Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on (...) the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: work to restore capacity; find previously unknown surrogates; work with agencies to obtain surrogates; and access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. (shrink)

Adults who are incapacitated and alone, having no surrogates, may be known as “unbefriended.” Decision-making for these particularly vulnerable patients is a common and vexing concern for healthcare providers and hospital ethics committees. When all other avenues for resolving the need for surrogate decision-making fail, patients who are incapacitated and alone may be referred for “public guardianship” or guardianship of last resort. While an appropriate mechanism in theory, these programs are often under-staffed and under-funded, laying the consequences of inadequacies on (...) the healthcare system and the patient him or herself. We describe a qualitative study of professionals spanning clinical, court, and agency settings about the mechanisms for resolving surrogate consent for these patients and problems therein within the state of Massachusetts. Interviews found that all participants encountered adults who are incapacitated and without surrogates. Four approaches for addressing surrogate needs were: work to restore capacity; find previously unknown surrogates; work with agencies to obtain surrogates; and access the guardianship system. The use of guardianship was associated with procedural challenges and ethical concerns including delays in care, short term gains for long term costs, inabilities to meet a patient’s values and preferences, conflicts of interest, and ethical discomfort among interviewees. Findings are discussed in the context of resources to restore capacity, identify previously unknown surrogates, and establish improved surrogate mechanisms for this vulnerable population. (shrink)

The trend toward increased levels of business interconnectedness in the value chain has clouded the issue of responsibility for business practices. Firms havehistorically denied responsibility for many questionable practices by suggesting that such acts were committed somewhere else in the value chain and that, because they are separated by an arm’s length transaction, they are not responsible. Emerging evidence suggests that in light of the interconnected and networked business environment, the arm’s length defense is growing less effective. We discuss the (...) practical realities that firms are facing in the highly networked environment and offer examples of each. We also offer practical guidance about each example within a total responsibility management framework. (shrink)

Previous accounting ethics research berates auditors for ethical lapses that contribute to the failure of Andersen (e.g., Duska, R.: 2005, Journal of Business Ethics 57, 17–29; Staubus, G.: 2005, Journal of Business Ethics 57, 5–15; however, some of the blame must also fall on regulatory and professional bodies that exist to mitigate auditors’ ethical lapses. In this paper, we consider the ethical and economic context that existed and facilitated Andersen’s failure. Our analysis is grounded in Akerlof’s (1970, Quarterly Journal of (...) Economics August, 488–500) Theory of the Market for Lemons and we characterize the market for audit reports as a market for lemons. Consistent with Akerlof’s model, we consider the appropriateness of the countervailing mechanisms that existed at the time of Andersen’s demise that appeared to have effectively failed in counteracting Andersen’s ethical shortcomings. Finally, we assess the appropriateness of the remedies proposed by the Sarbanes–Oxley Act of 2002 (SOA) to ensure that similar ethical lapses will not occur in the future. Our analysis indicates that the SOA regulatory reforms should counteract some of the necessary conditions of the Lemons Model, and thereby mitigate the likelihood of audit failures. However, we contend that the effectiveness of the SOA critically depends upon the focus and attention of the␣Public Companies Accounting Oversight Board (PCAOB) towards assessing the ethical climates of public accounting firms. Assessments by the PCAOB of public accounting firm’s ethical climate are needed to sufficiently ensure that public accounting firms effectively promote and maintain audit quality in situations where unconscious bias or economic incentives may erode the public accounting firm’s independence. (shrink)

This paper describes a pilot study of a new model for narrative medicine training, “community-based participatory narrative medicine”, which centers on shared narrative work between healthcare trainees and patients. Nine medical students and eight patients participated in one of two, five-week-long pilot workshop series. A case study of participants’ experiences of the workshop series identified three major themes: the reciprocal and collaborative nature of participants’ relationships; the interplay between self-reflection and receiving feedback from others; and the clinical and pedagogical implications (...) of the CBPNM model. Principles and proposed outcomes of the CBPNM model are presented. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

The coronavirus disease 2019 pandemic is altering dynamics in academia, and people juggling remote work and domestic demands – including childcare – have felt impacts on their productivity. Female authors have faced a decrease in paper submission rates since the beginning of the pandemic period. The reasons for this decline in women’s productivity need to be further investigated. Here, we analyzed the influence of gender, parenthood and race on academic productivity during the pandemic period based on a survey answered by (...) 3,345 Brazilian academics from various knowledge areas and research institutions. Productivity was assessed by the ability to submit papers as planned and to meet deadlines during the initial period of social isolation in Brazil. The findings revealed that male academics – especially those without children – are the least affected group, whereas Black women and mothers are the most impacted groups. These impacts are likely a consequence of the well-known unequal division of domestic labor between men and women, which has been exacerbated during the pandemic. Additionally, our results highlight that racism strongly persists in academia, especially against Black women. The pandemic will have long-term effects on the career progression of the most affected groups. The results presented here are crucial for the development of actions and policies that aim to avoid further deepening the gender gap in academia. (shrink)

Activists’ investigations of animal cruelty expose the public to suffering that they may otherwise be unaware of, via an increasingly broad-ranging media. This may result in ethical dilemmas and a wide range of emotions and reactions. Our hypothesis was that media broadcasts of cruelty to cattle in Indonesian abattoirs would result in an emotional response by the public that would drive their actions towards live animal export. A survey of the public in Australia was undertaken to investigate their reactions and (...) responses to. The most common immediate reaction was feeling pity for the cattle. Women were more likely than men to feel sad or angry. Most people discussed the media coverage with others afterwards but fewer than 10 % contacted politicians or wrote to newspapers. We conclude that the public were emotionally affected by the media coverage of cruelty to cattle but that this did not translate into significant behavioral change. We recommend that future broadcasts of animal cruelty should advise the public of contact details for counseling and that mental health support contacts, and information should be included on the websites of animal advocacy groups to acknowledge the disturbing effect animal cruelty exposes can have on the public. (shrink)

In this article, we examine disability and eugenics discourses and the ways they function in spaces where vulnerable persons have been historically excluded by the state and blamed for their own “immiseration.” We ask how queer theories of repudiation, abjection, and vulnerability lend insight into the ways that people with intellectual disabilities are discursively located outside normative discourses of home, care, and quality of life, and whether these discourses shifted to serve this vulnerable population when historically the very places in (...) question repudiated them, infringed on their human rights, and questioned their sexuality. To address these questions, we focus on the recent and impending closures of Virginia’s Training Centers, residential institutions for persons with intellectual disabilities now scheduled for staggered closures before 2020. (shrink)

This article re-examines the theoretical basis for environmental and heritage interpretation in tourist settings in the light of hermeneutic philosophy. It notes that the pioneering vision of heritage interpretation formulated by Freeman Tilden envisaged a broadly educational, ethically informed and transformative art. By contrast, current cognitive psychological attempts to reduce interpretation to the monological transmission of information, targeting universal but individuated cognitive structures, are found to be wanting. Despite growing signs of diversity, this information processing approach to interpretation remains dominant. (...) The article then presents the alternative paradigm of hermeneutics through the works of Schleiermacher, Dilthey, Heidegger and Gadamer, to provide a broader interpretation of interpretation. This not only captures the essence of Tilden’s definition but construes heritage interpretation as a more inclusive, culturally situated, critically reflexive and dialogical practice. (shrink)

Undercover filming is a method commonly used by animal activist groups to expose animal cruelty and it is important to consider the effects of publically releasing video footage of cruel practices on the viewers’ mental health. Previously, we reported that members of the Australian public were emotionally distressed soon after viewing media broadcasts of cruelty to Australian cattle exported for slaughter in Indonesia in 2011. To explore if there were any long term impacts from exposure to media on this issue, (...) a self-selecting group of 15 people who were exposed to a documentary exposé of the cruelty were re-interviewed 12 months later. Nearly all recalled their strong initial reaction to the footage. Approximately one half of the respondents who initially had had a strong emotional reaction to the footage reported negative reactions that were still strong even after this period of time. They reported potential triggers for these feelings. Of the rest, some managed to internalise their feelings. Approximately one half of respondents were unaware of continued live export exposés, suggesting less prominent media coverage. Despite the aversion and repulsion reported after viewing the initial coverage, most respondents said they would choose to watch another broadcast of animal cruelty and nearly all supported undercover investigations as a means of revealing cruelty to animals. We conclude that many people viewing footage of cruelty to animals will have long term memory of this, but that they would prefer to be informed about the issues and not be protected from them. (shrink)

: The transplantation of adult human neural stem cells into prenatal non-humans offers an avenue for studying human neural cell development without direct use of human embryos. However, such experiments raise significant ethical concerns about mixing human and nonhuman materials in ways that could result in the development of human-nonhuman chimeras. This paper examines four arguments against such research, the moral taboo, species integrity, "unnaturalness," and human dignity arguments, and finds the last plausible. It argues that the transfer of human (...) brain or retinal stem cells to nonhuman embryos would not result in the development of human-nonhuman chimeras that denigrate human dignity, provided such stem cells are dissociated. The article provides guidelines that set ethical boundaries for conducting such research that are consonant with the requirements of human dignity. (shrink)

The present study had two main aims: to determine whether deaf children show higher rates of key behaviors of ADHD and of Conduct Disorder—CD— than hearing children, also examining whether the frequency of these behaviors in deaf children varied based on cochlear implant use, type of school and level of receptive vocabulary; and to determine whether any behavioral differences between deaf and hearing children could be explained by deficits in inhibitory control. We measured behaviors associated with ADHD and CD in (...) 34 deaf and hearing children aged 9–10 years old, using the revised Spanish version of the Conners scale. We then assessed inhibitory control ability using a computerized Stroop task and a short version of the Attention Network Test for children. To obtain a measure of the level of receptive vocabulary of the deaf children we used a Spanish version of the Carolina Picture Vocabulary Test for Deaf and hearing-impaired children. Deaf children showed significantly higher rates of behaviors associated with ADHD and CD, and over 85% of cases detected with high risk of ADHD-inattentive type in the entire present sample were deaf children. Further, in the group of deaf children a negative correlation was found between receptive vocabulary and frequency of disruptive, aggressive, or antisocial behaviors associated with CD. However, inhibitory control scores did not differ between deaf and hearing children. Our results suggested that the ADHD-related behaviors seen in deaf children were not associated with a deficit in inhibitory control, at least in the interference suppression subcomponent. An alternative explanation could be that these behaviors are reflecting an adaptive strategy that permits deaf children to access information from their environment which is not available to them via audition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hypermediated Art CriticismPamela G. Taylor (bio) and B. Stephen Carpenter II (bio)Technological media catapults our perception into what Marshall McLuhan called "new transforming vision and awareness."1 As our lives become more and more immersed in such technologies as television, film, and interactive computers, we find ourselves inundated with a heightened sense of mindfulness—an aesthetic experience made possible through such computer technological characteristics as hyperlinks, hypermedia, and hyperreality. In these (...) terms, the prefix "hyper" represents various linking devices inherent to computer technology that allure and transport us between, above, below, and toward vast areas of information, places, and peoples. Hypermediacy, according to Bob Cotton and Richard Oliver, is "an entirely new kind of media experience born from the marriage of TV and computer technologies. Its raw ingredients can be brought together in any combination. It is a medium that offers random access; it has no physical beginning, middle, or end."2 In other words, there is no set or static structure inherent in technological media. It is not so much an "anything goes" apparatus as it is an "anything is possible" system. The seemingly vast possibilities inherent to technological media offer us many and alternate views of the world.Just as technological media encourage multiple means of viewing the world, no single approach to art criticism can be considered dominant, as several methods, methodologies, and approaches exist for responding to [End Page 1] works of art. We conceive of art criticism as a complex means of making meanings about works of art and communicating those meanings to other people. Following the lead of art educator Terry Barrett,3 art criticism hinges on the four activities of describing, interpreting, judging, and theorizing about art. Barrett suggests that, although all four overlap, interpretation is the most important and most likely the most complex aspect of art criticism. Although interwoven with description, analysis, and judgment, interpretation of the meanings of individual works of art is of foremost concern in contemporary art criticism. Similarly, we situate hypermediated art criticism as a synthesis of our descriptions, interpretations, judgments, and theories—both verbal and visual—with the various ways in which computer technology facilitates the simultaneous existence, representation, storage, and presentation of these and other forms of meaning making about works of art.Hypermediated art criticism is built upon our own technological abilities to both create and follow divergent paths, ideas, and beliefs according to our choices. Hypermediated art criticism is inclusive of the ways that our choices change daily depending upon our situation, role, and purpose, or simply as a result of what we witness or experience in a moment. In the hypermediated criticism process, our ways of seeing and knowing change from a linear to multilinear perspective, from single to multilayered, and from static to mutable perception. Indeed, the disparate ways of seeing and knowing made possible through technological media and hypermedia provide us with an expansive and personally reflective approach to art criticism.Personal Reflection and Art CriticismMichael Joyce, known for his poetic approach to computer hypertext theory and fictional writing, says, "We are who we are. Layered and overlaid, we make a world within our bodies."4 Possibly now more than ever that world within our bodies can be represented, re-presented, and re-invented right before our eyes through technological media. Digital ethnographer Ricki Goldman-Segall refers to this technological world as a learning constellation in which "we are each composed of many selves, all of which interact with each other as we learn.... With the use of new computer technologies, we extend not only our technological abilities, but also our various personae—the societies of our minds—in the form of new objects for others to think with."5 In the classroom, hypermediated art criticism generated through computer technology functions just this way—as new objects that we, and our students, use to help us extend the ways in which we think about works of art.Contrary to the antihumanist approach so often associated with computer technology theory,6 our discussion of hypermediated art criticism—the symbiotic relationship of art criticism and technology—begins with the [End Page 2] basic assumption that a primary purpose of... (shrink)

Past work has demonstrated that people’s moral judgments can influence their judgments in a number of domains that might seem to involve straightforward matters of fact, including judgments about freedom, causation, the doing/allowing distinction, and intentional action. The present studies explore whether the effect of morality in these four domains can be explained by changes in the relevance of alternative possibilities. More precisely, we propose that moral judgment influences the degree to which people regard certain alternative possibilities as relevant, which (...) in turn impacts intuitions about freedom, causation, doing/allowing, and intentional action. Employing the stimuli used in previous research, Studies 1a, 2a, 3a, and 4a show that the relevance of alternatives is influenced by moral judgments and mediates the impact of morality on non-moral judgments. Studies 1b, 2b, 3b, and 4b then provide direct empirical evidence for the link between the relevance of alternatives and judgments in these four domains by manipulating (rather than measuring) the relevance of alternative possibilities. Lastly, Study 5 demonstrates that the critical mechanism is not whether alternative possibilities are considered, but whether they are regarded as relevant. These studies support a unified framework for understanding the impact of morality across these very different kinds of judgments. (shrink)

Philosophers have lately seized upon Sperling's partial report technique and subsequent work on iconic memory in support of controversial claims about perceptual experience, in particular that phenomenology overflows cognitive access. Drawing on mounting evidence concerning postdictive perception, I offer an interpretation of Sperling's data in terms of cue-sensitive experience which fails to support any such claims. Arguments for overflow based on change-detection paradigms (e.g. Landman et al., 2003; Sligte et al., 2008) cannot be blocked in this way. However, such paradigms (...) are fundamentally different from Sperling's and, for rather different reasons, equally fail to establish controversial claims about perceptual experience. (shrink)

Ethical issues surrounding the marketing and trade of controversial products such as tobacco require a better understanding. Virginia Slims, an exclusively women’s cigarette brand first launched in 1968 in the USA, was introduced during the mid 1980s to major Asian markets, such as Japan and Korea, dominated by male smokers. By reviewing internal corporate documents, made public from litigation, we examine the marketing strategies used by Philip Morris as they entered new markets such as Japan and Korea and consider the (...) extent that the company attempted to appeal to women in markets where comparatively few women were smokers. The case study of Virginia Slims reveals that the classification of “vulnerable” consumers is variable depending on culture, tobacco firms display responsive efforts and strategies when operating within a “mature” market, and cultural values played a role in informing Philip Morris’ strategic decision to embrace an adaptive marketing approach, particularly when entering the Korean market. Finally, moral questions are raised with tobacco being identified as a priority product for export and international trade agreements being used by corporations, governments, or trade partners in efforts to undermine domestic public health policies. (shrink)

This book applies Augustine's thought to current questions of teaching and learning. The essays are written in an accessible style and is not intended just for experts on Augustine or church history.

Orthodox interpretations of Sperling‘s partial report paradigm support the idea that there is substantially more in our streams of consciousness than we can attend to or recall. I propose an alternative, postdictive interpretation which fails to support any such conclusion. This account is defended at greater length in my ‗Perception and iconic memory‘. Here I focus on the role ascribed to attention by the rival interpretations. I argue that orthodox accounts fail to assign a plausible role to attention. In contrast, (...) I suggest a novel way in which heterodox, postdictive account can assign attention a plausible role. We should therefore prefer such accounts over their orthodox rivals. Consequently, Sperling‘s paradigm fails to probe the true extent of conscious awareness unfettered by limitations on attention or memory. (shrink)

Recent books by Paul Johnston, D. Z. Phillips, Philip Shields, and B. R. Tilghman all depict Wittgenstein as centrally concerned with ethics, but they range from representing his main works as expressing and advocating a particular religious-ethical outlook to arguing that his work has no ethical content but aims primarily to clarify such logical distinctions as that between ethical and empirical judgments. All four books raise the question about the moral philosopher's proper role, and each suggests a rather different (...) answer. Via the discussion of these books, I argue that Wittgenstein's stress on diversity in the ways of human life, his notion of conceptual grammar, the idea of a perspicuous representation, his lifelong involvement with art and his suggestions about its connection with morality, and his preoccupation with aspect-seeing-all suggest new possibilities of rehabilitating the historically recurrent idea that the philosopher may be a moral sage. (shrink)

Offering cash payments to research subjects is a common recruiting method, but this practice continues to be controversial because of its potential to compromise the protection of human subjects. Some critics question whether researchers should be allowed to offer money at all, citing concerns about commodification of the research subject, invalidation of study results, and increased risks to subjects. Other critics are comfortable with the idea of monetary payments but question how much researchers can pay their subjects, citing concerns about (...) undue inducement, crowding out, and monetary exploitation. Focusing only on the amount researchers can pay their subjects, this paper argues that the federal regulations and guidelines should implement a standard payment formula. It argues for a wage payment model, and critically examines three candidates for a base wage: the nonfarm production wage, the FLSA minimum wage, and a living wage. (shrink)

A Martian reading contemporary work on perception might be forgiven for thinking that humans had only one sense: vision. Witness the title of one popular recent collection: Vision and mind: selected readings in the philosophy of perception. Our obsession with sight is stifling. It leads to distorted vision-based models of the other senses, and it means that the distinctive puzzles raised by non-visual modalities are routinely neglected. With this pioneering and long-overdue collection of essays on auditory perception, Nudds and O’Callaghan (...) aim to start correcting this state of affairs. They deserve much praise, not least for their own substantial contributions and splendid introduction. (shrink)

Thirteen essays on the treatment of a criterion for truth by such classical writers as Parmenides, Protagoras, Plato, Aristotle, Theophrastus, Philo, Epicurius, the Stoics, Plotinus, and Ptolemy, whose neglected Greek work on the subject is included here, along with an annotated English translation. The price $LB12.50, has been estimated to US $24. Annotation copyrighted by Book News, Inc., Portland, OR.

(No abstract is available for this citation).

Discussions of socioeconomic liability and compensation must necessarily start from an understanding of the socioeconomic, legal, and scientific basis for identifying, assessing, managing, and apportioning blame for hazards related to innovations. Public discussions about the nature of the liability challenge related to genetically modified (GM) crops and other modified organisms have focused less on direct, traditional health, public safety, technical, or environmental failures (e.g., innovations that generate hazards directly for users or indirectly to bystanders) and more on socioeconomic concerns, such (...) as comingled product that offends product quality standards. This article examines the theoretical and legal underpinnings of the current risk analysis framework used in most Organization for Economic Cooperation and Development countries and uses it to assess two areas of significant controversy—the release of herbicide-tolerant canola and flax varieties in Western Canada. The article offers lessons for the management of liabilities arising from the introduction of GM crops. (shrink)

The FDA's new table of surrogate endpoints used for drug approvals is an important step forward for overseeing the use of biomarkers in clinical trials. Nevertheless, we present several ways in which the table can be improved.