The COVID-19 pandemic has strained healthcare resources the world over, requiring healthcare providers to make resource allocation decisions under extraordinary pressures. A year later, our understanding of COVID-19 has advanced, but our process for making ethical decisions surrounding resource allocation has not. During the first wave of the pandemic, our institution uniformly ramped-down clinical activity to accommodate the anticipated demands of COVID-19, resulting in resource waste and inefficiency. In preparation for the second wave, we sought to make such ramp down (...) decisions more prudently and ethically. We report the development of a tool that can be used to make fair and ethical decisions in times of resource scarcity. We formed an interprofessional team to develop and use this tool to ensure that a diverse range of stakeholder perspectives were represented in this development process. This team, called the clinical activity recovery team, established institutional objectives that were combined with well-established procedural values, substantive ethical principles and decision-making criteria by using a variation on the well-known accountability for reasonableness ethical framework. The result of this is a stepwise, semiquantitative, ethical decision tool that can be applied to resource allocation challenges in order to reach fair and ethically defensible decisions. This ethical decision tool can be applied in various contexts and may prove useful at both the institutional and the departmental level; indeed this is how it is applied at our centre. As the second wave of COVID-19 strains healthcare resources, this tool can help clinical leaders to make fair decisions. There are no data in this work. (shrink)

We show that under the proper forcing axiom the class of all Aronszajn lines behave like [Formula: see text]-scattered orders under the embeddability relation. In particular, we are able to show that the class of better-quasi-order labeled fragmented Aronszajn lines is itself a better-quasi-order. Moreover, we show that every better-quasi-order labeled Aronszajn line can be expressed as a finite sum of labeled types which are algebraically indecomposable. By encoding lines with finite labeled trees, we are also able to deduce a (...) decomposition result, that for every Aronszajn line [Formula: see text] there is an integer [Formula: see text] such that for any finite coloring of [Formula: see text] there is subset [Formula: see text] of [Formula: see text] isomorphic to [Formula: see text] which uses no more than [Formula: see text] colors. (shrink)

In this study, we explore the global effect of the Internet on democracy over the period of 1992 to 2002 by observing the relationships between measures related to democracy and Internet prevalence. Our findings suggest that while Internet usage was not a very powerful predictor of democracy when examining full panel data from 1992 to 2002, it was a stronger predictor when we study data from just the years 2001 to 2002. We hypothesize that the jump in the ability of (...) Internet penetration indicators to explain variation in democratization that occurred in 2000 suggests that the Internet may have only recently come into its own as a positive force for democratization. However, these results are not globally consistent, and we show that some regions do not enjoy a positive Internet/democracy correlation suggesting that the Internet can be used both as a tool for democratization as well as an instrument for authoritarianism. (shrink)

Dubbed 'the oracle' by no less an authority than James Madison, Montesquieu stands as a theoretical founder of the liberal political tradition. But equally central to his project was his account of the relationship of law to each nation's particular customs and place, a teaching that militates against universal political solutions. This teaching has sometimes been thought to stand in tension with his liberal constitutionalism. In this book, Keegan Callanan argues that Montesquieu's political particularism and liberalism are complementary and (...) mutually reinforcing parts of a coherent whole. In developing this argument, Callanan considers Montesquieu's regime pluralism, psychological conception of liberty, approach to political reform, and account of 'the customs of a free people', including the complex interaction of religion and commerce. Callanan concludes that, by re-orienting our understanding of liberalism and redirecting our attention toward liberty's distinctive preconditions, a return to Montesquieu's political philosophy leaves us better prepared to confront liberal democracy's contested claim to universality. (shrink)

The Companion to Montesquieu provides a first port-of-call for readers new to the study of Montesquieu, even as it makes major contributions to the specialist literature. The volume will attract scholars of multiple disciplines and readers interested in concepts like liberty, cosmopolitanism, sovereignty, and slavery treated in the thematic chapters.

Heightened political polarization challenges civic educators seeking to prepare youth as citizens who can navigate affective boundaries. Current approaches to civic education do not yet account for the emotional basis of citizenship. This paper presents an argument for critical affective literacy in civic education classrooms. Drawing from concepts and theories in critical emotion studies, affective citizenship, and agonistic political theory, critical affective civic literacy challenges the rationalistic bent of civic education, and offers instructional strategies for educating the political emotions of (...) students. The voices of late-arrival migrant youth enacting affective citizenship are featured in order to help illuminate the contributions of critical affective literacy to social studies research and practice. (shrink)

Our contribution in this paper is to highlight the ethical implications of workforce engagement strategies in an age of austerity. Hard or instrumentalist approaches to workforce engagement create the potential for situations where engaged employees are expected to work ever longer and harder with negative outcomes for their well-being. Our study explores these issues in an investigation of the enactment of an engagement strategy within a UK Health charity, where managers and workers face paradoxical demands to raise service quality and (...) cut costs. We integrate insights from engagement, paradox, and ethic of care literatures, to explore these paradoxical demands—illustrating ways in which engagement experiences become infused with tensions when the workforce faces competing requirements to do ‘more with less’ resources. We argue that those targeted by these paradoxical engagement strategies need to be supported and cared for, embedded in an ethic of care that provides explicit workplace resources for helping workers and managers cope with and work through corresponding tensions. Our study points to the critical importance of support from senior and frontline managers for open communications and dialogue practices. (shrink)

Medical-legal partnership (MLP) embeds attorneys and paralegals into care delivery to help clinicians address root causes of health inequities. Notwithstanding decades of favorable outcomes, MLP is not as well-known as might be expected. In this essay, the authors explore ways in which strategic alignment of legal services with healthcare services in terms of professionalism, information collection and sharing, and financing might help the MLP movement become a more widespread, sustainable model for holistic care delivery.

An implicit assumption in most works on change recipient reactions is that employees are self-centred and driven by a utilitarian perspective. According to large parts of the organizational change literature, employees’ reactions to organizational change are mainly driven by observations around the question ‘what will happen to me?’ We analysed change recipients’ reactions to 26 large-scale planned change projects in a policing context on the basis of 23 in-depth interviews. Our data show that change recipients drew on observations with three (...) foci to assess change, making sense of change as multidimensional and mostly ambivalent in nature. In their assessment of organizational change, recipients care not only about their own personal outcomes, but go beyond self-interested concerns to show a genuine interest in the impact of change on their colleagues and organization. Meaningful engagement of employees in organizational change processes requires recognizing that reactions are not simply ‘all about me’. We add to the organizational change literature by introducing a behavioural ethics perspective on change recipients’ reactions highlighting an ethical orientation where moral motives that trigger change reactions get more attention than is common in the change management literature. Beyond the specifics of our study, we argue that the genuine concern of change recipients for the wellbeing of others, and the impact of the organizations’ activities on internal and external stakeholders, needs to be considered more systematically in research on organizational change. (shrink)

We survey the literature that has explored the implications of decision-making under ambiguity for financial market outcomes, such as portfolio choice and equilibrium asset prices. This ambiguity literature has led to a number of significant advances in our ability to rationalize empirical features of asset returns and portfolio decisions, such as the failure of the two-fund separation theorem in portfolio decisions, the modest exposure to risky securities observed for a majority of investors, the home equity preference in international portfolio diversification, (...) the excess volatility of asset returns, the equity premium and the risk-free rate puzzles, and the occurrence of trading break-downs. (shrink)

This chapter contains sections titled: The Language of Psychopathy Why a Moral Grounding Traits versus Behaviors Primates, Communication, and Serial Killers.

Military personnel often perform complex cognitive operations under unique conditions of intense stress. This requirement to perform diverse physical and mental tasks under stress, often with high stakes, has led to recognition of the term ‘tactical athlete’ for these performers. Impaired cognitive performance as a result of this stress may have serious implications for the success of military operations and the well-being of military service men and women, particularly in combat scenarios. Therefore, understanding the nature of the stress experienced by (...) military personnel and the resilience of cognitive functioning to this stress is of great importance. This review synthesises the current state of the literature regarding cognitive resilience to psychological stress in tactical athletes. The experience of psychological stress in military personnel is considered through the lens of the Transactional Theory of stress, while offering contemporary updates and new insights. Models of the effects of stress on cognitive performance are then reviewed to highlight the complexity of this interaction before considering recent advancements in the preparation of military personnel for the enhancement of cognitive resilience. Several areas for future research are identified throughout the review, emphasising the need for the wider use of self-report measures and mixed methods approaches to better reflect the subjective experience of stress and its impact on the performance of cognitive operations. (shrink)

Emergency services personnel are a high stress occupation, being frequently confronted with highly consequential stressors and expected to perform: without fault; under high pressure; and in unpredictable circumstances. Research often invokes similarities between the experiences of emergency services personnel and elite athletes, opening up the possibility of transferring learnings between these contexts. Both roles involve genuine risks to emotional wellbeing because their occupations involve significant stress. Similarly, both roles face obstacles and injury, and their “success” is dependent on high-quality execution (...) of their skills under pressure. As such, both occupations are required to have resilience and effective coping abilities to ensure psychological well-being. Researchers suggest emotional awareness may be a key variable in the management and maintenance of resilience. This study: explored the experiences of emergency services personnel; characterised connections between emotional awareness and resilience; and reflected on the ways these findings can be extrapolated to elite athletes. We analysed 11 interviews with emergency services personnel. Participants identified resilience as crucial when coping with stress, however, many defined resilience as remaining unaffected by stress rather than, for example, managing and responding to it. Participants defined emotional awareness as understanding their emotions, and they recognised associated benefits for coping, resilience, and burnout. Nevertheless, most participants did not engage in practices to improve their emotional awareness. Barriers, such as maladaptive beliefs and help-seeking stigma, interfered with participants’ ability to cultivate emotional awareness, to promote resilience. In contrast, some participants described profound improvements in resilience and coping following the cultivation of emotional awareness. This finding illustrates that systemic change must target the individual, team, and organisation to correct misperceptions about resilience, emotional awareness, and psychological help-seeking. Developing emotional awareness may help emergency services personnel and other high stress occupations like elite athletes process difficult experiences and enhance their resilience, promoting well-being, and career longevity. (shrink)

In this paper we compare the strategies applied by two successful biological components of the ecosystem, the viruses and the human beings, to interact with the environment. Viruses have had and still exert deep and vast actions on the ecosystem especially at the genome level of most of its biotic components. We discuss on the importance of the human being as contraptions maker in particular of robots, hence of machines capable of automatically carrying out complex series of actions. Beside the (...) relevance of designing and assembling these contraptions, it is of basic importance the goal for which they are assembled and future scenarios of their possible impact on the ecosystem. We can’t procrastinate the development and implementation of a highly inspired and stringent “ethical code” for human beings and humanoid robots because it will be a crucial aspect for the wellbeing of the mankind and of the entire ecosystem. (shrink)

Understanding the impact of robot errors in child-robot-interactions (CRI) is critical, as current technological systems are still limited and may randomly present a variety of mistakes during interactions with children. In this study we manipulate a task-based error of a NAO robot during a semi-autonomous computational thinking task implemented with the Cozmo robot. Data from 72 children aged 7–10 were analysed regarding their attitudes towards NAO (social trust, competency trust, liking, and perceived agency), their behaviour towards the robot (self-disclosure, following (...) recommendations), as well as their task performance. We did not find quantitative effects of the robot’s error on children’s self-reported attitudes, behaviour, or task performance. Age was also not significantly related to either social attitudes or behaviours towards NAO, although there were some age-related differences in task performance. Potential reasons behind the lack of statistical effects and limitations of the study with regards to the manipulation of robot errors are discussed and insights into the design of future CRI studies provided. (shrink)

Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients’ ability to comprehend (...) complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17%) would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician’s decision as to whether to comply with a patient’s AD. Conclusions Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient’s initial wishes and preferences expressed by the AD. (shrink)

How do we identify the "queer auteur" and their queer imaginings? Is it possible to account for such a figure when the very terms "queer" and "auteur" invoke aesthetic surprises and disorientations, disconcerting ironies and paradoxes, and biographical deceits and ambiguities? David A. Gerstner traces a history of ideas that spotlight an ever-shifting terrain associated with auteur theory and, in particular, queer-auteur theory. Engaging with the likes of Oscar Wilde, Walter Benjamin, James Baldwin, Jean Louis Baudry, Linda Nochlin, Jane Gallop, (...) Cáel Keegan, Luce Irigaray, and other prominent critical thinkers, Gerstner contemplates how the queer auteur in film theory might open us to the work of desire. Ultimately, Queer Imaginings is a journey in shared pleasures in which writing for and about cinema makes way for unanticipated cinematic friendships."--Page 4 of cover. (shrink)

Clausewitz made the intuitively appealing claim that wars tend to “absoluteness,” and that all limitations imposed by law and morality are in theory alien to it. Clausewitz of course knew that there are in practice many limitations to how wars are fought, but he saw them as contingent to what war is. Since then, however, historians such as John Lynn (Battle: A History of Combat and Culture [Westview Press, 2003]), John Keegan (A History of Warfare ([Random House,1993]) and Victor (...) Davis Hanson (The Western Way of War [Oxford University Press, 1989]) have taught us to see things differently: war is a cultural phenomenon, and the limitations that rituals and taboos impose are essential to what war is. With Conspiring with the Enemy, her intelligent and erudite book on cooperation in war, Yvonne Chiu builds on that work by showing the wide variety of forms cooperation in war can take—something that, Chiu claims, we tend to overlook and take for granted at the same time. (shrink)