The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (...) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described. (shrink)
“Offsetting” habitat destruction has widespread appeal as an instrument for balancing economic growth with biodiversity conservation. Requiring proponents to pay the nontrivial costs of habitat loss encourages sensitive planning approaches. Offsetting, biobanking, and biodiverse carbon sequestration schemes will play an important role in conserving biodiversity under increasing human pressures. However, untenable assumptions in existing schemes are undermining their beneﬁts. Policies that allow habitat destruction to be offset by the protection of existing habitat are guaranteed to result in further loss of (...) biodiversity. Similarly, schemes that allow trading the immediate loss of existing habitat for restoration projects that promise future habitat will, at best, result in time lags in the availability of habitat that increases extinction risks, or at worst, fail to achieve the offset at all. We detail concerns about existing approaches and describe how offsetting and trading policies can be improved to provide genuine beneﬁts for biodiversity. Due to uncertainties about the way in which restored vegetation matures, we propose that the biodiversity bank should be a savings bank. Accrued biodiversity values should be demonstrated before they can be used to offset biodiversity losses. We provide recommendations about how this could be achieved in practice. (shrink)
As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted (...) a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male, white, between 50 and 69 years old, of non-Hispanic origin, and of Roman Catholic faith. Nearly half were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making, goals of care/treatment, and end-of-life. More specifically, capacity, patient’s wishes/autonomy, and surrogate decision maker were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment, patient wishes/autonomy, and capacity. Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field. (shrink)
This book presents a sympathetic yet critical treatment of the major philosophical attempts to define a viable project for philosophy in the face of historical changes. McCarthy, then, proposes a comprehensive, critical, and methodological strategy of epistemic integration that fully respects the progressive and pluralistic character of contemporary science and common sense. The programs of Frege, Husserl, Wittgenstein, Carnap, Sellers, Dewey, Quine, and Rorty are carefully presented and an assessment is made of their merits and limitations. This assessment results in (...) a defense of Lonergan’s integrative strategy — a nuanced philosophical strategy around which a gathering center could be built. McCarthy presents Lonergan’s work as containing the firm outline and partial execution of a philosophical project continuous with philosophy’s historic purposes and equal to the exigences of the present. The book examines a broad range of seminal topics and, after extended dialectical treatment of them, develops a coherent account of their interdependence. These topics include psychologism, intentionality, the limits of naturalism, semantical and epistemic realism, historical belonging, epistemic invariance, foundational analysis, the limitation of logic and of the linguistic turn, generalized empirical method, the interdependence of mind and language, the interplay of nature and history, and the critical appropriation of tradition. (shrink)
This critical study of Arendt explores the sources and dangers of political alienation in the West from the citizen republics of classical antiquity to the consumer societies of modern liberal democracies. It is a sympathetic appraisal of the high promise and great perils of the political life.
In memoriam of Vernon Venable, American philosopher who for four decades was a master teacher in the history of Western philosophy, author of an important study of Marx, and the seminal spirit in the development and flourishing of the program in philosophy at Vassar College.
Summary 1. Ecologists and conservation biologists consider many issues when designing a field study, such as the expected value of the data, the interests of the study species, the welfare of individual organisms and the cost of the project. These different issues or values often conflict; however, neither animal ethics nor environmental ethics provides practical guidance on how to assess trade-offs between them. -/- 2. We developed a decision framework for considering trade-offs between values in ecological research, drawing on the (...) field of ecological ethics. We used a case study of the population genetics of three frog species, in which a researcher must choose between four methods of sampling DNA from the study animals. We measured species welfare as the reduction in population growth rate following sampling, and assessed individual welfare using two different definitions: (i) the level of suffering experienced by an animal, and (ii) the level of suffering combined with loss of future life. -/- 3. Tipping the tails of tadpoles ranked as the best sampling method for species welfare, while collecting whole tadpoles and buccal swabbing of adult frogs ranked best for the first and second definitions of individual welfare, respectively. Toe clipping of adult frogs ranked as the worst sampling method for species welfare and the first definition of individual welfare, and equal worst for the second definition of individual welfare. -/- 4. When considering species and individual welfare simultaneously, toe clipping was clearly inferior to the other sampling methods, but no single sampling method was clearly superior to the other three. Buccal swabbing, collecting tadpoles and tail tipping were all preferred options, depending on the definition of individual welfare and the level of precision with which we assessed species welfare. -/- 5.Synthesis and applications. The decision framework we present can be used by ecologists to assess ethical and other trade-offs when planning field studies. A formal decision analysis makes transparent how a researcher might negotiate competing ethical, financial and practical objectives. Defining the components of the decision in this way can help avoid errors associated with human judgement and linguistic uncertainty. (shrink)
DURING THE PAST TWO HUNDRED YEARS, uncertainty and suspicion about the philosophical enterprise have become acute. The educated public is confused about the intellectual and cultural importance of philosophy, and philosophers themselves are divided on its theoretical purpose and meaning. There are, to be sure, specifically philosophical sources of this condition. They include Kant’s critique of traditional metaphysics, the logical positivists’ debunking of ethics and theology, Wittgenstein’s restrictions on the scope of meaningful discourse, Richard Rorty’s call for an end to (...) epistemology, and the deconstructionist attempt to envisage a postphilosophical world. Yet it would be a mistake to assume that the unease of philosophers is solely the result of an intramural debate. The practice of philosophy has always been responsive to the cultural context in which it occurs. The extended crisis of philosophy through the last two centuries is the natural reflection of an ongoing crisis in modernity. (shrink)
Catholic health care has long been a key place where the Church embodies its social doctrine. However, the moral methodology that shapes Catholic bioethics relies on an act-based approach to decision making, which is rooted in the pre–Vatican II manualist tradition, focusing primarily on clinical issues related to the beginning and end of life. This essay argues that given the doctrinal status of Catholic social thought, Catholic bioethics must revisit its scope and methodology. It proceeds in three steps: a meta-analysis (...) of traditional Catholic bioethics, validating the claim made above; an overview of the limited literature published since 1980 engaging Catholic bioethics and CST; and a map of a Catholic bioethics informed by CST generated from a dual starting point. The essay concludes by focusing on both the places where marginalized persons encounter Catholic health care and the ethical issues presented, including race, health care disparities, immigration status, and gender inequality, as well as the interrelated perspective of the common good, expanding the array of issues to include environmental degradation, unions, health care financing, and more. (shrink)