The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...) the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions. (shrink)

The COVID-19 pandemic introduced significant disruptions and challenges to the learning environment for many post-secondary students with many shifting entirely to remote online learning. Barriers to academic success already experienced in traditional face-to-face classes may be compounded in the online environment and exacerbated by stressors related to the pandemic. In 2020–2021, post-secondary institutions were faced with the reality of rolling out fully online instruction with limited access to resources for assisting students in this transition. Instructional interventions that target students’ ability (...) to self-regulate their learning have been shown to improve academic performance and self-regulated learning competencies have also been found to mediate the effect of SRL interventions on higher education. However, few studies have examined the efficacy of fully online SRL intervention on mitigating the impact of psychological distress and academic challenges on academic success. This study examined the moderating roles of self-regulatory practices and SRL intervention in buffering the influence of COVID-related psychological distress and academic challenges on academic outcomes and academic challenges) in a Canadian sample of undergraduate students. We found levels of metacognitive and motivational challenges fully mediated the impact of COVID distress on GPA, SRL adapting practices moderated the impact of metacognitive challenges on GPA, and semester-long SRL intervention buffered the impact of COVID distress on academic challenges and resulted in lower levels of social-emotional, cognitive, and metacognitive challenges for first year undergraduate students. (shrink)

The number of admissions to hospitals of patients without a proxy decision maker is rising. Very often these patients need fairly immediate medical intervention for which informed consent—or informed refusal—is required. Many have recommended that there be a process in place to make these decisions, and that it include a variety of perspectives. People are particularly wary of relying solely on medical staff to make these decisions. The University Hospitals Case Medical Center recruits community members from its Ethics Committee to (...) serve on a subcommittee, the Patients Without Proxies (PWP) Committee, which works with medical staff during the decision-making process for these patients. Generally, the community members go to the bedside to observe patients. This article looks at how those unused to observing hospitalized patients who are sick and/or dying are affected, comparing them to mock jurors in a research study who are exposed to graphic photographs related to a fabricated crime scene. Judgments made by the mock jurors are affected by viewing such images. The personal experience of witnessing unfamiliar and shocking scenes affects their subsequent judgments. While it may be difficult to tease out whether observing patients causes PWP members to be benefited or harmed, they are affected by what they see. If a variety of perspectives is desirable to reduce possible bias or error, this article argues that at least one community member should refrain from seeing the patient in order to add a different and valuable voice to the decision-making process. Members of the subcommittee base their judgments on the various kinds of information available. Sometimes the things they see, hear, or feel may affect them particularly deeply, and affect their judgments as well. In this article I explore the idea that something like this may be happening in a particular kind of clinical ethics case consultation. (shrink)

In the clinical setting, not enough attention is paid to the role that emotion plays. It is at worst ignored or avoided, isolating those who are suffering, at best treated as something to help another to endure. This is the result, in part, of an impoverished idea that views emotion as mere feelings. However, emotions are not just feelings, they are cognitive. If we look beneath the surface, emotions can provide information about values and beliefs, some of which may be (...) false or unreasonable. When they are motivating decisions that seriously affect the lives of others, there is a moral obligation to ferret them out and correct or deal with them. Attention needs to be paid to the emotions of healthcare providers as well as to the emotions of patients and their loved ones, and more done to train healthcare providers to deal effectively and productively with emotion – their own and others’. A son tearfully requests everything be done for his dying father. He fears limiting treatment means his father will be ignored. A physician orders another course of chemotherapy because she cannot bear for this patient to die. The patient, fearing he will painfully suffocate to death, agrees. Paying attention to emotions and bringing to light the beliefs and values behind them can only enhance the care and consideration of all involved. (shrink)

One of the challenges of modern healthcare ethics practice is the navigation of boundaries. Practicing healthcare ethicists in the performance of their role must navigate meanings, choices, decisions and actions embedded in complex cultural and social relationships amongst diverse individuals. In light of the evolving state of modern healthcare ethics practice and the recent move toward professionalization via certification, understanding boundary navigation in healthcare ethics practice is critical. Because healthcare ethics is endowed with many boundaries which often delineate concerns about (...) professional expertise and authority, epistemological reflection on the relationship between theory and practice points toward the social context as relevant to the conceptualization of boundaries. The skills of social scientists may prove helpful to provide data and insights into the conceptualization and navigation of clinical ethics qua profession. Empirical ethics research, which combines empirical description (usually social scientific) with normative-ethical analysis and reflection, is a way forward as we engage and reflect upon issues which have implications for practice standards and professionalization of the role. This requires cooperative engagement of the descriptive and normative disciplines to explore our understandings of boundaries in healthcare ethics practice. This will contribute to the ongoing reflection not only as we envision the professional role but to ensure that it is enacted in practice. (shrink)

This article is the lead piece in a special report that presents the results of a bioethical investigation into chimeric research, which involves the insertion of human cells into nonhuman animals and nonhuman animal embryos, including into their brains. Rapid scientific developments in this field may advance knowledge and could lead to new therapies for humans. They also reveal the conceptual, ethical, and procedural limitations of existing ethics guidance for human‐nonhuman chimeric research. Led by bioethics researchers working closely with an (...) interdisciplinary work group, the investigation focused on generating conceptual clarity and identifying improvements to governance approaches, with the goal of helping scholars, funders, scientists, institutional leaders, and oversight bodies (embryonic stem cell research oversight [ESCRO] committees and institutional animal care and use committees [IACUCs]) deliver principled and trustworthy oversight of this area of science. The article, which focuses on human‐nonhuman animal chimeric research that is stem cell based, identifies key ethical issues in and offers ten recommendations regarding the ethics and oversight of this research. Turning from bioethics’ previous focus on human‐centered questions about the ethics of “humanization” and this research's potential impact on concepts like human dignity, this article emphasizes the importance of nonhuman animal welfare concerns in chimeric research and argues for less‐siloed governance and oversight and more‐comprehensive public communication. (shrink)

While few soldiers may have read the works of Epictetus or Marcus Aurelius, it is undoubtedly true that the ancient philosophy known as Stoicism guides the actions of many in the military. Soldiers and seamen learn early in their training "to suck it up," to endure, to put aside their feelings and to get on with the mission. Stoic Warriors is the first book to delve deeply into the ancient legacy of this relationship, exploring what the Stoic philosophy actually is, (...) the role it plays in the character of the military (both ancient and modern), and its powerful value as a philosophy of life. Marshalling anecdotes from military history--ranging from ancient Greek wars to World War II, Vietnam, and Iraq--Nancy Sherman illuminates the military mind and uses it as a window on the virtues of the Stoic philosophy, which are far richer and more interesting than our popularized notions. Sherman--a respected philosopher who taught at the US Naval Academy--explores the deep, lasting value that Stoicism can yield, in issues of military leadership and character; in the Stoic conception of anger and its control (does a warrior need anger to go to battle?); and in Stoic thinking about fear and resilience, grief and mourning, and the value of camaraderie and brotherhood. Sherman concludes by recommending a moderate Stoicism, where the task for the individual, both civilian and military, youth and adult, is to temper control with forgiveness, and warrior drive and achievement with humility and humor. Here then is a perceptive investigation of what makes Stoicism so compelling not only as a guiding principle for the military, but as a philosophy for anyone facing the hardships of life. (shrink)

This paper proposes an essentially theoretical reflection on initial training, a reflection based on four fundamental concepts: professional development, professional identity, well-being and strengths of character. More specifically, recognizing the complexity of the teaching profession, the authors argue that the teacher training in Quebec gives too little room for self-reflection. According to them, this reflection should be based on a search for meaning in terms of a vision of well-being. Positive psychology research on strengths of character may provide useful avenues (...) for rethinking teacher education. (shrink)

University based academic Research Ethics Boards (REB) face the particularly difficult challenge of trying to achieve representation from a variety of disciplines, methodologies and research interests. Additionally, many are currently facing another decision – whether to have students as REB members or not. At Ryerson University, we are uniquely situated. Without a medical school in which an awareness of the research ethics review process might be grounded, our mainly social science and humanities REB must also educate and foster awareness of (...) the ethics review process throughout the academic community. Our Board has had and continues to have students as active members. While there are challenges to having students as Board members, these are clearly outweighed by the advantages, for both the academic community and the future of ethically sound research in the social sciences and humanities. Moreover, the challenges are often based on misconceptions and can be easily overcome through increased education and understanding of the research ethics review process by the academic community at large. The purpose of this paper is to describe and discuss the experiences, advantages and challenges of having students as REB members. The advantages of having students as REB members include the following: (1) Students are the proposed participants in many of our reviewed protocols and student members may illuminate unique issues of participation. (2) Students are active and highly engaged members of the REB. (3) Having students on the REB enhances awareness of research ethics within the University. (4) Student REB members have an opportunity to mentor other students and provide leadership for both undergraduate and graduate students. (5) Students are more vigorously recruited than faculty members and often apply for student positions with enthusiasm and preparation. (6) In creating an atmosphere of excellence in research, engaging students at the beginning of their research career will help in creating tomorrow’s leaders in research and research ethics. The challenges of having students as REB members include the following: (1) Faculty members may be uneasy regarding the prospect of students reviewing protocols. (2) Faculty members may be concerned about confidentiality and respect with students reviewing faculty research protocols. (3) There may be an increased burden for students who serve as members on an REB. (4) There is concern that students will offer less continuous service to the REB. (5) There is a common misconception that students do not have the experience to carry out ethical reviews. While there are challenges from faculty members and others regarding having students as REB members, these challenges are often based on misconceptions about the nature of the REB work and the ethics review process in general. These challenges are also often based on the misconception of the ethics review process as one of peer review and evaluation, instead of a community-based and inclusive process. Having student members is a long-term strategy for both overcoming the misconceptions of the REB as a “necessary evil” and for fostering an awareness of the imperative for ethically sound research in the social sciences and humanities. (shrink)

Unlike bioethics mediators who are employed by healthcare organizations as outside consultants, mediators who are embedded in an institution must be authorized to chronicle a clinical ethics consultation (CEC) or a mediation in a patient’s medical chart. This is an important privilege, as the chart is a legal document. In this article I discuss this important part of a bioethics mediator’s tool kit in my presentation of a case illustrating how bioethics mediation may proceed, and what this approach using both (...) bioethics and mediation may add. (shrink)

Are the laws of nature consistent with contingency about what happens in the world? That depends on what the laws of nature actually are, but it also depends on what they are like. The latter is the concern of this chapter, which looks at three views that are widely endorsed: ‘Humean’ regularity accounts, laws as relations among universals, and disposition/powers accounts. Given an account of what laws are, what follows about how much contingency, and of what kinds, laws allow? In (...) all three cases, the authors argue, the root idea of what laws are does not settle the issue of whether they allow contingency. Advocates of the different accounts may argue for one view or another on the issue, but this will be an add-on rather than a consequence of the basic view about what laws are. -/- . (shrink)

In recent years, scholars have begun to lay the groundwork to justify a distinct application of ethics to the field of public health. They have highlighted important features that differentiate public health ethics from bioethics, especially public health’s emphasis on population health rather than issues of individual health. Articulations of public health ethics also tend to emphasize the role of social justice compared to the predominance of autonomy in the bioethical literature. Now that the field of public health ethics is (...) developing a unique focus and a language of its own, including a code of ethics disseminated by the American Public Health Association, the future of public health ethics may well be global health ethics, focusing on issues of global justice. As public health ethics evolves from its nascent stage of reflection to a place of action and application in the national and global arenas, two interrelated developments will need to occur: public health professionals, including practitioners, policymakers, and scholars, will need a richer understanding of the ethical challenges practitioners face on a daily basis and scholars will need to develop useful tools that practitioners may employ for identifying and tackling these ethical challenges. (shrink)

This paper opens a critical conversation about the ethics of international bioethics conferencing and proposes principles that commit to being anti-discriminatory, global, and inclusive. We launch this conversation in the Section, Case Study, with a case example involving the International Association of Bioethics’ (IAB’s) selection of Qatar to host the 2024 World Congress of Bioethics. IAB’s choice of Qatar sparked controversy. We believe it also may reveal deeper issues of Islamophobia in bioethics. The Section, Principles for International Bioethics Conferencing, sets (...) forth and defends proposed principles for international bioethics conferencing. The Section, Applying Principles to Site Selection applies the proposed principles to the case example. The Section, Applying Principles Beyond Site Selection addresses other applications of the proposed principles. The Section, Objections responds to objections. We close (in the Section, Conclusion) by calling for a wider discussion of our proposed principles.One-Sentence Capsule Summary: How should bioethicists navigate the ethics of global bioethics conferencing? (shrink)

Autumn Fiester identifies an important element in clinical ethics consultation (CEC) that she labels, from the Greek, aporia, “state of perplexity,” evidenced in CEC as ethical ambiguity. Fiester argues that the inherent difficulties of cases so characterized render them inappropriate for voting and more amenable to mediation and the search for consensus. This commentary supports Fiester’s analysis and adds additional reasons for rejecting voting as a process for resolving disputes in CEC including: it distorts the analysis by empowering individual voters (...) preferences and biases rather than focusing on the interests and wishes of the patient and family; it offers an insufficiently sensitive model for resolving the awesome, nuanced, conflicted, and ethically complex issues surrounding life and death; it marginalizes minority opinions that may have moral validity. (shrink)

The distinctive depth and seriousness of moral responsibility is often thought to stem from the seriousness of violating moral obligations. But this raises questions about being morally responsible for normative failure that does not belong to the deontic realm. This paper focuses on actions that we might, in the Aristotelian tradition, call ethical, and which concern how we order relations with ourselves; they concern certain fundamental conditions for agency. The paper provides a novel defense of the depth of self-directed aretaic (...) appraisal as intrapersonal responsibility; it also explains and provides a defense for Gary Watson’s claim that “Responsibility is important to issues about what it is to lead a life, indeed what it is to have a life in a biographical sense, and the quality and character of that life.” The depth of self-directed aretaic appraisal, I argue is a function of three features: its structure, the violation of normative standards and the reflective activity that it requires. Reflective human beings have an interest in leading lives that are rich, rewarding and expressive of our values and concerns. From the first-personal point of view, a life that is impoverished along any of these dimensions is defective in the aretaic sense. Protecting these interests requires discernment of these values and is accordingly a deep and serious form of appraisal. Because violation of these standards explains why at least one class of responsibility appraisal is deep and serious, depth and seriousness may have a plurality of explanations. (shrink)

Excitation at widely dispersed loci in the cerebral cortex may represent a neural correlate of consciousness. Accordingly, each unique combination of excited neurons would determine the content of a conscious moment. This conceptualization would be strengthened if we could identify what orchestrates the various combinations of excited neurons. In the present paper, cholinergic afferents to the cerebral cortex are hypothesized to enhance activity at specific cortical circuits and determine the content of a conscious moment by activating certain combinations of postsynaptic (...) sites in select cortical modules. It is proposed that these selections are enabled by learning-related restructuring that simultaneously adjusts the cytoskeletal matrix at specific constellations of postsynaptic sites giving all a similar geometry. The underlying mechanism of conscious awareness hypothetically involves cholinergic mediation of linkages between microtubules and microtubule-associated protein-2 . The first reason for proposing this mechanism is that previous studies indicate cognitive-related changes in MAP-2 occur in cholinoceptive cells within discrete cortical modules. These cortical modules are found throughout the cerebral cortex, measure 1–2 mm2, and contain approximately 103–104cholinoceptive cells that are enriched with MAP-2. The subsectors of the hippocampus may function similarly to cortical modules. The second reason for proposing the current mechanism is that the MAP-2 rich cells throughout the cerebral cortex correspond almost exactly with the cortical cells containing muscarinic receptors. Many of these cholinoceptive, MAP-2 rich cells are large pyramidal cell types, but some are also small pyramidal cells and nonpyramidal types. The third reason for proposing the current mechanism is that cholinergic afferents are module-specific; cholinergic axons terminate wholly within individual cortical modules. The cholinergic afferents may be unique in this regard. Finally, the tapering apical dendrites of pyramidal cells are proposed as primary sites for cholinergic mediation of linkages between MAP-2 and microtubules because especially high amounts of MAP-2 are found here. Also, the possibility is raised that muscarinic actions on MAP-2 could modulate microtubular coherence and self-collapse, phenomena that have been suggested to underlie consciousness. (shrink)

Significantly, Berkeley, in his Essay Towards a New Theory of Vision, leveled a sustained attack on just this geometrical theory of distance perception. At first glance it may seem, as it did to Berkeley, that Descartes’ geometrical theory is produced by a simple error: namely, by the idea that a physiological optics provides an adequate description of the psychological processes of judging distances. In truth, this is the weakest of Berkeley’s objections to Descartes’ theory. Obviously we do not see the (...) angles and lines of convergence when we focus on a distant object, nor are we aware of having used any geometrical rules in judging distance. And Descartes never claimed this. (shrink)

I discuss pedagogical issues that concern incest survivors. As teachers, we need to understand the ways in which the legacy of incest variously affects survivors' educational experiences and to be aware that the interplay of trust, knowledge, and power may be particularly complex for survivors. I emphasize the responsibility teachers have to create classrooms that are inclusive of survivors, while raising concerns about the practice of personal disclosure and assumptions about trust and safety in the classroom.

Efforts to decrease errors in health care are directed at prevention rather than at managing a situation when a mistake has occurred. Consequently, nurses and other health care providers may not know how to respond properly and may lack sufficient support to make a healthy recovery from the mental anguish and emotional suffering that often accompany making mistakes. This article explores the conceptualization of mistakes and the ethical response to making a mistake. There are three parts to an ethical response (...) to error: disclosure, apology and amends. Honesty and humility are discussed as important virtues that facilitate coping and personal growth for the health care provider who is involved in mistakes. In conclusion, a healthy view of nursing practice and mistake making is one that prevents error but, when prevention is not possible, accepts fallibility as part of the human condition and achieves the best possible outcome for all. (shrink)

This letter replies to the letter “Colonial and Neocolonial Barriers to Companion Digital Humans in Africa,” by Luís Cordeiro‐Rodrigues, in the same, May‐June 2024, issue of the Hastings Center Report.

An advertising firm''s ethical culture (as defined by the firm''s managerial and peer ethical behaviors) may affect the employees'' comfort levels and ethical behaviors. In this research, scenarios were used to describe advertising firms with various ethical cultures. Respondents'' perceived comfort levels in working for the firms described in the scenarios and the respondents'' behavioral intentions when faced with various advertising situations were assessed. Results of the study indicate that peer ethical behavior exerts a strong influence on the comfort or (...) discomfort level and the ethical behavioral intentions of potential advertising employees. Further, the strong influence exerted by peers seems to transcend the ethical behavior of the manager and carry over to the attitude toward the entire corporate advertising environment. This study provides insights for firms and researchers interested in assessing the impact of an advertising firm''s ethical culture on potential employees. (shrink)

In this paper I want to analyse the meaning of education for democracy and thinking as this is generally understood by Philosophy for Children. Although we may be inclined to applaud Philosophy for Children's emphasis on children, critical thinking, autonomy and dialogue, there is reason for scepticism too. Since we are expected as a matter of course to subscribe to the basic assumptions of Philosophy for Children, we seem to become tied, as it were, to the whole package, without reservation. (...) Following ideas of Hannah Arendt, I draw attention to the instrumentalised nature of Philosophy for Children and the loss of originality that this instrumentalisation means. This does not mean that I wish to abandon Philosophy for Children. The point is rather that I want to examine whether or not another kind of philosophy for children is possible. (shrink)

In the course of the last 30 years, feminist theories of gender have shifted from quasi-Marxist, labor-centered conceptions to putatively ‘post-Marxist’ culture-and identity-based conceptions. Reflecting a broader political move from redistribution to recognition, this shift has been double edged. On the one hand, it has broadened feminist politics to encompass legitimate issues of representation, identity and difference. Yet, in the context of an ascendant neoliberalism, feminist struggles for recognition may be serving less to enrich struggles for redistribution than to displace (...) the latter. Thus, instead of arriving at a broader, richer paradigm that could encompass both redistribution and recognition, feminists appear to have traded one truncated paradigm for another – a truncated economism for a truncated culturalism. This article aims to resist that trend. I propose an anaysis of gender that is broad enough to house the full range of feminist concerns, those central to the old socialist-feminism as well as those rooted in the cultural turn. I also propose a correspondingly broad conception of justice, capable of encompassing both distribution and recognition, and a non-identitarian account of recognition, capable of synergizing with redistribution. I conclude by examining some practical problems that arise when we try to envision institutional reforms that could redress gender maldistribution and gender misrecognition simultaneously. (shrink)

Public engagement in ethically laden pandemic planning decisions may be important for transparency, creating public trust, improving compliance with public health orders, and ultimately, contributing to just outcomes. We conducted focus groups with members of the public to characterize public perceptions about social distancing measures likely to be implemented during a pandemic. Participants expressed concerns about job security and economic strain on families if businesses or school closures are prolonged. They shared opposition to closure of religious organizations, citing the need (...) for shared support and worship during times of crises. Group discussions elicited evidence of community-mindedness, while some also acknowledged strong self-interest. Participants conveyed desire for opportunities for public input and education, and articulated distrust of government. Social distancing measures may be challenging to implement and sustain due to strains on family resources and lack of trust in government. (shrink)

Video games are popular and ubiquitous aspects of human culture, but their relationships to psychological and neurophysiological traits have yet to be analyzed in social-evolutionary frameworks. We examined the relationships of video game usage, motivations, and preferences with autistic and schizotypal traits and two aspects of neurophysiology, reaction time and targeting time. Participants completed the Autism Quotient, Schizotypal Personality Questionnaire, a Video Game Usage Questionnaire, and two neurophysiological tasks. We tested in particular the hypotheses, motivated by theory and previous work, (...) that: participants with higher autism scores would play video games more, and participants with higher schizotypy scores would play video games less; and autism and positive schizotypy would be associated with opposite patterns of video game use, preferences and motivations. Females, but not males, with higher autism scores played more video games, and exhibited evidence of relatively male-typical video game genre preferences and motivations. By contrast, positive schizotypy was associated with reduced video game use in both genders, for several measures of game use frequency. In line with previous findings, males played video game more than females did overall, preferred action video games, and exhibited faster reaction and targeting times. Females preferred Puzzle and Social Simulation games. Faster reaction and targeting times were associated with gaming motives related to skill development and building behavior. These findings show that gaming use and patterns reflect aspects of psychology, and gender, related to social cognition and imagination, as well as aspects of neurophysiology. More generally, the results suggest that video game use is notably affected by levels of autistic and schizotypal traits, and that video games may provide an evolutionarily novel medium for imaginative play in which immersive play experiences can be decoupled from social interaction. (shrink)

The question of whether fluid intelligence can be differentiated from general intelligence in older adults is addressed. Data indicate that the developmental pattern of performance on fluid tasks differs from the pattern of general intelligence. These results suggest that it is important to identify changes in fluid cognitive functions associated with frontal lobe decline, as they may be early indicators of cognitive decline. (Published Online April 5 2006).

While few soldiers may have read the works of Epictetus or Marcus Aurelius, it is undoubtedly true that the ancient philosophy known as Stoicism guides the actions of many in the military. Soldiers and seamen learn early in their training “to suck it up,” to endure, to put aside their feelings and to get on with the mission. This book explores what the Stoic philosophy actually is, the role it plays in the character of the military (both ancient and modern), (...) and its powerful value as a philosophy of life. Marshalling anecdotes from military history—ranging from ancient Greek wars to World War II, Vietnam, and Iraq—the book illuminates the military mind and uses it as a window on the virtues of the Stoic philosophy, which are far richer and more interesting than our popularized notions. The book explores the deep, lasting value that Stoicism can yield, in issues of military leadership and character; in the Stoic conception of anger and its control (does a warrior need anger to go to battle?); and in Stoic thinking about fear and resilience, grief and mourning, and the value of camaraderie and brotherhood. The book concludes by recommending a moderate Stoicism, where the task for the individual, both civilian and military, youth and adult, is to temper control with forgiveness, and warrior drive and achievement with humility and humor. (shrink)

This paper explores the relationship between the bonds of practitioner/patient trust and the notion of a justified lie. The intersection of moral theories on lying which prioritize right action with institutional discretionary power allows practitioners to dismiss, or at least not take seriously enough, the harm done when a patient's trust is betrayed. Even when a lie can be shown to be justified, the trustworthiness of the practitioner may be called into question in ways that neither theories of right action (...) nor contemporary discourse in health care attends to adequately. I set out features of full trustworthiness along Aristotelian lines. (shrink)

This article agrees with Philip Kitcher that we should aim for a well-ordered science, one that answers the right questions in the right ways. Crucial to this is to address questions of use: Which scientific account is right for which system in which circumstances? This is a difficult question: evidence that may support a scientific claim in one context may not support it in another. Drawing on examples in physics and other sciences, this article argues that work on the warrant (...) of theories in philosophy of science needs to change. Emphasis should move from the warrant of theories in the abstract to questions of evidence for use. (shrink)

We often hold people morally responsible for their emotions. We praise individuals for their compassion, think less of them for their ingratitude or hatred, reproach self-righteousness and unjust anger. In the cases I have in mind, the ascriptions of responsibility are not simply for offensive behaviors or actions which may accompany the emotions, but for the emotions themselves as motives or states of mind. We praise and blame people for what they feel and not just for how they act. In (...) cases where people may subtly mask their hatred or ingratitude through more kindly actions, we still may find fault with the attitude we see leaking through the disguise. (shrink)

Informed consent in clinical research is widely regarded as broken, but essential nonetheless. The most recent attempt to reform it comes as part of the first revisions to the Common Rule since it became truly “common” in 1991. This change, the addition of a “key information” requirement for most consent forms, is intended to support and promote a reasoned decision-making process by potential subjects. The key information requirement is both promising and problematic. It is promising because it encourages clarity and (...) honesty about research participation, creativity in information disclosure, and mutual learning through the investigator-subject relationship. It is problematic because those goals — which have remained aspirational since the beginning — may be difficult to achieve in what has become an excessively compliance-oriented regulatory regime. (shrink)

Hastings Center Report, Volume 52, Issue 3, Page 3-3, May–June 2022.

In this commentary, arguments are made for a dendritic code being preferable to a temporal synaptic code as a model of conscious experience. A temporal firing pattern is a product of an ongoing neural computation; hence, it is based on a neural algorithm and an algorithm may not provide the most suitable model for conscious experience. Reiteration of a temporal firing code as suggested in a preceding article (Helekar, 1999) does not necessarily improve the situation. The alternative model presented here (...) is that certain synaptic activity patterns, possibly those possessing universal features as suggested by Helekar, can become encoded in the dendritic structure. Following dendritic encoding, quantum phenomena in those specific dendrite sets could illuminate the static image of that encoded synaptic activity. It is the activation of the static image that would be equivalent to conscious experience; thus, conscious awareness would not be directly affiliated with synaptic activity. This dendrite encoding model may go farther than other models to explain the gestalt nature of consciousness, insofar as quantum entanglement could produce an interconnectedness between specific sets of dendrites-an interconnectedness that need not be based on neural computation or neural connections. (shrink)

In the course of the last thirty years, feminist theories of gender have shifted from quasi-Marxist, labor-centered conceptions to putatively “post-Marxist”culture- and identity-based conceptions. Reflecting a broader political move from redistribution to recognition, this shift has been double-edged. On the one hand, it has broadened feminist politics to encompass legitimate issues of representation, identity, and difference. Yet, in the context of an ascendant neoliberalism, feminist struggles for recognition may be serving to less to enrich struggles for redistribution than to displace (...) the latter. I aim to resist that trend. In this essay, I propose an analysis of gender that is broad enough to house the full range of feminist concerns, those central to the old socialist-feminism as well as those rooted in the cultural turn. I also propose a correspondingly broad conception of justice, capable of encompassing both distribution and recognition, and a non-identitarian account of recognition, capable of synergizing with redistribution. I conclude by examining some practical problems that arise when we try to envision institutional reforms that could redress gender maldistribution and gender misrecognition simultaneously. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.3 (2003) 58-77 [Access article in PDF] The Ethics of Care and the Private Woodwind Lesson Nancy Nourse Jeremy's family was getting ready for the concert. It wasn't that he was tired of watching his father conduct. He loved his father and he loved the concerts. But people were always asking Jeremy the same question and that question didn't seem to have an (...) answer....They weren't even inside the concert hall before the doorman smiled at Jeremy and asked, "Well, young man, do you think you'll be a conductor like your father?" 1Children like Jeremy, situated in the world of established music-making, are routinely subjected to stereotypical expectations, often not seen for who they are themselves, but for the qualities of their situatedness. Jeremy, as a result, found himself continually bombarded with this question which spokein fortissimo tones that the inquirer was impressed by the stature of his maestro father, but really did not seem to care to see the young boy as a person in his own right. The dreaded question, that he so frequently faced, festered in him, shouting of his own lack of personhood in its flagrant assumptions. But what voice did he have? After the concert: a lady in a long gown and a huge strand of pearls came in next [backstage]...."So this is your little son," she cried. Jeremy blushed as she kissed the top of his head and squeezed his face so that he looked like a fish. "Tell me, young man, are you going to be a conductor like your father?" 2Of course stories such as Jeremy's in which individuals suffer because others have not been truly caring, are not unique to the world of music. Such thoughtless pleasantries are nothing more than symptoms of the widespread absence of knowing and care experienced in day-to-day living. While Patricia Benner and Suzanne Gordon suggest that there are few people who would wish to be perceived as uncaring persons, there are often spoken platitudes about care, especially about large institutions, that seemshallow and meaningless. 3 Take, for example, a hospital whose slogan claims [End Page 58] it is caring, but is only really interested in research or profit, or the doctor who quadruple books patients for appointments all the while insisting that he really does care about his patients. The obstacles to true understanding about care include the view that care is merely a sentiment that need be expressed, but not the thoughtful planning out of means to create ample opportunities to enact deeds of caring. 4 In day-to-day situations of modern living with big corporations, governments, and institutions, there may be individuals who claim to care, but there are no features in these organizations' blueprints that ensure and take responsibility for providing care. Care must extend beyond sentiment into action.In the name of superior curriculum and specialist teachers and programs,tiny rural schools were abandoned and students were moved into bigger and bigger schools. As schools and educational institutions have greatly increased in size over the past century, teachers have found it more and more difficult to connect to the larger and larger number of students found on their class rosters. Beyond their class lists how can teachers really be responsible for the sea of faces for whom they cannot even supply names? In The Students are Watching, Theodore and Nancy Sizer ask: Do [current] conditions in the school allow each student to be known well?...Anonymity is the curse of good teaching and inevitably contributes to corner-cutting. If no one knows the students in a high school, it is easy for them to drift through. 5Benner and Gordon cite the shop program in a vocational school as an ideal setting in which teachers have the opportunity to develop caring relationships with their students since the settings are informal, class time is significantly extended, and the teachers work with the same students over several years. 6 Special education teachers as well usually... (shrink)

Ault, Nancy J Spiritual direction is at risk in a society which is turning increasingly to personal feelings to validate experience and justify decision making. An appeal to feelings and emotions enables marketers to sell religion and spirituality as consumer products. As a product among many, the wider contexts of religion and spirituality may fade from consciousness and be lost. In such a 'pick and mix' culture, as well as losing sight of the embodied nature of understanding, what may (...) happen is a slow drifting apart of thinking, feelings and action. The cost of such a separation is high. Feelings may disintegrate into sentimentalism, thinking sink into legalism and action become uninformed reaction. Hence, practices which facilitate the intentional integration of mind, heart and behaviour can provide an essential counterbalance to the contemporary forces engendering separation. (shrink)

Advance directives have been lauded by scholars and supported by professional organizations, Congress, and the United States Supreme Court. Despite this encouragement, only a small number of capable patients execute living wills or appoint health care agents. When patients do empower proxies, doctors may be uncertain about the scope of their duties and obligations to these persons who, in theory, stand in the shoes of the patient. This article argues for a conscious focus on the ethical duties, emotional supports, and (...) guidance owed by physicians to health care agents. (shrink)

Approximately 11.2 million undocumented immigrants have settled in the United States. Providing health care to these residents is an everyday concern for the clinicians and health care organizations who serve them. Uncertain how to proceed in the face of severe financial constraints, clinicians may improvise remedies–a strategy that allows our society to avoid confronting the clinical and organizational implications of public policy gaps. There is no simple solution‐no quick fix‐that will work across organizations (in particular, hospitals with emergency departments) in (...) states with different concentrations of undocumented immigrants, varying public and private resources for safety‐net health care, and differing approaches to law and policy concerning the rights of immigrants. However, every hospital can help its clinicians by addressing access to health care for undocumented immigrants as an ethical issue. We offer some recommendations for doing this in a structured, fair, and transparent way. We also describe the problems that may result when clinicians are forced to grapple with this issue on their own. (shrink)

The Moral Psychology Handbook is a contribution to a relatively new genre of philosophical writing, the “handbook.” In the first section, I comment on an expectation about handbooks, namely that handbooks contain works representative of a field, and raise concerns about The Moral Psychology Handbook in this regard. In the rest of the article I comment in detail on two Handbook articles, “Moral Motivation” by Timothy Schroeder, Adina Roskies, and Shaun Nichols, and “Character” by Maria W. Merritt, John M. Doris, (...) and Gilbert Harman. Both articles illustrate the perils as well as the promise of reliance on empirical studies for philosophers who work in moral psychology. (shrink)

Do you want a life you live on your own terms and not one that feels like it happens to you? Nanci Danison found out how to create a happier life in the most dramatic way possible. She died! During the most extensive afterlife visit ever reported, the author was shown and told that we souls consciously and unconsciously create our own physical reality during human life through an incredible spiritual power called manifesting. Create a New RealityMove Beyond Law of (...) Attraction Theory introduces you to the power of manifesting and leads you step-by-step through how to create more opportunities to better your life, to replace old beliefs that hold you back from creating a happier life, and to heal yourself of physical and emotional wounds. Learn why and how you have the amazing ability to literally change the physical world you experience, as it was explained to the author by God/Source. It is far more powerful than anything you may have read about law of attraction theories. (shrink)

In translating and editing Dai Qing's Zawen [Piquant Essays], we have tried to retain the author's original if somewhat disjointed style. This includes Dai Qing's tendency to combine the main narrative with quick asides on related issues that may occasionally confuse the reader. Dai Qing's original notes appear as footnotes on the bottom of a page on which they are referenced. Additional explanatory notes provided by the translators are placed at the end of each essay. These notes help to clarify (...) for the reader the most obscure events, personages, and Chinese terminology. We have kept these to a minimum to prevent unnecessary interruptions to Ms. Dai's free-flowing narrative and to retain the original quality of the essays, thereby avoiding undue elaborations and explications for the unacquainted. The essays are presented in no particular chronological order; some have been dated by Dai Qing and others not. (shrink)

Fostering shame in societies may not curb violence, because shame is alienating. The person experiencing shame may not care enough about others to curb violent instincts. Furthermore, men may be less shame-prone than are women. Finally, if shame is too prevalent in a society, perpetrators may be reluctant to talk about their actions and motives, if indeed they know their own motives. We may be unable accurately to discover how perpetrators think about their own violence.

In the course of an immune response, antibodies undergo affinity maturation in order to increase their efficiency in neutralizing foreign invaders. Affinity maturation occurs by the introduction of multiple point mutations in the variable region gene that encodes the antigen binding site. This somatic hypermutation is restricted to immunoglobulin genes and occurs at very high rates. The precise molecular basis of this process remains obscure. However, recent studies using a variety of in vivo and in vitro systems have revealed important (...) regulatory regions, base motifs that are preferred targets of mutation and evidence that transcription may play an active role in hypermutation. BioEssays 20:227–234, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

Participants in clinical research sometimes view participation as therapy or exaggerate potential benefits, especially in phase I or phase II trials. We conducted this study to discover what methods might improve cancer patients’ understanding of early-phase clinical trials. We randomly assigned 130 cancer patients from three U.S. medical centers who were considering enrollment in a phase I or phase II cancer trial to receive either a multimedia intervention or a National Cancer Institute pamphlet explaining the trial and its purpose. Intervention (...) participants were 32 times more likely to believe that the trial’s purpose was to examine safety and 60 % less likely to believe they would experience long-term benefit or cure. There was no difference in enrollment decision. However, while patients’ understanding of the trial’s purpose improved and expectations of long-term benefit diminished, half the respondents still believed they would experience long-term benefit or cure from participation. Therefore, we conclude that multimedia interventions such as this one may help oncologists to explain the risks and benefits of early-phase cancer trials in a way that patients can more easily understand, helping them to make more informed decisions about participation. But further research into other factors that influence patients’ beliefs about the outcome of enrollment is needed, both to modify the interventions and to determine how malleable patient beliefs are. (shrink)

Robert Sparrow has recently claimed that unless there are reasons to think the sexed nature of human beings is normatively significant, current trends in bioethical reasoning force the conclusion that “we may do well to move toward a ‘post sex’ humanity” (American Journal of Bioethics 10: 7 (2010)). This commentary uses basic methodological principles from feminist ethics to argue that he has, in fact, given no reasons to think that a 'post sex' humanity is any more valuable than gender diverse (...) one, and no reason to think that sexual dimorphism has normative significance as a brute biological fact. (shrink)

Small pendant discs known as Scandinavian gold bracteates are visually impressive indicators of status and identity during the early medieval Migration Period (c. 450–550 CE). Much of the emphasis in bracteate studies has been on typological classification and iconographic interpretation of the pictures, along with decipherment of the inscriptions, yet the sensory impression made by bracteates has been neglected. For decades, archaeologists considered it futile to speculate on the experiential; however, recent research has begun to contend with the materiality of (...) senses and emotions in the past. In this paper, I focus on the both sensory effect of experiencing the pendants and the emotional impact of the objects on those who wore and handled them. Since bracteates are often discovered in women’s graves and show evidence of wear on their suspension loops, it is assumed that these objects were actually used in life. A spotlight on agency turns the study of bracteates from an emphasis on typology, iconography, and runology to trace instead the agency and multisensory effects of these objects on people and the effects of people’s actions on these items. This allows an examination of how bracteates were entangled with the senses and emotions of those who made, wore, and gazed upon these small but important objects. I consider what it may have felt like to make, receive, wear, lose, or bequeath a bracteate – or to deposit it into a bog or a grave. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.3 (2003) 58-77 [Access article in PDF] The Ethics of Care and the Private Woodwind Lesson Nancy Nourse Jeremy's family was getting ready for the concert. It wasn't that he was tired of watching his father conduct. He loved his father and he loved the concerts. But people were always asking Jeremy the same question and that question didn't seem to have an (...) answer....They weren't even inside the concert hall before the doorman smiled at Jeremy and asked, "Well, young man, do you think you'll be a conductor like your father?" 1Children like Jeremy, situated in the world of established music-making, are routinely subjected to stereotypical expectations, often not seen for who they are themselves, but for the qualities of their situatedness. Jeremy, as a result, found himself continually bombarded with this question which spokein fortissimo tones that the inquirer was impressed by the stature of his maestro father, but really did not seem to care to see the young boy as a person in his own right. The dreaded question, that he so frequently faced, festered in him, shouting of his own lack of personhood in its flagrant assumptions. But what voice did he have? After the concert: a lady in a long gown and a huge strand of pearls came in next [backstage]...."So this is your little son," she cried. Jeremy blushed as she kissed the top of his head and squeezed his face so that he looked like a fish. "Tell me, young man, are you going to be a conductor like your father?" 2Of course stories such as Jeremy's in which individuals suffer because others have not been truly caring, are not unique to the world of music. Such thoughtless pleasantries are nothing more than symptoms of the widespread absence of knowing and care experienced in day-to-day living. While Patricia Benner and Suzanne Gordon suggest that there are few people who would wish to be perceived as uncaring persons, there are often spoken platitudes about care, especially about large institutions, that seemshallow and meaningless. 3 Take, for example, a hospital whose slogan claims [End Page 58] it is caring, but is only really interested in research or profit, or the doctor who quadruple books patients for appointments all the while insisting that he really does care about his patients. The obstacles to true understanding about care include the view that care is merely a sentiment that need be expressed, but not the thoughtful planning out of means to create ample opportunities to enact deeds of caring. 4 In day-to-day situations of modern living with big corporations, governments, and institutions, there may be individuals who claim to care, but there are no features in these organizations' blueprints that ensure and take responsibility for providing care. Care must extend beyond sentiment into action.In the name of superior curriculum and specialist teachers and programs,tiny rural schools were abandoned and students were moved into bigger and bigger schools. As schools and educational institutions have greatly increased in size over the past century, teachers have found it more and more difficult to connect to the larger and larger number of students found on their class rosters. Beyond their class lists how can teachers really be responsible for the sea of faces for whom they cannot even supply names? In The Students are Watching, Theodore and Nancy Sizer ask: Do [current] conditions in the school allow each student to be known well?...Anonymity is the curse of good teaching and inevitably contributes to corner-cutting. If no one knows the students in a high school, it is easy for them to drift through. 5Benner and Gordon cite the shop program in a vocational school as an ideal setting in which teachers have the opportunity to develop caring relationships with their students since the settings are informal, class time is significantly extended, and the teachers work with the same students over several years. 6 Special education teachers as well usually... (shrink)