Nanotechnology presents significant challenges in terms of developing a regulatory framework. This is due to a lack of scientific knowledge about the behaviour of the technology in its interactions with biological and ecological processes, the environment and other technologies. Crucially, there is a great deal of uncertainty surrounding the potential environmental and human health and safety impacts of NT. Consequently, the development of NT is a potential test case for framing new models of ‘soft law’ voluntary governance as a substitute (...) for traditional command and control type regulation. Driven by ‘new science governance,’ an approach based on a combination of ideas in anticipatory ethics, future-oriented responsibility, upstream public engagement and deliberation and theories of justice may offer a solution. The uniqueness of the approach can be found in the incorporation of anticipatory approaches via public participation and deliberation as the input into procedural justice approaches with distributional justice as the output. The overarching objective of this work is to contribute to the discussion in relation to the internalisation of responsibility and the building of intellectual and societal capacity to anticipate negative consequences before they arise in the hope that such an approach could be the antithesis of the retrospective imposition of responsibility and liability after the harm is done, which is the outcome of traditional regulatory and ethical approaches. Ultimately, the purpose is to contribute to the long-term sustainability of NT. (shrink)

The phenomenon of technological hazards, whose existence is only revealed many years after they were initially produced, shows that the question of our responsibilities toward future generations is of urgent importance. However, the nature of technological societies means that they are caught in a condition of structural irresponsibility: the tools they use to know the future cannot encompass the temporal reach of their actions. This article explores how dominant legal and moral concepts are equally deficient for helping us (...) understand what future-oriented responsibility requires. An alternative understanding of responsibility is needed, one which can be developed from phenomenological and feminist concepts of care. Care, by opening up for us an understanding of the diversity of values that are constitutive of a worthwhile life, also connects us to the future as the future of care. As such, it provides us with ethical resources that can guide us in the face of uncertainty. (shrink)

Recently implemented Chinese health insurance schemes have failed to achieve a Chinese health care system that is family-oriented, family-based, family-friendly, or even financially sustainable. With this diagnosis in hand, the authors argue that a financially and morally sustainable Chinese health care system should have as its core family health savings accounts supplemented by appropriate health insurance plans. This essay’s arguments are set in the context of Confucian moral commitments that still shape the background culture of contemporary China.

This study presents the Italian adaptation of the Measure of Moral Orientation, second revision. Based on Carol Gilligan’s theory of the Ethics of Care, the MMO-2 was designed to measure two complementary moral stances, namely, Care and Justice. For this study, questionnaire responses from 683 university students were assessed against an Italian-adapted MMO-2 scale. Data were analyzed through exploratory structural equation modeling first as separate scenarios and then as a single model. The final model comprises 4 intercorrelated (...) pairs of latent variables and shows highly satisfactory goodness of fit indices with moderate construct validity and reliability. Strengths, limitations, and directions for the future developments of the MMO-2 are discussed. (shrink)

Knowledge about moral development and elderly persons is very limited. A hermeneutical interpretative study was conducted with healthy elderly persons in order to explore and describe their moral orientation based on the paradigms of justice and care . The types of moral reasoning, dominance, alignment and orientation were determined. All but one participant included both types of reasoning when discussing an ethical conflict. None of the men’s moral reasoning was dominated by caring, but justice dominated the reasoning (...) of four women. The implications for ethical decision-making and future research are discussed. (shrink)

Knowledge about moral development and elderly persons is very limited. A hermeneutical interpretative study was conducted with healthy elderly persons (n = 20) in order to explore and describe their moral orientation based on the paradigms of justice (Kohlberg) and care (Gilligan). The types of moral reasoning, dominance, alignment and orientation were determined. All but one participant included both types of reasoning when discussing an ethical conflict. None of the men’s moral reasoning was dominated by caring, but (...) justice dominated the reasoning of four women. The implications for ethical decision-making and future research are discussed. (shrink)

The author reflects on the future of Catholic health care by looking at the essays in this volume by Dennis Brodeur, Clarke E. Cochran, and Christopher J. Kauffman. The author argues that (1) Roman Catholic teaching on the Trinity is defective, yielding an inadequate model of society, (2) Roman Catholic teaching on the Incarnation is defective, yielding an impoverished understanding of the “sacramental,” and (3) the institutional orientation of Roman Catholicism combined with the lack of true sacramental (...) vision makes it nearly impossible for Roman Catholic theory to criticize the current structure of health care financing. (shrink)

Following the seminal work of Ingvar (1985. “Memory for the future”: An essay on the temporal organization of conscious awareness. Human Neurobiology, 4, 127–136), Suddendorf (1994. The discovery of the fourth dimension: Mental time travel and human evolution. Master’s thesis. University of Waikato, Hamilton, New Zealand), and Tulving (1985. Memory and consciousness. Canadian Psychology/Psychologie Canadienne, 26, 1–12), exploration of the ability to anticipate and prepare for future contingencies that cannot be known with certainty has grown into a thriving (...) research enterprise. A fundamental tenet of this line of inquiry is that future-oriented mental time travel, in most of its presentations, is underwritten by a property or an extension of episodic recollection. However, a careful conceptual analysis of exactly how episodic memory functions in this capacity has yet to be undertaken. In this paper I conduct such an analysis. Based on conceptual, phenomenological, and empirical considerations,I conclude that the autonoetic component of episodic memory, not episodic memory per se, is the causally determinative factor enabling an individual to project him or herself into a personal future. (shrink)

The article is devoted to the problem of moral motivation. Author presents a view which, as he argues, is able to bridge the gap between acceptance of a moral rule and an action according to this rule. The main issue here is the future ethics that could possibly become a part of environmental ethics if it takes into consideration future goods and condition of nature. The author discusses rationality of moral norms in future ethics from a perspective (...) of a universalistic paradigm. Drawing from Hare and Sidgwick he maintains that temporal position of someone harmed by a present action cannot be relevant to the moral evaluation of the action in question. He also emphasizes that in case when moral agent is a future and abstract one, there is an important factor involved which could have an influence on our moral identity. It plays a crucial role because our ,,natural” motivation to act according to a rule concerns, first of all, moral subjects within a moral community. Birnbacher claims that taking non-moral motivations into account makes the prospects of future-oriented action appear much less gloomy. Therefore, in his project of future ethics, he fuses together levels of moral theory and of emotional basis of our motivation. He illustrates the point by demonstrating that the course of psychological factors has an impact on our motivation for action by the data drawn from empirical social research conducted in Europe and USA. Key words MORAL MOTIVATION, FUTURE. (shrink)

The impacts of the activities of technological societies extends further into the future than their capacity to predict and control these impacts. Some have argued that the repercussions of this deficiency of knowledge cause fatal difficulties for both consequentialist and deontological accounts of future oriented obligations. Increasingly, international politics encompasses issues where this problem looms large: the connection between energy production and consumption and climate change provides an excellent example. As the reach of technologically-mediated social action increases, it (...) is necessary to ask whether a political imaginary that extends itself to match this reach requires new concepts, and how far they should displace traditional political concepts of obligation, based on reciprocity and harm avoidance. This paper draws on recent scholarship on the role of concepts of care in political philosophy, bringing together phenomenological and feminist concepts of care in contributing to a positive concept of non-reciprocal intergenerational obligation that defends a constitutive connection between care and justice. (shrink)

The article is devoted to the problem of moral motivation. Author presents a view which, as he argues, is able to bridge the gap between acceptance of a moral rule and an action according to this rule. The main issue here is the future ethics that could possibly become a part of environmental ethics if it takes into consideration future goods and condition of nature. The author discusses rationality of moral norms in future ethics from a perspective (...) of a universalistic paradigm. Drawing from Hare and Sidgwick he maintains that temporal position of someone harmed by a present action cannot be relevant to the moral evaluation of the action in question. He also emphasizes that in case when moral agent is a future and abstract one, there is an important factor involved which could have an influence on our moral identity. It plays a crucial role because our,,natural” motivation to act according to a rule concerns, first of all, moral subjects within a moral community. Birnbacher claims that taking non-moral motivations into account makes the prospects of future-oriented action appear much less gloomy. Therefore, in his project of future ethics, he fuses together levels of moral theory and of emotional basis of our motivation. He illustrates the point by demonstrating that the course of psychological factors has an impact on our motivation for action by the data drawn from empirical social research conducted in Europe and USA. Key words MORAL MOTIVATION, FUTURE. (shrink)

There is an urge to introduce high technology and robotics in care settings. Assisted living is the fastest growing form of older adults’ long-term care. Resident autonomy has become the watchword for good care. This article sheds light on the potential effects of care robotics on the sense of autonomy of older people in AL. Three aspects of the residents’ sense of autonomy are of particular interest: interaction-based sense of autonomy, coping-based sense of autonomy, and potential-based (...) sense of autonomy. Ethnographical data on resident autonomy in an AL facility and existing literature on care robots are utilized in studying what kind of assurances different types of robots would provide to maintain the sense of autonomy in AL. Robots could strengthen the different types of sense of autonomy in multiple ways. Different types of robots could widen the residents’ space of daily movements, sustain their capacities, and help them maintain and even create future expectations. Robots may strengthen the sense of autonomy of older persons in AL; however, they may simultaneously pose a threat. Multi-professional discussions are needed on whether robots are welcomed in care, and if they are, how, for whom, and in what areas. (shrink)

COVID-19 has been studied extensively for its direct effects on healthcare workers. Despite this, very little is known about the effect of COVID-19 fear on future orientation. Studying medical social workers’ fear of being infected with COVID-19 and their future orientation was the primary method used to examine this relationship. 204 Turkish medical social workers on the pandemic’s front lines were included in the total sample. Social workers were found to be extremely concerned about contracting COVID-19. (...) Although only gender is a significant predictor of the fear of contracting COVID-19 infection, the study also found that female social workers have a higher fear of infection than males. Also, no correlation exists between social workers’ vaccination status and their fear of contracting COVID-19. There was a weak negative correlation between social workers’ fear of contracting COVID-19 and their future orientation, but in general, social workers had a positive future orientation. Medical social workers and front-line health care providers can use these findings to develop effective and culturally appropriate intervention programs to reduce COVID-19 concerns and foster a forward-looking outlook. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:158 Feminist Studies 46, no. 1. © 2020 by Feminist Studies, Inc. María Fernanda Olarte-Sierra and Tania Pérez-Bustos Careful Speculations: Toward a Caring Science of Forensic Genetics in Colombia Feminist Science and Technology Studies (STS) has recently opened up the question of care as a set of practices related to the sustainability of life.1 The field of feminist studies more broadly has extensively 1. This literature mostly comes (...) from Northern contexts and started to flourish with the seminal work of María Puig de la Bellacasa, “Matters of Care in Technoscience: Assembling Neglected Things,” Social Studies of Science 41, no. 1 (2010): 85–106. This essay gathers scattered feminist STS reflections on these issues and looks at them through the lens of care, including authors such as Susan Leigh Star, Donna Haraway, Isabelle Stengers, Hilary Rose, and Annemarie Mol. The concept of care orienting this exercise of rereading these authors is proposed by Berenice Fisher and Joan Tronto, “Toward a Feminist Theory of Caring,” in Circles of Care: Work and Identity in Women’s Lives, ed. Emily K. Abel and Margaret K. Nelson (Albany: State University of New York Press, 1990), 35–62. Before and after that essay came out, Puig de la Bellacasa published several other papers related to this issue, including “Touching Technologies, Touching Visions. The Reclaiming of Sensorial Experience and the Politics of Speculative Thinking,” Subjectivity 28, no. 1 (2009): 297–315; “‘Nothing Comes without Its World’: Thinking with Care,” The Sociological Review 60, no. 2 (2012): 197– 216; “Ethical Doings in Naturecultures,” Ethics, Place & Environment 13, no. 2 (2010): 151–69; “Making Time for Soil: Technoscientific Futurity and the Pace of Care,” Social Studies of Science 45, no. 5 (2015): 691–716; and Matters of Care: Speculative Ethics in More than Human Worlds (Minneapolis: University of Minnesota Press, 2017). All these publications have been widely cited by other authors, particularly in a special issue of Social Studies of Science on the politics of care published in 2015 (volume 45, issue 5). Other examples María Fernanda Olarte-Sierra and Tania Pérez-Bustos 159 studied how care, and associated practices such as transnational care chains, are feminized and precarious—involving an ethos embodied by those who actively work to maintain or preserve another’s life. Feminists have focused on the politics of care embedded in invisible jobs related to aesthetics, domestic work, child and elder care, and sexual activities and see all these tasks as related to the reproduction of life and culture.2 Central to this conceptualization of care is the understanding that these jobs are typically women’s work. There is a common association between this care and notions of “motherhood” as it relates to values such as compassion, love, and respect, which have been constructed as universally feminine. However, the main goal of feminist studies of care has been to deconstruct this association, particularly because it is imbued with the white, wealthy, heteronormative ideal of femininity that underlies a gendered division of labor. The reality is that class, race, nation, and gender determine who cares for whom, whether or not labor is paid, and to what extent care is exploitative. One strand of recent research problematizes both valorizing and criticizing care practices on the grounds that they are based on a rather homogeneous understanding of the feminine. Instead, these scholars seek to resurrect valuable feminist work without relying on essentialism of authors contributing to this discussion on care as an ethos for science include Ruth Müller and Martha Kenney, “Agential Conversations: Interviewing Postdoctoral Life Scientists and the Politics of Mundane Research Practices,” Science as Culture 24, no. 4 (2014): 537–59; Charis Thompson, Good Science: The Ethical Choreography of Stem Cell Research (Cambridge, MA: MIT Press, 2013); and Carrie Friese, “Realizing Potential in Translational Medicine: The Uncanny Emergence of Care as Science,” Current Anthropology 54 (S7): S129-S138. 2. From Latin America, see, for example, Luz Gabriela Arango Gaviria, Adira Amaya Urquijo, Tania Pérez-Bustos, and Javier Pineda Duque, eds., Género y cuidado: teorías, escenarios y políticas (Bogotá: Universidad Nacional de Colombia, 2018); Pascale Molinier and Luz Grabriela Arango Gaviria, eds., El trabajo y... (shrink)

Definition of the problemThe upcoming reforms according to the specifications of the Master Plan 2020 provide for a competency-oriented restructuring of medical studies. This article aims to develop perspectives on how teaching ethics in medical studies can be more strongly oriented at building competencies. In this way, it pursues the goal of making the concept of competency more tangible for medical ethics and usable for the design of medical ethics education.ArgumentsWe understand competencies as dispositions for actions that enable problem solving. (...) By transferring the concept of moral intelligence to the moral actions of physicians in patient care, we specify five ethical–moral competencies that must be present for morally appropriate, ethically reflected actions by future physicians: (1) the ability to form a professional moral compass, (2) the willingness to align oneself with professional ethical norms and values, (3) the ability to perceive moral dimensions of medical action, (4) the ability to make moral judgments based on ethical considerations about the right action, and (5) the willingness to realize ethically justified action. We illustrate their importance for teaching medical ethics using the example of teaching clinical ethics in medical studies.ConclusionOur conceptualization of moral–ethical competencies can be used to design concrete courses in a competency-oriented way. Our approach could be applied analogously to other areas of teaching ethics in health care. (shrink)

This article offers a novel account of a key concept in Hannah Arendt’s political thought: amor mundi. In political theory’s ethical turn, theorists have increasingly turned to amor mundi as a source of ethical guidance and inspiration for politics. However, in doing so, they have elided Arendt’s distinct understanding of care. This article recovers Arendt’s understanding of amor mundi as care for the world by reconstructing the central concerns of her dissertation, Der Liebesbegriff bei Augustin, and tracing them (...) to the “Crisis” essays of Between Past and Future. It shows that amor mundi emerges in the dissertation as part of a question: if love is our fundamental orientation toward the world, how can we love the world without instrumentalizing it? The two “Crisis” essays provide the following answer: if love is to avoid—and perhaps militate against—the instrumentalization of the world, it must take the form of care. Following this analysis, this article contends that the contribution of amor mundi to the ethical turn is best understood, not as the ethos needed to guide action in the political realm, but as a key pre- or nonpolitical ethos needed to conserve the world where politics takes place—and thus the very possibility of politics. (shrink)

Research on future-oriented mental time travel (FMTT) is highly active yet somewhat unruly. I believe this is due, in large part, to the complexity of both the tasks used to test FMTT and the concepts involved. Extraordinary care is a necessity when grappling with such complex and perplexing metaphysical constructs as self and time and their co-instantiation in memory. In this review, I first discuss the relation between future mental time travel and types of memory (episodic and (...) semantic). I then examine the nature of both the types of self-knowledge assumed to be projected into the future and the types of temporalities that constitute projective temporal experience. Finally, I argue that a person lacking episodic memory should nonetheless be able to imagine a personal future by virtue of (a) the fact that semantic, as well as episodic, memory can be self-referential, (b) autonoetic awareness is not a prerequisite for FMTT, and (c) semantic memory does, in fact, enable certain forms of personally-oriented FMTT. (shrink)

Both Martin Heidegger and Harry Frankfurt have argued that the fundamental feature of human identity is care. Both contend that caring is bound up with the fact that we are finite beings related to our own impending death, and both argue that caring has a distinctive, circular and non-instantaneous, temporal structure. In this paper, I explore the way Heidegger and Frankfurt each understand the relations among care, death, and time, and I argue for the superiority of Heideggerian version (...) of this nest of claims. Frankfurt claims that we should conceive of the most basic commitments which practically orient a person in the world and define his identity (“volitional necessities”) as naturalistic facts, foundational for and located completely without the normative space of reasons. In support of this he appeals to the supposedly foundational role played in human life by the instinct for self-preservation, what Frankfurt calls the “love of living.” The claim is that in questions of practical identity there is a definite priority of the factual over the normative. Frankfurt’s naturalistic model of volitional necessity is motivated by a misunderstanding of the temporal structure of care, a misunderstanding that helps lead him to an implausible conception of the basic structures of human identity. Heidegger advances an anti-naturalistic conception of caring, one bound up with his way of understanding how human beings relate to their own future. I argue that the existential, temporal, and normative significance that Frankfurt attributes to the naturalized “love of living” is better captured by the Heideggerian claim that human identity is defined by being “for-the-sake-of” certain projects and commitments, a way of being lived out in the way Heidegger calls “being-towards-death.”. (shrink)

This paper aims at explicating a theory of hope that is also suitable for gravely ill people and based on virtue ethics, research in the psychology of “well-being,” and the philosophy of palliative care. The working hypotheses of the theory are that hope is conditioned neither by past events nor by present needs, but is not necessarily oriented toward the future, especially the distant future; that hope is related to personal agency and to freedom; and that hope (...) is deliberative, hence evaluative, motivatory, and rationally critical. Following Higgins’ distinction between “prevention-focus” and “promotion-focus” strategies of coping, and Rawls’ notion of the “Aristotelian principle,” it is argued that hope is the valuation of and personal identification with “promotion-focus” goals with an attitude of nonattachment to any one goal. (shrink)

The care of patients with many illnesses often appears fragmented by many boundaries in the health care system when the care is provided in several locations of primary and secondary care. In the article, boundaries are examined in an interaction between patients and multiple providers in an effort to develop collaboration in inter-organizational provision in a Change Laboratory intervention. Firstly, it will be traced how the boundaries are expressed in the interaction. Secondly, it will be studied (...) how the boundaries expressed in the interaction relate to health care organizations and patient care practices. Thirdly, the practical activity that was embedded in the interaction between patients and providers will be focused on at the laboratory. The expression of boundaries was examined in activity theoretical terms as discursive actions. In discursive actions the ‘lived past’ becomes involved in the situational actions that orient towards future activity. The findings suggest that expressing boundaries uses various linguistic means and it seems relevant to propose that boundaries cannot be studied in a formal way; the analysis needs to be related to the organizational context of the specific study. However, the linguistic means may serve as useful “landmarks” or “pointers” of boundaries that are often expressed implicitly in the interaction. The laboratory session provides an opportunity to study boundaries “on the spot”, or “in their own right”. The realization of the emergent inter-organizational care at the session created challenges for the provision while contradicting some elements of the prevailing provision. During these kinds of interaction, the boundaries between providers became obvious. Furthermore, challenging the boundaries in the normal flow of interaction may be a potential for boundary crossing and even further, a re-constitution of boundaries. Consequently, a boundary crossing represents an interesting unit of analysis for future studies of boundaries and boundary crossing in interaction and discourse. At the laboratory setting was displayed the ability to control others through an indirect use of power that may reflect a simultaneous value system supported by the prevailing hierarchies. In the studies to come, it will be important to pay attention to these implicit power linkages when monitoring the boundaries in horizontal collaborations. (shrink)

This article explores the ways in which ultrasound screening influences the temporal dimensions of prevention in the obstetrical management of pregnancy. Drawing on praxeographic perspectives and empirically based on participant observation of ultrasound examinations in obstetricians’ offices, it asks how ultrasound scanning facilitates anticipatory modes of pregnancy management, and investigates the entanglement of different notions of time and temporality in the highly risk-oriented modes of prenatal care in Germany. Arguing that the paradoxical temporality of prevention—acting now in the name (...) of the future—is intensified by ultrasound screening, I show how the attribution of risk regarding foetal growth in prenatal check-ups is based on the fragmentation of procreative time and ask how time standards come into play, how pregnancy is located in calendrical time, and how notions of foetal time and the everyday life times of pregnant women clash during negotiations between obstetricians and pregnant women about the determination of the due date. By analysing temporality as a practical accomplishment via technological devices such as ultrasound, the paper contributes to debates in feminist STS studies on the role of time in reproduction technologies and the management of pregnancy and birth in contemporary societies. (shrink)

The link between leadership and mental health at the workplace is well established by prior research. However, most of the studies have addressed this relationship from a single-source perspective. The aim of this study was to examine how supervisor and employee ratings of health-oriented leadership correspond to each other and which sources are predictive for employee mental health. We assessed data within 99 teams containing 713 employees in 11 different companies in Southern Germany. Supervisors and their staff completed questionnaires on (...) the supervisors’ health-oriented staff-care dimensions awareness, value of health and health behavior and current mental distress. Hierarchical linear models revealed that supervisors’ self-ratings were significantly related to their employees’ ratings only on the health behavior dimension, but not on the health awareness and value of health dimensions. Also, supervisors rated themselves significantly higher on HoL compared to their employees. Employee ratings of HoL significantly predicted their own level of mental distress, whereas supervisor ratings of HoL did not predict employees’ mental distress at the team level. Supervisors’ self-ratings of HoL did not influence the relationship between employee ratings of HoL and their mental distress on an individual level. These results highlight the complex relationship between multisource assessments of HoL and employee mental health, emphasizing the importance of subjective perception for mental health. Future studies should investigate under which conditions supervisor and employee ratings correspond to each other and are predictive for mental health at the workplace. (shrink)

In an age where issues like climate change and the unintended consequences of technological innovation are high on the ethical and political agenda, questions about the nature and extent of our responsibilities to future generations have never been more important, yet simultaneously so difficult to answer. This book takes a unique approach to the problem by drawing on diverse traditions of thinking about care (including developmental psychology, phenomenology and feminist ethics) to explore the nature and meaning of our (...) relationship with the future. Demonstrating that many influential perspectives on intergenerational ethics, including positions advanced by John Rawls, Brian Barry, and Ulrich Beck are undermined by problems relating to uncertainty, it shows that an approach based on care ethics can confront the uncertain future successfully and give a viable account of the nature and scope of future-oriented responsibilities. (shrink)

In The Decline of the West Spengler puts forward a type of philosophical anthropology, an account of the structures of human experiential consciousness and a method of “physiognomic” analysis, which I argue has dimensions that can be understood as akin to existential phenomenology. Humanity, for Spengler, is witness to the creative flux of “Becoming” and constructs a world of phenomena bounded by death, underpinned by the two prime feelings of dread and longing and structured by the two forms of Destiny (...) (Time) and Direction (Space). Human existence, Spengler argues, is future-directed and open in the sense that there is a certain degree of freedom in the ways in which humanity can actualize its existential possibilities. In the course of elaborating the existential implications of this future-orientation, Spengler introduces the concept of care (Sorge), the fundamental experiential structure. (shrink)

In this paper, we suggest the likely effects of the application of Emmanuel Levinas’s philosophy to the care ethic, particularly as it is represented by the author Joan Tronto, one of the most cogent exponents of care ethics.Thus, we ask: does Levinas’s philosophy have enough in common with the care ethic to be able to overlap it and fruitfully address shared issues of pressing importance? And, is Levinas’s philosophy different enough to challenge the care ethic and (...) help it grow in the ways that it must to become a more philosophically recognized and viable perspective? Our answer is affirmative in both regards.This paper does not intend to criticize the philosophy of Levinas on the basis of care ethics but instead lends the care ethic a perspective with the philosophical legitimacy that it has been hitherto lacking.In terms of alterations to the care ethics, we believe first and foremost that, from a Levinasian point of departure, it would be necessary for the care ethic to adopt a greater awareness of asymmetry in the ethical relation, as well as become more future-oriented towards the consequences of the individual agent’s actions. (shrink)

This chapter discusses imaginary technologies that do not exist yet but are expected to be implemented in clinical work in the near future. Adopting a phenomenological view on the politics of organizational time, we illuminate how the rhetoric of futurity and protentional anticipation dominate managerial acts in healthcare organizations. This future-oriented management includes strategies of risk assessment, investments in emerging technologies, and other actions to reduce external uncertainty and move towards an enhanced capacity to cope with potential challenges. (...) However, we suggest that potentially harmful consequences of emerging technologies cannot be established reliably in advance by investigation, experiments, and risk assessments. The phenomenological notion of embodied information infrastructure allows us to consider how visions of complex technologies intertwine with clinical practices in healthcare professionals’ work. We use two examples of imaginary technologies—automated decision-making systems and care robotics—to concretize how the line between imaginary technologies and existing technologies becomes increasingly volatile in healthcare organizations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Future of Environmental PhilosophyEugene Hargrove (bio)In my 1989 book Foundations of Environmental Ethics, I predicted that environmental philosophy would eventually come to an end because it would be adequately taken care of in mainstream philosophy. That is, it would become part of philosophy of science, ethics, aesthetics, social, and political philosophy, everything except perhaps logic, which could still use it as examples.Whether there will still be (...) a need for environmental philosophy outside of philosophy is another matter. A good deal of progress has been made in the biological sciences. Students frequently take courses in environmental philosophy these days, and those courses even have an effect on their general reasoning ability, making them better future scientists. There has not been, as far as I know, a similar willingness of departments and schools in the social sciences to provide their students the opportunity to take environmental philosophy, and most students still move into policy jobs without knowing that environmental philosophy even exists. I suppose that the school at Georgia Tech where Bryan Norton works might be an exception, perhaps providing some hope.The problem with the social sciences, as I see it, is that these fields are based on an economic view that claims to have gone beyond philosophy even though it is really only a simplistic mix of utilitarianism, logical positivism, and pragmatism. Introducing environmental philosophy into these social sciences would likely undermine the self-conception of these [End Page 130] social scientists, causing them to have to reevaluate their approaches, which they are reluctant to do.A work-around approach might be simply to create policy approaches in environmental philosophy that are so wonderful that the social scientists teaching economics, public administration, and other social sciences will be hypnotically drawn to them. This is apparently the preferred approach today among environmental philosophers who call for an emphasis on policy in environmental philosophy. They generally hold that the original contributors to the field of environmental philosophy did not realize the importance of policy and therefore wasted their time on useless distinctions. In reality, they did know policy was important but they didn't know how to do it generally without the assistance of their disinterested counterparts in the social sciences. The development of the new policy-oriented approaches depends on whether the advocates can transition from "call-for" papers to actual results. Whether they can do so without active involvement from the social scientists controlling the policy graduate school curriculum remains to be seen. Medical ethics has been effective in large part because of the interaction between medical professionals and philosophers. A similar relationship between biologists and philosophers is now developing with good results in many cases, though the road is bumpy. The development of such relationships with social scientists is still on the horizon.An area that I would like to see developed is both easier and more difficult: the introduction of value education into elementary schools. Environmental education at that level is generally done subversively. As one educator explained it to me, the idea is to teach values but in a way that neither the children nor their parents know that it is being taught. The object is to make children care about the environment emotionally. However, in order to avoid attack by conservatives and the religious right, no value words are used. The result in my view is emotivism. It can be seen in graduate students in the sciences who take a course in environmental philosophy. They have no vocabulary to understand what is being taught. Thinking about values makes their heads spin. If much of the things that have to be said to get them to relate could be introduced in elementary school, it would be commonplace when they arrived in graduate school. Doing so would be easy if the problem of the Culture War could be overcome.Eugene Hargrove Eugene C. Hargrove is the founding editor of the journal Environmental Ethic and the author of Foundations of Environmental Ethics (Prentice Hall, 1986). As chair of the philosophy department at the University of North Texas, he was instrumental in creating the first environmental philosophy M.A. and Ph.D. programs in the United... (shrink)

Background Forward-looking, democratically oriented governance is needed to ensure that human genome editing serves rather than undercuts public values. Scientific, policy, and ethics communities have recognized this necessity but have demonstrated limited understanding of how to fulfill it. The field of bioethics has long attempted to grapple with the unintended consequences of emerging technologies, but too often such foresight has lacked adequate scientific grounding, overemphasized regulation to the exclusion of examining underlying values, and failed to adequately engage the public. Methods (...) This research investigates the application of scenario planning, a tool developed in the high-stakes, uncertainty-ridden world of corporate strategy, for the equally high-stakes and uncertain world of the governance of emerging technologies. The scenario planning methodology is non-predictive, looking instead at a spread of plausible futures which diverge in their implications for different communities’ needs, cares, and desires. Results In this article we share how the scenario development process can further understandings of the complex and dynamic systems which generate and shape new biomedical technologies and provide opportunities to re-examine and re-think questions of governance, ethics and values. We detail the results of a year-long scenario planning study that engaged experts from the biological sciences, bioethics, social sciences, law, policy, private industry, and civic organizations to articulate alternative futures of human genome editing. Conclusions Through sharing and critiquing our methodological approach and results of this study, we advance understandings of anticipatory methods deployed in bioethics, demonstrating how this approach provides unique insights and helps to derive better research questions and policy strategies. (shrink)

In this paper we aim to discuss a theoretical explanation for the positive relationship between patients’ knowledge and their trust in healthcare personnel. Our approach is based on John Dewey’s notion of continuity. This notion entails that the individual’s experiences are interpreted as interrelated to each other, and that knowledge is related to future experience, not merely a record of the past. Furthermore, we apply Niklas Luhmann’s theory on trust as a way of reducing complexity and enabling action. Anthony (...) Giddens’ description and analysis of the high modern society provides a frame for discussing the preconditions for patient-healthcare personnel interaction. High modernity is dominated by expert systems and demands trust in these. We conclude that patient knowledge and trust in healthcare personnel is related because both knowledge and trust are future- and action-oriented concepts. The traits of high modernity provides opportunities and challenges as the personnel can and must perform discretion. This discretion must be made in a context where knowledge is considered uncertain and preliminary. (shrink)

In _Psychoanalytic Therapy as Health Care_, a timely and trenchant consideration of the clash of values between managed care and psychoanalysis, contributors elaborate a thoughtful defense of the therapeutic necessity and social importance of contemporary psychoanalytic and psychodynamic approaches in the provision of mental health care. Part I begins with the question of where psychoanalytic treatments now stand in relation to health care; contributors offer explanations of the current state of affairs and consider possible directions of (...) class='Hi'>future developments. Part II looks directly at the conundrums that have resulted from the attempt to integrate psychotherapy and managed care, with contributors examining the ethical and legal dimensions of confidentiality, privacy, and reporting to third parties. Part III opens to wider consideration of the experiences of psychoanalysts under health care systems throughout the world. Finally, Part IV demonstrates the relevance of contemporary psychoanalytic approaches to a variety of contemporary patient populations, with contributors focusing on the applicability of analytically oriented treatment to AIDS patients, seriously disturbed young adults, and inner-city clinic patients. Collectively, the contributors to _Psychoanalytic Therapy as Health Care_ convincingly refute the claim that psychoanalytically informed therapy is an esoteric treatment suited only to the "worried well." Drawing on a wide range of clinical and empirical evidence, they forcefully argue that contemporary psychoanalytic approaches are applicable to seriously distressed persons in a variety of treatment contexts. Failure to include such long-term therapies within health care delivery systems, they conclude, will deprive many patients of help they need - and help from which they can benefit in enduring ways that far transcend the limited treatment goals of managed care. (shrink)

This thesis examines the practice of haemodialysis and kidney transplantation, the two medical therapies available for persons with kidney failure, from a phenomenological perspective. A basic assumption made in the thesis is that contemporary biomedicine is deeply embedded in the cultural, historical, economic, and political circumstances provided by the particular local, national, and transnational contexts in which it is practiced. The aim of the thesis is twofold. On the one hand, the aim is to examine the forms of person- and (...) patienthood enacted and negotiated in haemodialysis and kidney transplantation care and in the daily lives of persons with kidney failure. On the other hand, the aim is to investigate the ways in which the enacted and negotiated forms of person- and patienthood are culturally embedded and normatively charged. In order to examine and investigate this twofold aim, an empirical material has been gathered that comprises observations and in-depth interviews with patients and caregivers at four haemodialysis units, one in Riga, Latvia, and three in Stockholm, Sweden. The theoretical approach and methodology of the study is cultural and phenomenological in character, drawing on an ethnological and anthropological understanding of culture as processual and relational, and on a phenomenological understanding of personhood as embodied and intertwined with the surrounding world. The thesis shows that patients’ encounters and attempts to deal with the diagnoses and treatments associated with kidney failure are complex and often misalign them with the normatively charged orientations enacted and recommended by medicine. The complex situation that emerges when they undergo transplantation, for example, stands in stark contrast to the widespread official view of organ transplantation as a self-evidently health-bringing and normalising therapy. Through their repeated and extensive experiences of undergoing haemodialysis and living with the disease, patients eventually become able to create a synthesis between their lived experiences of their own body and their body as a medical object – what in the thesis is called a ‘sick body’ – a synthesis that allows them to reorient themselves in life and experience a sense of direction. This process relies, to a large extent, on the temporal structure that haemodialysis affords life; it is by repeatedly undergoing the treatment that patients become able to create a sick body. Even so, many of them find this temporal structure problematic; they experience it as disruptive of their control and future-orientedness and as causing an existentially difficult-to-handle boredom. The thesis also shows that the political developments and the norms prevalent in the two national contexts studied greatly affect the orientations of the treatment practices and the participants’ lives. In both Riga and Stockholm, ideals of freedom, activity, control, and self-actualisation influence what forms of patienthood and personhood are enacted. The study indicates that persons who fall ill with a serious and chronic disease only gradually become able to understand and actively cope with their differently embodied circumstances of life. This suggests that medical professionals should not too hastily enlist their patients as experts on their own bodies, but rather provide them with the time and support necessary for making repeated attempts at creating and maintaining a life with a sick body. (shrink)

In this article I examine how start-up capitalism recalibrates transnational ‘outsourcing’ or the work of so-called ‘cyber coolies’ to instead create labour as a site of innovation and experimental consumption. First, I draw on ethnographic fieldwork in India to theorise digital labour as a form of experimental mediation and temporal work oriented to the future. Second, I show how work is deeply embodied and centres on the racialised and gendered bodies of non-elite workers. Finally, I show how invitations to (...) innovate with work processes encourage workers to cultivate attachments of love and care for the company that ultimately privatise affect and conceal class and labour hierarchies. Tracing employees’ experiences through a period of automation and layoffs, this article argues for an understanding of how precarious feminised work creates the conditions of possibility for postcolonial and transnational technocapitalism to flourish. (shrink)

This paper provides an interpretation, based on the social systems theory of German sociologist Niklas Luhmann, of the recent paradigmatic shift of mental health care from an asylum-based model to a community-oriented network of services. The observed shift is described as the development of psychiatry as a function system of modern society and whose operative goal has moved from the medical and social management of a lower and marginalized group to the specialized medical and psychological care of the (...) whole population. From this theoretical viewpoint, the wider deployment of the modern social order as a functionally differentiated system may be considered to be a consistent driving force for this process; it has made asylum psychiatry overly incompatible with prevailing social values (particularly with the normative and regulative principle of inclusion of all individuals in the different functional spheres of society and with the common patterns of participation in modern function systems) and has, in turn, required the availability of psychiatric care for a growing number of individuals. After presenting this account, some major challenges for the future of mental health care provision, such as the overburdening of services or the overt exclusion of a significant group of potential users, are identified and briefly discussed. (shrink)

In this article, human–computer interaction is explored as a design-oriented practice nurturing the becoming of what is not-yet in future-oriented and speculative manners. Such approaches have evolved over time and now the field seems ready to take leaps targeting social and culturally infused contexts, such as those suggested by critical design, design things, adversarial design, making futures, pluriversal design and critical fabulations. It is in this respect that feminist theories, methods and imaginaries are rendered important. Feminist theory is in (...) this article considered an important companion and part of the practical tool-kit necessary for generative, speculative and ethical approaches within the field of HCI. How to think with care is explored as a meta-design strategy directed and informed by feminist onto-epistemologies – a strategy intended to ‘seed’ speculative and social justice-oriented design endeavours through generative figurations and critical dilemmas to foster abilities and sensibilities for dealing with difference differently. What is advanced is the need for meta-design space in HCI, in this article referred to as a contact zone, a feminist figuration with the intention to open up for design explorations with ethical imperatives. Four other interrelated feminist figurations are also loosely explored in order to frame how thinking with care in HCI could be advanced further, i.e. diffractive thinking, intra-activism, becoming-with and response-ability. By considering serious feminist accounts of situated knowledges and touching visions, it is argued that feminist thinking is well on its way to offering real alternatives of great importance for HCI. (shrink)

Following Bratman, I distinguish between the Cummins or component-function of the planning capacity (its role as a component of larger forms of practical organizations) and its Wright or existence-function – the planning capacity's effect that explains its existence. I agree with Bratman that these functions are distinct. The planning capacity's role within larger practical organizations need not explain its origin. But I argue that the distinction is less stark for future-oriented existence-functions, which concern the future persistence and stability (...) of the capacity. In mature practical organizations, component-functions usually give rise to matching future-oriented existence-functions, given that pressures for the persistence of practical organizations transfer to their components (such as the planning capacity) because of their component-functions. But in the special case of individual temporally extended agency, there is an even stronger alignment of functions. The planning capacity and individual temporally extended agency are part of an inextricable package. The capacity is not just a distinct component. This entails that, within individual agency, the two functions merge and the planning capacity is the primary rather than the derivative target of pressures of persistence, care, and value. Or so I speculatively conjecture. (shrink)

'Health promotion' has unfortunately come to mean different things to different people. Interpretations have frequently been left implicit and where spelt out have often been too diffuse or too limited to be useful. Nevertheless the term can be usefully employed to define a set of health-enhancing activities in which the focus is deflected from current disease- and cure-oriented power bases. Used in this way health promotion can come to include the best of the developing theory and practice from a wide (...) range of 'experts' but can also place due emphasis on community involvement. To reject health promotion on the basis of selected, inadequate interpretations is to discard past successes, current developments and future possibilities in important fields of activity and to preserve an inappropriate status quo. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Toxic Progeny:The Plastisphere and Other Queer FuturesHeather Davis… the whole world can be plasticized, and even life itself.—Roland Barthes, MythologiesOn April 11, 2014, the Norwegian newspaper The Local reported that Bjørn Frilund caught a large cod that, as he discovered as he was gutting it, had swallowed a dildo. Frilund speculated that the fish mistook the dildo for one of the multicolored octopi that are its usual food source (...) and are common to the area. This is certainly not the first case of a marine animal mistaking a piece of plastic for food. Everything from whales to birds to turtles to bacteria have been documented consuming plastic (Tremlett 2013; Stephanis, Giménez, Carpinelli et al. 2013; Zettler, Mincer, and Amaral-Zettler 2013), presumably in a moment of misrecognition, or due to an inability to filter out the plastic that is now, in some parts of the ocean, six times more abundant than plankton (Andrady 2011; Law and Moret-Ferguson 2010). But what is interesting to me about this example is the explicit enmeshment and strange congruence of oceanic plastic as it ties into nonreproductive sex and queer futurity. Although silicone (the most likely material that the dildo was made from) is not what is normally grouped under the (very broad) term “plastic” because it is not derived from petrochemicals, it shares the same problem that plastic poses; that is, its non-decomposability. We are not certain how long plastic may stick around for, but as is now commonly known, plastic can be considered practically immortal. That is, the timescale for which plastic may biodegrade, meaning that it turns into something else (delineated from simply breaking [End Page 231] down, tearing, or becoming smaller), is on the order of thousands of years. Given this incredible longevity, plastic can then be understood as a non-filial human progeny, a bastard child that will most certainly outlive us. And it is heralding in a future in which—regardless of one’s gender, sexual orientation, or religious beliefs—reproduction is increasingly decoupled from sex. Plastic is contributing to this non-reproductivity while birthing a future of strange new life forms adapted to deal with these chemicals. What kind of offspring is plastic? How might it intersect with questions of queer life and (non)reproduction? And, in light of our increasingly nonreproductive futures, might there be something to be learned from queer theory, and the embodiment of queer subjects that have never assumed biological reproduction to be the ultimate signifier of hope?This essay will look to bring the worlds of plastic and queer theory together under the conditions of non-reproduction and extinction, a world where our progeny may not even be human much less our biological offspring. Here, I am following Nicole Seymour’s assertion that “queer values—caring not (just) about the individual, the family, or one’s descendants, but about the Other species and persons to whom one has no immediate relations—may be the most effective ecological values” (2013, 27). This fissuring of reproductive logic from biology could be one of the most important lessons in a world that is increasingly toxic. For, as Catriona Mortimer-Sandilands and Bruce Erickson write in Queer Ecologies, “queer attachments work both to celebrate the excess of life and to politicize the sites at which this excess is eradicated” (2010, 37). To develop these ideas, I build upon and am indebted to feminist science studies scholars such as Nancy Tuana, Donna Haraway, and Mel Chen, among many others, who assert the inherently intertwined viscous porosity of our bodies, our multiple compositions, and the necessarily imbricated and implicated nature of that position.PlasticPlastic is a curious substance. The first fully synthetic polymer was made in 1907 by Leo Bakeland and patented in 1909. Made to replace other materials that were becoming increasingly scarce, it fueled an era of mass consumerism and the cheap replication and distribution of goods. Plastic is a generic category that describes about twenty different types of polymers. The five families of commodity plastics that make up about seventy-five percent “of the roughly one hundred billion pounds of plastic produced and sold annually in... (shrink)

The study discusses a new approach to parental agency in pediatric palliative care based on an active form of caregiving. It also explores the possibility of a positive conceptualization of parental agency in its relational context. The paper begins with an illustrative case study based on a clinical situation. This is followed by an analysis of various aspects of parental agency based on empirical studies that disclose the insufficiencies of the traditional approach to parental agency. In the next step, (...) parental agency is analyzed from a reality‐based perspective as an activity focused on relationships and the cognitive capacity of parents vis‐a‐vis their seriously ill children. The paper also considers the importance of the cultural and social contexts in which parental agency and decision‐making take place. This agency is addressed not as individualistic in form, and nor is it exercised in terms of fixed choices. Rather, the focus is on its dynamic and future‐oriented aspects. Consequently, parental agency should be comprehended not only as a form of proxy agency representing the child's best interests but also as a complex decision‐making process in which the parents learn from their child how to become good, compassionate caregivers and at the same time good parents. (shrink)

This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention. We (...) evaluated an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners in co-designing integrated clinical services. The key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based. From our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making. (shrink)

Background To determine whether fetal care paediatric and maternal–fetal medicine specialists harbour differing attitudes about pregnancy termination for congenital fetal conditions, their perceived responsibilities to pregnant women and fetuses, and the fetus as a patient and whether self-perceived primary responsibilities to fetuses and women and views about the fetus as a patient are associated with attitudes about clinical care.Methods Mail survey of 434 MFM and FCP specialists .Results MFMs were more likely than FCPs to disagree with these statements (...) : ‘the presence of a fetal abnormality is not an appropriate reason for a couple to consider pregnancy termination’ ; ‘the effects that a child born with disabilities might have on marital and family relationships is not an appropriate reason for a couple to consider pregnancy termination’ ; and ‘the cost of healthcare for the future child is not an appropriate reason for a couple to consider pregnancy termination’ . 65% MFMs versus 47% FCPs disagreed that their professional responsibility is to focus primarily on fetal well-being . Specialists did not differ regarding the fetus as a separate patient. Responses about self-perceived responsibility to focus on fetal well-being were associated with clinical practice attitudes.Conclusions Independent of demographic and sociopolitical characteristics, FCPs and MFMs possess divergent ethical sensitivities regarding pregnancy termination, pregnant women and fetuses, which may influence clinical care. (shrink)

In this article, I introduce the critical study of the skin in three parts. I start with a reflection on what makes the skin such a suggestive and, arguably, special phenomenon. I then provide a brief overview of the key works, recurring themes and ongoing debates that characterize the skin studies subfield. And finally, I end with a presentation of the articles that make up Body and Society’s special issue on the skin, taking care to highlight how they both (...) contribute to the subfield as it currently stands while orienting it towards new questions, concerns and challenges. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Personal Identity and the Moral Authority of Advance DirectivesAndrea OttSection 1What is the metaphysical basis for respecting an advance directive first drawn up by an individual who is competent but who is at present rendered incapacitated?1 What are the roles of autonomy, personal values, integrity, and beneficence contained within said respect? In this section the positions of two prominent philosophers, Ronald Dworkin and Jeff McMahan, will be analyzed with (...) regard to the above questions. While the two thinkers have different scholastic orientations—with Dworkin primarily a philosopher of law and McMahan an ethicist and metaphysician—their conclusions regarding the respect of the wishes of the competent-turned-demented are remarkably similar. Namely, they both argue that the values and desires held by the previously competent agent trump any current (contrary) wishes. What this amounts to for Dworkin involves respecting the autonomy of the dominant, competent part of the life where countermanding such autonomy would be worse for the life as a whole. For McMahan this means respecting the precedent autonomy generated by the deep prudential unity relations which form the basis for egoistic concern; this concern is often the basis for drafting a directive regarding future care in the first place.I will argue in this paper that if McMahan is to be consistent with his position regarding prudential unity relations then he will, in fact, not arrive at the same conclusion as Dworkin.2 Consistency will demand that the demented patient’s directive should not be followed because the demented individual will, at best, be only weakly connected to the previously autonomous, decision-capable agent. Therefore, I will argue, the moral authority [End Page 38] of the advance directive will be similarly weakened. According to McMahan, Dworkin maintains that the precedent autonomous decision has moral authority, for he assumes that the individual in question is understood to be one “temporally extended individual,” so that what is best for her life now will, in fact, be what is best for her life as a whole (501). McMahan claims to support Dworkin’s conclusion, albeit for different reasons. McMahan supports the execution of the directive out of some sort of respect for the earlier “reasonably full and complete life with its own deep prudential unity” (502). I argue that McMahan, though ostensibly in agreement with Dworkin, will have to acknowledge that the weakened prudential unity relations which make the life as a whole matter less will also undercut the moral authority of the directive. In other words, the moral authority of an advance directive weakens as the prudential unity relations weaken.Ultimately, I believe, Lynne Baker and her metaphysics of constitution can provide the best direction when faced with dilemmas such as The Advance Directive. Baker can do this and avoid the charge of positing a “post-person” (the basis for McMahan’s criticism of other versions of psychological accounts of personal identity). I use her metaphysics of constitution and derivative properties within a novel explanation of prudential concern for the organism without positing identity. I argue, in section 2, that the organism made the decision for advance care when it was derivatively (in Baker’s sense) a person. We can thus avoid the charges of (1) new entities “popping” into existence and (2) a person binding a nonperson. Such a metaphysics of constitution may thus offer some hope of adjudication within debate concerning these matters.Now I shall turn to the thought experiment in The Ethics of Killing that forms the basis of this discussion. True to the general style of his work, Jeff McMahan asks the reader to consider a thought experiment. To avoid any misinterpretation of the facts, I reproduce The Advance Directive in full below:A woman whose life has been devoted to creative intellectual work finds herself in the very early stages of Alzheimer’s disease. Given her nature, her values, and the character of her previous life, she believes that for her to continue to live in a demented state would be horribly degrading, worse than simply ceasing to exist. She accepts, however, that her life will continue to be worth living as long as she remains competent; therefore to commit... (shrink)

View of future time orientation is a cognitive construct about future time. This view has its unique work of motivation and effect on academic performance. Previous studies have only explored the influence that future time orientation brings to the learning process at a single time, and most of them focus on cross-sectional studies. To further explore the cross-lagged relationship for freshmen between future time orientation and learning engagement during different periods, AMOS 23.0 was (...) performed for cross-lagged analysis in this study to explore the influence and effect among variables of different periods. This research was based on the theory of self-determination to discover the relationship between future time and learning involvement for freshmen in enrollment and the first summer vacation. In this research, there were 1,000 valid samples in the first stage and 840 valid samples in the second stage for the conduction of descriptive statistics, pair t-test, and cross-lagged analysis. The results show that: for learning engagement, freshmen at the end of the first year have a higher average score than at the beginning of the first year. View of students of future time orientation can affect their learning engagement of the future through self-determination of students. At last, we provide some suggestions as references for institutional research and future research. (shrink)

In view of the ethical crises that have proliferated over the last decade, scholars have reflected critically on the ideal of management as a value-neutral, objective science. The alternative conceptualization of management as a craft has been introduced but not yet sufficiently elaborated. In particular, although authors such as Mintzberg and MacIntyre suggest craft as an appropriate alternative to science, neither of them systematically describes what “craft” is, and thus how it could inform an ethical managerial orientation. In this (...) paper, we draw from the literature to elaborate three caring orientations associated with craft practices: caring for materials, caring for process, and caring for end-users. We suggest that conceptualizing management as a craft in these terms offers an approach to business ethics that goes beyond the “ethics of compliance” and toward a more embodied and embedded form of ethical enactment within organizations. (shrink)

A motivation problem may arise when morally principled public policy calls for serious sacrifice, relative to ways of life and levels of well-being, on the part of the meInbers of a free society. Apart from legal or other forms of “external” coercion, what will, could, or should move people to make the sacrifices required by morality? I explore the motivation problem in the context of morally principled public policyconcerning our legacy for future generations. In this context the problem raises (...) special moral-psychological difficulties. My inquiry suggests pessimism regarding our ability to solve the motivation problem relative to what morality requires on behalf of future generations. (shrink)

Over the past two decades there has been a great deal of research conducted into the question of gender differences in ethical decision making in organisations. Much of this has been based on questionnaire surveys, typically asking respondents (often students, sometimes professionals) to judge the moral acceptability of actions as described in short cases or vignettes. Overall the results seem inconclusive, although what differences have been noted tend to show women as ‘more ethical’ than men. The authors of this paper (...) believe that attention should be paid to the insight, from Carol Gilligan and others, that women are more inclined than men to subscribe to an ‘ethic of care’, and that once this perspective is adopted a pattern is discernible. In a critical examination of previous research we pay particular attention to the detailed content of cases used in surveys, and the statistical analysis of findings. We advocate greater reflection on the results of quantitative surveys and sensitivity to different possible interpretations of findings. This we do with our own exploratory study, conducted with UK undergraduate students of accounting, the findings from which seem to support the original hypothesis that where a ‘care’ orientation is invited, women do indeed react differently to business ethics issues than do men. (shrink)

Over the past two decades there has been a great deal of research conducted into the question of gender differences in ethical decision making in organisations. Much of this has been based on questionnaire surveys, typically asking respondents (often students, sometimes professionals) to judge the moral acceptability of actions as described in short cases or vignettes. Overall the results seem inconclusive, although what differences have been noted tend to show women as 'more ethical' than men. The authors of this paper (...) believe that attention should be paid to the insight, from Carol Gilligan and others, that women are more inclined than men to subscribe to an 'ethic of care', and that once this perspective is adopted a pattern is discernible. In a critical examination of previous research we pay particular attention to the detailed content of cases used in surveys, and the statistical analysis of findings. We advocate greater reflection on the results of quantitative surveys and sensitivity to different possible interpretations of findings. This we do with our own exploratory study, conducted with UK undergraduate students of accounting, the findings from which seem to support the original hypothesis that where a 'care' orientation is invited, women do indeed react differently to business ethics issues than do men. (shrink)

A motivation problem may arise when morally principled public policy calls for serious sacrifice, relative to ways of life and levels of well-being, on the part of the members of a free society. Apart from legal or other forms of “external” coercion, what will, could, or should move people to make the sacrifices required by morality? I explore the motivation problem in the context of morally principled public policy concerning our legacy for future generations. In this context the problem (...) raises special moral-psychological difficulties. My inquiry suggests pessimism regarding our ability to solve the motivation problem relative to what morality requires on behalf of future generations. (shrink)

Background: The concept of digital twins has great potential for transforming the existing health care system by making it more personalized. As a convergence of health care, artificial intelligence, and information and communication technologies, personalized health care services that are developed under the concept of digital twins raise a myriad of ethical issues. Although some of the ethical issues are known to researchers working on digital health and personalized medicine, currently, there is no comprehensive review that maps (...) the major ethical risks of digital twins for personalized health care services. Objective: This study aims to fill the research gap by identifying the major ethical risks of digital twins for personalized health care services. We first propose a working definition for digital twins for personalized health care services to facilitate future discussions on the ethical issues related to these emerging digital health services. We then develop a process-oriented ethical map to identify the major ethical risks in each of the different data processing phases. Methods: We resorted to the literature on eHealth, personalized medicine, precision medicine, and information engineering to identify potential issues and developed a process-oriented ethical map to structure the inquiry in a more systematic way. The ethical map allows us to see how each of the major ethical concerns emerges during the process of transforming raw data into valuable information. Developers of a digital twin for personalized health care service may use this map to identify ethical risks during the development stage in a more systematic way and can proactively address them. Results: This paper provides a working definition of digital twins for personalized health care services by identifying 3 features that distinguish the new application from other eHealth services. On the basis of the working definition, this paper further layouts 10 major operational problems and the corresponding ethical risks. Conclusions: It is challenging to address all the major ethical risks that a digital twin for a personalized health care service might encounter proactively without a conceptual map at hand. The process-oriented ethical map we propose here can assist the developers of digital twins for personalized health care services in analyzing ethical risks in a more systematic manner. (shrink)