Born at 24 weeks gestation, Baby G now lies in a neonatal intensive care unit two months post-birth. He has pulmonary hypoplasia, congenital scoliosis, and swallowing issues that will require placement of a feeding tube, and bowel dystonia that interferes with his ability to absorb feedings. Shortly after birth, he experienced a cardiopulmonary arrest and now has obvious neurological impairments. As a result of incomplete development of his lungs and severe chronic lung disease, he cannot breathe on his own. Because (...) of his chronic respiratory failure, tracheostomy and long-term assisted ventilation was offered as an option that would allow him to be discharged from the acute care setting. However, his congenital.. (shrink)

Children like Baby G, born with complex chronic medical conditions that compromise function in the long term, are an increasing presence in tertiary-level neonatal intensive care units. The parents and health-care providers of these children are faced with profoundly difficult decisions. Whether severe congenital anomalies with poor prognosis are diagnosed antenatally or are discovered at the time of birth, the issues are vexing, and the impact decisions will have on everyone in the family is profound. What should such decisions be (...) based upon? What values and principles might guide the decision-making process? What moral justifications allow for pursuing.. (shrink)

The explicit objective for the 2014 Symposium hosted by the University of North Florida, which serves as the basis for this collection of papers, was to explore the relationship and potential for mutual support between the disciplines of child rights and pediatric bioethics in advancing the health and well-being of children in the United States and around the world. The U.N. Convention on the Rights of the Child served as the locus for this discussion. A significant question emerged in the (...) Symposium about whether the CRC could serve any beneficial purpose in the United States, where it has not yet been ratified. Further, there was.. (shrink)

In this article, we examine how the U.N. Convention on the Rights of the Child can be useful in pediatric bioethics. Adopted in 1989, the CRC reflects norms that have been deliberated upon for a long period of time and endorsed by most nations. The United States is now the only country that has not ratified the CRC.1 International human rights law shares many key moral concepts with clinical pediatric bioethics, and the CRC provides a considered language common to many (...) jurisdictions that can assist bioethicists in their daily practice and help health-care organizations in their policy development and international interactions. There may, however, be practical challenges with using the CRC in the practice of.. (shrink)

The manuscripts in this issue of Perspectives in Biology and Medicine reflect the work of an international group of pediatric bioethicists and child rights advocates who convened in March 2014 to pursue several questions related to the intersection of pediatric bioethics and child rights. The prequel for the Symposium involved several years of dialogue between the editors of this volume—dialogue through which it became clear that there was much to be learned about our respective disciplines and how they might inform (...) our heretofore mutually exclusive work.The principles of pediatric bioethics have been used for decades to analyze and help resolve challenging clinical situations in pediatrics, but there has been.. (shrink)

This study examined the role of temporal orientation and affective frame in the execution of ethical decision-making strategies. In reflecting on a past experience or imagining a future experience, participants thought about experiences that they considered either positive or negative. The participants recorded their thinking about that experience by responding to several questions, and their responses were content-analyzed for the use of ethical decision-making strategies. The findings indicated that a future temporal orientation was associated with greater strategy use. Likewise, a (...) positive affective frame was associated with greater strategy use. Future orientation may permit better strategy execution than a past orientation because it facilitates more objective, balanced contemplation of the reflected-upon situation and minimizes potential self-threat associated with past behavior. A positive affective frame likely improves strategy execution because it facilitates active analysis of the experience. Future directions and implications of these findings are discussed. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policy makers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.Advancing and protecting the public's health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policy makers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.Advancing and protecting the public's health depends upon the coordination of actions by many, diverse partners. For effective public health preparedness, there must be effective coordination of legal tools and law-based strategies across local, state, tribal, and federal jurisdictions, and also across sectors such as public health, health care, emergency management, education, law enforcement, community design, and academia. (shrink)

Can the institutional systems that prepare Black nurse researchers question the ways their systemic pathways have impacted health equity knowledge development in nursing? We invite our readers to keep this question in mind and engage with our conversation as Black nurse researchers, scholars, educators, and clinicians. The purpose of our conversation, and this article, is to explore the transactional impact of knowledge development pathways and Black faculty retention pathways on the state of health equity knowledge in nursing today. Over a (...) series of conversations, we discuss the research exploitation of communities of color, deficit research funding, knowledge capitalization, the marginalization of diversity as a continuous process, a lack of sociocultural authority, and our thoughts on solutions. We conclude by using the wisdom of a generation to answer our initial question. (shrink)

This paper reframes the futility debate, moving away from the question “Who decides when to end what is considered to be a medically inappropriate or futile treatment?” and toward the question “How can society make policy that will best account for the multitude of values and conflicts involved in such decision-making?” It offers a pragmatist moral epistemology that provides us with a clear justification of why it is important to take best standards, norms, and physician judgment seriously and a clear (...) justification of why ample opportunity must be made for patients, families, and society to challenge those standards and norms. (shrink)

This project examined the ethical issues faced by academics and professionals in the Humanities. We conducted focus groups to gather information about the ethical concerns in these fields and used the qualitative data arising from the discussions to create a taxonomy that represents the structure of ethical issues in the Humanities. A key implication of our findings is that while the focus of ethics research and interventions has been primarily on the sciences and engineering, academics and professionals in other fields (...) also encounter some unique critical ethical dilemmas that require further research and methods of intervention. (shrink)

This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the (...) problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. (shrink)

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

Abstract:AbstractOne of the most recognized playwrights and stage directors on the African continent today, Werewere Liking is the Cameroonian founder of the Village et Fondation Panafricaine Ki-yi Mbock in Abidjan. A 2000 Prince Claus Award laureate for her contributions to culture and development, Liking has also produced impressive works of literature and art. From the beginning of her career in the late 1970s, Liking has always promoted and expanded her project of elite theater for development, with her productions of the (...) last decade bringing to the masses theater and performance as a form of resistance to the surrounding conflict and chaos in the West African nations of Cote-d'Ivoire and, most recently, Mali. The ability of Liking and the Village to carry out their projects to fruition both in times of relative prosperity as well as in periods of conflict is a testament to Liking's successful matriarchal style of African feminist leadership and shared governance made possible by the espousing of traditional African values necessary for tackling problems of a contemporary world. (shrink)

This study examined the role of reflection on personal cases for making ethical decisions with regard to new ethical problems. Participants assumed the position of a business manager in a hypothetical organization and solved ethical problems that might be encountered. Prior to making a decision for the business problems, participants reflected on a relevant ethical experience. The findings revealed that application of material garnered from reflection on a personal experience was associated with decisions of higher ethicality. However, whether the case (...) was viewed as positive or negative, and whether the outcomes, processes, or outcomes and processes embedded in the experience were examined, influenced the application of case material to the new problem. As expected, examining positive experiences and the processes involved in those positive experiences resulted in greater application of case material to new problems. Future directions and implications for understanding ethical decision making are discussed. (shrink)

The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision making. Using a sample of 163 undergraduates, a low-fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision making. A mediated model is presented which suggests that environmental factors influence reasoning (...) strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision making. Findings were mixed but generally supported the hypothesized model. It is interesting to note that framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies. (shrink)

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development (...) of agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

Husserl und die transzendentale Intersubjektivität analyses the transcendental relevance of intersubjectivity, and argues that an intersubjective transformation of transcendental philosophy can already be found in phenomenology, especially in Husserl. Husserl eventually came to believe that an analysis of transcendental subjectivity was a conditio sine qua non for a phenomenological philosophy. Drawing on both published and unpublished manuscripts the book examines his reasons for this conviction and delivers a detailed analysis of his radical and complex concept of intersubjectivity, showing that precisely (...) his reflections on transcendental intersubjectivity are capable of clarifying his phenomenological core-concepts, thus making possible a new understanding of his philosophy. Against this background the book then attempts to establish to what extent the phenomenological approach to intersubjectivity can contribute to the current discussions of intersubjectivity. This is achieved through a systematic confrontation with the language-pragmatical positions of Apel and Habermas. Die Abhandlung untersucht die transzendentale Relevanz der Intersubjektivität und zeigt, daß eine intersubjektive Transformation der Transzendentalphilosophie schon innerhalb der Phänomenologie - besonders der Husserlschen - zu finden ist. Husserl gelangte zu der Auffassung, daß eine Analyse und Einbeziehung der transzendentalen Intersubjektivität als conditio sine qua non für eine phänomenologische Philosophie zu betrachten sei. Die Gründe, die Husserl zu dieser Überzeugung führten, werden herausgearbeitet. Dabei weist die Analyse des radikalen und komplexen Begriffs der Intersubjektivität auf, daß erst seine Überlegungen zur transzendentalen Intersubjektivität viele phänomenologische Grundbegriffe ins rechte Licht stellen können und darüber hinaus ein neues Grundverständnis seiner Phänomenologie ermöglichen. Vor diesem Hintergrund wird die Frage, inwieweit die Phänomenologie zur gegenwärtigen Intersubjektivitätsdiskussion beitragen kann, durch eine systematische Auseinandersetzung mit der sprachpragmatischen Intersubjektivitätstheorie von Apel und Habermas beantwortet. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:preface “Africa Reconfigured,” the cluster in this issue on recent scholarly and creative work on Africa, displays a variety of cultural, artistic, and linguistic approaches to decolonizing gender. Originating in disparate fields, each article in this cluster presents examples of how new meanings of gender are produced that defy dominant definitions. Xavier Livermon examines the cultural and political context of postapartheid South Africa, arguing that redefinitions of “tradition”—not just (...) legal rights—have led Black South Africans to “queer” marriage practices. Busi Makoni pushes the boundaries of feminist linguistics to consider how young women creatively relate to the prevailing lexicon of body parts in southern African languages and, in doing so, how they challenge normative gender identities. Cheryl Toman offers an account of writer, playwright, and performer Werewere Liking’s distinctive lifelong fusing of performance art and social activism in Côte d’Ivoire and Mali and how Liking’s plays, prose, and poetry enact decolonization in unique ways. Nigerian artist Peju Alatise, whose work is featured in our art spread, presents an array of ideas, materials, and genealogies that deeply question European and US aesthetics, as the art essay by Moyo Okediji explains. Concluding “Africa Reconfigured” are critical perspectives on Euro-American gender orders found in Olumide Popoola’s except from a novel and the poems by Gabeba Baderoon. Two articles in the second half of this issue reconsider a specific moment of US women’s history: women’s liberation in the 1960s and early 1970s. Sara M. Evans challenges the stereotyping of the women’s liberation movement as white, middle class, and antisex, arguing that this is a myth fostered by academic theory, the movement’s opponents, and the mistaken notion that women ’s liberation rejected its New Left roots. Complementing Evans’s argument, Agatha Beins addresses the issue of racism in that same historical moment of women’s liberation in the United States by revisiting images 8Preface of revolutionary women of color in US feminist periodicals of the time, arguing that we have to understand the use of these images in the context of mainstream and New Left portrayals that demeaned feminism as being not serious about politics. Also in this issue is Mark Schuller ’s analysis of gender-based violence in Haiti in the aftermath of the earthquake of 2010, in which he examines how international humanitarian organizations are not always fully aware of how structural violence operates in the country. In our forum “Teaching about Ferguson,” Feminist Studies offers our readers reflections on the pedagogical challenges and opportunities in taking up the issue of state-sanctioned violence against people of color in the United States. All the articles and essays in this issue emphasize that the specificities of transnational, historical, and political contexts—rather than abstract invocations of globalization —are essential for understanding the changing meanings of gender identities and hierarchies as well as the political goals of women ’s organizations. The first article in our cluster on “Africa Reconfigured” takes on a popular Western assumption about South Africa, which is that the constitutional changes that acknowledged and legalized same-sex partnerships replaced intolerant “traditional” practices among Black South Africans. Xavier Livermon challenges this assumption by demonstrating how Black South Africans engage tradition in creative nonheteronormative ways. He closely follows how Black South Africans redefine autochthonous cultural practices in order to create new meanings and practices for marriage. Just as the very definitions of gender have been continuously in flux, so have the definitions of marriage, and Livermon demonstrates how marriage and long-standing coupling practices have become queered and reconstituted in contemporary Black South Africa. In line with Livermon’s interest in redefinitions of sexuality and gender in a postapartheid context, Busi Makoni explores the relationship between the naming of genitalia and gender positionings. Studying both men’s and women’s uses of the lexicon for body parts in multiple Southern African languages, Makoni concludes that women engage in a process of dis-identification with, and reappropriation of, socially inscribed language for their bodies. Women use the same name labels, but assign them completely different meanings, thereby creating counternarratives of feminine identity. Preface 9 The ability to create new meanings permeates the art... (shrink)

This volume commemorates the centenary of Logical Investigations by subjecting the work to a comprehensive critical analysis. It contains new contributions by leading scholars addressing some of the most central analyses to be found in the book.

Human aesthetic experiences are pervasive; they are triggered by faces, art, natural scenery, foods, ideas, theories, and decision-making situations, among many sources, and seem to be a distinctive trait of our species. Our moral sense, understood as our capacity to judge events, actions, or people as good or bad, appropriate or inappropriate, also seems to be an exclusively human endowment (Ayala 2010). As part of the scientific efforts to characterize the biological foundations of our human uniqueness, recently there has been (...) interest in the brain’s underpinnings of aesthetic reactions to art on the one hand, and in the neural correlates of moral judgment and decision-making on the other (Greene and Paxton .. (shrink)

Guidelines for a model bride in Islam based on Islamic teachings; includes stories of six exemplary Muslim wives during Prophet Muhammad's time.