A collection of personal narratives and essays, Living Professionalism is designed to help medical students and residents understand and internalize various aspects of professionalism. These essays are meant for personal reflection and above all, for thoughtful discussion with mentors, with peers, with others throughout the health care provider community who care about acting professionally.

Much has been made of the importance of training ethical, socially conscious engineers, but does US engineering education actually encourage neophytes to take seriously their professional responsibility to public welfare? Counter to such ideals of engagement, I argue that students’ interest in public welfare concerns may actually decline over the course of their engineering education. Using unique longitudinal survey data of students at four colleges, this article examines (a) how students’ public welfare beliefs change during their engineering education, (b) whether (...) engineering programs emphasize engagement, and (c) whether these program emphases are related to students’ public welfare beliefs. I track four specific public welfare considerations: the importance to students of professional/ethical responsibilities, understanding the consequences of technology, understanding how people use machines, and social consciousness. Suggesting a culture of disengagement, I find that the cultural emphases of students’ engineering programs are directly related to their public welfare commitments and students’ public welfare concerns decline significantly over the course of their engineering education. However, these findings also suggest that if engineering programs can dismantle the ideological pillars of disengagement in their local climates, they may foster more engaged engineers. (shrink)

Occupational gender segregation is an obdurate feature of gender inequality in the United States The “family plans thesis”—the belief that women and men deliberately adjust their early career decisions to accommodate their anticipated family roles—is a common theoretical explanation of this segregation in the social sciences and in popular discourse. But do young men and women actually account for their family plans when making occupational choices? This article investigates the validity of this central mechanism of the family plans thesis. Drawing (...) on in-depth interviews with 100 college students at three universities, I find that most women and men report no deliberate consideration of their family plans in their college major or post-graduation career choices. Only a quarter of men accommodate provider role plans in their choice of occupations, and only 7 of 56 women accommodate caregiving plans. Further, men who anticipate a provider role are not typically enrolled in more men-dominated fields, and women who seek caregiver-friendly occupations are not typically enrolled in more women-dominated fields. These findings question the validity of the family plans thesis and suggest instead that the thesis itself may reproduce segregation as a cultural schema that buttresses essentialist stereotypes about appropriate fields for men and women. (shrink)

It is inevitable that physicians in training will be exposed to behavior by supervising physicians that the trainees find unethical. By nature these events are rare. It is imperative within any residency training program that resident physicians have immediate access to a meaningful review process in cases of moral conflict with supervising physicians. Here, I discuss the reasons why this issue must be recognized and what it entails. Most important, I discuss the procedural steps that are essential for the training (...) program to make this a meaningful safety mechanism in residency training. This issue is central to promoting conscious development of professionalism in clinical training. Physicians in training, especially resident physicians, need to be taught to value and protect their own professional integrity. The responsibility for fulfilling this ethical duty falls on the individual residency programs as well as the administrative organizations that regulate residency training. Thus, ensuring this process of review is an organizational ethical imperative. Availability of this process is fundamental to promoting and ensuring ethical behavior by all participants in residency training. (shrink)

Can epistemologies anchor processes of social inequality? In this paper, we consider how epistemological dominance in science, engineering, and health fields perpetuates disadvantages for students who enter higher education with alternative epistemologies. Drawing on in-depth interviews with Native American students enrolled at two US research universities who adhere to or revere indigenous epistemologies, we find that epistemological dominance in SE&H degree programs disadvantages students through three processes. First, it delegitimizes Native epistemologies and marginalizes and silences students who value them. Second, (...) in the process of imparting these dominant scientific epistemologies, SE&H courses sometimes require students to participate in pedagogical practices that challenge indigenous ways of knowing. Third, students encounter epistemological imperialism: most students in the sample are working to earn SE&H degrees in order to return to tribal communities to “give back,” yet, because the US laws regulating the practice of SE&H extend onto tribal lands, students must earn credentials in epistemologies that devalue, delegitimate, and threaten indigenous knowledge ways to practice on tribal lands. We examine how students navigate these experiences, discuss the implications of these findings for SE&H education, and describe how epistemological dominance may serve as a mechanism of inequality reproduction more broadly. (shrink)

ABSTRACTPeople often use metaphors to discuss their financial prospects – for example, finding a fortune or searching for wealth. The purpose of the present research was to utilize conceptual metap...

This collection examines questions of medical accountability and ethics. It analyses how the criminal justice system regulates health care practice, and to what extent it is appropriate to use it as a tool to resolve ethical conflict in health care.

While people’s lives continue to be put at risk by the dearth of organs available for transplantation, we must give urgent consideration to any option that may make up the shortfall. A market in organs from living donors is one such option. The market should be ethically supportable, and have built into it, for example, safeguards against wrongful exploitation. This can be accomplished by establishing a single purchaser system within a confined marketplace.Statistics can be dehumanising. The following numbers, however, have (...) more impact than most: as of 24th November, during 2002 in the United Kingdom, 667 people have donated organs, 2055 people have received transplants, and 5615 people are still awaiting transplants.1 It is difficult to estimate how many people die prematurely for want of donor organs. “In the world as a whole there are an estimated 700 000 patients on dialysis . . . . In India alone 100 000 new patients present with kidney failure each year”2 . Almost “three million Americans suffer from congestive heart failure . . . deaths related to this condition are estimated at 250 000 each year . . . …. (shrink)

We agree with Alfandre and colleagues that ethics guidance for contingency conditions in public health emergencies is urgently needed. The Minnesota COVID Ethics Collabora...

It is well-documented that mathematics achievement is an important predictor of many positive life outcomes like college graduation, career opportunities, salary, and even citizenship. As such, it is important for researchers and educators to help students succeed in mathematics. Although there are undoubtedly many factors that contribute to students' success in mathematics, much of the research and intervention development has focused on variations in instructional techniques. Indeed, even a cursory glance at many educational journals and granting agencies reveals that there (...) is a large amount of time, energy, and resources being spent on determining the best way to convey information through direct, declarative instruction. The proposed project is motivated by recent calls to expand the focus of research in mathematics education beyond direct, declarative instruction. The overarching goal of the presented experiment is to evaluate the efficacy of a novel mathematics intervention designed using principles taken from the literature on non-declarative learning. The intervention combines errorless learning and structured cue fading to help second grade students improve their understanding of symbolic magnitude. Results indicate that students who learned about symbolic magnitude using the novel intervention did better than students who were provided with extensive declarative support. These findings offer preliminary evidence in favor of using learning combination of errorless learning and cue fading techniques in the mathematics classroom. (shrink)

The widespread use of stimulants among healthy individuals to improve cognition has received growing attention; however, public attitudes toward this practice are not well understood. We determined the effect of framing metaphors and context of use on public opinion toward cognitive enhancement. We recruited 3,727 participants from the United States to complete three surveys using Amazon’s Mechanical Turk between April and July 2017. Participants read vignettes describing an individual using cognitive enhancement, varying framing metaphors (fuel versus steroid), and context of (...) use (athletes versus students versus employees). The main outcome measure was the difference in respondent-assigned level of acceptability of the use of cognitive enhancement by others and by themselves between the contrasting vignettes. Participants were more likely to support the use of cognitive enhancement by others than by themselves and more when the use of enhancement by others was framed with a fuel metaphor than with a steroid metaphor. Metaphoric framing did not affect participants’ attitudes toward their own use. Participants supported the use of enhancement by employees more than by students or athletes. These results are discussed in relation to existing ethical and policy literature. (shrink)

This paper presents the results of a national study of the beliefs and perceptions of small business professionals concerning ethics within their company and business in general. The study examined their views on the relationship between success and ethical conduct as well as the extent and nature of ethical conflicts experienced by the respondents. Some comparisons are made with similar studies that have been conducted in the past. Respondents have the most ethical conflicts with customers and employees, and with regard (...) to honesty in contracts/agreements. Most also believe that ethical standards are lower than they were 10 and 20 years ago, primarily because society's moral standards are lower. Additionally, they believe that the behavior of top management has the most influence on decisions in ethical situations. Finally, consistent with prior studies, they believe that they have the most responsibility to customers, ahead of employees and stockholders. (shrink)

Introduction This article is a response to Zagouras, Ellick, and Aulisio who presented a case study justifying the questioning of the capacity and autonomy of a young woman with a physical disability who was pregnant and facing coercive pressure to terminate. Case description Julia is described as a 26-year-old woman with a neurological disability that requires her to receive assistance with activities of daily living. She was described as living with her parents who provided her with personal care assistance. Julia (...) became pregnant and her parents wished her to terminate because they did not want to care for her child in addition to her. In fact, Julia's parents threatened her with institutionalization if she did not elect to terminate the pregnancy. Her health care team questioned her decision-making capacity based on her alleged “mental age” and experiences of being sheltered and excluded. The health care team used directive tactics to convince Julia to terminate the pregnancy, which describe as both an ethical and feminist intervention. Discussion The current authors take issue with the case analysis provided by and argue that they neglected to account for numerous instances of systemic ableism that adversely affected Julia, demonstrated prejudicial and judgmental attitudes toward pregnancy and disability, inappropriately questioned her decision-making capacity by infantilizing her, misconstrued the feminist concept of relational autonomy, and colluded with coercive interference from family members. This is a classic example of discriminatory and culturally incompetent reproductive health care for a disabled woman. (shrink)

If you care about securing knowledge, what is wrong with being biased? Often it is said that we are less accurate and reliable knowers due to implicit biases. Likewise, many people think that biases reflect inaccurate claims about groups, are based on limited experience, and are insensitive to evidence. Chapter 3 investigates objections such as these with the help of two popular metaphors: bias as fog and bias as shortcut. Guiding readers through these metaphors, I argue that they clarify the (...) range of knowledge-related objections to implicit bias. They also suggest that there will be no unifying problem with bias from the perspective of knowledge. That is, they tell us that implicit biases can be wrong in different ways for different reasons. Finally, and perhaps most importantly, the metaphors reveal a deep—though perhaps not intractable—disagreement among theorists about whether implicit biases can be good in some cases when it comes to knowledge. (shrink)

The ethical principle of ‘respect for persons’ in clinical research has traditionally focused on protecting individuals’ autonomy rights, but respect for participants also includes broader, although less well understood, ethical obligations to regard individuals’ rights, needs, interests and feelings. However, there is little empirical evidence about how to effectively convey respect to potential and current participants. To fill this gap, we conducted exploratory, qualitative interviews with participants in a clinical genomics implementation study. We interviewed 40 participants in English or Spanish (...) about their experiences with respect in the study and perceptions of how researchers in a hypothetical observational study could convey respect or a lack thereof. Most interviewees were female, identified as Hispanic/Latino or non-Hispanic white, reported annual household income under US$60 000 and did not have a Bachelor’s degree ; 30% had limited health literacy. We identified four key domains for demonstrating respect: personal study team interactions, with an emphasis on empathy, appreciation and non-judgment; study communication processes, including following up and sharing results with participants; inclusion, particularly ensuring materials are understandable and procedures are accessible; and consent and authorisation, including providing a neutral informed consent and keeping promises regarding privacy protections. While the experience of respect is inherently subjective, these findings highlight four key domains that may meaningfully demonstrate respect to potential and current research participants. Further empirical and normative work is needed to substantiate these domains and evaluate how best to incorporate them into the practice of research. (shrink)

The ability to consider and analyze different stakeholder interests is a skill required of today’s business students. This paper describes a 35-minute experiential exercise using Tinkertoys® or Legos® to demonstrate and reinforce the concept of stakeholder management. The exercise, the Tower Building Challenge (TBC), is targeted toward classes in business ethics, strategy, or decision-making and requires students to work in groups to build a tower with the underpinning challenge that each group member has a different interest in how the tower (...) should be built. Student feedback reflects on the difficulty of satisfying all stakeholders when making business decisions, the importance of making the interests of stakeholders transparent to enhance cooperation and the effectiveness of the decision-making process, and the need for stakeholder management when considering business decisions that impact stakeholders. Following this experiential exercise, students’ preliminary understanding presents an opportunity for a deeper discussion of stakeholder management. Specifically, students are prompted to consider stakeholder interests as joint, rather than opposed, when engaged in stakeholder management. (shrink)

Morality can help guide behavior and facilitate relationships. Although moral judgments by autistic people are similar to neurotypical individuals, many researchers argue that subtle differences signify deficits in autistic individuals. Moral foundation theory describes moral judgments in terms of differences rather than deficits. The current research, aimed at assessing autistic individuals’ moral inclinations using Haidt’s framework, was co-designed with autistic community members. Our aim was to describe autistic moral thinking from a strengths-based perspective while acknowledging differences that may pose interpersonal (...) challenges among autistic youth. We assessed 25 autistic and 23 neurotypical children’s moral judgments using the Moral Foundations Questionnaire for Kids. We used semi-structured interviews and qualitative analysis with a subset of participants to describe children’s moral reasoning. Analyses suggested that autistic and neurotypical children make similar judgments about moral transgressions across all five moral foundations. General linear mixed modeling showed that the greatest predictor of recommending punishment was how bad children deemed moral transgressions to be. We also found a trend that autistic children were more likely to recommend punishment for harmless norms violations than were neurotypical children. Future research could use longitudinal methods to understand the development of moral judgments among autistic and neurotypical children. (shrink)

This study examines whether microfinance institutions (MFIs) that serve women borrowers at the base of the economic pyramid are likely to adopt a written code of positive organizational ethics (POE). Using econometric analysis of operational and economic data of a sample of MFIs from across the world, we find that two contextual factors—poverty level and lack of women’s empowerment—moderate the influence of an MFI’s percentage of women borrowers on the probability of the MFI having a POE code. MFIs that serve (...) more women borrowers are more likely to adopt a POE code, especially in negative contexts (where women borrowers face poverty and disempowerment and are therefore susceptible to abuse). This study provides evidence that MFIs can build positive ethical strength in negative contexts. (shrink)

Public opinion can affect the adoption of genome editing technologies. In food production, genome editing can be applied to a wide range of applications, in different species and with different purposes. This study analyzed how the public responds to five different applications of genome editing, varying the species involved and the proposed purpose of the modification. Three of the applications described the introduction of disease resistance within different species, and two targeted product quality and quantity in cattle. Online surveys in (...) Canada, the US, Austria, Germany and Italy were carried out with a total sample size of 3698 participants. Using a between-subject design, participants were confronted with one of the five applications and asked to decide whether they considered it right or wrong. Perceived risks, benefits, and the perception of the technology as tampering with nature were surveyed and were complemented with socio-demographics and a measure of the participants’ moral foundations. In all countries, participants evaluated the application of disease resistance in humans as most right to do, followed by disease resistance in plants, and then in animals, and considered changes in product quality and quantity in cattle as least right to do. However, US and Italian participants were generally more positive toward all scenarios, and German and Austrian participants more negative. Cluster analyses identified four groups of participants: ‘strong supporters’ who saw only benefits and little risks, ‘slight supporters’ who perceived risks and valued benefits, ‘neutrals’ who showed no pronounced opinion, and ‘opponents’ who perceived higher risks and lower benefits. This research contributes to understanding public response to applications of genome editing, revealing differences that can help guide decisions related to adoption of these technologies. (shrink)

Janet Radcliffe Richards is as always to the point and radical. We agree with her that “if it is presumptively bad to prevent sales altogether because lives will be lost . . . it is for the same reason presumptively bad to restrict the selling of organs”. Her complaint against our paper is that we are unnecessarily restrictive. John Harris indeed has argued that there are no sound ethical or philosophical reasons for objecting on principle to the sale of live (...) tissue and organs.1 If a scheme can be devised …. (shrink)

ABSTRACT Principles of justice and equality demand that HIV seropositive individuals and those with AIDS should not be discriminated against in any area of social provision. If social policy on AIDS is constructed in terms of reciprocal obligations, that is if obligations to the HIV seropositive individual and obligations of the HIV seropositive individual are given equal weight, the civil rights of HIV seropositive individuals may be secured and this may create a climate in which HIV seropositive individuals will more (...) readily notify partners, and others at risk of infection, of their HIV status. It is conceivable that such a climate could facilitate greater control of the spread of HIV/aids. (shrink)

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as (...) they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning. (shrink)

From co-authored publications to sponsored projects involving multiple partner institutions, collaborative practice is an expected part of work in the academy. As evaluators of a National Science Foundation Alliances for Graduate Education and the Professoriate grant awarded to four university partners in a large southern state, the authors recognized the increasing value of collaborative practice in the design, implementation, evaluation, and dissemination of findings in the partnership over time. When planning a program among partnering institutions, stakeholders may underestimate the need (...) for, and value of, collaborative practice in facilitating partnership functioning. This method paper outlines an evaluative model to increase the use of collaborative practice in funded academic partnership programs. The model highlights collaborative practice across multiple stakeholder groups in the academic ecology: Sponsors of funded programs, Program partners and participants, Assessment and evaluation professionals, academic researchers, and the national and global Community. The SPARC model emphasizes evidence-based benefits of collaborative practice across multiple outcome domains. Tools and frameworks for evaluating collaborative practice take a view of optimizing partnership operational performance in achieving stated goals. Collaborative practice can also be an integral element of program activities that support the academic success and scholarly productivity, psychosocial adjustment, and physical and psychological well-being of stakeholders participating in the program. Given the goal of our alliance to promote diversification of the professoriate, the model highlights the use of collaborative practice in supporting stakeholders from groups historically underrepresented in STEM fields across these outcome domains. Using data from a mixed-methods program evaluation of our AGEP alliance over 4 years, the authors provide concrete examples of collaborative practice and their measurement. Results discuss important themes regarding collaborative practice that emerged in each stakeholder group. Authors operationalize the SPARC model with a checklist to assist program stakeholders in designing for and assessing collaborative practice in support of project goals in funded academic partnership projects, emphasizing the contributions of collaborative practice in promoting diversification of the professoriate. (shrink)

In this essay, I explore the view that wrongful discrimination is disrespectful. In section 1, I articulate three conceptions of disrespect, each of which provides a special way to understand the way in which wrongful discrimination is disrespectful. In section 2, I ask what it would take for any of these conceptions to serve as the basis for a plausible theory of wrongful discrimination. I argue that any adequate theory of wrongful discrimination must be able to do two things well: (...) reliably identify cases of wrongful discrimination and, also, explain why they are wrong. In section 3, I examine the objection that all respect-focused theories violate the first desideratum. In section 4, I contend that the objection does not apply to all respect-based theories; in particular, it does not apply to a respect-focused deliberative theory of wrongful discrimination. Though such a theory is much more powerful than its competitors, I argue that it fails to offer a satisfying explanation of why discrimination is wrong due to the fact that it locates the wrong of discrimination within deliberative processes, rather than looking to the harmful-impacts of discrimination on people affected by it. (shrink)

With _Relationscapes_, Erin Manning offers a new philosophy of movement challenging the idea that movement is simple displacement in space, knowable only in terms of the actual. Exploring the relation between sensation and thought through the prisms of dance, cinema, art, and new media, Manning argues for the intensity of movement. From this idea of intensity--the incipiency at the heart of movement--Manning develops the concept of preacceleration, which makes palpable how movement creates relational intervals out of which displacements take (...) form. Discussing her theory of incipient movement in terms of dance and relational movement, Manning describes choreographic practices that work to develop with a body in movement rather than simply stabilizing that body into patterns of displacement. She examines the movement-images of Leni Riefenstahl, Étienne-Jules Marey, and Norman McLaren, and explores the dot-paintings of contemporary Australian Aboriginal artists. Turning to language, Manning proposes a theory of prearticulation claiming that language's affective force depends on a concept of thought in motion. _Relationscapes_ takes a "Whiteheadian perspective," recognizing Whitehead's importance and his influence on process philosophers of the late twentieth century--Deleuze and Guattari in particular. It will be of special interest to scholars in new media, philosophy, dance studies, film theory, and art history. (shrink)