A volume in Evaluation and Society Series Editors, Jennifer C. Greene, University of Illinois at Urbana-Champaign and Stewart I. Donaldson, Claremont Graduate University In this book, Ernie House reframes how we think about evaluation by reconsidering three key concepts of values, biases, and practical wisdom. The first part of the book reconstructs core evaluation concepts, with a focus on the origins of our values and biases. The second part explores how we handle values and biases in practice, and the (...) third shows how we learn practical wisdom and use it in evaluations. Value is the central concept in this volume, yet it's a fuzzy concept. In Part I, Ernie clarifies the concept of value by addressing basic questions: What are values? Where do they come from? Why do we have them? Why is our conception so confused? How do we handle values in evaluations? In Part II, another central concept is added, that of biases. Prominent evaluation frameworks have focused on biases, including Campbell and Stanley's (1963) framework for validating causal inferences and Scriven's (1972) conception of objectivity, which is achieved by correcting for biases in general. In addition, research on thought processes has made progress by focusing on cognitive biases (Kahneman, 2011). Even so, through a case example, Ernie demonstrates that the concept of biases is under-appreciated and not well engaged in evaluation practice. The third important concept, featured in Part III, is practical wisdom, which is the knowledge that evaluators acquire through experience. Practical wisdom informs what we do, possibly as much as theory. Experienced evaluators often conduct evaluations in similar ways, regardless of their theory, because practical wisdom determines much of what they do. Ernie provides concrete examples of practical wisdom and how we employ it. Throughout the book, he draws on the empirical research on thinking processes, especially Kahneman's Thinking Fast and Slow (2011). This book will be of interest and relevance to all evaluation scholars and practitioners, as it thoughtfully engages core constructs of the field. The book can also well serve as a supplementary text in multiple evaluation courses, as it offers valuable conceptual and practical perspectives on our craft. (shrink)

This book celebrates the work of Patricia Werhane, an iconic figure in business ethics. This festschrift is a collection of articles that build on Werhane’s contributions to business ethics in such areas as Employee Rights, the Legacy of Adam Smith, Moral Imagination, Women in Business, the development of the field of business ethics, and her contributions to such fields as Health Care, Education, Teaching, and Philosophy. All papers are new contributions to the management literature written by well-known business ethicists, (...) such as Norman Bowie, Richard De George, Ronald Duska, Edwin Hartman, Michael Hoffman, Mollie Painter-Morland, Mark Schwartz, Andrew Wicks, and others. The volume is comprised of articles that reflect on Werhane’s work as well as build on it as a way to advance further research. At the end of the festschrift, Pat Werhane provides responses to each chapter. The first chapter of the book also includes the overview of Patricia Werhane’s work and her academic career. The book is written to appeal to management scholars and graduate students interested in the areas of Business Ethics, Modern Capitalism, and Human Rights. Patricia Werhane is one of the most distinguished figures in the field of business ethics. She was a founder of the field, she is one of its leading scholars, and she has had a profound impact on the world of business practice. Among her many accomplishments, Pat is known for her original work on moral imagination, she is an acclaimed authority on employee rights in the workplace, and she is one of the leading scholars on Adam Smith. Having been active in Academia for over 50 years, Werhane is a prolific author of over a hundred articles and book chapters, and the author or editor of twenty-seven books, including Adam Smith and his Legacy for Modern Capitalism, Moral Imagination and Management Decision-Making, and co-authored books Organization Ethics in Health Care, Alleviating Poverty Through Profitable Partnerships, Obstacles to Ethical Decision-Making, Corporate Responsibility: The American Experience, and Research Approaches to Business Ethics and Corporate Responsibility. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

Objective: To determine the usefulness of Q methodology to locate and describe shared subjective influences on clinical decision making among participant physicians using hypothetical cases containing common ethical issues. Design: Qualitative study using by-person factor analysis of subjective Q sort data matrix. Setting: University medical center. Participants: Convenience sample of internal medicine attending physicians and house staff (n = 35) at one midwestern academic health sciences center. Interventions: Presented with four hypothetical cases involving urgent decision making near the end (...) of life, participants selected one of three specific clinical actions offered for each case. Immediately afterward and while considering their decision, each respondent sorted twenty-five subjective self-referent items in terms of the influence of each statement on their decision-making process. By-person factor analysis, where participants are defined as variates, yielded information about the attitudinal background the physicians brought to their consideration of each hypothetical case. We performed a second-order factor analysis on all of the subjective viewpoints to determine if a smaller core of shared attitudes existed across some or all of the four case vignettes. Factor scores for each item and post-sort comments from interviews conducted individually with each respondent guided the interpretation of ethical perspective used by these respondents in making clinical decisions about the cases. Measurements and Main Results: Second-order factor analysis on seventeen viewpoints used by physicians in the four hypothetical urgent decision cases revealed three moderately correlated (r 2 < 40%) subjective core attitudinal guides used broadly among all the cases and among sixteen of the seventeen original factors. Across all the cases, our participants were guided in general by: (1) patient-focused beneficence, (2) a patient- and surrogate-focused perspective that includes risk avoidance, and (3) best interest of the patient guided by ethical values. Economic impact on the physician, expediency in resolution of the situation, and the expense of medical treatment were not found to be influential determinants in this study. Conclusions: Q sorting and by-person factor analysis are useful qualitative methodological tools to study the complex structure of subjective attitudes that influence physicians in making medical decisions. This study revealed the subjective viewpoints used by our physician participants as they made ethically challenging treatment decisions. The three second-order factors identified here are grounded in current bioethical values as well as the personal traits of physicians. The participants' decision methods appear to resemble casuistry more than principle-based decision making. Generalizability of results will require further studies. (shrink)

In Decent People, Norman Care explores how we may understand and be reconciled to the fragility of our moral nature. In his highly original vision of what it means to be a decent person, Care claims that our moral-emotional nature pressures us to seek relief from moralized pain - pain that comes from our awareness of our own wrongdoing, the suffering of current or future people, and our experience of indifference to moral imperatives. Care argues that (...) decent people are neither 'pure' nor self-righteous and that they are vulnerable to the need for forgiveness. Decent people may take morality seriously, but they are not guaranteed success at its challenges. (shrink)

The article is a critical discussion of "contractualism" in moral and political philosophy as developed by john rawls and applied by w. G. Runciman. It attempts to clarify the sense in which contractualism is a moral theory and to assess its powers as a normative account of moral criticism. It argues that the structure of contractualism suggests an attractive way of formulating rival moral theories but not a way of arguing for any moral theory, That this reduces the force of (...) a contractualist critique of utilitarianism, And that contractualism is incomplete as a normative account of moral criticism. (shrink)

A motivation problem may arise when morally principled public policy calls for serious sacrifice, relative to ways of life and levels of well-being, on the part of the meInbers of a free society. Apart from legal or other forms of “external” coercion, what will, could, or should move people to make the sacrifices required by morality? I explore the motivation problem in the context of morally principled public policyconcerning our legacy for future generations. In this context the problem raises special (...) moral-psychological difficulties. My inquiry suggests pessimism regarding our ability to solve the motivation problem relative to what morality requires on behalf of future generations. (shrink)

A motivation problem may arise when morally principled public policy calls for serious sacrifice, relative to ways of life and levels of well-being, on the part of the members of a free society. Apart from legal or other forms of “external” coercion, what will, could, or should move people to make the sacrifices required by morality? I explore the motivation problem in the context of morally principled public policy concerning our legacy for future generations. In this context the problem raises (...) special moral-psychological difficulties. My inquiry suggests pessimism regarding our ability to solve the motivation problem relative to what morality requires on behalf of future generations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Parenting Adults with ASD: Lessons for Researchers and CliniciansCassandra R. Newsom, Amy S. Weitlauf, Cora M. Taylor, and Zachary E. WarrenRecent reviews of treatments for individuals with autism spectrum disorders (ASD) reveal how little we still know about how to help adolescents with ASD and their families successfully transition into adulthood (Shattuck et al., 2012b; Taylor et al., 2012a). Shattuck and colleagues found that services in the United States (...) for adults with ASD were marked by high unemployment rates, a reliance on families to provide care across the lifespan, high turnover rates in front-line service providers, insufficient transition planning for high school students, and generally insufficient services to meet current needs. In a recent Agency for Healthcare Research and Quality (AHRQ) Comparative Effectiveness Review, the authors similarly found that there is very little evidence available to pinpoint specific intervention approaches for adolescents and young adults with ASD due to a lack of good quality studies. This was especially true for evidence-based approaches to support the transition of youth with ASD to adulthood (Taylor et al., 2012a).For the last decade, with dramatic increases in both ASD awareness and estimates of ASD prevalence, our field has understandably focused intensely on improving early detection and treatment of ASD. Our diagnostic tools and understanding of ASD presentation in very young children has improved tremendously. Different from many of the young adults in these stories, who were often diagnosed in their early teens, we now aim to identify children well before their third birthdays. Research has consistently shown that early and intense ASD-specific intervention can dramatically enhance outcomes for children with ASD. As such, there has been heavy investment in attempting to take full advantage of this early window of neuro-plasticity. However, as these stories illustrate, these children grow up. Their needs change, and our systems are often poorly equipped to help them live fulfilling lives, capitalize on their talents, and obtain independence and equal access, while still providing a safe, supportive environment. Without readily accessible and understandable coordinated systems of care, parents are forced to adopt the multiple roles of case manager, teacher, therapist, community educator, advocate, job coach, housing specialist, financial planner, and often, lifelong caregiver. These stories eloquently illustrate those struggles and successes.Grief and Joy: Opposite Sides of the Same Parenting CoinThe idea of grieving a diagnosis is controversial. Many of the writers seemed to feel conflicted about their grief responses and the validity of their feelings. Research shows that many families view the diagnostic process as extremely stressful (Siklos & [End Page 199] Kerns, 2005; Heiman, 2002). Feelings of sadness, anxiety, and depression are common at the point of diagnosis and may reemerge as milestones pass unmet. Families must modify the futures they imagined for their children and begin to envision new goals and dreams. Anonymous Three described this process when she wrote:Most children grow up, go to school, get jobs, move out of their parents’ home, etc. My husband and I have had to seriously consider how much of these are even possible for a young man with autism, even one who has a good number of functional life skills.Tasks of adolescence and adulthood such as starting high school, driving a car, and moving out of the house may be delayed and hard won if met. Raising a child with ASD appears to have particular challenges. Throughout this process, families begin to redefine what “success” means. Rather than ascribing to societal standards, they find joy in personal milestones. McDonald described the triumph of teaching his nephew to shake women’s hands instead of touching their hair, an important safety goal that took three months to accomplish. Each family thereby creates its own path.People outside of the family often do not understand the complicated interplay of love and obligation as well as the frustration and fulfillment that families experience. Just like any family, the parents of children with ASD describe many joys in addition to their struggles. They see their children’s strengths in a world that too often focuses on their weaknesses. Gifted with the everyday experience of their child’s development, they see past the necessity of a... (shrink)

Yemeni writer Ahmed Qāsim al-Arīqī, in addition to his profession as a pharmacist, is a writer who has made a name for himself in the country's literary field, especially in the last fifteen years. A prolific writer, al-Arīqī is the author of poetry collections as well as stories and novels that emphasise awareness of the traditional issues of the Yemeni people. He has published "Maḳāmāt al-'Arīḳī" (2006), "Ġalṭṭetu Ḳalem" (2012), "Qurāt al-S̱-S̱elj" (2017), "Ta'riyya" (2018), "Zurbet al-Yumnā" (2018), "Da'wat al-Ḥuḳūl" (2019), (...) "Zuhr al-Ġarām" and "Sīret al-Kūbī" (2022). His novel "Yawma Māta al-Shaytan" (The Day Satan Died) was published electronically by Hindāwī Publishing House in 2022. The novel, which is approximately 120 pages, is written in six chapters. There are eleven passages in the first and fourth chapters, thirteen in the second and sixth chapters, twelve in the third chapter, and eight in the fifth chapter. The novel is about the adventures of a member of the army named Marwan Naji, who was wounded in the war between the Houthi militia and the Yemeni army, and after nine months in a coma, opens his eyes in a perfect world dominated by biological and technological advances. Symbolising the treatment of selfishness and various narcissisms with advanced vaccines through the death of Satan, the author describes Marwan's adventures in his world, which he sometimes describes as the realm of the jinn, in a very simple language, while not failing to criticise reality in its various political, social and religious dimensions. In fact, Marwan's world of imagination and fantasy is the main story of the novel, but not the only one. The author also includes the stories of family members in Marwan's world of turmoil, destruction, massacre, war and victory, giving the reader the opportunity to compare both worlds. While his mother Gusoun, his wife Hamide and his daughter Fatma, who later got engaged in time after being widowed, are the female characters of his real world, Professor Mari and Mariana, one of his seven wives, are the other important characters of his imaginary world. Gusûn is a devoted mother who does not leave the bedside of her comatose son, prays for him day and night and tries to do everything she can for his recovery. Gusûn, who is listened to at home to a certain extent, scolds her grandchildren to prevent the breakup of her son's home because of inheritance, defends that the existing wealth still belongs to her son and reminds them that she will not hesitate to spend money for his recovery. Gusûn's daughter-in-law Hamide also takes care of her husband, who shows no signs of recovery. Hamide, who is not as patient as her mother-in-law, is also a jealous woman. On the other hand, although both of them display false religious tendencies that have no relation with real life, Gusûn is more prone to the superstitious approaches put forward and adopted in the name of religion. Fatma is also a widow who, although she has the will to take care of her children and live her life alone, has been engaged for a long time to her uncle's son Münir, who, like her, took part in anti-regime demonstrations and whose love she believes in. Fatma, who is more conscious than her grandmother and mother, is not alien to the issues that society complains about and often participates in women's movements organised against the government. Professor Mari, one of the two important characters belonging to Marwan's imaginary world, is a psychologist and the chief physician of a large hospital who treats jealousy, anger, lying and selfishness, which are considered dangerous viruses, with vaccines developed by scientists. Professor Mari, who is personally involved in Marwan's treatment, also chairs the committee that records his memory and projects all his memories on a giant screen. Mariana, on the other hand, monitors Marwan's behaviour and thoughts through a biological chip to control the effect of the vaccines given to him, criticises him through the tragic images projected on the screen and provides information that will facilitate his adaptation to his new world. In the article, in which the author's main published works are briefly introduced along with a broad summary of the novel, the social messages that an author, who is not indifferent to the realities of the geography he lives in, tries to give directly and indirectly with a language far from locality, are tried to be determined through the mentioned female characters. It is seen that the desire to become a single nation by making; love, brotherhood, friendship and peace dominant lies behind the author's novelisation of the dream of an ideal world symbolised by the death of Satan. (shrink)

BackgroundAn analysis of the position statements of secular US medical and surgical professional societies on physician-assisted suicide (PAS) and euthanasia have not been published recently. Available statements were evaluated for position, content, and sentiment.MethodsIn order to create a comprehensive list of secular medical and surgical societies, the results of a systematic search using Google were cross-referenced with a list of societies that have a seat on the American Medical Association House of Delegates. Societies with position statements were identified. These (...) statements were divided into 5 categories: opposed to PAS and/or euthanasia, studied neutrality, supportive, acknowledgement without statement, and no statement. Linguistic analysis was performed using RapidMinder in order to determine word frequency and sentiment respective to individual statements. To ensure accuracy, only statements with word counts > 100 were analyzed. A 2-tailed independentttest was used to test for variance among sentiment scores of opposing and studied neutrality statements.ResultsOf 150 societies, only 12 (8%) have position statements on PAS and euthanasia: 11 for PAS (5 opposing and 4 studied neutrality) and 9 for euthanasia (6 opposing and 2 studied neutrality). Although the most popular words used in opposing and studied neutrality statements are similar, notable exceptions exist (suicide,medicine, andtreatmentappear frequently in opposing statements, but not in studied neutrality statements, whereaspsychologists,law, andindividualsappear frequently in studied neutrality statements, but not in opposing statements). Sentiment scores for opposing and studied neutrality statements do not differ (mean, 0.094 vs. 0.104;P = 0.90).ConclusionsFew US medical and surgical societies have position statements on PAS and euthanasia. Among them, opposing and studied neutrality statements share similar linguistic sentiment. Opposing and studied neutrality statements have clear differences, but share recommendations. Both opposing and studied neutrality statements cite potential risks of PAS legalization and suggest that good palliative care might diminish a patient’s desire for PAS. (shrink)

The ability of the medical profession to sustain life, or more appropriately, to prolong dying, in patients with terminal illness, creates a most complex and controversial situation for all involved: the patient, if mentally alert; the patient's family; and the medical care team including physicians, nurses and attendants. This situation is especially complex in large acute care hospitals where medical and nursing students, residents and house officers receive advanced medical training. A major problem, prolonging the dying of (...) the terminally ill, with its medical, legal, ethical and economic complexities now confronts American society. The problem is particularly acute in teaching hospitals, in which one finds a disproportionate number of terminally ill patients. The ability to work at these questions as a community rather than as adversaries will determine much about the ability of the health care system to respect the dignity and autonomy of those who seek aid and comfort when faced with serious illness and impending death. Better communication between the physicians, health care providers, the lawyers and ethicists must be developed in order to solve these problems. Over the next ten years society and our elected representatives will be making very demanding decisions about the use of the health dollar. One possible way to prevent increasing costs is to reach significant agreement on the proper care of the dying. Proper care for the dying is being considered, discussed, and evaluated by very thoughtful people. It is not governments which should decide who is to live or who is to die. There is the serious problem of the 'slippery slope' to euthanasia by omission if cost containment becomes the major force in formulating policy on the proper care of the dying. (shrink)