Little is known about how certain patient characteristics can affect the timing of an ethics consultation, which has been hypothesized to affect patient length of stay. This study assessed how specific patient characteristics affect the timing of an ethics consultation, namely, age (over 65 years), race, Medicaid status, the presence of a living will, the presence of a health care proxy, and the absence of decisional capacity. Moving beyond the typical case-series evaluation of an ethics consultation service, this study used (...) an innovative approach to model how predisposing, enabling, and need factors affect health behavior and subsequently affect health outcomes for patients who received an ethics consultation at a Catholic health care system in Oklahoma. (shrink)

Firearm violence in the United States produces over 36,000 deaths and 74,000 sustained firearm-related injuries yearly. The paper describes the burden of firearm violence with emphasis on the disproportionate burden on children, racial/ethnic minorities, women and the healthcare system. Second, this paper identifies factors that could mitigate the burden of firearm violence by applying a blend of key ethical theories to support population level interventions and recommendations that may restrict individual rights. Such recommendations can further support targeted research to inform (...) and implement interventions, policies and laws related to firearm access and use, in order to significantly reduce the burden of firearm violence on individuals, health care systems, vulnerable populations and society-at-large. By incorporating a blended public health ethics to address firearm violence, we propose a balance between societal obligations and individual rights and privileges. (shrink)

In this article, we develop a non-rights-based argument based on beneficence (i.e., the welfare of individuals and communities) and justice as the disposition to act justly to promote equity in health care resource allocation. To this end, we structured our analysis according to the following main sections. The first section examines the work of Amartya Sen and his equality of capabilities approach and outlines a framework of health care as a fundamental human need. In the subsequent section, we provide a (...) definition of health equity based on the moral imperative to guarantee that every individual ought to have the freedom to pursue health goals and well-being. In the later part of the article, we outline a non-right approach to health care based on three pillars: (1) human flourishing, (2) justice as a disposition not a process, and (3) solidarity. (shrink)

Drawing on field data gathered from 1994 to 1996, this article considers tensions in the development of community networks and highlights the decisions that shape particular types of networks. Four key decision points include interface choice, content, interaction, and outreach. Discourse about decision making is often dichotomized around civic and consumer social currents. Civic currents demand text-only interfaces, exclusively non- profit content, full electronic interaction capabilities for everyone, and deep outreach efforts. In contrast, consumer currents push graphical interfaces, the inclusion (...) of profit-making content, limited interaction options, and meso to shallow outreach. While considering the influences of these currents, the article problematizes the dichotomy and considers more specific social influences on decision making. It also suggests specific network decisions that may contribute to greater communications equity. (shrink)

In the _World Library of Educationalists_, international experts themselves compile career-long collections of what they judge to be their finest pieces – extracts from books, key articles, salient research findings, major theoretical and practical contributions – so the world can read them in a single manageable volume, allowing readers to follow the themes of their work and see how it contributes to the development of the field. Mary James has researched and written on a range of educational subjects which (...) encompass curriculum, pedagogy and assessment in schools, and implications for teachers´ professional development, school leadership and policy frameworks. She has written many books and journals on assessment, particularly assessment for learning and is an expert on teacher learning, curriculum, leadership for learning and educational policy. Starting with a specially written introduction in which Mary gives an overview of her career and contextualises her selection, the chapters are divided into three parts: Educational Assessment and Learning Educational Evaluation and Curriculum Development Educational Research and the Improvement of Practice Through this book, readers can follow the different strands that Mary James has researched and written about over the last three decades, and clearly see her important contribution to the field of education. (shrink)

Recently the relevance of the philosophy of Martin Heidegger has been critiqued in nursing literature. However, this critique is based primarily upon an appropriation of Heidegger that does not reflect an understanding of meaning as grounded in temporality. Therefore, this paper aims to (1) explicate Heidegger's grounding of meaning, (2) briefly contrast Heidegger's and Husserl's notions of the origin of meaning, (3) describe how Heidegger was first introduced to nursing, and (4) illustrate through examples from a research study how the (...) philosophy of Heidegger might inform the phenomenological researcher. (shrink)

Traditionally, psychoanalytically oriented clinicians have eschewed a direct focus on symptoms, viewing it as superficial turning away from underlying psychopathology. But this assumption is an artifact of a dated classical approach; it should be reexamined in the light of contemporary relational thinking. So argues Mary Connors in _Symptom-Focused Dynamic Psychotherapy_, an integrative project that describes cognitive-behavioral techniques that have been demonstrated to be empirically effective and may be productively assimilated into dynamic psychotherapy. What is the warrant for symptom-focused interventions (...) in psychodynamic treatment? Connors argues that the deleterious impact of symptoms on the patient's physical and emotional well being often impedes psychodynamic engagement. Symptoms associated with addictive disorders, eating disorders, OCD, and posttraumatic stress receive special attention. With patients suffering from these and other symptoms, Connors finds, specific cognitive-behavior techniques may relieve symptomatic distress and facilitate a psychodynamic treatment process, with its attentiveness to the therapeutic relationship and the analysis of transference-countertransference. Connors' model of integrative psychotherapy, which makes cognitive-behavioral techniques responsive to a comprehensive understanding of symptom etiology, offers a balanced perspective that attends to the relational embeddedness of symptoms without skirting the therapeutic obligation to alleviate symptomatic distress. In fact, Connors shows, active techniques of symptom management are frequently facilitative of treatment goals formulated in terms of relational psychoanalysis, self psychology, intersubjectivity theory, and attachment research. A discerning effort to enrich psychodynamic treatment without subverting its conceptual ground, _Symptom-Focused Dynamic Psychotherapy_ is a bracing antidote to the timeworn mindset that makes a virtue of symptomatic suffering. (shrink)

Volume 20, Issue 10, October 2020, Page 94-96.

Mary Daly had a complicated relationship to the Catholic tradition. While it is commonly assumed that she rejected it thoroughly, this article offers a more nuanced look at the various ways in which it shaped her thinking. What is clear is that she had a decisive impact on the Catholic tradition, indeed on religion in general. Language about the divine, images of deities, human participation in things spiritual will never be the same after her thorough-going feminist critique. Her legacy (...) is multi-faceted like the woman herself. (shrink)

Use of humanities content in American medical education has been debated for well over 60 years. While many respected scholars and medical educators have purported the value of humanities content in medical training, its inclusion remains unstandardized, and the undergraduate medical curriculum continues to be focused on scientific and technical content. Cited barriers to the integration of humanities include time and space in an already overburdened curriculum, and a lack of consensus on the exact content, pedagogy and instruction. Edmund Pellegrino, (...) physician and scholar of the latter twentieth century, spent much of his professional life promoting the value and importance of the humanities in medical education, seeking the best way to incorporate and teach this content in clinically relevant ways. His efforts included the founding of multiple enterprises starting in the 1960s and 1970s to promote human values in medical education, including the Society for Health and Human Values and its Institute on Human Values in Medicine. Regardless of his efforts and those of many others into the current century, the medical humanities remains a curricular orphan, unable to find a lasting home in medical education and training. (shrink)

Mary E. Hunt agrees with Rosemary Radford Ruether’s conclusion that women-church and women priests ‘both have their place in a vision of renewed church and renewed priestly ministry.’ She observes that the ‘either/or’ frame plays into what many feminists have tried to avoid with integrity, namely, setting progressive Catholic women against one another in the public arena. The writer explores the evolving relationship between and among the various feminist individuals and groups that are engaged in this work. She describes (...) how they co-operate to transform kyriarchal Roman Catholicism and meet the needs of the world. (shrink)

Sexual assault cases are challenging for both the patient and provider, particularly given the emotional and logistic overlays in the majority of these cases. In this article we offer sexual assault programs information and areas for consideration when developing a policy addressing sexual assault examinations on patients who are either incapacitated or otherwise unable to consent to examination. This information is based on our experience in creating and implementing such a policy for our program. We also offer the written policy (...) and associated consent form that we designed.The protocol manual for sexual assault medical forensic examinations authored by the Department of Justice actually recommends that each and every sexual assault nurse examiner program have “internal policies based on applicable jurisdictional statutes governing consent for treatment of vulnerable adult patients. In cases of adolescents, the jurisdictional statutes governing consent and access to the exam should be followed.“. (shrink)

This paper provides an analysis of nursing as a knowledgeable discipline. We examined ways in which knowledge operates in the practice of home care nursing and explored how knowledge might be fruitfully understood within the ambiguous spaces and competing temporalities characterizing contemporary healthcare services. Two popular metaphors of knowledge in nursing practice were identified and critically examined; evidence-based practice and the nurse as an intuitive worker. Pointing to faults in these conceptualizations, we suggest a different way of conceptualizing the relationship (...) between knowledge and practice, namely practice as being activated by contextualized knowledge. This conceptualization is captured in an understanding of the intelligent creation of context by the nurse for nursing practice to be ethical and effective. (shrink)

Storytelling, art and craft can be considered aesthetic expressions of identities. Kalahari identities are not fixed, but fluid. Research with present-day Kalahari People regarding their artistic expression and places where it has been, and is still, practised highlights that these expressions are informed by spirituality. This article explores this idea via two Kalahari case studies: Water Stories recorded in the Upington, Kakamas area, as well as research on a specific rock engraving site at Biesje Poort near Kakamas. The importance of (...) the Kalahari People’s spiritual beliefs as reflected in these case studies and its significance regarding their identities and influence on social change and/or community development projects is discussed. The article thus highlights ways in which spirituality can be considered in relation to social change projects that are characterised by partnerships between local community, non-government and tertiary education representatives and researchers and that highlight storytelling as an integral part of people’s spirituality. (shrink)

This essay situates Object Lessons in the contemporary academic spaces of women’s studies in India. A decade ago, Object Lessons offered an extensive critique of identity knowledges in the US academy with a special focus on women’s studies. What might its relevance be in the contemporary Indian context? The institutionalisation of women’s studies in India has been shaped by the resources of the social sciences, with their empirical bent and especially their connection to state and development policy. This makes for (...) specific differences with the US context while many concerns are shared. The essay also looks at how gender as a category has been deployed in specific contexts in contrast to that of “women”, in the light of Wiegman’s cautions over seeking resolutions to particular problems through a preferential treatment of categories. By way of concluding thoughts on the Indian situation, women’s studies in India is hypervisible compared to other identity knowledges. In spite of its marginal and precarious location in the academy, it carries a disproportionate political burden, one that a heterogeneous student body is shouldering in their struggles for a sustainable future. (shrink)

Background: Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives (to implement research protocols and advance science), setting (research facilities), and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether (...) research nurses experience unique ethical challenges distinct from those experienced by nurses in traditional patient-care settings. Research objectives: The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice. Research design: The study utilized a qualitative descriptive design with individual interviews. Participants and research context: Participating nurses (N = 12) self-identified as having experienced ethical challenges during screening. The majority were Caucasian (90%), female (83%), and worked in outpatient settings (67%). Approximately 50% had > 10 years of research experience. Ethical considerations: The human subjects review board approved the study. Written informed consent was obtained. Findings: Predominant themes were revealed: (1) the inability to provide a probable good, or/do no harm, and (2) dual obligations (identity as a nurse vs a research nurse). The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship. Discussion: Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science. Conclusion: Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

One of the core problems with engineering ethics education is perceptual. Although ethics is meant to be a central component of today’s engineering curriculum, it is often perceived as a marginal requirement that must be fulfilled. In addition, there is a mismatch between faculty and student perceptions of ethics. While faculty aim to communicate the nuances and complexity of engineering ethics, students perceive ethics as laws, rules, and codes that must be memorized. This paper provides some historical context to better (...) understand these perceptual differences, and suggests that curriculum constraints are important contributing factors. Drawing on the growing scholarship of student engagement approaches to pedagogy, the paper explores how students can be empowered to effect change in the broader engineering curriculum through engineering ethics. The paper describes a student engagement approach to pedagogy that includes students as active participants in curriculum design—a role that enables them to critically reflect about why ethics is a requirement. Including students in the process of curriculum design leads students to reframe ethics as an integrative tool with the capacity to bring together different engineering departments and build bridges to non-engineering fields. This paper argues that students can and should play an active and important role in relocating ethics from the periphery to the core of the engineering curriculum. (shrink)

Marcella Althaus-Reid's Indecent Theology: Theological Perversions in Sex, Gender and Politics brings a liberationist view to postmodern analysis, a queer eye to Christianity, and a theologian's critique to culture. It marks the beginning of what Hunt hopes will be sustained reflection by Latin American women on the relationship between sexuality and theo-politics.

2021 Catholic Media Association Award first place award in Catholic Social Teaching In The Meal That Reconnects, Dr. Mary McGann, RSCJ, invites readers to a more profound appreciation of the sacredness of eating, the planetary interdependence that food and the sharing of food entails, and the destructiveness of the industrial food system that is supplying food to tables globally. She presents the food crisis as a spiritual crisis—a call to rediscover the theological, ecological, and spiritual significance of eating and (...) to probe its challenge to Christian eucharistic practice. Drawing on the origins of Eucharist in Jesus’s meal fellowship and the worship of early Christians, McGann invites communities to reclaim the foundational meal character of eucharistic celebration while offering pertinent strategies for this renewal. (shrink)

Researchers have recently documented the unexpected opportunities war can present for women. While acknowledging the devastating effects of mass violence, this burgeoning field highlights war’s potential to catalyze grassroots mobilization and build more gender sensitive institutions and legal frameworks. Rwanda and Bosnia-Herzegovina serve as important examples of this phenomenon, yet a closer examination of both cases reveals the limits on women’s capacity to take part in and benefit from these postwar shifts. This article makes two key contributions. First, it demonstrates (...) how the postwar political settlement created hierarchies of victimhood that facilitated new social divisions and fractured women’s collective organizing. Second, it argues that while war creates certain opportunities for women, a revitalization of patriarchy in the aftermath can undermine these gains. Drawing on more than 250 interviews with women in both countries, this article ultimately questions the extent to which postwar mobilization can be maintained or harnessed for genuine gender emancipation. (shrink)

ABSTRACT The criteria for adequate explanation have been the subject of intense debate in the philosophy of social science. This paper examines a variety of explanations of a decade of violence in Kampuchea in order to clarify the dimensions of the Kampuchean tragedy and to challenge both the hypothetico‐deductive and the Verstehen models of explanation central to contemporary debates in the philosophy of social science. Using the Kampuchean case as an example, I suggest that the analyst's propensity to assimilate new (...) information into a tacit, pre‐supposition‐laden conceptual framework contributes to an oversimplification or caricature of the event to be explained. For this reason, no individual explanation of an event can be definitive. An adequate explanation can emerge only from the juxtaposition of and extrapolation from multiple, non‐privileged interpretations representing different methodological and ideological perspectives on the socio‐political event to be explained. (shrink)