Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called (...) holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. (shrink)

In 2004, the agricultural economies of many rural communities in the United States were impacted by the cessation of a price-support and supply-control program for tobacco production. Tobacco was not only an important livelihood, but also was central to social and cultural life. Using a social–ecological systems lens and the adaptive cycle metaphor, we examine the reorganization of agriculture in communities that previously produced tobacco under the program. Specifically, we seek to understand how transitional policy that provided financial support to (...) tobacco farmers interacted with other social, cultural, physical and human capitals to condition system reorganization. We conducted semi-structured interviews with farmers, extension agents, and policy makers in Kentucky as well as examined trends in income and number of farmers before and after the transition as indicators of reorganization. We determined that the financial support was perceived as helpful in supporting the transition and that tobacco farmers reorganized their livelihoods primarily around existing, remnant assets and endogenous capacities. In addition, we determined that though the agricultural system may be reorganizing economically, it is not necessarily supportive of the same social bonds and values that co-existed with tobacco economy. Understanding agricultural economies as part of complex social–ecological systems that consist of interconnected values, identities, ecology and social ties is important for developing policies to support systems and communities through economic transitions. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

The need for informed analyses of health policy is now greater than ever. The twelve essays in this volume show that public debates routinely bypass complex ethical, sociocultural, historical, and political questions about how we should address ideals of justice and equality in health care. Integrating perspectives from the humanities, social sciences, medicine, and public health, this volume illuminates the relationships between justice and health inequalities to enrich debates. Understanding Health Inequalities and Justice explores three questions: How do scholars approach (...) relations between health inequalities and ideals of justice? When do justice considerations inform solutions to health inequalities, and how do specific health inequalities affect perceptions of injustice? And how can diverse scholarly approaches contribute to better health policy? From addressing patient agency in an inequitable health care environment to examining how scholars of social justice and health care amass evidence, this volume promotes a richer understanding of health and justice and how to achieve both. -/- The contributors are Judith C. Barker, Paula Braveman, Paul Brodwin, Jami Suki Chang, Debra DeBruin, Leslie A. Dubbin, Sarah Horton, Carla C. Keirns, J. Paul Kelleher, Nicholas B. King, Eva Feder Kittay, Joan Liaschenko, Anne Drapkin Lyerly, Mary Faith Marshall, Carolyn Moxley Rouse, Jennifer Prah Ruger, and Janet K. Shim. (shrink)

In accordance with ethical principles and standards, researchers conducting studies with children are expected to seek assent and respect their dissent from participation. Little attention has been given to assent and dissent in research with toddlers, who have limited cognitive and emotional capabilities. We discuss research with toddlers in the context of assent and dissent and propose guidelines to ensure that research with toddlers still adheres to ethical principles. These guidelines include designing engaging studies, monitoring refusal and distress, and partnering (...) with parents. Research with toddlers requires flexibility and creativity to respect toddlers in the context of their developmental capabilities. (shrink)

In this paper I first argue that we do not need to intend all the features of X in order to consent to X. I will present cases in which agents intend to consent to gambles, and intend to consent to have sex with people under certain descriptions, de re, rather than de dicto. Next, I argue that deception – even deception about features of a sexual act that qualify as “deal-breakers” for a participant – might not always have the (...) power to undermine sexual consent. In both sections I craft my arguments by appealing to a proposal about the scope of rights. I suggest that we may have intentions regarding our sexual experiences that do not map onto the rights that we actually hold pertaining to those sexual experiences. (shrink)

In this article I examine the most prevalent explanation for why coercion ever undermines consent, an explanation that I call “moral debilitation.” On this view, the manipulative strategy of coerci...

This book is about permissive consent--the moral tool we use to give another person permission to do what would otherwise be forbidden. For instance, consent to enter my home gives you permission to do what would otherwise be trespass. This transformation is the very thing that philosophersidentify as consent--which is why we call it a normative power. It is something individuals can do, by choice, to change the moral or legal world. But what human acts or attitudes render consent? When (...) do coercive threats, offers, or lies undermine the transformative power of consent? What intentionsor conventions are necessary to render consent meaningful?This book develops a novel theory that explains the moral features of consent in some of the most central domains of human life--but that also serves as a study in how to theorize normative power. It argues that consent is a moral mechanism with exactly the set of features that, when triggered,prevents another person's behavior from constituting a certain kind of wrongdoing. What kind of wrongdoing? It depends on what sort of permission is being granted. Sometimes consent permits others to enter, occupy, or act within some bounded domain wherein the consent-giver holds moral authority. Inthese cases, consent operates to prevent what the book calls: Invasive Wrongdoing. By identifying the moral features that underlie this special wrongdoing, we can learn what it takes to render consent. (shrink)

I present a set of cases that pose problems for existing theories of promissory uptake. These cases involve a delayed receipt and/or acceptance of a promise, though the obligation arises before the receipt or acceptance has taken place; a delay or absence of agency on the part of the promisee—making it impossible to satisfy the various suggested uptake criteria, though promissory obligation is nonetheless generated; and the promise is made to someone, de dicto—that is, the person who will be the (...) promisee has not yet been filled in at the time when the obligation begins. I identify clues within each theory of promising to determine the temporal and agency-related boundaries on promissory obligation. I then introduce the backward reach of uptake. (shrink)

I first distinguish promises with positive sexual content (e.g., promises to perform sexual acts) and promises with negative sexual content (e.g., promises to refrain from sexual acts—as one does when making monogamy promises). I argue that sexual content—even positive sexual content—does not cause a promise to misfire. However, the content of some successful promises is such that a promisee ought not to accept the promise, and, if she does accept, she ought then to release her promisor from the promise. I (...) argue that both positive and negative sexual promises have content of this kind. (shrink)

: Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers' raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's (...) account of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

What a person is doing often depends on that person’s thought about what they are doing, or about the wider circumstances of their action. For example, whether my killing is murder or manslaughter depends, in part, on whether I understand that what I am doing is killing you, and on whether I understand that my killing is unjustified. Similarly, if I know that the backpack I am taking is yours, then my taking it may be an act of theft; but (...) it is not theft if I simply mistook your backpack for my own. And if I don’t know that in signing a document I’m promising to do some thing, then in signing it I’m not promising to do this at all. -/- According to Elizabeth Anscombe, a central task of philosophical psychology is to articulate this dependency of action on thought. And in a range of papers published during the 1960s, Anscombe sought to elucidate various aspects of this dependency. In this paper we give a systematic overview of how Anscombe understands this dependency, and in the process reveal the conceptual framework underlying Anscombe’s thinking about perception, desire, intention, voluntariness, responsibility, guilt, and sin. (shrink)

Dan Marshall and Josh Parsons note, correctly. that the property of being either a cube or accompanied by a cube is incorrectly classified as intrinsic under the definition we have given unless it turns out to be disjunctive. Whether it is disjunctive, under the definition we gave, turns on certain judgements of the relative naturalness of properties. They doubt the judgements of relative naturalness that would classify their property as disjunctive. We disagree. They also suggest that the whole idea (...) of judging relative naturalness is a dubious business. We reply that, like them or not, such judgements cannot easily be avoided. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

The 'Gamer's Dilemma' is the problem of why some actions occurring in video game contexts seem to have similar, albeit attenuated, kinds of moral significance to their real-world equivalents, while others do not. In this paper, I argue that much of the confusion in the literature on this problem is not ethical but metaphysical. The Gamer's Dilemma depends on a particular theory of the virtual, which I call 'inflationary', according to which virtual worlds are a metaphysical novelty generated almost exclusively (...) by video games. Actions performed in virtual worlds really belong to the kinds of action they appear to—'virtual murder' is a kind of murder. Inflationary theories are contrasted with 'deflationary' theories which, in effect, consider video games purely as systems for generating images, and thus the gamer as a consumer of media images. Inflationary theories struggle to explain why video games produce this unique metaphysical novelty; deflationary theories fail to do justice to the intuition that there is some significant difference between the gamer and the consumer of other media forms. In place of either, I sketch a theory of the gamer as performer, primarily by analogy with stage and cinema actors, which I suggest captures more of the moral complexity of the gamer's action. (shrink)

The Collective Unconscious in the Age of Neuroscience brings the connection between C.G. Jung's theory of a collective unconscious, neuroscience, and personal experiences of severe mental illness to life. Hallie B. Durchslag uses narrative analysis to examine four autobiographical accounts of mental illness, including her own, and illuminate the interplay between psychic material and human physiology that Jung intuited to exist. Durchslag's unique study considers the links between expressions of the collective unconscious, such as myth, fairy tales, folk tales, (...) and 'big dreams', and the experiences of those diagnosed with severe mental illnesses, such as schizophrenia and bipolar disorder. The author's personal narrative account of a psychotic episode is at its heart, bringing both an intimate foundation and exceptional insight to the book. With reference to neuroscientific and genetic research throughout, The Collective Unconscious in the Age of Neuroscience highlights the gap between depth psychological notions of etiology and treatment, highlights patterns of collective material in the qualitative experience of these genetic and biological disorders, and explores how the efficacy of pharmacological treatment sheds light on Jung's theoretical model. The Collective Unconscious in the Age of Neuroscience will be essential reading for academics and students of Jungian and post-Jungian studies, consciousness, neuroscience and mental health. It will also provide unique insight for analytical psychologists interested in severe mental illness and the collective unconscious. (shrink)

What conditions of vulnerability must an individual face in order that we might ever correctly say that she or he has been wrongfully exploited? Mikhail Valdman has recently argued that wrongful exploitation is the extraction of excessive benefits from someone who cannot reasonably refuse one’s offer. So, ‘being unable to reasonably refuse an offer’ is Valdman’s answer to this question. I will argue that this answer is too narrow, but that other competing answers, like Alan Wertheimer’s, are too broad. I (...) propose a new answer, a “vulnerability clause” to partially comprise a theory of wrongful exploitation. In so doing, I appeal to Marilyn Frye’s account of oppression and take guidance from her inclusion and exclusion criteria. (shrink)

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

In face of rising flood losses globally, the approach of “living with floods,” rather than relying on structural measures for flood control and prevention, is acquiring greater resonance in diverse socioeconomic contexts. In the Lerma Valley in the state of Mexico, rapid industrialization, population growth, and the declining value of agricultural products are driving livelihood and land use change, exposing increasing numbers of people to flooding. However, data collected in two case studies of farm communities affected by flooding in 2003 (...) illustrate that the concept of flood as agricultural “hazard” has been relatively recently constructed through public intervention in river management and disaster compensation. While farming still represents subsistence value to rural households, increasingly rural communities are relying on non-farm income and alternative livelihood strategies. In this context, defining flooding in rural areas as a private hazard for which individuals are entitled to public protection may be counterproductive. A different approach, in which farmers’ long acceptance of periodic flooding is combined with valuing agricultural land for ecoservices, may enable a more sustainable future for the region’s population. (shrink)

Julia Driver has argued that there is a special set of actions, lodged between neutral actions and wrongful actions called suberogatory actions. These actions are not impermissible, according to Driver, but still strike us as troubling or bad, and are therefore worse than morally neutral (1992). Since this paper was written 20 years ago, many philosophers have utilized or alluded to this moral territory. The existence of some action-types that are not wrong but still carry some dis-value has become a (...) staple in the realm of moral evaluation. However, Driver's argument for the existence of this moral territory amounts to three types of moral cases that, according to Driver, can only be explained by the existence of the suberogatory. In this short paper, I will respond by saying that we can account for these cases using our traditional notions of moral neutrality and moral wrongness. The temptation of invoking the suberogatory is that it can be used as a substitute for answering a variety of hard ethical questions. However appealing this substitute may be, we should resist it so long as the problem cases put forward to motivate the new evaluative realm can be handled, and handled well, by our traditional apparatus. (shrink)

I begin this paper by summarizing and critiquing the debate between two views: Moral Specificationism about rights and Moral Generalism about rights. I then show how the conceptual framework that Wesley Hohfeld uses to describe legal rights can also clarify the discussion of moral rights, in general, and of moral specification, in particular. Drawing upon Hohfeld’s framework, I argue for the Restricted Account of the moral specification of rights, which stakes out a middle-ground between the view that all justified exceptions (...) are built into the description of rights and the view that no exceptions are built in. According to the Restricted Account, if and only if the justification for an exception is the same as the justification for rights within the broader ethical theory, then the exception is specified in the right. The Restricted Account is compatible with a wide variety of theories of the function of rights. (shrink)

When discussing exploitation, we often say things like this, “sweatshop laborers have terrible working conditions and are paid almost nothing, but they are better off with that labor than with no labor.” Similarly, in describing the Non-Identity Problem, Derek Parfit points out: we cannot say that the individuals born in future generations are worse off because of our destructive environmental policies because the particular people living in those future generations wouldn’t even exist if it were not for these destructive policies. (...) How can we explain these cases, exploitation and environmental destruction, as ones of wrongdoing when the victims in both cases are no worse off than they would have otherwise been? This paper investigates the link between these two moral puzzles and ultimately uses one to solve the other: an exploitation solution to the Non-Identity Problem. (shrink)

I argue that women in traditional marriages are a vulnerable source for kidneys and this vulnerability gives rise to exploitative donation arrangements made within families. In so doing, I critique Alan Wertheimer’s account of the impact that emotional closeness between participants in an agreement has on the wrongfulness of exploitation. I propose a regulated market scheme that is not only less exploitative than our current donation scheme, but also resolves a variety of other moral problems that typically arise in real (...) and imagined kidney sale scenarios, problems that render markets “noxious,” according to Debra Satz. (shrink)

Organisms' environments are thought to play a fundamental role in determining their fitness and hence in natural selection. Existing intuitive conceptions of environment are sufficient for biological practice. I argue, however, that attempts to produce a general characterization of fitness and natural selection are incomplete without the help of general conceptions of what conditions are included in the environment. Thus there is a "problem of the reference environment"—more particularly, problems of specifying principles which pick out those environmental conditions which determine (...) fitness. I distinguish various reference environment problems and propose solutions to some of them. While there has been a limited amount of work on problems concerning what I call "subenvironments", there appears to be no earlier work on problems of what I call the "whole environment". The first solution I propose for a whole environment problem specifies the overall environment for natural selection on a set of biological types present in a population over a specified period of time. The second specifies an environment relevant to extinction of types in a population; this kind of environment is especially relevant to certain kinds of long-term evolution. (shrink)

"Patient advocates can help make research more ethical, but advocacy raises ethical issues of its own.

I describe a realist, ontologically objective interpretation of probability, "far-flung frequency (FFF) mechanistic probability". FFF mechanistic probability is defined in terms of facts about the causal structure of devices and certain sets of frequencies in the actual world. Though defined partly in terms of frequencies, FFF mechanistic probability avoids many drawbacks of well-known frequency theories and helps causally explain stable frequencies, which will usually be close to the values of mechanistic probabilities. I also argue that it's a virtue rather than (...) a failing of FFF mechanistic probability that it does not define single-case chances, and compare some aspects of my interpretation to a recent interpretation proposed by Strevens. (shrink)

In this article, we outline a novel approach to understanding the role of responsibility in health promotion. Efforts to tackle chronic disease have led to an emphasis on personal responsibility and the identification of ways in which people can ‘take responsibility’ for their health by avoiding risk factors such as smoking and over-eating. We argue that the extent to which agents can be considered responsible for their health-related behaviour is limited, and as such, state health promotion which assumes certain forms (...) of moral responsibility should be avoided. This indicates that some approaches to health promotion ought not to be employed. We suggest, however, that another form of responsibility might be more appropriately identified. This is based on the claim that agents have prudential reasons to maintain their health, in order to pursue those things which make their lives go well—i.e. that maintenance of a certain level of health is rational for many agents, given their pleasures and plans. On this basis, we propose that agents have a self-regarding prudential responsibility to maintain their health. We outline the implications of a prudential responsibility approach to health promotion. (shrink)

Former NAACP chapter head Rachel Dolezal's attempted transition from the white to the black race occasioned heated controversy. Her story gained notoriety at the same time that Caitlyn Jenner graced the cover of Vanity Fair, signaling a growing acceptance of transgender identity. Yet criticisms of Dolezal for misrepresenting her birth race indicate a widespread social perception that it is neither possible nor acceptable to change one's race in the way it might be to change one's sex. Considerations that support transgenderism (...) seem to apply equally to transracialism. Although Dolezal herself may or may not represent a genuine case of a transracial person, her story and the public reaction to it serve helpful illustrative purposes. (shrink)

Human Rights Education (HRE) has traditionally been articulated in terms of cultivating better citizens or world citizens. The main preoccupation in this strand of HRE has been that of bridging a gap between universal notions of a human rights subject and the actual locality and particular narratives in which students are enmeshed. This preoccupation has focused on ‘learning about the other’ in order to improve relations between plural ‘others’ and ‘us’ and reflects educational aims of national identity politics in citizenship (...) education. The article explores the learning of human rights through narratives in relations, drawing on Hannah Arendt and Sharon Todd. For this re-thinking of relations in learning human rights, the article argues that HRE needs to address both competing historical narratives on the drafting of the Universal Declaration on Human Rights (UDHR) as well as unique life narratives of learners. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

One controversy about the existence of so called evolutionary forces such as natural selection and random genetic drift concerns the sense in which such “forces” can be said to interact. In this paper I explain how natural selection and random drift can interact. In particular, I show how population-level probabilities can be derived from individual-level probabilities, and explain the sense in which natural selection and drift are embodied in these population-level probabilities. I argue that whatever causal character the individual-level probabilities (...) have is then shared by the population-level probabilities, and that natural selection and random drift then have that same causal character. Moreover, natural selection and drift can then be viewed as two aspects of probability distributions over frequencies in populations of organisms. My characterization of population-level probabilities is largely neutral about what interpretation of probability is required, allowing my approach to support various positions on biological probabilities, including those which give biological probabilities one or another sort of causal character. ‡This paper has benefited from feedback on and discussions of this and earlier work. I want to thank André Ariew, Matt Barker, Lindley Darden, Patrick Forber, Nancy Hall, Mohan Matthen, Samir Okasha, Jeremy Pober, Robert Richardson, Alex Rosenberg, Eric Seidel, Denis Walsh, and Bill Wimsatt. †To contact the author, please write to: Department of Philosophy, University of Alabama at Birmingham, HB 414A, 900 13th Street South, Birmingham, AL 35294-1260; e-mail: [email protected]. (shrink)

It has been argued that biological fitness cannot be defined as expected number of offspring in all contexts. Some authors argue that fitness therefore merely satisfies a common schema or that no unified mathematical characterization of fitness is possible. I argue that comparative fitness must be relativized to an evolutionary effect; thus relativized, fitness can be given a unitary mathematical characterization in terms of probabilities of producing offspring and other effects. Such fitnesses will sometimes be defined in terms of probabilities (...) of effects occurring over the long term, but these probabilities nevertheless concern effects occurring over the short term. †To contact the author, please write to: Department of Philosophy, University of Alabama at Birmingham, HB 414A, 900 13th Street South, Birmingham, AL 35294‐1260; e‐mail: [email protected]. (shrink)

Citing a lifelong engagement with Marxism, critic and writer Marshall Berman reveals the movement's positive points and suggests a new beginning for Marxism may be on the horizon with its recent 150th anniversary attention.

Ruth Millikan and others advocate theories which attempt to naturalize wide mental content (e.g. beliefs.