The Medical Innovation Bill continues its journey through Parliament. On 23 January 2015, it was debated for the final time in the House of Lords and with one final amendment, the House moved to support the Bill, which then moved to the House of Commons on 26 January. It will be debated again on 27 February 2015. The Bill’s purpose is to encourage responsible innovation in medical treatment. Although this goal is laudable, it is argued that the Bill is unnecessary (...) and has the potential to undermine the very cause it aims to advance. More useful for encouraging responsible innovation is the continued education of health-care professionals on how the law already supports practitioners who look to improve care through responsible innovation. (shrink)
Moral distress is a phenomenon of increasing concern in nursing practice, education and research. Previous research has suggested that moral distress is associated with perceptions of ethical climate, which has implications for nursing practice and patient outcomes. In this study, a randomly selected sample of registered nurses was surveyed using Corley’s Moral Distress Scale and Olson’s Hospital Ethical Climate Survey (HECS). The registered nurses reported moderate levels of moral distress intensity. Moral distress intensity and frequency were found to be inversely (...) correlated with perceptions of ethical climate. Each of the HECS factors (peers, patients, managers, hospitals and physicians) was found to be significantly correlated with moral distress. Based on these findings, we highlight insights for practice and future research that are needed to enhance the development of strategies aimed at improving the ethical climate of nurses’ workplaces for the benefit of both nurses and patients. (shrink)
Moral distress in health care has been identified as a growing concern and a focus of research in nursing and health care for almost three decades. Researchers and theorists have argued that moral distress has both short and long-term consequences. Moral distress has implications for satisfaction, recruitment and retention of health care providers and implications for the delivery of safe and competent quality patient care. In over a decade of research on ethical practice, registered nurses and other health care practitioners (...) have repeatedly identified moral distress as a concern and called for action. However, research and action on moral distress has been constrained by lack of conceptual clarity and theoretical confusion as to the meaning and underpinnings of moral distress. To further examine these issues and foster action on moral distress, three members of the University of Victoria/University of British Columbia (UVIC/UVIC) nursing ethics research team initiated the development and delivery of a multi-faceted and interdisciplinary symposium on Moral Distress with international experts, researchers, and practitioners. The goal of the symposium was to develop an agenda for action on moral distress in health care. We sought to develop a plan of action that would encompass recommendations for education, practice, research and policy. The papers in this special issue of HEC Forum arose from that symposium. In this first paper, we provide an introduction to moral distress; make explicit some of the challenges associated with theoretical and conceptual constructions of moral distress; and discuss the barriers to the development of research, education, and policy that could, if addressed, foster action on moral distress in health care practice. The following three papers were written by key international experts on moral distress, who explore in-depth the issues in three arenas: education, practice, research. In the fifth and last paper in the series, we highlight key insights from the symposium and the papers in the series, propose to redefine moral distress, and outline directions for an agenda for action on moral distress in health care. (shrink)
Stakeholder theory provides a framework for investigating the relationship between corporate social performance (CSP) and corporate financial performance. This relationship is investigated by examining how change in CSP is related to change in financial accounting measures. The findings provide some support for a tenet in stakeholder theory which asserts that the dominant stakeholder group, shareholders, financially benefit when management meets the demands of multiple stakeholders. Specifically, change in CSP was positively associated with growth in sales for the current and subsequent (...) year. This indicates that there are short-term benefits from improving CSP. Return on sales was significantly positively related to change in CSP for the third financial period, indicating that long-term financial benefits may exist when CSP is improved. (shrink)
Abstract Despite various criticisms, Ian Barbour's fourfold classification of the possible relationships between religion and science remains influential. I compare Barbour's taxonomy with the theories of four authors who, in the last four decades, have addressed the relationship between science and religion from a Muslim perspective. The aim of my analysis is twofold. First, I offer a comparative perspective to the debate on science and Islam. Second, following Barbour's suggestion, I test the general applicability of his categories (...) by comparing them with a discourse on science and religion that is not focused on Christianity. In the first section, I reconstruct Barbour's typologies, recalling some major objections to them, and arguing why despite the latter, Barbour's model is employed for the present analysis. I also reconstruct Barbour's parallel model for the relationships between different religions. In the second section, I reconstruct the discourse on science and religion developed by the Palestinian-American scholar Ismail Raji al-Faruqi. The third section is devoted to the ideas of the Persian-American scholar Seyyed Hossein Nasr. In the fourth section, I examine the views of the Iranian author Mehdi Golshani. The fifth section reconstructs the theories of the Algerian author Nidhal Guessoum. In the final section, I argue that a generalized use of the “integration” concept to refer to the entire debate on Islam and science is unhelpful. While these positions do not appear to instantiate Barbourian integration of science and religion, they do move toward what Barbour (skeptically) describes as integration between religions. (shrink)
Approaches to business ethics can be roughly divided into two streams: ‹codes of behavior’ and ‹forms of subjectification’, with code-oriented approaches clearly dominating the field. Through an elaboration of poststructuralist approaches to moral philosophy, this paper questions the emphasis on codes of behaviour and, thus, the conceptions of the moral and responsible subject that are inherent in rule-based approaches. As a consequence of this critique, the concept of a practice-based ‹ethics of responsiveness’ in which ethics is never final but rather (...) always ‹to come’, is investigated. In such an approach the ethical self is understood as being continuously constituted within power/knowledge relations. Following this line, we ask how one can become a responsible subject while also acknowledging certain limits of full responsibility. We thereby explore responsibility as a considered but unconditional openness in response to the other. (shrink)
. In responding to Taede Smedes, I first examine his thesis that the recent dialogue between science and religion has been dominated by scientism and does not take theology seriously. I then consider his views on divine action, free will and determinism, and process philosophy. Finally I use the fourfold typology of Conflict, Independence, Dialogue, and Integration to discuss his proposal for the future of science and religion.
Two definitions of Mach’s principle are proposed. Both are related to gauge theory, are universal in scope and amount to formulations of causality that take into account the relational nature of position, time, and size. One of them leads directly to general relativity and may have relevance to the problem of creating a quantum theory of gravity.
The first mission of Zygon has been the exploration of the relation between Religion and Science. The second, I suggest, has been consideration of the relation between Ethics and Technology. Some articles have given attention to the relation of Religion to Ethics, or that of Science to Technology. The interaction of Ethics and Science, and that of Religion and Technology, are also significant. I give examples of articles or symposia in each of these categories and close with great hope for (...) Zygon's future. (shrink)
Charles Barbour argues not only that we can examine the literary and rhetorical aspects of Marx’s texts, but also that, as soon as we begin to do so, those texts begin to take on new and entirely unexpected political implications.
In many countries grappling with the politics of equal recognition, the experiences, beliefs and reasons for action of people who identify as non-binary are starting to be seen as valid and intelligible.1 And, despite some gender clinics still responding cautiously to requests for non-standard medical interventions, their treatment needs are now recognised in major clinical guidelines. This is the current social context in which Notini and colleagues outline the case of ‘Phoenix’, an 18-year-old birth-assigned woman, who has requested the indefinite (...) continuation of puberty suppression, a treatment that was initiated when the client was 11 years old to mitigate their intense distress at the onset of puberty. Drawing on a conception of health as overall well-being, the authors conclude that OPS is ‘consistent with the proper goals of medicine’, and that there are ‘equity-based reasons’ for offering OPS to adults as a group. They concede that the physical risks are greater for OPS than for hormonal interventions generally provided to people with a binary gender identity. They also acknowledge the need for ‘a fine-grained ethical evaluation of Phoenix’s particular situation’ to assess whether the potential benefits of OPS outweigh the potential harms for this individual. Here I respectfully raise three points to amplify the authors’ discussion. First, there seem to be significant ethical issues of a general, not a particular, kind arising from the type of individual evaluation they call for. Following initial screening for significant mental distress and other major vulnerabilities, the key undertaking …. (shrink)
Family members do not have an official position in the practice of euthanasia and physician assisted suicide in the Netherlands according to statutory regulations and related guidelines. However, recent empirical findings on the influence of family members on EAS decision-making raise practical and ethical questions. Therefore, the aim of this review is to explore how family members are involved in the Dutch practice of EAS according to empirical research, and to map out themes that could serve as a starting point (...) for further empirical and ethical inquiry. A systematic mixed studies review was performed. The databases Pubmed, Embase, PsycInfo, and Emcare were searched to identify empirical studies describing any aspect of the involvement of family members before, during and after EAS in the Netherlands from 1980 till 2018. Thematic analysis was chosen as method to synthesize the quantitative and qualitative studies. Sixty-six studies were identified. Only 14 studies had family members themselves as study participants. Four themes emerged from the thematic analysis. 1) Family-related reasons to request EAS. 2) Roles and responsibilities of family members during EAS decision-making and performance. 3) Families’ experiences and grief after EAS. 4) Family and ‘the good euthanasia death’ according to Dutch physicians. Family members seem to be active participants in EAS decision-making, which goes hand in hand with ambivalent feelings and experiences. Considerations about family members and the social context appear to be very important for patients and physicians when they request or grant a request for EAS. Although further empirical research is needed to assess the depth and generalizability of the results, this review provides a new perspective on EAS decision-making and challenges the Dutch ethical-legal framework of EAS. Euthanasia decision-making is typically framed in the patient-physician dyad, while a patient-physician-family triad seems more appropriate to describe what happens in clinical practice. This perspective raises questions about the interpretation of autonomy, the origins of suffering underlying requests for EAS, and the responsibilities of physicians during EAS decision-making. (shrink)
Synthetic biology, materials chemistry and soft robotics are fast becoming leading disciplines within the field of practices which look to nature for inspiration and opportunities. In this article I discuss how these molecular-scale practices fit within the existing trends of bio-informed design defined at the macro level, that is, bionics, biomimetics and more specifically biomimicry. Based on the metaphysical views underlying bio-informed design practices, I argue that none of them currently fit the biomimicry model, as they are not consistently concerned (...) with environmental sustainability. While biomimetic chemistry loosely belongs to the field of biomimetics, and soft robotics to the field of bionics, both practices have a profound impact on their respective fields, as they question the places of nature and engineers. (shrink)
The most obvious thing about the universe in which we find ourselves is its structure. Before the scientific revolution, the instinctive reaction of thinkers to the existence of perceived structure was to find a direct reason for that structure. This is reflected above all in the Pythagorean notion of the well-ordered cosmos: the cosmos has the structure it does because that is the best structure it could have. In fact, that is what the word cosmos really means—primarily order, but also (...) decoration, embellishment, or dress. Kepler and Galileo were no less entranced by the beauty of the world than was Pythagoras, and they formulated their ideas in the overall conceptual framework of the well-ordered cosmos. However, both studied the world so intently that they actually identified aspects of motion that fairly soon led to the complete overthrow of such a notion of cosmos. The laws of the new physics were found to determine not the actual structure of the universe, but the way in which structure changes from instant to instant. Ultimately, no explanation is provided for the currently observed structure; it is simply attributed to an initial structure that was never fashioned by the laws of nature but merely continually refashioned thereafter. The initial and boundary conditions for our universe lie outside the purview of science. But all of the structure we observe around us must ultimately be traced back to those mysterious initial and boundary conditions. (shrink)
Relatively congruence regular quasivarieties and quasivarieties of logic have noticeable similarities. The paper provides a unifying framework for them which extends the Blok-Pigozzi theory of elementarily algebraizable (and protoalgebraic) deductive systems. In this extension there are two parameters: a set of terms and a variable. When the former is empty or consists of theorems, the Blok-Pigozzi theory is recovered, and the variable is redundant. On the other hand, a class of membership logics is obtained when the variable is the only (...) element of the set of terms. For these systems the appropriate variant of equivalent algebraic semantics encompasses the relatively congruence regular quasivarieties. (shrink)
Synthetic biologists are extremely concerned with responsible research and innovation. This paper critically assesses their culture of responsibility. Their notion of responsibility has been so far focused on the identification of risks, and in their prudential attitude synthetic biologists consider that the major risks can be prevented with technological solutions. Therefore they are globally opposed to public interference or political regulations and tend to self-regulate by bringing a few social scientists or ethicists on board. This article emphasizes that ethics lies (...) beyond prudence and requires a cultural evaluation of the modes of existence of the various microorganisms designed by synthetic biologists, independently of their potential applications. (shrink)
. A brief comparison of the Zygon Center for Religion and Science and the Center for Theology and the Natural Sciences is given. The work and emphases of the two Centers overlap but also differ in significant ways. Without neglecting the physical sciences or the Christian tradition, ZCRS would do well to continue to give high priority to the biological sciences and the dialogue with the major world religions.
Relatively congruence regular quasivarieties and quasivarieties of logic have noticeable similarities. The paper provides a unifying framework for them which extends the Blok-Pigozzi theory of elementarily algebraizable deductive systems. In this extension there are two parameters: a set of terms and a variable. When the former is empty or consists of theorems, the Blok-Pigozzi theory is recovered, and the variable is redundant. On the other hand, a class of 'membership logics' is obtained when the variable is the only element of (...) the set of terms. For these systems the appropriate variant of equivalent algebraic semantics encompasses the relatively congruence regular quasivarieties. (shrink)
The promises of nanotechnology have been framed by a variety of metaphors, that not only channel the attention of the public, orient the questions asked by researchers, and convey epistemic choices closely linked to ethical preferences. In particular, the image of the ‘therapeutic missile’ commonly used to present targeted drug delivery devices emphasizes precision, control, surveillance and efficiency. Such values are highly praised in the current context of crisis of pharmaceutical innovation where military metaphors foster a general mobilization of resources (...) from multiple fields of cutting-edge research. The missile metaphor, reminiscent of Paul Ehrlich’s ‘magic bullet’, has framed the problem in simple terms: how to deliver the right dose in the right place at the right moment? Chemists, physicists and engineers who design multi-functional devices operating in vitro can think in such terms, as long as the devices are not actually operating through the messy environment of the body. A close look at what has been done and what remains to be done suggests that the metaphor of the “therapeutic missile” is neither sufficient, nor even necessary. Recent developments in nanomedicine suggest that therapeutic efficacy cannot be obtained without negotiating with the biological milieu and taking advantage of what it affords. An ‘oikological’ approach seems more appropriate, more heuristic and more promising than the popular missile. It is based on the view of organism as an oikos that has to be carefully managed. The dispositions of nanocapsules have to be coupled with the affordances of the environment. As it requires dealing with nanoparticles as relational entities (defined by their potential for interactions) rather than as stable substances (defined by intrinsic properties) this metaphor eventually might well change research priorities in nanotechnology in general. (shrink)
Christian solitude -- Bounded solitude in Augustine's Confessions -- The humanist tradition : Petrarch, Montaigne, and Gibbon -- Rousseau's myth of solitude in reveries of the solitary walker -- Thoreau at Walden : soliloquizing and talking to all the universe at the same time -- Twentieth-century varieties of solitary experience -- Thomas Merton and solitude : the door to solitude opens only from the inside -- Solitude, writing, and fathers in Paul Auster's The invention of solitude -- Conclusion: The value (...) of solitude. (shrink)