In a recent study, female dispersal in nineteenth-century Sweden has been found to correlate negatively with access to resources: women with limited access to local resources tended to migrate more frequently. In this paper I review the literature to explore whether this observed correlation was derived from a relationship in which a woman’s limited access to resources worsened her position in the marriage market and led to migration, as a strategy to improve resources and this position. Many studies within a (...) variety of disciplines indicate that a woman’s propensity to disperse from her parish of birth variedinversely with her propensity to inherit resources. My review of the literature suggests that the less likely a woman was to inherit resources, the lower her probability of marriage, the later her expected age at marriage, and the earlier she left home, presumably to improve her resource base for marriage. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to Creative Writing ContributionsAlexis Pauline Gumbs, Akasha Gloria Hull, Cheryl Clarke, doris diosa davenport, Cheryl Boyce-Taylor, Asha French, Sharon Bridgforth, Omi Osun Joni L. Jones, Alexis De Veaux, and Sokari Ekinewhen i first began to dream of creative writing contributions for this special issue of Feminist Studies celebrating the fortieth anniversaries of This Bridge Called My Back: Writings by Radical Women of Color and All the Women (...) Are White, All the Blacks Are Men, But Some of Us Are Brave: Black Women's Studies, I imagined a wealth of examples of the world and the work made possible by these two groundbreaking anthologies. I wondered what their editors and contributors were writing now. I wondered about the work of their students and people like me: those of us who understand everything we write as indebted to the path-making, silence-clearing, generative, and bodacious work of the participants in the miracles that are This Bridge Called My Back and But Some of Us Are Brave.But today as I reread the contributions that actually emerged from this process, I realize that my dream was too small. I imagined writing that would provide evidence of the ongoing impact made by these two anthologies. Instead, the creative writing in this special issue offers something more crucial and beautiful than I had imagined. These works are not mere evidence of a transformed world; these works are continuing to transform the world in urgent and visionary ways. As repeated again and again by participants in the 2022 celebration for the fortieth anniversary celebration of This Bridge Called My Back, the work that inspired these anthologies is not over. The writings featured in this issue not only show [End Page 198] how this work continues, but they feed, nurture, and provoke us as we honor our responsibility to transform this world.For example, when Akasha Gloria Hull, coeditor of But Some of Us Are Brave, shares her daily early morning meditative writing in "Writing and Rebirth: A Set of Journal Poems," we remember not only her fundamental work excavating the daily lives of Black women writers from the nineteenth century—most notably in Give Us Each Day, her edited book based on the diaries of poet Alice Dunbar Nelson—but also our own imperative. Hull's reflections on health challenges, interpersonal conflict, resurrection, collaboration, and writing itself remind us that our feminist praxis is impactful because of its dailyness. Those of us who wake up tomorrow will need to ask the same critical questions the editors of But Some of Us Are Brave asked of the fields of Black studies and women's studies. We will find surprises and repetitions in the days we meet, and then we will have to do it again.When we read two new prose poems by Cheryl Clarke, an original contributor to This Bridge Called My Back, we have an opportunity to time travel. In "Living as a Lesbian in the Archive of Style," we venture into a critical engagement with the term "hardcore lesbian," displacing the desires of the person who needs to classify others using that term with those of someone who has been hailed by it. Clarke's poem is a reminder that as we work in literary traditions and fields of study made possible by the revolutionary identity politics of an earlier era, we are still responsible for centering the experiences of those most impacted by our fluent and fluid naming practices. In "History," Clarke offers us a timely Black lesbian feminist lens on many iterations of responding to police violence, centering the perspective of a lesbian, her lover, and her lover's husband.The poem "On Being an hbcu Graduate, Teacher, Professor-Scholar at Stillman College, Tuscaloosa, AL, in May 2015" by doris diosa davenport—an original contributor to But Some of Us Are Brave—highlights the intimacy, hilarity, and poignancy of the daily work of intergenerational critical and creative praxis. In particular, she considers the context of institutions and regions that are sometimes excluded from the imaginary of how and where feminist work happens. davenport transmits the lessons and energy gained through her practice of thinking and gathering otherwise... (shrink)

Obtaining consent for medical treatment in older adults raises a number of complex challenges. Despite being required by ethics and the law, consent for medical treatment is not always validly sought in this population. The dynamic nature of capacity, particularly in individuals who have dementia or other cognitive impairments, adds complexity to obtaining consent. Further challenges arise in ensuring that older people comprehend the medical treatment information provided and that consent is not vitiated by coercion or undue influence. Existing mechanisms (...) to address issues surrounding consent for older adults only address incapacity and raise further challenges. As the ageing population increases, these issues are likely to become more profound, thus action is required to address these challenges. Raising awareness, more education, engaging with people with dementia, and conducting further research would assist in beginning to overcome these challenges. (shrink)

L’excellent ouvrage de Pascale Barthélémy constitue un nouveau titre, très bienvenu, dans la floraison d’études dévolues à ce que Gregory Mann a appelé « la relation contrainte particulière » entre la France et l’Afrique. Pascale Barthélémy s’est penchée sur la petite minorité d’Africaines – à peine un millier au total – issues de la fédération d’Afrique Occidentale Française (AOF) et formées par les Français pour devenir sages-femmes, infirmières-visiteuses (jusqu’en 1938) ou encore institut...

En racontant de très belle manière la vie de Madame Luce, enseignante française et arabophone dans l’Algérie de la fin du xixe siècle, Rebecca Rogers enrichit les travaux, de plus en plus nombreux, sur les Européennes installées dans la colonie dans les premières décennies de la colonisation. Centré sur une femme ordinaire, qui a laissé peu de traces dans les archives publiques, ce travail est en réalité une étude plus large, consacrée à l’histoire sociale des changements de pratiques éducati...

I consider reasons for questioning ‘the laws of logic’, and suggest that these laws do not accord with everyday reality. Either they are rhetorical tools rather than absolute truths, or else Plato and his successors were right to think that they identify a reality distinct from the ordinary world of experience, and also from the ultimate source of reality.

Cette étude de l’histoire des femmes européennes qui ont eu une vie professionnelle du milieu du XIXe siècle à nos jours est une précieuse synthèse et une belle introduction à l’historiographie récente. Sylvie Schweitzer s’intéresse surtout aux femmes françaises, mais elle apporte de nombreux éléments qui permettent de les comparer à leurs collègues d’autres pays en Europe occidentale, voire de quelques pays de l’Europe de l’Est. Un thème central du livre est l’histoire de la résistance à l’é...

The Treatment Escalation Plan (TEP) was introduced into our trust in an attempt to improve patient involvement and experience of their treatment in hospital and to embrace and clarify a wider remit of treatment options than the Do Not Resuscitate (DNR) order currently offers. Our experience suggests that the patient and family are rarely engaged in DNR discussions. This is acutely relevant considering that the Mental Capacity Act (MCA) now obliges these discussions to take place. The TEP is a form (...) that the doctor completes, ideally with the competent patient or close relative, documenting what treatment options would be appropriate if that patient were to become acutely unwell. Ventilation of the lungs, cardiac resuscitation, renal replacement therapy, intravenous fluids and antibiotics are all discussed. The study evaluated patient and relative experiences with the TEP. 55 patients or their relatives were interviewed regarding their experience of the TEP and thoughts regarding the process. 96% of patients and relatives evaluated thought that the TEP was a good idea. Free text comments were all positive and only 34% of patients claimed to feel anxious when completing the form. Following this study, the TEP has been expanded hospital wide and into the community within our trust. Discussions are currently taking place in hospitals within our region to introduce the TEP form into other local trusts. (shrink)

1. Believing Enough to Think The Scottish system of university education requires most aspirants to an Ordinary Degree to study some philosophy. Philosophers in Scottish Universities must therefore contend with enormous first-year classes, stocked with youngsters who have little real desire to be philosophers, or even to philosophize. Some years ago, at Glasgow, a question in the final exam was as follows: ‘“Philosophy is of no use, and so should not be studied.” Discuss’. A couple of hundred students answered, more (...) or less fluently, that one should not assume that what was of no use should not be studied, since some things were worth studying in their own right, but that in any case the study of philosophy was useful since it helped one to question what authoritative figures said. No essayist, apparently, saw any paradox in this reply, which was, of course, taken word for word from the professor's lectures. (shrink)

Previous studies have shown that children retreat from argument‐structure overgeneralization errors (e.g., *Don’t giggle me) by inferring that frequently encountered verbs are unlikely to be grammatical in unattested constructions, and by making use of syntax‐semantics correspondences (e.g., verbs denoting internally caused actions such as giggling cannot normally be used causatively). The present study tested a new account based on a unitary learning mechanism that combines both of these processes. Seventy‐two participants (ages 5–6, 9–10, and adults) rated overgeneralization errors with higher (...) (*The funny man’s joke giggled Bart) and lower (*The funny man giggled Bart) degrees of direct external causation. The errors with more‐direct causation were rated as less unacceptable than those with less‐direct causation. This finding is consistent with the new account, under which children acquire—in an incremental and probabilistic fashion—the meaning of particular constructions (e.g., transitive causative = direct external causation) and particular verbs, rejecting generalizations where the incompatibility between the two is too great. (shrink)

There are good reasons for being suspicious of the very concept of ‘a religion’, let alone a ‘world religion’. It may be useful for a hospital administrator to know a patient's ‘religion’ – as Protestant or Church of England or Catholic or Buddhist – but such labels clearly do little more than identify the most suitable chaplain, and connote groupings in the vast and confusing region of ‘religious thought and practice’ that are of very different ranks. By any rational, genealogical (...) taxonomy ‘Protestant’, ‘Anglican’, ‘Catholic’ connote species, genera or families within Christianity, which is in turn a taxon within the multivariant tradition traced back to Abraham. ‘Buddhism’ includes as many variants as would ‘Abrahamism’. Most Abrahamists, traditionally, have been theists, but it is difficult not to suspect that Marxist socialism is an atypical variant which has inherited a linear view of time, a contest between the chosen agents of justice and the doomed powers-that-be, and the prospect of a future in which ‘there shall be no more sea’. (shrink)

For trans youth, the experience of gender differs from expectations based on sex assigned at birth (Frohard-Dourlent, Dobson, Clark, Duoll, & Saewyc, 2016). To support gender health—the ability to...

This article explores how corporate governance processes and structures are being used in large Australian companies to develop, lead and implement corporate responsibility strategies. It presents an empirical analysis of the governance of sustainability in fifty large listed companies based on each company’s disclosures in annual and sustainability reports. We find that significant progress is being made by large listed Australian companies towards integrating sustainability into core business operations. There is evidence of leadership structures being put in place to ensure (...) that board and senior management are involved in sustainability strategy development and are then incentivised to monitor and ensure implementation of that strategy through financial rewards. There is evidence of a willingness to engage and communicate clearly the results of these strategies to interested stakeholders. Overall, there appears to be a developing acceptance amongst large corporations that efforts towards improved corporate sustainability are not only expected but are of value to the business. We suggest that this is evidence of a managerial shift away from an orthodox shareholder primacy understanding of the corporation towards a more enlightened shareholder value approach, often encompassing a stakeholder-orientated view of business strategy. However, strong underlying tensions remain due to the insistent market emphasis on shareholder value. (shrink)

Anyone who wishes to talk about angels has to respond to the mocking question, how many of them can dance on the point of a pin. The answer is: ‘just as many as they please’. Angels being immaterial intellects do not occupy space to the exclusion of any other such intellectual substance, and their being ‘on’ the point of a pin can only mean that they attend to it. The question, however, is not one that concerned our mediaeval predecessors, although (...) it seems as difficult to persuade anyone of this as it is to clear Canute of the charge of insane conceit. (shrink)

While substantial evidence is emerging internationally of positive increases in the participation of women on company boards, there is less evidence of any significant change in the proportion of women in senior executive ranks. This paper describes evidence of positive changes in the number of women on boards in Australia. Unfortunately these changes are not mirrored in the senior executive ranks where the proportion of women remains consistently low. We explore some of the reasons for these disproportionate changes and examine (...) the likely effect of the recent amendments to the Australian stock exchange’s corporate governance code designed to improve gender diversity both on boards and throughout organisations. Based on the early corporate response to these regulatory changes, it is interesting to consider whether Australia’s approach in promoting voluntary self-regulation at the corporate level may be as effective in the long run as the emerging trend in Europe to apply legislated quotas for female corporate board representation. Interview evidence is presented suggesting that the primary reasons for the lack of women in leadership are not simply lack of opportunity at the apex of the corporation, but issues at mid-management level that are unlikely to be resolved by mandatory board quotas. In some circumstances carefully monitored voluntary targets may be more effective at promoting cultural and strategic change at the heart of the corporation. In summary, mandatory quotas may achieve early and significant results in terms of female board representation. However, voluntary targets for women’s participation on boards and in executive ranks may promote more effective cultural and practical change in support of greater representation of women in leadership. (shrink)

Two studies document that people are more willing to express emotions that reveal vulnerabilities to partners when they perceive those partners to be more communally responsive to them. In Study 1, participants rated the communal strength they thought various partners felt toward them and their own willingness to express happiness, sadness and anxiety to each partner. Individuals who generally perceive high communal strength from their partners were also generally most willing to express emotion to partners. Independently, participants were more willing (...) to express emotion to particular partners whom they perceived felt more communal strength toward them. In Study 2, members of romantic couples independently reported their own felt communal strength toward one another, perceptions of their partners’ felt communal strength toward them, and willingness to express emotions to each other. The communal strength partners reported feeling toward the participants predicted the participants’ willingness to express emotion to those partners. This link was mediated by participants’ perceptions of the partner’s communal strength toward them which, itself, was a joint function of accurate perceptions of the communal strength partners had reported feeling toward them and projections of their own felt communal strength for their partners onto those partners. (shrink)

In The Art Instinct, Denis Dutton promoted a theoretical framework that “has more validity, more power, and more possibilities than the hermetic discourse that deadens so much of the humanities.”1 This framework is Charles Darwin’s theory of evolution by natural and sexual selection. Dutton proposed to seek “human universals that underlie the vast cacophony of cultural differences and across the globe” (AI, p. 39), based on a shared, evolved human nature.This contrasts with the relativistic presumptions of those falling under the (...) shadow of Margaret Mead and Clifford Geertz, or “the dogmas of Freud, the speculations of Jung, the sterile formulations of behaviorism, all variously empty or misleading” (p. 37). Also .. (shrink)

Building on research demonstrating relationships between well being and perceptions of aspects of life as sacred, this study describes the rationale for and development of a scale measuring perceiving sacredness in life. It then explores associations between perceptions of sacredness in life and these four domains: religious/spiritual, personal, social, and situational. Participants responded to a mailing to a national random sample within the United States, completing 16 scales pertaining to the religious/spiritual, personal, social, and situational domains. While many variables were (...) correlated with perceiving sacredness in life, there were three overall predictors: intrinsic religiosity, mysticism, and community service attitude. (shrink)

This article situates the analysis of fair-trade consumption in the context of debates about civic activism and political participation. It argues that fair-trade consumption should be understood as a political phenomenon, which, through the mediating action of organizations and campaigns, makes claims on states, corporations, and institutions. This argument is made by way of a case study of Traidcraft, a key player in the fair-trade movement in the United Kingdom. The study focuses on how Traidcraft approaches and enrolls its supporters.

Inherent in providing healthcare for youth lie tensions among best interests, decision-making capacity, rights, and legal authority. Transgender youth experience barriers to needed gender-affirming care, often rooted in ethical and legal issues, such as healthcare provider concerns regarding youth capacity and rights to consent to hormone therapy. Even when decision-making capacity is present, youth may lack the legal authority to give consent. The aims of this paper are therefore to provide an empirical analysis of minor trans youth capacity to consent (...) to hormone therapy and to address the normative question of whether there is ethical justification for granting trans youth the authority to consent to this care. Through qualitative content analysis of interviews with trans youth, parents, and healthcare providers, we found that trans youth demonstrated the understandings and abilities characteristic of the capacity to consent to hormone therapy and that they did consent to hormone therapy with positive outcomes. Employing deontological and consequentialist reasoning and drawing on a foundation of empirical evidence, human rights, and best interests we conclude that granting trans youth with decisional capacity both the right and the legal authority to consent to hormone therapy via the informed consent model of care is ethically justified. (shrink)

It's surprising that contemporary moral philosophers have not thought more about food. The rapidly expanding industrialized landscape of modern western agribusiness raises moral concerns about large-scale livestock production, the increased usage of genetically modified crops, and the effects these now common practices may have on long-term environmental and human health. Here Pence argues that biotechnology is more helpful than harmful, on the ground that it will abate world hunger. Positioning himself as an "impartialbioethicist" he sets about the task of sorting (...) through the extremism he thinks drives all environ- mental movements' opposition to genetically modified (GM) crops. His argu- ment is simple: the claim that GM foods are unsafe is the product of alarmism, not sound reason. Discarding what environmentalists have called the Precau- tionary Principle, he argues that GM foods are safe because they have not been proven unsafe. And GM foods have been tested more than many food products now on the market. (shrink)

BackgroundThe wellbeing of people living with dementia and their family caregivers may be impacted by stigma, changing roles, and limited access to meaningful opportunities as a dyad. Group therapeutic songwriting and qualitative interviews have been utilized in music therapy research to promote the voices of people with dementia and family caregivers participating in separate songwriting groups but not together as dyads.ProceduresThis study aimed to explore how ten people with dementia/family caregiver dyads experienced a 6-week group TSW program. Dyads participated in (...) homogenous TSW groups involving 2–4 dyads who were either living together in the community or living separately because the person with dementia resided in a care home. The TSW program, informed by personhood, couplehood, family centered and group process frameworks, involved creating original lyrics through song parody and song collage. Qualified Music Therapists facilitated sessions and interviewed each dyad separately. Interviews were analyzed using interpretative phenomenological analysis.FindingsFive recurrent group themes were developed, indicating group TSW: was a positive shared experience, benefiting both members of the dyad and motivating further engagement with music; stimulated mental processes and reignited participants’ interests and skills; provided meaningful opportunities for reflection and connection with memories and life experiences; and prompted interaction and collaboration, leading to social connections, empathic relationships and experiences of inclusion. Participants also highlighted how: the facilitated process supported engagement, highlighting abilities and challenging doubts.ConclusionDyads identified group TSW as an opportunity to recognize strengths, voice ideas and opinions, share meaningful experiences, and do “more with music.” Participants valued TSW as a new, creative and stimulating experience that enabled connection with self and others and led to feelings of pride and achievement. Our findings further recognize how therapeutic intention and approach were reflected in participants’ engagement and responses regardless of dementia stage and type, dyad relationship, or musical background. This research may broaden perspectives and expand understanding about how people with dementia and their family caregivers access and engage in music therapy. (shrink)

Words have determinable sense only within a complex of unstated assumptions, and all interpretation must therefore go beyond the given material. This book addresses what is man's place in the Aristotelian world. It also describes man's abilities and prospects in managing his life, and considers how far Aristotle's treatment of time and history licenses the sort of dynamic interpretation of his doctrines that have been given. The ontological model that explains much of Aristotle's conclusions and methods is one of life-worlds, (...) in which the material universe of scientific myth is no more than an abstraction from lived reality, not its transcendent ground. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.2 (2003) 157-159 [Access article in PDF] Constructing Persons:The Psychopathology of Identity Stephen R. L. Clark Keywords identity, legal fictions, materialism, psychopathology. Steve Matthews argues that the criteria proposed by Stephen Behnke and Walter Sinnott-Armstrong for establishing personal identity in cases of Dissociative Identity Disorder (DID) are flawed. Neither brain identity nor memory convergence are adequate grounds for ascribing identity, even in the absence of (...) DID. Someone suffering from DID is no less responsible than a drunkard for the crimes she commits when not in her right—or at least her usual—mind, and perhaps no more responsible than someone suffering from some other mental disorder. We may decide to punish someone suffering from DID for her crimes only when she and her presumed alter both share a brain (as obviously they do) and might—at least after therapy—have memories in common, and only when the alternate personality that led to the crime is herself sane. But we should not pretend to ourselves that this judgment rests upon a clear and uncontentious notion of identity.It may be that Matthews still shares too much of his opponents' attitude: namely, that there is some matter of fact about identity, or at least some fact about the central principles by which we ascribe or recognize identity. This, at first sight, is the force of his counterexamples: that the Behnke/Sinnott-Armstrong criteria give counterintuitive results and so cannot exactly map the notion that we have in mind. Just so Socrates was able to prove that Justice did not consist in Paying One's Debts, because we would all at once acknowledge that it was not Just (or Right) to restore his sword to a homicidal maniac (or at least that there were real doubts about who it was that really owned the sword). But neither Socrates' nor Matthews' conclusion need be referred to any simple fact. It would not be sensible to say that the maniac had a right to have his sword, or that its keeper had a duty to return it, because we recognize implicitly that the very point of Justice is to do Good. Correspondingly, maybe the real effect of Matthews's counterexamples is to remind us what the point of Judgment is. Is there any matter of fact about identity, or is identity simply a way of saying who it is that should now be held responsible? Joe is not to be held responsible because he is the same person as the one who committed the crime: he is reckoned the same person because he is the one who is here now to be held responsible. That is what it is to be the same person: to be held responsible for what is personally done. [End Page 157]Someone who is not a person at all is not the same person as anyone (although they may be the same creature). And a person is a creature who holds herself responsible, or can do so: who has memories and anticipations to which she lays claim, appropriates as her own. This in turn is possible because (or so it seems) she has acquired the necessary words and customs: because she sees people being held responsible she can also hold herself responsible—or sometimes disclaim all responsibility. She will not always be allowed to escape all blame or credit, merely because her memories are of a self that no longer makes much sense to her, nor even because she has no memories at all of what was done. But this need not be because she is objectively the very same person as the sometime agent; rather, the person she is taken to be is constructed by the legal and moral attitudes of those who judge her. Those attitudes are not necessarily determinate: how exactly the ordinary rules apply in novel cases may be a matter of decision rather than discovery. The connections that ordinarily ground or specify identity are not robust enough to rely upon in DID patients (that, after all, is the trouble). We have to make... (shrink)

Stephen R. L. Clark; XIV*—On Wishing there were Unicorns, Proceedings of the Aristotelian Society, Volume 90, Issue 1, 1 June 1990, Pages 247–266, https://doi.o.

Few diagnoses present as great a challenge to one's life as cancer. Many men each year are confronted with a diagnosis of early stage prostate cancer and find themselves making decisions about treatment in the face of side effects that present often devastating effects, including problems controlling one's urine and an inability to perform sexually. In this paper, we explore the narratives of men who, having chosen and undergone treatment for early stage prostate cancer, are living with the consequences. Faced (...) with what Charmaz calls an ‘identity dilemma’, how do these men linguistically construct their identities in the face of challenges to their bodily, personal, and social integrity? Drawing upon theories of social languages and Discourses, we examine how men linguistically resolve the identity dilemmas they encounter and in turn construct an identity in response to a question about the quality of their lives in the face of the adverse event of prostate cancer. We present an analysis of the interview narratives of two men and show how they ‘re-collage’ an identity in the face of fundamental changes in their functioning as men. We argue that these men draw upon alternative discourses to construct themselves as whole, competent, and ‘no less a man'. (shrink)

Twenty years ago, people thought only cranks or sentimentalists could be seriously concerned about the treatment of non-human animals. However, since then philosophers, scientists and welfarists have raised public awareness of the issue; and they have begun to lay the foundations for an enormous change in human practice. This book is a record of the development of 'animal rights' through the eyes of one highly-respected and well-known thinker. This book brings together for the first time Stephen R.L. Clark's major essays (...) in one volume. Written with characteristic clarity and persuasion, Animals and Their Moral Standing will be essential reading for both philosophers and scientists, as well as the general reader concerned by the debates over animal rights and treatment. (shrink)

Dennett's Consciousness Explained presents, but does not demonstrate, a fully naturalized account of consciousness that manages to leave out the very consciousness he purports to explain. If he were correct, realism and methodological individualism would collapse, as would the very enterprise of giving reasons. The metaphors he deploys actually testify to the power of metaphoric imagination that can no more be identified with the metaphors it creates than minds can be identified with memes. That latter equation, of minds with meme?complexes, (...) rests for its meaning on the existence of real minds, which are not to be equated with the thoughts they have. (shrink)

Hospitals long ago shed their role as alms houses for the poor. What vestiges remain of the early American hospital are the tax-exempt, nonprofit hospital form and a general perception that hospitals, as charitable institutions, owe a duty to their communities. The appropriateness of the nonprofit hospital tax exemption has long been debated, and many theories have been advanced to justify the tax exemption of nonprofit hospitals. In a growing number of jurisdictions, however, state and local authorities have gone beyond (...) the theoretical debate and are challenging the tax exemption of their nonprofit hospitals. For various reasons, efforts are afoot to capture greater community benefit from nonprofit hospitals.At the heart of such challenges is the debate over the nature and extent of the duty charitable institutions owe to their communities. A demand is growing for nonprofit hospitals to earn their tax exemptions by benefiting their communities in concrete ways. Some have been stripped of their tax-exempt status by local authorities or pressured to make payments in lieu of taxes. A number of states have recently implemented initiatives in an attempt to make hospitals more accountable for their community benefits. Many hospitals are responding to this heightened scrutiny in a proactive way, by voluntarily documenting community benefits. A number of nonprofit hospitals and hospital associations are cooperating with—or even sponsoring—state legislation in this area. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)