BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

Research Ethics, Volume 18, Issue 2, Page 93-113, April 2022. Twitter is an increasingly common source of rich, personalized qualitative data, as millions of people daily share their thoughts on myriad topics. However, questions remain unclear concerning if and how to quote publicly available social media data ethically. In this study, focusing on 136 education manuscripts quoting 2667 Tweets, we look to investigate the ways in which Tweets are quoted, the ethical discussions forwarded and actions taken, and the extent to (...) which quoted Tweets are “discoverable.” A concerning result is that in almost all manuscripts, and for around half of all quoted Tweets, the original author could be identified. Drawing on our findings we share some ethical dilemmas, including those that arise from an apparent lack of understanding of the technical aspects of the platform, and offer suggestions for promoting ethically-informed practice. (shrink)

Update on donation of bodily material in the UKIn March 2010, the Human Tissue Authority announced that the first pooled kidney transplants, each involving three living donors and three recipients, had been performed in the UK. 1 While the vast majority of living donor transplants take place between people who are genetically related or are otherwise emotionally close, the Human Tissue Act 2004 introduced greater flexibility, permitting, for example, altruistic, paired and pooled donation. The HTA commented that these types of (...) donation represent one in three of all kidney transplants in the UK. Under the system of paired and pooled donation, in which someone needs a donor organ and has a friend or relative willing to donate, but the two are not compatible with each other, they can pair up with one or more other incompatible donor and recipient pairs in an organ exchange. In paired donation, donor A gives an organ to recipient B and donor B gives to recipient A; in pooled donation, more than two donor–recipient pairs take part in an organ exchange, coordinated by the HTA . Under the human tissue legislation, all cases of paired and pooled donation need to be considered by an independent assessor and approved by a panel of at least three members of the HTA, to ensure that all parties fully understand the risks involved and the donors are not under any pressure to donate.The first pooled transplant took place late in 2009, and was followed shortly afterwards by a second. Several paired living kidney transplants, involving two couples, had already taken place, however, with 16 such transplants going ahead between 1 April 2008 and 31 March 2009. Also in March 2010, a …. (shrink)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

There are many reports about the digital divideand many discrepant interpretations of what thereports indicate. This pattern of competinganalyses, often in relation to identical datasets, has endured for a good part of the lastdecade. It is argued here that a major problemwith much of the digital divide research is afailure to include ethical concerns as anexplicit part of analyzing and interpretingdigital divide gaps. If researchers includemore recognition of ethics with their findingsabout divide gaps, it is likely that they willproduce better (...) research and findings as well asmore defensible linkages between study reportsand policy deliberations. (shrink)

Emotions are open to various kinds of normative assessment. For example, we can assess emotions for their prudential or moral value. Recently, philosophers have increasingly attended to a distinct form of normative assessment of emotions – fittingness assessment. An emotion is fitting when it is merited by its object. For example, admiration is fitting when it is felt towards the admirable, and shame towards the shameful. This paper defends a hybrid account of emotional fittingness. Emotions are complex, and typically involve (...) various elements. As well as involving representations that can be assessed for accuracy, emotions typically motivate their subjects in characteristically urgent ways. The fittingness of an emotion as a whole is a function of the fittingness of both its representational and motivational aspects. (shrink)

In this article, we reflect on our experiences teaching a PWOL course called Philosophy for Living. The course uses modules focused on different historical philosophical ways of life (Epicureanism, Stoicism, Confucianism, Existentialism, etc.) to engage students in exploring how philosophy can be a way of life and how its methods, virtues, and ideas can improve their own lives. We describe and compare our experiences with two central aspects of our approach: engagement with diversity and the use of immersive experiences and (...) assignments. In particular, we discuss how we recognize and center various forms of diversity in philosophy—cultural and gender diversity, but also diversity in how and in what forms philosophy can be done and what “philosophy as a way of life” can be. We also examine how the experimental and experiential aspects of immersive assignments promote deeper understanding and create possibilities for personal transformation. (shrink)

I argue that current discussions of the epistemological significance of reflection have entangled concerns about reflection with agential concerns. I begin by showing that a central strand of internalist criticism finds externalism unsatisfactory because it fails to provide a particular kind of self-knowledge, knowledge about the epistemic status of one’s own beliefs. Identifying this internalist motivation as the desire for a kind of self-knowledge opens up new possibilities and suggests new conceptual resources. I employ one of these resources—Richard Moran’s distinction (...) between the theoretical stance and the deliberative stance—to locate two types of reflection: mere reflective awareness of one’s attitudes and agent-awareness of one’s attitudes. I then examine Ernest Sosa’s account of the importance of reflection, showing how Moran’s distinction brings out the centrality of agential concerns in Sosa’s argument for reflective knowledge. I also consider briefly its relevance to fully apt knowledge. While I focus on Sosa’s epistemology, the point extends to internalism more generally. (shrink)

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

In August, Amnesty International and the World Medical Association expressed concern at reports that a judge in Saudi Arabia had asked several hospitals in the country whether they could perform an operation to damage a man's spinal cord as punishment for attacking another man and leaving him paralysed. The man had already been sentenced to seven months imprisonment for the crime, the injured victim requested the further sentence under Sharia Law, which is strictly enforced across Saudi Arabia. According to reports, (...) one of the hospitals approached declined on ethical grounds. Another hospital stated that it was possible to damage the spinal cord in the way requested, but that the procedure would have to be done at a specialised hospital. 1In its statement, Amnesty International urged the authorities not to carry out the sentence, which it argued would be a grave violation of international human rights law and contravene the United Nations convention against Torture, to which Saudi Arabia is a state party. 2 The WMA expressed its support for the physicians who refused to carry out the request by the Saudi court, participation in which would constitute a severe breach of medical ethics. 3 The WMA reminded doctors that the Declaration of Tokyo clearly states that no physician should participate in the practice of torture or any other forms of cruel, inhuman or degrading procedures, whatever the offence of which the victim of such procedures is suspected, accused or guilty of. The Declaration also includes a prohibition of participation in the planning or advising for such a procedure. NHS white paperIn July 2010 the government published a White Paper outlining its plans to transform the delivery of National Health Services in England. 4 The White Paper has been described as ‘one of the biggest shake ups of the health system …. (shrink)

Proponents of fetal rights argue that, from the moment of conception, a fetus has significant human rights. There are degrees of opinion, however, about the scope of those rights, with some arguing that, in certain circumstances, such as where the conception is the result of rape, the mother's rights predominate. Others argue that the fetus' rights are absolute and should override the woman's right to life and health so that pregnancies cannot be terminated, even to save women's lives. Various countries (...) explicitly or implicitly recognise the status of the fetus as a separate person with varying degrees of rights. For example, the Irish Constitution recognises the ‘right to life of the unborn’ and the 2004 US Unborn Victims of Violence Act views violence against a pregnant woman as a crime against two people, one of whom is the child in utero. The 1969 American Convention on Human Rights has been signed by most Latin American countries and recognises full human rights as applying from conception. In the UK, the fetus has no legal rights but it is widely agreed that the closer a fetus is to being capable of independent existence outside the womb, the greater the moral obligations owed to it. This is reflected in the abortion law only permitting termination of a pregnancy at the later stages in restricted circumstances.In Brazil, the issue of fetal rights was highlighted in May 2010 when a Bill was put forward which aimed to give the fetus priority in law and to make illegal any act or omission that could have a negative impact on it. The bill proposes that the family, society and the …. (shrink)

In the film The Corporation* (Mark Achbar, Jennifer Abbott and Joel Bakan, 2004, http://www.thecorporation.com/) there are several scenes taken from an interview with Ray Anderson, CEO of Interface, Inc., the largest commercial carpet manufacturing firm in the world. Anderson had founded the company twenty one years earlier with a bank loan of $5000, and had built it up to its present size. In this interview the camera focuses in a close up on Anderson’s face so that he is speaking directly (...) to the viewer. This is filmed in such a way as to capture the candor with which he describes a vivid experience which led him to a sudden appreciation for the enormous value of the natural world and.. (shrink)

Stephen Mason lived quietly in southern California, raising his family and pursuing his own spiritual path. Over the years he worked out a personal philosophical and religious worldview. In his last years he wanted to pass down to his children and grandchildren the essence of what he had found on his life quest. Rather than a long monologue on the meaning of life, he adopted the use of aphorisms, in the style of Chinese sages or Sufi mystics, to share his (...) lifetime of wisdom. The result is this book. A gem of a book that helps us navigate the complex road of life by understanding we are on a journey of self-development, linked to our connection with the Divine. Mason weaves a kaleidoscope of provocative quotes by famous writers, thinkers, and artists into his philosophy. He offers not only the practical suggestions of simplicity, solitude, meditation, and prayer, but also compelling advice. He speaks to us of our completeness, while clearing the path toward personal evolution. Mason helps you enter the heart of your life, into the Garden of Life, where you experience 'the cultivation of your soul'. (shrink)

Part One of Montesquieu's Idea of Justice comprises a survey of the currency in philosophical, ethical and aesthetic debate during the second half of the 17th century of the terms rapport and convenance, which are central to the enigmatic definition given to justice by Mon tesquieu in Lettres Persanes LXXXllI. In this survey, attention is concen trated on the way in which the connotations of these terms fluctuate with the divergent development of the methodological and speculative outgrowths of Cartesian ism (...) into two schools of thought, materialist and idealist, often widely at variance in their views of the nature and orga nization of the universe. In Part Two, Montesquieu's definition of justice is set against this background, whose doctrinal conflicts, because of the characteristic as sociations of its key terms, it may be taken to reflect, just as it may be held to epitomize, by virtue of its elaboration in the opening chapter of De l' Esprit des Lois and its close terminological affinities with the defini tion of law there given, an undoubtedly related conflict between the implications of causal determinism and the aspirations of idealist meta physics surviving at the heart of Montesquieu's outlook, and, remaining unresolved, often said to impair the coherence if not the validity of his theory of society. (shrink)

I am lying on a small table in a tiny room, dizzy with nausea and apprehension. A young woman busies herself with the preparations of a plaster mold that will be used to position my arm and chest for the twenty five ‘shots’ of radiotherapy that I will undergo during the ensuing five weeks. I had called the hospital that morning to say that I was too sick to come for this appointment. I had better come, said a young man (...) from the department, because if I missed this appointment I would I might not get a new appointment in time start the treatments within the recommended time frame. So I am here, on the table. I mention the nausea to the technician. My apprehension at this moment is that I might become so dizzy as to somehow swirl out of control. The young woman gives me a mask to blunt the smell of the plaster. The procedure will take twenty-five minutes. I keep my mind focused on each breath and get through the ordeal breath by breath. She seems, in contrast to me, gloriously free of distress and worry, listening to the radio while she works. I envy her good fortune. As we finish up the procedure I take a chance and share my experience: I say that being a cancer patient can be tricky because you are sometimes utterly in the grip of the idea that the cancer will spread and you’ll die soon and in a very unpleasant way. After each round of chemo I was admitted to hospital for extreme nausea and dehydration. During those days in the cancer ward some of those who were dying called out and moaned distressingly, sometimes for hours, during the night. I was, at those moments, unable to shake off the belief that I too would be in that state within a few months. The signs of cancer had been missed on the mammogram two years earlier and, when the lump made itself evident, I was in Stage III. When I mentioned this experience of being gripped by the idea of death she said “Oh I know exactly what you mean, my mother has breast cancer, and every time she has an examination I go searching the internet to find out what I can.” This young woman was twenty four, and I fifty six at the time, and she had given me an unexpected small precious gift that I took with me out of that little cupboard of a room.. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)