Nurses and physicians may experience ethical conflict when there is a difference between their own values, their professional values or the values of their organization. The distribution of limited health care resources can be a major source of ethical conflict. Relatively few studies have examined nurses' and physicians' ethical conflict with organizations. This study examined the research question ‘What are the organizational ethical conflicts that hospital nurses and physicians experience in their practice?’ We interviewed 34 registered nurses, 10 nurse managers, (...) and 31 physicians as part of a larger study, and asked them to describe their ethical conflicts with organizations. Through content analysis, we identified themes of nurses' and physicians' ethical conflict with organizations and compared the themes for nurses with those for physicians. (shrink)

Much of the literature on clinical ethical conflict has been specific to a specialty area or a particular patient group, as well as to a single profession. This study identifies themes of hospital nurses’ and physicians’ clinical ethical conflicts that cut across the spectrum of clinical specialty areas, and compares the themes identified by nurses with those identified by physicians. We interviewed 34 clinical nurses, 10 nurse managers and 31 physicians working at four different Canadian hospitals as part of a (...) larger study on clinical ethics committees and nurses’ and physicians’ use of these committees. We describe nine themes of clinical ethical conflict that were common to both hospital nurses and physicians, and three themes that were specific to physicians. Following this, we suggest reasons for differences in nurses’ and physicians’ ethical conflicts and discuss implications for practice and research. (shrink)

Formal models of argumentation have been investigated in several areas, from multi-agent systems and artificial intelligence (AI) to decision making, philosophy and law. In artificial intelligence, logic-based models have been the standard for the representation of argumentative reasoning. More recently, the standard logic-based models have been shown equivalent to standard connectionist models. This has created a new line of research where (i) neural networks can be used as a parallel computational model for argumentation and (ii) neural networks can be used (...) to combine argumentation, quantitative reasoning and statistical learning. At the same time, non-standard logic models of argumentation started to emerge. In this paper, we propose a connectionist cognitive model of argumentation that accounts for both standard and non-standard forms of argumentation. The model is shown to be an adequate framework for dealing with standard and non-standard argumentation, including joint-attacks, argument support, ordered attacks, disjunctive attacks, meta-level attacks, self-defeating attacks, argument accrual and uncertainty. We show that the neural cognitive approach offers an adequate way of modelling all of these different aspects of argumentation. We have applied the framework to the modelling of a public prosecution charging decision as part of a real legal decision making case study containing many of the above aspects of argumentation. The results show that the model can be a useful tool in the analysis of legal decision making, including the analysis of what-if questions and the analysis of alternative conclusions. The approach opens up two new perspectives in the short-term: the use of neural networks for computing prevailing arguments efficiently through the propagation in parallel of neuronal activations, and the use of the same networks to evolve the structure of the argumentation network through learning (e.g. to learn the strength of arguments from data). (shrink)

To investigate the current status of hospital clinical ethics committees (CEC) and how they have evolved in Canada over the past 20 years, this paper presents an overview of the findings from a 2008 survey and compares these findings with two previous Canadian surveys conducted in 1989 and 1984. All Canadian hospitals over 100 beds, of which at least some were acute care, were surveyed to determine the structure of CEC, how they function, the perceived achievements of these committees and (...) opinions about areas with which CEC should be involved. The percentage of hospitals with CEC in our sample was found to be 85% compared with 58% and 18% in 1989 and 1984, respectively. The wide variation in the size of committees and the composition of their membership has continued. Meetings of CEC have become more regularised and formalised over time. CEC continue to be predominately advisory in their nature, and by 2008 there was a shift in the priority of the activities of CEC to meeting ethics education needs and providing counselling and support with less emphasis on advising about policy and procedures. More research is needed on how best to define what the scope of activities of CEC should be in order to meet the needs of hospitals in Canada and elsewhere. More research also is needed on the actual outcomes to patients, families, health professionals and organisations from the work of these committees in order to support the considerable time committee members devote to this endeavour. (shrink)

Hospitals in many countries have had clinical ethics committees for over 20 years. Despite this, there has been little research to evaluate these committees and growing evidence that they are underutilized. To address this gap, we investigated the question ‘What are the barriers and facilitators nurses and physicians perceive in consulting their hospital ethics committee?’ Thirty-four nurses, 10 nurse managers and 31 physicians working at four Canadian hospitals were interviewed using a semi-structured interview guide as part of a larger investigation. (...) We used content analysis of the interview data related to barriers and facilitators to use of hospital ethics committees to identify nine categories of barriers and nine categories of facilitators. These categories as well as their subcategories are discussed and those specific to nurses or physicians are identified. The need to increase health professionals' use of clinical ethics committees through reducing barriers and maximizing facilitators is discussed. (shrink)

Open peer commentary on the article “Investigating Extended Embodiment Using a Computational Model and Human Experimentation” by Yuki Sato, Hiroyuki Iizuka & Takashi Ikegami. Upshot: First, we comment on a potential weakness highlighted by the use of self-reporting in the human-coupled windmill experiment as described in the target article. Second, we suggest that the authors treat their windmill models as soft-assembled dynamical systems. This would allow them to investigate extended body schemes by looking for 1/f noise in the interface between (...) the agent and the windmills. (shrink)

This report explores the relationship between philosophy and medicine in the U.K. We note that medical training involves very little formal instruction in philosophy and ethics, and that, with few exceptions, philosophers in the U.K. do not contribute to the instruction of physicians or the philosophy of medicine. However, reviewing the problems arising out of recent developments within scientific medicine we find a pressing need for future philosophical analysis in the following areas: psychiatry, organ transplantation, abortion, euthanasia, experiments on living (...) subjects, consent, confidentiality, the relationship between medicine and political authority, and the provisions for social justice in medicine. (shrink)

The authors conducted a baseline survey of baccalaureate and graduate degree health humanities programs in the United States and Canada. The object of the survey was to formally assess the current state of the field, to gauge what kind of resources individual programs are receiving, and to assess their self-identified needs to become or remain programmatically sustainable, including their views on the potential benefits of program accreditation. A 56-question baseline survey was sent to 111 institutions with baccalaureate programs and 20 (...) institutions with graduate programs. Respondents were asked about three areas: (1) program administration (managing unit, paid director, faculty lines, paid staff, funding sources); (2) educational program (curricular structure, CIP code usage, completion rates); and (3) views on accreditation for the field. A clear majority of respondents agreed that some form of accreditation or consultation service could address resource and sustainability issues. Overall, the survey responses to staffing, curricular structure, and support suggest the need for developing a sustainable infrastructure for health humanities. (shrink)

A multiple-case study of four hospital ethics committees in Canada was conducted and data collected included interviews with key informants, observation of committee meetings and ethics-related hospital documents, such as policies and committee minutes. We compared the hospital committees in terms of their structure, functioning and perceptions of key informants and found variation in the dimensions of empowerment, organizational culture of ethics, breadth of ethics mandate, achievements, dynamism, and expertise.

Background: The division of non-paid labor in heterosexual parents in the West is usually still gender-based, with mothers taking on the majority of direct caregiving responsibilities. However, in same-sex couples, gender cannot be the deciding factor. Inspired by Feinberg’s ecological model of co-parenting, this study investigated whether infant temperament, parent factors (biological relatedness to child, psychological adjustment, parenting stress, and work status), and partner relationship quality explained how first-time gay, lesbian, and heterosexual parents divided labor (childcare and family decision-making) when (...) their infants were four months and 12 months old. We also tested whether family type acted as a moderator. Method: Participants were drawn from [MASKED FOR REVIEW]. Only those who provided information about their biological relatedness (yes or no) to their child (N = 263 parents) were included. When infants were four months (T1), parents completed a password-protected online questionnaire exploring their demographic characteristics including work status and standardized online-questionnaires on task division (childcare and family decision-making), infant temperament, parental anxiety, parental depression, parental stress, and partner relationship satisfaction. When infants were 12-months-old (T2), parents provided information about task division and their biological relatedness to their children. Results: Linear mixed models showed that no factor explained the division of family decision making at T1 and T2. For relative time spent on childcare tasks at T1, biological relatedness mattered for lesbian mothers only: biologically related mothers appeared to spend more time on childcare tasks than did non-related mothers. Results showed that, regardless of family type, parents who were not working or were working part-time at T1 performed more childcare tasks at T1. This was still true at T2. The other factors did not significantly contribute to relative time spent on childcare tasks at T2. Conclusion: We had the opportunity to analyze the division of non-paid tasks in families where parenting was necessarily planned and in which gender could not affect that division. Although Feinberg’s model of co-parenting suggests that various factors are related to task division, we found that paid work outside the home was most important during the first year of parenthood in determining caregiving roles. (shrink)

Ideas about heredity and evolution are undergoing a revolutionary change. New findings in molecular biology challenge the gene-centered version of Darwinian theory according to which adaptation occurs only through natural selection of chance DNA variations. In Evolution in Four Dimensions, Eva Jablonka and Marion Lamb argue that there is more to heredity than genes. They trace four "dimensions" in evolution -- four inheritance systems that play a role in evolution: genetic, epigenetic, behavioral, and symbolic. These systems, they argue, can (...) all provide variations on which natural selection can act. Evolution in Four Dimensions offers a richer, more complex view of evolution than the gene-based, one-dimensional view held by many today. The new synthesis advanced by Jablonka and Lamb makes clear that induced and acquired changes also play a role in evolution.After discussing each of the four inheritance systems in detail, Jablonka and Lamb "put Humpty Dumpty together again" by showing how all of these systems interact. They consider how each may have originated and guided evolutionary history and they discuss the social and philosophical implications of the four-dimensional view of evolution. Each chapter ends with a dialogue in which the authors engage the contrarieties of the fictional "I.M.," or Ifcha Mistabra -- Aramaic for "the opposite conjecture" -- refining their arguments against I.M.'s vigorous counterarguments. The lucid and accessible text is accompanied by artist-physician Anna Zeligowski's lively drawings, which humorously and effectively illustrate the authors' points. (shrink)

This book explores why, regarding practical reasoning, humans are sometimes still faster than artificial intelligence systems. It is the first to offer a self-contained presentation of neural network models for many computer science logics.

Introducing Applied Ethics Edited by Brenda Almond, Blackwell, 1995. Pp. 375. ISBN 0-631-19389-8. 45.00 (hbk), 14.99 (pbk). Environmental Ethics Edited by Robert Elliot, Oxford University Press, 1995. Pp. 255. ISBN 9-19-875144-3. 9.95 (pbk) Medicine and Moral Reasoning Edited by K.W.M. Fulford, Grant Gillett and Janet Martin Soskice Cambridge University Press, 1994. Pp. 207. ISBN 0-521-45325-9 37.50 (hbk), 12.95 (pbk). Enlightenment and Religion. Rational Dissent in Eighteenth-century Britain Edited by Knud Haakonssen, Cambridge University Press, 1996. Pp. xii + 348. ISBN 0-521-56060-8. (...) 40.00. Dialettica, Arte e Societ : Saggio su Theodor W. Adorno By Giacomo Rinaldi, Quattroventi, Urbino, 1994. Pp. 205. L. 30,000. Relevance: Communication and Cognition, new revised edition, By Dan Sperber and Deirdre Wilson, Blackwell, 1995. Pp. 326. ISBN 0-631-19878-4. 15.99. Autobiographical Reflections By Eric Voegelin (Edited, with Introduction, by Ellis Sandoz), Louisiana State University Press, 1996. Pp. 131. ISBN 0807120766 $10.95. (shrink)

Many philosophers who support a four-dimensionalist metaphysics of things also conceive of experience as a state of a mind having temporal extension or existing as a momentary feature of the dimension of time. This essay shows that such a strict four-dimensionalism — suggested in works by D. M. Armstrong, Mark Heller, and David Lewis — cannot be correct, since it cannot allow for the passing of time that is essential to awareness. The argument demonstrates that the positing of any temporal (...) process at all must compromise the strict four-dimensionalist view of the temporality of experience. This is not to say that the traditional endurantist view is left wholeheartedly endorsed. As I point out, this traditional view makes several questionable claims of its own that must be carefully scrutinized. Still, the criticism of the strict four-dimensionalist ontology indicates a direction to be followed in developing a successful metaphysics of experience. (shrink)

Taylor, R. A tribute.--Epistemology: Cornman, J. W. Chisholm on sensing and perceiving. Ross, J. F. Testimonial evidence. Lehrer, K. Reason and consistency. Keim, R. Epistemic values and epistemic viewpoints. Hanen, M. Confirmation, explanation, and acceptance. Canfield, J. V. "I know that I am in pain" is senseless. Steel, T. J. Knowledge and the self-presenting.--Metaphysics: Cartwright, R. Scattered objects. Duggan, T. J. Hume on causation. Arnaud, R. B. Brentanist relations. Johnson, M. L., Jr. Events as recurrables.--Ethics: Stevenson, J. T. On doxastic (...) responsibility. Feldman, F. World utilitarianism. Lamb, J. W. Some definitions for the theory of rules. Donnelly, J. Suicide: some epistemological considerations. (shrink)

Like many other locals, I was unprepared for the global media's invasion of Roslin. The former mining village just outside the southern city limits is best known to most Edinburgh citizens for its tiny, ornately carved medieval chapel. Constructed for Crusading Knights and long associated with Freemasons, Rosslyn Chapel was made famous by Sir Walter Scott's LayoftheLastMinstrel. Nowadays it is visited, in coachloads, by devotees of less literary and historically more dubious esoterica, many of whom believe that the Holy Grail (...) and/or a version of the gospels are buried beneath it. In the local media, demands for the chapel's foundations to be excavated in search of secret clues to the meaning of life, death, and everything, have figured just as prominently as articles agonizing over scientific developments at the Roslin Institute, half a country mile away. (shrink)

Hamaker's conjecture κομâ at Lysias 16.18 was adopted by Rauchenstein in his influential edition of 1869 and soon given powerful endorsement by Jebb and by Shuckburgh. Successive later editors and commentators have seen no reason to demur: Thalheim, Adams, Hude, Gernet and Bizos, Lamb, and finally Edwards and Usher all adopt κομâ, and, where they comment, unanimously cite Aristophanic parallels in support of a connection between longhaired affectation and ‘oligarchic’ affiliations; some also adduce the expression ảπ’Ψεως in justification. But (...) this is an egregious instance of unwarranted tampering with a sound text. τóλμα is a quality conspicuously displayed by Mantitheus, on his own account of his character, words, and actions. (shrink)

Hamaker's conjecture κομâ (for τολμâ,sic) at Lysias 16.18 was adopted by Rauchenstein in his influential edition of 1869 and soon given powerful endorsement by Jebb and by Shuckburgh. Successive later editors and commentators have seen no reason to demur: Thalheim, Adams, Hude, Gernet and Bizos, Lamb, and finally Edwards and Usher all adopt κομâ, and, where they comment, unanimously cite Aristophanic parallels (especiallyEq.580) in support of a connection between longhaired affectation and ‘oligarchic’ affiliations; some also adduce the expression ảπ’ὂΨεως (...) in justification. But this is an egregious instance of unwarranted tampering with a sound text. τóλμα is a quality conspicuously displayed by Mantitheus, on his own account of his character, words, and actions. (shrink)

Dolly is a lamb that was cloned by Dr. Ian Wilmut, a Scottish embryologist. But she is also a Rorschach test. The public response to the production of a lamb by cloning a cultured cell line reflects the futuristic fantasies and Frankenstein fears that have more broadly surrounded research in genetics and especially genetic engineering. Cloning was a term originally applied to a botanical technique of asexual reproduction. But following early experiments in the manipulation of the hereditary and (...) reproductive process during the mid-1960s, the term became associated with human biological engineering. It also became a pervasive theme in horror films and science fiction fantasies. Appearing to promise both amazing new control over nature and terrifying dehumanization, cloning has gripped the popular imagination. (shrink)

The prospects for a complete stochastic theory of microscopic phenomena are considered. The two traditional schools of stochastic physics, the diffusion process school and the zero-point electromagnetic field school, are reviewed. A completely relativistic theory, stochastic field theory, is proposed as an extension of the ideas of these two schools. Within the context of stochastic field theory we present the following new results: an elementary stochastization scheme which produces the zero-point electromagnetic field; a physical interpretation of the mathematical methods developed (...) by Lukosz for calculating zero-point energies; a calculation of the first-order Lamb shift which generalizes that of Welton; a new setting for a finite-temperature theory; and comments on the bag model for quark confinement. (shrink)