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)

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)

BackgroundAdolescents living with human immunodeficiency virus (HIV) experience challenges, including lack of involvement in their care as well nondisclosure of HIV status, which leads to poor adherence to antiretroviral therapy (ART). Parents have authority over their children, but during adolescence there is an increasing desire for independence. The aim of the study was to explore adolescents’ experience of challenges identified by adolescents ages 10–19 years attending HIV care and treatment at Temeke Regional Referral Hospital in Tanzania. MethodsAn exploratory descriptive qualitative (...) design was employed in the HIV Care and Treatment Centre (CTC) in the Out-Patient Department at the Temeke Regional Referral Hospital in Tanzania with adolescents living with HIV who were 10–19 years of age. A total of 22 adolescents participated in semi-structured face-to-face interviews after parental consent and adolescent assent were obtained. Participants were interviewed about their participation in decisions to be tested for HIV and enrolled in the CTC, concerns surrounding disclosure of their HIV status to the adolescent or to others, stigma and discrimination, and the effect of these challenges on their adherence to medication. All interviews were audio-taped, transcribed verbatim in Swahili, and back-translated to English. Data analysis included both inductive and deductive thematic analysis.ResultsQualitative themes identified included lack of participation in decisions about HIV testing, challenges to enrollment in care and treatment; issues around disclosure of HIV status, such as delays in disclosure to the adolescent and disclosure to other persons and benefits and harms of such disclosures; and factors supporting and interfering with adherence to ART, such as parental support, organizational (clinic) support and problems, and self-stigmatization and shame.ConclusionLack of adolescents’ involvement in their care decision making and delayed disclosure of HIV status to the adolescent were identified concerns, leading to poor adherence to ART among adolescents. Disclosure to others, especially teachers, helped adolescents at school to take their medication properly. Disclosure to others led to stigma and discrimination for some adolescents. More research is needed to better understand the role of disclosure and its benefits and challenges for HIV-positive adolescents in Tanzania. (shrink)

Background The COVID-19 pandemic continues to disrupt every society as SARs-CoV-2 variants surge among the populations. Health care providers are exhausted, becoming ill themselves, and in some instances have died. Indeed, hospitals are struggling to find staff to care for critically ill patients most in need. Previous work has reported on the unending work-related conditions that hospital staff are laboring under and their subsequent mental and physical health strains. Health care providers need support, but it is not clear where that (...) support is to come from. While much research has reported on the COVID-19-related fears of nurses and physicians, fewer studies have focused on supportive features of the hospital work environment and how it may provide relief to front-line health care providers.Purpose This purpose of this study was to explore an often-overlooked resource within hospital systems across the United States—clinical ethicists—and examine their many roles during COVID-19 and the types of ethical issues they addressed with nurses, physicians, administrators, and others.Methods This was a primary analysis of semi-structured, qualitative interviews with 23 clinical ethicists across the United States. The interviews were conducted from November 2020–April 2021 and were audiotaped, transcribed verbatim, and de-identified; both inductive and deductive analyses were used to identify qualitative themes.Results Five major themes were identified: ethical issues that were increasingly more complex, moral distress that was “endemic,” shifting ethical paradigms from the focus on the individual to the population, fostering a supportive environment, and organizational ethics: variation in the value, roles, and policy input of clinical ethicists.Conclusions Our findings report on the integral and expanded role of clinical ethicists at an unprecedented time in our nation, and how they stepped forward to support front-line clinicians in hospitals across the country. (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)

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...

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)

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)

In his book, The Solace: Finding Value in Death through Gratitude for Life, Joshua Glasgow recounts his thoughts as he tried to prepare for a conversation about death with his dying mother, whom he hoped to comfort. After rejecting certain possible sources of solace, he argues that our passing away itself has value, which it derives from the meaningfulness of our lives as a whole, and this value can provide the comfort we may seek. I raise a number of difficulties (...) for and questions about Glasgow’s claims, ultimately concluding that even if our passing away had some value, recognizing thiswould add nothing to the solace we may derive from reflecting on the value of our lives themselves. (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)

In his critique of egoism as a doctrine of ends, G. E. Moore famously challenges the idea that something can be someone. Donald Regan has recently revived and developed the Moorean challenge, making explicit its implications for the very idea of individual welfare. If the Moorean is right, there is no distinct, normative property good for, and so no plausible objectivism about ethics could be welfarist. In this essay, I undertake to address the Moorean challenge, clarifying our theoretical alternatives so (...) that we may better decide what to admit into our moral ontology and better assess what may be at stake in whether objectivists treat good or good for (or neither) as fundamental. I compare the Moorean and welfarist pictures of value, providing an account of the form and function of good for. According to this account expresses a distinct relational value that has its source in the value of persons. Good for value is thus a form of extrinsic value that provides agent-neutral reasons for action, and it plays a pervasive normative role in regulating child rearing, guiding individual life choices, and shaping social policy formation. (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)

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)

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)

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)

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)

Few bioethicists are educated with a view into nursing. Thus, much of the conceptual and empirical research on ethical issues in nursing practice has been conducted by nurse ethicists themselves and, to a lesser degree, by individuals with a strong interest in nursing ethics. Although this work has internally shaped nursing practice, education, and policy, the broader field of bioethics has seldom examined and acknowledged the everyday ethical concerns of practicing nurses and their important contributions to bioethics discourse. In this (...) special report of the Hastings Center Report —the first to focus on nursing—Christine Grady, Ann Hamric, and I, along with consulting editor Nancy Berlinger, strive to give voice to the contributions of nurses in addressing some of our obstinate everyday ethics and health policy challenges. (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...

Stephen Darwall has recently suggested (following work by Mark Overvold) 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)

Volume 20, Issue 6, June 2020, Page 68-70.

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)

We review three possible theoretical mechanisms for the placebo effect: conditioning, expectancy and endogenous opiates and consider the implications of the first two for clinical research and practice in the area of pain management. Methodological issues in the use of placebos as controls are discussed and include subtractive versus additive expectancy effects, no treatment controls, active placebo controls, the balanced placebo design, between- versus within-group designs, triple blind methodology and the double expectancy design. Therapeutically, the possibility of shaping negative placebo (...) responses through placebo sag, overservicing and the use of placebos on their own are explored. Suggestions for using conditioned placebos strategically in conjunction with nonplacebos are made and ways of maximizing the placebo component of nonplacebo treatments are examined. Finally, the importance of investigating the placebo effect in its own right is advocated in order to better understand the long-neglected psychological aspects of the therapeutic transaction. (shrink)

Individuals are downloading copyrighted materials at escalating rates (Hill 2007; Siwek 2007). Since most materials shared within these networks are copyrighted works, providing, exchanging, or downloading files is considered to be piracy and a violation of intellectual property rights (Shang et al. 2008). Previous research indicates that personal moral philosophies rooted in moral absolutism together with social context may impact decision making in ethical dilemmas; however, it is yet unclear which motivations and norms contextually impact moral awareness in a peer-to-peer (...) (P2P) file sharing context (Shang et al. 2008). In sum, factors affecting the decision to share copyrighted material require further clarification and investigation (Shang et al. 2008). The purpose of this study was to use a consumer-based scenario and multiple ethics measures to explore how idealism, formalism, and perceived social consensus impact users’ propensity to recognize that the sharing of copyrighted media through P2P networks was an ethical issue and their subsequent ethical intentions. Results showed that high levels of idealism and formalism were associated with an increased recognition that file sharing was an ethical issue, but neither construct had a direct effect on ethical intention. Strong social consensus among respondents that other people consider file sharing to be unethical was also positively related to the recognition that file sharing was an ethical issue, and ethical recognition was a moderate predictor of intention not to engage in file sharing. Finally, a post hoc mediation analysis indicated that idealism, formalism, and social consensus operated through recognition of an ethical issue to impact ethical intention (indirect-only mediation). (shrink)

Signed utterances are densely packed with pointing signs, reaching a frequency of one in six signs in spontaneous conversations . These pointing signs attain a wide range of functions and are formally highly diversified. Based on corpus analysis of spontaneous pointing signs in Kata Kolok, a rural signing variety of Bali, this paper argues that the full meaning potentials of pointing signs come about through the integration of a varied set of linguistic and extralinguistic cues. Taking this hybrid nature of (...) pointing phenomena into account, it is argued that pointing signs may become an intrinsic aspect of sign language grammars through two mechanisms: morphemization and syntactic integration. Although not entailed in this research, this approach could implicate that some highly systematized pointing systems of speaking communities may to a degree be grammatical as well. (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)