As infancy is characterized by rapid physical growth and critical periods of development, disruptions due to illness or disease reveal vulnerability associated with this period. Spinal cord injury has devastating consequences at any age, but its onset neonatally, at birth, or within the first year of life multiplies its impact. The immediate physical and physiological consequences are obvious and immense, but the effects on the typical trajectory of development are profound. Activity-based restorative therapies capitalize on activity-dependent plasticity of the neuromuscular (...) system below the lesion and when provided to children with SCI aim to improve the child’s neuromuscular capacity, health and quality of life. This is a report of an infant with a cervical SCI at birth resulting in paralysis of leg and trunk muscles and paresis of arm and hands who was enrolled in an ABRT program at 3 years of age. After 59 sessions of ABRT, the child demonstrated significant improvements in trunk control and arm function, as well as social and emotional development. Despite the chronicity of injury and low expectations for improvement with therapeutic interventions, ABRT had a positive impact on the child’s physical capacity and provided benefits across multiple developmental domains. (shrink)

This paper aims to critique the phenomenon of advanced patient autonomy and choice in healthcare within the specific context of self-testing devices. A growing number of self-testing medical devices are currently available for home use. The premise underpinning many of these devices is that they assist individuals to be more autonomous in the assessment and management of their health. Increased patient autonomy is assumed to be a good thing. We take issue with this assumption and argue that self-testing provides a (...) specific example how increased patient autonomy and choice within healthcare might not best serve the patient population. We propose that current interpretations of autonomy in healthcare are based on negative accounts of liberty to the detriment of a more relational understanding. We also propose that Kantian philosophy is often applied to the healthcare arena in an inappropriate manner. We draw on the philosophical literature and examples from the self-testing process to support these claims. We conclude by offering an alternative account of autonomy based on the interrelated concepts of relationality, care and responsibility. (shrink)

Diagnostic self-testing devices are being developed for many illnesses, chronic diseases and infections. These will be used in hospitals, at point-of-care facilities and at home. Designed to allow earlier detection of diseases, self-testing diagnostic devices may improve disease prevention, slow the progression of disease and facilitate better treatment outcomes. These devices have the potential to benefit both the individual and society by enabling individuals to take a more proactive role in the maintenance of their health and by helping society improve (...) health and reduce health costs. However, the full implications of future home-based diagnostic technology for individuals and society remain unclear due to their novelty. We argue that the development of diagnostic tools, especially for home use, will heighten a number of ethical challenges. This paper will explore some of the ethical implications of home-based self-testing diagnostic devices for the autonomous and relational dimensions of the person. This will be facilitated by examining the impact of diagnostic devices for individual autonomy, for the delivery of accurate diagnosis and for the personal significance of the information for the user. The latter will be examined using Charles Taylor's view of personhood and his emphasis on human agency and interpretation. While the ethical issues are not necessarily new, the development of home-based self-testing diagnostic devices will make issues regarding autonomy, accuracy of information and personal significance more and more demanding. This will be the case particularly when an individual's autonomous choices come into conflict with the person's relational responsibilities. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

This paper offers an account of a fallacy we will call bothsiderism, which is to mistake disagreement on an issue for evidence that either a compromise on, suspension of judgment regarding, or continued discussion of the issue is in order. Our view is that this is a fallacy of a unique and heretofore untheorized type, a fallacy of meta-argumentation. The paper develops as follows. After a brief introduction, we examine a recent bothsiderist case in American politics. We use this as (...) a pivot point to survey the theoretical literature on the fallacy. The most prominent theory is that bothsiderism is a case of dialogue-shifting. This view fails, we maintain, to explain how bothsiderism might be persuasive. We argue, rather, bothsiderism is a kind of meta-argumentative fallacy. (shrink)

The straw man fallacy consists in inappropriately constructing or selecting weak versions of the opposition’s arguments. We will survey the three forms of straw men recognized in the literature, the straw, weak, and hollow man. We will then make the case that there are examples of inappropriately reconstructing stronger versions of the opposition’s arguments. Such cases we will call iron man fallacies. The difference between appropriate and inappropriate iron manning clarifies the limits of the virtue of open-mindedness.

This article presents the results of a study that investigated the roles that religiosity and ones money ethic play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. One dimension of religiosity – intrinsic religiousness – was studied. Four separate dimensions of a money ethic scale were initially examined, but only one was used in the final analyses. Results indicated that both intrinsic religiousness and one’s money ethic were significant determinants of most types of consumer ethical beliefs.

John Dewey points out in A Common Faith (1934) that what stands in the way of religious belief for many is the apparent commitment of Western religious traditions to supernatural phenomena and questionable historical claims. We are to accept claims that in any other context we would find laughable. Are we to believe that water can be turned into wine without the benefit of the fermentation process? Are we to swallow the claim that there is such a phenomenon as the (...) spontaneous conception of a child without the intervention of the traditional technique? Were we to confront these claims in any but a religious context, we would dismiss them as the workings of an overactive imagination or simple cover for an overactive sex life. But for the devout believer, there is no doubt even with a paucity of evidence. At the same time, the rise of science has forcibly suggested the idea that the natural world is self-contained and, if explainable, that explanation will come from within. There seems to be no room for the traditional God and, much as one might wish otherwise, nothing for him to do. Perhaps... (shrink)

This article presents the results of a study that investigated the role that religiosity plays in determining consumer attitudes/beliefs regarding various questionable consumer practices. Additionally, other personal factors were examined including idealism, relativism, consumer alienation and selected demographics such as income and age. All of these constructs were examined as antecedents of consumer ethical beliefs. The results of a post hoc analysis indicated that religiosity was a significant determinate of both idealism and relativism, and since idealism and relativism determine consumer (...) ethical beliefs, religiosity is a significant indirect determinate of consumer ethical beliefs. (shrink)

This article presents the results of an exploratory study that investigated the role that religiosity plays in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity – intrinsic and extrinsic religiousness – were studied. Results indicated that an intrinsic religiousness was a significant determinant of consumer ethical beliefs, but extrinsic religiousness was not related to those beliefs.

This article presents the results of a study that investigated the roles that one's money ethic, religiosity and attitude toward business play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity - intrinsic and extrinsic religiousness - were studied. A global scale of money ethic was examined, as was a global measure of attitude toward business. Results indicate that both types of religiosity as well as one's money ethic and attitude toward business were significant (...) determinants of at least some types of consumer ethical beliefs. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

The ethics literature has identified moral motivation as a factor in ethical decision-making. Furthermore, moral identity has been identified as a source of moral motivation. In the current study, we examine religiosity as an antecedent to moral identity and examine the mediating role of self-control in this relationship. We find that intrinsic and extrinsic dimensions of religiosity have different direct and indirect effects on the internalization and symbolization dimensions of moral identity. Specifically, intrinsic religiosity plays a role in counterbalancing the (...) negative impact of extrinsic religiosity on the internalization of moral identity. Further, intrinsic religiosity also counterbalances the negative and indirect impact of extrinsic religiosity on symbolization of moral identity via self-control. Lastly, self-control does not play a mediating role in the impact of religiosity on the internalization dimension of moral identity. We conclude that this study presents important findings that advance our understanding of the antecedents of moral identity, and that these results may have implications for the understanding of ethical decision-making. (shrink)

Many of the activities of clinical practice happen to, with or upon vulnerable human beings. For this reason numerous nursing authors draw attention to or claim a significant moral domain in clinical practice. A number of nursing authors also discuss the emotional involvement and/or emotional labour which is often experienced in clinical practice. In this article I explore the importance of emotion for moral perception and moral agency. I suggest that an aspect of being a good nurse is having an (...) emotional sensitivity to other human beings (patients), because this emotional sensitivity allows the nurse to perceive more accurately the context and perspective of the patient. It is thus important to the moral agency of the nurse and to morally sensitive clinical practice. As such education of the emotions should be a feature of the moral education of the nurse. A useful conception of the role of educated emotion in the moral life can be discovered in Aristotelian ethics. (shrink)

This study examined the effect of various antecedent variables on marketers’ perceptions of the role of ethics and socialresponsibility in the overall success of the firm. Variables examined included Hofstede’s cultural dimensions (i.e., power distance, uncertainty avoidance, individualism, masculinity, and Confucian dynamism), as well as corporate ethical values and enforcement ofan ethics code. Additionally, individual variables such as ethical idealism and relativism were included. Results indicated that most ofthese variables impacted marketers’ perceptions of the importance of ethics and social responsibility, (...) although to varying degrees. (shrink)

The visual world of adults consists of objects at various distances, partly occluding one another, substantial and stable across space and time. The visual world of young infants, in contrast, is often fragmented and unstable, consisting not of coherent objects but rather surfaces that move in unpredictable ways. Evidence from computational modeling and from experiments with human infants highlights three kinds of learning that contribute to infants’ knowledge of the visual world: learning via association, learning via active assembly, and learning (...) via visual-manual exploration. Infants acquire knowledge by observing objects move in and out of sight, forming associations of these different views. In addition, the infant’s own self-produced behavior—oculomotor patterns and manual experience, in particular—is an important means by which infants discover and construct their visual world. (shrink)

This paper situates the moral domain of practice within the context of a particular description of nursing practice – one that sees human interaction at the heart of that practice. Such a description fits not only with professional rhetoric but also with literature from patients and recent empirical work exploring the nature of nursing practice.Martha Levine in her 1977 description of ethics, within the context of nursing practice, indicated that what was important from an ethical perspective was how we interact (...) with each other, with patients and colleagues, on a daily basis. What enables such interaction to display moral sensitivity, insight into patient need, and a focus on the good for the patient? Of relevance when answering this question is the empirical evidence indicating that professional socialization, as a nurse or a doctor, may dull the individual’s moral sense. If this is the case, cognizance needs to be taken of such evidence when identifying theoretical approaches from mainstream ethics that may provide insight and value for nurse education. It is suggested that such insight and value can be gained from a consideration of the work of Aristotle, Murdoch, and Vetlesen. (shrink)

Moral injury emerged in the healthcare discussion quite recently because of the difficulties and challenges healthcare workers and healthcare systems face in the context of the COVID-19 pandemic. Moral injury involves a deep emotional wound and is unique to those who bear witness to intense human suffering and cruelty. This article aims to synthesise the very limited evidence from empirical studies on moral injury and to discuss a better understanding of the concept of moral injury, its importance in the healthcare (...) context and its relation to the well-known concept of moral distress. A scoping literature review design was used to support the discussion. Systematic literature searches conducted in April 2020 in two electronic databases, PubMed/Medline and PsychInfo, produced 2044 hits but only a handful of empirical papers, from which seven well-focused articles were identified. The concept of moral injury was considered under other concepts as well such as stress of conscience, regrets for ethical situation, moral distress and ethical suffering, guilt without fault, and existential suffering with inflicting pain. Nurses had witnessed these difficult ethical situations when faced with unnecessary patient suffering and a feeling of not doing enough. Some cases of moral distress may turn into moral residue and end in moral injury with time, and in certain circumstances and contexts. The association between these concepts needs further investigation and confirmation through empirical studies; in particular, where to draw the line as to when moral distress turns into moral injury, leading to severe consequences. Given the very limited research on moral injury, discussion of moral injury in the context of the duty to care, for example, in this pandemic settings and similar situations warrants some consideration. (shrink)

The Heythrop Journal, Volume 63, Issue 4, Page 807-816, July 2022.

To better illuminate aspects of stress that are relevant to the moral domain, we present a definition and theoretical model of “moral stress.” Our definition posits that moral stress is a psychological state born of an individual’s uncertainty about his or her ability to fulfill relevant moral obligations. This definition assumes a self-and-others relational basis for moral stress. Accordingly, our model draws from a theory of the self (identity theory) and a theory of others (stakeholder theory) to suggest that this (...) uncertainty arises as a manager faces competing claims for limited resources from multiple stakeholders and/or across multiple role identities. We further propose that the extent to which the manager is attentive to the moral aspects of the claims (i.e., moral attentiveness) moderates these effects. We identify several consequences of managerial moral stress and discuss theoretical, empirical, and practical implications of our approach. Most importantly, we argue that this work paves an important path for considering stress through the lens of morality. (shrink)

Modernism is both a contested aesthetic category and a powerful political statement. Modernist music was condemned as degenerate by the Nazis and forcibly replaced by socialist realism under the Soviets. Sympathetic philosophers and critics have interpreted it as a vital intellectual defence against totalitarianism, yet some American critics consider it elitist, undemocratic, and even unnatural. Drawing extensively on the philosophy of Heidegger and Badiou, Quilting Points proposes a new dialectical theory of faithful, reactive, and obscure subjective responses to musical modernism, (...) which embraces all the music of Western modernity. (shrink)

The repercussions of unconscious priming on the neural correlates subsequent cognition have been explored previously. However, the neural dynamics during the unconscious processing remains largely uncharted. To assess both the complexity and temporal dynamics of unconscious cognition the present study contrasts the evoked response from classes of masked stimuli with three different levels of complexity; words, consonant strings, and blanks. The evoked response to masked word stimuli differed from both consonant strings and blanks, which did not differ from each other. (...) This response was qualitatively different to any evoked potential observed when stimuli were consciously visible and peaked at 140 ms, earlier than is usually associated with differences between words and strings and 100 ms earlier than word-consonant string differences in the visible condition. The evoked response demonstrates a qualitatively distinct signature of unconscious cognition and directly demonstrates the extraction of abstract information under subliminal conditions. (shrink)

Question processing involves parsing, memory retrieval, question categorization, initiation of appropriate answer‐retrieval heuristics, answer formulation, and output. Computational and psychological models have traditionally treated these processes as separate, sequential, independent, and in pursuit of a single answer type at a time. Here this view is challenged and the implications of a theory in which question processes operate simultaneously on multiple question interpretations are explored. A highly interactive model is described in which an expectation‐driven parser generates multiple question candidates, including partially‐specified (...) candidates. Question candidates act as constraints for a matcher which activates memory items. An answer retrieval process examines question candidates and the active portions of memory in an attempt to generate answer candidates. Answer candidates are examined by an output process that derives the final answer. These processes run simultaneously and interact. Three experiments on human question answering are also described which provide evidence that working memory load during question reading is affected by processes related to answer retrieval. (shrink)

This article presents the results of a study that investigated the roles that one’s money ethic, religiosity and attitude toward business play in determining consumer attitudes/beliefs in various situations regarding questionable consumer practices. Two dimensions of religiosity – intrinsic and extrinsic religiousness – were studied. A global scale of money ethic was examined, as was a global measure of attitude toward business. Results indicate that both types of religiosity as well as one’s money ethic and attitude toward business were significant (...) determinants of at least some types of consumer ethical beliefs. (shrink)

A review of the literature on palliative care in the United Kingdom over the last fifteen years suggests that elements such as the development of the modern hospice, on the model developed by Cicely Saunders, have led to major improvements in the lot of the terminally ill.

Despite recent advances in HIV prevention and treatment, high HIV incidence persists among people who inject drugs. Difficult legal and political environments and lack of services for PWID likely contribute to high HIV incidence. Some advocates question whether any HIV prevention research is ethically justified in settings where healthcare system fails to provide basic services to PWID and where implementation of research findings is fraught with political barriers. Ethical challenges in research with PWID include concern about whether research evidence will (...) be translated into practice; concerns that research might exacerbate background risks; and ethical challenges regarding the standard of HIV prevention in research. While these questions arise in other research settings, for research with PWID, these questions are especially controversial. This paper analyses four ethical questions in determining whether research could be ethically acceptable: Can researchers ensure that research does not add to the burden of social harms and poor health experienced by PWID? Should research be conducted in settings where it is uncertain whether research findings will be translated into practice? When best practices in prevention and care are not locally available, what standard of care and prevention is ethically appropriate? Does the conduct of research in settings with oppressive policies constitute complicity? We outline specific criteria to address these four ethical challenges. We also urge researchers to join the call to action for policy change to provide proven safe and effective HIV prevention and harm reduction interventions for PWID around the world. (shrink)