Genetic information and technologies are increasingly important in health care, not only in technologically advanced countries, but world-wide. Several global factors promise to increase future demand for morally conscious genetic health services and research. Although they are the largest professional group delivering health care world-wide, nurses have not taken the lead in meeting this challenge. Insights from feminist analysis help to illuminate some of the social institutions and cultural obstacles that have impeded the integration of genetics technology into the discipline (...) of nursing. An alternative model is suggested - the transdisciplinary model - which was developed initially by a nurse and introduced in the 1970s into the delivery of health care and social services for children with developmental disabilities. This holistic model enables all health care professionals to have an equal voice in determining how genetic health care will be globalized. (shrink)

To make behavioral choices that are in line with our goals and our moral beliefs, we need to gather and consider information about our current situation. Most information present in our environment is not relevant to the choices we need or would want to make and thus could interfere with our ability to behave in ways that reflect our underlying values. Certain sources of information could even lead us to make choices we later regret, and thus it would be beneficial (...) to be able to ignore that information. Our ability to exert successful self-governance depends on our ability to attend to sources of information that we deem important to our decision-making processes. We generally assume that, at any moment, we have the ability to choose what we pay attention to. However, recent research indicates that what we pay attention to is influenced by our prior experiences, including reward history and past successes and failures, even when we are not aware of this history. Even momentary distractions can cause us to miss or discount information that should have a greater influence on our decisions given our values. Such biases in attention thus raise questions about the degree to which the choices that we make may be poorly informed and not truly reflect our ability to otherwise exert self-governance. (shrink)

Peter Winch's The Idea of a Social Science has been the subject of repeated misunderstanding. This discussion takes one recent example and shows how Winch's argument is gravely distorted. What is at issue is not, as is usually supposed, whether we can accept or endorse another society's explanations of its activities, but whether we have to look for an explanatory connection between concepts and action. Winch's argument is that before we can try to explain actions, we have to identify them (...) correctly. This can only be done by seeing how they, and the concepts they are associated with, fit within a way of life. Grasping its rule?following character is understanding action. Once the difficulties in making such identifications are appreciated, we will be less inclined to accept facile explanations why people in other societies do the things they do. (shrink)

Heyes's literature review of deception, imitation, and self-recognition is inadequate, misleading, and erroneous. The anaesthetic artifact hypothesis of self-recognition is unsupported by the data she herself examines. Her proposed experiment is tantalizing, indicating that theory of mind is simply a Turing test.

The following is the transcript of a lecture taken in shorthand by Hans-Georg Backhaus. The transcript was originally published as an appendix in Hans-Georg Backhaus, Dialektik der Wertform. Untersuchungen zur marxschen Ökonomiekritik, a complete translation of which is forthcoming in the Historical Materialism book series.

Little is known about study co-ordinators of gene therapy clinical trials. The purposes of this study were to: (1) describe characteristics of co-ordinators of gene therapy (transfer) clinical trials; (2) assess differences between nurse and non-nurse study co-ordinators; and (3) identify factors indicative of study co-ordinators' role preparation that could affect their role performance. This exploratory correlational study employed a convenience sample of 118 co-ordinators in the USA (55 participants; 47% response rate). The researcher created the Study Coordinator Role Preparedness (...) and Performance Survey to assess factors or correlates of study co-ordinator performance. Analysis of variance was used to compare nurses and non-nurses, and men versus women on their perceived preparedness, perceived quality of orientation, and satisfaction with educational opportunities. The findings contribute to knowledge by identifying present inadequacies in the training of study co-ordinators and in recognizing the need for more effective provision of orientation and continuing education with respect to ethical issues, knowledge of genetic science, and potential research integrity challenges. (shrink)

Human rights legislation pertaining to applications of human genetic science is still lacking at an international level. Three international human rights documents now serve as guidelines for countries wishing to develop such legislation. These were drafted and adopted by the United Nations Educational, Scientific and Cultural Organization, the Human Genome Organization, and the Council of Europe. It is critically important that the international nursing community makes known its philosophy and practice-based knowledge relating to ethics and human rights, and contributes to (...) the globalization of genetics. Nurses have particular expertise because they serve in a unique role at grass roots level to mediate between genetic science and its application to public health policies and medical interventions. As a result, nurses worldwide need to focus a constant eye on human rights ideals and interpret these within social, cultural, economic and political contexts at national and local levels. The purpose of this article is to clarify and legitimate the need for an international declaration on nursing, human rights, human genetics and public health policy. Because nurses around the world are the professional workforce by which genetic health care services and genetic research protocols will be delivered in the twenty-first century, members of the discipline of nursing need to think globally while acting locally. Above all other disciplines involved in genetics, nursing is in a good position to articulate an expanded theory of ethics beyond the principled approach of biomedical ethics. Nursing is sensitive to cultural diversity and community values; it is sympathetic to and can introduce an ethic of caring and relational ethics that listen to and accommodate the needs of local people and their requirements for public health. (shrink)

Medicine is incorporating genetic services into all avenues of health‐care, ranging from the rarest to the most common diseases. Cognitive theories of decision‐making still dominate professionals’ understanding of patient decision‐making about how to use genetic information and whether to have testing. I discovered a conceptual model of decision‐making while carrying out a phenomenological‐hermeneutic descriptive study of a convenience sample of 12 couples who were interviewed while deciding whether to undergo prenatal genetic testing.Thirty‐two interviews were conducted with 12 men and 12 (...) women separately. Interviews were transcribed verbatim and all data were analyzed using three levels of coding that were sorted into 30 categories and then abstracted into three emergent meta‐themes that described men's and women's attempts to make sense and find meaning in how to best use prenatal genetic technology. Their descriptions of how they thought about, communicated, and coped with their decision were so detailed it was possible to discern nine different types of thinking they engaged in while deciding to accept or decline testing.They believed that decision‐making is a process of working through your own personal style of thinking. This might include only one or any combination of the following types of thinking: analytical, ethical, moral, reflective, practical, hypothetical, judgmental, scary, and second sight, as described in detail by these 12 couples. (shrink)

In this article, we defend the view that problematic epistemological extremism, which presents puzzles for many learners new to philosophy, is a result of earlier learning at the K–12 level. Confirming this hunch serves as a way of locating the problem and suggesting that recent learning interventions proposed by Christopher Edelman (2021) and Galen Barry (2022) are on the right track. Further, we offer that this extremism is plausibly described as what Miranda Fricker (2007) calls an epistemic injustice. This suggests (...) that disrupting the problem is a boon for learners, the discipline, and good citizenship. In our discussion we introduce work by Derek Muller suggesting that it is important to address the misconceptions involved in epistemological extremism (and its precursors) lest we simply reinforce these problematic misconceptions for the worse—inhibiting student learning, reproducing challenges to good citizenship, and leading to a discounting of many ways of knowing. (shrink)

Focusing on a discussion by Ruddich and Stassen of the ?Remarks on Frazer's Golden Bough?, this paper shows that some of the usual criticisms made by sociologists of Wittgenstein are misplaced. He does not reject causal explanations of beliefs and actions and replace them with some other form of explanation, but dismisses the idea that any explanation is called for here. His argument that the origin of the desire to explain beliefs is to be found in a misconceived parallel between (...) science and magic is explained and discussed. (shrink)

The paper builds on the postulate of “myths we live by,” which shape our imaginative life (and hence our social expectations), but which are also open to reflective study and reinvention. It applies this principle, in particular, to the concepts of love and vulnerability. We are accustomed to think of the condition of vulnerability in an objectifying and distancing way, as something that affects the bearers of specific (disadvantaged) social identities. Against this picture, which can serve as a pretext for (...) paternalist and controlling attitudes to the groups in question – notably to women – Anderson urges us to reimagine our vulnerability as a condition not merely of exposure to violence but of openness to mutual affection, love, and friendship. Hegel’s celebrated image of the owl of Minerva, which takes wing only with the coming of dusk, suggests an association of (philosophical) wisdom with negativity – with the experience of death or loss. Anderson, by contrast, proposes an alternative and more hopeful image of the dawn of enlightenment, in the guise of new ethical dispositions shaped by an emancipatory (and so, no longer an oppressive or sexist) conception of our capacity for love. Her main interlocutors or influences in this piece are Judith Butler (who contributes the idea of a “relational ontology”), Michèle Le Doeuff, and Mary Midgley. (shrink)

Drawing on the legacy of prominent pragmatic philosophers and political economists—C. S. Peirce, William James, John Dewey, Thorstein Veblen, and John R. Commons—Charles W. Anderson creatively brings pragmatism and liberalism together, striving to temper the excesses of both and to fashion a broader vision of the proper domain of political reason.

Modern information technologies, beginning with the fax and audiocassettes but now exemplified in satellite television and the Internet, have opened the public discourse of Islam to new voices and, more subtlely, to new practices. While media-savvy militants draw the attention of outside observers, a quieter drama is unfolding. Pious middle classes are extending conventional patterns of seeking out religious guidance into new channels, particularly the Internet; the continuous search for role models and reference groups is meeting increasingly modern ways of (...) providing those - namely, media and increasingly media that target specific needs of growing middle classes. These range from religious instructional material for children to be used by parents to religious advice columnists, both conventional and contemporary to sermons to selections of news. Once 'private' discourses are on public display, and this public world of Islam is decidedly intimate. Where scholars of print note an officialization of discourse that moves into that medium, and programmatic 'islamizers' of knowledge, politics, etc. generally pursue entextualization strategies, electronic communication is moving Islam into the marketplace and aligning its practices, both metaphorically in the sense that the range of public choice and alternatives expands and literally in the rise of businesses to service these demands. (shrink)

This study evaluates the ontological and ethical premises and presuppositions of three abortion theorists: Germain Grisez, Eike-Henner W. Kluge, and Michael Tooley. ;Grisez's argument that human embryos and fetuses are moral persons because moral rights are derived from moral value, and the full moral value of human adults who are moral persons is implicit in the living genetic mechanism of all human beings, is criticized on the basis of the tension in Aristotle's doctrine between the notion of essence as an (...) internal causitive principle, and as a set of observable qualities considered to be definitive of the nature of a living thing. However, David Wiggins' use of the semantical theory of natural kind terms of Hilary Putnam is suggested as a possible resolution. ;Kluge's argument that rational beings are moral persons because rational awareness has an absolute and intrinsic value, and that mature fetuses are moral persons because their neurological systems have become sufficiently complex to provide the present capability for rational awareness is criticized because he fails to show that mature fetuses do have such a present capability, and because his discussion of the relationship of potential being to actual being of living things wrongly presupposes that human gestation is analogous to the making of an artifact. ;Tooley's contrary argument that the right to life is not derivable from moral value but must, itself, be something violable, and that there is a conceptual connection between its violation and one's desire to continue to live, excludes fetuses and neonates because they lack the mental capability to desire to continue to live. Tooley's analysis is criticized as incomplete, and his argument as presupposing the existence of an essentially mentalistic self. ;The final chapter is a synthesis which considers the ontology of the development of personality or self, including the theories of Descartes, Locke and Wiggins. The conclusion is reached that theories which claim that a moral person "comes to be" as a fundamentally different kind of being at some point after conception, due to either morphological changes or the development of personality or self, entail dual principles of identity and, hence, are in danger of unintelligibility. (shrink)

A distinguished political philosopher with years of experience teaching in undergraduate liberal arts programs, Anderson shows how the ideal of practical reason can reconcile academia’s research aims with public expectations for universities: the preparation of citizens, the training of professionals, the communication of a cultural inheritance. It is not good enough, he contends, to simply say that the university should stick to the great books of the classic tradition, or to denounce this tradition and declare that all important questions (...) are a matter of personal or cultural choice. By applying the methods of practical reason, instead, teachers and students will think critically about the essential purposes of any human activity and the underlying arguments of any text. (shrink)

A distinguished political philosopher with years of experience teaching in undergraduate liberal arts programs, Anderson shows how the ideal of practical reason can reconcile academia’s research aims with public expectations for universities: the preparation of citizens, the training of professionals, the communication of a cultural inheritance. It is not good enough, he contends, to simply say that the university should stick to the great books of the classic tradition, or to denounce this tradition and declare that all important questions (...) are a matter of personal or cultural choice. By applying the methods of practical reason, instead, teachers and students will think critically about the essential purposes of any human activity and the underlying arguments of any text. (shrink)

RationaleSurrogates of critically ill patients often have inaccurate expectations about prognosis. Yet there is little research on how intensive care unit clinicians should discuss prognosis, and existing expert opinion-based recommendations give only general guidance that has not been validated with surrogate decision makers.ObjectiveTo determine the perspectives of key stakeholders regarding how prognostic information should be conveyed in critical illness.MethodsThis was a multicenter study at three academic medical centers in California, Pennsylvania, and Washington. One hundred eighteen key stakeholders completed in-depth semistructured (...) interviews. Participants included 47 surrogates of adult patients with acute respiratory distress syndrome; 45 clinicians working in study ICUs, including physicians, nurses, social workers, and spiritual care providers; and 26 experts in health communication, decision science, ethics, family-centered care, geriatrics, healthcare disparities, palliative care, psychology, psychiatry, and critical care.Measurements and main resultsThere was broad support among surrogates for existing expert recommendations, including truthful prognostic disclosure, emotional support, tailoring the disclosure strategy to each family's needs, and checking for understanding. In addition, stakeholders offered suggestions that add specificity to existing recommendations, including: In addition to conveying prognostic estimates, clinicians should help families "see the prognosis for themselves" by showing families radiographic images and explaining the clinical significance of physical manifestations of severe disease at the bedside. Many physicians did not support using numeric estimates to convey prognosis to families, whereas many surrogates, clinicians from other disciplines, and experts believed numbers could be helpful. Clinicians should conceptualize prognostic communication as an iterative process that begins with a preliminary mention of the possibility of death early in the ICU stay and becomes more detailed as the clinical situation develops. Although prognostic information should be initially disclosed by physicians, other members of the multidisciplinary team-nurses, social workers, and spiritual care providers-should be given explicit role responsibilities to reinforce physicians' prognostications and help families process a poor prognosis emotionally.ConclusionsFamily members, clinicians, and experts identified specific communication behaviors that clinicians should use to discuss prognosis in the critical care setting. These findings extend existing opinion-based recommendations and should guide interventions to improve communication about prognosis in ICUs. (shrink)