Context Conflicts over treatment decisions have been linked to physicians' emotional states. Objective To measure the prevalence of emotional exhaustion and conflicts over treatment decisions among US obstetrician/gynaecologists (ob/gyns), and to examine the relationship between the two and the physician characteristics that predict each. Methods Mailed survey of a stratified random sample of 1800 US ob/gyn physicians. Criterion variables were levels of emotional exhaustion and frequency of conflict with colleagues and patients. Predictors included physicians' religious characteristics and self-perceived empathy. Results (...) Response rate among eligible physicians was 66% (1154/1760). 36% of ob/gyns reported high levels of emotional exhaustion, and majorities reported conflict with colleagues (59%) and patients (61%). Those reporting conflict were much more likely to report emotional exhaustion (58% vs 29% who never conflict, OR, 95% CI 2.8, 1.6 to 4.8 for conflict with colleagues; 55% versus 26%, OR, 95% CI 2.2, 1.4 to 3.5 for conflict with patients). Physicians with lower self-perceived empathy were more likely to report physician-patient conflicts (65% vs 58% with higher empathy, OR, 95% CI 1.4, 1.0 to 1.9), as were female ob/gyns (66% vs 57% of males, OR, 95% CI 1.5, 1.1 to 2.0). Foreign-born physicians were less likely to report such conflicts (47% vs 64% of US born, OR, 95% CI 0.5, 0.4 to 0.8). Physicians' religious characteristics were not significantly associated with reporting conflict. Conclusions Conflicts over treatment decisions are associated with physicians' empathy, gender, immigration history and level of emotional exhaustion. With respect to the latter, conflict in the clinical encounter may represent an overlooked source or sign of burnout among ob/gyns. (shrink)

Contributed research papers presented at a seminar organized by Dept. of Post-graduate Studies and Research in Christianity, University of Mysore, India in collaboration with the Society of Intercultural Philosophy, Koeln, Germany in Oct. 1994.

Court D. Lewis, author of Repentance and the Right to Forgiveness, presents a rights-based theory of ethics grounded in eirenéism, a needs-based theory of rights (inspired by Nicholas Wolterstorff) that seeks peaceful flourishing for all moral agents. This approach creates a moral relationship between victims and wrongdoers such that wrongdoers owe victims compensatory obligations. However, one further result is that wrongdoers may be owed forgiveness by victims. This leads to the “repugnant implication” that victims may be wrongdoers who do not (...) forgive. Author Lewis addresses the “repugnant implication” by showing that victims are obligated to work toward forgiveness, if not forgiveness itself. Critic Gregory L. Bock argues that victims are not the only ones who can forgive, that the personal dimensions of forgiveness are overlooked, and that the force of the “repugnancy implication” may be questioned. Instead of rights-based eirenéism, Bock supports a virtue ethics framework. Instead of rights-based eirenéism, Bock encourages virtue ethics. Critic David Boersema raises questions about the binding nature of relationships, the dependency of flourishing upon forgiveness, and the nature of needs or rights. Boersema also questions the wisdom of a rights-based approach to forgiveness. Critic Jennifer Kling asks whether a rights-based approach is necessary to ground obligations to meet the needs of others: why not an ethics of care? If a rights-based approach is taken, perhaps a wrongdoer is obligated to not make forgiveness a life good. By disengaging this obligation, we avoid constraining a victim’s work toward forgiveness, especially when the wrongdoing is oppressive. Author Lewis responds to these objections. (shrink)

This book provides a variety of diverse perspectives related to the ethics of anger, some more analytical in nature, others focused on practical issues, some in defense of anger, and others arguing against its necessity. This book is an essential resource for scholars who want to reflect critically on the place of anger in contemporary life.

An inclusive survey from Frederick Douglass to the voices of Black Lives Matter.

The essays in Practicing Gnosis demonstrate that the Gnostics were not necessarily trendy intellectuals seeking epistomological certainities. Instead, this book explores how Gnostics were seeking religious experiences that relied on practices including ritual, magic, liturgy, and theurgy. This book celebrates the career of Birger A. Pearson.

In this paper, we focus on whether and to what extent we judge that people are responsible for the consequences of their forgetfulness. We ran a series of behavioral studies to measure judgments of responsibility for the consequences of forgetfulness. Our results show that we are disposed to hold others responsible for some of their forgetfulness. The level of stress that the forgetful agent is under modulates judgments of responsibility, though the level of care that the agent exhibits toward performing (...) the forgotten action does not. We argue that this result has important implications for a long-running debate about the nature of responsible agency. (shrink)

Book reviewed in this article: Classic Cases in Medical Ethics. By Gregory Pence.

Cognitive Science, Volume 46, Issue 1, January 2022.

As noted In Part II of this series, perhaps the most critical elements to define in deciding when treatment Is futile are the goals of therapy from, both the physician's and the patient's point of view. A patient's personal goals are based upon value system., life goals, and personal definition of “quality of life.” These personal goals must then be interpreted and applied in a reasonable and realistic fashion against what the physician has previously described as the legitimate, objective, and (...) attainable therapeutic goals. As far as possible, both, parties must work together to eliminate the uncertainties in their discussion. The ideal situation includes a competent, alert patient and a prudent, caring physician who have had a long-term ongoing relationship. The key to collaboration is communication: a sincere interest in and professional concern for the patient; a willingness to be honest and open; a commitment to talk and to listen; an attempt to make one another feel comfortable in the collaboration; and an effort to recognize and to overcome barriers to communication, whether barriers are personal to either the patient or the physician or are professional, institutional, or societal. (shrink)

Recent contributions to the literature on the topic of futility have focused primarily on two areas: 1) definitions of the term and 2) the suggestion that cardiopulmonary resuscitation may be futile in certain patients. This suggestion is based on “scientific” measures and analyses of outcomes, describing the low probability of success of CPR in patients over age 70, those with cancer, those with multiorgan failure, etc. The research reported suggests that with such patients the physician need not get the patient's (...) consent to withhold resuscitation; the physician need only inform either the patient or the surrogate that CPR will not be Instituted in the event of an arrest. (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

The patient was a woman in her 30s who, until the rapid progression of an ultimately fatal neurologic disease, had been a very successful professional, enjoying athletics and an active social life. In the 6 months of swift deterioration, she had gone from being extremely vibrant and energetic to being totally unable to care for her personal needs. There had been no loss of intellectual capacity. Her sister later recounted to Dr. J., the emergency department physician, that she had found (...) the patient unconscious and unresponsive at home and had immediately called the patient's neurologist in a neighboring city. He directed her to call the paramedics. (shrink)

Background and objectives Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. Design A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee—whether the (...) doctor referred and whether the doctor disclosed their objection to the abortion. Participants and setting 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Measurement Physicians indicated their approval for the vignette doctor's decision. Main results Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. Conclusion OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor–patient relationship. (shrink)

This rich and varied collection of essays addresses some of the most fundamental human questions through the lenses of philosophy, literature, religion, politics, and theology. Peter Augustine Lawler and Dale McConkey have fashioned an interdisciplinary consideration of such perennial and enduring issues as the relationship between nature and history, nature and grace, reason and revelation, classical philosophy and Christianity, modernity and postmodernity, repentance and self-limitation, and philosophy and politics.

A physician recently asked how to respond in the case of an 87-year-old patient with advanced Alzheimer's disease, who was unable to swallow or tolerate a nasogastric tube, when the family insisted a gastrostomy tube be inserted but the physician believed the intervention futile. That question encompasses some of the crucial issues in the concept of futility of the treatment goals of physician, patient, and family; the rights of patients and families to demand care; physician judgment; family values; and, to (...) the degree that it represents many similar dilemmas, justice. What are professionals saying when they pronounce treatment futile? What are patients' rights if they or their surrogates disagree?The word “futile” implies a precision about outcome probability that we do not have, and it ignores the wide range of treatments for a given diagnosis. Is futile the same as useless or the opposite of hope? Futile for what? Cure? Restora tion of function? Prolongation of life? Relief from pain? Relief from anxiety? Com fort? Reassurance? To satisfy or placate the patient or the family? The word “futile” is so imprecise that, rather than clarifying, it confuses and clutters the discussion. (shrink)

We posit a key goal of firms’ corporate social responsibility efforts is to influence reputation through carefully crafted communicative practices. This trend has accelerated with the rise of social media such as Twitter and Facebook, which are essentially public message networks that organizations are leveraging to engage with concerned audiences. Given the large number of messages sent on these sites, only some will be effective and achieve broad public resonance. Building on signaling theory, this paper asks whether and how messages (...) conveying CSR-related topics resonate with the public and, if so, which CSR topics and signal qualities are most effective. We test our hypotheses using data on public reactions to Fortune 500 companies’ CSR-focused Twitter feeds, using the retweeting of firms’ messages as a proxy for public resonance. We find resonance is positively associated with messages that convey CSR topics such as the environment or education, those that make the topic explicit through use of hashtags, and those that tap into existing social movement discussions. (shrink)

Dans la septième dissertation de son Commentaire sur la République de Platon, Proclus fournit les éléments d’une philosophie politique néoplatonicienne très structurée. Fidèle, de façon générale, à la description platonicienne de l’âme tripartite et des quatre vertus cardinales, il introduit cependant d’importantes nuances dans cette théorie. L’idée de la prédominance d’une partie de l’âme sur une autre et l’idée de « vies mixtes » où deux parties de l’âme prédominent en même temps élargissent la description platonicienne des différents types poli­tiques. (...) En outre, en s’efforçant de donner diverses explications métaphysiques de la nature et du nombre des parties de l’âme et des vertus, Proclus inscrit la philosophie politique platonicienne plus ou moins tout d’une pièce dans une hiérarchie cosmique néoplatonicienne. (shrink)

Social media offers a platform for diffused stakeholders to interact with firms—alternatively praising, questioning, and chastising businesses for their CSR performance and seeking to engage in two-way dialogue. In 2014, 163,402 public messages were sent to Fortune 200 firms’ CSR-focused Twitter accounts, each of which was either shared, replied to, “liked,” or ignored by the targeted firm. This paper examines firm reactions to these messages, building a model of firm response to stakeholders that combines the notions of CSR communication and (...) stakeholder salience. Our findings show that firm response to a stakeholder on social media is positively and most significantly associated with what we refer to as the stakeholder’s connective power but negatively associated with the firm’s own connective power. To a lesser extent, firm response is positively associated with the stakeholder’s normative power but negatively associated with the firm’s own normative power. Firm response is also shown to be positively associated with stakeholder urgency in terms of both the originality of a stakeholder message and the expression of positive sentiment. (shrink)

Social media is changing social accountability practices. The release of the Panama Papers on April 3, 2016 by the International Consortium of Investigative Journalists (ICIJ) unleashed a tsunami of over 5 million tweets decrying corrupt politicians and tax-avoiding business elites, calling for policy change from governments, and demanding accountability from corporate and private tax avoiders. The current study uses 297,000+ original English-language geo-codable tweets with the hashtags #PanamaGate, #PanamaPapers, or #PanamaLeaks to examine the trajectory of Twitter-based social accountability conversations and (...) the potential for the emergence of a longer-term social accountability user network. We propose that it is the combination of financial inscriptions and evaluative ethical utterances that incite and sustain social accountability conversations and social accountability networks. Financial inscriptions simultaneously remind audiences of both the information event that fomented the initial public reaction and the monetary magnitude of the event. Value-based ethical messaging, in turn, enunciates an ethical stance that simultaneously evaluates existing practices and emphasizes the need for accountability. It is the combining of these two types of messaging that helps to construct and sustain a normative narrative about social accountability. The results illustrate how the repetition and re-working of these two forms of messaging facilitated the construction of a normative narrative that coalesced into a social accountability network which persisted beyond the initial Panama Paper information event and which was re-activated in 2017 when the ICIJ published the Paradise Papers. (shrink)

In his commentary on Euclid, Proclus says both that the first principle of geometry are self-evident and that they are hypotheses received from the single, highest, unhypothetical science, which is probably dialectic. The implication of this seems to be that a geometer both does and does not know geometrical truths. This dilemma only exists if we assume that Proclus follows Aristotle in his understanding of these terms. This paper shows that this is not the case, and explains what Proclus himself (...) means by definition, hypothesis, axiom, postulate, and the self-evident, and how geometry is a science that receives its principles from dialectic. (shrink)

Through emotionally charged portraits and richly layered interior views, the photographs of Chicago-based artist Paul D Amato provide a genuine and complex perspective on life in some of the most challenging and troubled neighborhoods in the nation. This publication is supported in part by grants from the David C. and Sarajean Ruttenberg Arts Foundation and the Robert Mapplethorpe Foundation.".

Nature contact has associations with emotional ill-being and well-being. However, the mechanisms underlying these associations are not fully understood. We hypothesised that increased adaptive and decreased maladaptive emotion regulation strategies would be a pathway linking nature contact to ill-being and well-being. Using data from a survey of 600 U.S.-based adults administered online in 2022, we conducted structural equation modelling to test our hypotheses. We found that (1) frequency of nature contact was significantly associated with lesser emotional ill-being and greater emotional (...) well-being, (2) effective emotion regulation was significantly associated with lesser emotional ill-being and greater emotional well-being, and (3) the associations of higher frequency of nature contact with these benefits were partly explained via emotion regulation. Moreover, we found a nonlinear relationship for the associations of duration of nature contact with some outcomes, with a rise in benefits up to certain amounts of time, and a levelling off after these points. These findings support and extend previous work that demonstrates that the associations of nature contact with emotional ill-being and well-being may be partly explained by changes in emotion regulation. (shrink)

Supporting Hamilton’s inclusive fitness theory, archival analyses of inheritance patterns in wills have revealed that people invest more of their estates in kin of closer genetic relatedness. Recent classroom experiments have shown that this genetic relatedness effect is stronger for relatives of direct lineage (children, grandchildren) than for relatives of collateral lineage (siblings, nieces, nephews). In the present research, multilevel modeling of more than 1,000 British Columbian wills revealed a positive effect of genetic relatedness on proportions of estates allocated to (...) relatives. This effect was qualified by an interaction with lineage, such that it was stronger for direct than for collateral relatives. Exploratory analyses of the moderating role of benefactors’ sex and estate values showed the genetic relatedness effect was stronger among female and wealthier benefactors. The importance of these moderators to understanding kin investment in modern humans is discussed. (shrink)