Caring for unrepresented patients encompasses legal, ethical, and moral challenges regarding decision-making, consent, the patient’s values, wishes, best interest, and the healthcare team’s professional integrity and autonomy. In this article, I consider the impact of the aging population and the effects of the social determinants of health and suggest that without preventive intervention, the number of unrepresented patients will continue to increase. The health, social, and legal risk factors for becoming unrepresented require a multidisciplinary response. Medical-Legal Partnerships (MLPs) bring healthcare (...) and legal professionals together to address risk factors and health-harming legal needs. The article discusses the role of MLPs in identifying at-risk individuals, providing preventive interventions, and providing support. I make recommendations and conclude that proactive MLPs offer a sustainable approach to the ethical challenges in caring for unrepresented patients by providing interventions to prevent individuals from becoming unrepresented. (shrink)

Background: One of the barriers to interprofessional ethics education is a lack of resources that actively engage students in reflection on living an ethical professional life. This project implemented and evaluated an innovative resource for interprofessional ethics education. Objectives: The objective of this project was to create and evaluate an interprofessional learning activity on professionalism, clinical ethics, and research ethics. Design: The Brewsters is a choose-your-own-adventure novel that addresses professionalism, clinical ethics, and research ethics. For the pilot of the book, (...) a pre-test/post-test design was used. Once implemented across campus, a post-test was used to evaluate student learning in addition to a student satisfaction survey. Participants and research context: A total of 755 students in six academic schools in a health science center completed the activity as part of orientation or in coursework. Ethical considerations: The project was approved as exempt by the university’s Committee for the Protection of Human Subjects. Findings: The pilot study with 112 students demonstrated a significant increase in student knowledge. The 755 students who participated in the project had relatively high knowledge scores on the post-test and evaluated the activity positively. Discussion: Students who read The Brewsters scored well on the post-test and had the highest scores on clinical ethics. Clinical ethics scores may indicate issues encountered in mass media. Conclusion: The Brewsters is an innovative resource for teaching interprofessional ethics and professionalism. Further work is needed to determine whether actual and long-term behavior is affected by the activity. (shrink)

The authors propose a framework to integrate virtue ethics into marketing theory and apply it to the development of marketing strategies. Virtue ethics, a philosophy that focuses on an individual's moral character, has received limited attention from marketing scholars and researchers. The authors argue that without consideration of virtue ethics a comprehensive analysis of the ethical character of marketing decision makers and their strategies cannot be achieved. They provide an overview of virtue ethics supplemented by a case study of The (...) Body Shop, International to demonstrate how evaluation of the ethics of corporate executives and their marketing strategies is completed by virtue ethics. (shrink)

Background:Ethics education is essential to the education of all healthcare professionals. The purpose of this study was to evaluate an interprofessional approach to ethics education to all students across an academic health science center.Research objectives:The objectives were to (1) compare student perception of ethics education before and after the implementation of the campus-wide ethics program and (2) determine changes in student ethical decision-making skills following implementation of a campus-wide ethics program.Research design:This study was a quasi-experimental design with seniors graduating prior (...) to the intervention serving as the control group.Participants and research context:The setting was a comprehensive health science center in the southwestern United States. All students enrolled in the university participated in the intervention; however, 976 graduating students were used for evaluation of the intervention.Ethical considerations:Study materials for each survey were submitted to the university’s IRB, and the project was approved as exempt by the Committee for the Protection of Human Subjects. Student participation in the surveys was voluntary. No names or other identifying information were collected, and responses to the survey questions were kept confidential.Findings:Students’ perception of the adequacy of time spent on the ethics content in course instruction and practical training decreased from the baseline to the fifth-year survey. Students’ overall comfort level with their abilities to deal with ethical issues increased from the baseline to the fifth year. Student ethical decision-making skills were higher at the third-year evaluation for all indicators. For the fifth-year survey, responses were also higher scoring on all four indicators.Discussion:After participation in an interprofessional campus-wide effort on health professions ethics, students demonstrated higher ethical decision-making scores according to the Health Professional Ethics Rubric. However, their scores still did not reach the proficiency level identified in the rubric.Conclusion:Examination of the effectiveness of each part of the intervention is needed. (shrink)

Critical thinking is viewed as an important outcome of undergraduate education by higher education institutions and potential employees of graduates. However, the lack of clarity and inadequate assessment of critical thinking development in higher education is problematic. The purpose of this study was to develop instruments to assess the competence of faculty to develop critical thinking of undergraduate students as perceived by students and by faculty themselves. The measures of critical thinking teaching were developed in two phases. Phase I focused (...) on development of critical thinking items while Phase II focused on initial validation of the critical thinking inventories. Six brief instruments were developed, all with high reliability and validity. Scale length ranged from 10 to 13 items. Four measures captured students’ perceptions of learning critical thinking and constituted the Learning Critical Thinking Inventory . Two scales were intended for faculty to assess their perceptions of the extent they facilitated learning critical thinking in their teaching, and these constituted the Teaching Critical Thinking Inventory . The psychometric characteristics of the inventories meet high standards, the measures are sufficiently brief to make them suitable for repeated administration, and different parallel forms are of great value for multiple administrations. (shrink)

Faculty in a large, urban school of engineering designed a longitudinal study to assess the critical thinking skills of undergraduate students as they progressed through the engineering program. The Paul-Elder critical thinking framework was used to design course assignments and develop a holistic assessment rubric. This paper presents the analysis of the freshman course artifacts (baseline and course critical thinking assignments) and associated faculty scoring sessions for all three cohorts. A total of 649 first semester freshman students at least 18 (...) years old agreed to participate in the study. The majority were white males with a mean high school grade point average of 3.73, ACT composite score of 28.33, and final freshman engineering course grade of 3.57. There was a statistically significant positive relationship between the freshman course artifacts and the faculty scores. Data from the study are being used to enhance the critical thinking experiences for undergraduate engineering students. (shrink)

Faculty in a large, urban school of engineering designed a longitudinal study to assess the critical thinking skills of undergraduate students as they progressed through the engineering program. The Paul-Elder critical thinking framework was used to design course assignments and develop a holistic assessment rubric. This paper presents the analysis of the freshman course artifacts (baseline and course critical thinking assignments) and associated faculty scoring sessions for all three cohorts. A total of 649 first semester freshman students at least 18 (...) years old agreed to participate in the study. The majority were white males with a mean high school grade point average of 3.73, ACT composite score of 28.33, and final freshman engineering course grade of 3.57. There was a statistically significant positive relationship between the freshman course artifacts and the faculty scores. Data from the study are being used to enhance the critical thinking experiences for undergraduate engineering students. (shrink)

Four Island Utopias provides a convenient compilation of four key texts, important for the understanding of utopian thinking in the ancient world and middle ages, along with maps and an extensive introduction to Classical Utopian thought. Ideal for courses in utopian thought.

Introduction: Evidence supporting the use of music interventions to maximize arousal and awareness in adults presenting with a disorder of consciousness continues to grow. However, the brain of a child is not simply a small adult brain, and therefore adult theories are not directly translatable to the pediatric population. The present study aims to synthesize brain imaging data about the neural processing of music in children aged 0-18 years, to form a theoretical basis for music interventions with children presenting with (...) a disorder of consciousness following acquired brain injury.Methods: We conducted a systematic review with narrative synthesis utilizing an adaptation of the methodology developed by Popay and colleagues. Following the development of the narrative that answered the central question “what does brain imaging data reveal about the receptive processing of music in children?”, discussion was centered around the clinical implications of music therapy with children following acquired brain injury.Results: The narrative synthesis included 46 studies that utilized EEG, MEG, fMRI, and fNIRS scanning techniques in children aged 0-18 years. From birth, musical stimuli elicit distinct but immature electrical responses, with components of the auditory evoked response having longer latencies and variable amplitudes compared to their adult counterparts. Hemodynamic responses are observed throughout cortical and subcortical structures however cortical immaturity impacts musical processing and the localization of function in infants and young children. The processing of complex musical stimuli continues to mature into late adolescence.Conclusion: While the ability to process fundamental musical elements is present from birth, infants and children process music more slowly and utilize different cortical areas compared to adults. Brain injury in childhood occurs in a period of rapid development and the ability to process music following brain injury will likely depend on pre-morbid musical processing. Further, a significant brain injury may disrupt the developmental trajectory of complex music processing. However, complex music processing may emerge earlier than comparative language processing, and occur throughout a more global circuitry. (shrink)

The knowledge base of how student engagement affects educational outcomes and career attainment has grown immeasurably in the last decade. This title presents methods to connect and re-engage marginalised, uninterested students.

With increasing development in the field of early childhood education and care, and new interest in alternative approaches to early years provision internationally, there is an urgent need for a book which explores and explains historical roots of practices and philosophical ideas which have underpinned the development of those practices in the field. This book traces historical ideas and their pioneers. It provides brief biographies and critical insights into their work as individuals and compares their principles and practices to those (...) of others past and present. Traditionally, historical reflections and philosophical critiques can be dense and difficult for readers to access and so many students and practitioners remain unaware of the roots of their current practice. This book takes an innovative and accessible approach to the history and philosophy of early childhood education. It gives sufficient, meaningful detail about individual educators and contributors to the field in order to help readers understand how contributions and developments in the past have created routes to present thinking and practice. So, the book offers five things: " An historical overview of the development of key ideas and practices in ECE from JJ Rousseau to the present time; " A series of biographical accounts of some 20 key contributors to the field, with summaries of their major achievements and key texts; " An exploration of ways in which their ideas compare through lively, imagined conversations based on their writings; " An analysis of ways in which certain common themes can be seen in both early writings and current practices; and " An illustration of how teachers can use these ideas in professional development activities in LEA and HE contexts. (shrink)

This article looks at riots that consumed Paris and much of France for three consecutive weeks in November 2005. The author argues that the uprisings were not instigated by radical Muslims, children of African polygamists, or despairing youth suffering from high unemployment. First and foremost, they were provoked by a terrible incident of police brutality, a tragedy among a litany of similar tragedies. Black and Arab youth were already frustrated: decades of violent enforcement of France's categorical boundaries—both racial and geographic—had (...) filled many with rage. When Minister of Interior Nicholas Sarkozy responded to the violent death of three teenage boys on October 25, 2005, by condemning the boys rather than the police officers who had killed them, he merely reaffirmed what many young blacks and Arabs already believed: that their lives have no value in France. (shrink)

I argue that hope is an ethical virtue. Hope, I suggest, is necessary for engaging in a broad kind of project which is essential for living a meaningful human life, and this gives us reason to think that it is non-instrumentally valuable in our lives. Specifically, I claim that hope is well understood as a ‘structural virtue’ without which we are prone to slip into despair, fantasy and cynicism. Moreover, I argue that this virtue will be particularly significant in turbulent (...) times, when we may not be in a position to have outright (positive) expectations about the future. (shrink)

Hope powerfully influences our lives, deeply shaping our actions, as well as being essential for social and political change. Many accounts of hope, however, fail to do justice to its active role, ignoring the connection between hope and action that makes it a significant feature of our lives. In this essay, I propose a new account of hope in which hopes characteristically shape and figure in intentions. I argue that this account does justice to hope's distinctive manifestations in action, explains (...) the rational constraints on hoping, and sheds light on the distinctions between hoping and wishing. (shrink)

If mourning is a proof of value, how could it be appropriate to move on when one has truly loved and valued someone? Assuming that it is appropriate to value others extremely highly – perhaps even infinitely – how could it ever make sense for one’s grief to abate? Do loss and proper mourning thus present us with a choice between living well and loving well? This paper aims to vindicate the pressing nature of these questions while arguing that we (...) do not need to choose between living well and loving well. It discusses how these questions become pressing, some empirical research seeming to imply that humans do not tend to love well at all, and finally, offers an explanation of why ceasing to mourn need not be a failure of love. In particular, we offer an account of how ceasing to mourn can be a fitting response to the object of love, as well as compatible with living well. (shrink)

De nos expériences de conseillères conjugales et familiales, nous avons le sentiment d’un féminin difficile à représenter, comme si les jeunes femmes “zappaient” le féminin pour le maternel. À partir de situations auprès de groupes d’adolescentes et d’adultes, les deux auteures se sont attachées à saisir ce qui vient se dire du féminin chez les jeunes filles et leurs parents. Elles en discutent la spécificité de leurs places en tant que conseillères conjugales et familiales comme créatrices d’un espace de transmission.

Humility can seem like a somewhat ‘unfashionable’ virtue: the word can conjure an image of cringing servility, unduly romanticised feelings of inferiority, or a level of self-denial which seems ill-placed in a life well-lived. But the term can also capture something of great ethical importance. In this paper, I will propose an account of humility that attempts to capture this moral significance. I will then explore the connection between humility and ethical development, seeking to argue that humility has an important (...) role in ethical improvement. If such a connection is vindicated, it suggests that humility is valuable twice over: it has intrinsic worth but is also instrumentally valuable, enabling us to become better people. (shrink)

First Published in 1993. Routledge is an imprint of Taylor & Francis, an informa company.

The authors led the development of a framework for ethical decision-making for an Academic Health Sciences Centre. They understood the existing mission, vision, and values statement (MVVs) of the centre as a foundational assertion that embodies an ethical commitment of the institution. Reflecting the Patient and Family Centred Model of Care the institution is living, the MVVs is a suitable base on which to construct an ethics framework. The resultant framework consists of a set of questions for each of the (...) MVVs. Users of the framework are expected to identify two or more possible decisions to address the issue at hand and then, by applying the provided sequence of questions to each, examine these options and determine the overall ethically preferable decision. The construction of such a framework requires the creative involvement of the institution’s staff. Thus the development of the framework can represent a training process in ethical decision-making as well as advance the ethical atmosphere of the institution. This novel approach has the advantage of placing the MVVs on active duty, at the centre of ethical decision-making, and lifts it from its otherwise relative obscurity in most institutions. (shrink)

Policy officials often assert that the U.S. has the best health care system in the world, but a recent scorecard on U.S. health system performance finds that the U.S. achieves a score of only 65 out of a possible 100 points on key indicators of performance in five key domains: healthy lives, access, quality, equity, and efficiency, where 100 represents the best achieved performance in other countries or within the U.S. The U.S. should aim higher by adopting a set of (...) policies that will extend affordable health insurance to all; align financial incentives for health care providers to enhance value and achieve savings; organize the health care system around the patient to ensure that care is accessible and coordinated; meet and raise benchmarks for high-quality, efficient care; and ensure accountable national leadership and public-private collaboration. The incoming president and Congress should aspire to have the best health system in the world — not just assert it — and can do so by learning from examples of excellence within the U.S. and abroad. (shrink)

On the eve of the presidential inauguration, the U.S. health system faces rising costs of care, growing numbers of uninsured, wide variations in quality of care, and mounting public dissatisfaction. Despite spending more on health care than any other country, a recent Commonwealth Fund Commission on a High Performance Health Care System National Scorecard reports that the United States is lagging far behind other major industrialized countries — all of which provide universal health insurance — in five key domains: healthy (...) lives, access, quality, equity, and efficiency. U.S. national performance is well below benchmarks of top performance set by other countries or high performing states, hospitals, or health plans within the United States, with broad disparities in experience depending on geographic location, income, race/ethnicity, and insurance coverage. National leadership is required to manage the growing health care crisis in the United States and improve care for all Americans. (shrink)

Is it true that innovation occurs only in abundant environments? Baumard defends that increased standards of living are a necessary condition for a change in life history strategy to help understand the Industrial Revolution. Here, we argue that many examples of innovations occur in scarce environments when there is near-zero opportunity cost. We suggest potential psychological pathways to explain this dual-cognitive process.

This clear and user-friendly text provides practical guidance on how to incorporate citizenship into the curriculum. It offers a wealth of teaching aids including: * tried-and-tested photocopiable materials * case studies * suggested teaching strategies * comprehensive reference and resource section. Nick Clough and Cathie Holden are fully experienced in the field having both taught in primary and middle schools and both now specialise in providing citizenship education courses for trainee teachers and practising teachers. This up-to-date book will help engage (...) those teaching the new requirement of Education for Citizenship at Key Stages 2 and 3, and along with lively examples of pupils' work and discussions of the changes to the QCA guidelines regarding citizenship, they provide a comprehensive and complete resource. It is also of immense value to curriculum coordinators and to those wishing to know more about the thinking behind education for citizenship. (shrink)

Les auteurs, thérapeutes familiaux, rapportent un travail avec une famille pour laquelle la relation d’emprise est le mode singulier et privilégié d’interaction entre les membres. À travers des éléments cliniques, les auteurs montrent comment la relation d’emprise côtoie l’indifférenciation des membres du groupe familial, celle des générations ainsi que la violence qui en découle. Enfin cet écrit montre comment, en utilisant la vulnérabilité des analystes, elle devient vecteur de l’efficacité thérapeutique à travers le transfert et le contre-transfert.

There are few living thinkers who have enjoyed the eminence and reown of Jürgen Hamermas. His work has been highly influential not only in philosopy, but also in the fields of politics, sociology and law. This is the first collection dedicated to exploring the connections between his body of work ahd America's most significant philosophical movement, pragmatism. Habermas and Pragmatism considers the influence of pragmatism on Habermas's thought and the tensions between Habermasian social theory and pragmatism. Essays by distinguished pragmatists, (...) legal and critical theorists, and Habermas cover a range of subjects including the philosophy of language, the nature of rationality, democracy, objectivity, transcendentalism, aesthetics, and law. The collection also addresses the relationship to Habermas of Kant, Peirce, Mead, Dewey, Piaget, Apel, Brandom and Rorty. (shrink)

Ethics applications to conduct research with children who have experienced domestic violence will frequently raise a red flag to ethics committees about the potential for risk and re-traumatization. On the other hand, such sensitive research can enable a hidden, marginalized population to have their voices heard. It can deliver findings about children’s lives that can inform otherwise adult-centric research, policy and practice initiatives. The authors highlight ethical concerns and practical solutions using examples from domestic violence, family law and child abuse (...) research with children. Ethical planning is explored according to methodologies, context and whether the violence has been named. Also discussed are consent procedures, confidentiality and the development of protocols for disclosure, distress, safety and risk assessment, which support ethical and safe research with children. (shrink)

BackgroundThe role of consent for research use of health information is contentious. Most discussion has focused on when project-specific consent may be waived but, recently, a broader range of consent options has been entertained, including broad opt-in for multiple studies with restrictions and notification with opt-out. We sought to elicit public values in this matter and to work toward an agreement about a common approach to consent for use of personal information for health research through deliberative public dialogues.MethodsWe conducted seven (...) day-long public dialogues, involving 98 participants across Canada. Immediately before and after each dialogue, participants completed a fixed-response questionnaire rating individuals' support for 3 approaches to consent in the abstract and their consent choices for 5 health research scenarios using personal information. They also rated how confident different safeguards made them feel that their information was being used responsibly.ResultsBroad opt-in consent for use of personal information garnered the greatest support in the abstract. When presented with specific research scenarios, no one approach to consent predominated. When profit was introduced into the scenarios, consent choices shifted toward greater control over use. Despite lively and constructive dialogues, and considerable shifting in opinion at the individual level, at the end of the day, there was no substantive aggregate movement in opinion. Personal controls were among the most commonly cited approaches to improving people's confidence in the responsible use of their information for research.ConclusionBecause no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record for purposes other than clinical care. This could be done, for example, through a web-based patient portal to their electronic health record. Researchers and policy makers should continue to engage the public to promote greater public understanding of the research process and to look for feasible alternatives to existing approaches to project-specific consent for observational research. (shrink)

Cerebral Visual Impairment is an umbrella term which includes abnormalities in visual acuity, or contrast sensitivity or colour; ocular motility; visual field and the conscious and unconscious filtering or processing of visual input. Children with CVI have specific needs and problems relating to their development from infancy to adulthood which can impact on their wellbeing. Recent research indicates the complexities of living with CVI but there remains limited information of the full impact of CVI on families’ everyday lives. The qualitative (...) interviews reported here explored families’ experiences to discover the impact of CVI on all aspects of everyday life. Parents and children were invited to participate in semi-structured interviews, either face to face, by phone or video call between January 2018 and February 2019. Topics covered everyday practicalities of living with CVI, focusing on challenges and what worked well at school and home. Interviews were audio-recorded and subject to thematic analysis to look for patterns across the data. Twenty families took part in interviews, with eight children/young people within those families contributing interviews of their own. Four themes were developed from the interviews: Assessment and understanding implications of CVI, Education, Family life, Psychological wellbeing and quality of life. The interviews provide valuable insights into the impact of living with CVI and highlight the need for more awareness of the condition among professionals in both health and education settings. (shrink)

This book presents three of the works of Abdu'l-Bahá, son of the founder of the Bahá'i Faith, dealing with social and political issues.00In 'The Secret of Divine Civilization' (1875) Abdu'l-Bahá supports the administrative and broader social reforms of Mirzá Hosayn Khán, but looks mainly for organic reform through the efforts of Iranian intellectuals to waken and educate the masses. In this work, Abdu'l-Bahá gives virtuous and progressive Islamic clerics a leading role among these intellectuals, indeed most of his appeals are (...) directed specifically to them. 'A Traveller's Narrative' (1889/90) is an authoritative statement of the broad lines of Bahá'i social and political thinking. 'The Art of Governance' (1892/93) was written as Iran entered a pre-revolutionary phase, and ideas that we recognise today as the precursors of political Islam were spreading. It sets out the principles underlying the ideal relationship between religion and politics and between the government and the people.00In addition to presenting the first parallel text translations of these works, the Persian texts incorporate notes on variants in the early published sources. An introduction outlines the intellectual and political landscape from which Abdu'l-Bahá wrote, and in which his expected readers lived. (shrink)

Heidegger''s conception of death as an attitude toward life, overlooked in current literature on death and dying, offers potential for deepening our understanding of the care of non-critically ill patients. By breaking away from the notion of death as an event distinct from life and viewing it as an anticipated possibility at every moment of life, Heidegger provides insight into our attempts to evade death through our fundamental attitudes and value commitments, which in turn determine our behavior and actions. When (...) combined with a method of application — the Nietzschean principle of reversal — these insights permit the understanding of diverse types of human mentality confronted with significant situations. Among the most important applications of these conceptions is to persons in need of medical care, and the resultant types, which are sampled as hypothetical cases, carry important implications for the sensitive care and psychosocial management of non-terminally ill patients. (shrink)