In times of global economic and political crises, the notion of solidarity is gaining new currency. This book argues that a solidarity-based perspective can help us to find new ways to address pressing problems. Exemplified by three case studies from the field of biomedicine: databases for health and disease research, personalised healthcare, and organ donation, it explores how solidarity can make a difference in how we frame problems, and in the policy solutions that we can offer.

Combining knowledge of social policy and practice with insights from poststructural and feminist theory, the text demonstrates how democratic citizens and the political are continually recreated.

In recent years, critical scholarship has drawn attention to increasing power differentials between corporations that use data and people whose data is used. A growing number of scholars see digital data and information commons as a way to counteract this asymmetry. In this paper I raise two concerns with this argument: First, because digital data and information can be in more than one place at once, governance models for physical common-pool resources cannot be easily transposed to digital commons. Second, not (...) all data and information commons are suitable to address power differentials. In order to create digital commons that effectively address power asymmetries we must pay more systematic attention to the issue of exclusion from digital data and information commons. Why and how digital data and information commons exclude, and what the consequences of such exclusion are, decide whether commons can change power asymmetries or whether they are more likely to perpetuate them. (shrink)

This paper, which is based on an extensive analysis of the literature, gives a brief overview of the main ways in which solidarity has been employed in bioethical writings in the last two decades. As the vagueness of the term has been one of the main targets of critique, we propose a new approach to defining solidarity, identifying it primarily as a practice enacted at the interpersonal, communal, and contractual/legal levels. Our three-tier model of solidarity can also help to explain (...) the way in which crises of solidarity can occur, notably when formal solidaristic arrangements continue to exist despite ‘lower tiers’ of solidarity practices at inter-personal and communal levels having ‘broken away’. We hope that this contribution to the growing debate on the potential for the value of solidarity to help tackle issues in bioethics and beyond, will stimulate further discussion involving both conceptual and empirically informed perspectives. (shrink)

Richard Rorty's rejection of prevailing interior-mirror understandings of the presumed relationship between “minds” and “nature,” along with his promotion of nonrepresentational accounts of knowledge, truth, and science, participates in a rich tradition of jointly pragmatist and constructivist views that spans the twentieth century. This contribution to the symposium “Whatever Happened to Richard Rorty?” considers Rorty's complex and ambivalent relation to that tradition, particularly to the work of his American pragmatist predecessors, William James and John Dewey, and to subsequent pragmatist-constructivist antirepresentationalism (...) in contemporary science and technology studies (STS) and “4E” (embodied, embedded, extended, enactive) cognitive theory. A final section on Nicholas Gaskill's contribution to the symposium questions his sense of Rorty's rhetorical recklessness and suggests that his worries over relativism, in Rorty's texts and more generally, are misplaced. (shrink)

This article challenges a key tacit assumption underpinning legal and ethical instruments in health care, namely, that people are ideally bounded, independent, and often also strategically rational individuals. Such an understanding of personhood has been criticized within feminist and other critical scholarship as being unfit to capture the deeply relational nature of human beings. In the field of medicine, however, it also causes tangible problems. I propose that a solidarity-based perspective entails a relational approach and as such helps to formulate (...) new solutions to complex ethical and regulatory questions, ranging from caring for people at the end of their lives to improving policies for organ donation and better governance of health data. It also underscores the importance of universal health care. Although a solidarity-based perspective does not require health to be seen as an individually enforceable right, it does influence our understanding of individual rights: it draws attention to how their meaning is shaped by shared social practices. I conclude by arguing that, in light of current pressures for medicine to become more personalized, using a relational understanding of personhood to shape policies and practices is a much needed endeavor. (shrink)

Whistleblowing is a controversial yet socially significant topic of interest due to its impact on employees, organizations, and society at large. The purpose of this paper is to integrate knowledge of whistleblowing with theoretical advancements in the broader domain of business ethics to propose a novel approach to research and practice engaged in this complex phenomenon. The paper offers a conceptual framework, i.e., the wheel of whistleblowing, that is developed to portray the different features of whistleblowing by applying the whistleblower’s (...) perspective. The framework is based on five “W” questions: Who, What, hoW, Why, and to Whom? The answers to the proposed questions clarify the main aspects of whistleblowing, provide insights into existing studies of the subject, and identify relevant gaps in the literature which, in turn, offer opportunities for future research. (shrink)

Chronic and current epistemological controversies, with particular attention to the development of pragmatist/historicist/constructivist reconceptions of knowledge and science in the 20th century and the scandalized responses to them by defenders of more traditional rationalist/objectivist/realist conceptions. Individual chapters deal with complex and confused relations among epistemic skepticism, relativism, and constructivist epistemology ; 20th-century "postmodern" relativism and anti-relativism; Ludwik Fleck and constructivist views of truth, science, and knowledge; attacks on and disavowals of constructivism and/or relativism by established and feminist philosophers; the Science (...) Wars and fraught relations between the humanities and the sciences; the problematic claims of Evolutionary Psychology; and chronic problems and contemporary views of animal-human relations. (shrink)

The purpose of this article is to report what can be learned about nurses’ ethical conflicts by the systematic analysis of methodologically similar studies. Five studies were identified and analysed for: (1) the character of ethical conflicts experienced; (2) similarities and differences in how the conflicts were experienced and how they were resolved; and (3) ethical conflict themes underlying four specialty areas of nursing practice (diabetes education, paediatric nurse practitioner, rehabilitation and nephrology). The predominant character of the ethical conflicts was (...) disagreement with the quality of medical care given to patients. A significant number of ethical conflicts were experienced as ‘moral distress’, the resolution of which was variable, depending on the specialty area of practice. Ethical conflict themes underlying the specialty areas included: differences in the definition of adequacy of care among professionals, the institution and society; differences in the philosophical orientations of nurses, physicians and other health professionals involved in patient care; a lack of respect for the knowledge and expertise of nurses in specialty practice; and difficulty in carrying out the nurse’s advocacy role for patients. (shrink)

This article provides a concise overview of the history of scholarship on solidarity in Europe and North America. While recent decades have seen an increase in conceptual and scholarly interest in solidarity in North America and other parts of the Anglo-Saxon world, the concept is much more strongly anchored in Europe. Continental European politics in particular have given rise to two of the most influential traditions of solidarity, namely, socialism and Christian ethics. Solidarity has also guided important public instruments and (...) institutions in Europe. Despite the much stronger affinity of continental European societies to solidaristic thinking, we argue that solidarity has much to offer for addressing societal challenges on both sides of the Atlantic and beyond. After proposing a working definition of solidarity that highlights its utility for guiding policy and practice, we give an example of how a solidarity-based perspective can shape instruments for the governance of data use. (shrink)

The paper investigates the ethical decisions of Millennials, who are not only part of an expanding cohort of the workforce, but also represent potential future managers with a growing influence on work practices and employment relationships. In the conceptual model, we propose that three ethical frames of reference, represented by perceived organisational ethics, perceived employee ethics and reflective moral attentiveness, antecede ethical judgements, which further influence the ethical intentions of Millennials. Using structural equation modelling, we test the model for three (...) different business ethics scenarios: paying a consulting fee, dumping hazardous waste, and running an offensive advertising campaign. The findings confirm the link between ethical judgements and intentions across the board, while the influence of the ethical frames of reference varies among the scenarios. We propose that the differences in the predictive ability of the ethical frames of reference depend on the nature of the ethical issue, which holds important implications for today's managers in their attempts to encourage ethical behaviour of Millennial employees. (shrink)

It has been a commonplace from the beginnings of philosophical thought that what distinguishes humans from other species is the ability to reason; reason- ing is held to be an essential characteristic of the species and one that is unique to it. The essence condition requires that all humans possess at least the capacity for reasoning and that it be exercised in many of the ordinary cases of acquiring beliefs. And uniqueness entails that non-humans cannot reason, no matter how much (...) their behavior resembles that of humans. I think that a certain specific model of reasoning has been presupposed by proponents of these claims. And there are grounds to believe that this model is inaccurate in essential respects: if reasoning does correspond to it, then few human beliefs are acquired through reason. However, given a more accurate description of what goes on in normal human reasoning, it is no longer plausible to think that only humans reason. So either the essence or the uniqueness claim must be given up. In this paper I argue for the second option. (shrink)

In today’s digital societies, it has become very difficult for people to exercise meaningful control over what and how data is collected and used. McCoy and colleagues (2023) seek to address this p...

ABSTRACT Amidst trends that emphasize languishing patterns in teen mental health, there is a bright spot: social science research indicates that adolescents who develop relationships with adult mentors demonstrate increased signs of flourishing. This social science research on mentors, though limited to school performance outcome goals, offers a lifeline to character educators. I offer a theoretical framework based on Aristotelian principles, informed by anecdotal case studies of authentic moral dilemmas that emerged from the direct experiences of mentees, to suggest a (...) framework to explain why adolescents with adult mentors have an advantage. Patterns of conversation in trusted mentoring relationships developed over time, and in a school context that provides sufficient professional development for mentors, support the youth: (1) to advance in practical wisdom (phronesis) by honing skills for emotional regulation as well as cognitive skills to recognize goods in conflict and (2) to learn how to engage in civic friendship through these friendships of inequality with mentors. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:20. HUME ON REASON1 One of the main concerns of Hume's Treatise of 2 Human Nature (T) is the investigation of the role that reason plays in belief and action. On the standard interpretation, Hume is taken to argue that neither our beliefs nor our actions are determined by reason; Books I and III are thus seen as sharing a common theme: the denigration of reason's role in human (...) affairs. Arguing for this view, Kemp Smith claims that "Hume's principle of the subordination of reason to the passions runs through his whole philosophy ", not merely through Books II and III. This interpretation of Hume's enterprise presupposes that the faculty of reason whose role in action is discussed in Book III is the same faculty which has been shown not to determine belief in Book I. In this paper I argue that a univocal reading of 'reason' and related terms like 'reasoning' throughout the Treatise has the consequence that there are major internal inconsistencies in Hume's philosophy, cannot account for some important sections of the work, and leads to misinterpretation of the nature of his overall argument. In its place I develop an interpretation which avoids these difficulties and emphasizes the radical nature of Hume's naturalism. The Argument of the Treatise Let me begin by reviewing the salient features of the main argument of the Treatise. In Book I, Hume is concerned to show that our most fundamental beliefs — e.g., about the continued and distinct existence of object, about what we are not presently observing, and in the existence of the self — are not acquired by reason, but instead by the imagination, influenced by custom and habit. In a typical passage, he argues: Reason can never shew us the connexion of one object with another, tho' aided by experience, and the observation of their constant conjunction in all past instances. When the mind, 21. therefore, passes from the idea or impression of one object to the idea or belief of another, it is not determin'd by reason... (T92)4 In Book III, and in Book II, Part III, Section III (Of the influencing motives of the will), Hume is concerned to show that reason alone can never produce any action, or give rise to volition (T414), and the same faculty is as incapable of preventing volition, or of disputing the preference with any passion or emotion (T414-415). Hume uses this result in Book III, Part I, Section I, to show that the rules of morality...are not conclusions of our reason (T457). Proponents of the univocal reading of 'reason' would hold that the Treatise thus constitutes a continuous attack on reason, showing that it causes neither our most fundamental beliefs nor our actions and moral judgments. But if this reading were correct, Hume would fail to avail himself of an obvious and persuasive argument for the conclusion he reaches in Books II and III, and in the latter books he would contradict the results of Book I. Conflict between Book I and Books II and III If Hume did have the same faculty in mind throughout the Treatise, a strong argument to show that reason does not cause action would be available to him in Books II and III, utilizing the results he has established in Book I. The principal way in which reason would be thought to influence action is by informing us of facts about efficient means to achieve our ends and about the possible effects of actions — facts about causal relations. Since the conclusion of Book I is that judgments about causal relations do not result from reason, it follows that even if such beliefs did cause action, it would still not be the case that reason caused action. But Hume not only does not make such an argument in Books II and III, he denies one of its premises — the claim that beliefs about causal relations do not result from reason — which was the main conclusion of Book I. In the 22. later books he asserts repeatedly that reason can cause beliefs about causal relations. For example, in Book III, he says:...reason, in a strict and philosophical... (shrink)

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 17 Heft: 1 Seiten: 331-344.

This paper proposes an approach to narrative deixis which offers a coherent analysis of the respective roles of proximal and distal deictic expressions. The paper starts by arguing that fictional narratives require an approach to deixis which modifies a number of broadly held assumptions, especially as regards the interaction between tense and other deictic forms. It then considers the widely discussed instance of the temporal adverb now in the context of Past Tense. The second part of the paper gives special (...) focus to demonstratives in narrative fiction, showing their role in temporal construals. It argues that both temporal and demonstrative expressions are primarily used to serve narrative viewpoint construction. Examples from several novels are then used to show how the proximal and distal choices of demonstratives, temporal adverbs and locative adverbs structure narrative viewpoint, including narrative representation of character experience. The paper concludes by proposing that in the context of fictional narratives the proximal/distal contrast is more relevant to meaning emergence than individual aspects of deixis, and that the construal of time can be achieved through the whole spectrum of deictic forms, not just tense and temporal adverbs such as now and then. (shrink)

Advocates of literary Darwinism, cognitive cultural studies, neuroaesthetics, digital humanities, and other such hybrid fields now seek explicitly to make the aims and methods of one or another humanities discipline approximate more closely the aims and methods of science, and at their most visionary, they urge as well the overall integration of the humanities and natural sciences. This essay indicates some major considerations—historical, conceptual, and pragmatic—that may be useful for assessing these efforts and predicting their future. Arguments promoting integration often (...) involve dubious teleological models of intellectual history and betray limited understandings of the distinctive epistemic orientations and cultural functions of the humanities vis-à-vis the sciences. Recurrent institutional difficulties encountered by scholars and/or scientists in hybrid fields reflect steep prestige differentials between the humanities and sciences, along with significant differences of training, experience, style, and temperament. Meanwhile, both the sciences and humanities are being shaken up by technological and related intellectual developments. Though worrisome, the new disciplinary configurations are thus likely to play out in surprising and, not inconceivably, positive ways. (shrink)

Whistleblowers remain essential as complainants in allegations of research misconduct. Frequently internal to the research team, they are poorly protected from acts of retribution, which may deter the reporting of misconduct. In order to perform their important role, whistleblowers must be treated fairly. Draft regulations for whistleblower protection were published for public comment almost a decade ago but never issued. In the face of the growing challenge of research fraud, we suggest vigorous steps, to include: organizational responsibility to certify the (...) accuracy of research including audit, required whistleblower action in the face of imminent or grave harm to subjects, strengthened legal protections against retaliation including prompt enactment of Federal whistleblower protections and consideration of criminalizing the most egregious cases of research misconduct. (shrink)

We study for each computably bounded $\Pi ^0_1$ class P the set of degrees of c.e. paths in P. We show, amongst other results, that for every c.e. degree a there is a perfect $\Pi ^0_1$ class where all c.e. members have degree a. We also show that every $\Pi ^0_1$ set of c.e. indices is realized in some perfect $\Pi ^0_1$ class, and classify the sets of c.e. degrees which can be realized in some $\Pi ^0_1$ class as exactly (...) those with a computable representation. (shrink)

The Rainbow Ramsey Theorem is essentially an "anti-Ramsey" theorem which states that certain types of colorings must be injective on a large subset (rather than constant on a large subset). Surprisingly, this version follows easily from Ramsey's Theorem, even in the weak system RCA₀ of reverse mathematics. We answer the question of the converse implication for pairs, showing that the Rainbow Ramsey Theorem for pairs is in fact strictly weaker than Ramsey's Theorem for pairs over RCA₀. The separation involves techniques (...) from the theory of randomness by showing that every 2-random bounds an ω-model of the Rainbow Ramsey Theorem for pairs. These results also provide as a corollary a new proof of Martin's theorem that the hyperimmune degrees have measure one. (shrink)

Everyone agrees that law is a constituent of social reality. Law seems to be a system by which conduct is governed and guided. Its usefulness consists, in part, on its ability to govern and guide conduct in its characteristic way. If laws guides the conduct of lay law subjects, then it must be (really) possible for the content of the laws governing their conduct to be known by them under standard social conditions. Moreover, if some degree of efficacy in guiding (...) and governing the conduct of lay law subjects is an existence condition for a legal system, then in existing legal systems enough of the content of directive law is epistemically accessed by enough law subjects so that they can apply it to their situations and correctly determine the act-tokens required of them. In this chapter, I argue that these modest epistemic reflections have important implications for a theory of legal content that have been largely ignored. Holistic theories of legal content, such as Greenberg’s and Dworkin’s, are inconsistent with an adequate account of epistemic access. After demonstrating the same problem in two mainstream non-holistic theories of legal content -- the view that legal content is set entirely by official interpretive conventions, and the view that legal content is set entirely by official intentions – I propose a theory of legal content that meets the epistemic access challenge. On my approach, law is, at its core, centered upon the understandings of law subjects. (This view is meant to exempt constitutional provisions.) More precisely, the legal content of statutes and judicial decisions is built around, and preserves, a core of understandings and meaning-assignments that is the province of anyone with sufficient linguistic ability and relevant socialization. The details of this view are, roughly: (1) in the case of judicial decisions in a common law system, the social salience of the example the decision sets concerning behavior sets the default legal content; (2) in the case of statutory directives, the set of socially salient applications (behavior in situations) sets the default legal content. I say `default’ because my account of legal content is a two-stage account beginning with the default content and permitting a second stage in which considerations from other sources can operate on the default. Yet if a certain amount of efficacy in guiding lay law subjects’ behavior is a requirement for the existence of a legal system, there must be a core of legal content undistorted from its default social salience by a second stage operation. There is and must be a `law of the street’. -/- . (shrink)

. . . I should like to review and summarize the preceding general points: 1. For any particular narrative, there is no single basically basic story subsisting beneath it but, rather, an unlimited number of other narratives that can be constructed in response to it or perceived as related to it.2. Among the narratives that can be constructed in response to a given narrative are not only those that we commonly refer to as "versions" of it but also those retellings (...) that we call "plot summaries," "interpretations," and, sometimes, "basic stories." None of these retellings, however, is more absolutely basic than any of the others.3. For any given narrative, there are always multiple basic stories that can be constructed in response to it because basic-ness is always arrived at by the exercise of some set of operations, in accord with some set of principles, that reflect some set of interests, all of which are, by nature, variable and thus multiple. Whenever we start to cut back, peel off, strip away, lay bare, and so forth, we always do so in accord with certain assumptions and purposes which, in turn, create hierarchies of relevance and centrality; and it is in terms of these hierarchies that we will distinguish certain elements and relations as being central or peripheral, more important or less important, and more basic or less basic.4. The form and feature of any "version" of a narrative will be a function of, among other things, the particular motives that elicited it and the particular interests and functions it was designed to serve. Some versions, such as translation and transcriptions, may be constructed in order to preserve and transmit a culturally valued verbal structure. Others, such as adaptations and abridgements, may be constructed in order to amuse or instruct a specific audience. And some versions, such as "interpretations," "plot summaries," and "basic stories," may be constructed in order to advance the objectives of a particular discipline, such as literary history, folklore, psychiatry—or, of course, narratology. None of these latter versions, however, is any less motivated or, accordingly, formally contingent than any of the other versions constructed to serve other interests or functions. Barbara Herrnstein Smith is professor of English and communications and the director of the Center for the Study of Art and Symbolic Behavior at the University of Pennsylvania, and the author of Poetic Closure and On the Margins of Discourse. "On the Margins of Discourse" was also contributed as an essay to Critical Inquiry in the June 1975 issue. Responses to the present essay are Nelson Goodman's "The Telling and the Told" and Seymour Chatman's "Reply to Barbara Herrnstein Smith". Both appear in the Summer 1981 issue of Critical Inquiry. (shrink)

This volume explores the cross-linguistic diversity, and possibly inconsistency, of the span of linguistic means that signal reported speech and thought. The integration of broad linguistic (viewpoint in conversation and narrative) and cognitive (theory of mind and understanding the inner life and thought of others) strategies for handling mixed points of view will be considered.

Designing the future of work is crucial to the health and well‐being of people and societies. Experts predict that developments such as the advancement of digital technologies, automation, and the movement of manufacturing jobs to low‐wage countries will lead to major transformations in the labour market, and some foresee significant job losses. Due to the close relationship between employment and health, major job losses would have significant negative impacts on the health and well‐being of individuals and societies. Job losses would (...) also pose a major challenge to solidaristic support within societies because they would negatively affect the recognition of similarities among people, which is vital for solidaristic practice and institutions. To prevent these negative effects, a fundamental redesign of the relationship between work and income is necessary. And for this project to succeed, we need to reconsider of the value of work. Building on definitions of flourishing people and societies, we argue that the value of work should not be determined by the labour market, but according to its importance for society. Using a solidarity‐based framework we argue that such a re‐valuation of work will help to ensure social cohesion and increase reciprocity in our societies. It will serve as a foundation upon which we can reconfigure the relationship between work and income without risking the loss of social cohesion and solidarity. (shrink)

This paper will examine the effects of gender, age, work experience, academic status and legality on certain ethical decisions. Six scenarios representing ethical dilemmas were presented to both undergraduate and MBA students in an attempt to determine if various demographic factors influenced ethical decision making. While some past studies have suggested that gender has an important effect on ethical decision making, this study does not completely support this conclusion and suggests that age and/or length of work experience should be included (...) in any study of ethical decision making.The legality of the decisions was determined and compared to the reason given by the students for their decisions. In some cases the choice made by a majority of the students was not the one that was supported by the legal authorities which suggests that there may be conflicts between the ethical system of the respondents and the behavior expected of them by society. (shrink)

This article considers the relevance of time theory for Beck's theory of reflexive modernization and vice versa. It focuses in particular on discontinuity in the context of continuity, on decontextualization, naturalization and responsibility as key concerns of both perspectives on the industrial way of life. It makes explicit the temporal underpinnings of that cultural form with respect to five Cs: the creation of time to human design, the commodification of time, the compression of time, the control of time and the (...) colonization of time. It concludes that explicit concern with temporal relations shows reflexive modernization in action and facilitates improved knowledge for deliberative change. (shrink)

We investigate the complexity of isomorphisms of computable structures on cones in the Turing degrees. We show that, on a cone, every structure has a strong degree of categoricity, and that degree of categoricity is${\rm{\Delta }}_\alpha ^0 $-complete for someα. To prove this, we extend Montalbán’sη-system framework to deal with limit ordinals in a more general way. We also show that, for any fixed computable structure, there is an ordinalαand a cone in the Turing degrees such that the exact complexity (...) of computing an isomorphism between the given structure and another copy${\cal B}$in the cone is a c.e. degree in${\rm{\Delta }}_\alpha ^0\left$. In each of our theorems the cone in question is clearly described in the beginning of the proof, so it is easy to see how the theorems can be viewed as general theorems with certain effectiveness conditions. (shrink)

Atmosphären zeichnen sich gleichermaßen durch ihre Profanität und ihre Wirkmächtigkeit aus. Wo immer man hinsieht, sind Atmosphären ein bestimmendes, vielleicht sogar das wichtigste Element im menschlichen Leben. Das Ziel des Sammelbandes besteht darin, die Bedeutung der Atmosphären im Gefühlsraum theoretisch und praktisch zu verdeutlichen und das Phänomen der Atmosphären in seinen vielfältigen Facetten, etwa in der Architektur, Kunst, Medizin, Psychiatrie, in der Pädagogik, in der Altenpflege, in Beruf und Privatleben, zu beleuchten.

An increasingly long line of high-profile scientific misconduct cases raises the question of whether regulatory policy ought to incorporate more rigorous sanctions for investigators and their institutions. Broad and Wade graphically describe these cases through the early 1980s. They continue to recent times with the cases of Evan Dreyer, Kimon Angelides and Robert Liburdy, Justin Radolf, and others. In addition, recent Congressional investigation into conflict of interest concerns surrounding consulting by National Institutes of Health scientists has raised further questions about (...) ethical standards. The record of continuing scandal suggests that current policy may not be optimal for controlling scientific misconduct. Would an alternative policy better minimize its incidence and associated costs?What should we expect of public policy governing misconduct by American scientists? Surely the public has a right to presume that its tax money is being spent wisely and that any economic rewards from taxpayer funded research are used prudently and in the public interest. (shrink)

An increasingly long line of high-profile scientific misconduct cases raises the question of whether regulatory policy ought to incorporate more rigorous sanctions for investigators and their institutions. Broad and Wade graphically describe these cases through the early 1980s. They continue to recent times with the cases of Evan Dreyer, Kimon Angelides and Robert Liburdy, Justin Radolf, and others. In addition, recent Congressional investigation into conflict of interest concerns surrounding consulting by National Institutes of Health scientists has raised further questions about (...) ethical standards. The record of continuing scandal suggests that current policy may not be optimal for controlling scientific misconduct. Would an alternative policy better minimize its incidence and associated costs?What should we expect of public policy governing misconduct by American scientists? Surely the public has a right to presume that its tax money is being spent wisely and that any economic rewards from taxpayer funded research are used prudently and in the public interest. (shrink)

Asked to define poetry, one is likely to reply with a sigh, a shrug, a look of exasperation or even one of contempt, indicating not only that the question is oppressive but that anyone who asks it must be something of a fool, a pest, or a vulgarian. Though these uncongenial reactions may be interpreted as the signs of intellectual embarrassment, they are, I think, quite justified. For the nature of definition and the particular historical fortunes of the term poetry (...) conjoin to this effect: that a definition of the term will either be a total chronicle of those fortunes or will constitute merely one more episode in them. In other words, a definition of poetry is bound to be either inadequate to the job or, if adequate, then both unmanageable and uninteresting for any other purpose. Barbara Herrnstein Smith, professor of English and communications at the University of Pennsylvania, is the author of Poetic Closure: A Study of How Poems End, for which she received the Christian Gauss and Explicator awards, and the editor of Shakespeare's Sonnets. This article will be part of a book, Fictive Discourse. She has also contributed "Narrative Versions, Narrative Theories" to Critical Inquiry. (shrink)

ABSTRACT Patient self‐management (SM) of chronic disease is an evolving movement, with some forms documented as yielding important outcomes. Potential benefits from proper preparation and maintenance of patient SM skills include quality care tailored to the patient's preferences and life goals, and increase in skills in problem solving, confidence and success, generalizable to other parts of the patient's life. Four central ethical issues can be identified: 1) insufficient patient/family access to preparation that will optimize their competence to SM without harm (...) to themselves, 2) lack of acknowledgement that an ethos of patient empowerment can mask transfer of responsibility beyond patient/family competency to handle that responsibility, 3) prevailing assumptions that preparation for SM cannot result in harm and that its main purpose is to deliver physician instructions, and 4) lack of standards for patient selection, which has the potential to exclude individuals who could benefit from learning to SM. Technology assessment offers one framework through which to examine available data about efficacy of patient SM and to answer the central question of what conditions must be put in place to optimize the benefits of SM while assuring that potential harms are controlled. (shrink)