Clinical trials for acute conditions such as myocardial infarction and stroke pose challenges related to informed consent due to time limitations, stress, and severe illness. Consent processes shou...

In this paper, I plan to show that the use of a specific population concept—Millstein’s Causal Interactionist Population Concept (CIPC)—has interesting and counter-intuitive ramifications for discussions of the reality of biological race in human beings. These peculiar ramifications apply to human beings writ large and to individuals. While this in and of itself may not be problematic, I plan to show that the ramifications that follow from applying Millstein’s CIPC to human beings complicates specific biological racial realist accounts—naïve or otherwise. (...) I conclude with the notion that even if biological races do exist—by fulfilling all of the criteria needed for Millstein’s population concept (which, given particular worries raised by Gannett (Synthese 177:363–385, 2010), and Winther and Kaplan (Theoria 60:54–80, 2013) may not)—the lower-bound limit for the scope of biological racial realism is at the level of populations, and as such they cannot say anything about whether or not individual organisms themselves have races. (shrink)

Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice. This article explores a philosophical perspective of nursing's social mandate, the disciplinary goals for the good of the individual and society, and one approach for translating knowledge into practice through the use of a middle-range theory. It is anticipated that the integration (...) of the philosophical perspective and model into nursing practice will strengthen the philosophy, disciplinary goal, theory, and practice links and expand knowledge within the discipline. With the focus on humanization, we propose that nursing knowledge for social good will embrace a synthesis of the individual and the common good. This approach converges vital and agency needs described by Hamilton and the primacy of maintaining the heritage of the good within the human species as outlined by Maritain. Further, by embedding knowledge development in a changing social and health care context, nursing focuses on the goals of clinical reasoning and action. McCubbin and Patterson's Double ABCX Model of Family Adaptation was used as an example of a theory that can guide practice at the community and global level. Using the theory-practice link as a foundation, the Double ABCX model provides practising nurses with one approach to meet the needs of individuals and society. The integration of theory into nursing practice provides a guide to achieve nursing's disciplinary goals of promoting health and preventing illness across the globe. When nursing goals are directed at the synthesis of the good of the individual and society, nursing's social and moral mandate may be achieved. (shrink)

Volume 20, Issue 8, August 2020, Page W12-W13.

This chapter aims to bring to the fore some of the ontological presuppositions that undergird the concepts of race and racism as they are used in public health. Included are discussions of differing accounts for race in public health, the ways in which racism is understood to be a public health issue, and where future research in public health, as it relates to the concepts of race and racism, is headed.

The growth in the direct-to-consumer genetic testing industry poses a number of challenges for healthcare practice, among a number of other areas of concern. Several companies providing this service send their customers reports including information variously referred to as genetic ethnicity, genetic heritage, biogeographic ancestry, and genetic ancestry. In this article, we argue that such information should not be used in healthcare consultations or to assess health risks. Far from representing a move toward personalized medicine, use of this information poses (...) risks both to patients as individuals and to racialized ethnic groups because of the way it misrepresents human genetic diversity. (shrink)

Although science supplies medicine's “gold standard,” knowledge exercised in the care of patients is, like moral knowing, a matter of narrative, practical reason. Physicians draw on case narrative to store experience and to apply and qualify the general rules of medical science. Literature aids in this activity by stimulating moral imagination and by requiring its readers to engage in the retrospective construction of a situated, subjective account of events. Narrative truths are provisional, uncertain, derived from narrators whose standpoints are always (...) situated, particular, and uncertain, but open to comparison and reinterpretation. Reading is thus a model for knowing in both morality and clinical medicine. While principles remain essential to bioethics and science must always inform good clinical practice, the tendency to collapse morality into principles and medicine into science impoverishes both practices. Moral knowing is not separable from clinical judgment. While ethics must be open to discussion and interpretation by patients, families, and society, it is nevertheless substantively and epistemologically an inextricable part of a physician's clinical practice. (shrink)

Persistent and pervasive rudeness and lack of respect are unfortunately common in workplaces today. The deleterious effects of this incivility at work may be even worse than previously demonstrated, impacting not only employee victims but also trickling down to those who employees contact. However, we propose that leaders who prioritize their followers’ needs above their own, also known as servant leaders, may be a critical preventative mechanism to reduce group-level incivility through promoting a virtuous climate. Applying social learning theory and (...) social information processing theory, we argue that servant leaders role model virtuous character that contributes to a virtuous climate that influences group members to reduce incivility and, in turn, treat others well. We utilize the healthcare setting to support this hypothesized process across multi-source measures of incivility from coworkers and team supervisors and three indicators of quality of patient care. Specific findings and implications for managers in healthcare settings and beyond are discussed. (shrink)

Although the volume of the surviving papers of Robert Boyle is substantial (over 20,000 leaves), a considerable amount of the written material left by Boyle at his death in 1691 has not survived in the Boyle archive. This paper gauges the scale and identity of these losses using the surviving inventories made by the Rev. Henry Miles in the 1740s when he was collecting and sorting Boyle's literary remains in conjunction with Thomas Birch's preparation of his 1744 Life and Works (...) of Boyle. These detailed lists (edited as appendices to this paper), together with other sources, indicate losses due to a variety of reasons, some deliberate, others accidental. The losses involved the disposal of both items judged (in the eighteenth century) to be peripheral to Boyle's archive and, ironically, those in the most finished state from Boyle's hand, which were perhaps abortively destined for the Birch edition. These losses have significantly altered the character of the Boyle Papers, and thus the view of Boyle that is derived from them. (shrink)

ABSTRACT To date, the American Psychological Association Ethical Standards and Code of Conduct does not include direct guidance about how psychologists should navigate social media. Given the variety of roles psychologists can choose to engage on social media, it is imperative that guidelines are established. These guidelines should consider the multidimensionality that exists as psychologists may choose to present on social media through a personal presence, a business presence, and/or even an influencer/content creator presence. Specific ethical considerations and recommendations are (...) provided. (shrink)

In reading Wittgenstein one can, and for the most part perhaps should, treat the expression ‘language-game’ as a term of art, a more or less arbitrarily chosen item of terminology meaning something like ‘an actual or possible way of using words’. It would then be a fairly routine task to work out answers to such questions as what features of the ways a word is used are emphasized by this term of art, what philosophical purposes are served by the description (...) of primitive language-games or of variations on actual language-games, or in exactly what way those purposes are supposed to be served. (shrink)

Parti INTRODUCTION Wittgenstein sometimes suggested looking on words as instruments, for example in the following passages from ...

Background: Attending surgeons must maintain balance between promoting education and assuring safe, transparent patient care. This investigation aimed to define ethics that guide surgical training. We hypothesized that resident autonomy in the operating room is influenced by attending approach to patients, specifically patients considered to be vulnerable. Materials and Methods: After IRB approval, surgeons from three institutions were invited to participate in a pilot, survey, exploring how principles of patient autonomy, physician beneficence, nonmaleficence, and justice apply to participant opinions. Responses (...) were transcribed and coded for quantitative and qualitative analysis. Results: 51 attendings and 55 residents completed the survey. We identified that patient autonomy is upheld through transparent consent practices. Intraoperative supervision is a key practice that maintains the principles of physician beneficence and nonmaleficence and mitigates the risk of resident participation. Vulnerable patients were defined by respondents as those unable to participate in their own consent and those limited by social determinants of health and barriers to medical literacy. In contrast, resident participation is not limited in the care of vulnerable patients but is restricted in cases of higher complexity and those procedures deemed to have lower error margins. Conclusions: Although residents measure the success of their training based on their level of intraoperative independence, autonomy afforded to the resident does not only depend on objective skill. There are ethical considerations that the attending must navigate as they decide on effective teaching and safe surgical management, which is especially relevant in the care of complex cases. (shrink)

Many people seem to find it quite impossible to doubt that if a person did not do something freely, then he can be neither praised nor blamed for doing it. This assumption is shared by people with very different views about freedom, determinism and moral responsibility. It is held by most ‘libertarians’, who, to preserve moral responsibility, reject determinism. It is held by ‘hard determinists’, who accept determinism and therefore reject moral responsibility; and it is held by ‘soft determinists’, who (...) accept determinism, but argue that determinism does not exclude any kind of freedom that is relevant to whether a person may be held responsible. (shrink)