ABSTRACTThe Norwegian government implemented a comprehensive welfare reform in 2012 to better manage an increasingly care-demanding patient demography while meeting budgetary constraints. This article discusses interdiscursive relationships between policy strategies and language use among rehabilitation professionals. It is based on a synthesis of textual analyses of policy documents and of transcribed interviews to produce complex insights into current rehabilitation discourse. The synthetic product is expressed in the form of two nodal discourses which subsume and articulate in particular ways the constituent (...) discourses of the policies and interviews. One nodal discourse approaches rehabilitation as a clinical practice; the other concerns rehabilitation as a management practice. These discourses serve different purposes. One is based in traditional medical science as a means for political action and relates to the body as an object of government policies and practices. The other relies on the individual... (shrink)

Scholars and policymakers have increasingly advocated to engage citizens more substantially in the development of science and technology. However, to a large extent it has remained unknown how citizens can contribute to technology development. In this study, we systematically characterized citizens’ contributions in the development of nanotechnology for health. We explored to which technology aspects citizens are able to provide suggestions on and on which values their suggestions are based. Fifty citizens in the Netherlands were asked to discuss different applications (...) of nanotechnology for health. They were divided over eight focus groups, which lasted approximately 6.5h each. The citizens were able to contribute to various technology aspects; they mainly focused on the technologies’ implementation and use, they paid some attention to the development and system aspects, and also addressed, but less, the design and communication aspects. Their suggestions were often derived from concerns about the potential effects of the technologies and were predominantly based on the values of well-being, autonomy, and privacy. (shrink)

Hazing behaviors as a part of group initiations have been theorized to contribute to a sense of group solidarity, to ensure loyalty and commitment of group members, to teach group-relevant skills and attitudes to group members, and to reinforce the social hierarchy within groups. In a survey of members of an international college fraternity, researchers propose and test a four-dimensional model of hazing motivation. Using exploratory factor analysis, the proposed four-factor model explains 74 percent of the overall variance and confirmatory (...) factor analysis demonstrated acceptable model fit. Correlation and regression analysis suggested that social dominance- motivated hazing is strongly associated with hazing tolerance, moral disengagement, and a variety of measures related to organizational commitment and attachment. (shrink)

In recent years, tremendous progress has been made toward recognizing the need for improved medical knowledge for pregnant people, a population group that has long been excluded from clinical trial...

We extend the discussion in the target article about distinctions between extrinsic coding and the alternative we and the target article both favor, intrinsic coding. Central to our thinking about intrinsic coding is population coding and the concept of high-dimensional neural response spaces.

This article presents a critique of an article previously featured in Nursing Philosophy (10: 26–33) by Ursula Naue and Thilo Kroll, who suggested that people living with dementia are assigned a negative status upon receipt of a diagnosis, holding the identity of the ‘demented other’. Specifically, in this critique, we suggest that unwitting use of the adjective ‘demented’ to define a person living with the condition is ill-informed and runs a risk of defining people through negative (self-)attributes, which has a (...) deleterious impact upon that person's social and relational personae. Moreover, use of the locution ‘demented’ reinforces a divide between the ‘demented’ (them) and the ‘healthy others’ (us). Social constructionist theory, malignant positioning and viewing people with dementia as semiotic subjects are the philosophical pillars through which we construct the main arguments of the critique. The article concludes with the voice of one of the authors, a younger person with dementia, asking for language in dementia care to be carefully reconsidered and reframed and for the recognition of the diagnosed person's agency in the conduct of their day-to-day lives. (shrink)

The "religious and secular divide" cannot be understood unless we think about the way sex gets mobilized on both sides of this supposed divide. In our joint writing, we have resisted thinking of the religious and the secular as a divide; we have rather been interested to think them relationally—as relations. Thus, the larger suggestion of this paper is that we cannot truly imagine and practice democratic politics—to name some keywords for this discussion—unless we rethink the relations between sex, secularism, (...) and religion. (shrink)

The target article does not consider neural data on primate spatial representations, which we suggest provide grounds for believing that navigational space may be three-dimensional rather than quasi–two-dimensional. Furthermore, we question the authors' interpretation of rat neurophysiological data as indicating that the vertical dimension may be encoded in a neural structure separate from the two horizontal dimensions.

Unfortunately, business is often associated with unethical behavior. While research has offered a number of explanations for why business might encourage unethical behavior, we argue that how a person frames a situation may provide important insight. Drawing on the decision frame literature, the goal of the current research is to identify the differences in cognitive processing associated with two decision frames dominant in the business ethics literature—business and ethical—and, with that knowledge, examine ways to mitigate the detrimental influence of frame (...) on unethical behavior. We first demonstrate the causal link between frame and misrepresentation, and then identify several differences in cognitive processing—cost–benefit analyses, concern for others, and construal level—that distinguish business and ethical frames, and investigate their effects on misrepresentation. In our final set of studies, we demonstrate that the influence of these frames on misrepresentation can be altered by manipulating these cognitive processes, both mitigating and exacerbating a decision maker’s engagement in misrepresentation. We conclude by summarizing our findings and their potential impact on unethical behavior more broadly. (shrink)

In 1966, island biogeographer Sherwin Carlquist published a list of 24 principles governing long-distance dispersal and evolution on islands. The 24 principles describe many aspects of island biology, from long-distance dispersal and establishment to community change and assemblage. Although this was an active period for island biogeography, other models and research garnered much more attention than did Carlquist’s. In this review, over 40 years of support for or against Carlquist’s principles is presented. Recent work has supported most of the 24 (...) principles, and improved methodologies have generally substantiated his initial claims. However, Carlquist’s original work and ideas remain relatively under-represented in the biogeographic literature. Use of philosophical model domains provides one explanation as to why Carlquist’s work has received little attention. Carlquist’s principles are largely natural history tests, and don’t translate well into the theoretical, design of preserves, or the experimental domains—whereas other competing models do well in such domains. (shrink)

High-hope and low-hope research participants (males and females), as preselected on the basis of a dispositional self-report scale, choose freely between brief audiotaped messages that varied in depressive content. In the first experiment, the messages were of either positive or negative content. Highhope as compared to low-hope persons preferred listening to the positive tapes (no differences related to Gender), and this Hope main effect remained after the shared variance related to depression and positive and negative affectivity were removed. In a (...) modified replication, the contents of the tapes were comprised of successful or unsuccessful goal-attainment statements related to hopeful thinking. High-hope as compared to low-hope persons again preferred to listen to the successful goal pursuit messages (no differences related to Gender), and this Hope main effect on listening choices remained after the shared variances related to depression, positive and negative affectivity, and self-esteem were removed. Implications are discussed. (shrink)

More than 200 million children under the age of 5 years are affected by malnutrition worldwide according to the World Health Organization. The Barbados Nutrition Study (BNS) is a 55-year longitudinal study on a Barbadian cohort with histories of moderate to severe protein-energy malnutrition (PEM) limited to the first year of life and a healthy comparison group. Using quantitative electroencephalography (EEG), differences in brain function duringchildhood(lower alpha1 activity and higher theta, alpha2 and beta activity) have previously been highlighted between participants (...) who suffered from early PEM and controls. In order to determine whether similar differences persisted intoadulthood, our current study used recordings obtained during a Go-No-Go task in a subsample of the original BNS cohort [population size (N) = 53] at ages 45–51 years. We found that previously malnourished adults [sample size (n) = 24] had a higher rate of omission errors on the task relative to controls (n= 29). Evoked-Related Potentials (ERP) were significantly different in participants with histories of early PEM, who presented with lower N2 amplitudes. These findings are typically associated with impaired conflict monitoring and/or attention deficits and may therefore be linked to the attentional and executive function deficits that have been previously reported in this cohort in childhood and again in middle adulthood. (shrink)

The excellent quality and depth of the various essays make [the book] an invaluable resource....It is likely to become essential reading in its field.—CHOICE.

(Statement of Responsibility) by Timothy S. Huebner.

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Feminist bioethicists have long shed light on the indignities and injustice of reproductive intrusions, be they coerced gestation or forced interventions during pregnancy and birth. Writing about t...

Since the U.S. Supreme Court's decision in Dobbs vs. Jackson Women's Health Organization, a growing web of state laws restricts access to abortion. Here we consider how, ethically, doctors should respond when terminating a pregnancy is clinically indicated but state law imposes restrictions on doing so. We offer a typology of cases in which the dilemma emerges and a brief sketch of the current state of legal prohibitions against providing such care. We examine the issue from the standpoints of conscience, (...) professional ethics, and civil disobedience and conclude that it is almost always morally permissible and praiseworthy to break the law and that, in a subset of cases, it is morally obligatory to do so. We further argue that health care institutions that employ or credential physicians to provide reproductive health care have an ethical duty to provide a basic suite of practical supports for them as they work to ethically resolve the dilemmas before them. (shrink)

Spitale et al. (2024) address a public health ethics question of great importance: How should governments communicate with the public during public health emergencies? The article highlights severa...

The concept of legitimacy is often used and emphasized in the context of setting limits in health care, but rarely described is what is actually meant by its use. Moreover, it is seldom explicitly stated how health-care workers can contribute to the matter, nor what weight should be apportioned to their viewpoints. Instead the discussion has focused on whether they should take on the role of the patients’ advocate or that of gatekeeper to the society’s resources. In this article, we (...) shed light on the role of health-care workers in limit setting and how their conferred legitimacy may support subordinators’ (i.e. citizens’) conferred legitimacy. We argue that health-care workers have an important role to play as both moral and political agents in limit setting, and delineate normative conditions that justify and facilitate health-care workers in conferring legitimacy on this kind of decision. Their role and potential impact on political limit setting does not—theoretically—affect the idea of democratic legitimacy negatively. Rather, as we suggest, by designing for limit-setting policymaking accordingly, health-care workers, as well as citizens, are more justified in conferring democratic legitimacy to health-care limit-setting decisions than if these concerns were not addressed. (shrink)

Introduction: Aristotle's phantasia and the ancient concept of imagination -- Visualization, vividness (enargeia) and realism -- Mathematical projection, copying and analogy -- Prophecy, inspiration and allegory -- Conclusion: ancient and modern imagination.

Liao and Carbonell discuss the role of (supposed) racial differences and racism in two medical devices: pulse oximeters and spirometers. They show that what might seem like cases of mere bias, are...

Eating disorders (EDs) are characterized by marked cognitive distortions and maladaptive schemas. Cognitive models of EDs highlight the direct impact of cognitive dysfunctions on eating-related disturbances, insofar as specific cognitive contents such as thoughts about diet rules and food or loss of control may trigger disturbed eating behavior. Moreover, early maladaptive schemas that reflect perfectionist standards and relate to achievement and performance seem to be associated with disturbed eating, e.g. via their impact on situation-specific appraisals. However, so far, no study (...) has investigated these assumptions. Hence, the present study sought to demonstrate whether and how cognitive content exerts an impact on eating behavior in daily life, and whether maladaptive core schemas impact the occurrence of binge eating via dysfunctional ED cognitions in eating-related contexts. N = 29 females with Bulimia Nervosa (BN), n = 31 females with Binge Eating Disorder (BED) and n = 30 female controls without EDs (NC) participated in the study. All participants received a handheld computer for a 48-hour period to capture antecedents of disturbed eating behavior in daily life. Event-sampling (meals, binge eating, purging, stressful situations) and signal-sampling (five times a day) methods were applied. EMA included a short questionnaire to assess dysfunctional cognitions and level of craving and to capture information about situational contexts. Early maladaptive schemas were assessed using a short version of the Young Schema Questionnaire at baseline. The main results showed specific patterns of dysfunctional eating-related cognitions for BED and BN. Binge eating was predicted by thoughts about loss of control (positively) and dietary restraint (negatively). For meal situations, no significant differences between the two ED groups emerged. All three domains exerted indirect effects on craving via thoughts about ‘eating/loss of control’, whereas neither a direct nor an indirect effect emerged regarding thoughts about ‘dietary restraint’. These results fit well with previous studies and support cognitive models of EDs; schema therapeutic approaches may be a valuable contribution to enhance treatment of EDs. Further studies should explore whether the findings from emerging adulthood can be generalized to younger age groups. (shrink)

Perceived behavioral integrity involves the employee’s perception of the alignment of the manager’s words and deeds. This meta-analysis examined the relationship between perceived behavioral integrity of managers and the employee attitudes of job satisfaction, organizational commitment, satisfaction with the leader and affect toward the organization. Results indicate a strong positive relationship overall (average r = 0.48, p<0.01). With only 12 studies included, exploration of moderators was limited, but preliminary analysis suggested that the gender of the employees and the number of (...) levels between the employee and the manager are potential moderators of the relationship. In the current sample of studies, country where the research was conducted did not seem to have any moderating effects. In addition to suggesting further investigation of potential moderators, we call for research that examines the relationship between behavioral integrity and outcomes that include individual behavior and organizational performance. (shrink)

The emergence and development of the field of clinical ethics coincided with the revitalization of moral philosophy following the publication of John Rawls’ ma...

Bishop is a professor of nursing; Scudder is a professor of philosophy.