Managed care poses a challenge to the traditional conceptualization of medicine and of the physician-patient relationship. People have evaluated the merits of managed care by focusing upon the way its incentives alter the relationship between physician and patient. However, this misses the key to rightly evaluating MCOs. To address the ethics of MCOs one should focus on the institution-patient relationship, and this has not been sufficiently addressed in the literature. I will address this relationship here and show how the institution-patient (...) relationship has evolved, why it has become increasingly prominent, and why we must move beyond business ethics for rightly understanding it. (shrink)

Although the notion of physician value neutrality in medicine may be traced back to the writings of Sir William Osler, it is relatively new to medicine and medical ethics. We argue in this paper that how physician value neutrality has been cashed out is often obscure and its defense not persuasive. In addition, we argue that the social/political implementation of neutrality, Political Liberalism, fails, and thus, PVN's case is weakened, for PVN's justification relies largely on the reasoning undergirding PL. For (...) these reasons, we conclude that PVN has no philosophical or ethical warrant and thus should be abandoned. We suggest that the physician present to her patients some type of statement or creed that would give them an idea of where she stands on important axiological issues and how these stands are cashed out clinically. (shrink)

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

Regional Perspectives in Bioethics" illustrates the ways in which the national and international political landscape encompasses persons from diverse and often fragmented moral communities with widely varying moral intuitions, premises, evaluations and commitments.

Christian physicians are in danger of losing the right of conscientious objection in situations they deem immoral. The erosion of this right is bolstered by the doctrine of "physician value neutrality" (PVN) which may be an impetus for the push to require physicians to refer for procedures they find immoral. It is only a small step from referral to compelling performance of these same procedures. If no one particular value is more morally correct than any other (a foundational PVN premise) (...) and a physician ought to be value neutral, than conscientious objection to morally objectionable actions becomes a thing of the past. However, the argument for PVN fails. Therefore, Christian physicians should state their values openly, which would allow patients the ability to choose like-minded physicians. Some possible responses to this erosion of conscientious objection include, disengagement from non-Christian institutions, the formation of distinctly Christian medical institutions and political action. However, for the Christian the initial focus should be on a life of holiness which requires each of us to avoid evil. (shrink)

Physician conflict of interest has been of concern since Hippocrates and rarely is this concern more evident than in the relationship between pharmaceutical sales representatives (PSR) and physicians. Given the acrimonious public debates concerning this issue a careful exploration of the concerns at sake and the conceptual arguments which support such concerns is called for. In this piece I will take as heuristic the conceptual philosophical framework argued for by H. Tristram Engelhardt. This framework would sanction interactions between PSRs and (...) physicians given that such relationships are free and without coercion. Further, patients must be informed, uncoerced and free in choosing such relationships with physicians who engage in interactions with PSRs. I consider four major criticisms which claim that PSR-physician interactions are morally impermissible: 1) influence, 2) “patients do not choose, but they pay,” 3) violation of ethical principles, and 4) erosion of the patient-physician relationship. Each is shown to be unpersuasive under Engelhardtian philosophy. As long as the principle of permission and informed consent obtain without coercion than the interaction between PSRs and physicians would be construed to be morally permissible. (shrink)

Ethics and Empowerment is aimed atproviding tactical, high-level solutions to today's business and professionalchallenges. Gathering together experts in various fields, this line of titleswill benefit professionals as they face the challenges of the ever-changingbusiness climate. Amid the burgeoning literature on business ethics, this book providesan important lead in taking a well-known everyday management notion such as"empowerment" and using it to make "ethics" more relevantand accessible to the business world. Adding a major contribution to theongoing debate about the role of business (...) in society, the content examines theissues of power, control, and autonomy, addressing such questions asempowerment as a matter of justice, and also provides case studies of theorganizational experiences of empowerment programs. (shrink)

The authors argue that the time is ripe for national and corporate leaders to move consciously towards the development of global ethics. This papers presents a model of global ethics, a rationale for the development of global ethics, and the implications of the model for research and practice.

As transnational interactions increase, cross-cultural conflict concerning ethical issues is inevitable. This article presents a model for assisting decision makers in selecting appropriate strategies for addressing cross-cultural ethical conflict. A theoretical framework for the model is developed based on the literature on international business ethics and on conflict resolution. The model is illustrated through several case examples. Implications for future research and practice are discussed.

Expert skill in music performance involves an apparent paradox. On stage, expert musicians are required accurately to retrieve information that has been encoded over hours of practice. Yet they must also remain open to the demands of the ever-changing situational contingencies with which they are faced during performance. To further explore this apparent paradox and the way in which it is negotiated by expert musicians, this article profiles theories presented by Roger Chaffin, Hubert Dreyfus and Tony and Helga Noice. For (...) Chaffin, expert skill in music performance relies solely upon overarching mental representations, while, for Dreyfus, such representations are needed only by novices, while experts rely on a more embodied form of coping. Between Chaffin and Dreyfus sit the Noices, who argue that both overarching cognitive structures and embodied processes underlie expert skill. We then present the Applying Intelligence to the Reflexes (AIR) approach?a differently nuanced model of expert skill aligned with the integrative spirit of the Noices? research. The AIR approach suggests that musicians negotiate the apparent paradox of expert skill via a mindedness that allows flexibility of attention during music performance. We offer data from recent doctoral research conducted by the first author of this article to demonstrate at a practical level the usefulness of the AIR approach when attempting to understand the complexities of expert skill in music performance. (shrink)

Expert skill in music performance involves an apparent paradox. On stage, expert musicians are required accurately to retrieve information that has been encoded over hours of practice. Yet they must also remain open to the demands of the ever-changing situational contingencies with which they are faced during performance. To further explore this apparent paradox and the way in which it is negotiated by expert musicians, this article profiles theories presented by Roger Chaffin, Hubert Dreyfus and Tony and Helga Noice. For (...) Chaffin, expert skill in music performance relies solely upon overarching mental representations, while, for Dreyfus, such representations are needed only by novices, while experts rely on a more embodied form of coping. Between Chaffin and Dreyfus sit the Noices, who argue that both overarching cognitive structures and embodied processes underlie expert skill. We then present the Applying Intelligence to the Reflexes approach—a differently nuanced model of expert skill aligned with the integrative spirit of the Noices’ research. The AIR approach suggests that musicians negotiate the apparent paradox of expert skill via a mindedness that allows flexibility of attention during music performance. We offer data from recent doctoral research conducted by the first author of this article to demonstrate at a practical level the usefulness of the AIR approach when attempting to understand the complexities of expert skill in music performance. (shrink)

In elite sport, the advantages demonstrated by expert performers over novices are sometimes due in part to their superior physical fitness or to their greater technical precision in executing specialist motor skills. However at the very highest levels, all competitors typically share extraordinary physical capacities and have supremely well-honed techniques. Among the extra factors which can differentiate between the best performers, psychological skills are paramount. These range from the capacities to cope under pressure and to bounce back from setbacks, to (...) the knowledge of themselves, opponents, and the domain, which experts access and apply in performance. In the companion chapter on breadth and depth of knowledge in expert sport (see Chapter 11), we discussed the forms or kinds of knowledge deployed by elite athletes, and described some lines of research which seek to tap and study such expert knowledge (McPherson & MacMahon, 2008; McRobert, Ward, Eccles & Williams, 2011). In this chapter we focus more directly on questions about methods for measuring or more accurately assessing expert knowledge, in particular addressing a wider range of methods to help us understand what experts know. Suggesting that sport researchers can productively adopt and adapt existing qualitative methodologies for integration with more standard quantitative methods, we introduce and survey a number of areas of qualitative research in psychology. (shrink)

We present a synthetic theory of skilled action which proposes that cognitive processes make an important contribution to almost all skilled action, contrary to influential views that many skills are performed largely automatically. Cognitive control is focused on strategic aspects of performance, and plays a greater role as difficulty increases. We offer an analysis of various forms of skill experience and show that the theory provides a better explanation for the full set of these experiences than automatic theories. We further (...) show that the theory can explain experimental evidence for skill automaticity, including evidence that secondary tasks do not interfere with expert performance, and evidence that experts have reduced memory for performance of sensorimotor skills. (shrink)

Much ink has been spilt in consideration of the once pervasive reliance on military metaphors to depict the relationships between science and religion in the nineteenth century. This has resulted in historically sensitive treatments of secularization; and the realization that the relationship between science and religion was not a bloody war between intellectual nation states, but a protracted divorce of former partners. Moreover, historians of science have been encouraged to throw off the yoke of the internalism–externalism debate, and to explore (...) the cultural boundaries that impinged upon practitioners of a natural knowledge of the world. Within the historiography of nineteenth-century science, this has resulted in many new perspectives on science and natural knowledge in relation to cultural control and authority. (shrink)

Taking John Paul II's teaching on the Christian meaning of suffering as my main source for a Catholic perspective on suffering, I show how seriously he takes the reality of suffering, and how seriously he takes the question as to the meaning of suffering. I proceed to explore his many-sided teaching on the way in which sin is and is not involved in the meaning of suffering, giving particular attention to his teaching on social dimensions of sin and suffering (...) that are little understood in the individualistic West today. The heart of his teaching on suffering lies in his explication of how it is that we have to be conformed in our suffering to the suffering of Christ so as to share in His resurrection. But it is not the suffering as such but the love that we are called to live when we suffer, that incorporates us into the risen Christ. (shrink)

In searching for appropriate business ethics for the 21st century, it is necessary to embrace a range of inter-related disciplines such as psychology and ethics, but also areas including philosophy, politics and religion. This text acts as an example of interdisciplinary scholarship.

John Locke:When we set before our eyes a round globe of uniform colour, v.g. gold, alabaster or jet, it is certain that the idea thereby imprinted in our mind is of a flat circle, variously shadowed, with several degrees of light and brightness coming to our eyes. But we having, by use, been accustomed to perceive what kind of appearance convex bodies are wont to make in us, what alterations are made in the reflections of light by the difference (...) of the sensible figures of bodies: the judgment presently, by an habitual custom, alters the appearances into their causes.H.H. Price:…. a distant hillside which is full of protuberances, and slopes upwards at quite a gentle angle, will appear flat and vertical….. This means that the sense-datum, the colour expanse which we sense, actually is flat and vertical. (shrink)

John Locke:When we set before our eyes a round globe of uniform colour, v.g. gold, alabaster or jet, it is certain that the idea thereby imprinted in our mind is of a flat circle, variously shadowed, with several degrees of light and brightness coming to our eyes. But we having, by use, been accustomed to perceive what kind of appearance convex bodies are wont to make in us, what alterations are made in the reflections of light by the difference (...) of the sensible figures of bodies: the judgment presently, by an habitual custom, alters the appearances into their causes.H.H. Price:…. a distant hillside which is full of protuberances, and slopes upwards at quite a gentle angle, will appear flat and vertical….. This means that the sense-datum, the colour expanse which we sense, actually is flat and vertical. (shrink)

We prove a converse to one of the theorems from [F], giving a description in terms of Turing complexity of sets which can be coded into recursive and r.e. quotient Boolean algebras.

Since their appearance in 1850, Pharmaceutical Sales Representatives (PSR) interactions with physicians have engendered intense emotional responses. The controversy has continued unabated since that time. Arguments in favor of the moral impermissibility of the PSR-physician relationship can be divided into four general categories; (1) influence, (2) patients pay but they do not choose, (3) violation of principlism, and (4) the erosion of the patient-physician relationship. None of the arguments that have thus far been proposed against the moral permissibility of these (...) interactions gives sufficient warrant to avoid them (or pursue them). It may be the case that PSR-physician interactions place the patientphysician relationship in jeopardy. This would constitute enough warrant, from a pragmatic perspective, to shun such relationships. However, no research supports this contention. A careful evaluation of the literature leaves one ambivalent at best. Keywords: pharmaceutical sales representatives, influence, conflict of interest CiteULike Connotea Del.icio.us What's this? (shrink)