The eight pieces constituting this Meeting Report are summaries of presentations made during a panel session at the 2011 Association for Practical and Professional Ethics (APPE) annual meeting held between March 3rd and 6th in Cincinnati. Lisa Newton organized the session and served as chair. The panel of eight consisted both of pioneers in the field and more recent arrivals. It covered a range of topics from how the field has developed to where it should be going, from identification of (...) issues needing further study to problems of training the next generation of engineers and engineering-ethics scholars. (shrink)
Although ethical leadership by formal nurse leaders is critical to enhancing ethical health-care practice, research has shown that many nurses feel unsupported by their leaders. In this article, we consider the limited attention directed toward ethical leadership of formal nurse leaders and how our own research on ethical nurse leadership compares to other research in this field. In searching Nursing Ethics since its inception 20 years ago, we found only a dozen articles that directly addressed this topic. We then reviewed (...) nurses’ professional codes of ethics in Canada and found significant retractions of ethical guidelines for formal nurse leaders’ ethical responsibilities over the past decade. We began to seek explanations of why this is so and offer some recommendations for the study and enhancement of ethics for formal nurse leadership. (shrink)
The concept of ?harmony? was taught by the Chinese sages as the practice of acceptance, tolerance, mutual respect, equality and patience, and is now given great importance by the Chinese government in its attempts to promote the stability and sustainability of the country. The concept could have significant implications for moral education. This article uses a Chinese Masters course on sustainability education as an example to analyse the positive and negative implications of the principle of harmony both for the practice (...) of sustainability education and for educational practice in general. The course encouraged students to plan and implement feasible and practical sustainability activities mainly in the context of Chinese schools. Influenced by the value of harmony, the course chose to promote sustainability in a pragmatic but limited way. Although the course resulted in some practical sustainability related activities, a holistic and critical view on sustainability was not evident amongst the students. However, the principle of harmony could be applied critically both as a criterion for evaluating social development and as a value underlying democratic decision-making. (shrink)
In his lectures on general logic Kant maintains that the generality of a representation (the form of a concept) arises from the logical acts of comparison, reflection and abstraction. These acts are commonly understood to be identical with the acts that generate reflected schemata. I argue that this is mistaken, and that the generality of concepts, as products of the understanding, should be distinguished from the classificatory generality of schemata, which are products of the imagination. A Kantian concept does not (...) provide mere criteria for noting sameness and difference in things, but instead reflects the inner nature of things. Its form consists in the self-consciousness of a capacity to judge (i.e. the Concept is the ‘I think’). (shrink)
This paper looks at a central issue with embodiment theories in cognition: the role, if any, they provide for mental representation. Thelen and Smith (1994) hold that the concept of representations is either vacuous or misapplied in such systems. Others maintain a place for representations (e.g. Clark 1996), but are imprecise about their nature and role. It is difficult to understand what those could be if representations are understood in the same sense as that used by computationalists: fixed or long-lasting (...) neural structures that represent the sensory stimuli that caused them (e.g. neural response patterns in the visual cortex), or whose “meaning” is fixed innately or in early development for particular functions (e.g. the body schemas for Meltzoff and Gopnik 1993). The paper proposes a distinctions between, on the one hand, neural patterns, traces of sensory activation that while not in themselves representations are available for representational activity, and on the other the act of representing, which is what gives representational content to neural patterns. (shrink)
Research on moral distress has paid limited attention to nurses’ responses and actions. In a survey of nurses’ perceptions of moral distress and ethical climate, 292 nurses answered three open-ended questions about situations that they considered morally distressing. Participants identified a range of situations as morally distressing, including witnessing unnecessary suffering, being forced to provide care that compromised values, and negative judgments about patients. They linked these situations to contextual constraints such as workload and described responses, including feeling incompetent and (...) distancing themselves from patients. Participants described considerable effort to effect change, calling into question the utility of defining moral distress as an “inability to act due to institutional constraints” or a “failure to pursue a right course of action.” Various understandings of moral distress operated, and action was integral to their responses. The findings suggest further conceptual work on moral distress and effort to support system-level change. (shrink)
Background: Both the Council for International Organization of Medical Sciences and the Helsinki Declaration emphasize that the potential benefits of research should outweigh potential harms; consequently, some work has been conducted on participants' perception of benefits in therapeutic research. However, there appears to be very little work conducted with participants who have joined non-therapeutic research. This work was done to evaluate participants' perception of benefits in a genetic epidemiological study by examining their perception of the potential benefits of enrollment.Methods: In-depth (...) interviews lasting between 45 and 60 minutes were conducted with a convenient sample of 25 ill patients and 25 healthy accompanying relatives enrolled in a genetic epidemiological study of tuberculosis. Recorded interviews were transcribed and analyzed using content analysis.Results: Participants perceived that research was beneficial and some of the benefits included the generation of new knowledge, finding the cause of diseases, as well as the control, eradication and prevention of disease. Some thought that research was risky whilst others thought that the benefits outweighed the risks.Conclusion: Participants perceived research to be beneficial and most of them thought that, though it was risky, the benefits outweighed the risks. It is our view that researchers need to give serious consideration to participant's perception of benefits in designing their consent forms, to see to the fulfillment of achievable goals. (shrink)
Background The post-trial period is the time period after the end of study drug administration. It is unclear whether post-trial arrangements for patient surveillance are routinely included in study protocols and consents, and whether research ethics boards (REB) consider the post-trial period. Objectives The objective was to determine whether trial protocols and consent forms reviewed by the REB describe procedures for post-trial period surveillance. Methods An observational study of protocols of randomised trials of chronic therapies for cardiac conditions, approved by (...) the REB of two academic institutions affiliated with the University of Toronto in Canada (University Health Network and Mount Sinai Hospital) from 1995 to 2007. Plans for patient surveillance in the post-trial period described in the protocol or in the consent form before and after REB approval were recorded. Results 42 studies were identified including 18 heart failure and 15 coronary artery disease trials. Only four studies planned a clinical visit after trial termination, and an additional three planned a telephone contact after trial completion. Five trials submitted consent forms to the REB with a discussion of the post-trial period. Conclusions The majority of protocols and consent forms did not discuss plans for post-trial period surveillance. The post-trial period and the REB approval process could be improved by systematic follow-up being described in the protocol and consent form. The small number of trial protocols evaluated in the study may impair the degree to which the results can be generalised. (shrink)
There is increasing emphasis on the need for collaboration between practice and academic leaders in health care research. However, many problems can arise owing to differences between academic and clinical goals and timelines. In order for research to move forward it is important to name and address these issues early in a project. In this article we use an example of a participatory action research study of ethical practice in nursing to highlight some of the issues that are not frequently (...) discussed and we identify the impact of things not-named. Further, we offer our insights to others who wish to be partners in research between academic and practice settings. These findings have wide implications for ameliorating misunderstandings that may develop between nurse leaders in light of collaborative research, as well as for participatory action research. (shrink)
This article responds to the preceding papers by Fletcher and Pasternack. Accepting Fletcher’s virtue-based approach as a useful starting point, it suggests the need for more careful philosophical work on the morality of gambling.
Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely (...) correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients. (shrink)
The increasing demands placed on the global water supply threaten biodiversity and the supply of water for food production and other vital human needs. Water shortages already exist in many regions, with more than one billion people without adequate drinking water. In addition, 90% of the infectious diseases in developing countries are transmitted from polluted water. Agriculture consumes about 70% of fresh water worldwide;for example, approximately 1000 liters (L) of water are required to produce 1 kilogram (kg) of cereal grain, (...) and 43,000 L to produce I kg of beef New water supplies are likely to result from conservation, recycling, and improved water-use efficiency rather than from large development projects. (shrink)
Sir Isaac Newton (1642-1727) left a voluminous legacy of writings. Despite his influence on the early modern period, his correspondence, manuscripts, and publications in natural philosophy remain scattered throughout many disparate editions. In this volume, Newton's principal philosophical writings are for the first time collected in a single place. They include excerpts from the Principia and the Opticks, his famous correspondence with Boyle and with Bentley, and his equally significant correspondence with Leibniz, which is often ignored in favor of Leibniz's (...) later debate with Samuel Clarke. Newton's exchanges with Leibniz place their different understandings of natural philosophy in sharp relief. The volume also includes 'De Gravitatione', offered here in a corrected translation, which is crucial for understanding Newton's relation to his great predecessor Descartes. In a historical and philosophical introduction, Andrew Janiak examines Newton's philosophical positions and his relations to canonical figures in early modern philosophy. (shrink)
We argue that the goal of natural excellence, discoverable by scientific observation of the species, is appropriately called good, and the proper object of human development and education. That affirmation stands, but we are forced to acknowledge several conceptual difficulties (in the deliberate creation of “natural” excellences, for example, and in cases of plurality of excellences) and a final inability to reconcile human freedom—surely part of the natural excellence of human life—with the need to prevent humans from using that freedom (...) to sacrifice it (through, for instance, drugs, self-indulgence, and emotional enthusiasms). (shrink)
Accountability is viewed as a civilizing element in society, with professional accountability formalized in most cases as duties dating to the Greeks and Socrates; journalists must find their own way, without formal professional or government regulation or licensing. Three scholars look at the process in a line from the formal professional discipline to suggesting problems the journalism fraternity faces without regulation to suggesting serious internal ethics conferences as 1 solution to the problem.
Grush makes an important contribution to a promising way of viewing mental representation: as a component activity in sensorimotor processes. Grush shows that there need be no entities in our heads that would count as representations, but that, nevertheless, the process of representation can be defined so as to include both natural and artificial (e.g., linguistic or pictorial) representing.