BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

Individuals differ considerably in their emotion experience. Some experience emotions in a highly differentiated manner, clearly distinguishing among a variety of negative and positive discrete emotions. Others experience emotions in a relatively undifferentiated manner, treating a range of like-valence terms as interchangeable. Drawing on self-regulation theory, we hypothesised that individuals with highly differentiated emotion experience should be better able to regulate emotions than individuals with poorly differentiated emotion experience. In particular, we hypothesised that emotion differentiation and emotion regulation would be (...) positively related in the context of intense negative emotions, where the press for emotion regulation is generally greatest. To test this hypothesis, participants' negative and positive emotion differentiation was assessed using a 14-day diary protocol. Participants' regulation of negative and positive emotions was assessed using laboratory measures. As predicted, negative emotion differentiation was positively related to the frequency of negative emotion regulation, particularly at higher levels of emotional intensity. (shrink)

Background: Expanded newborn screening generates incidental results, notably carrier results. Yet newborn screening programmes typically restrict parental choice regarding receipt of this non-health serving genetic information. Healthcare providers play a key role in educating families or caring for screened infants and have strong beliefs about the management of incidental results. Methods: To inform policy on disclosure of infant sickle cell disorder (SCD) carrier results, a mixed-methods study of healthcare providers was conducted in Ontario, Canada, to understand attitudes regarding result management (...) using a cross-sectional survey (N = 1615) and semistructured interviews (N = 42). Results: Agreement to reasons favouring disclosure of SCD carrier results was high (65.1%–92.7%) and to reasons opposing disclosure was low (4.1%–18.1%). Genetics professionals expressed less support for arguments favouring disclosure (35.3%–78.8%), and more agreement with arguments opposing disclosure (15.7%–51.9%). A slim majority of genetics professionals (51.9%) agreed that a reason to avoid disclosure was the importance of allowing the child to decide to receive results. Qualitatively, there was a perceived “duty” to disclose, that if the clinician possessed the information, the clinician could not withhold it. Discussion: While a majority of respondents perceived a duty to disclose the incidental results of newborn screening, the policy implications of these attitudes are not obvious. In particular, policy must balance descriptive ethics (ie, what providers believe) and normative ethics (ie, what duty-based principles oblige), address dissenting opinion and consider the relevance of moral principles grounded in clinical obligations for public health initiatives. (shrink)

. The ability to enforce the provisions of a code of conduct influences whether the code is effective in shaping behavior. Enforcement relies in part on the willingness of organization members to report violations of the code, but research from the business and educational environment suggests that fewer than half of those who observe code violations follow their organizations procedures for reporting them. Based on a review of the literature in the business and educational environments, and a survey of 3605 (...) students at a mid-sized comprehensive university, this paper attempts to make conceptual sense of the non-reporting phenomenon. We present a conceptual framework based on four distinct factors which we have labeled: (1) factual non-responsibility; (2) moral non-responsibility; (3) consequential exoneration; and, (4) functional exoneration. Each of these factors suggest a different remedial strategy as well as provide a theoretical foundation for future research. Testable propositions for future research are developed, and some implications for organization leaders are discussed. (shrink)

Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for patients (...) with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

Seeking to expand on previous theories, this paper explores the AIR (Applying Intelligence to the Reflexes) approach to expert performance previously outlined by Geeves, Christensen, Sutton and McIlwain (2008). Data gathered from a semi-structured interview investigating the performance experience of Jeremy Kelshaw (JK), a professional musician, is explored. Although JK’s experience of music performance contains inherently uncertain elements, his phenomenological description of an ideal performance is tied to notions of vibe, connection and environment. The dynamic nature of music performance (...) advocated by the AIR approach is illustrated by the strategies that JK implements during performance. Through executing these strategies, JK attempts to increase the likelihood of vibe and connection by selectively exercising agency over performance variables within his control. In order to achieve this, JK must engage in ongoing monitoring of his performance, whereby the spotlight of his attention pans across a vast array of disparate performance processes (and levels within these processes) in order to ascertain how he can most effectively meet the specific demands of a given performance situation. It is hoped that future research compiling data from numerous interviews and sources as well as using different research methodologies will further unlock the potential that the AIR approach holds for understanding expert performance. (shrink)

The Anthropology of Sport and Human Movement represents a collection of work that reveals and explores the often times dramatic relationship of our biology and culture that is inextricably woven into a tapestry of movement patterns. It explores the underpinning of human movement, reflected in play, sport, games and human culture from an evolutionary perspective and contemporary expression of sport and human movement.

Oregon is the only state in the United States where a physician may legally prescribe a lethal dose of barbiturate for a patient intending suicide. The Oregon Death with Dignity Act was passed by voters in 1994 and came into effect after much legal wrangling in October of 1997. At the same time, a cabinetmaker named Pat Matheny was struggling with progressive weakness from amyotrophic lateral sclerosis, or ALS. I met with Pat and his family for a lengthy interview in (...) October 1998 in Coos Bay, Oregon, for a television news report on his decision to get a lethal prescription. Below is an extract from that interview. On the day this introduction was written, 10 March 1999, Pat took the prescribed lethal overdose of barbiturates and died at home. His illness was taking his voice, he could not move his hands or legs, and breathing was becoming very difficult. His mother told me he knew that was for him. (shrink)

Fascinating and compelling in equal measure this volume presents a critical examination of the multilayered relationships between engineering and business. In so doing the study also stimulates ethical reflection on how these relationships either enhance or inhibit strategies to address vital issues of our time. In the context of geopolitical, economic, and environmental tendencies the authors explore the world that we should want to create and the role of the engineer and the business manager in this endeavor. Throughout this volume (...) the authors identify periods of alignment and periods of tension between engineering and business. They look at focal points of the engineering-business nexus related to the development of capitalism. The book explores past and present movements to reshape, reform, or reject this nexus. The volume is informed by questions of importance for industry as well as for higher education. These are: What kinds of conflict arise for engineers in their attempts to straddle both professional and organizational commitments? How should professionals be managed to avoid a clash of managerial and professional cultures? How do engineers create value in firms and corporations? What kinds of tension exist between higher education and industry? What challenges does the neoliberal entrepreneurial university pose for management, faculty, students, society, and industry? Should engineering graduates be ready for work, and can they possibly be? What kinds of business issues are reflected in engineering education curricula, and for what purpose? Is there a limit to the degree of business hybridization in engineering degree programs, and if so, what would be the criterion for its definition? Is there a place in engineering education curricula for reflective critique of assumptions related to business and economic thinking? One ideal of management and control comes to the fore as the Anthropocene - the world transformed into an engineered artefact which includes human existence. The volume raises the question as to how engineering and business together should be considered, given the fact that the current engineering-business nexus remains embedded within an economic model of continual growth. By addressing macro-level issues such as energy policy, sustainable development, globalization, and social justice this study will both help create awareness and stimulate development of self-knowledge among practitioners, educators, and students thereby ultimately addressing the need for better informed citizens to safeguard planet Earth as a human life supporting system. (shrink)

This paper focuses on Confucian formulations of personhood and the implications they may have for bioethics and medical practice. We discuss how an appreciation of the Confucian concept of personhood can provide insights into the practice of informed consent and, in particular, the role of family members and physicians in medical decision-making in societies influenced by Confucian culture. We suggest that Western notions of informed consent appear ethically misguided when viewed from a Confucian perspective.

Sex and sensibility: The role of social selection Content Type Journal Article DOI 10.1007/s11016-010-9464-6 Authors Erika L. Milam, Department of History, University of Maryland, 2115 Francis Scott Key Hall, College Park, MD 20742, USA Roberta L. Millstein, Department of Philosophy, University of California, Davis, One Shields Avenue, Davis, CA 95616, USA Angela Potochnik, Department of Philosophy, University of Cincinnati, P.O. Box 210374, Cincinnati, OH 45221, USA Joan E. Roughgarden, Department of Biology, Stanford University, Stanford, CA 94305-5020, USA Journal Metascience (...) Online ISSN 1467-9981 Print ISSN 0815-0796. (shrink)

Previous research has established that the success of strikes, and social movements more broadly, depends on their ability to garner support from the public. However, there is scant published research investigating the response of the public to strike action by healthcare workers. In this study, we address this gap through a study of public responses to UK nursing strikes in 2022–2023, using a data set drawn from Twitter of more than 2300 publicly available tweets. We focus on negative tweets, investigating (...) which societal discourses social media users draw on to oppose strike action by nurses. Using a combination of corpus‐based approaches and discourse analysis, we identified five categories of opposition: (i) discourse discrediting nurses; (ii) discourse discrediting strikes by nurses; (iii) discourse on the National Health System; (iv) discourse about the fairness of strikers' demands and (v) discourse about potential harmful impact. Our findings show how social media users operationalise wider societal discourses about the nursing profession (e.g., associations with care, gender, vocation and sacrifice) as well as recent crises such as the Covid‐19 pandemic to justify their opposition. The results also provide valuable insights into misconceptions about nursing, strike action and patient harm, which can inform strategies for public communication. (shrink)

Berichte zur Wissenschaftsgeschichte, Volume 45, Issue 1-2, Page 164-188, June 2022.

Women and men are biologically and reproductively dissimilar. This sexual distinctiveness gives rise to a “sexual asymmetry”—the fundamental reality that the potential consequences of sexual intercourse are far more immediate and serious for women than for men. Advocates of contraception and abortion sought to cure sexual asymmetry by decoupling sex from procreation, relieving women from the consequences of sex, and thus equalizing the sexual experiences of men and women. But efforts to suppress or reject biological difference have not relieved women (...) of the consequences of sex and the vulnerabilities of pregnancy, even as they have further relieved men. Although secular feminist responses to biological difference have served to exacerbate sexual asymmetry, Catholic teaching on abortion, sex, and marriage—even contraception—provides an authentically pro-woman cultural response. (shrink)

: The main contribution of this paper to current philosophical and sociological studies on modeling is to analyze modeling as an object-oriented interdisciplinary activity and thus to bring new insights into the wide, heterogeneous discourse on tools, forms and organization of interdisciplinary research. A detailed analysis of interdisciplinarity in the making of models is presented, focusing on long-standing interdisciplinary collaboration between specialists in infectious diseases, mathematicians and computer scientists. The analysis introduces a novel way of studying the elements of the (...) models as carriers of interdisciplinarity. These elements, being functionally interdependent building blocks, evolve during the modeling work and carry the disciplinary tensions in the process. This shows how the long and challenging process of defining and reformulating the object of research is crucial for understanding the dynamics of interdisciplinarity in the making. (shrink)

Current advances in assisted reproductive technologies aim to promote the health and well-being of future children. They offer the possibility to select embryos with the greatest potential of being born healthy (eg, preimplantation genetic testing) and may someday correct faulty genes responsible for heritable diseases in the embryo (eg, human germline genome modification (HGGM)). Most laws and policy statements surrounding HGGM refer to the notion of ‘serious’ as a core criterion in determining what genetic diseases should be targeted by these (...) technologies. Yet, this notion remains vague and poorly defined, rendering its application challenging and decision making subjective and arbitrary. By way of background, we begin by briefly presenting two conceptual approaches to ‘health’ and ‘disease’: objectivism (ie, based on biological facts) and constructivism (ie, based on human values). The basic challenge under both is sorting out whether and to what extent social and environmental factors have a role in helping to define what qualifies as a ‘serious’ disease beyond the medical criteria. We then focus on how a human rights framework (eg, right to science and right to the highest attainable health) could integrate the concepts of objectivism and constructivism so as to provide guidance for a more actionable consideration of ‘serious’. Ultimately, it could be argued that a human rights framework, by way of its legally binding nature and its globally accepted norms and values, provides a more universal foundation for discussions of the ethical, legal and social implications of emerging or disruptive technologies. (shrink)

In the following study we shall investigate the ancient Greek ‘(all-)day runners’ (ήμεροδρόμοι) 2 from a historical as well as from a modern physiological perspective. Hemerodromoi were of some importance in Greek interstate communication, in particular in military long-distance communication, and are, accordingly, a subject of some interest for the study of interaction in the ancient Greek city-state culture. The investigation begins by considering the ancient evidence on these ‘(all-)day runners’ and moves on to a physiological consideration of this evidence, (...) with particular reference to the feat of the Athenian hemerodromos Pheidippides 3 who ran from Athens to Sparta in 490 BC, shortly before the famous battle of Marathon. (shrink)

Existing whistle-blowing models rely on “cold” economic calculations and cost-benefit analyses to explain the judgments and actions of potential whistle-blowers. I argue that “hot” cognitions – value conflict and emotions – should be added to these models. I propose a model of the whistle-blowing decision process that highlights the reciprocal influence of “hot” and “cold” cognitions and advocate research that explores how value conflict and emotions inform reporting decisions. I draw on the cognitive appraisal approach to emotions and on the (...) social-functional value pluralism model to generate propositions. (shrink)

An absolute decline in US life expectancy in low education whites has alarmed policy makers and attracted media attention. Depending on which studies are correct, low education white women have lost between 3 and 5 years of lifespan; men, between 6 months and 3 years. Although absolute declines in life expectancy are relatively rare, some commentators see the public alarm as reflecting a racist concern for white lives over black ones. How ought we ethically to evaluate this lifespan contraction in (...) low education whites? Should we care, or is it racist to care? Does it constitute an injustice or reflect justice being done? I argue that the lifespan contraction in low education whites violates key normative criteria used to make determinations of health justice, and that these judgments do not vitiate concerns about racism. I conclude with reflections on US population health policy and building an inclusive health equity movement. (shrink)

The COVID-19 pandemic’s disproportionate harm to racialized communities and increased public attention to the deaths of Black people at the hands of police (Elijah McClain, Breonna Taylor, George F...

This article uses music and the discourse about music to understand the practice of tolerance in Prague during the period immediately preceding the outbreak of the Thirty Years’ War. Drawing on Las ensaladas, a collection of vernacular polyphony compiled by the Spanish composer Mateo Flecha the Younger, and Harmoniae morales, comprising musical settings of Latin texts by the Slovenian composer Jacobus Handl, the article argues that such music offered Prague's diverse citizens a medium for reflecting on how to live morally (...) and peaceably. Ultimately, this article challenges the commonplace that musical harmony offered an effective model for social harmony, arguing that the practice of singing together exposed the limits of tolerance even as it illuminated how difference might be accommodated. (shrink)

La domanda fondamentale della ricerca si muove attorno alla relazione tra arte, verità e essere, segnalando la natura metafisica del discorso. Questo fatto è sottolineato in quanto l’arte, in ambito filosofico, è di solito trattata in un contesto estetico, ma i due autori scelti vedono nell’arte un legame intrinseco al problema dell’essere, riconoscendo il suo valore anche nell’orizzonte metafisico. Heidegger e Merleau-Ponty avvertono la necessità di superare l’estetica e di svelare le possibilità ontologiche dell’arte, compiendo così una sua «riabilitazione ontologica», (...) mostrando la sua intima correlatività alla questione dell’Essere e con quella della verità. Il vero senso dell’arte non nasce al di fuori di questo contesto ontologico, ed è proprio questo il motivo per cui la riabilitazione ontologica è diventata necessaria: al punto che si potrebbe affermare che l’estetica conduce l’arte fuori della sua vera essenza. L’arte è, di natura sua, ontologica. Si tratta quindi di un tema assai speciale, che già a prima vista dà luogo a diverse domande. Accettando la sfida della crisi della metafisica nell’età contemporanea, è possibile salvaguardare la questione dell’Essere a partire dall’ambito non-filosofico dell’arte? Cosa offre l’arte alla filosofia a proposito della questione dell’Essere? Quale verità si esprime in essa? Cosa giustifica il mettere insieme i tre concetti fondamentali della dissertazione e due autori così diversi, anche se di eredità fenomenologica comune? L’obiettivo della ricerca è di vedere se la riabilitazione ontologica dell’arte potesse in qualche modo salvaguardare la metafisica dell’Essere; e se a partire da ciò che la filosofia può imparare dall’arte, sia possibile arrivare ad una formulazione filosofica della verità vivente, in dialogo con la concezione dei due autori scelti. (shrink)

In the field of teaching English to speakers of other languages (TESOL), much empirical research has investigated learner and teacher autonomy, agency, and identity. Yet, little prior research has...

Due to the ongoing advancements in technology, socio-technical collaboration has become increasingly prevalent. This poses challenges in terms of governance and accountability, as well as issues in various other fields. Therefore, it is crucial to familiarize decision-makers and researchers with the core of human–machine collaboration. This study introduces a taxonomy that enables identification of the very nature of human–machine interaction. A literature review has revealed that automation and technical autonomy are main parameters for describing and understanding such interaction. Both aspects (...) must be carefully evaluated, as their increase has potentially far-reaching consequences. Hence, these two concepts comprise the taxonomy’s axes. Five levels of automation and five levels of technical autonomy are introduced below, based on the assumption that both automation and autonomy are gradual. The levels of automation were developed from existing approaches; those of autonomy were carefully derived from a review of the literature. The taxonomy’s use is also explained, as are its limitations and avenues for further research. (shrink)

Separation-based accounts of privacy define privacy as being left alone and unaccessed. Pyrrho et al. propose a more control-based account where privacy is about having the age...

Childhood obesity may have severe long-term consequences for health—indeed, for the overall course of a person's life. Do these harms amount to a problem of social justice? And if so, what should be done about it? Parents are usually granted considerable leeway to make decisions that affect their children's health. Social and moral theory has often overlooked the family, however, leaving us with an inadequate understanding of parental autonomy and of how social policy may influence it.

Background This paper describes the design, implementation, and process outcomes from three public deliberations held in three tribal communities. Although increasingly used around the globe to address collective challenges, our study is among the first to adapt public deliberation for use with exclusively Indigenous populations. In question was how to design deliberations for tribal communities and whether this adapted model would achieve key deliberative goals and be well received.Methods We adapted democratic deliberation, an approach to stakeholder engagement, for use with (...) three tribal communities to respect tribal values and customs. Public deliberation convenes people from diverse backgrounds in reasoned reflection and dialogue in search of collective solutions. The deliberation planning process and design were informed by frameworks of enclave deliberation and community-based participatory research, which share key egalitarian values. The deliberations were collaboratively designed with tribal leadership and extensive partner input and involvement in the deliberations. Each deliberation posed different, locally relevant questions about genomic research, but used the same deliberation structure and measures to gauge the quality and experience of deliberation.Results A total of 52 individuals participated in the deliberations across all three sites. Deliberants were balanced in gender, spanned decades in age, and were diverse in educational attainment and exposure to health research. Overall, the deliberations were positively evaluated. Participant perceptions and external observer datasets depict three deliberations that offered intensive conversation experiences in which participants learned from one another, reported feeling respected and connected to one another, and endorsed this intensive form of engagement.Conclusion The adapted deliberations achieved key deliberative goals and were generally well received. Limitations of the study are described. (shrink)

The study focused on university students' understanding and conceptions of ethical issues in research. Domain-specific and domain-transcending measures were developed to gauge the students' awareness of ethical issues. Responses were obtained from 269 undergraduate and graduate students at a U.S. regional university. Participant withdrawal, the debriefing of research participants, the dissemination of findings, and giving credit to co-contributors were the most challenging ethical issues for the students. Ethical awareness was predicted by professional and organizational socialization, and perspective taking. Contextualization greatly (...) improved the students' ability to recognize ethical issues. Simulations and role-taking are suggested as the means with which to teach students about the ethical issues perceived as challenging. (shrink)

Darrel E. Christensen presented the following paper to the Charles Sanders Peirce Society meeting held on October 5–7, 1978, at Bloomington, Indiana.