When a group does harm, sometimes there’s no obvious individual who bears moral responsibility, and yet we still intuit that someone is to blame. This apparent ‘deficit’ of moral responsibility has led some scholars to posit that groups themselves can be responsible, and that this responsibility is distributed in some uniform fashion among group members. This solution to the deficit, however, risks providing a scapegoat for individuals who have acted wrongly and shifting blame onto those who have not. Instead, this (...) article argues that, in most deficit cases, moral responsibility is borne not by the group but by specific individual members. When an individual acts within a group, she gains an increased potential for doing harm – and, accordingly, heightened duties of care toward others. These duties can, depending on the individual’s position, require amending the group’s rules, procedures, and norms. In most deficit cases, it is individuals who have failed to fulfill these duties who are responsible. (shrink)

Although medical providers rely on similar tools to “treat” intersex and trans individuals, their enactment of medicalization practices varies. To deconstruct these complexities, we employ a comparative analysis of providers who specialize in intersex and trans medicine. While both sets of providers tend to hold essentialist ideologies about sex, gender, and sexuality, we argue they medicalize intersex and trans embodiments in different ways. Providers for intersex people are inclined to approach intersex as an emergency that necessitates medical attention, whereas providers (...) for trans people attempt to slow down their patients’ urgent requests for transitioning services. Building on conceptualizations of “giving gender,” we contend both sets of providers “give gender” by “giving sex.” In both cases too, providers shift their own responsibility for their medicalization practices onto others: parents in the case of intersex, or adult recipients of care in the case of trans. According to the accounts of most providers, successful medical interventions are achieved when a person adheres to heteronormative gender practices. (shrink)

During the Philippine-American War, the Anti-Imperialist League was the organizational vanguard of an anti-imperialist movement. Research on this period of U.S. imperialism has focused on empire building, ignoring the gendered activity of anti-imperialists in the metropole. The author outlines the constitutive relationship between gendered structures and experience that informed anti-imperialists' “contentious politics,” using archival sources of the Anti-Imperialist League and anti-imperialist debates in newspapers. The author shows how anti-imperialist leaders informally included women's monetary donations, labor, networks, and reputations while formally (...) excluding their full membership. Finally, the author shows how masculinist ambivalence, or the pattern of the gendered inclusions/exclusions of anti-imperialists, explains the incremental transformations and reproductions of gendered structures in anti-imperialists' contentious politics. The author suggests masculinist ambivalence has theoretical utility for explaining gendered inclusions and exclusions in movements that are not explicitly about gender conflict or change. (shrink)

The Cistercian order, which had its origins in the late eleventh century, transformed the spiritual landscape of western Europe. The order's insistence on a return to the austerity and simplicity that had originally informed Benedictine life reenergized monasticism, spawning hundreds of new abbeys within decades. By the beginning of the thirteenth century, the Cistercians dominated monastic life, surpassing their black-robed predecessors in terms of popularity and replacing them among patrons as favored recipients of donations. Yet, while a sizable body of (...) historiography exists concerning the ability of men's houses to translate this appeal into spiritual and material success, questions remain regarding the order's female members. In particular, some scholars have constructed a narrative of financial difficulties and eventual decline for Cistercian nunneries, one that began in the thirteenth century and accelerated throughout the late Middle Ages. According to this narrative, such difficulties, by-products of the secondary status of religious women, manifested themselves in small monastic complexes and limited patrimonies. In her work on English Cistercians, Sally Thompson argues that religious women were dependent upon men because of their inferior position in medieval society and generally lacked a true religious vocation, characteristics that led to smaller, impoverished houses. Cistercian nunneries are portrayed in monastic histories as constantly struggling and are often “lumped together as being poor, scandalous, passive institutions which were eschewed by medieval patrons.” The majority of their houses are characterized by modern historians as enjoying a perilous existence at best, permanently poised on the brink of extinction and beset by a host of financial and spiritual difficulties. (shrink)

University human research ethics application procedures can be complicated and daunting, especially for international students unfamiliar with the process and the language. We conducted focus groups and interviews with four research higher degree and 21 Master’s coursework international students at an Australian university to gain their views on the human ethics application process. We found the most important influences on their experience were: the time it took to do an application; support from supervisors, peers and others; their own language skills; (...) and their lack of familiarity with research ethics procedures. To improve the experience of international students undertaking research involving human research ethics applications, we recommend universities provide guidance on institutional ethics review processes, concepts and terminology, with translations in a range of languages, together with guidance on how to conduct research ethically within and outside the students’ own countries. We also recommend curricula be developed to further students’ understanding of the importance of ethical research practice, and that these curricula be embedded in undergraduate and postgraduate degree programs and reflected in course learning outcomes. (shrink)

Local food systems can have economic and social benefits by providing income for producers and improving community connections. Ongoing global climate change and the acute COVID-19 pandemic crisis have shown the importance of building equity and resilience in local food systems. We interviewed ten stakeholders from organizations and institutions in a U.S. midwestern city exploring views on past, current, and future conditions to address the following two objectives: 1) Assess how local food system equity and resilience were impacted by the (...) COVID-19 pandemic, and 2) Examine how policy and behavior changes could support greater equity and resilience within urban local food systems. We used the Community Capitals Framework to organize interviewees’ responses for qualitative analyses of equity and resilience. Four types of community capital were emphasized by stakeholders: cultural and social, natural, and political capital. Participants stated that the local food system in this city is small; more weaknesses in food access, land access, and governance were described than were strengths in both pre- and post-pandemic conditions. Stakeholder responses also reflected lack of equity and resilience in the local food system, which was most pronounced for cultural and social, natural and political capitals. However, local producers’ resilience during the pandemic, which we categorized as human capital, was a notable strength. An improved future food system could incorporate changes in infrastructure (e.g., food processing), markets (e.g., values-based markets) and cultural values (e.g., valuing local food through connections between local producers and consumers). These insights could inform policy and enhance community initiatives and behavior changes to build more equitable and resilient local food systems in urban areas throughout the U.S. Midwest. (shrink)

This mixed methods study examines how college students’ perceptions and experiences affect their understanding of academic integrity. Using qualitative and quantitative responses from the Personal and Social Responsibility Institutional Inventory, both quantitative and qualitative results demonstrate that while campuses may see a reduction in overall levels of cheating when punitive academic integrity policies are present, students may develop higher levels of personal and academic integrity through the use of more holistic and community-focused practices.

ABSTRACT:Business networks, which include joint ventures, supply chains, industry and trade associations, industrial districts, and community business associations, are considered the signature organizational form of the global economy. However, little is known about how they affect the social performance of their members. We utilize institutional theory to develop the position that business social performance has collectivist roots that deserve at least as much scholarly attention as owner/manager characteristics and business attributes. Hypotheses are tested using multilevel analysis on data gathered from (...) 898 members of twenty-nine business associations. Support is provided for institutional theory’s explanation for business social performance. Members of business associations are likely to conform to the pattern of social performance prevailing in their association, but not necessarily to the articulated values of the association. The potential of business associations to influence members’ social performance should be considered by agencies that start and support them as mechanisms for regional and local economic development. (shrink)

ABSTRACT:Business networks, which include joint ventures, supply chains, industry and trade associations, industrial districts, and community business associations, are considered the signature organizational form of the global economy. However, little is known about how they affect the social performance of their members. We utilize institutional theory to develop the position that business social performance has collectivist roots that deserve at least as much scholarly attention as owner/manager characteristics and business attributes. Hypotheses are tested using multilevel analysis on data gathered from (...) 898 members of twenty-nine business associations. Support is provided for institutional theory’s explanation for business social performance. Members of business associations are likely to conform to the pattern of social performance prevailing in their association, but not necessarily to the articulated values of the association. The potential of business associations to influence members’ social performance should be considered by agencies that start and support them as mechanisms for regional and local economic development. (shrink)

Although written consent forms are standard in clinical research, there is little regulatory or empirical guidance regarding how to most effectively review consent forms with potential participants. We developed an algorithm for embedding five questions with corrective feedback while reading consent forms with potential participants, and then applied it in the context of seven clinical research studies. A substantial proportion of participants within each protocol displayed initially inadequate responses to at least one question, but after the protocol elements were explained (...) again, most people demonstrated adequate understanding of them. These data illustrate the need for more attention not just to the content of consent forms, but also to the manner in which the forms are incorporated into the consent process. Embedding explicit inquiries about key protocol elements during consent form review and giving corrective feedback appears to be a simple yet effective way to foster better understanding of disclosed information. (shrink)

Next SectionThere has been considerable debate surrounding the ethics of sham-controlled trials of procedures and interventions. Critics argue that these trials are unethical because participants assigned to the control group have no prospect of benefit from the trial, yet they are exposed to all the risks of the sham intervention. However, the placebo effect associated with sham procedures can often be substantial and has been well documented in the scientific literature. We argue that, in light of the scientific evidence supporting (...) the benefits of sham interventions for pain and Parkinson's disease that stem from the placebo effect, these sham-controlled trials should be considered as offering potential direct benefit to participants. If scientific evidence demonstrates the positive effect of placebo from sham interventions on other conditions, sham-controlled trials of interventions for the treatment of these conditions should be considered to have prospects of benefit as well. This potential benefit should be taken into account by research ethics committees in risk-benefit analyses, and be included in informed consent documents. (shrink)

Although online education is becoming increasingly commonplace in health professional education, methods to evaluate student progress and knowledge base adequately remain uncertain. This paper describes a project that attempted to assess whether or not an online course was an effective way to teach applied ethics to students preparing for the health professions by qualitatively analyzing responses to a pre-test and post-test administered to students in the course. While previous studies have reported various findings regarding the success of online ethics courses, (...) our study failed to demonstrate that students gained a greater understanding of key concepts in ethics—respect for autonomy, decisional capacity, informed consent, and role of the provider. Our findings demonstrate the need for better subjective methods of evaluation and raise questions regarding the efficacy of current models of online ethics courses for health professional students. (shrink)

Background: This study attempts to understand if medical providers beliefs about the moral permissibility of honoring patient-directed refusals of life-sustaining treatment (LST) are tied to their beliefs about the patient’s decision-making capacity. The study aims to answer: 1) does concern about a patient’s treatment decision-making capacity relate to beliefs about whether it is morally acceptable to honor a refusal of LST, 2) are there differences between provider types in assessments of decision-making capacity and the moral permissibility to refuse LST, and (...) 3) do provider demographics impact beliefs about decision-making capacity and the moral permissibility to refuse LST. Methods: A mixed-methods survey using Likert assessment and vignette-based questions was administered to medical providers within a single health system in the upper Midwest (N = 714) to assess their perspectives on the moral acceptance and decision-making capacity in cases of withholding and withdrawing treatment and suicide. Results: Behavioral health providers report accepting of the moral permissibility of suicide (91.2%) more than either medical providers (77.2%) or surgeons (74.4%) (n = 283). Decision-making capacity was questioned more in the vignettes of the patients refusing life-saving surgery (36%) and voluntarily starvation (40.8%) than in the vignette of the patient requesting to deactivate a pacemaker (13%) (n = 283). Behavioral health providers were more concerned about the capacity to refuse life-saving surgery (55.9%) than medical providers (33.8%) or surgeons (23.1%) (n = 283). Conclusions: Respondents endorse the moral permissibility of persons to withhold or withdraw from treatment regardless of motive. Clinical concerns about a patient’s treatment decision-making capacity do not strongly correlate to views about the moral permissibility of honoring refusals of LST. Different provider types appear to have different thresholds for when to question treatment decision-making capacity. Behavioral health providers tend to question treatment decision-making capacity to refuse LST more than non-behavioral health providers. (shrink)

This article extends Lemieux’s concern for the interdisciplinary tension between philosophy and sociology to the intradisciplinary tension within psychology between approaches to the study of children focusing on universal principles and approaches adopting a contextual lens. This tension arises both in how development is defined and in the methods chosen for its study. This tension is exemplified in terms of the recent American preoccupation with the Word Gap (WG), a supposed difference of 30 million words heard by socioeconomically diverse children (...) by the age of 4 that is blamed for educational disparities throughout the school years. The article discusses the political implications of WG discourse as it gives rise to the erasure of language practices of diverse Americans and obscures the role that the educational system plays in fostering a ‘one-size-fits-all’ instructional model. The article concludes with a discussion of attempts to combat the deficit model that the WG discourse reproduces. (shrink)

_Clinical Interaction and the Analysis of Meaning_ evinces a therapeutic vitality all too rare in works of theory. Rather than fleeing from the insights of other disciplines, Dorpat and Miller discover in recent research confirmation of the possibilities of psychoanalytic treatment. In Section I, "Critique of Classical Theory," Dorpat proposes a radical revision of the notion of primary process consonant with contemporary cognitive science. Such a revised conception not only enlarges our understanding of the analytic process; it also provides (...) analysis with a conceptual language that can articulate meaningful connections with a growing body of empirical research about the development and nature of human cognition. In Section II, "Interactional Theory," Miller reverses the direction of inquiry. He begins with the literature on cognitive development and functioning, and proceeds to mine it for concepts relevant to the clinical process. He shows how a revised understanding of the operation of cognition and affect can impart new meaning to basic clinical concepts such as resistance, transference, and level of psychopathology. In Section III, "Applications and Exemplifications," Dorpat concludes this exemplary collaboration by exploring select topics from the standpoint of his and Miller's new psychoanalytic theory. At the heart of the authors' endeavor it "meaning analysis," a concept that integrates an up-to-date model of human information processing with the traditional goals of psychoanalysis. The patient approaches the clinical encounter, they argue, with cognitive-affective schemas that are the accumulatice product of his life experience to date; the manifold meanings ascribed to the clinical interaction must be understood as the product of these schemas rather than as distortions deriving from unconscious, drive-related fantasies. The therapist's goal is to make the patient's meaning-making conscious and thus available for introspection. (shrink)

Much research has examined the positive effects of legitimacy spillover. However, negative events may reduce the extent of legitimacy, which may in turn spillover to affect the legitimacy of important stakeholders including alliance partners. This study examines incidents of regulative legitimacy violation and focuses on the effect such incidents have on the alliance partners of the perpetrating organizations. We specifically examine three types of such violations—administrative law, criminal law, and civil law—to show that the loss of regulative legitimacy negatively influences (...) the stock market performance of alliance partners. More interestingly, not all corrective actions and repair efforts are equally impactful. We show that the effect of repair efforts by the perpetrating firm on the alliance partner differ depending on the nature of those violating incidents. (shrink)

This article integrates research on gendered organizations and the work-family interface to investigate an innovative workplace initiative, the Results-Only Work Environment, implemented in the corporate headquarters of Best Buy, Inc. While flexible work policies common in other organizations “accommodate” individuals, this initiative attempts a broader and deeper critique of the organizational culture. We address two research questions: How does this initiative attempt to change the masculinized ideal worker norm? And what do women’s and men’s responses reveal about the persistent ways (...) that gender structures work and family life? Data demonstrate the ideal worker norm is pervasive and powerful, even as employees begin critically examining expectations regarding work time that have historically privileged men. Employees’ responses to ROWE are also gendered. Women are more enthusiastic, while men are more cautious. Ambivalence about and resistance to change is expressed in different ways depending on gender and occupational status. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Narrative Symposium:Conflicting Interests in MedicineLaura Jean Bierut, Sal Cruz-Flores, Laura E. Hodges, Anthony A. Mikulec, Govind K. Nagaldinne, Erine L. Bakanas, John F. Peppin, Joel S. Perlmutter, William H. Seitz Jr., Edward Diao, Andre N. Sofair, and David M. Zientek• To Recruit or Not to Recruit for a Clinical Trial• An Unexpected Lesson• Am I on call for the entire Midwest?• Why is Medicare Wasting Away?• The Downside of (...) the Informed Consent Juggernaut• Expert Testimony at the Food and Drug Administration: Who Wants the Truth?• Crossroads: The Intersection of Personal, Professional Society, and Industry Relationships• A Change of Heart• The Evolution of Conflicts of Interest in a New Subspecialty: A Case Study of the Development of Interventional CardiologyCopyright © 2011 The Johns Hopkins University Press... (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)

It is estimated that 300,000 children 0–14 years of age are diagnosed with cancer worldwide each year. While the absolute risk of cancer in children is low, it is the leading cause of death due to disease in children in high‐income countries. In spite of this, the etiologies of pediatric cancer are largely unknown. Environmental exposures have long been thought to play an etiologic role. However, to date, there are few well‐established environmental risk factors for pediatric malignancies, likely due to (...) technical barriers in collecting biological samples prospectively in pediatric populations for direct measurements. In this review, we propose the use of novel or underutilized biospecimens (dried blood spots and teeth) and molecular approaches for exposure assessment (epigenetics, metabolomics, and somatic mutational profiles). Future epidemiologic studies of pediatric cancer should incorporate novel exposure assessment methodologies, data on molecular features of tumors, and a more complete assessment of gene‐environment interactions. (shrink)

Data are presented that focus on the nature and development of argumentative reasoning. In particular our study describes how support for or against an issue affects memory for critical parts of an argumentative interaction, judgments of argument goodness, and the content of the reasons given in support of one view versus another. Two other factors were examined: developmental differences in argumentation skill and the conditional nature of supporting one side of an argument across varying contexts. Our results show that even (...) seven year old children can recognize, identify, and use the basic components of an argument to provide evidence for and make judgements about their favored position. Moreover, if position support is held constant across all age groups of students, seven year old children were found to give reasons and explanations that were highly similar in content and principle to college students. The same similarities held across age with respect to biases in memory and judgements of argument goodness. The primary difference between children's and college students' argument behavior lay in the side of an argument the students chose to support. Seven year old children and some eleven yearold children supported positions that impute more value to friendship and social consequences than to the maintenance and advancement of individual rights, as specified in a contract agreement. The similarities and differences across development are discussed with respect to a theory of argumentation that speaks to the importance of understanding the nature of goal conflict and a theory of intentionality in predicting how arguments will be represented and resolved. (shrink)