Even appropriate, ethically sound recommendations can generate angst. In this case, the principal investigator is concerned about the ethics consult recommendation to not inform the participan...

Individual choice and freedom are repeatedly invoked in contemporary policy debates, including those with a focus on risk behaviors such as smoking and health insurance coverage. The idea of making the right choice with regard to health and well-being has been fortified by the neoliberal discourse of self-reliance, personal autonomy, and responsibility. This neoliberal view, stemming from the conceptualization of freedom of philosopher John Stuart Mill justifying the freedom of the individual in opposition to unlimited state control, holds that success, (...) good health, and favorable educational outcomes are largely due to individual effort. Correspondingly, so too is failure, including failure of.. (shrink)

Purpose – To review and discuss Luciano Floridi’s 2019 book The Logic of Information: A Theory of Philosophy as Conceptual Design, the latest instalment in his philosophy of information (PI) tetralogy, particularly with respect to its implications for library and information studies (LIS). Design/methodology/approach – Nine scholars with research interests in philosophy and LIS read and responded to the book, raising critical and heuristic questions in the spirit of scholarly dialogue. Floridi responded to these questions. Findings – Floridi’s PI, including (...) this latest publication, is of interest to LIS scholars, and much insight can be gained by exploring this connection. It seems also that LIS has the potential to contribute to PI’s further development in some respects. Research implications – Floridi’s PI work is technical philosophy for which many LIS scholars do not have the training or patience to engage with, yet doing so is rewarding. This suggests a role for translational work between philosophy and LIS. Originality/value – The book symposium format, not yet seen in LIS, provides forum for sustained, multifaceted and generative dialogue around ideas. (shrink)

In a world that has become increasingly dependent upon employee ownership, commitment, and initiative, organizations need leaders who can inspire their␣employees and motivate them individually. Love, forgiveness, and trust are critical values of today’s organization leaders who are committed to maximizing value for organizations while helping organization members to become their best. We explain the importance of love, forgiveness, and trust in the modern organization and identify 10 commonalities of these virtues.

The ongoing cynicism about leaders and organizations calls for a new standard of ethical leadership that we have labeled “transformative leadership.” This new leadership model integrates ethically-based features of six other well-regarded leadership perspectives and combines key normative and instrumental elements of each of those six perspectives. Transformative leadership honors the governance obligations of leaders by demonstrating a commitment to the welfare of all stakeholders and by seeking to optimize long-term wealth creation. Citing the scholarly literature about leadership theory, we (...) identify key elements of the six leadership perspectives that make up transformative leadership, suggest leaders who exemplify each perspective, describe the ethical foundations and message of each perspective, and offer ten propositions that scholars and practitioners can use to test the dimensions of this new transformative leadership model. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

BackgroundAlthough patient advocates have developed templates for standard consent forms, evaluating patient preferences for first in human (FIH) and window of opportunity (Window) trial consent forms is critical due to their unique risks. FIH trials are the initial use of a novel compound in study participants. In contrast, Window trials give an investigational agent over a fixed duration to treatment naïve patients in the time between diagnosis and standard of care (SOC) surgery. Our goal was to determine the patient-preferred presentation (...) of important information in consent forms for these trials.MethodsThe study consisted of two phases: (1) analyses of oncology FIH and Window consents; (2) interviews of trial participants. FIH consent forms were analyzed for the location(s) of information stating that the study drug has not been tested in humans (FIH information); Window consents were analyzed for the location(s) of information stating the trial may delay SOC surgery (delay information). Participants were asked about their preferred placement of the information in their own trial’s consent form. The location of information in the consent forms was compared to the participants’ suggestions for placement. Results34 [17 FIH; 17 Window] of 42(81%) cancer patients approached participated. 25 consents [20 FIH; 5 Window] were analyzed. 19/20 FIH consent forms included FIH information, and 4/5 Window consent forms included delay information. 19/20(95%) FIH consent forms contained FIH information in the risks section 12/17(71%) patients preferred the same. Fourteen (82%) patients wanted FIH information in the purpose, but only 5(25%) consents mentioned it there. 9/17(53%) Window patients preferred delay information to be located early in the consent, before the “Risks” section. 3/5(60%) consents did this.ConclusionsDesigning consents that reflect patient preferences more accurately is essential for ethical informed consent; however, a one-size fits all approach will not accurately capture patient preferences. We found that preferences differed for FIH and Window trial consents, though for both, patients preferred key risk information early in the consent. Next steps include determining if FIH and Window consent templates improve understanding. (shrink)

Eighteenth-century England saw the rise of a "peculiarly English" art form—landscape gardening—and a corresponding change in attitudes toward the antural world. While the French, who lived under tyranny, had a tightly organized, restrictive gardens, the "free" English enjoyed gardens where they were at liberty to wander. John Dixon Hunt examines eighteenth-century letters, literary and critical works, biographies, paintings, prints, and drawings to trace the gradual movement from formal regularity toward a carefully calculated naturalness.

Although leadership of organizations rarely is discussed in terms of the religious construct of repentance, we propose that repentance and continuous improvement are closely related ideas that profoundly impact individuals and organizations. We identify six parallels between repentance and continuous improvement and then show how these parallels apply to the fundamental principles associated with highly regarded leadership perspectives. We conclude by identifying five contributions of the article to the management literature.

Biological ontologies are used to organize, curate, and interpret the vast quantities of data arising from biological experiments. While this works well when using a single ontology, integrating multiple ontologies can be problematic, as they are developed independently, which can lead to incompatibilities. The Open Biological and Biomedical Ontologies Foundry was created to address this by facilitating the development, harmonization, application, and sharing of ontologies, guided by a set of overarching principles. One challenge in reaching these goals was that the (...) OBO principles were not originally encoded in a precise fashion, and interpretation was subjective. Here we show how we have addressed this by formally encoding the OBO principles as operational rules and implementing a suite of automated validation checks and a dashboard for objectively evaluating each ontology’s compliance with each principle. This entailed a substantial effort to curate metadata across all ontologies and to coordinate with individual stakeholders. We have applied these checks across the full OBO suite of ontologies, revealing areas where individual ontologies require changes to conform to our principles. Our work demonstrates how a sizable federated community can be organized and evaluated on objective criteria that help improve overall quality and interoperability, which is vital for the sustenance of the OBO project and towards the overall goals of making data FAIR. Competing Interest StatementThe authors have declared no competing interest. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

The ethical codes of the professional engineering bodies identify the responsibilities of the engineer. Of equal importance to the codes are the virtues which enable the engineer to fulfil these responsibilities. After briefly reviewing such virtues this paper argues that the systematic learning of virtues is possible in a formal way through learner centred learning. Central to this learning experience is the development of integrity which focuses the other major virtues and enables reflection upon them. A review of undergraduate courses (...) suggests how this can be achieved. (shrink)

Recent writing on the idea of a form of life has tended to be critical of the use made of this notion by writers such as Peter Winch, D. Z. Phillips and Norman Malcolm. Rightly or wrongly these writers have been regarded as meaning by ‘a form of life’, something like ‘a way or style of life’, and recent explicatory work on the notion has largely tended to discount this as a plausible interpretation of what Wittgenstein meant in his use (...) of the expression. The intention of this paper is not that of direct intervention in this particular dispute, though the conclusions drawn, if correct, would have some bearing on it. The intention is rather to develop, in order to make use of it, the idea of a form of life within the context of a number of philosophical difficulties. I should certainly claim to be drawing upon the remarks made by Wittgenstein in his own use of the expression: but I should not claim to be expounding Wittgenstein. Hence I do not wish to enter into the disputes referred to above about what precisely Wittgenstein meant by the expression, though again, what I say, if not wholly misguided, should have some bearing on these disputes. (shrink)

Review of 'Consciousness and Emotion', edited by Ralph D. Ellis and Natika Newton, John Benjamins Publishing Company.

The study seeks to elucidate the nature of early Dhamma-transmission. While Buddhism has achieved broad geographical dissemination, sometimes earning the epithet ‘missionary’, P?li sources are ambivalent regarding approaches to potential followers. The Buddha’s final words do not instruct the sangha to spread the message; the exhortation, ‘walk, monks … for the blessing of the manyfolk’, rather appears to be an early, isolated episode. The Buddha’s own hesitation to teach provides the paradigm for the renunciant sangha, whose members rarely initiate teaching (...) episodes, preferring to wait for specific questions, an approach still formalised in modern practice. Following brahmanical norms, excessive eagerness to communicate would have devalued the message. Capacity to understand varied between individuals, and intelligent questions indicated preparedness. Given the dependence upon lay-followers, the alms-round ensured regular sangha visibility. Embodied serenity, closely regulated by the Vinaya, both excited curiosity and proved beneficial to onlookers – an affecting dar?ana. Frequently d?na, meal offerings, provided the locus for communicating Dhamma in a graduated, step-by-step manner, according to the capacity of the listeners. Kindness and generosity thus provided the point of departure, while miraculous displays were generally eschewed. In the proposed model, the alms-round is viewed as being undertaken to occasion generosity, making available a merit-field to generate benefits for the givers, rather than promotionally. The infrequent hints of greater assertion are confined to lay-followers, who, building on friendships, may occasionally draw attention to Dhamma. Arguably, this complements the role of the renunciant sangha, the guardian of the tradition, for whom teaching was not in fact obligatory. Though some lay-followers instructed others, their practice focussed on generosity and devotion. Some commentators have suggested that the original zeal waned over the centuries. However, the broadly reticent approach emerges as authentic in underlining the importance of the teachings, valuing goodness in other traditions, and accepting progression across multiple lifetimes. Most significantly, it underlines that coercion sits uneasily within a tradition which insists on exploration and personal transformation. (shrink)

PREFACE I AM greatly indebted to my friends, Professor Dewar of Reading and Miss Maude G. May of Glasgow, for many corrections and suggestions while the following pages were passing through the press. W. M. D. PART I I INTRODUCTION Y. D.H.S. The most singular and deepest themes in the History of the Universe and Mankind, to which all the rest are subordinate, are those in which there is a conflict between Belief and Unbelief, and all epochs, wherein Belief prevails, (...) under, what form it will, are splendid, heart-elevating and fruitful. (shrink)

This distinguished collection of essays has been produced to honour Donald McKinnon, who retired from the Norris-Hulse Professorship of Divinity in the ...