Leader behavioral integrity (BI) is central to perceived credibility and thus to leaders’ effectiveness at fostering ethical and other climates. Our research broadens the theoretical foundation for BI research by integrating the cognitive–attributional role of trust in the formation and maintenance of leader BI perceptions. Guided by recent research on trust primacy and prior theories of fairness used to examine ethical behavior, we examine how perceptions of leader BI can be either diminished or maintained through trust velocity following a psychological (...) contract breach. Using a field and an experimental study, we explore the manner in which followers perceive leader’s actions when conflicting interests lead to unfulfilled promises. We found that trust velocity mediates the relationship between a psychological contract breach and leader BI (study 1), and that informational justice moderates this relationship (study 2), suggesting that leaders can attenuate the impact of broken promises on ascribed BI. Our findings offer a pathway for leaders operating in dynamic contexts to preserve BI and also help address concerns that have been raised about the behavioral integrity construct regarding its conceptual overlap with related constructs such as trust, psychological contracts, and informational justice. (shrink)

We, in the rare disease community are grateful to Halley et al. (2023) for highlighting some of the long-overlooked barriers to care. As the parent of a non-ambulatory, teenage boy living with Duch...

Decision making is a crucial element in the field of medicine. The physician has to determine what is wrong with the patient and recommend treatment, while the patient has to decide whether or not to seek medical care, and go along with the treatment recommended by the physician. Health policy makers and health insurers have to decide what to promote, what to discourage, and what to pay for. Together, these decisions determine the quality of health care that is provided. Decision (...) Making in Health Care is an up-to-date, comprehensive overview of the field of medical decision making. It includes quantitative theoretical tools for modeling decisions, psychological research on how decisions are actually made, and applied research on how physician and patient decision making can be improved. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

The postconflict Rwandan state has crafted a “we are all Rwandans” national identity narrative without ethnicity, in the interest of maintaining a delicate, postgenocide peace. The annual genocide commemoration period called Kwibuka—“to remember”—which takes place over the course of one hundred days every year, is an underresearched part of this narrative. During the commemoration period, génocidaires’ confessions increase dramatically; these confessions lead the government to previously undiscovered graves all over the country, just as confessions given during the grassroots justice system—gacaca—did (...) in the more immediate aftermath of the genocide. According to a prominent government official known for his prison outreach, the Rwandan government no longer provides incentives for prisoners to confess. Instead, he stated in a 2017 interview, those who speak up over twenty years later are simply “moved by the spirit of Kwibuka.” When confessions are made, memories of past action are used by the state, seemingly toward an ultimate end of reinforcing the national master narrative, to subsume the individual memories of innocent survivors into the national collective memory. This paper explores the questions around the state’s evolving use of prisoner confessions, both how those confessions are obtained, and how they factor into commemoration practices now. (shrink)

“Hooking up,” a popular type of sexual behavior among college students, has become a pathway to dating relationships. Based on open-ended narratives written by 273 undergraduates, we analyze how students interpreted a vignette describing a heterosexual hookup followed by a sexless first date. In contrast to the sexual script which holds that women want relationships more than sex and men care about sex more than relationships, students generally accorded women sexual agency and desire in the hookup and validated men’s post-hookup (...) relationship interest. However, in explaining the sexless date, students typically reasoned the woman was being chaste and withholding sex to redeem her reputation whereas they often characterized the man’s abstinence in terms of a pity date. The findings underscore the tenacity of gendered sexual scripts around heterosexual dates and hookups but also reveal fissures and contradictions that suggest some changes to the sexual double standard. (shrink)

This paper is concerned with the inverted gender roles portrayed in the Middle English Partonope of Blois, and the part played by Urake in realigning them. The relationship between hero and heroine begins with Partonope in a female passive role as a "kept man," and Melior in a male dominating role as a sexually self-assured woman who chooses the man she wants and controls him. Urake, one of the most unusually interventionistic of romance go-betweens, saves Partonope's life and prepares him, (...) both physically and psychologically, to assume his position as the triumphal hero; she also torments Melior into accepting a less controlling form of love more suitable for a medieval woman. In this way the conventional ending to the romance is enhanced by the satisfaction of seeing the inverted gender roles of hero and heroine put to rights. (shrink)

A curriculum guide and reference, detailing sequentially, according to age level, learning activities and selected resources and intended to facilitate classroom projects and discussions conducive to an understanding of death, dying, and bereavement.

Humans have been called “cooperative breeders” because mothers rely heavily on alloparental assistance, and the grandmother life stage has been interpreted as an adaptation for alloparenting. Many studies indicate that women invest preferentially in their daughters’ children, but little research has been conducted where patrilocal residence is normative. Bangladesh is such a place, but women nevertheless receive substantial alloparental investment from the matrilateral family, and child outcomes improve when maternal grandmothers are alloparents. To garner this support, women must maintain contact (...) with their natal families. Here, the visiting behavior of 151 interviewed mothers was analyzed. Despite the challenges of patrilocality and purdah, almost all respondents visited their own mothers, and mothers-in-law were visited far less. This contrast persists in analyses controlling for proximity, respondent age, postmarital residence, family income, and marital status. These results affirm the importance women place on matrilateral ties, even under a countervailing ideology. (shrink)

It is commonly accepted that conversation is, in some sense, cooperative. This is due in part to Paul Grice’s articulation of the Cooperative Principle, which states that participants should “make [their] conversational contributions such as is required...” (1989, 26). Yet the significance of this principle, as well as the notion of cooperation that is entailed, is up for interpretation. For example, there are several ways of understanding what kind of force the Cooperative Principle is supposed to have: it could be (...) meant as a requirement on the behavior of speakers, a description of the way speakers behave, or an articulation of what speakers assume of one another’s contributions. I consider each of these options, and I argue that the first, which is often seen as a naïve interpretation, is worth considering. Although I ultimately reject the prescriptive interpretation of the Cooperative Principle, it offers a jumping off point for exploring other prescriptions on conversational behavior, such as the Requirement of Interlocutor Responsiveness, which I offer as an explicitly prescriptive conversational principle. (shrink)

This article draws upon affect theory to analyze transformations of garage sale sellers through the exchange of their affectively charged possessions. Garage sales are awash with human emotion; they feature used personal belongings suffused with identities, histories, stories, and memories that are moved along with affect. The objects for sale are “sticky” in that they act as vessels and glue for strands of sentiment to reflexively pass between sellers and buyers, transmitting affective orientations, whether positive or negative. The affective elements (...) of garage sale goods are contagious as they can intersubjectively leap from one body to another. (shrink)

'Ugly as sin', 'ugly duckling', 'rear its ugly head'. The word 'ugly' is used freely, yet it is a loaded term: from the simply plain and unsightly to the repulsive and even offensive, definitions slide all over the place. Hovering around 'feared and dreaded', ugliness both repels and fascinates. But the concept of ugliness has a lineage that has long haunted our cultural imagination. Gretchen E. Henderson explores perceptions of ugliness through history, from ancient Roman feasts to medieval grotesque (...) gargoyles, from Mary Shelley's monster cobbled from corpses to the Nazi Exhibition of Degenerate Art. Covering literature, art, music and even Uglydolls, Henderson reveals how ugliness has long posed a challenge to aesthetics and taste. Henderson digs into the muck of ugliness, moving beyond the traditional philosophic argument or mere opposition to beauty, and emerges with more than a selection of fascinating tidbits. Following ugly bodies and dismantling ugly senses across periods and continents, [this book] draws on a wealth of fields to cross cultures and times, delineating the changing map of ugliness as it charges the public imagination. Illustrated with a range of artefacts, this book offers a refreshing perspective that moves beyond the surface to ask what 'ugly' truly is, even as its meaning continues to shift. (shrink)

Hymenoplasty is a practice that must be judged from within its cultural confines and not only from outside. It offers women who have grown up within the sexual norms of a Western society the chance to return to their parental culture, with its female-specific virginity expectations. Hymenoplasty allows women to be sexually active prior to marriage, which equalizes the discrepancy between gender norms on premarital sexual experience. Caution is needed when comparing hymenoplasty to female genital mutilation. However, comparing hymenoplasty to (...) other cosmetic genital modification procedures raises unique ethical, social, and medical quandaries that highlight the importance of patient’s autonomy. (shrink)

Transactions in the U.S. garage sale range from the commercial to the giftlike, in a Maussian sense. As two-thirds of the participants, women create a sense of community through garage sale exchange. This article explores how women, partly differentiated along lines of race and class, solidify their personal relationships, transmit something of themselves with their possessions, transform their own lives in the process, and contribute to a broader spirit of community through the generalized reciprocity and even moral economy that manifests (...) in giftlike exchange. There is an important link, both material and symbolic, between women's relational skills, their association with the home and the moral, and the creation of community in the garage sale. (shrink)

For the last 50 years the idea of consumer rights has formed an essential element in the formulation of policy to guide the workings of the marketplace. The extent and coverage of these rights has evolved and changed over time, yet there has been no comprehensive analysis as to the purpose and scope of consumer rights. In moral and ethical philosophy, rights are integrally linked to the notion of justice. By reassessing consumer rights through a justice-based framework, a number of (...) key issues emerge regarding the way in which markets enable justice for consumers. The consumer rights which underpin the United Nations consumer protection guidelines address all forms of justice to some degree, but the predominant focus is on procedural justice. Our conclusions question whether this is sufficient and also whether there is a case to develop the notion of consumer ‘duties’ that complement the idea of rights. (shrink)

Human diploid fibroblasts have a finite proliferative lifespan in culture, at the end of which they are ararrested with G1 phase DNA contents. Upon serum stimulation, senescent cells are deficient in carrying out a subset of early signal transduction events such as activation of protein kinase C and induction of c‐fos. Later in G1, they uniformly fail to express late G1 genes whose products are required for DNA synthesis, implying that they are unable to pass the R point. Failure to (...) pass the R point may occur because senescent cells are unable to phosphorylate the retinoblastoma protein, owing to the accumulation of inactive complexes of cyclin E/Cdk2 and possibly cyclin D/Cdk4. Senescent cells contain high amounts of p21, a potent cyclin‐dependent kinase inhibitor whose levels are also elevated in cells arrested in G1 following DNA damage, suggesting that both arrests might share a common mechanism. Cell aging is accompanied by a progressive shortening of chromosomal telomeres, which could be perceived by the cells as a form of DNA damage that gives rise to the signals that inactivate the cell cycle machinery. (shrink)

Many states prohibit patients from appointing their physicians as health care proxies, fearing paternalism and conflict of interest. But the potential for conflict is not unique to physicians, and patients may have compelling reasons to prefer that their doctor make decisions on their behalf. Managing potential conflicts serves patients better than denying them the right to choose who will make health care decisions for them when they are no longer competent.

Extracorporeal membrane oxygenation (ECMO) is a form of life support for cardiac and/or pulmonary failure with unique ethical challenges compared to other forms of life support. Ethical challenges with ECMO exist when conventional standards of care apply, and are exacerbated during periods of absolute ECMO scarcity when “crisis standards of care” are instituted. When conventional standards of care apply, we propose that it is ethically permissible to withhold placing patients on ECMO for reasons of technical futility or when patients have (...) terminal, short-term prognoses that are untreatable by ECMO. Under crisis standards of care, it is ethically permissible to broaden exclusionary criteria to also withhold ECMO from patients who have a low likelihood of recovery, to maximize the overall number of lives saved. Unilateral withdrawal of ECMO against a patient’s preferences is unethical under conventional standards of care, but is ethical under crisis standards of care to increase access to ECMO to others in society. ECMO should only be rationed when true scarcity exists, and allocation protocols should be transparent to the public. When rationing must occur under crisis standards of care, it is imperative that oversight bodies assess for inequities in the allocation of ECMO and make frequent changes to improve any inequities. (shrink)