© 2015 NATCO, The Organization for Transplant Professionals.Despite the known benefits of kidney transplant, less than 30% of the 615 000 patients living with end-stage renal disease in the United States have received a transplant. More than 100 000 people are presently on the transplant waiting list. Although the shortage of kidneys for transplant remains a critical factor in explaining lower transplant rates, another important and modifiable factor is patients' lack of comprehensive education about transplant. The purpose of this article (...) is to provide an overview of known best practices from the broader literature that can be used as an evidence base to design improved education for ESRD patients pursuing a kidney transplant. Best practices in chronic disease education generally reveal that education that is individually tailored, understandable for patients with low health literacy, and culturally competent is most beneficial. Effective education helps patients navigate the complex health care process successfully. Recommendations for how to incorporate these best practices into transplant education design are described. Providing more ESRD patients with transplant education that encompasses these best practices may improve their ability to make informed health care decisions and increase the numbers of patients interested in pursuing transplant. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:President’s Council on BioethicsEdmund D. Pellegrino (bio) and F. Daniel Davis (bio)Approximately two weeks before what was to have been its final meeting, the White House dissolved the President’s Council on Bioethics by terminating the appointments of its 18 members. The letters of dismissal, dated 10 June 2009, informed the members that their service on the Council would end with the close of business the next day.The Council’s (...) term was set to expire on 30 September 2009. After President Obama’s election in November and during the transition, we were advised to proceed on the assumption that the Council would be permitted to cease on that date. Reasons for the abrupt move to disband the Council are unknown. We have accepted the fact that we Council members served at the pleasure of the President and that he simply exercised his rightful prerogative. No explanation is therefore required.Some observers have speculated that the action was retaliatory. They related to the fact that several members of the Council disagreed with the President’s stem cell policy in a signed statement published in the Hastings Center’s Bioethics Forum. Others have speculated that the move was pre-emptive. At its final meeting, scheduled for 25–26 June, the Council was set to sign-off on two of its final publications. One was a comprehensive report on the ethics of organ transplantation, and the other a white paper entitled Health Care and the Common Good. The aim was immediately to release the latter as a contribution to the intensifying debate about health care reform. Health Care and the Common Good could well have aided rather than impeded the President’s drive to better control health care costs and achieve universal coverage. The Council report attempted to ground both goals in the ethical framework of, as the title indicates, the common good of all Americans.In his letter terminating the members’ appointments, Assistant to the President for Presidential Personnel Don Gips said that the President “recognizes the values of having a commission of experts in bioethical issues to provide objective and non-ideological bioethics advice to his administration.” Gips went on to say that the President is “currently rethinking the purposes and goals of such a bioethics commission, and is carefully considering a revitalized mission and mandate.” And, [End Page 309] responding to media enquiries, White House press officer Reid Cherlin explained that the President’s Council was terminated because it was a “philosophically leaning advisory group” and, according to a New York Times account by Nicholas Wade, “because it favored discussion over developing a shared consensus.” As for the ultimate outcome of the President’s “rethinking,” Cherlin indicated that President Obama will appoint a new commission with the mandate of offering “practical policy options” in bioethics.In the light of our experiences with the Council, we leave it with hopes that certain questions of national importance will be addressed. In light of the nature of federal advisory commissions, what is or are the proper roles of a national bioethics commission? If the aim is to provide advice and counsel to the President or, perhaps to the U. S. Congress, is that advice best rendered as a group consensus or as an in-depth exploration of the inevitably conflicting ethical perspectives on a given issue? How should such a commission be constituted—with what sorts of individuals? And what is the nature of the expertise that they individually and collectively bring to the commission’s functions? If the commission is to promote public debate and discussion, how exactly should it go about that task? And how is the efficacy of a commission to be assessed? Such questions inevitably lead us deep into contested territory, as the experience of this Council has shown: into the intersections of politics, religion, and science and into the relations between practice and theory—between policy and what some seem to deride as “philosophy.” Indeed, policy without an underlying philosophy is an edifice without a foundation; philosophy without policy is a foundation without an edifice.At the last meeting of the Council in March 2009, we launched a discussion of these questions with the... (shrink)

The large body of literature labeled “ethics in nursing education” is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or issues ought to be included in all nursing curricula. Where the nursing literature actually focuses on particular ethical issues, it addresses only single topics. Absent from the literature, however, is any systematic analysis and explication of ethical issues or dilemmas that occur (...) within the context of nursing education. The objective of this article is to identify the spectrum of ethical issues in nursing education to the end of prompting a systematic and thorough study of such issues, and to lay the groundwork for research by identifying and provisionally typologizing the ethical issues that occur within the context of academic nursing. (shrink)

An experiment investigated the relationship between the ability to encode verbal stimuli during an attentional lapse. The task employed a variation on the sustained attention to response task which involved the detection of an infrequent target against a background of words. As a manipulation, participants were either instructed to encode the stimuli or were merely exposed to the stimuli. Retrieval was measured using process dissociation. Irrespective of the instructions given to the participants during the task, participants were more likely to (...) retrieve information on the basis of recollection after an error was made than before, whilst the likelihood of retrieving information on the basis of familiarity remained invariant over the same period. The implications of this result for methods of investigating subjective experience are discussed. (shrink)

Edited book on the prospects of non-Platonist realism in the philosophy of mathematics. Physicalism holds that mathematics studies properties realised or realisable in the physical world. This collection of papers has its origin in a conference held at the University of Toronto in June of 1988. The theme of the conference was Physicalism in Mathematics: Recent Work in the Philosophy of Mathematics. At the conference, papers were read by Geoffrey Hellman (Minnesota), Yvon Gauthier (Montreal), Michael Hallett (McGill), Hartry Field (USC), (...) Bob Hale (Lancaster & St Andrew's), Alasdair Urquhart (Toronto) and Penelope Maddy (Irvine). This volume supplements updated versions of six of those papers with contributions by Jim Brown (Toronto), John Bigelow (La Trobe), John Burgess (Princeton), Chandler Davis (Toronto), David Papineau (Cambridge), Michael Resnik (North Carolina at Chapel Hill), Peter Simons (Salzburg) and Crispin Wright (St Andrews & Michigan). Together they provide a vivid, expansive snapshot of the exciting work which is currently being carried out in philosophy of mathematics. (shrink)

BackgroundDespite rapid growth of the scientific literature, no consensus guidelines have emerged to define the optimal criteria for editors to grade submitted manuscripts. The purpose of this project was to assess the peer reviewer metrics currently used in the surgical literature to evaluate original manuscript submissions.MethodsManuscript grading forms for 14 of the highest circulation general surgery-related journals were evaluated for content, including the type and number of quantitative and qualitative questions asked of peer reviewers. Reviewer grading forms for the seven (...) surgical journals with the higher impact factors were compared to the seven surgical journals with lower impact factors using Fisher’s exact tests.ResultsImpact factors of the studied journals ranged from 1.73 to 8.57, with a median impact factor of 4.26 in the higher group and 2.81 in the lower group. The content of the grading forms was found to vary considerably. Relatively few journals asked reviewers to grade specific components of a manuscript. Higher impact factor journal manuscript grading forms more frequently addressed statistical analysis, ethical considerations, and conflict of interest. In contrast, lower impact factor journals more commonly requested reviewers to make qualitative assessments of novelty/originality, scientific validity, and scientific importance.ConclusionSubstantial variation exists in the grading criteria used to evaluate original manuscripts submitted to the surgical literature for peer review, with differential emphasis placed on certain criteria correlated to journal impact factors. (shrink)

The National Science Foundation's Second Merit Criterion, or Broader Impacts Criterion , was introduced in 1997 as the result of an earlier Congressional movement to enhance the accountability and responsibility as well as the effectiveness of federally funded projects. We demonstrate that a robust understanding and appreciation of NSF BIC argues for a broader conception of research ethics in the sciences than is currently offered in Responsible Conduct of Research training. This essay advocates augmenting RCR education with training regarding broader (...) impacts. We demonstrate that enhancing research ethics training in this way provides a more comprehensive understanding of the ethics relevant to scientific research and prepares scientists to think not only in terms of responsibly conducted science, but also of the role of science in responding to identified social needs and in adhering to principles of social justice. As universities respond to the mandate from America COMPETES to “provide training and oversight in the responsible and ethical conduct of research”, we urge institutions to embrace a more adequate conception of research ethics, what we call the Ethical Dimensions of Scientific Research, that addresses the full range of ethical issues relevant to scientific inquiry, including ethical issues related to the broader impacts of scientific research and practice. (shrink)

The eight pieces constituting this Meeting Report are summaries of presentations made during a panel session at the 2011 Association for Practical and Professional Ethics (APPE) annual meeting held between March 3rd and 6th in Cincinnati. Lisa Newton organized the session and served as chair. The panel of eight consisted both of pioneers in the field and more recent arrivals. It covered a range of topics from how the field has developed to where it should be going, from identification of (...) issues needing further study to problems of training the next generation of engineers and engineering-ethics scholars. (shrink)

The distinction between singular and multiple artworks is usually drawn modally in terms of the notion of an ‘instance’ of a work. Singular works, it is claimed, can only have a single instance, whereas multiple works allow of more than one instance. But this is enlightening only if we have a clear idea of what is meant by an ‘instance’. I argue that there are two different notions of a work's ‘instances’ in play in the literature – what I term (...) its ‘provenential instances’ (‘P-instances’) and its ‘purely epistemic instances’ (E-instances). I further argue that these notions are conflated in the literature critical of Gregory Currie's ‘instance multiplicity hypothesis’ (IMH) – the claim that all artworks are multiple in nature. I defend a modified version of the IMH as a claim about a work's E-instances against a range of criticisms. (shrink)

As the gap between the need for and supply of human organs continues to widen, the aim of securing additional sources of these “gifts of the body” has become a seemingly overriding moral imperative, one that could—and some argue, should—override the widespread ban on organ markets. As a medical practice, organ transplantation entails the inherent risk that one human being, a donor, will become little more than a means to the end of healing for another human being and that he (...) or she will come to have a purely instrumental value. With the establishment of organ markets, not only will the harms of instrumentalization be a reality—the ends of medicine will be further compromised and confused. (shrink)

Three experiments investigated the relationship between subjective experience and attentional lapses during sustained attention. These experiments employed two measures of subjective experience to examine how differences in awareness correspond to variations in both task performance and psycho-physiological measures . This series of experiments examine these phenomena during the Sustained Attention to Response Task . The results suggest we can dissociate between two components of subjective experience during sustained attention: task unrelated thought which corresponds to an absent minded disengagement from the (...) task and a pre-occupation with one's task performance that seems to be best conceptualised as a strategic attempt to deploy attentional resources in response to a perception of environmental demands which exceed ones ability to perform the task. The implications of these findings for our understanding of how awareness is maintained on task relevant material during periods of sustained attention are discussed. (shrink)

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who (...) were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit. (shrink)

This volume is a collection of essays by various contributors in honor of the late Laurence Berns, Richard Hammond Elliot Tutor Emeritus at St. John's College, Annapolis. The essays address the literary, political, theological, and philosophical themes of his life's work as a scholar, teacher, and constant companion of the "great books.".

Facial electromyography (EMG) was used to investigate patterns of facial mimicry in response to partial facial expressions in two contexts that differ in how naturalistic and socially significant the faces are. Experiment 1 presented participants with either the upper- or lower-half of facial expressions and used a forced-choice emotion categorisation task. This task emphasises cognition at the expense of ecological and social validity. Experiment 2 presented whole heads and expressions were occluded by clothing. Additionally, the emotion recognition task is more (...) open-ended. This context has greater social validity. We found mimicry in both experiments, however mimicry differed in terms of which emotions were mimicked and the extent to which the mimicry involved muscle sites that were not observed. In the more cognitive context, there was relatively more motor matching (i.e. mimicking only what was seen). In the more socially valid context, participants were less likely to mimic only what they saw – and instead mimicked what they knew. Additionally, participants mimicked anger in the cognitive context but not the social context. These findings suggest that mimicry involves multiple mechanisms and that the more social the context, the more likely it is to reflect a mechanism of social regulation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Addressing Alterity:Rhetoric, Hermeneutics, and the Nonappropriative RelationDiane DavisTeaching is not reducible to maieutics; it comes from the exterior and brings me more than I contain.—Emmanuel Levinas, Totality and InfinityThere is always the matter of a surplus that comes from an elsewhere and that can no more be assimilated by me, than it can domesticate itself in me. A teaching that may part ways with Heidegger's motif of our being (...) able to learn only what we already understand—when does learning take place? what do we already understand?—the Conversation belongs, as ethical relation, to the effort of thinking the infinite, the transcendent, the Stranger. None of this amounts to thinking an object.—Avital Ronell, DictationsFrom Rhetorical Power to Reception Histories Steven Mailloux has brilliantly performed and explicated a "rhetorical hermeneutics" that demonstrates the "practical inseparability of interpretation and language use and thus of the discourses that theorize those practices, hermeneutics and rhetoric" (1998, 3). Many rhetoricians have challenged the specifics of Mailloux's various arguments and have more generally objected that "rhetorical hermeneutics" leans too far toward the hermeneutical, reducing rhetoric to an analytic or critical art and giving its productive (political) function the squeeze.1 Yet within these lively debates, very few have challenged his basic premise that rhetoric and hermeneutics are inextricably intertwined: the question has not been whether they are indissociable but which side of the production-reception coin rhetorical studies ought to emphasize.2 Michael Leff, for example, flipped Mailloux's adjective-noun relation to spotlight production, promoting a "hermeneutical rhetoric" that focuses more on political than literary texts; nonetheless, he agrees that "all interpretive work involves participation in a rhetorical exchange, and that every rhetorical exchange involves some interpretive work" (1997, 197-98). [End Page 191] Rosa Eberly goes further in Citizen Critics, offering a hermeneutical rhetoric that is less interested in "already-written discourses" than in spotlighting "rhetoric's power as an art productive of discourses and subjectivities for the present and the future" (2000, 34). Yet Eberly, too, affirms Mailloux's basic premise, which was nudged in the direction of conflation in the introduction to the 1997 collection Rhetoric and Hermeneutics in Our Time, in which the editors, Walter Jost and Michael Hyde note in passing that their title can "be understood as virtually tautological."And there is of course no doubt that rhetoric has a hermeneutic dimension; or, more carefully, that rhetoric constitutes the hermeneutic dimension. If "hermeneutics" indicates "the art of understanding," as Friedrich Schleirmacher wanted, then interpretation clearly depends upon production.3 "Rhetoric not only has its place within the sphere of objects surveyed by hermeneutics," as Werner Hamacher puts it, "but also constitutes an integral component of every hermeneutic operation. Every step in an interpretation corresponds to a rhetorical—or grammatical—figure" (1996, 70). Put more bluntly: intelligibility, including self-intelligibility, is a tropological product; cognition itself is a trope that can in no way be secured. Hermeneutics—as it's being used here—is completely dependent on, even absorbed by, rhetoric.4 I have no problem with this. Nor with Mailloux's suggestion that the reverse is also true:In some ways rhetoric and interpretation are practical forms of the same extended human activity: Rhetoric is based on interpretation; interpretation is communicated through rhetoric. Furthermore, as a reflection on practice, hermeneutics and rhetorical theory are mutually defining fields: hermeneutics is the rhetoric of establishing meaning, and rhetoric the hermeneutics of problematic linguistic situations.(Mailloux 1998, 4)I don't disagree: As the production and appropriation of meaning, rhetoric and hermeneutics are an indissociable team; together, they complete understanding's circle. I take this as a given.However, I want to suggest that there is also a non-hermeneutical dimension of rhetoric that has nothing to do with meaning-making, with offering up significations to comprehension. This dimension is reducible neither to figuration nor to what typically goes by the name persuasion; it is devoted to a certain reception, but not to the appropriation of meaning. Preceding and exceeding all hermeneutic interpretation, it deals not in signified meaning but in the address itself, in the exposure to the other; it deals not... (shrink)

The series builds an extensive collection of high quality descriptions of languages around the world. Each volume offers a comprehensive grammatical description of a single language together with fully analyzed sample texts and, if appropriate, a word list and other relevant information which is available on the language in question. There are no restrictions as to language family or area, and although special attention is paid to hitherto undescribed languages, new and valuable treatments of better known languages are also included. (...) No theoretical model is imposed on the authors; the only criterion is a high standard of scientific quality. (shrink)

A long-standing objection to the artistic pretensions of photography is that, because of the ‘causal’ nature of the process whereby a photographic image is produced, the formative intelligence of the photographer does not play a significant role in the generation of the image. Only where we can see such intelligence manifested in an image, it is claimed, can we legitimately take the representational content of the image to be a proper subject of artistic interest. I examine the most sophisticated modern (...) version of this argument in Roger Scruton's paper, ‘Photography and Representation’. I first critically examine Dominic Lopes's reconstruction of Scruton's argument and his proposed response to it. I then present an alternative analysis that brings out a central charge—what I term the ‘inscrutability’ argument that is obscured in Lopes's analysis. I then suggest how we can answer the inscrutability argument. (shrink)

Patient consent has been formulated in terms of radical individualism rather than shared benefits. Medical education relies on the provision of patient consent to provide medical students with the training and experience to become competent doctors. Pelvic examination represents an extreme case in which patients may legitimately seek to avoid contact with inexperienced medical students particularly where these are male. However, using this extreme case, this paper will examine practices of framing and obtaining consent as perceived by medical students. This (...) paper reports findings of an exploratory qualitative study of medical students and junior doctors. Participants described a number of barriers to obtaining informed consent. These related to misunderstandings concerning student roles and experiences and insufficient information on the nature of the examination. Participants reported perceptions of the negative framing of decisions on consent by nursing staff where the student was male. Potentially coercive practices of framing of the decision by senior doctors were also reported. Participants outlined strategies they adopted to circumvent patients’ reasons for refusal. Practices of framing the information used by students, nurses and senior doctors to enable patients to decide about consent are discussed in the context of good ethical practice. In the absence of a clear ethical model, coercion appears likely. We argue for an expanded model of autonomy in which the potential tension between respecting patients’ autonomy and ensuring the societal benefit of well-trained doctors is recognised. Practical recommendations are made concerning information provision and clear delineations of student and patient roles and expectations. (shrink)