A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

It is inevitable that physicians in training will be exposed to behavior by supervising physicians that the trainees find unethical. By nature these events are rare. It is imperative within any residency training program that resident physicians have immediate access to a meaningful review process in cases of moral conflict with supervising physicians. Here, I discuss the reasons why this issue must be recognized and what it entails. Most important, I discuss the procedural steps that are essential for the training (...) program to make this a meaningful safety mechanism in residency training. This issue is central to promoting conscious development of professionalism in clinical training. Physicians in training, especially resident physicians, need to be taught to value and protect their own professional integrity. The responsibility for fulfilling this ethical duty falls on the individual residency programs as well as the administrative organizations that regulate residency training. Thus, ensuring this process of review is an organizational ethical imperative. Availability of this process is fundamental to promoting and ensuring ethical behavior by all participants in residency training. (shrink)

Much has been made of the importance of training ethical, socially conscious engineers, but does US engineering education actually encourage neophytes to take seriously their professional responsibility to public welfare? Counter to such ideals of engagement, I argue that students’ interest in public welfare concerns may actually decline over the course of their engineering education. Using unique longitudinal survey data of students at four colleges, this article examines (a) how students’ public welfare beliefs change during their engineering education, (b) whether (...) engineering programs emphasize engagement, and (c) whether these program emphases are related to students’ public welfare beliefs. I track four specific public welfare considerations: the importance to students of professional/ethical responsibilities, understanding the consequences of technology, understanding how people use machines, and social consciousness. Suggesting a culture of disengagement, I find that the cultural emphases of students’ engineering programs are directly related to their public welfare commitments and students’ public welfare concerns decline significantly over the course of their engineering education. However, these findings also suggest that if engineering programs can dismantle the ideological pillars of disengagement in their local climates, they may foster more engaged engineers. (shrink)

Occupational gender segregation is an obdurate feature of gender inequality in the United States The “family plans thesis”—the belief that women and men deliberately adjust their early career decisions to accommodate their anticipated family roles—is a common theoretical explanation of this segregation in the social sciences and in popular discourse. But do young men and women actually account for their family plans when making occupational choices? This article investigates the validity of this central mechanism of the family plans thesis. Drawing (...) on in-depth interviews with 100 college students at three universities, I find that most women and men report no deliberate consideration of their family plans in their college major or post-graduation career choices. Only a quarter of men accommodate provider role plans in their choice of occupations, and only 7 of 56 women accommodate caregiving plans. Further, men who anticipate a provider role are not typically enrolled in more men-dominated fields, and women who seek caregiver-friendly occupations are not typically enrolled in more women-dominated fields. These findings question the validity of the family plans thesis and suggest instead that the thesis itself may reproduce segregation as a cultural schema that buttresses essentialist stereotypes about appropriate fields for men and women. (shrink)

Previous research on counterfactual thoughts about prevention suggests that people tend to focus on enabling rather than causing events and controllable rather than uncontrollable events. Two experiments explore whether counterfactual thinking about enablers is distinct from counterfactual thinking about controllable events. We presented participants with scenarios in which a cause and an enabler contributed to a negative outcome. We systematically manipulated the controllability of the cause and the enabler and asked participants to generate counterfactuals. The results indicate that when only (...) the cause or the enabler is controllable participants undid the controllable event more often. However, when the cause and enabler are matched in controllability participants undid the enabler slightly more often. The findings are discussed in the context of the mental model, functional and judgement dissociation theories as well as previous research on counterfactual thinking. The importance of controllability and.. (shrink)

Ambiguities in liberal 1 education and the problem of its content RSPeters INTRODUCTION If one was mounting a defence of certain distinctive values in ...

For the past year we have been introducing teachers in western Massachusetts to Philosophy for Children by means of letters, bulletins, and informational demonstrations. Occasionally we find that a number of teachers in a given school district are interested in the idea, but they may not want to commit themselves to the time and expense of taking a course for college credit. A useful alternative, at least in Massachusetts, has been for the teachers to apply to the state for funding (...) to set up a Commonwealth Inservice program. If their proposal is approved, the Commonwealth of Massachusetts pays for a consultant to conduct the requested program and supplies a fixed amount of money for materials. Upon successful completion of the program teachers receive inservice credit which count toward salary increments. (shrink)

Can epistemologies anchor processes of social inequality? In this paper, we consider how epistemological dominance in science, engineering, and health fields perpetuates disadvantages for students who enter higher education with alternative epistemologies. Drawing on in-depth interviews with Native American students enrolled at two US research universities who adhere to or revere indigenous epistemologies, we find that epistemological dominance in SE&H degree programs disadvantages students through three processes. First, it delegitimizes Native epistemologies and marginalizes and silences students who value them. Second, (...) in the process of imparting these dominant scientific epistemologies, SE&H courses sometimes require students to participate in pedagogical practices that challenge indigenous ways of knowing. Third, students encounter epistemological imperialism: most students in the sample are working to earn SE&H degrees in order to return to tribal communities to “give back,” yet, because the US laws regulating the practice of SE&H extend onto tribal lands, students must earn credentials in epistemologies that devalue, delegitimate, and threaten indigenous knowledge ways to practice on tribal lands. We examine how students navigate these experiences, discuss the implications of these findings for SE&H education, and describe how epistemological dominance may serve as a mechanism of inequality reproduction more broadly. (shrink)

ABSTRACTPeople often use metaphors to discuss their financial prospects – for example, finding a fortune or searching for wealth. The purpose of the present research was to utilize conceptual metap...

While people’s lives continue to be put at risk by the dearth of organs available for transplantation, we must give urgent consideration to any option that may make up the shortfall. A market in organs from living donors is one such option. The market should be ethically supportable, and have built into it, for example, safeguards against wrongful exploitation. This can be accomplished by establishing a single purchaser system within a confined marketplace.Statistics can be dehumanising. The following numbers, however, have (...) more impact than most: as of 24th November, during 2002 in the United Kingdom, 667 people have donated organs, 2055 people have received transplants, and 5615 people are still awaiting transplants.1 It is difficult to estimate how many people die prematurely for want of donor organs. “In the world as a whole there are an estimated 700 000 patients on dialysis . . . . In India alone 100 000 new patients present with kidney failure each year”2 . Almost “three million Americans suffer from congestive heart failure . . . deaths related to this condition are estimated at 250 000 each year . . . …. (shrink)

“There’s no disputing about taste.” That’s got a nice ring to it, but it’s not quite the ring of truth. While there’s definitely something right about the aphorism – there’s a reason why it is, after all, an aphorism, and why its utterance tends to produce so much nodding of heads and muttering of “just so” and “yes, quite” – it’s surprisingly difficult to put one’s finger on just what the truth in the neighborhood is, exactly. One thing that’s pretty (...) clear is that what’s right about the aphorism, that there’s no disputing about taste, isn’t that there’s no disputing about taste. There’s heaps of disputing about taste. People engage in disputes about which movies, music, paintings, literature, meals, furniture, architectural styles, etc. are good, beautiful, tasty, fun, elegant, ugly, disgusting, etc. all the time. This is obvious to anyone who has watched dueling-movie-critics shows, read theater reviews, or negotiated with a group or partner about which movie or restaurant to go to, or which sofa or painting to put in the living room. It takes great care and good aim to fling a brick without hitting somebody who’s engaged in a dispute about taste. (shrink)

We agree with Alfandre and colleagues that ethics guidance for contingency conditions in public health emergencies is urgently needed. The Minnesota COVID Ethics Collabora...

Among the cognitive capacities of evolved creatures is the capacity to represent. Theories in cognitive neuroscience typically explain our manifest representational capacities by positing internal representations, but there is little agreement about how these representations function, especially with the relatively recent proliferation of connectionist, dynamical, embodied, and enactive approaches to cognition. In this talk I sketch an account of the nature and function of representation in cognitive neuroscience that couples a realist construal of representational vehicles with a pragmatic account of (...) mental content. I call the resulting package a deflationary account of mental representation and I argue that it avoids the problems that afflict competing accounts. (shrink)

Primordial emotions are the subjective element of the instincts which are the genetically programmed behaviour patterns which contrive homeostasis. They include thirst, hunger for air, hunger for food, pain and hunger for specific minerals etc.There are two constituents of a primordial emotion—the specific sensation which when severe may be imperious, and the compelling intention for gratification by a consummatory act. They may dominate the stream of consciousness, and can have plenipotentiary power over behaviour.It is hypothesized that early in animal evolution (...) complex reflex mechanisms in the basal brain subserving homeostatic responses, in concert with elements of the reticular activating system subserving arousal, melded functionally with regions embodied in the progressive rostral development of the telencephalon. This included the emergent limbic and paralimbic areas, and the insula. This phylogenetically ancient organization subserved the origin of consciousness as the primordial emotion, which signalled that the organisms existence was immediately threatened. Neuroimaging confirms major activations in regions of the basal brain during primordial emotions in humans. The behaviour of decorticate humans and animals is discussed in relation to the possible existence of primitive awareness.Neuroimaging of the primordial emotions reveals that rapid gratification of intention by a consummatory act such as ingestion causes precipitate decline of both the initiating sensation and the intention. There is contemporaneous rapid disappearance of particular regions of brain activation which suggests they may be part of the jointly sufficient and severally necessary activations and deactivations which correlate with consciousness [Crick, F. & Koch, C. . A framework for consciousness. NatureNeuroscience,6, 119–126]. (shrink)

It is well-documented that mathematics achievement is an important predictor of many positive life outcomes like college graduation, career opportunities, salary, and even citizenship. As such, it is important for researchers and educators to help students succeed in mathematics. Although there are undoubtedly many factors that contribute to students' success in mathematics, much of the research and intervention development has focused on variations in instructional techniques. Indeed, even a cursory glance at many educational journals and granting agencies reveals that there (...) is a large amount of time, energy, and resources being spent on determining the best way to convey information through direct, declarative instruction. The proposed project is motivated by recent calls to expand the focus of research in mathematics education beyond direct, declarative instruction. The overarching goal of the presented experiment is to evaluate the efficacy of a novel mathematics intervention designed using principles taken from the literature on non-declarative learning. The intervention combines errorless learning and structured cue fading to help second grade students improve their understanding of symbolic magnitude. Results indicate that students who learned about symbolic magnitude using the novel intervention did better than students who were provided with extensive declarative support. These findings offer preliminary evidence in favor of using learning combination of errorless learning and cue fading techniques in the mathematics classroom. (shrink)

Introduction This article is a response to Zagouras, Ellick, and Aulisio who presented a case study justifying the questioning of the capacity and autonomy of a young woman with a physical disability who was pregnant and facing coercive pressure to terminate. Case description Julia is described as a 26-year-old woman with a neurological disability that requires her to receive assistance with activities of daily living. She was described as living with her parents who provided her with personal care assistance. Julia (...) became pregnant and her parents wished her to terminate because they did not want to care for her child in addition to her. In fact, Julia's parents threatened her with institutionalization if she did not elect to terminate the pregnancy. Her health care team questioned her decision-making capacity based on her alleged “mental age” and experiences of being sheltered and excluded. The health care team used directive tactics to convince Julia to terminate the pregnancy, which describe as both an ethical and feminist intervention. Discussion The current authors take issue with the case analysis provided by and argue that they neglected to account for numerous instances of systemic ableism that adversely affected Julia, demonstrated prejudicial and judgmental attitudes toward pregnancy and disability, inappropriately questioned her decision-making capacity by infantilizing her, misconstrued the feminist concept of relational autonomy, and colluded with coercive interference from family members. This is a classic example of discriminatory and culturally incompetent reproductive health care for a disabled woman. (shrink)

Morality can help guide behavior and facilitate relationships. Although moral judgments by autistic people are similar to neurotypical individuals, many researchers argue that subtle differences signify deficits in autistic individuals. Moral foundation theory describes moral judgments in terms of differences rather than deficits. The current research, aimed at assessing autistic individuals’ moral inclinations using Haidt’s framework, was co-designed with autistic community members. Our aim was to describe autistic moral thinking from a strengths-based perspective while acknowledging differences that may pose interpersonal (...) challenges among autistic youth. We assessed 25 autistic and 23 neurotypical children’s moral judgments using the Moral Foundations Questionnaire for Kids. We used semi-structured interviews and qualitative analysis with a subset of participants to describe children’s moral reasoning. Analyses suggested that autistic and neurotypical children make similar judgments about moral transgressions across all five moral foundations. General linear mixed modeling showed that the greatest predictor of recommending punishment was how bad children deemed moral transgressions to be. We also found a trend that autistic children were more likely to recommend punishment for harmless norms violations than were neurotypical children. Future research could use longitudinal methods to understand the development of moral judgments among autistic and neurotypical children. (shrink)

Janet Radcliffe Richards is as always to the point and radical. We agree with her that “if it is presumptively bad to prevent sales altogether because lives will be lost . . . it is for the same reason presumptively bad to restrict the selling of organs”. Her complaint against our paper is that we are unnecessarily restrictive. John Harris indeed has argued that there are no sound ethical or philosophical reasons for objecting on principle to the sale of live (...) tissue and organs.1 If a scheme can be devised …. (shrink)

From co-authored publications to sponsored projects involving multiple partner institutions, collaborative practice is an expected part of work in the academy. As evaluators of a National Science Foundation Alliances for Graduate Education and the Professoriate grant awarded to four university partners in a large southern state, the authors recognized the increasing value of collaborative practice in the design, implementation, evaluation, and dissemination of findings in the partnership over time. When planning a program among partnering institutions, stakeholders may underestimate the need (...) for, and value of, collaborative practice in facilitating partnership functioning. This method paper outlines an evaluative model to increase the use of collaborative practice in funded academic partnership programs. The model highlights collaborative practice across multiple stakeholder groups in the academic ecology: Sponsors of funded programs, Program partners and participants, Assessment and evaluation professionals, academic researchers, and the national and global Community. The SPARC model emphasizes evidence-based benefits of collaborative practice across multiple outcome domains. Tools and frameworks for evaluating collaborative practice take a view of optimizing partnership operational performance in achieving stated goals. Collaborative practice can also be an integral element of program activities that support the academic success and scholarly productivity, psychosocial adjustment, and physical and psychological well-being of stakeholders participating in the program. Given the goal of our alliance to promote diversification of the professoriate, the model highlights the use of collaborative practice in supporting stakeholders from groups historically underrepresented in STEM fields across these outcome domains. Using data from a mixed-methods program evaluation of our AGEP alliance over 4 years, the authors provide concrete examples of collaborative practice and their measurement. Results discuss important themes regarding collaborative practice that emerged in each stakeholder group. Authors operationalize the SPARC model with a checklist to assist program stakeholders in designing for and assessing collaborative practice in support of project goals in funded academic partnership projects, emphasizing the contributions of collaborative practice in promoting diversification of the professoriate. (shrink)

ABSTRACT Principles of justice and equality demand that HIV seropositive individuals and those with AIDS should not be discriminated against in any area of social provision. If social policy on AIDS is constructed in terms of reciprocal obligations, that is if obligations to the HIV seropositive individual and obligations of the HIV seropositive individual are given equal weight, the civil rights of HIV seropositive individuals may be secured and this may create a climate in which HIV seropositive individuals will more (...) readily notify partners, and others at risk of infection, of their HIV status. It is conceivable that such a climate could facilitate greater control of the spread of HIV/aids. (shrink)

The ability to consider and analyze different stakeholder interests is a skill required of today’s business students. This paper describes a 35-minute experiential exercise using Tinkertoys® or Legos® to demonstrate and reinforce the concept of stakeholder management. The exercise, the Tower Building Challenge (TBC), is targeted toward classes in business ethics, strategy, or decision-making and requires students to work in groups to build a tower with the underpinning challenge that each group member has a different interest in how the tower (...) should be built. Student feedback reflects on the difficulty of satisfying all stakeholders when making business decisions, the importance of making the interests of stakeholders transparent to enhance cooperation and the effectiveness of the decision-making process, and the need for stakeholder management when considering business decisions that impact stakeholders. Following this experiential exercise, students’ preliminary understanding presents an opportunity for a deeper discussion of stakeholder management. Specifically, students are prompted to consider stakeholder interests as joint, rather than opposed, when engaged in stakeholder management. (shrink)

Written by a diverse range of scholars, this accessible introductory volume asks: What is implicit bias? How does implicit bias compromise our knowledge of others and social reality? How does implicit bias affect us, as individuals and participants in larger social and political institutions, and what can we do to combat biases? An interdisciplinary enterprise, the volume brings together the philosophical perspective of the humanities with the perspective of the social sciences to develop rich lines of inquiry. Its 12 chapters (...) are written in a non-technical style, using relatable examples that help readers understand what implicit bias is, its significance, and the controversies surrounding it. Each chapter includes discussion questions and additional annotated reading suggestions. And a companion webpage contains teaching resources. The volume is invaluable resource for students―and researchers―seeking to understand criticisms surrounding implicit bias, as well as how one might answer them by adopting a more nuanced understanding of bias and its role in maintaining social injustice. (shrink)

The ethical principle of ‘respect for persons’ in clinical research has traditionally focused on protecting individuals’ autonomy rights, but respect for participants also includes broader, although less well understood, ethical obligations to regard individuals’ rights, needs, interests and feelings. However, there is little empirical evidence about how to effectively convey respect to potential and current participants. To fill this gap, we conducted exploratory, qualitative interviews with participants in a clinical genomics implementation study. We interviewed 40 participants in English or Spanish (...) about their experiences with respect in the study and perceptions of how researchers in a hypothetical observational study could convey respect or a lack thereof. Most interviewees were female, identified as Hispanic/Latino or non-Hispanic white, reported annual household income under US$60 000 and did not have a Bachelor’s degree ; 30% had limited health literacy. We identified four key domains for demonstrating respect: personal study team interactions, with an emphasis on empathy, appreciation and non-judgment; study communication processes, including following up and sharing results with participants; inclusion, particularly ensuring materials are understandable and procedures are accessible; and consent and authorisation, including providing a neutral informed consent and keeping promises regarding privacy protections. While the experience of respect is inherently subjective, these findings highlight four key domains that may meaningfully demonstrate respect to potential and current research participants. Further empirical and normative work is needed to substantiate these domains and evaluate how best to incorporate them into the practice of research. (shrink)

This collection examines questions of medical accountability and ethics. It analyses how the criminal justice system regulates health care practice, and to what extent it is appropriate to use it as a tool to resolve ethical conflict in health care.

Problems about the accidental properties of properties motivate us--force us, I think--not to identify properties with the sets of their instances. If we identify them instead with functions from worlds to extensions, we get a theory of properties that is neutral with respect to disputes over counterpart theory, and we avoid a problem for Lewis's theory of events. Similar problems about the temporary properties of properties motivate us--though this time they probably don't force us--to give up this theory as well, (...) and to identify properties with functions from world, time pairs to extensions. Again, the replacement theory is neutral with respect to a metaphysical dispute that the old theory (arguably) forces us to take a stand on--the dispute over whether objects have temporal parts. It also allows us to give a smoother semantics for predication, to better accommodate our intuitions about which objects temporary properties are properties of, and to make temporally self-locating beliefs genuinely self -locating. (shrink)

Responsible research and innovation has come to represent a change in the relationship between science, technology and society. With origins in the democratisation of science, and the inclusion of ethical and societal aspects in research and development activities, RRI offers a means of integrating society and the research and innovation communities. In this article, we frame RRI activities through the lens of layers of science and technology governance as a means of characterising the context in which the RRI activity is (...) positioned and the goal of those actors promoting the RRI activities in shaping overall governance patterns. RRI began to emerge during a time of considerable deliberation about the societal and governance challenges around nanotechnology, in which stakeholders were looking for new ways of integrating notions of responsibility in nanotechnology research and development. For this reason, this article focuses on nanotechnology as the site for exploring the evolution and growth of RRI. (shrink)

Written by a diverse range of scholars, this accessible introductory volume asks: What is implicit bias? How does implicit bias compromise our knowledge of others and social reality? How does implicit bias affect us, as individuals and participants in larger social and political institutions, and what can we do to combat biases? An interdisciplinary enterprise, the volume brings together the philosophical perspective of the humanities with the perspective of the social sciences to develop rich lines of inquiry. It is written (...) in a non-technical style, using relatable examples that help readers understand what implicit bias is, its significance, and the controversies surrounding it. Each chapter includes discussion questions and additional reading suggestions. A companion webpage contains teaching resources. The volume will be an invaluable resource for students—and researchers—seeking to understand criticisms surrounding implicit bias, as well as how one might answer them by adopting a more nuanced understanding of bias and its role in maintaining social injustice. (shrink)