguridad Alimentaria en la Agricultura Urbana.,» Cuadernos del CEAgro, nº 8, pp. 71-76, 2006. (shrink)

First published in 1987. Our understanding of the nature of power in western societies is currently undergoing a major reassessment. The significance of this reassessment emerges forcefully through comparing the writings of the principal exponents of Critical Theory - Max Horkheimer, Herbert Marcuse and Jürgen Habermas - with those of Michel Foucault. Peter Miller suggests that these two traditions embody fundamentally distinct philosophical and sociological principles. He grounds his analysis in the concepts of domination and power. Miller identifies (...) the notion of subjectivity as central to a differentiation of the respective approaches of Critical Theory and Foucault. For Critical Theory it is the repression of subjectivity which provides the evidence of domination and the rationale for its critique, while for Foucault subjectivity in western societies is fabricated through power and linked to the deployment of specific knowledges. Miller shows that despite the achievements of Critical Theory in bringing to light the repressive nature of advanced industrial societies, its thinking is inadequate as a basis for future analysis and critique. He argues that Foucault's genealogy of the modern subject, which highlights the role of the human sciences in its fabrication, is a more fruitful basis for charting and investigating the mode of operation of contemporary forms of power. The book includes a survey of all published works by Foucault, up to the time of his death in 1984, and commentaries on the writings of Max Horkheimer, Herbert Marcuse and Jürgen Habermas. (shrink)

Payment for research participation has raised ethical concerns, especially with respect to its potential for coercion. We argue that characterising payment for research participation as coercive is misguided, because offers of benefit cannot constitute coercion. In this article we analyse the concept of coercion, refute mistaken conceptions of coercion and explain why the offer of payment for research participation is never coercive but in some cases may produce undue inducement.

We assert that one of the examples used by Keller & Miller (K&M), namely, autism, is indeed common, and heritable, but we question whether it is harmful. We provide a brief review of cognitive science literature in which autistics perform superiorly to non-autistics in perceptual, reasoning, and comprehension tasks; however, these superiorities are often occluded and are instead described as dysfunctions. (Published Online November 9 2006).

In 1980, Michel Foucault's work makes two decisive turns. On the one hand, as announced at the start of his course at the Collège de France for that year, Le Gouvernement des vivants, his topic will be the modalities through which power constitutes itself in relation to truth. On the other hand, the texts on which he will concentrate will no longer be those of the early modern period. Rather, he begins with one by Dio Cassius on the emperor Septimius (...) Severus and then proceeds to spend the next two sessions offering a reading of Oedipus Tyrannus. He will concentrate on works from antiquity for the rest of his life. This book will offer the first detailed account of these lectures, examining both the development of their philosophical argument and the ancient texts on which that argument is based. This is the period during which Foucault also began work on Volumes 2 and 3 of the History of Sexuality. Yet, while there are clear overlaps between the work he was presenting in his course and the last books he published before his death, nonetheless the seminars are anything but rough drafts for the published work. Instead they offer a sustained encounter with the texts of the classical and early Christian era while seeking to trace a genealogy of the western subject as a speaker of truth. (shrink)

In the still highly politicized question of rupture or continuity between the Russian Empire and the Soviet Union, elements of continuity are not hard to find, nor should this be a surprise, since a new state arose in the same geographical space and made use of the economic, intellectual, and demographic resources inherited from the Russian Empire. At the same time, the Soviet Union could not have been more different than the Russian Empire. It rejected a number of key elements (...) of the sociopolitical project that underlay the nationalizing tsarist empire and introduced radically new political and social principles for organizing that space. In particular, the Bolsheviks purposefully engaged in dismantling the tsarist efforts to build a great ethnic-Russian nation to stand at the center of the Russian Empire’s nationalities policy. The irreversible disintegration of post-Soviet space into separate nationalizing states became possible only toward the end of the twentieth century. At the same time, the imperial nature of the modern post-Soviet Russian core permits us to say that the imperial logic has survived. This is where we can find an element of inescapable continuity. We present studies of “continuities” and “ruptures” in modern academic discourse and in an updated format, gravitating toward “empirically nuanced” tools for analyzing multiple historical temporalities. (shrink)

Although Friedrich Nietzsche had no less to say about value than he did about truth, his writings reflect contradictory views about their interrelation. In several passages, Nietzsche explicitly remarks that no relation exists between phenomena and value, describing value as a derivative and secondary mode of interpretation arbitrarily ‘attached’ to primary, non-evaluative interpretations. Elsewhere and more understated, however, runs an opposing line of argumentation in which Nietzsche presents interpretation as emerging through evaluation and therefore as necessarily ‘colored’ by it. While (...) Gilles Deleauze's exegesis of Nietzsche struggles to maintain a certain faithfulness to this ambiguity, most contemporary inheritors of Nietzschean thought, including Richard Rorty and Michel Foucault, have embraced the claim of ‘no relation’ between value and interpretation. This article provides support, in part through the analytic of race, for the alternative hypothesis that holds the indissociable relation of value and interpretation. (shrink)

We assessed the attitudes, perceptions, and stereotypes toward Latino immigrants among 247 mental health professionals across 32 U.S. states. We also randomly presented two versions of an attitude measure that varied in their references to immigrants. Participants reported that they did not agree with the anti-immigration law Arizona SB 1070 and other similar bills. Also, greater multicultural awareness was related to positive attitudes and fewer stereotypes toward immigrants. Furthermore, participants who were asked to think about “undocumented immigrants” viewed Latino immigrants (...) more positively than those who were asked think about “illegal aliens.” Findings show the continued need for multicultural awareness and competence training for mental health professionals, which align with the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. Limitations and future directions for research are discussed. (shrink)

John McMillan's article raises numerous important points about the ethics of surgical castration of sex offenders.1 In this commentary, we focus solely on and argue against the claim that the offer of release from detention conditional upon surgical castration is a coercive offer that compromises the validity of the offender's consent. We take no view on the question as to whether castration for sex offenders is ethically permissible. But, we reject the claim that it is ethically permissible only if competing (...) ethical considerations outweigh worries about coercion. For in the situation described, the proposal is not coercive at all.McMillan states that if offenders agree to castration because they fear long-term detention, then ‘it seems, intuitively, as if agreeing to be castrated under these conditions makes the decision coerced in some way.’1 He adds that if castration is ‘the only way that they will be released back into the community, the status of this decision as a genuine expression of their autonomy is questionable.’1 In defence of his claim, he uses two analogies that he borrows from Joel Feinberg. First, if a governor offers to commute a death sentence if the prisoner agrees to participate in a medical experiment, then ‘it's clear that the governor is coercing the prisoner.’1 Second, if a millionaire offers to give a woman $1 000 000 …. (shrink)

Much existing literature in anthropology suggests that teaching is rare in non-Western societies, and that cultural transmission is mostly vertical (parent-to-offspring). However, applications of evolutionary theory to humans predict both teaching and non-vertical transmission of culturally learned skills, behaviors, and knowledge should be common cross-culturally. Here, we review this body of theory to derive predictions about when teaching and non-vertical transmission should be adaptive, and thus more likely to be observed empirically. Using three interviews conducted with rural Fijian populations, we (...) find that parents are more likely to teach than are other kin types, high-skill and highly valued domains are more likely to be taught, and oblique transmission is associated with high-skill domains, which are learned later in life. Finally, we conclude that the apparent conflict between theory and empirical evidence is due to a mismatch of theoretical hypotheses and empirical claims across disciplines, and we reconcile theory with the existing literature in light of our results. (shrink)

ABSTRACTJoseph E. Uscinski and Ryden W. Butler argue that fact-checking should be condemned to the dustbin of history because the methods fact-checkers use to select statements, consider evidence, and render judgment fail to stand up to the rigors of scientific inquiry and threaten to stifle political debate. However, the premises upon which they build their arguments are flawed. By sampling from multiple “fact-checking agencies” that do not practice fact-checking on a regular basis in a consistent manner, they perpetuate the selection (...) effects they criticize and thus undermine their own position. Furthermore, not only do their arguments suffer from overgeneralization, they fail to offer empirical quantification to support some of their anecdotal criticisms. This rejoinder offers a study demonstrating a high level of consistency in fact-checking and argues that as long as unambiguous practices of deception continue, fact-checking has an important role to play in the United States and around the world. (shrink)

Much human adaptation depends on the gradual accumulation of culturally transmitted knowledge and technology. Recent models of this process predict that large, well-connected populations will have more diverse and complex tool kits than small, isolated populations. While several examples of the loss of technology in small populations are consistent with this prediction, it found no support in two systematic quantitative tests. Both studies were based on data from continental populations in which contact rates were not available, and therefore these studies (...) do not provide a test of the models. Here, we show that in Oceania, around the time of early European contact, islands with small populations had less complicated marine foraging technology. This finding suggests that explanations of existing cultural variation based on optimality models alone are incomplete because demography plays an important role in generating cumulative cultural adaptation. It also indicates that hominin populations with similar cognitive abilities may leave very different archaeological records, a conclusion that has important implications for our understanding of the origin of anatomically modern humans and their evolved psychology. (shrink)

Business and Society Review, Volume 127, Issue S1, Page 193-222, Spring 2022.

This paper attempts to sort out some of the current tensions and ambiguities inherent in the field of bioethics as it continues to mature. In particular it focuses on the question of the methodological relevance of theory or ethical principles to the domain of clinical ethics. I offer an approach to reasoning about moral conflict that combines the insights of contemporary moral theorists, the philosophy of American pragmatism, and the skills of rhetorical deliberation. This synthetic approach locates a proper role (...) for moral theory in the practice of clinical ethics, thus linking abstract philosophical ideas about morality, humanity, suffering, and health to specific deeds, actions, and decisions in the concrete lives of particular individuals. The aim of this synthetic approach of bioethical inquiry is a rapprochement between theoretical knowledge in moral philosophy and the contextualized, relational, and practical understanding of what morality demands of us in our daily lives. I argue for a conception of bioethical inquiry that takes morality to be a study of certain practical, socially embedded concerns about matters of right and wrong, good and evil, as well as a study of the moral theories by which these actual concerns can be explored and critically evaluated. (shrink)

Purpose Prescription stimulant use as “cognitive enhancers” has been described among undergraduate college students. However, the use of prescription stimulants among future health care professionals is not well characterized. This study was designed to determine the prevalence of prescription stimulant misuse among students at an academic health sciences center. -/- Method Electronic surveys were e-mailed to 621 medical, pharmacy, and respiratory therapy students at East Tennessee State University for four consecutive weeks in fall 2011. Completing the survey was voluntary and (...) anonymous. Surveys asked about reasons for, frequency of, and side effects of nonprescription misuse of prescription stimulants. Given the sensitive material, an opportunity to win one of ten $50 gift cards was used as an incentive. -/- Results Three hundred seventy-two (59.9%) students completed the survey from three disciplines (47.6% medical, 70.5% pharmacy, and 57.6% respiratory therapy). Overall, 11.3% of responders admitted to misusing prescription stimulants. There was more misuse by respiratory therapy students, although this was not statistically significant (10.9% medicine, 9.7% pharmacy, 26.3% respiratory therapy; P = .087). Reasons for prescription stimulant misuse included to enhance alertness/ energy (65.9%), to improve academic performance (56.7%), to experiment (18.2%), and to use recreationally/get high (4.5%). -/- Conclusions Prescription stimulant misuse was prevalent among participating students, but further research is needed to describe prevalence among future health care workers more generally. The implications and consequences of such misuse require further study across professions with emphasis on investigating issues of academic dishonesty (e.g., “cognitive enhancement”), educational quality, and patient safety or health care quality. (shrink)

An apparently simple answer to this question is 'diversity': there is a diversity of women readers, diversity of interests, diversity of methods and diversity of results of women reading the Bible. In this article I will discuss the complex reality of the diversity of contemporary women's reading of the Bible. I will discuss women readers under two headings, namely the everyday, non-academic reader on the one hand, and the professional, academically trained biblical exegete on the other. I will first suggest (...) a general comparison of these two groups before I treat each one in greater detail. Finally, I will offer a reading of a story about a woman from the Gospel of Mark that draws on feminist hermeneutics to read for a meaning that liberates women from a burdensome, conventional reading. (shrink)

The idea that our conscious decisions determine our actions has been challenged by a report suggesting that the brain starts to prepare for a movement before the person concerned has consciously decided to move . Libet et al. claimed that their results show that our actions are not consciously initiated. The current article describes two experiments in which we attempted to replicate Libet et al.'s comparison of participants' movement-related brain activity with the reported times of their decisions to move and (...) also the reported times of their decisions of which hand to move. We also looked at the distribution of participants' reports over time to evaluate an alternative explanation of Libet et al.'s results. Although the Readiness Potential was usually present before all of the decisions to move, consistent with the findings of Keller and Heckhausen and Libet et al. , we found that many reported decision times were before the onset of the Lateralized Readiness Potential, which measures hand-specific movement preparation. The latter finding is consistent with the conclusion that the LRP always started after the conscious decision to move. We conclude that even though activity related to movement anticipation may be present before a conscious decision to move, the cortical preparation necessary for the movement to happen immediately may not start until after the conscious decision to move. (shrink)

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

We argued last year in this journal that extensive integration of research and care is a worthy goal of health system design, and we second the call from Ruth Faden and colleagues to move toward learning health care systems. As they recognize, learning health care systems demand the coordination of research and medical ethics—two sets of normative commitments that have long been considered distinct. In offering a novel ethics framework for such systems, Faden et al. advance the scholarly debate about (...) how best to do this and challenge us to think more deeply about its practical implications. However, we believe that at least three issues they raise require additional attention. First, the research‐care distinction has more normative bite than they are willing to concede. Second, the role for independent oversight requires clarification. Finally, they neglect the concept of stewardship as a guiding obligation of learning health care systems. (shrink)

White evangelical habits of mind and idolatrous allegiances propped up a devastatingly irresponsible political administration; I argue that the COVID-19 pandemic should be viewed as an apocalypse: “a catastrophic revelation”—in this case, of Christian responsibility refused. I engage the works of Christian historians Mark Noll and Kristin Kobes Du Mez to interrogate how evangelical habits of mind and heart have nurtured anti-intellectualism, credulousness, and the uncritical adoption of neoliberal economic individualism before turning to a constructive Christian realist call for “nasty” (...) (honest, embodied) thinking and genuine repentance which draws from Andrew DeCort’s Bonhoeffer scholarship. (shrink)

The negative emotions generated following stressful life events can increase one’s risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the (...) changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally mediated HRV to moderate the influence of emotion regulatory strategies among our sample of 267 adults. We found support for the hypothesis that higher vagally mediated HRV buffers against the typical adverse effects of expressive suppression when evaluating depressive symptoms and found weak support when considering perceived stress. There was no evidence for an interaction between cognitive reappraisal and vagally mediated HRV but there was a significant, negative association between cognitive reappraisal and depressive symptoms and perceived stress. Future work may determine if intervening on either emotion regulation strategies or HRV may change these within-persons over time. (shrink)

The use of aborted fetal tissues in research and therapy has raised exciting possibilities and a host of social, legal and ethical issues. Perhaps the most difficult issue is whether the use of materials from elective abortion can be viewed and weighed separately from the abortion itself, or if in using these tissues there is inherent complicity with the abortion act. Those who oppose FTT claim that there is complicity with the abortion act and liken the use of fetal tissue (...) from abortions to the use of data from the Nazi experiments. Within this lobby are those who claim that the option to donate fetal tissues will make abortion a more attractive alternative for pregnant women, and that there are doctors who will offer fetal tissue donation as a positive incentive to abortion-with the net effect that more abortions will take place. (shrink)

The use of aborted fetal tissues in research and therapy has raised exciting possibilities and a host of social, legal and ethical issues. Perhaps the most difficult issue is whether the use of materials from elective abortion can be viewed and weighed separately from the abortion itself, or if in using these tissues there is inherent complicity with the abortion act. Those who oppose FTT claim that there is complicity with the abortion act and liken the use of fetal tissue (...) from abortions to the use of data from the Nazi experiments. Within this lobby are those who claim that the option to donate fetal tissues will make abortion a more attractive alternative for pregnant women, and that there are doctors who will offer fetal tissue donation as a positive incentive to abortion-with the net effect that more abortions will take place. (shrink)

In the rapidly evolving healthcare environment, perhaps no role is in greater flux and redefinition than that of the clinical bioethicist. The discussion of ethics consultation in the bioethics literature has moved from an ambiguous concern regarding its proper place in the clinical milieu to the more provocative question of which methods and theories should best characterize the intellectual and practical work it claims to do. The American Society for Bioethics and Humanities addressed these concerns in its 1998 report, CoreCompetenciesforHealthCareEthicsConsultation. (...) The report tries to answer the question as to what disciplinary training, background experience, and levels of knowledge in ethics the clinical ethics consultant should have, and what specific skills and character traits the clinical ethics consultant should cultivate. In addition to acquiring knowledge of common bioethical issues, theoretical concepts in ethical theory and moral reasoning, and health-related law and policy, the report also recommends that ethics consultants demonstrate knowledge of the health beliefs and perspectives of patients and healthcare providers. In our opinion, this recommendation underscores a crucial aspect of the practice of ethics consultation in the increasingly multicultural settings of healthcare institutions. Clearly, the dynamic of American life and culture is permeated with diversity and variety as new groups suffuse their own beliefs and faith perspectives into the health sector. New immigrant groups force society to question traditional healthcare practices and to accommodate changing medical needs. (shrink)