On February 20 of 1917, John Dewey addressed a meeting of the Public Education Association in New York City with a paper about vocational education, a topic of particular interest at the time—the Smith–Hughes Act would be signed by President Woodrow Wilson a few days later. The following month, his paper would be published as "Learning to Earn: The Place of Vocational Education in a Comprehensive Scheme of Public Education" in School & Society.1 Of concern to Dewey and many other (...) progressives at the time was whether the potential virtues of this early piece of federal aid to schools would chiefly serve the interests of students or those of employers: would the funds support vocational education in comprehensive... (shrink)

Istarted my nursing career as a pediatric nurse working with children and their families at the Children's Hospital National Medical Center in Washington, DC. My first position was a staff nurse on a busy surgical floor called 4 Blue. To some degree, and as I reflect on that time, one is never truly prepared as a newly minted nurse or physician for the realities of becoming a clinician. So it was for me. I initially worked a rotational schedule of two (...) weeks of days and two weeks of nights where textbook pediatric cases became everyday experiences. Caring for the most complex of childhood illnesses included patients with osteosarcoma, Wilms tumor, neuroblastoma, short gut syndrome, biliary... (shrink)

Dr. Brown, a hospitalist, admits Mark, a patient transferred from a local jail for management of cellulitis. The patient, who was taken into custody two days prior to hospital admission, has a history of intravenous heroin use. Mark explains that he had been prescribed buprenorphine-naloxone maintenance therapy for opioid use disorder for several years prior to being arrested and had not used other opioids during that time. As a policy, the jail where Mark is detained does not prescribe opioid agonists, (...) and his maintenance therapy was stopped upon his arrival there. Dr. Brown discovers that Mark is diaphoretic and appears distressed. Mark's symptoms suggest to Dr. Brown that, in addition to having cellulitis, Mark is actively withdrawing from opioids. Mark tells Dr. Brown that he has felt “horrible” since his buprenorphine-naloxone therapy was stopped and that he now has intense cravings for opioids. He asks Dr. Brown to help alleviate the withdrawal symptoms. Dr. Brown, who is accustomed to treating opioid withdrawal with opioid replacement therapy, wonders if she should initiate ORT for Mark while he is in the hospital. (shrink)

Background The field of nursing has long been concerned with ethical issues. The history of the nursing profession has a rich legacy of attention to social justice and to societal questions regarding issues of fairness, access, equity, and equality. Some nurses have found that their clinical experiences spur an interest in ethical patient care, and many are now nurse bioethicists, having pursued additional training in bioethics and related fields (e.g., psychology, sociology). Purpose The authors describe how the clinical and research (...) experiences of nurses give them a unique voice in the field of bioethics. Results Authors present reasons for the relative invisibility of nurse bioethicists, compared with physician, theologian, or philosopher bioethicists, as well as current efforts to increase the visibility of nurse bioethicists. They also describe four specific areas where nurse bioethicists have made and continue to make important contributions: as ethics consultants to colleagues in hospitals and other settings; as bioethics researchers or as advisers to researchers conducting trials with human subjects; as educators of trainees, patients and families, healthcare providers, and the public; and in helping to draft humane and ethical policies for the care of vulnerable patients and underserved populations. Conclusion Nurse bioethicists are central to the future goals of healthcare bringing a unique perspective to the day-to-day ethical challenges of both clinical care and research, as well as to the education of health professionals and the public. (shrink)

Background:Despite the growing body of knowledge about surrogate decision making, we know very little about the use of ethical frameworks (including ethical theories, principles, and concepts) to understand surrogates’ day-to-day experiences in end-of-life care planning for incapacitated adults.Objectives and Methods:This qualitative systematic review was conducted to identify the types of ethical frameworks used to address surrogates’ experiences in end-of-life care planning for incapacitated adults as well as the most common themes or patterns found in surrogate decision-making research.Findings:Seven research papers explicitly (...) identified ethical theories, principles, or concepts, such as autonomy, substituted judgment, and best interest standards as guidelines for the research. Surrogate decision making themes included the responsibilities and goals of being a surrogate, factors influencing surrogates’ decision making, outcomes for surrogates, and an overarching theme of “wanting to do the right thing” for their loved one and/or themselves.Discussion:Understanding the complexity of surrogates’ experiences of end-of-life care planning is beyond the scope of conventional ethical frameworks.Conclusion:Ethical frameworks that address individuality and contextual variations related to decision making may more appropriately guide surrogate decision-making research that explores surrogates’ end-of-life care planning experiences. (shrink)

Using information collected from a convenience sample of graduate and undergraduate students affiliated with a Midwestern university in the United States, this study determined the extent to which gender (defined as sex differences) is related to consumers' moral philosophies and ethical intentions. Multivariate and univariate results indicated that women were more inclined than men to utilize both consequence-based and rulebased moral philosophies in questionable consumption situations. In addition, women placed more importance on an overall moral philosophy than did men, and (...) women had higher intentions to behave ethically. The marketing and practical implications of these findings are discussed, and the limitations of the research are presented along with several suggestions for future inquiry, which could advance current understanding of consumer ethics. (shrink)

Connie Wang ABSTRACT: Accounts of deep disagreements can generally be categorized as optimistic or pessimistic. Pessimistic interpretations insist that the depth of deep disagreements precludes the possibility of rational resolution altogether, while optimistic variations maintain the contrary. Despite both approaches’ respective positions, they nevertheless often, either explicitly or implicitly, agree on the underlying assumption that...

The effects of psycholinguistic variables on reading development are critical to the evaluation of theories about the reading system. Although we know that the development of reading depends on both individual differences (endogenous) and item-level effects (exogenous), developmental research has focused mostly on average-level performance, ignoring individual differences. We investigated how the development of word recognition in Chinese children in both Chinese and English is affected by (a) item-level, exogenous effects (word frequency, radical consistency, and curricular grade level); (b) subject-level, (...) endogenous individual differences (orthographic awareness and phonological awareness); and (c) their interactive effect. We tested native Chinese (Putonghua)-speaking children (n = 763) in grades 1 to 6 with both Chinese character and English word identification (lexical) decision tasks. Our findings show that (a) there were effects of both word frequency and age of acquisition in both Chinese and English, but these item-level effects generally weakened with increasing age; (b) individual differences in phonological and orthographic awareness each contributed to successful performance; and (c) in Chinese, item-level effects were weaker for more proficient readers. We contend that our findings can be explained by theoretical models that incorporate cumulative learning as the basis for development of item-level effects in the reading system. (shrink)

Who carries the burden of proof in analytic philosophical debates, and how can this burden be satisfied? As it turns out, the answer to this joint question yields a fundamental challenge to the very conduct of metaphysics in analytic philosophy. Empirical research presented in this book indicates that the vastly predominant goal pursued in analytic philosophical dialogues lies not in discovering truths or generating knowledge, but merely in prevailing over one’s opponents. Given this goal, the book examines how most effectively (...) to allocate and discharge the burden of proof. It focuses on premises that must prudently be avoided because a burden of proof on them could never be satisfied, and in particular discusses unsupportable bridge premises across inference barriers, like Hume’s barrier between ‘is’ and ‘ought’, or the barrier between the content of our talk or thought, and the world beyond such content. Employing this content/world barrier for a critical assessment of mainstream analytic philosophical methods, this book argues that we must prudently avoid invoking intuitions or other content of thought or talk in support of claims about the world beyond content, that is, metaphysically significant claims. Yet as content-located evidence is practically indispensable to metaphysical debates throughout analytic philosophy, from ethics to the philosophy of mathematics, this book reaches the startling conclusion that all such metaphysical debates must, prudently, be terminated. (shrink)

The idea that normativity and agency are importantly connected goes back at least as far as Kant. But it has recently become associated with a view called “constitutivism.” Perhaps the best-known critique of constitutivism appears in David Enoch’s article, “Agency, Shmagency,” which is the focus of this chapter. His critique of my article, “Agency and the Open Question Argument,” is briefly addressed, explaining why, contrary to his claims, I do not therein defend a form of constitutivism. It is then explained (...) why his “shmagency challenge” does not effectively expose the real challenge faced by those who might wish to develop constitutivist theories. Finally, the chapter considers why we should take seriously the idea that normativity and agency are importantly connected, an idea that neither Enoch’s challenge nor the challenge articulated for constitutivism here does anything to defeat. Enoch has not shown that normativity won’t come from what is constitutive of agency. (shrink)

There has been neglect of systematic conceptual development and empirical investigation within consumer ethics. Scenarios have been a long-standing tool yet their development has been haphazard with little theory guiding their development. This research answers four questions relative to this gap: Do different scenario decision frames encourage different moral reasoning styles? Does the way in which framing effects are measured make a difference in the measurement of the relationship between moral reasoning and judgment by gender? Are true framing effects likely (...) to vary with the situation? and Are true framing effects likely to vary by gender? The conclusions reached were that (1) different scenario frames encourage both types of reasoning, but rule based moral reasoning is dominant regardless of frame, (2) accounting for formal equivalency in the measurement of true framing effects is likely to enhance the interpretation of studies in moral reasoning and judgment, (3) True framing effects are more likely to occur in situations with low to moderate perceived ethicality, and (4) true framing effects are not likely to vary by gender. Explanations as to why these results occurred are discussed. (shrink)

Scopo di questo breve lavoro è cercare di portare alla luce la presenza di due modi distinti di declinare il concetto di volontà in quel lavoro preparatorio al Tractatus (T) ma anche fucina di intenti che sono i Tagebücher 1914-1916 (TB) di Ludwig Wittgenstein. Si proverà a ripercorrere attraverso un continuo confronto fra i due testi, una fase di elaborazione del pensiero di Wittgenstein tanto intensa da lasciare emergere nitidamente quelle perplessità, e anche tormenti, legati alle tensioni...

In this discourse analysis of a social-skills intervention, the narratives of a girl with autism and her female peers were analyzed. Some 162 narratives were identified in 12 hours of video, which documented an eight-week program. Using conversation/talk-in-interaction analysis methods, we determined that over 60% of peers’ narratives were cooperatively completed by group members compared to less than 20% of Cindy’s. In contrast, a majority of Cindy’s narratives were cooperatively sanctioned. Analysis of these unsuccessful narratives revealed that: 1) peers often (...) contest Cindy’s narratives if they are about a restricted interest; 2) Cindy often notices her peers’ resistance but persists with her storytelling activity; and 3) peers’ sanctioning becomes more intense over time. We claim that Cindy’s autism-related behaviors manifest themselves in inflexible interactions that systematically lead to her exclusion. This study emphasizes that storytelling is a fundamental tool that girls use to socialize with one another, which has implications for autism intervention practices. (shrink)

In this illustrated choose-your-own-ending book, Margo must choose between cleaning her room or putting it off to do something fun. Readers make choices for Margo and read what happens next, with each story path leading to different consequences. Includes four different endings and discussion questions.

In this illustrated choose-your-own-ending picture book, Dahabo must decide whether to keep working on her science fair project or quit. Readers make choices for Dahabo and read what happens next, with each story path leading to different consequences. Includes four different endings and discussion questions.

Accounts of deep disagreements can generally be categorized as optimistic or pessimistic. Pessimistic interpretations insist that the depth of deep disagreements precludes the possibility of rational resolution altogether, while optimistic variations maintain the contrary. Despite both approaches’ respective positions, they nevertheless often, either explicitly or implicitly, agree on the underlying assumption that argumentation offers the only possible rational resolution to deep disagreements. This paper challenges that idea by, first, diagnosing this argument-only model of arriving at rational resolutions, second, articulating a (...) competing but undertheorized Hegelian-informed approach, and third, attending briefly to some of the challenges of such an approach. (shrink)

In a digital era that neglects handwriting, the current study is significant because it examines the mechanisms underlying this process. We recruited 9- to 10-year-old Chinese children, who were at an important period of handwriting development, and adult college students, for both behavioral and electroencephalogram experiments. We designed four learning conditions: handwriting Chinese, viewing Chinese, drawing shapes followed by Chinese recognition, and drawing shapes followed by English recognition. Both behavioral and EEG results showed that HC facilitated visual word recognition compared (...) to VC, and behavioral results showed that HC facilitated visual word recognition compared to drawing shapes. HC and VC resulted in a lateralization of the N170 in adults, but not in children. Taken together, the results of the study suggest benefits of handwriting on the neural processing and behavioral performance in response to Chinese characters. The study results argue for maintaining handwriting practices to promote the perception of visual word forms in the digital age. (shrink)

Proponents of numerous recent theories of a person's good hold that a plausible account of the good for a person must satisfy existence internalism. Yet little direct defense has been given for this position. I argue that the principal intuition behind internalism supports a stronger version of the thesis than it might appear--one that effects a "double link" to motivation. I then identify and develop the main arguments that have been or might be given in support of internalism about a (...) person's good, showing how these arguments support this stronger version of internalism. (shrink)

Dialogical egalitarianism is the thesis that any proposition asserted in dialogue, if questioned, must be supported or else retracted. Dialogical foundationalism is the thesis that some propositions are privileged over this burden of proof, standing in no need of support unless and until support for their negation is provided. I first discuss existing arguments for either thesis, dismissing each one of them. Absent a successful principled argument, I then examine which thesis it is pragmatically more advantageous to adopt in analytic (...) philosophical dialogue. This requires identifying the goal of such dialogue, to the attainment of which the thesis would be so advantageous. To identify this goal, I draw on Douglas Walton’s typology of dialogues for an analysis of the types of dialogue of 110 representatively selected journal articles in current analytic philosophy. 95% of articles are found to instantiate persuasion dialogue. In light of the thus prevalent goal of persuading one’s opponent, I argue that the adoption of dialogical egalitarianism in analytic philosophical dialogue is pragmatically inescapable. (shrink)

Using information collected from a convenience sample of graduate and undergraduate students affiliated with a Midwestern university in the United States, this study determined the extent to which gender is related to consumers’ moral philosophies and ethical intentions. Multivariate and univariate results indicated that women were more inclined than men to utilize both consequence-based and rule-based moral philosophies in questionable consumption situations. In addition, women placed more importance on an overall moral philosophy than did men, and women had higher intentions (...) to behave ethically. The marketing and practical implications of these findings are discussed, and the limitations of the research are presented along with several suggestions for future inquiry, which could advance current understanding of consumer ethics. (shrink)

On elective students may not always be clear about safeguarding themselves and others. It is important that placements are safe, and ethically grounded. A concern for medical schools is equipping their students for exposure to and response to uncomfortable and/or unfamiliar requests in locations away from home, where their comfort and safety, or that of the patient, may be compromised. This can require legal, ethical, and/or moral reasoning on the part of the student. The goal of this article is to (...) establish what students actually encounter on elective, to inform better preparing students for safe and ethical medical placements. We discuss the implications of our findings, which are arguably applicable to other areas of graduate training, e.g. first medical roles post-qualification. An anonymised survey exploring clinical and ethical dilemmas on elective was issued across 3 years of returning final year elective medical students. Questions included the prevalence and type of potentially unsafe scenarios encountered, barriers to saying ‘no’ in unsafe situations, perceived differences between resource poor and developed world settings and the degree to which students refused or consented to participation in events outside of the ‘norms’ of their own training experience. Three hundred seventy-nine students participated. 45% were asked to do something “not permissible” at home. 27% were asked to do something they felt “uncomfortable” with, often an invasive clinical task. Half asked to do something not usually permissible were “comfortable”. 48% felt it more acceptable to bypass guidelines in developing settings. 27% refused an offer outside their experience. Of interest are reasons for “going along with” uncomfortable invitations, e.g. “emergency”, self-belief in ‘capability’ and being ‘more qualified’ than host-personnel. This “best pair of hands available” merits scrutiny. Adverse scenarios were not exclusive to developing settings. We discuss preparing students for decision-making in new contexts, and address whether ‘home’ processes are too inflexible to prepare students for ‘real’ medical life? Ethical decision-making and communicating reluctance should be included in elective preparation. (shrink)

In our everyday lives, we confront a host of moral issues. Once we have deliberated and formed judgments about what is right or wrong, good or bad, these judgments tend to have a marked hold on us. Although in the end, we do not always behave as we think we ought, our moral judgments typically motivate us, at least to some degree, to act in accordance with them. When philosophers talk about moral motivation, this is the basic phenomenon they seek (...) to understand. Moral motivation is an instance of a more general phenomenon—what we might call normative motivation—for our other normative judgments also typically have some motivating force. When we make the normative judgment that something is good for us, or that we have a reason to act in a particular way, or that a specific course of action is the rational course, we also tend to be moved. Many philosophers have regarded the motivating force of normative judgments as the key feature that marks them as normative, thereby distinguishing them from the many other judgments we make. In contrast to our normative judgments, our mathematical and empirical judgments, for example, seem to have no intrinsic connection to motivation and action. The belief that an antibiotic will cure a specific infection may move an individual to take the antibiotic, if she also believes that she has the infection, and if she either desires to be cured or judges that she ought to treat the infection for her own good. All on its own, however, an empirical belief like this one appears to carry with it no particular motivational impact; a person can judge that an antibiotic will most effectively cure a specific infection without being moved one way or another. (shrink)

Successful marketing efforts and professional sales encounters often depend on consumer involvement in the purchase decision process itself, which in turn may impact firm performance. Despite the importance of consumer involvement, research has yet to fully explain the relationship between consumer personality characteristics and the nature of consumer purchase involvement. This study explores the degree to which consumer perception of salesperson ethical treatment helps explain the relationship between consumer personality characteristics and nature of involvement. Data were collected from a large (...) sample of working adults placed in two scenario-based positive professional sales encounters featuring an important purchase decision. The results indicated that adult consumers’ personality characteristics functioned through judgment of salesperson ethical treatment to affect the nature of purchase involvement. Specifically, consumer judgment of salesperson ethical treatment fully mediated a positive relationship between internal locus of control and cognitive involvement. By comparison, consumer judgment of a salesperson ethical treatment partially mediated the positive relationship between emotional awareness and cognitive involvement. The above findings were similar for informational and relational salesperson customer-orientated scenarios. Key implications for selling professionals and sales organizations are discussed, such as augmenting consumers’ self-assessments to increase their perceptions of salesperson ethics and purchase involvement. The limitations and recommendations for future research are also presented. (shrink)

We examined participants' reading and recall of informed consent documents presented via paper or computer. Within each presentation medium, we presented the document as a continuous or paginated document to simulate common computer and paper presentation formats. Participants took slightly longer to read paginated and computer informed consent documents and recalled slightly more information from the paginated documents. We concluded that obtaining informed consent online is not substantially different than obtaining it via paper presentation. We also provide suggestions for improving (...) informed consent-in both face-to-face and online experiments. (shrink)

This essay explores the nature of narrative representations of individual lives and the connection between these narratives and personal good. It poses the challenge of determining how thinking of our lives in story form contributes distinctively to our good in a way not reducible to other value-conferring features of our lives. Because we can meaningfully talk about our lives going well for us at particular moments even if they fail to go well overall or over time, the essay maintains that (...) our good must consist in something more than an accumulation of good discrete moments. Since persons have the capacities to reason, remember, and imagine, our good depends on a larger view of our lives that integrates its particular moments in a narrative. That narrative provides shape and texture to our lives. Storytelling serves to connect the events of our lives to each other, and to explain why the meaning and value of past events or features of our lives can shift as the life, and hence the story of the life, continues to unfold. The essay concludes that narrative enables us to see our lives in ways that support, encourage, or promote our self-concept and self-worth as agents who have controlling authority over our own lives. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Stephen Darwall has recently suggested that theories which identify a person's good with her own ranking of concerns do not properly delimit the ‘scope’ of welfare, making self‐sacrifice conceptually impossible. But whether a theory of welfare makes self‐sacrifice impossible depends on what self‐sacrifice is. I offer an alternative analysis to Overvold's, explaining why self‐interest and self‐sacrifice need not be opposed, and so why the problems of delimiting the scope of welfare and of allowing for self‐sacrifice are distinct. If my analysis (...) is correct, desire theories may allow for self‐sacrifice however they delimit the scope of welfare. (shrink)

As persons, beings with a capacity for autonomy, we face a certain practical task in living out our lives. At any given period we find ourselves with many desires or preferences, yet we have limited resources, and so we cannot satisfy them all. Our limited resources include insufficient economic means, of course; few of us have either the funds or the material provisions to obtain or pursue all that we might like. More significantly, though, we are limited to a single (...) life and one of finite duration. We also age, and pursuits that were possible at earlier points within a life may become impossible at later stages; we thus encounter not only an ultimate time limit but episodic limits as well. Because we must live our lives with limited resources—material and temporal—we are pressed to choose among and to order our preferences. Without some selection and ordering, few if any of them would be satisfied, and we would be unable to live lives that are recognizably good at all. Moreover, we would be unable to function well as the autonomous beings that we are. Our practical task then is to form a coherent, stable, and attractive ordering of aims—to develop a conception of our good. (shrink)

Background: Moral distress is an important and well-studied phenomenon among nurses and other healthcare providers, yet the conceptualization of parental moral distress remains unclear. Objective: The objective of this dimensional analysis was to describe the nature of family moral distress in serious pediatric illness. Design and methods: A dimensional analysis of articles retrieved from a librarian-assisted systematic review of Scopus, CINAHL, and PsychInfo was conducted, focusing on how children, parents, other family members, and healthcare providers describe parental moral distress, both (...) explicitly through writings on parental moral experience and implicitly through writings on parental involvement in distressing aspects of the child’s serious illness. Ethical considerations: To promote child and family best interest and minimize harm, a nuanced understanding of the moral, existential, emotional, and spiritual impact of serious pediatric illness is needed. The cases used in this dimensional analysis come from the first author’s IRB approved study at the Children’s Hospital of Philadelphia and subsequent published studies; or have been adapted from the literature and the authors’ clinical experiences. Findings: Three dimensions emerged from the literature surrounding parent moral distress: an intrapersonal dimension, an interpersonal dimension, and a spiritual/existential dimension. The overarching theme is that parents experience relational solace and distress because of the impact of their child’s illness on relationships with themselves, their children, family, healthcare providers, their surrounding communities, and society. Discussion: Elucidating this concept can help nurses and other professionals understand, mitigate, or eliminate antecedents to parental moral distress. We discuss how this model can facilitate future empirical and conceptual bioethics research, as well as inform the manner in which healthcare providers engage, collaborate with, and care for families during serious pediatric illness. Conclusion: Parent moral distress is an important and complex phenomenon that requires further theoretical and empirical investigation. We provide an integrated definition and dimensional schematic model that may serve as a starting point for future research and dialogue. (shrink)

Collects the photographs of Carleton Watkins that contributed to the argument for creating the National Park Service, along with essays that explore the artist and his work providing context and depth to the images.