Multiprofessional guidelines for fair access to and use of adult critical care services are desperately needed to define a consistent transparent standard of care: when such therapies have the potential to benefit and help a patient as they journey with illness and when they cannot.

The ethics sections of Critical Care Societies have issued position statements and proposed a variety of position papers and policies describing the appropriate use of critical care services. These policies describe the goals of critical care provision — to support a patient through an acute, potentially reversible, life-threatening illness — and provide broad guidance on physiological and hemodynamic criteria that require the specialized care of an ICU environment. In recent years, many critical care professionals have, however, reported providing care they (...) felt was inappropriate or futile even though most felt they should not have done so. Futile care encompasses treatments that will not work or treatments that have no chance of providing any benefit. ICU teams define care as inappropriate when it fails to restore a person to an awareness of self, and an ability to interact with their environment particularly when a lot of critical care resources are required. When patients experience significant amounts of pain and suffering, such care seems even more inappropriate. (shrink)

BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were (...) exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many (...) were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying (...) ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. (shrink)

Although there is evidence parent–child attachment security is associated with trait-like emotion indices, trait perspectives do not fully capture children's responses to context, an important emotion regulation component. This paper evaluates whether attachment is associated with two dynamic emotion indicators: emotion reactivity and emotion recovery. We review conceptual and empirical connections, describe the dynamic emotion perspective, discuss hypotheses, and review evidence. Our review (15 studies) shows that secure attachment was more consistently related to recovery than reactivity, avoidant attachment was related (...) to low emotion reactivity and recovery, ambivalent attachment was associated with greater emotion reactivity, and disorganized attachment was related to high reactivity and recovery difficulties. We close by comparing trait-like and dynamic emotion conclusions then propose future research directions. (shrink)

Current work on hooking up—or casual sexual activity on college campuses—takes an individualistic, “battle of the sexes” approach and underestimates the importance of college as a classed location. The authors employ an interactional, intersectional approach using longitudinal ethnographic and interview data on a group of college women’s sexual and romantic careers. They find that heterosexual college women contend with public gender beliefs about women’s sexuality that reinforce male dominance across both hookups and committed relationships. The four-year university, however, also reflects (...) a privileged path to adulthood. The authors show that it is characterized by a classed self-development imperative that discourages relationships but makes hooking up appealing. Experiences of this structural conflict vary. More privileged women struggle to meet gender and class guidelines for sexual behavior, placing them in double binds. Less privileged women find the class beliefs of the university foreign and hostile to their sexual and romantic logics. (shrink)

New developments in genetics could affect a variety of real property rights. Mortgage lenders, mortgage insurers, real estate sellers, senior living centers, retirement communities, or other parties in residential real estate transactions begin requiring predictive genetic information as part of the application process. One likely use would be by retirement communities to learn an individual's genetic risk for Alzheimer's disease. The federal Fair Housing Act prohibits discrimination based on disability, but it is not clear that it would apply to genetic (...) risk assessments. Only California law explicitly applies to this situation and there have been no reported cases. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

The definitive book on ethics for chemical dependency treatment professionals.

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

Time processing is a multifaceted skill crucial for managing different aspects of life. In the current work, we explored the relationship between interoception and time processing by examining research on clinical models. We investigated whether time processing deficits are associated with dysfunction of the interoceptive system and/or insular cortex activity, which is crucial in decoding internal body signaling. Furthermore, we explored whether insular activation predicts the subjective experience of time (that is, the subjective duration of a target stimulus to be (...) timed). Overall, our work suggests that alteration of the interoceptive system could be a common psychophysiological hallmark of mental disorders affected by time processing deficits. (shrink)

ABSTRACTUnmarried and childless women are frequently portrayed negatively in society. Social storytelling often renders them discriminated against, or in extreme cases, outcast by their kin or clan. Twelve semi-structured interviews were conducted with never married women to explore the concept of femininity, constructions of identity in daily-life, identity changes over time, marital status, and the interaction between having not married and womanhood. Data specifically relating to self-definitions of femininity and marital status concentrate on the speakers’ constructions of themselves as both (...) the subject and the object of their own reflective enquiry. Four key themes emerged through the analysis: ‘Being Never Married’; ‘Society’s Perceptions’; ‘Being Feminine’; and ‘The Self and Transitions’. This study facilitates understanding of never married women’s relationship with themselves, their gender identity, and marital status; and is key to understanding how this population discusses their marginalisation in society. (shrink)

Lack of specificity around stakeholder identity remains a serious obstacle to the further development of stakeholder theory andits adoption in actual practice by business managers. Nowhere is this shortcoming more evident than in stakeholder theory’s treatment of the constituency known as “community.”In this paper we attempt to set forth what we call “the Problem of Community” as indicative of the definitional problems of stakeholdertheory. We then begin the process of gaining greater specificity around our notions of community and the role (...) of community in stakeholder theory and management. In doing so, we identify the emergence of two fairly new forms of community that we believe are particularly relevant to the stakeholder theorist and practicing manager. These two new variants of community—the virtual advocacy group and the community of practice—extend the notion of community in new directions, which have strikingly different implications for stakeholder theory and practice. (shrink)

The 2006 outbreak of E. coli O157:H7, traced to bagged spinach from California, illustrates a number of contradictions. The solutions sought by many politicians and popular food analysts have been to create a centralized federal agency and a uniform set of production standards modeled after those of the animal industry. Such an approach would disproportionately harm smaller-scale producers, whose operations were not responsible for the epidemic, as well as reduce the agroecological diversity that is essential for maintaining healthy human beings (...) and ecosystems. Why should responses that only reinforce the problem be proffered? We use the framework of accumulation and legitimation to suggest corporate and government motives for concealing underlying problems and reinforcing powerful ideologies of individualism, scientism, and centralizing authority. Food safety (or the illusion of safety) is being positioned to secure capital rather than public welfare. We propose implementing the principle of subsidiarity as a more democratic and decentralized alternative. Because full implementation of this principle will be resisted by powerful interests, some promising intermediate steps include peer production or mass collaboration as currently applied to disease prevention and surveillance, as well as studying nascent movements resisting current food safety regulations. (shrink)

The discovery of conjunctive causes--factors that act in concert to produce or prevent an effect--has been explained by purely covariational theories. Such theories assume that concomitant variations in observable events directly license causal inferences, without postulating the existence of unobservable causal relations. This article discusses problems with these theories, proposes a causal-power theory that overcomes the problems, and reports empirical evidence favoring the new theory. Unlike earlier models, the new theory derives (a) the conditions under which covariation implies conjunctive causation (...) and (b) functions relating observable events to unobservable conjunctive causal strength. This psychological theory, which concerns simple cases involving 2 binary candidate causes and a binary effect, raises questions about normative statistics for testing causal hypotheses regarding categorical data resulting from discrete variables. (shrink)

A growing number of multi-stakeholder initiatives seek to improve labor and environmental standards through third-party certification. Fairtrade, one of the most popular third-party certifications in the agro-food sector, is currently expanding its operations from its traditional base in commodities like coffee produced by peasant cooperatives to products like flowers produced by hired labor enterprises. My analysis reveals how Fairtrade’s engagement in the hired labor sector is shaped by the tensions between traditional market and industrial conventions, rooted in price competition, bureaucratic (...) efficiency, product standardization and certification and alternative domestic and civic conventions, rooted in trust, personal ties, and concerns for societal wide benefits. At the global level, these tensions shape Fairtrade’s global standard setting as reflected in Fairtrade’s recently revised labor standards. At the local level, these tensions shape the varied impacts of certification on the ground as revealed through a case study of certified flower production in Ecuador. (shrink)

The debate over the propriety of cognitive enhancement evokes both enthusiasm and worry. To gain further insight into the reasons that people may have for endorsing or eschewing pharmacological enhancement, we used empirical tools to explore public attitudes towards PE of twelve cognitive, affective, and social domains. Participants from Canada and the United States were recruited using Mechanical Turk and were randomly assigned to read one vignette that described an individual who uses a pill to enhance a single domain. After (...) reading the vignette, participants were asked how comfortable they were with the individual using the enhancement. People were significantly more comfortable when they read about enhancement of certain CAS domains than others. We found a modest negative correlation between comfort level and the degree to which the PE was perceived as changing core features of the person. We also found a modest correlation between comfort level and the degree to which the PE was perceived as improving success in life. Finally, using a sequential mixed method technique, we found that participants who felt uncomfortable about PE use overwhelmingly focused on a lack of need and, to a lesser degree, expressed concerns about safety; those who felt comfortable about PE use most frequently mentioned the safety of the pill and its ability to provide a positive outcome. The data provide novel insights into public enthusiasms and concerns over the use of PE. (shrink)

In this article, I argue that if we challenge some tacit assumptions of narrow rationality that endure in much of entrepreneurial studies, we can elevate entrepreneurial ethics beyond mere external constraints on rational action, and move toward fuller integration of ethics as an intrinsic part of the process of value creation itself. To this end, I propose the concept of practical wisdom as a framework for exploring entrepreneurial decision making and action that can broaden the scope of our research to (...) recognize entrepreneurship as an inherendy normative enterprise. Specifically, I suggest that a framework built upon a concept of practical wisdom enables us to adopt a richer and more complex view of entrepreneurial decision making that is well suited to the dynamic and uncertain context of entrepreneurship. Further, this framework enriches our view of entrepreneurial ethics to include consideration of the personal character, values, and purpose of the entrepreneur. By examining entrepreneurship through a lens of practical wisdom, we can open up new avenues of fruitful inquiry for scholars of entrepreneurship. (shrink)

Proponents of children's liberation (CL) argue that there are no morally relevant differences between children and adults. Consequently, special protective laws that limit children's freedom are unjustified, and should be abolished. Protectionists reject the premise of this argument, and hence also the conclusion. Proponents of CL mostly fix upon the capacity for instrumental reasoning as the criterion that should separate autonomous from non-autonomous individuals. I argue that most children are substantially worse at instrumental reasoning than most adults, and although drawing (...) a line between the two categories has an arbitrary element, outstanding exceptions on both sides can be justly accommodated. Furthermore, the capacity for instrumental reasoning is a necessary but not sufficient basis for equal rights. A morally decent society is more demanding of individuals than the skeptical or libertarian one that most plausibly grounds CL. To construct and live in such a society requires both prudence and morality. But there is evidence that children need protection and limits to develop these traits. So there are morally relevant differences between children and adults after all, and the argument from justice fails. The utilitarian arm of the argument also fails: because of these morally relevant differences, CL would have worse consequences than those envisioned by its supporters. Parents would lose important authority, and there would be more homeless children. Consequently, the gap between advantaged and disadvantaged persons would become larger and more irreversible. (shrink)

How does violence shape citizens’ preferences for conflict termination? The existing literature has argued that violence either begets sympathy for more violence or drives support for making peace. Focusing on the 2016 Colombian Peace Agreement, this article finds that victimhood dissociation strongly shapes these preferences. With victimhood dissociation, a discrepancy exists between objective and subjective victimization, and the effect of violence on peace attitudes depends on citizens’ subjective interpretations of their personal experiences of violence. Citizens who do not experience violence (...) often see themselves as victims of the conflict and vice versa. Victimhood dissociation is linked to cultural stereotypes of victimhood as portrayed in elite narratives concerning the conflict. In Colombia, political leaders framed victimhood around rurality, business entrepreneurship, kidnapping, extortion, and disappearance. In 2016, this widespread narrative was instrumental for politicians opposing the peace agreement. Citizens who disassociated their personal experiences of violence from their self-understanding as victims were instrumental to the failure of the peace plebiscite. (shrink)

Dystonia is a movement disorder that can have a debilitating impact on motor functions and quality of life. There are 250,000 cases in the United States, most with childhood onset. Due to the limited effectiveness and side effects of available treatments, pediatric deep brain stimulation has emerged as an intervention for refractory dystonia. However, there is limited clinical and neuroethics research in this area of clinical practice. This paper examines whether it is ethically justified to offer pDBS to children with (...) refractory dystonia. Given the favorable risk-benefit profile, it is concluded that offering pDBS is ethically justified for certain etiologies of dystonia, but it is less clear for others. In addition, various ethical and policy concerns are discussed, which need to be addressed to optimize the practice of offering pDBS for dystonia. Strategies are proposed to help address these concerns as pDBS continues to expand. (shrink)

Drawing on the built environment concept of “inclusive design” and its emphasis on creating accessible environments for all persons regardless of ability, I suggest that a central task for feminist disability theory is to redesign foundational philosophical concepts to present opportunities rather than barriers to inclusion for people with disability. Accounts of autonomy within liberal philosophy stress self-determination and the dignity of all individual persons, but have excluded people with intellectual disability from moral and political theories by denying their capacity (...) for individual autonomy, seen as a chief marker of moral personhood. This paper modifies and extends feminist theories of relational autonomy by arguing for the need to view autonomy as a feature of persons that is manifested only through relations of support, advocacy, and enablement. An “inclusively designed,” relational account negotiates the tensions encountered in attempts to apply autonomy to people with high support needs, and politicizes the concept as an advocacy tool for people with intellectual disability and their allies. (shrink)

In this article we investigate how Latino immigrant farmers in the Mid-Atlantic region of the United States navigate United States Department of Agriculture programs, which necessitate standardizing farming practices and an acceptance of bureaucracy for participation. We show how Latino immigrant farmers’ agrarian norms and practices are at odds with the state’s requirement for agrarian standardization. This interview-based study builds on existing historical analyses of farmers of color in the United States, and the ways in which their farming practices and (...) racialized identities are often unseen by and illegible to the state. This disjuncture leads to the increased racial exclusion of immigrant farmers from USDA opportunities. Such exclusions impede the transition to a “new era of civil rights,” as has been proclaimed by USDA leadership. Although efforts to address institutionalized racism on a national level may be genuine, they have failed to acknowledge this schism between rural Latino immigrants and the state, thereby inhibiting a meaningful transition in the fields, and continuing a legacy of unequal access to agrarian opportunities for non-white immigrant farmers. (shrink)

We surveyed IRB chairs' perspectives on offering individual genetic research results to participants and families, including family members of deceased participants, and the IRB's role in addressing these issues. Given a particular hypothetical scenario, respondents favored offering results to participants but not family members, giving choices at the time of initial consent, and honoring elicited choices. They felt IRBs should have authority regarding the process issues, but a more limited role in medical and scientific issues.

It is common to believe that some of our concerns are deeper concerns of ours than are others and that some of our attitudes are central rather than peripheral to our psychological identity. What is the best approach to characterizing depth or centrality to the self? This paper addresses the matter of the depth and authenticity of attitudes and the relation of this matter to the autonomy of action. It defends a conception of the real self in terms of preferences (...) and convictions that cohere in a particular structural sense. It thereby gives content to the notion of wholeheartedness to which various action theorists make appeal. The approach is defended in part by an examination of how it handles the phenomenon of ambivalence.1. (shrink)

This paper presents the contribution of the pragmatic sociology of critical capacities to the understanding of environmental conflicts. In the field of 'environmental valuation', nowadays colonised by economics, the approach of plural modes (or 'regimes') of engagement provides a sociological understanding of the unequal power of conflicting 'languages of valuation'. This frame entails a shift from 'values' to 'modes of valuation', and links modes of valuation to modes of practical engagement and coordination with the surrounding environment. Different social sources of (...) incommensurability are thus detected and reframed as critical tension within and among modes of human coordination with the environment. (shrink)

Recent revisions in child support and paternity establishment legislation enacted under the 1996 welfare reform act, the Personal Responsibility and Work Opportunity Reconciliation Act, significantly alter the American welfare state's relationship to men's fathering. Through a critical review of prior research and social service literature, the authors argue that PRWORA actively constructs fatherhood not only through state policies that maintain males as “breadwinners” but also through state-sponsored social service programs that seek to influence men's identities as fathers. PRWORA's policies and (...) their accompanying discourses simultaneously reproduce and undermine gender hierarchy yet tacitly maintain structural race and class inequalities. (shrink)

Some feminist epistemologists make the radical claim that there are varieties of epistemically valid warrant that agents access only through having lived particular types of contingent history, varieties of epistemic warrant to which, moreover, the confirmation-theoretic accounts of warrant favored by some traditional epistemologists are inapplicable. I offer Aristotelian virtue as a model for warrant of this sort, and use loosely Aristotelian vocabulary to express, and begin to evaluate, a range of feminist epistemological positions.

In recent years, discussion around memory modification interventions has gained attention. However, discussion around the use of memory interventions in the criminal justice system has been mostly absent. In this paper we start by highlighting the importance memory has for human well-being and personal identity, as well as its role within the criminal forensic setting; in particular, for claiming and accepting legal responsibility, for moral learning, and for retribution. We provide examples of memory interventions that are currently available for medical (...) purposes, but that in the future could be used in the forensic setting to modify criminal offenders’ memories. In this section we contrast the cases of dampening and enhancing memories of criminal offenders. We then present from a pragmatic approach some pressing ethical issues associated with these types of memory interventions. The paper ends up highlighting how these pragmatic considerations can help establish ethically justified criteria regarding the possibility of interventions aimed at modifying criminal offenders’ memories. (shrink)

An “intrinsically mixed” state is a mixed state of a system that is ‘orthogonal’ to every pure state of that system. Although the presence of such states in the quantum theories of infinite systems is well known to those who work with such theories, intrinsically mixed states are virtually unheralded in the philosophical literature. Rob Clifton was thoroughly familiar with intrinsically mixed states. I aim here to introduce them to a wider audience—and to encourage that audience to cultivate their acquaintance (...) by suggesting that intrinsically mixed states undermine assumptions framing standard discussions of the quantum measurement problem. (shrink)

This study explores corporate social responsibility (CSR) by conducting a cross-cultural analysis of communication of CSR activities in a total of 16 U.S. and European corporations. Drawing on previous research contrasting two major approaches to CSR initiatives, it was proposed that U.S. companies would tend to communicate about and justify CSR using economic or bottom-line terms and arguments whereas European companies would rely more heavily on language or theories of citizenship, corporate accountability, or moral commitment. Results supported this expectation of (...) difference, with some modification. Specifically, results indicated that EU companies do not value sustainability to the exclusion of financial elements, but instead project sustainability commitments in addition to financial commitments. Further, U.S.-based companies focused more heavily on financial justifications whereas EU-based companies incorporated both financial and sustainability elements in justifying their CSR activities. In addition, wide variance was found in both the prevalence and use of specific CSR-related terminology. Cross-cultural distinctions in this use create implications with regard to measurability and evidence of both strategic and bottom-line impact. Directions for further research are discussed. (shrink)

Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...) work processes at the CEGD. In this paper, we describe the CES services offered there in detail and elaborate on the 16 lessons we learned from the process of developing an integrative approach to CES. These learning points can inform and inspire CES professionals, who wish to bring about greater integration of CES services into clinical practice. (shrink)

Clinical ethics support for health care professionals and patients is increasingly seen as part of good health care. However, there is a key drawback to the way CES services are currently offered. They are often performed as isolated and one-off services whose ownership and impact are unclear. This paper describes the development of an integrative approach to CES at the Center of Expertise and Care for Gender Dysphoria at Amsterdam University Medical Center. We specifically aimed to integrate CES into daily (...) work processes at the CEGD. In this paper, we describe the CES services offered there in detail and elaborate on the 16 lessons we learned from the process of developing an integrative approach to CES. These learning points can inform and inspire CES professionals, who wish to bring about greater integration of CES services into clinical practice. (shrink)

A sociologist examines contemporary engagements of queer bodies and identities with fertility biomedicine. Drawing on social science, media culture, and the author’s own empirical research, three questions frame the analysis: 1. In what ways have queers on the gendered margins moved into the center and become implicated or central users of biomedicine’s fertility offerings? 2. In what ways is Fertility Inc. transformed by its own incorporation of various gendered and queered bodies and identities? And 3. What are the biosocial and (...) bioethical implications of expanded queer engagements and possibilities with Fertility Inc.? The author argues that “patient” activism through web 2.0 coupled with a largely unregulated free-market of assisted reproduction has included various queer identities as “parents-in-waiting.” Such inclusions raise a set of ethical tensions regarding how to be accountable to the many people implicated in this supply and demand industry. (shrink)

A single mother doing her best to raise her children. A small business owner realizing her dreams in a rural Kansas town. A caregiver for a disabled child. All these Kansans deserve the ability to...

This is the first of a two-part introduction to some interpretive questions that arise in connection with quantum field theories (QFTs). Some of these questions are continuous with those familiar from the discussion of ordinary non-relativistic quantum mechanics (QM). For example, questions about locality can be rigorously posed and fruitfully pursued within the framework of QFT. A stark disanalogy between QFTs and ordinary QM – the former, but not the latter, typically admit infinitely many putatively physically inequivalent realizations – prompts (...) relatively novel questions, questions about how to understand and adjudicate different strategies for equipping quantum theories with content. Part I sketches the fate of locality and related notions in QFT, then documents the non-uniqueness unprecedented in ordinary QM but rampant in QFT. Part II presents foundations issues raised by non-uniqueness. (shrink)

Essays and articles in the November‐December 2022 issue of the Hastings Center Report explore the complexities of medical decision‐making. A case‐study essay, for example, argues that the dismaying decision to perform resuscitation efforts on a patient who had obviously been dead for some time can be understood in the context of the harmful practice of defensive medicine. A narrative essay concerns whether an adolescent with locked‐in syndrome should be asked her wishes about life‐sustaining interventions, and the articles illuminate the ethical (...) value of the parental role in pediatric decision‐making, an array of ways in which patient decision‐making is interdependent, and the limitations of measures designed to evaluate the quality of a patient's decision and decision‐making process. (shrink)

This paper discusses the widespread use of "trolley problems" in the ethics classroom from a critical perspective. After tracing the enormous popularity of ‘trolleyology’ in recent moral philosophy, differentiating various functions these hypotheticals are supposed to fulfill in ethical discourse and carving out the underlying conception of normative ethics as a quasi-scientific enterprise, I examine how they are constructed and how they affect their recipient. Against this background, I argue that despite their popularity, the use of trolley problems in the (...) ethics classroom turns out to be questionable for a number of reasons, most of which have already been advanced in the philosophical debate but hardly been reflected upon in the didactic context. Finally, I argue that the deconstruction of trolleyesque scenarios would be a good educational use of them. When it comes to using cases for didactic purposes, I suggest we give trolley problems a rest and develop more realistic scenarios. (shrink)

The following address considers the relevance of business ethics education to our students. Is our concept of ethics one of practiceand application? And, if so, are we accountable to our students, our institutions and ourselves, for the practical impact that we haveor, conversely, that we do not have? Aren’t we responsible in part if one of our students ventures forth and does not act in an ethicalmanner? Though a positive response to this query may not be popular, what is the (...) alternative? If we are not responsible for the impact(or lack thereof) that we have on our students, then what is our purpose? The discussion further explores the nature of this impact andthe process by which we can amplify the results. (shrink)