Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the (...) experience of moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

The term compassion fatigue has come to be applied to a disengagement or lack of empathy on the part of care-giving professionals. Empathy and emotional investment have been seen as potentially costing the caregiver and putting them at risk. Compassion fatigue has been equated with burnout, secondary traumatic stress disorder, vicarious traumatization, secondary victimization or co-victimization, compassion stress, emotional contagion, and counter-transference. The results of a Canadian qualitative research project on nurses? experience of compassion fatigue are presented. Nurses, self-identified as (...) having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families. Time to help patients and families cope with suffering seemed unavailable, and many felt they were running on empty and, ultimately, impotent as nurses. Feelings of irritability, anger, and negativity arose, though participants described denying or ignoring these emotions as a way to try to survive their work day. Difficulties with work carried over into the nurses? personal lives, affecting their relationships with family and friends. Such experiences invariably called into question the participants? identity, causing them to reflect on the kind of nurse they were. The participants? compassion fatigue created a sense of hopelessness regarding positive change, although some nurses described strategies that seemed to help alleviate their compassion fatigue. (shrink)

COVID-19 has created significant concern surrounding the impact of pandemic lockdown on mental health. While the pandemic lockdown can be distressing, times of crisis can also provide people with the opportunity to think divergently and explore different activities. Novelty seeking, where individuals explore novel and unfamiliarly stimuli and environments, may enhance the creativity of individuals to solve problems in a way that allows them to adjust their emotional responses to stressful situations. This study employs a longitudinal design to investigate changes (...) in novelty seeking and mental health outcomes before, during, and after COVID-19 pandemic lockdown, among a group of students from a university in southeast China. Participants were surveyed at three points: November, 2019 ; between February and March, 2020 ; and between May and June, 2020. Cross-sectionally, correlation analysis indicated that greater novelty seeking was associated with lower levels of stress, anxiety, and depression at all three time points. Univariate latent curve modeling indicated a growth trajectory in which novelty seeking increased over time and then remained high during the post-lockdown period. Stress, anxiety, and depression all showed V-shaped growth trajectories in which these variables decreased during lockdown, before increasing in the post-lockdown period. Multivariate LCM indicated the growth trajectory for novelty seeking was associated with the growth trajectories for stress, anxiety, and depression. This suggests that the observed decreases in stress, anxiety, and depression during the lockdown period may be attributable to the sample’s observed increase in novelty seeking. These findings are valuable in that they challenge the notion that lockdown measures are inherently detrimental to mental health. The findings indicate the important role of novelty seeking in responding to crises. It may be possible for future public health measures to incorporate the promotion of novelty seeking to help individuals’ respond to stressful situations and maintain good mental health in the face of crises. (shrink)

This study aims to investigate mental health among Chinese people living in areas with differing levels of infection severity during the COVID-19 outbreak. It also assesses the association between reciprocal and authoritarian filial piety and mental health in times of crises. A sample of 1,201 Chinese participants was surveyed between April and June 2020. Wuhan city, Hubei province outside Wuhan, and elsewhere in China were categorized into high, moderate, and low infection severity areas, respectively. The Depression, Anxiety, and Stress (...) Scale’s severity cut-points were used to categorize participants. In the overall sample, 20.9, 34.2, and 29.0% of the participants showed elevated levels of stress, anxiety, and depression. Those in the highest infection severity group were significantly more likely to be categorized as having elevated levels of stress, anxiety, and depression. General linear modeling was performed on a composite mental distress variable. This model indicated that, even after adjusting for group differences in age, gender, education, and filial piety, the high infection severity group displayed more mental distress than the low infection severity groups. The model also found reciprocal filial piety to have a negative association with mental distress. Conversely, authoritarian filial piety was found to be unrelated to mental distress when controlling for the other variables in the model. No evidence was found for an interaction between either authoritarian or reciprocal filial piety and infection severity, which suggests that the negative association observed between reciprocal filial piety and mental distress was relatively consistent across the three infection severity groups. The findings suggest that future public health programs may integrate the promotion of filial piety as a strategy to help Chinese people maintain good mental health in the face of pandemic crises. (shrink)

What is found at the historical beginnings of things is not the inviolable identity of their origin; it is the dissention of other things. It is diaparity. —Michel Foucault.

Rationale, aims and objectives: Bioethics and professionalism are standard subjects in medical training programmes, and these curricula reflect particular representations of meaning and practice. It is important that these curricula cohere with the actual concerns of practicing clinicians so that students are prepared for real-world practice. We aimed to identify ethical and professional concerns that do not appear to be adequately addressed in standard curricula by comparing ethics curricula with themes that emerged from a qualitative study of medical practitioners. Method: (...) Curriculum analysis: Thirty-two prominent ethics and professionalism curricula were identified through a database search and were analysed thematically. Qualitative study: In-depth, semi-structured interviews were conducted with 20 medical practitioners. Participants were invited to reflect upon their perceptions of the ways in which values matter in their practices and their educational experiences. The themes emerging from the two studies were compared and contrasted. Results: While representations of meaning and value in ethics and professionalism curricula overlap with the preoccupations of practicing clinicians, there are significant aspects of ‘real-world’ clinical practice that are largely ignored. These fell into two broad domains: ‘sociological’ concerns about enculturation, bureaucracy, intra-professional relationships, and public perceptions of medicine; and epistemic concerns about making good decisions, balancing different kinds of knowledge, and practising within the bounds of professional protocols. Conclusions: Our findings support the view that philosophy and sociology should be included in medical school and specialty training curricula. Curricula should be reframed to introduce students to habits of thought that recognize the need for critical reflection on the social processes in which they are embedded, and on the philosophical assumptions that underpin their practice. (shrink)

In evolutionary psychology predictions, women’s mate preferences shift between fertile and nonfertile times of the month to reflect ancestral fitness benefits. Our meta-analytic test involving 58 independent reports was largely nonsupportive. Specifically, fertile women did not especially desire sex in short-term relationships with men purported to be of high genetic quality. The few significant preference shifts appeared to be research artifacts. The effects declined over time in published work, were limited to studies that used broader, less precise definitions of (...) the fertile phase, and were found only in published research. (shrink)

Filial piety is a Confucian concept derived from Chinese culture, which advocates a set of moral norms, values, and practices of respect and caring for one’s parents. According to the dual-factor model of filial piety, reciprocal and authoritarian filial piety are two dimensions of filial piety. Reciprocal filial piety is concerned with sincere affection toward one’s parent and a longstanding positive parent-child relationship, while authoritarian filial piety is about obedience to social obligations to one’s parent, often by suppressing one’s own (...) wishes to conform the demands of the parent. The primary aim of this study is to investigate the moderating effect of culture on the relationships between filial piety and palliative care knowledge. The secondary aim is to investigate whether filial piety is a universal construct across Singaporean and Australian cultures. A total of 508 participants living in Singapore and Australia were surveyed between May and October 2020. The final sample comprised of 406 participants, with 224 Singaporeans and 182 Australians. There were 289 females, 115 males, and two unspecified gender in the sample, with an average age of 27.27 years. Results indicated a significant effect of culture on authoritarian filial piety and palliative care knowledge. Singaporeans showed higher authoritarian filial piety and higher palliative care knowledge than Australians. However, no effect of culture was found on reciprocal filial piety. Overall, no significant correlation existed between palliative care knowledge and reciprocal filial piety and authoritarian filial piety. For Singaporeans, a weak negative correlation was found between palliative care knowledge and authoritarian filial piety. In contrast, Australians and Singaporeans indicated a positive, moderate correlation between reciprocal and authoritarian filial piety. Further, culture moderated the relationship between authoritarian filial piety and palliative care knowledge. High authoritarian filial piety was associated with increased palliative care knowledge among Australians, while high authoritarian filial piety was associated with decreased palliative care knowledge among Singaporeans. The results support the conceptualization of filial piety as a possible psychological universal construct. In addition, the results point out an important implication that public health programs should target the appropriate filial piety types to enhance palliative care knowledge among Singaporeans and Australians. (shrink)

Trigger warnings captured national attention in 2014 when students from several U.S. universities called for inclusion of the warnings on course syllabi and in classrooms. Opinions spread through news outlets across the spectrum, and those weighing in were quick to pronounce trigger warnings as either unnecessary coddling and an affront to free speech, or as a responsible pedagogical practice that treats students with respect and minimizes harm. Put simply, the debate about trigger warnings has followed the trajectory of many (...) debates in the public sphere: The issue has largely been framed by highly committed opponents and proponents whose positions represent the extremes of the spectrum. Lost has been the nuance that an issue like trigger warnings necessarily requires. This article examines trigger warnings—particularly the call for trigger warnings on university campuses—from a pluralistic ethical perspective and addresses the question: When, if ever, are trigger warnings ethically appropriate? (shrink)

This article describes a qualitative investigation of environmental ethics as construed by environmental activists. Twenty-nine participants responded in writing to open-ended questions on their definitions of an environmental ethic, how they expressed and experienced this moral orientation in their lives, and what sustained it. Four major themes emerged. First, ethical consideration of the natural environment pervaded morality, values, and private and public life. Second, emotional or spiritual experiences, or personal fulfillment, were important for many. Third, there was disagreement on (...) the relationships among environmental principles, intentions, and behaviors, as well as the necessity of prescribing specific behaviors. Finally, there were diverse views on the role of humanitarian concerns in an environmental ethic. These themes are discussed in terms of parallels to religious experience, motivations for an environmental ethic, and implications for nonenvironmental realms of ethics and justice. (shrink)

This article summarizes the April 5–6, 2002 conference on Conflict of Interest and Its Significance in Science and Medicine. Several themes are identified and addressed, including the globalization of science, the widespread presence of conflicts, the increased interest and involvement in conflict of interest by a number of organizations, the difference between academic research and research conducted by industry, and the tension between science and medicine. At the heart of the matter lies objectivity in research and the need for transparency (...) to ensure objectivity. Several future activities were discussed, including the need to share specific examples of how conflict has been managed, and the need for behavioral research to provide a sound empirical understanding of the best ways to provide informed consent for research subjects. (shrink)

The aim of the contribution is to outline the ethical foundations in Maritain’s and Novak’s interpretation of human rights in a wider historical context and to assess its meaning for the present, with special regard to our Central European area. The issue of human rights has, in addition to its political aspect, an inherent ethical one. Fundamental human rights relate to the possibility of autonomy of a person as a moral being endowed with reason and striving for a meaningful life. (...) Therefore, these rights have a fundamental role in practical life; however, they have also become an issue of speculative philosophy and theology, where the focus is upon concepts of freedom and reason. Jacques Maritain and Michael Novak were important figures in the advancement of human rights at the international level, with exceptional impacts especially in Central Europe. Both have their roots in Christian humanism, and for both their concept of human relations is derived from Biblical religion and love for one’s neighbour. Novak accepts Maritain’s concepts of a person and human dignity, and he tries to explain his own concept of democratic capitalism in accordance with it. (shrink)

Inclusion in research is a question of both scientific validity of research results and just distribution of the benefits of medical research within a community. Therefore, inappropriate exclusions from research can be regulated as a matter of science or a matter of ethics. In this paper we examine the definitions of appropriate/fair inclusion in the Australian and U.S. regulatory systems and discuss the processes for interpreting and implementing these normative standards. In the second part of the paper, we present original (...) results from the first study of sex-specific research in Australia. One hundred and thirteen published papers were examined: 35 percent were classified as inappropriate sex-specific research, where exclusion was not biologically necessary, and/or there was no justification for the exclusion of one sex. Our results indicate that a scientific approach to inclusion, rather than one grounded in ethical review, is likely to be more effective in achieving appropriate sex-specific research. In the absence of effective regulation, we will continue to see research that discriminates unfairly and perpetuates gender stereotyping. (shrink)

From Booker T. Washington to a neighbor who speaks up at a city council meeting, many of the people who represent us were never elected. Wendy Salkin provides the first systematic analysis of the ubiquitous phenomenon of informal political representation, a practice of immense political value that raises serious ethical concerns.

Trigger warnings captured national attention in 2014 when students from several U.S. universities called for inclusion of the warnings on course syllabi and in classrooms. Opinions spread through news outlets across the spectrum, and those weighing in were quick to pronounce trigger warnings as either unnecessary coddling and an affront to free speech, or as a responsible pedagogical practice that treats students with respect and minimizes harm. Put simply, the debate about trigger warnings has followed the trajectory of many (...) debates in the public sphere: The issue has largely been framed by highly committed opponents and proponents whose positions represent the extremes of the spectrum. Lost has been the nuance that an issue like trigger warnings necessarily requires. This article examines trigger warnings—particularly the call for trigger warnings on university campuses—from a pluralistic ethical perspective and addresses the question: When, if ever, are trigger warnings ethically appropriate? (shrink)

Twenty-nine environmental activists (mean age, 49.8) responded in writing to questions on influences that gave rise to environmental ethics in their own lives. Answers represented all phases of the lifespan. Through a qualitative analysis, six principle themes emerged: (a) deep environmental concern and an affiliation with nature often began in early childhood; (b) a combination of intellectual or academic and direct experiences with nature contributed to the development of environmental ethics; (c) familial and extra familial models were influential; (d) (...) for some, environmental ethics was tied to spiritual, cultural, or religious feeling; (e) the development of environmental ethics was linked with identity and generativity issues; and (f) historical events interacted with individual development in the formation of an environmental ethics. These themes are discussed in terms of continuities and discontinuities in lifespan development, the role of the family and of history, and the relation between reason and emotion in the development of an environmental ethics. (shrink)

Background: The pharmaceutical industry has been responsible for major medical advances, but the industry has also been heavily criticized. Such criticisms, and associated regulatory responses, are no doubt often warranted, but do not provide a framework for those who wish to reason systematically about the moral dimensions of drug development. We set out to develop such a framework using Beauchamp and Childress's “four principles” as organizing categories. Methods: We conducted a qualitative interview study of people working in the “medical affairs” (...) departments of pharmaceutical companies to determine: (1) whether our data could meaningfully be organized under the headings of “autonomy,” “beneficence,” “nonmaleficence,” and “justice”; (2) how principles might be expressed in this particular commercial setting; and (3) if these principles are expressed, whether and how competing principles are balanced. We then critiqued these findings using existing normative theory. Results: Our interviews demonstrated that three of Beauchamp and Childress's four principles were salient to our participants: beneficence, nonmaleficence, and justice. Within each of these principles, participants had two broad ethical orientations: an altruistic public focus (“other-ness”) and a commitment to their companies (“firm-ness”). Our participants also demonstrated efforts to balance these principles and highlighted the importance of phronesis (or practical wisdom) in balancing and enacting principles. Notably, however, our participants did not spontaneously emphasize the importance of autonomy. Conclusions: It is possible to use qualitative empirical research, together with normative analysis, to derive a framework for pharmaceutical ethics. We suggest that our framework would be useful for those who wish to reason ethically within, or in collaboration with, the pharmaceutical industry. (shrink)

Peer review of manuscripts for biomedical journals has become a subject of intense ethical debate. One of the most contentious issues is whether or not peer review should be anonymous. This study aimed to generate a rich, empirically-grounded understanding of the values held by journal editors and peer reviewers with a view to informing journal policy. Qualitative methods were used to carry out an inductive analysis of biomedical reviewers’ and editors’ values. Data was derived from in-depth, open-ended interviews with (...) journal editors and peer reviewers. Data was “read for” themes relevant to reviewer anonymisation and interactions among editors, reviewers, and authors. Editors and peer reviewers provided three arguments that would support a more open and interactive peer-review process. First, a number of participants emphasised the importance of not only ensuring the scientific quality of published research but also nurturing their colleagues and supporting their communities. Second, many spoke about the ongoing moral responsibilities that reviewers and editors felt toward authors. Finally, participants spoke at length about their enjoyment of social interactions and of the value of collective, rather than isolated, reasoning processes. Whether or not journal editors decide to allow anonymous review , the values of editors and reviewers need to be seriously addressed in codes of publication ethics, in the management of biomedical journals, and in the establishment of journal policies. (shrink)

This paper accesses continental philosophy to explore an analogy between the destruction caused by lack of resistance to National Socialism and the destruction caused by climate change denial. Husserl, Levinas, et alia identified a spirit of abstraction and ideology as elements of a catastrophic cultural crisis. Just as human beings were denuded of personhood, the natural world is denuded of inherent meaning. Social communication degenerates into anti-rational propaganda. Together these undermine response to climate change. Invigorating a genuine desire for (...) truth and appreciation of the non-utilitarian good of beauty may provide some resource for undoing denial. (shrink)

Research suggests that the incidence of moral distress experienced by health professionals is significant and increasing, yet the concept lacks clarity and remains largely misunderstood. Currently, there is limited understanding of moral distress in the context of midwifery practice. The term moral distress was first used to label the psychological distress experienced following complex ethical decision-making and moral constraint in nursing. The term is now used across multiple health professions including midwifery, nursing, pharmacy and medicine, yet is used cautiously due (...) to confusion regarding its theoretical and contextual basis. The aim of this study is to understand the concept of moral distress in the context of midwifery practice, describing the attributes, antecedents and consequences. This concept analysis uses Rodgers’ evolutionary framework and is the first stage of a sequential mixed-methods study. A literature search was conducted using multiple databases resulting in eight articles for review. Data were analysed using NVivo12©. Three core attributes were identified: moral actions and inactions, conflicting needs and negative feelings/emotions. The antecedents of clinical situations, moral awareness, uncertainty and constraint were identified. Consequences of moral distress include adverse personal professional and organisational outcomes. A model case depicting these aspects is presented. A midwifery focused definition of moral distress is offered as ‘a psychological suffering following clinical situations of moral uncertainty and/or constraint, which result in an experience of personal powerlessness where the midwife perceives an inability to preserve all competing moral commitments’. This concept analysis affirms the presence of moral distress in midwifery practice and provides evidence to move towards a consistent definition of moral distress. (shrink)

Experiences of moral distress encountered in psychiatric practice were explored in a hermeneutic phenomenological study. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychiatrists describe struggling ‘to do the right thing’ for individual patients within a societal system that places unrealistic demands on psychiatric expertise. Certainty on the part of the psychiatrist is an expectation when judgments of dangerousness and/or the need for coercive treatments are made. This assumption, however, ignores the uncertainty (...) and complexity of reality. Society entrusts psychiatrists to care for and treat those among its most vulnerable members: persons deemed to have a severely diminished capacity for autonomy due to a mental disorder. Simultaneously, psychiatrists are held accountable by society for the protection of the public. Moral distress arose for psychiatrists in their efforts to fulfill both roles. They described an ‘outsider/insider’ status and the ways in which they attempted to cope with moral distress. (shrink)

Plato has received his share of bad press in this century. A number of significant schools of thought, like existentialism and phenomenology, have openly expressed impatience with Platonic ‘essentialism.’ He has even been blamed for fascism. Perhaps the problem goes back to Nietzsche’s call, at the turn of the century, to be true to the earth, our common mother. His message was aimed at otherworldly, pious Christians who, with a spiritualism worthy of the Platonists, regarded contemplative thought as the way (...) to truth. Like a doubleedged sword Nietzsche’s call was also directed against metaphysics, dogmatism and intellectualism, the fruits of which he confronted in the weighty tomes for which German scholars then were justifiably renowned. It is not surprising that in the Soviet empire, built on Marxist-Leninist atheism, Nietzsche’s words fell on receptive ears. Not only were philosophers who dared openly to identify themselves as ‘Platonist’ or ‘idealist’ banned, exiled or executed. The teaching of classical antiquity, too, was almost entirely removed from the curriculum; the ancients could be considered only from a highly restricted point of view, via Democritus, Lucretius, or Aristotle. (shrink)

This article describes a qualitative investigation of 20 student activists' resolutions to environmental dilemmas. Participants responded to an oral interview asking them to resolve 6 dilemmas involving the natural environment and to give justifications for their resolutions. Several major themes emerged. First, participants tended to be concerned with maintaining human self-determination and tolerating human diversity. They also resolved dilemmas by reference to 3rd parties, and attributions of responsibility and sacrifice were made according to several patterns. Both humans and nonhumans (...) were considered in resolutions, and resolutions reflected concerns with procedural justice and fairness and context-based value hierarchies. These themes are discussed in terms of the difficulty of resolving such dilemmas and implications for studying values and moral choices in the environmental context. (shrink)

This paper is based on a study that explored the responses of bioscientists to changes in national science policy and research funding in Canada. In the late 1990s, a range of new science policies and funding initiatives were implemented, linking research funding to Canada’s competitiveness in the ‘global knowledge economy’. Bourdieu’s theory of practice is used to explore the multi-scalar, cross-field effects of global economic policy and national science policy on scientific practice. While most science and educational policy studies (...) use Bourdieu’s concepts ontologically, as “thinking tools” to theorize power, this study adopted Bourdieu’s relational epistemology, empirically linking objective positions of power with position-takings towards market-oriented science. A relational epistemology made it possible to explore what forms and weight of capital scientists brought to bear on symbolic struggles over the legitimacy of a market and scientific logic. By empirically investigating how power shaped bioscientists’ responses to market-oriented science policy, this study was able to identify key mechanisms of change within the scientific field and between science, politics and the market. First, it identified the rise of a new form of entrepreneurial capital and a market-oriented logic that coexists alongside a traditional scientific logic within the scientific field in a bipolar system of stratification. Second, it illustrated changes in scientific practice, which contribute to change in the structure of the distribution of capital within the scientific field. This study challenges Bourdieu’s emphasis on a single dominant logic or symbolic order and challenges science and technology scholars to both use and extend his theoretical contributions. (shrink)

Problem solving in a materially rich environment requires interacting with chance. Sixty-four participants were invited to solve 5-letter anagrams presented as movable tiles in conditions that either allowed the participants to move the tiles as they wished or only allowed random shuffling (without rearranging the tiles post shuffling) thus contrasting pure luck with an interactive model. We hypothesised that shuffling would break unhelpful mental sets and introduce beneficial unplanned problem-solving trajectories. However, participants performed significantly worse when shuffling, which suggests (...) luck plays less of a role than has been previously suggested. Granular analysis of seven critical cases revealed arbitrary path dependency across both conditions and moments of missed luck. It also questions current models of non-agentic luck and the ability to separate agent and luck. This research has implications for fostering better problem solving in an uncertain and fluid world. (shrink)

Omnipresent calls for more women in university administration assume these women will prioritize using resources and power to increase female representation, especially in STEM fields where women are most underrepresented. However, empirical evidence is lacking for systematic differences in female versus male administrators’ attitudes. Do female administrators agree on which strategies are best, and do men see things differently? To answer this question, we explored United States college and university administrators’ opinions regarding policies, strategies, and structural changes in their organizations (...) designed to increase women professors’ representation and retention in STEM fields. A comprehensive review of past research yielded a database of potentially-effective, recommended policies (e.g., increasing emphasis on teaching, service, and administration during promotion reviews; stopping the tenure clock for childbearing; providing on-campus childcare; couples-hiring; sharing tenure lines; having more women chair search committees; setting gender quotas for promotion). A survey based on these recommended policies was sent to provosts, deans, associate deans, and department chairs of STEM fields at 96 public and private research universities (formerly called R1s) across the U.S. These administrators were asked to rate the quality and feasibility of each recommended policy; 474 provided data, of which 334 contained complete numerical data used in the analyses, so our results are based on a large, geographically diverse group of administrators at research universities. Our data revealed that female administrators perceived the 44 strategies to be higher in quality overall than did male administrators--but not higher in feasibility--with 9 policies perceived differently when rated by women versus men administrators, after imposing conservative statistical controls. There was broad general agreement on the relative rankings of the 44 policies in terms of their perceived quality. Overall, our national survey of U.S. administrators supported the assertion that placing women in administrative roles creates greater emphasis on the importance of enacting policies to attract and retain women in STEM. Topics of disagreement between women and men regarding strategy quality are important focuses of future policy and planning, because female administrators may have insights into how to retain women professors that male administrators do not share. (shrink)

Recent evidence from psychological science and genetics suggests that genetic influences underlie all behavior as well as the most worrisome social inequalities. This may be considered to call into question traditional conceptions of agency and agent responsibility. They could be thought to be undermined if gene-environment transactions were sufficiently potent in influencing behaviors. Here we identify the theoretical parameters that require investigation and the conceptual challenges to agent responsibility that arise from research in behavior genetics. We (i) introduce the (...) empirical basis of the discussion, (ii) identify the particular questions that arise from considering the connection between behavior genetics and agent responsibility in the context of the legal system, (iii) bring into focus the general challenges to agent responsibility, and (iv) outline a potential resolution. (shrink)

The debate about whether misoprostol should be distributed to low resource communities to prevent post-partum haemorrhage, recognised as a major cause of maternal mortality, is deeply polarised. This is in spite of stakeholders having access to the same evidence about the risks and benefits of misoprostol. To understand the disagreement, we conducted a qualitative analysis of the values underpinning debates surrounding community distribution of misoprostol. We found that different moral priorities, epistemic values, and attitudes towards uncertainty were the main (...) factors sustaining the debate. With this understanding, we present a model for ethical discourse that might overcome the current impasse. (shrink)

Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuable but scarce resource in the (...) pandemic context.In this paper, we argue that the concern about achieving equity in ICU triage is problematic for two reasons. First, ICU can be futile and prolong or exacerbate suffering rather than ameliorate it. This may be especially true in patients with COVID-19 with emerging data showing that most who receive access to a ventilator will still die. There is no value in admitting patients with poor prognostic indicators to ICU to meet an equity target when intensive critical care is contrary to their best interests. Second, the focus on ICU admission shifts focus away from important aspects of COVID-19 care where there is greater opportunity for mitigating suffering and enhancing equitable care.We propose that the focus on equity concerns during the pandemic should broaden to include providing all people who need it with access to the highest possible standard of end-of-life care. This requires attention to culturally safe care in the following interlinked areas: palliative care, communication and decision support and advanced care planning. (shrink)

Erotic religious imagery is as old as Hinduism. The earliest Hindu sacred text, the Rig Veda , revels in the language of both pleasure and fertility. In addition to this and other religious texts that incorporated eroticism, there were more worldly texts that treated the erotic tout court, of which the Kamasutra, composed in north India, probably in the third century CE, is the most famous. The two words in its title mean "desire/love/pleasure/sex" and "a treatise" . Virtually nothing (...) is known about the author, Vatsyayana, other than his name and what we learn from this text. There is nothing remotely like it even now, and for its time it was astonishingly sophisticated; it was already well known in India at a time when the Europeans were still swinging in trees, culturally speaking. The Kamasutra's ideas about gender are surprisingly modern, and its stereotypes of feminine and masculine natures are unexpectedly subtle. It also reveals attitudes to women's education and sexual freedom, and views of homosexual acts, that are strikingly more liberal than those of other texts in ancient India—or, in many cases, in contemporary India. (shrink)

This article reports the findings of a qualitative study that explored the organizational influences on moral distress for health professionals working in pediatric intensive care units across Canada. Participants were recruited to the study from PICUs across Canada. The PICU is a high-tech, fast-paced, high-pressure environment where caregivers frequently face conflict and ethical tension in the care of critically ill children. A number of themes including relationships with management, organizational structure and processes, workload and resources, and team dynamics (...) class='Hi'>were identified. This study provides a rare and important multi-disciplinary perspective on this topic and the findings have implications for administrators and leaders who seek to improve the moral climate of healthcare delivery. (shrink)

This essay discusses the semiotic scaffolding of modern science, the roots of which lie in the Protestant Reformation and the latter’s repudiation of the “semiotics of nature” upon which medieval theology depended. Taking the fourteenth-century battles between realism and nominalism as the semiotic scaffolding of the Reformation which was subsequently built on nominalist principles, and the Reformation as what made possible the development of early modern science, this essay argues that nominalism, Protestantism, and early modern science were all infected (...) by the gnostic influences which had always accompanied Christianity from the start. Indicating that forms of creative discovery, in the arts, humanities and sciences, are closer to poetic forms than they are to the Baconian model which informed modern science, the essay goes on to link the latter gnostic-influenced metaphysics, motivated by a Reformation anxiety about sin and error, to the development of the modern “megamachine” as described by Lewis Mumford in The Myth of the Machine volumes 1 and 2. Finally the essay suggests that semiotically revivified life sciences might be capable of resolving some of the systemic and ecological problems which Mumford identifies. (shrink)

Wood, Kressel, Joshi, and Louie’s meta-analysis of menstrual cycle influences on mate preferences identified three artifacts that influenced study findings: imprecise estimates of the fertile phase, decline over time, and publication effects. These artifacts also were evident in another recent meta-analysis by Gildersleeve, Haselton, and Fales. This consistent evidence of artifacts is not challenged by Gildersleeve et al.’s failure to find another artifact–chasing significance levels. In addition, Wood et al. correctly coded the findings of Gangestad and colleagues’ research, given (...) the variation in their reporting formats and inclusion criteria, which in some studies included only 54% of the sample. The controversy over menstrual cycle effects could be beneficial in increasing interest in publishing null results as well as in identifying evolutionary models that build on women’s capacity to regulate reproduction according to societal roles. (shrink)

Erotic religious imagery is as old as Hinduism. The earliest Hindu sacred text, the Rig Veda, revels in the language of both pleasure and fertility. In addition to this and other religious texts that incorporated eroticism, there were more worldly texts that treated the erotic tout court, of which the Kamasutra, composed in north India, probably in the third century CE, is the most famous. The two words in its title mean "desire/love/pleasure/sex" and "a treatise". Virtually nothing is known (...) about the author, Vatsyayana, other than his name and what we learn from this text. There is nothing remotely like it even now, and for its time it was astonishingly sophisticated; it was already well known in India at a time when the Europeans were still swinging in trees, culturally speaking. The Kamasutra's ideas about gender are surprisingly modern, and its stereotypes of feminine and masculine natures are unexpectedly subtle. It also reveals attitudes to women's education and sexual freedom, and views of homosexual acts, that are strikingly more liberal than those of other texts in ancient India—or, in many cases, in contemporary India. (shrink)

BackgroundSchool violence and bullying are prevalent problems that affect health in general, especially through the development of emotional and behavioral problems, and can result in the deterioration of the academic performance of the student victim. The objective of this study was to determine the prevalence rates of aggressive behaviors according to types of school violence and bullying, sociodemographic characteristics, and variation by department, region, and time in the period between 2014 and 2018 in Peru.MethodsThe design was observational and cross-sectional based (...) on data from the Specialized System for Reporting Cases of School Violence in Peru, which covers a population of 23,641 students at the initial, primary, and secondary levels of Basic Regular Education [Educación Básica Regular ], for the 2014–2018 period. The prevalence rates of the different types of school violence and bullying, the sociodemographic characteristics, and the variation by department, region, and time in the period between 2014 and 2018 were estimated.ResultsPsychological violence/bullying occurred at higher prevalence rates. Women from public institutions reported greater sexual violence, mostly by teachers than by other students. The Selva region had the highest prevalence rate of sexual violence. The departments of Tacna and Piura had the highest and lowest rates of psychological/verbal violence and bullying in 2018.ConclusionPsychological/verbal violence and bullying is highly prevalent among students; women report being victims of sexual violence by administrative personnel of public institutions. The Selva region had the highest rate of sexual violence, and Piura and Tacna had the highest and lowest rates of violence and psychological/verbal bullying. Based on these results, it is suggested to conduct evidence-based prevention programs in Peruvian schools to reduce these social problems. (shrink)

This article examines feminist agency in the light of Merleau-Ponty’s phenomenological account of the body subject. Stressing the importance of embodiment to feminist agency (without reifying an essential female body), I argue that bodies inhabit specific social, historical and discursive contexts which shape our corporeal experience and our opportunities for political contestation. Beginning with the assertion that we cannot think of agency without the body, I examine a historical instance of feminist agency in which women’s bodies were central to (...) the articulation of political dissent, namely the British suffragette movement. In particular, I focus on the suffragette career of Mary Leigh and argue that it represents a feminist agency derived from corporeal performance. Through daring acts of protest which drew attention to the comportment and capacities of their bodies, suffragettes like Leigh contested the constitution of the political domain and the nature of citizenship. (shrink)

Background: Limited knowledge of the experiences of conflicts of conscience found in nursing literature. Objectives: To explore the individual experiences of a conflict of conscience for neonatal nurses in Alberta. Research design: Interpretive description was selected to help situate the findings in a meaningful clinical context. Participants and research context: Five interviews with neonatal nurses working in Neonatal Intensive Care Units throughout Alberta. Ethical consideration: Ethics approval from the Health Research Ethics Board at the University of Alberta. Findings: Three common (...) themes emerged from the interviews: the unforgettable conflict with pain and suffering, finding the nurse’s voice, and the unique proximity of nurses. Discussion and conclusion: The nurses described a conflict of conscience when the neonate in their care experienced undermanaged pain and unnecessary suffering. During these experiences, they felt guilty, sad, hopeless, and powerless when they were unable to follow their conscience. Informal ways to follow their conscience were employed before declaration of conscientious objection was considered. This study highlights the vital importance of respecting a conflict of conscience to maintain the moral integrity of neonatal nurses and exposes the complexities of conscientious objection. (shrink)

The mass media is a major source of health information for the public, and as such the quality and independence of health news reporting is an important concern. Concerns have been expressed that journalists reporting on health are increasingly dependent on their sources—including representatives of industries responsible for manufacturing health-related products—for story ideas and content. Many critics perceive an imbalance of power between journalists and industry sources, with industry being in a position of relative power, however the empirical evidence to (...) support this view is limited. The analysis presented here—which is part of a larger study of industry-journalist relationships—draws on in-depth, semi-structured interviews with representatives of health-related industries in Australia to inductively examine their perceptions of power relations between industry and journalists. Participants painted a picture in which journalists, rather than themselves, were in a position to control the nature, extent, and outcome of their interactions with industry sources. Our results resonate with the concept of “mediatisation” as it has been applied in the domain of political reporting. It appears that, from the perspective of industry representatives, the imposition of media logic on health-related industries may inappropriately influence the information that the public receives about health-related products. (shrink)

This article critically analyses correspondence and decisions regarding children/young people who were included in the Canadian child migration schemes that ran between 1883 and 1939, and those who were deemed ‘undeserving’ and outside the scope of the schemes. Drawing on critical realist ontology, a metatheory that centralises the causal non-linear dynamics and generative mechanisms in the individual, the cultural sphere, and wider society, the research starts from the premise that the principle of ‘less or more eligibility’ lies at (...) the heart of the British welfare system, both now and historically. Through analysing case files and correspondence relating to children sent to Canada via the Waifs and Strays Society and Fegan Homes, I shed light on the complex interplay between morality, biological determinism, resistance, and resilience in decisions around which children should be included or excluded. I argue that it was the complex interplay and nuance between the moral/immoral, desirable/undesirable, degenerate, and capable/incapable child that guided practice with vulnerable children in the late 1800s. In judgements around ‘deservedness’, related stigmas around poverty and ‘bad’ behaviour were rife. Within this, the child was punished for his/her ‘immoral tendencies’ and ‘inherited traits’, with little regard for the underlying reasons for their behaviour and ‘mental deficiencies’. (shrink)

There was a strong consensus in the commentaries that animals' performances in metacognition paradigms indicate high-level decisional processes that cannot be explained associatively. Our response summarizes this consensus and the support for the idea that these performances demonstrate animal metacognition. We amplify the idea that there is an adaptive advantage favoring animals who can – in an immediate moment of difficulty or uncertainty – construct a decisional assemblage that lets them find an appropriate behavioral solution. A working consciousness would serve (...) this function well. This explains why animals may have the functional equivalent of human declarative consciousness. However, like other commentators who were friendly to this equivalence, we approach carefully the stronger claims that animals' metacognitive performances imply full-blown self-awareness or phenomenal consciousness. We discuss the commentators' interesting ideas for future research, as well as their intriguing ideas about the evolution and development of metacognition and its relation to theory of mind. We also discuss residual confusions about existing research and remaining methodological issues. (shrink)

Forms of Artificial Intelligence (AI) are already being deployed into clinical settings and research into its future healthcare uses is accelerating. Despite this trajectory, more research is needed regarding the impacts on patients of increasing AI decision making. In particular, the impersonal nature of AI means that its deployment in highly sensitive contexts-of-use, such as in healthcare, raises issues associated with patients’ perceptions of (un) dignified treatment. We explore this issue through an experimental vignette study comparing individuals’ perceptions of being (...) treated in a dignified and respectful way in various healthcare decision contexts. Participants were subject to a 2 (human or AI decision maker) x 2 (positive or negative decision outcome) x 2 (diagnostic or resource allocation healthcare scenario) factorial design. We found evidence of a “human bias” (i.e., a preference for human over AI decision makers) and an “outcome bias” (i.e., a preference for positive over negative outcomes). However, we found that for perceptions of respectful and dignified interpersonal treatment, it matters more who makes the decisions in diagnostic cases and it matters more what the outcomes are for resource allocation cases. We also found that humans were consistently viewed as appropriate decision makers and AI was viewed as dehumanizing, and that participants perceived they were treated better when subject to diagnostic as opposed to resource allocation decisions. Thematic coding of open-ended text responses supported these results. We also outline the theoretical and practical implications of these findings. (shrink)

Plato has received his share of bad press in this century. A number of significant schools of thought, like existentialism and phenomenology, have openly expressed impatience with Platonic ‘essentialism.’ He has even been blamed for fascism. Perhaps the problem goes back to Nietzsche’s call, at the turn of the century, to be true to the earth, our common mother. His message was aimed at otherworldly, pious Christians who, with a spiritualism worthy of the Platonists, regarded contemplative thought as the way (...) to truth. Like a doubleedged sword Nietzsche’s call was also directed against metaphysics, dogmatism and intellectualism, the fruits of which he confronted in the weighty tomes for which German scholars then were justifiably renowned. It is not surprising that in the Soviet empire, built on Marxist-Leninist atheism, Nietzsche’s words fell on receptive ears. Not only were philosophers who dared openly to identify themselves as ‘Platonist’ or ‘idealist’ banned, exiled or executed. The teaching of classical antiquity, too, was almost entirely removed from the curriculum; the ancients could be considered only from a highly restricted point of view, via Democritus, Lucretius, or Aristotle. (shrink)

Tetrapods have two distinct nasal chemosensory systems, the main olfactory system and the vomeronasal system (VNS). Defined by certain morphological components, the main olfactory system is present in all groups of vertebrates, while the VNS is found only in tetrapods. Previous attempts to identify a VNS precursor in teleost fish were limited by functional and morphological characters that could not clearly distinguish between homologous and analogous systems. In the past decade, several genes that specifically function in the VNS have (...) been discovered. Here we first describe recent evolutionary studies of mammalian VNS‐specific genes. We then review evidence showing the presence and tissue‐specific expression of the VNS‐specific genes in teleosts, as well as co‐expression patterns of these genes in specific regions of the teleost olfactory epithelium. We propose that a VNS precursor exists in teleosts and that its evolutionary origin predated the separation between teleosts and tetrapods. BioEssays 28: 709–718, 2006. © 2006 Wiley Periodicals, Inc. (shrink)

Peer review of manuscripts has recently become a subject of academic research and ethical debate. Critics of the review process argue that it is a means by which powerful members of the scientific community maintain their power, and achieve their personal and communal aspirations, often at others' expense. This qualitative study aimed to generate a rich, empirically‐grounded understanding of the process of manuscript review, with a view to informing strategies to improve the review process. Open‐ended interviews were carried out (...) with 35 journal editors and peer reviewers in the United Kingdom, the USA and Australia. It is clear from this research that relations of power and epistemic authority in manuscript review are complex and dynamic, and may have positive and negative features, and that even where power is experienced as controlling, restrictive and illegitimate, it can also be resisted. In conclusion, the manuscript review process is best thought of not in terms of simple dominance of reviewers and editors over authors, but rather as a shifting “net” of power relations. These complex power relations need to be understood if reviewers are to be encouraged to participate in the process and to do so in the the most ethical and effective manner. (shrink)

Research leadership in Australian universities takes place against a backdrop of policy reforms concerned with measurement and comparison of institutional research performance. In particular, the Excellence in Research in Australian initiative undertaken by the Australian Research Council sets out to evaluate research quality in Australian universities, using a combination of expert review process, and assessment of performance against ?quality indicators?. Benchmarking exercises of this sort continue to shape institutional policy and practice, with inevitable effects on the ways in which research (...) leadership, mentoring and practice are played out within university faculties and departments. In an exploratory study that interviewed 32 Australian academics in universities in four Australian states, we asked participants, occupying formal or informal research leadership roles, to comment on their perceptions of research leadership as envisioned and enacted in their particular workplaces. We found a pervasive concern amongst participants that coalesced around binaries characterized in metaphoric terms of ?carrots and whips?. Research leadership was seen by many as managerial in nature, and as such, largely tethered to instrumentalist notions of productivity and performativity, while research cultures were seen as languishing under the demoralizing weight of reward and punishment systems. Here, we consider what is at stake for the future of the academic workforce under such conditions, arguing that new models of visionary research leadership are urgently needed in the ?troubled times? of techno-bureaucratic university reforms. (shrink)

On the twelfth anniversary of the name of Mexican Gastronomy as intangible cultural heritage of humanity, its safeguarding continues in different contexts. Nayarit stands out for its natural and cultural wealth which is reflected in the local gastronomy, whose recognition attracts locals and foreigners to taste the delicious dishes. This text contains research results whose purpose is to document the cultural and natural elements that make up the gastronomic heritage of Nayarit with potential for the development of tourism products. Through (...) a qualitative, applied, descriptive research, historical sources were consulted and contrasted with the information collected through interviews, for the integration of a non-exhaustive inventory of the north coast region of Nayarit, which serves as a basis for the tourist product design. (shrink)

The behavioral sciences have come under attack for writings and speech that affront sensitivities. At such times, academic freedom and tenure are invoked to forestall efforts to censure and terminate jobs. We review the history and controversy surrounding academic freedom and tenure, and explore their meaning across different fields, at different institutions, and at different ranks. In a multifactoral experimental survey, 1,004 randomly selected faculty members from top-ranked institutions were asked how colleagues would typically respond when confronted with dilemmas (...) concerning teaching, research, and wrong-doing. Full professors were perceived as being more likely to insist on having the academic freedom to teach unpopular courses, research controversial topics, and whistle-blow wrong-doing than were lower-ranked professors (even associate professors with tenure). Everyone thought that others were more likely to exercise academic freedom than they themselves were, and that promotion to full professor was a better predictor of who would exercise academic freedom than was the awarding of tenure. Few differences emerged related either to gender or type of institution, and behavioral scientists' beliefs were similar to scholars from other fields. In addition, no support was found for glib celebrations of tenure's sanctification of broadly defined academic freedoms. These findings challenge the assumption that tenure can be justified on the basis of fostering academic freedom, suggesting the need for a re-examination of the philosophical foundation and practical implications of tenure in today's academy. (Published Online February 8 2007) Key Words: academia; academic freedom; ethical issues; faculty beliefs; professoriate; promotion; scientific misconduct; tenure; whistle-blowing. (shrink)

The promotion of tourists’ environmentally responsible behavior plays a central role in destination management for sustainability. Based on the stimulus–organism–response framework, this study proposes an integrated model for behavior management by examining the relationship between stimuli and response factors through the organism. Survey data from 458 tourists visiting Mount Heng in Hunan Province, Southern China, were used to empirically evaluate the proposed framework. The findings demonstrate that the perception of a destination’s natural environment positively impacts tourists’ sense of awe (...) and satisfaction; the perception of availability of infrastructure positively and significantly influences awe, satisfaction, and TERB; and awe positively impacts satisfaction and TERB. Moreover, the emotion of awe plays a significant mediating role in this proposed model. The theoretical significance of this study and the implications for tourism destinations are discussed. (shrink)

Many scientists and philosophers of science are troubled by the relative isolation of developmental from evolutionary biology. Reconciling the science of development with the science of heredity preoccupied a minority of biologists for much of the twentieth century, but these efforts were not corporately successful. Mainly in the past fifteen years, however, these previously dispersed integrating programmes have been themselves synthesized and so reinvigorated. Two of these more recent synthesizing endeavours are evolutionary developmental biology and developmental systems theory. While (...) the former is a bourgeoning and scientifically well-respected biological discipline, the same cannot be said of DST, which is virtually unknown among biologists. In this review, we provide overviews of DST and EDB, summarize their key tenets, examine how they relate to one another and to the study of epigenetics, and survey the impact that DST and EDB have had on biological theory and practice. (shrink)