SummaryIntense, sustained nursing lengthens inter-birth intervals and is causally linked with low natural fertility. However, in traditional settings, the effects of such nursing on fertility are difficult to disentangle from those of nutrition. Results from an prospective, direct observational study of reproductive function in well-nourished Amele women who nurse intensively and persistently but who also have high fertility are here presented. Endocrine measures show that ovarian activity resumes by median 11·0 months postpartum. Median duration of postpartum amenorrhoea is 11·3 months, (...) time to next conception is 19·0 months, and the inter-birth interval is 28·0 months. Average life time fertility is 6·8. High fertility in Amele women is due both to refractoriness of reproductive function to suckling stimuli, and to maintenance of equivalent age-specific fertility rates across the reproductive life span. (shrink)

As professionals, nurses are engaged in a moral endeavour, and thus confront many challenges in making the right decision and taking the right action. When nurses cannot do what they think is right, they experience moral distress that leaves a moral residue. This article proposes a theory of moral distress and a research agenda to develop a better understanding of moral distress, how to prevent it, and, when it cannot be prevented, how to manage it.

This study examined the relationship between moral distress intensity, moral distress frequency and the ethical work environment, and explored the relationship of demographic characteristics to moral distress intensity and frequency. A group of 106 nurses from two large medical centers reported moderate levels of moral distress intensity, low levels of moral distress frequency, and a moderately positive ethical work environment. Moral distress intensity and ethical work environment were correlated with moral distress frequency. Age was negatively correlated with moral distress intensity, (...) whereas being African American was related to higher levels of moral distress intensity. The ethical work environment predicted moral distress intensity. These results reveal a difference between moral distress intensity and frequency and the importance of the environment to moral distress intensity. (shrink)

Leuridan (2011) questions whether mechanisms can really replace laws at the heart of our thinking about science. In doing so, he enters a long-standing discussion about the relationship between the mech-anistic structures evident in the theories of contemporary biology and the laws of nature privileged especially in traditional empiricist traditions of the philosophy of science (see e.g. Wimsatt 1974; Bechtel and Abrahamsen 2005; Bogen 2005; Darden 2006; Glennan 1996; MDC 2000; Schaffner 1993; Tabery 2003; Weber 2005). In our view, Leuridan (...) misconstrues this discussion. His weak positive claim that mechanistic sciences appeal to generalizations is true but uninteresting. His stronger claim, that all causal claims require laws, is unsupported by his arguments. Though we proceed by criticizing Leuridan’s arguments, our greater purpose is to embellish his arguments in order to show how thinking about mechanisms enriches and transforms old philosophical debates about laws in biology and provides new insights into how generalizations afford prediction, explanation and control. (shrink)

In an increasingly diverse America, the experience of race and racial discrimination is too often described as if it is the same for all racial and ethnic groups. Utilizing the perspective on ethnic and racial groups developed by Zolberg that stresses their contingent and dynamic nature, we explore ethnic and racial discrimination in depth. Drawing on data from the New York Second Generation Study we describe the experience of prejudice and discrimination among eight groups of young adults-native born whites, native (...) born blacks, native born Puerto Ricans, and second generation Dominicans, South Americans, Chinese, West Indians and Russian Jews. While the experience of racial discrimination is common to many Americans, the nature and severity of that experience varies widely among the increasingly diverse people that are now often lumped together as "minorities" in the popular imagination. African Americans, and those who most often confused with African Americans have different kinds of experiences than other non white groups. They face more systematic and brighter racial boundaries than do Asians and light-skinned Latinos. This creates more formidable obstacles for those defined as black, as opposed to those who are just "nonwhite" to full incorporation into American society. We propose a typology of types of discrimination that begins to unpack this complex phenomena. (shrink)

We present a new method for characterizing the interpretive possibilities generated by elliptical constructions in natural language. Unlike previous analyses, which postulate ambiguity of interpretation or derivation in the full clause source of the ellipsis, our analysis requires no such hidden ambiguity. Further, the analysis follows relatively directly from an abstract statement of the ellipsis interpretation problem. It predicts correctly a wide range of interactions between ellipsis and other semantic phenomena such as quantifier scope and bound anaphora. Finally, although the (...) analysis itself is stated nonprocedurally, it admits of a direct computational method for generating interpretations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.4 (2004) 411-425 [Access article in PDF] Vulnerability, Vulnerable Populations, and Policy Mary C. Ruof "Special justification is required for inviting vulnerable individuals to serve as research subjects and, if they are selected, the means of protecting their rights and welfare must be strictly applied."Guideline 13: Research Involving Vulnerable Persons International Ethical Guidelines for Biomedical Research Involving Human Subjects Council for International Organizations (...) of Medical Sciences (CIOMS) and World Health Organization (WHO) Geneva, Switzerland, 2002 Within medical research and healthcare certain groups are afforded special protections and services because of their designation as vulnerable. The vulnerable require special justification to participate in human subject research in order to eliminate potential human rights abuses. The Nuremberg Code of 1947 was written in response to the extreme human subject abuses that occurred under the Nazi regime, and, although the intent of the 1947 Code was to protect human rights, rigid voluntary consent requirements deprived some individuals of the right to participate in clinical trials. Recent human research guidelines, such as the CIOMS/WHO guidelines referenced above and the guidelines referenced in Section V of this Scope Note, attempt to balance both protection from abuse in research and access to new, experimental treatments for the vulnerable.Although various protective guidelines stipulate special protections for vulnerable populations, the concept of vulnerability and consequently the criteria designating vulnerable populations remain vague. Precisely who are the vulnerable? The word "vulnerability" stems from the Latin vulnerare, "to wound." (Oxford Encyclopedic English Dictionary 1995). In clinical research, the term [End Page 411] vulnerable generally is applied to individuals who are unable to give informed consent or who are susceptible to coercion. The Common Rule (45 CFR 46, Subpart A) includes as vulnerable research subjects: children, prisoners, pregnant women, and persons who are handicapped, mentally disabled, economically disadvantaged, or educationally disadvantaged. Although the Common Rule specifies certain vulnerable categories, the guidelines were not intended to be exclusive, leaving open the interpretation of vulnerability.In medical research and health policy, vulnerability is an abstract concept that has concrete effects both for those labeled vulnerable and for those not. Clinical researchers, healthcare workers, ethical reviewers, and policymakers must be able to identify vulnerable subjects to establish how healthcare resources will be allocated and who will qualify for special protections and socialized benefits. Attempts to quantify vulnerability in clear, measurable ways have met little if any consensus. As Alexander Morawa (II, 2003, p. 150) states, "There is no single approach to definition of vulnerability. In fact, there is no purposeful categorisation at all."Difficulties in defining vulnerability have prompted discourse surrounding its utility as a qualifying factor in the allocation of health resources and its appropriateness as a guiding principle in bioethics. Some of the authors cited in this Scope Note argue against the labeling and categorization of vulnerable individuals and populations. "Labeling individuals as 'vulnerable' risks viewing vulnerable individuals as 'others' worthy of pity, a view rarely appreciated" (III, Danis and Patrick 2002, p. 320). The categories of vulnerable groups listed under the Common Rule have been the source of controversy, "for example, many find the suggestion that pregnant women are vulnerable to be quite sexist" (IV, DeBruin 2001, p. 7). Instead of creating categories of vulnerable populations, would it not be better to derive an account of just treatment from a just social policy at large that encompasses human vulnerabilities (II, Brock 2002, p. 283).For some of the authors listed here, the concept of vulnerability is essential to bioethics. Robert Goodin (I, 1985, p. 107) writes that the vulnerability of other human beings is the source of our special responsibilities to them. In contrast to the four American principles of biomedical ethics—autonomy, nonmaleficence, beneficence, and justice—the four principles of European bioethics and biolaw include vulnerability along with autonomy, dignity, and integrity. According to, Jacob Dahl Rendtorff and Peter Kemp (I, 2000, p. 274) "the principle of vulnerability is ontologically prior to the other [European] principles, it expresses better than all of the other ethical principles... the finitude of the human condition."Some of the... (shrink)

Just Life reorients ethics and politics around the generativity of mothers and daughters rather than the right to property and the sexual proprieties of the Oedipal drama. Invoking two concrete universals – everyone is born of a woman and everyone needs to eat – Rawlinson rethinks labor and food as relationships that make ethical claims and sustain agency. Just Life counters the capitalization of bodies under biopower with the solidarity of sovereign bodies.

While the history of philosophy has traditionally given scant attention to food and the ethics of eating, in the last few decades the subject of food ethics has emerged as a major topic, encompassing a wide array of issues, including labor justice, public health, social inequity, animal rights and environmental ethics. This handbook provides a much needed philosophical analysis of the ethical implications of the need to eat and the role that food plays in social, cultural and political life. Unlike (...) other books on the topic, this text integrates traditional approaches to the subject with cutting edge research in order to set a new agenda for philosophical discussions of food ethics. The Routledge Handbook of Food Ethics is an outstanding reference source to the key topics, problems and debates in this exciting subject and is the first collection of its kind. Comprising over 35 chapters by a team of international contributors, the Handbook is divided into 7 parts: the phenomenology of food gender and food food and cultural diversity liberty, choice and food policy food and the environment farming and eating other animals food justice Essential reading for students and researchers in food ethics, it is also an invaluable resource for those in related disciplines such as environmental ethics and bioethics. (shrink)

After we die, our persona may live on in the minds of the people we know well. Two essential elements of this process are mourning and acts of commemoration. These behaviors extend well beyond grief and must be cultivated deliberately by the survivors of the deceased individual. Those who are left behind have many ways of maintaining connections with their deceased, such as burials in places where the living are likely to return and visit. In this way, culturally defined places (...) often serve as metaphors of social association and shared experience. Humans are the only kind of animal that buries their dead, and this gesture is preserved in Paleolithic sites as early as 120,000 years ago. Though not the only method of honoring the dead in human cultures, the emergence of burial traditions in the Middle Paleolithic implies that both Neandertals and early anatomically modern humans had already begun to conceive of the individual as unique and irreplaceable. Claims of primitive mortuary behavior in earlier periods than the Middle Paleolithic fall short in that they lack any signs of positive social-spatial associations between the deceased and survivors. The archaeological evidence for burial behavior in the Middle Paleolithic provides the first clear translation of mourning into a stereotypical action. These burials therefore may represent the first ritualized bridge between the living and the deceased in human evolutionary history. (shrink)

This paper examines the effects of employees’ sense that they work for a purpose-driven company on their workplace sustainability behaviors. Conceptualizing corporate purpose as an overarching, relevant, shared ethical vision of why a company exists and where it needs to go, we argue that it is particularly suited for driving employee sustainability behaviors, which are more ethically complex than the types of employee ethical behaviors typically examined by prior research. Through four studies, two involving the actual employees of construction companies, (...) we demonstrate that purpose drives the sustainability behaviors of employees by causing them to take psychological ownership of sustainability. In addition, we show that the sustainability-enhancing effect of purpose is stronger when employees perceive that they have higher autonomy in enacting their sustainability actions and for those employees for whom being moral is more central to their sense of self. (shrink)

This paper examines the effects of three different types of father absence on the timing of life history events among women in rural Bangladesh. Age at marriage and age at first birth are compared across women who experienced different father presence/absence conditions as children. Survival analyses show that daughters of fathers who divorced their mothers or deserted their families have consistently younger ages at marriage and first birth than other women. In contrast, daughters whose fathers were labor migrants have consistently (...) older ages at marriage and first birth. Daughters whose fathers died when they were children show older ages at marriage and first birth than women with divorced/deserted fathers and women with fathers present. These effects may be mediated by high socioeconomic status and high levels of parental investment among the children of labor migrants, and a combination of low investment, high psychosocial stress, and low alloparental investment among women with divorced/deserted fathers. Our findings are most consistent with the Child Development Theory model of female life history strategies, though the Paternal Investment and Psychosocial Acceleration models also help explain differences between women in low paternal investment situations (e.g., father divorced/abandoned vs. father dead). Father absence in and of itself seems to have little effect on the life history strategies of Bangladeshi women once key reasons for or correlates of absence are controlled, and none of the models is a good predictor of why women with deceased fathers have delayed life histories compared with women whose fathers are present. (shrink)

Ornaments are the most common and ubiquitous art form of the Late Pleistocene. This fact suggests a common, fundamental function somewhat different to other kinds of Paleolithic art. While the capacity for artistic expression could be considerably older than the record of preserved art would suggest, beads signal a novel development in the efficiency and flexibility of visual communication technology. The Upper Paleolithic was a period of considerable regional differentiation in material culture, yet there is remarkable consistency in the dominant (...) shapes and sizes of Paleolithic beads over more than 25,000 years and across vast areas, even though they were made from diverse materials and, in the case of mollusc shells, diverse taxonomic families. Cultural and linguistic continuity cannot explain the meta-pattern. The evidence indicates that widespread adoption of beads of redundant form was not only about local and subregional communication of personal identity or group affinity, but also an expansion in the geographic scale of social networks. The conformity of the beads grew spontaneously and in a self-organizing manner from individuals’ interest in tapping into the network as a means for spreading social and environmental risk. (shrink)

Feminist bioethics poses a challenge to bioethics by exposing the masculine marking of its supposedly generic human subject, as well as the fact that the tradition does not view womens rights as human rights. This essay traces the way in which this invisible gendering of the universal renders the other gender invisible and silent. It shows how this attenuation of the human in man is a source of sickness, both cultural and individual. Finally, it suggests several ways in which images (...) drawn from womens experience and womens bodies might contribute to a constructive rethinking of basic ethical concepts. (shrink)

This study explores the impact of participation in a series of moral case deliberations (MCD) on the moral craftsmanship (MCS) of Dutch prison staff. Between 2017–2020, ten MCDs per team were implemented in three prisons (i.e., intervention group). In three other prisons (i.e., control group) no MCDs were implemented. We compared the intervention and control group using a self-developed questionnaire, administered before (pre-measurement) and after the series of MCDs (post-measurement). Results After the MCDs, participants scored significantly higher on 7 of (...) the 70 items related to MCS. On some items there were significant impact differences between the various professional disciplines. Discussion Possible explanations for a relatively low impact are discussed. A shorter and validated questionnaire is needed in order to further study the MCS of professionals and the impact of Ethics Support Services (ESS). Conclusions There was a positive development on some elements of MCS after participation in a series of MCDs. (shrink)

ABSTRACT This essay focuses on two underlying presumptions that impinge on the effort of UNESCO to engender universal agreement on a set of bioethical norms: the conception of universality that pervades much of the document, and its disregard of structural inequalities that significantly impact health. Drawing on other UN system documents and recent feminist bioethics scholarship, we argue that the formulation of universal principles should not rely solely on shared ethical values, as the draft document affirms, but also on differences (...) in ethical values that obtain across cultures. UNESCO's earlier work on gender mainstreaming illustrates the necessity of thinking from multiple perspectives in generating universal norms. The declaration asserts the ‘fundamental equality of all human beings in dignity and rights’1 and insists that ‘the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition’2 yet it does not explicitly recognize disparities of power and wealth that deny equal dignity and rights to many. Without attention to structural (as opposed to merely accidental) inequities, UNESCO's invocation of rights is so abstract as to be incompatible with its avowed intention. (shrink)

Retaliation against whistleblowers is a well-recognized problem, yet there is little explanation for why uninvolved peers choose to retaliate through ostracism. We conduct two experiments in which participants take the role of a peer third-party observer of theft and subsequent whistleblowing. We manipulate injunctive norms and descriptive norms. Both experiments support the core of our theoretical model, based on social intuitionist theory, such that moral judgments of the acts of wrongdoing and whistleblowing influence the perceived likeability of each actor and (...) ultimately influence intention to ostracize each actor and indicate more willingness to ostracize the whistleblower than the wrongdoer. When we vary norms for the wrongdoing in Experiment 1, we find that descriptive and injunctive norms indirectly influence intentions to ostracize both the wrongdoer and whistleblower. These relationships are serially mediated by the observers’ moral judgments of the act and likeability of the actor. When we vary norms for whistleblowing in Experiment 2, the injunctive norm manipulation affected moral judgment of the action of whistleblowing, and we do not observe any other significant effects of the norm manipulations on moral judgments of the actions of wrongdoing or whistleblowing. (shrink)

This paper investigates the exemplarity of medicine in Foucault's analyses of knowledge generally. By tracing the development of his concept of power and its relation to knowledge, it offers an account of Foucault's unconventional philosophical project. Finally, it specifies Foucault's strategy for undermining processes of normalisation.

Giving Voice To Values (GVV) serves as a framework to teach individuals methods to speak up when they witness actions that are contrary to their professional and personal values. This essay illustrates how GVV serves as a catalyst to advance both research and teaching activities.

Medical practice is animated by the intention to cure; it aims to relieve the immense variety of sufferings to which human beings are subject in virtue of the conditions of their embodied existence. My purpose here is to demonstrate how a philosophical analysis of the formal structures and kinds of human suffering provides an essential foundation for determining certain ethical dimensions of the physician's relation to his suffering patient. Can paternalism in medical practice be justified by the aim of relieving (...) suffering? What are the scope and limits of the patient's responsibility for his suffering, and what difference does this make in the physician's response to it? How is the suffering that medical treatment itself exacts in the name of cure to be justified? Such questions can be answered only by an analysis of the sense or value of suffering in human life. Keywords: suffering, sin, autonomy, paternalism, patient values CiteULike Connotea Del.icio.us What's this? (shrink)

Few works have had the impact on contemporary philosophy exerted by Hegel's Phenomenology of Spirit. Twentieth-century philosophers in France were bound together by a reading of Hyppolite's translation and commentary. Sartre, Merleau-Ponty, Lacan, and Bataille were all shaped by Kojève's lectures on the book. Late twentieth-century philosophers such as Derrida, Lyotard, Deleuze, and Irigaray all operate against a Hegelian horizon. Similarly, in Germany Heidegger, Adorno, and Habermas developed their philosophies in large part through an engagement with Hegel. In the United (...) States the book has had a profound influence on feminism and gender studies. Thinkers as diverse as Butler, Benhabib, Mills, and Honig have developed political theories as well as theories of sexual difference by rereading Hegel's reading of Antigone. As Derrida suggests, this text must be read. It lays out the infrastructures and architectures of life in the modern nation state. It unfolds a grand narrative of the ways of thinking and acting that comprise human experience in "our time." The purpose of the text is to effect a transformation in readers, so that they cease to think of themselves as particular humans and come to know that their existence inheres in membership in a complex community-social, cultural, economic, religious, aesthetic, and political infrastructures that form the culture of possibilities in which self-consciousness emerges and is sustained. Rawlinson's reading reveals how Hegel's politics of the "we" is undermined both by his effacement of sexual difference and by his misappropriation of art as a "betrayal of substance." Both of these gestures discount specificity in favor of a generic subject and a mutual recognition in which the other is the same. She uses Hegel's own critique of abstraction against him to rethink the "we" as a community of difference, figured materially in the differentiated styles or signatures of art, and in so doing argues that that the task of phenomenology is never completed and that the abstract concepts of logic will always be dependent on phenomenology's productive or generative movement. In her reading Hegel is neither a metaphysician nor a subjective idealist. He is a phenomenologist, analyzing experience to articulate the ways in which humans generate narratives and material infrastructures to sustain the complexities of life. (shrink)

Universals are a class of mind independent entities, usually contrasted with individuals, postulated to ground and explain relations of qualitative identity and resemblance among individuals. Individuals are said to be similar in virtue of sharing universals. An apple and a ruby are both red, for example, and their common redness results from sharing a universal. If they are both red at the same time, the universal, red, must be in two places at once. This makes universals quite different from individuals, (...) and controversial. (shrink)

What are the driving forces of cultural macroevolution, the evolution of cultural traits that characterize societies or populations? This question has engaged anthropologists for more than a century, with little consensus regarding the answer. We develop and fit autologistic models, built upon both spatial and linguistic neighbor graphs, for 44 cultural traits of 172 societies in the Western North American Indian (WNAI) database. For each trait, we compare models including or excluding one or both neighbor graphs, and for the majority (...) of traits we find strong evidence in favor of a model which uses both spatial and linguistic neighbors to predict a trait’s distribution. Our results run counter to the assertion that cultural trait distributions can be explained largely by the transmission of traits from parent to daughter populations and are thus best analyzed with phylogenies. In contrast, we show that vertical and horizontal transmission pathways can be incorporated in a single model, that both transmission modes may indeed operate on the same trait, and that for most traits in the WNAI database, accounting for only one mode of transmission would result in a loss of information. (shrink)

Respected Catholic ethicists have recently defended the use of salpingostomy and methotrexate in the management of ectopic pregnancies.This article examines the arguments for the revised assessments to determine whether there are sound reasons to believe that these two methods do not constitute the direct and immediate killing of innocent human beings. National Catholic Bioethics Quarterly 11.1 (Spring 2011): 65–82.

Studies of consumer complaint behavior have shown that many elderly consumers are very reluctant to pursue their rights through the complaint process when they encounter problems with products or services. This passive complaint behavior may be very costly to the elderly, who often live on fixed incomes. This paper presents a theory developed in experimental psychology that may help explain why clderly consumers are more likely than other consumers to incur losses rather than engage in complaint activity. The theory, known (...) as learned helplessness (LH), refers to a process whereby noncontingent reinforcement produces the expectation that events are uncontrollable.The theory of learned helplessness is presented and related to specific behaviors of dissatisfied elderly consumers that have been reported in the literature. Strategy implications of the theory are discussed for counselors, consumer affairs practitioners, and others interested in helping elderly consumers exercise their rights. (shrink)

This article discusses two complementary themes that play an important role in contemporary South African political philosophy: (1) the racist tradition in Western philosophy; and (2) the role of ubuntu in regaining an authentic African identity, which was systematically suppressed during the colonial past and apartheid. These are also leading themes in Mogobe Ramose’s African Philosophy Through Ubuntu. The first part concentrates on John Locke. It discusses the thesis that the reprehensible racism of many founders of liberal political philosophy has (...) lethally infected liberal theory. This view neglects the distinction between genesis and justification. Political liberalism has since cleansed itself of the prejudices of its spiritual ancestors. Liberal human rights exclude racism as a matter of principle. The second part discusses the claim that the ubuntu philosophy provides a better basis for a constitution in a modern society than political liberalism. A major problem is that ubuntu is an essentially contested concept. Some philosophers consider ubuntu to be a moribund notion (Matolino); others see it as a vital concept par excellence. In the latter case, it is elaborated from sundry incompatible political views, ranging from African nationalism (Ramose) via humanist communitarianism (Metz) to liberalism (Mboti). Conclusion: as an essentially contested ideological concept, ubuntu should not be a decisive constitutional standard for the application of state force. In contrast, the constitutional model of political liberalism provides a reasonable alternative, as it is designed precisely to solve the problem of social plurality and ideological contest. (shrink)

H. B. Smith, Professor of Philosophy at the influential 'Pennsylvania School' was (roughly) a contemporary of C. I. Lewis who was similarly interested in a proper account of 'implication'. His research also led him into the study of modal logic but in a different direction than Lewis was led. His account of modal logic does not lend itself as readily as Lewis' to the received 'possible worlds' semantics, so that the Smith approach was a casualty rather than a beneficiary of (...) the renewed interest in modality. In this essay we present some of the main points of the Smith approach, in a new guise. (shrink)