Family relationships are complex, interdependent, multifactorial, cultural, and sociopolitical. In instances of family caregiving, the dynamics of these relationships influence the well-being of all members. This paper will address one dynamic of family relationships, moral reasoning, as set forth in the theories of Carol Gilligan. Gilligan's theories about two patterns of reasoning, based on the ethics of justice and care, will be examined within “stories” from fiction and interviews with family caregivers. This examination will raise issues about Gilligan's theories as (...) well as about the literary works themselves and will suggest new ways for health professionals to work with family caregivers. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Augustine of Hippo strongly influenced western theology, but he has often been accused of over-emphasizing the unity of God to the detriment of the Trinity. In Augustine and the Trinity, Lewis Ayres offers a new treatment of this important figure, demonstrating how Augustine's writings offer one of the most sophisticated early theologies of the Trinity developed after the Council of Nicaea. Building on recent research, Ayres argues that Augustine was influenced by a wide variety of earlier Latin Christian (...) traditions which stressed the irreducibility of Father, Son and Spirit. Augustine combines these traditions with material from non-Christian Neoplatonists in a very personal synthesis. Ayres also argues that Augustine shaped a powerful account of Christian ascent toward understanding of, as well as participation in the divine life, one that begins in faith and models itself on Christ's humility. (shrink)

This paper seeks to understand the treatment effect of Prescription Drug Monitoring Programs on opioid prescription rates. Using county-level panel data on all opioid prescriptions in the U.S. between 2006 and 2015, we investigate whether state interventions like PDMPs have heterogeneous treatment effects at the sub-state level, based on regional and temporal variations in policy design, extent of urbanization, race, and income. Our models comprehensively control for a set of county and time fixed effects, countyspecific and time-varying demographic controls, potentially (...) endogenous time-series trends in prescription rates, and other state-level opioid interventions such as Naloxone Access and Good Samaritan laws, Medicaid expansion, and the provision of Methadone Assistance Treatment. We find that PDMPs are only effective in reducing prescription rates if they obligate doctors to check for patients' history prior to filling out a prescription, but the frequency at which a state requires its PDMP to be updated is irrelevant to its effectiveness. Moreover, the significant treatment effects of PDMPs are almost exclusively driven by urban and predominantly white counties, with the relatively more affluent regions showing greater responsiveness than their less affluent counterparts. (shrink)

The meaning of sustainability is the subject of intense debate among environmental and resource economists. Perhaps no other issue separates more clearly the traditional economic view from the views of most natural scientists. The debate currently focuses on the substitutability between the economy and the environment or between “natural capital” and “manufactured capital”—a debate captured in terms of weak versus strong sustainability. In this article, we examine the various interpretations of these concepts. We conclude that natural science and economic perspectives (...) on sustainability are inconsistent. The market-based Hartwick-Solow “weak sustainability” approach is far removed from both the ecosystem-based “Holling sustainability” and the “strong sustainability” approach of Daly and others. Each of these sustainability criteria implies a specific valuation approach, and thus an ethical position, to support monetary indicators of sustainability such as a green or sustainable Gross Domestic Product. The conflict between “weak sustainability” and “strong sustainability” is more evident in the context of centralized than decentralized decision making. In particular, firms selling “services” instead of material goods and regarding the latter as “capital” leads to decisions more or less consistent with either type of sustainability. Finally, we discuss the implications of global sustainability for such open systems as regions and countries. Open systems have not been dealt with systematically for any of the sustainability criteria. (shrink)

This first-of-its-kind national survey of 485 psychiatrists in nine states and the District of Columbia finds substantial evidence of clinicians being uninformed, misinformed, and misinforming patients of their gun rights regarding involuntary commitments and voluntary inpatient admissions. A significant percentage of psychiatrists did not understand that an involuntary civil commitment triggered the loss of gun rights, and the majority of psychiatrists in states with prohibitors on voluntary admissions and emergency holds were unaware that patients would lose gun rights upon voluntary (...) admission or temporary commitment. Moreover, the survey found evidence that psychiatrists may use gun rights to negotiate “voluntary” commitments with patients: 15.9% of respondents reported telling patients they could preserve their gun rights by permitting themselves to be voluntarily admitted for treatment, in lieu of being involuntarily committed. The results raise questions of whether psychiatrists obtained full informed consent for voluntary patient admissions, and suggest that some medical providers in states with voluntary admission prohibitor laws may unwittingly deprive their patients of a constitutional right. The study calls into question the fairness of state prohibitor laws as policy, and — at minimum — indicates an urgent need for psychiatrist training on their state gun laws. (shrink)

A scholastic-Cartesian schema faithfully maps ordinary, effective ways of dealing with intentionality; yet its apparent incoherence provokes philosophers into opting for one of two stances, 'Cartesian' or 'direct realist', seemingly incompatible, yet each seem in accord with ordinary thought. A wide range of canonical and current theories, realist, idealist and hybrid, essentially involve one option or the other. We should instead consider why the language of intentionality, with its apparent anomalies, works so well. Released from the obligation to opt for (...) one stance over the other, we can identify a robust realism different in kind from anything currently on offer. (shrink)

Smart farming has largely been driven by productivity and efficiency aims, but there is an increasing awareness of potential socio-ethical challenges. The responsible research and innovation approach aims to address such challenges but has had limited application in smart farming contexts. Using smart dairying research and development in New Zealand as a case study, we examine the extent to which principles of RRI have been applied in NZ smart dairying development and assess the broader lessons for RRI application in smart (...) farming. We draw on insights from: a review of research on dairy technology use in NZ; interviews with smart dairying stakeholders; and the application of an analytical framework based on RRI dimensions. We conclude that smart dairying R&D and innovation activities have focused on technology development and on-farm use without considering socio-ethical implications and have excluded certain actors such as citizens and consumers. This indicates that readiness to enact RRI in this context is not yet optimal, and future RRI efforts require leadership by government or dairy sector organisations to fully embed RRI principles in the guidelines for large R&D project design. More broadly, enacting RRI in smart farming requires initial identification of RRI readiness in a given sector or country and devising a roadmap and coherent project portfolio to support capacity building for enacting RRI. Additionally, methods for operationalising RRI must be adapted to the context of the national or sectoral innovation system in which smart farming is being developed. (shrink)

Smart farming has largely been driven by productivity and efficiency aims, but there is an increasing awareness of potential socio-ethical challenges. The responsible research and innovation approach aims to address such challenges but has had limited application in smart farming contexts. Using smart dairying research and development in New Zealand as a case study, we examine the extent to which principles of RRI have been applied in NZ smart dairying development and assess the broader lessons for RRI application in smart (...) farming. We draw on insights from: a review of research on dairy technology use in NZ; interviews with smart dairying stakeholders; and the application of an analytical framework based on RRI dimensions. We conclude that smart dairying R&D and innovation activities have focused on technology development and on-farm use without considering socio-ethical implications and have excluded certain actors such as citizens and consumers. This indicates that readiness to enact RRI in this context is not yet optimal, and future RRI efforts require leadership by government or dairy sector organisations to fully embed RRI principles in the guidelines for large R&D project design. More broadly, enacting RRI in smart farming requires initial identification of RRI readiness in a given sector or country and devising a roadmap and coherent project portfolio to support capacity building for enacting RRI. Additionally, methods for operationalising RRI must be adapted to the context of the national or sectoral innovation system in which smart farming is being developed. (shrink)

This article tests the impact of Walmart's corporate decisions to end the sale of handguns at its stores in 1994 and to discontinue the sale of all firearms at approximately 59% of its stores in 2006 before resuming firearms sales at some of those stores in 2011. Using a difference-in-differences framework, we find that that from 1994 to 2005 counties with Walmarts robustly experienced a reduction in the suicide rate and experienced no change in the homicide rate. These models suggest (...) that Walmart's policy change caused a 3.3 to 7.5% reduction in the suicide rate within affected counties, which represents an estimated 5,104 to 11,970 lives saved over the studied period. In contrast, Walmart's 2006 and 2011 decisions to discontinue and subsequently resume the sale of rifles and shotguns in many of its stores was not associated with a robustly measured effect on homicide or suicide rates. We do find evidence that Walmart's 2006 decision to reduce the number of its stores that sold firearms caused a statistically significant reduction in the suicide rate for counties in which Walmart did not subsequently resume firearms sales. (shrink)

Este artigo visa apresentar as relações entre as religiões e o Estado no Brasil evitando um enquadramento teleológico e normativo, onde um modelo universal sirva de paradigma. Para tal, busca construir um mosaico de configurações diferenciadas que expressam situações de laicidade desiguais, mas convivendo entre si no país. Visa então, apresentar a própria noção de laicidade, tal como foi apropriada no Brasil, enquanto um processo que envolve conflitos, negociações e acordos em marchas e contra-marchas. Isto se dá através da interação (...) de atores sociais, sejam eles quadros religiosos da Igreja Católica, evangélicos, pentecostais e das religiões afro-brasileiras, ou setores organizados da sociedade civil e agentes estatais do sistema político e jurídico. As controvérsias em que estes atores sociais religiosos e laicos estão envolvidos abrangem um conjunto de temas, que vão desde aqueles que prefiguram uma retração da religião como descriminalização do aborto, união civil de homossexuais, inclusão dos direitos sexuais e reprodutivos no rol dos Direitos Humanos, até os que implicam na sua promoção como, o ensino religioso na escola pública e a presença de símbolos religiosos em repartições e fóruns estatais. Por fim, como não existe nenhuma definição normativa pré-existente do que seja laicidade, o que o texto postula é que, pelo caráter polissêmico que adquiriu no Brasil, esta noção é sempre invocada pelos segmentos em disputa - laicos e religiosos - de acordo com suas concepções e interesses próprios. (shrink)