Medicine and Ethics in Black Women's Speculative Fiction engages the complex nexus of black women's health, the fraught history of medicine as it relates to black women, and the problems with the inconsistent application of medical ethics that should concern us all through the lens of black women's literary speculation.

My own ongoing reflection on the Polanyian understanding of knowing leads me to recommend that we help people acknowledge and reaccredit authority as a key feature of all human knowing. This recommendation I support in this essay by showing the following. First, I argue that reliance on authority is unavoidable. The Polanyian model, along with the complementary insights of a few others, and reflection on human experience, together show that human knowledge is what it is only by virtue of its (...) normative component. Such normativity, I argue, requires persons as mentors and as recipients. Second, I describe some of the ins and outs of responsible reliance on authority in a way that I hope will make it a more palatable and delightful prospect, and will encourage its skillful employment. I believe that this message offers much needed epistemological therapy for philosophy and ordinary people today. (shrink)

After briefly summarizing Blythe Clinchy’s account of connected knowing as a knowing procedure distinguishable from separate knowing and subjectivism, I draw comparisons between it and certainfeaturesof Polanyi’s epistemology. Connected knowing and Polanyi’s indwelling have much in common. Polanyian destructive analysis comparesfavorably with separate knowing, and they concur in the detrimental restriction of knowledge to that procedure. Neither indwelling nor connected knowing should be gender-specific, though their de facto gender-specificity may be challenged along with all the other false dichotomies which are (...) the fall-out of an overweening objectivist ideal.My own experience ofdrawing on Polanyi’s insights to shape my own teaching practices confirm and help to elucidate the implications of revised epistemology for the classroom. Also, my own work developing covenant epistemology underscores and develops the idea of connected knowing. I give practical examples of personal classroom practices. Finally, I offer further comments in response to Clinchy’s collection of quotations regarding the college classroom. (shrink)

This response to papers on my 2003 book, Longing to Know, presented at the Polanyi Society’s November 2004 meetings, addresses two primary concerns about the book’s argument: first, that the book’s argument depends on an inappropriately unquestioned commitment to the authority of Scripture that falls short of the adjustment required by modern higher critical biblical scholarship; and second, that the book’s argument implies a religious exclusivism that overlooks the fact that the model of knowing it defends suits competing religious positions (...) equally well. I argue that LTK’s strategy is more sophisticated than has been represented, and that the commitment to Scripture as an authoritative guide in knowing God, as over against the commitment to modem higher critical scholarship, may be reasonably justified as a consistent elucidation of the Polanyian model of knowing. I argue that, indeed, the Polanyian model of knowing may be applied to or by competing religious claims, where the claim that we must treat all such claims as having equal validity must itself be treated as a religious claim. In fact, Polanyi’s argument about competing scientific claims makes more sense of how we may (yea, must) maintain the rightness of our own position while acknowledging respectfully the disagreements of others. (shrink)

This essay introduces Michael Polanyi’s work through contrasting his innovative epistemology of subsidiary-focal integration with key distinctives of Christian analytic philosopher Alvin Plantinga. Polanyi’s contrasting proposals helpfully bring to light shaping assumptions of the analytic tradition, contributing creatively to a larger common agenda. Polanyi disputes the unexamined assumption that the simplest epistemic experience is a focally apprehended “find-myself-believing” that is explicitly and propositionally expressed. I also contrast the two regarding infallibilism, foundationalism, externalism, justification, epistemic duty, creative antirealism, and ways of (...) tapping Calvin’s notion of the sensus divinitatis. (shrink)

A reengagement of my 1983 dissertation, this essay describes and amplifies the commitment to realism presupposed by Michael Polanyi’s alternative model of knowing, recommending its value for thought and life. The idea of contact with reality replaces an unworkable traditional notion of correspondence. Truth bears indeterminately on reality and thus its assessment is ultimately unspecifiable. We assess successful contact by our anticipation of the discovery’s indeterminate future manifestations (IFM Effect, the reality criterion) as well as the radicality of the integrative (...) coherence achieved (the integrative criterion). Polanyi’s realism offers grounds for a critique of postmodernism. Alternative concepts of truth and progress as well as the value of the analytic method, are examined in light of the Polanyian model. (shrink)

Our model of haptic object recognition points to the importance of material, as well as geometric properties of objects. Collectively, these can elicit a recognition response after an initial contact, without sequential exploration. This model suggests a revision of the authors' proposals, which takes into account an individual's intention and the extent of exploratory movement.

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

Conflicts of interest. None to report. Despite widespread acceptance in the United States of neurological criteria to determine death, clinicians encounter families who object, often on religious grounds, to the categorization of their loved ones as “brain dead.” The concept of “reasonable accommodation” of objections to brain death, promulgated in both state statutes and the bioethics literature, suggests the possibility of compromise between the family’s deeply held beliefs and the legal, professional and moral values otherwise directing clinicians to withdraw medical (...) interventions. Relying on narrative to convey the experience of a family and clinical caregivers embroiled in this complex dilemma, the case analyzed here explores the practical challenges and moral ambiguities presented by the concept of reasonable accommodation. Clarifying the term’s meaning and boundaries, and identifying guidelines for its clinical implementation, could help to reduce uncertainty for both health care professionals and families and, thereby, the incremental moral distress such uncertainty creates. (shrink)

This review critically examines the current state of the science on the concept of family caregiver–care receiver mutuality, summarizes accomplishments and gaps and identifies directions for future theory development and research. Mutuality between family caregivers and care receivers is of increasing interest to researchers. However, no analysis of the current state of the science of this important concept has been published. Our literature search revealed 34 research articles that met inclusion criteria. The studies were assessed in terms of conceptualization of (...) mutuality, instrument development, populations studied, research designs and methods and findings. Significant scientific progress during the past 30 years includes the development of clear definitions and new instruments, expansion of research beyond the clinical populations in which mutuality was first studied, the use of a variety of research designs, and increasingly sophisticated methods of data analysis. Growing evidence suggests that mutuality is associated with caregiver emotional health outcomes and may decrease over time in the context of chronic illness. Directions for future research include development of new theoretical frameworks grounded in relational theory, development of theory on the dynamics of mutuality over time, exploration of mutuality in diverse cultures and populations, and intervention studies aimed at enhancing mutuality. (shrink)

This special volume of Studies in Christian Ethics constitutes the most significant continuation to date of Christian social ethics in the tradition of Ronald Preston. It brings together leading scholars and new voices in the field from around the world, covering a broad range of contemporary issues, including globalisation, poverty, feminism, civil society, economics and religious pluralism.

Welfare science has built its foundations on veterinary medicine and thus measures of health. Since bottlenose dolphins (Tursiops truncatus) tend to mask symptoms of poor health, management in captivity would benefit from advanced understanding on the links between health and behavioural parameters, and few studies exist on the topic. In this study, four representative behavioural and health measures were chosen: health status (as qualified by veterinarians), percentage of daily food eaten, occurrences of new rake marks (proxy measure of social activity), (...) and willingness to participate (WtP) in Positive Reinforcement Training sessions as qualitatively measured by their caretakers. These data were collected multiple times a day, every day over the course of a year from a multi-facility, large sample size (ndolphins= 51), allowing powerful analyses of the relationships between measures. First, it was found that dolphins with a higher WtP score also had a significantly better health status, ate a higher percentage of their daily food, and a lower occurrence of new rake marks. In addition, the WtP score was significantly lower up to 3 days before the weekly veterinary diagnosis of a decrease in health state; the percentage of daily food eaten and new rake mark measures did not show any significant change before such a diagnosis. These results suggest that WtP in training sessions is a potential behavioural measure of dolphin welfare, and an indicator of early changes in the dolphins’ health state. We therefore suggest measurement of WtP as a more practical and non-invasive tool to support veterinary care and general management. More work needs to be conducted to elucidate the influence of social behaviour on health, and to identify other potential welfare indicators, but this long-term study has shown that qualitative measures can be both practical and valid when assessing dolphin welfare. (shrink)

We describe and analyze 13 cases handled by our ethics consultation service (ECS) in which families requested continuation of physiological support for loved ones after death by neurological criteria (DNC) had been declared. These ethics consultations took place between 2005 and 2013. Patients’ ages ranged from 14 to 85. Continued mechanical ventilation was the focal intervention sought by all families. The ECS’s advice and recommendations generally promoted “reasonable accommodation” of the requests, balancing compassion for grieving families with other ethical and (...) moral concerns such as stewardship of resources, professional integrity, and moral distress. In cases we characterized as finitegoal accommodation, a “reasonable accommodation” strategy proved effective in balancing stakeholders’ interests and goals, enabling steady progress toward resolution. When a family objected outright to a declaration of DNC and asked for an indefinite accommodation, the “reasonable accommodation” approach offered clinicians little practical direction, and resolution required definitive action by either the family or the clinical team. Based on our analysis and reflections on these 13 cases, we propose ethically justified and practical guidelines to assist healthcare professionals, administrators, and ECSs faced with similar cases. (shrink)

This special volume of Studies in Christian Ethics constitutes the most significant continuation to date of Christian social ethics in the tradition of Ronald Preston. It brings together leading scholars and new voices in the field from around the world, covering a broad range of contemporary issues, including globalisation, poverty, feminism, civil society, economics and religious pluralism.

Comment by Aaron L. Mackler on “‘Through Her I Too Shall Bear a Child’: Birth Surrogates in Jewish Law” by Elie Spitz Reply by Elie Kaplan Spitz Research Note by G. Scott Davis.

Notion complexe et problématique objet de crainte et de crispation, la stásis renvoie tout autant à la discorde, à la sédition, à la guerre civile, qu'à la division. Loin de lire dans cette équivocité le signe de son indétermination, cette enquête se propose de mettre en lumière l'unité et la cohérence de ce concept dans la philosophie pratique d'Aristote. Sans être banalisée, comment la stásis devient-elle le corrélat direct et explicite de la cité? En quel sens la théorie aristotélicienne rompt-elle (...) avec la tradition grecque, pour laquelle la stásis, figure du mal absolu, constituait pourtant un impensé de la cité grecque? (shrink)

Les atlas linguistiques sont-ils des corpus? Nous voudrions ici montrer pourquoi certains atlas ne sont pas des corpus et comment leur informatisation pourrait, néanmoins, permettre de les exploiter comme tels. Le questionnement auquel font écho ces lignes est celui de la possibilité d’une informatisation de l’Atlas linguistique de la Wallonie (ALW), envisagée dans un premier temps comme l’intégration d’échantillons des publications dans des bases de données, exploitables via une interface de consultation en ligne. Ce travail consisterait à réduire la matière (...) de l’enquête qui avait été enrichie lors de l’édition des matériaux. Cependant, nous voudrions montrer la part d’analyse qu’il est souhaitable de conserver lors de cette réduction. (shrink)

How to engage farmers that have limited formal education is at the foundation of environmentally-sound and equitable agricultural development. Yet there are few examples of curricula that support the co-development of knowledge with farmers. While transdisciplinary and participatory techniques are considered key components of agroecology, how to do so is rarely specified and few materials are available, especially those relevant to smallholder farmers with limited formal education in Sub-Saharan Africa. The few training materials that exist provide appropriate methods, such as (...) compost making, but do not explain relationships and synergies between nutrition, social inequalities, climate change and agroecology. Some food sovereignty and agroecology courses aim at popular political education for those with more formal education. Here we describe the process of development of an innovative curriculum, which integrates agroecology, nutrition, climate change, gender and other dimensions of social equity across 2 weeks of training explicitly for smallholders in southern Africa with limited formal education. The curriculum is highly participatory; we use concepts in popular education, transformative and experiential-based learning, and theatre. It is also integrative; we link agroecology with climate change, human and soil nutrition, gender, and related components of social equity. Developed in partnership with Malawian farmers, community development experts and academics from five countries, the curriculum was piloted with 520 smallholder farming households in Malawi and Tanzania, and evaluated using qualitative techniques. Clashes of language, cultural norms, and terminology were as great of a challenge as agreeing on and conveying technical information, to weave into a coherent whole. However, farmers who participated in the curriculum training demonstrated high interest, comprehension of material and interest in immediate application to their lives. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

How to engage farmers that have limited formal education is at the foundation of environmentally-sound and equitable agricultural development. Yet there are few examples of curricula that support the co-development of knowledge with farmers. While transdisciplinary and participatory techniques are considered key components of agroecology, how to do so is rarely specified and few materials are available, especially those relevant to smallholder farmers with limited formal education in Sub-Saharan Africa. The few training materials that exist provide appropriate methods, such as (...) compost making, but do not explain relationships and synergies between nutrition, social inequalities, climate change and agroecology. Some food sovereignty and agroecology courses aim at popular political education for those with more formal education. Here we describe the process of development of an innovative curriculum, which integrates agroecology, nutrition, climate change, gender and other dimensions of social equity across 2 weeks of training explicitly for smallholders in southern Africa with limited formal education. The curriculum is highly participatory; we use concepts in popular education, transformative and experiential-based learning, and theatre. It is also integrative; we link agroecology with climate change, human and soil nutrition, gender, and related components of social equity. Developed in partnership with Malawian farmers, community development experts and academics from five countries, the curriculum was piloted with 520 smallholder farming households in Malawi and Tanzania, and evaluated using qualitative techniques. Clashes of language, cultural norms, and terminology were as great of a challenge as agreeing on and conveying technical information, to weave into a coherent whole. However, farmers who participated in the curriculum training demonstrated high interest, comprehension of material and interest in immediate application to their lives. (shrink)

BackgroundThe emphasis on impact factors and the quantity of publications intensifies competition between researchers. This competition was traditionally considered an incentive to produce high-quality work, but there are unwanted side-effects of this competition like publication pressure. To measure the effect of publication pressure on researchers, the Publication Pressure Questionnaire (PPQ) was developed. Upon using the PPQ, some issues came to light that motivated a revision.MethodWe constructed two new subscales based on work stress models using the facet method. We administered the (...) revised PPQ (PPQr) to a convenience sample together with the Maslach Burnout Inventory (MBI) and the Work Design Questionnaire (WDQ). To assess which items best measured publication pressure, we carried out a principal component analysis (PCA). Reliability was sufficient when Cronbach’s alpha > 0.7. Finally, we administered the PPQr in a larger, independent sample of researchers to check the reliability of the revised version.ResultsThree components were identified as ‘stress’, ‘attitude’, and ‘resources’. We selected 3 × 6 = 18 items with high loadings in the three-component solution. Based on the convenience sample, Cronbach’s alphas were 0.83 for stress, 0.80 for attitude, and 0.76 for resources. We checked the validity of the PPQr by inspecting the correlations with the MBI and the WDQ. Stress correlated 0.62 with MBI’s emotional exhaustion. Resources correlated 0.50 with relevant WDQ subscales. To assess the internal structure of the PPQr in the independent reliability sample, we conducted the principal component analysis. The three-component solution explains 50% of the variance. Cronbach’s alphas were 0.80, 0.78, and 0.75 for stress, attitude, and resources, respectively.ConclusionWe conclude that the PPQr is a valid and reliable instrument to measure publication pressure in academic researchers from all disciplinary fields. The PPQr strongly relates to burnout and could also be beneficial for policy makers and research institutions to assess the degree of publication pressure in their institute. (shrink)

En contexte de protection de la jeunesse, dans plusieurs situations, il arrive que le développement d’un lien d’attachement ne puisse s’établir suite à du rejet, de l’abandon ou par l’incapacité des parents à reconnaître ou répondre aux besoins de l’enfant. Dans de telles situations, au Québec, on envisage de plus en plus une approche « projet de vie » pour l’enfant avec l’objectif de mettre fin à l’ambivalence et au vide affectif, ceci dans des délais qui ne compromettent pas sa (...) capacité de se développer harmonieusement. Dans cette perspective, nous présentons ici les résultats d’une étude exploratoire qui a pour objectif de dresser un premier portrait des jeunes pour qui un « projet de vie » fut élaboré dans sept centres jeunesse du Québec. (shrink)

The life, works, and philosophy of rabbi Hasdai Crescas.

BackgroundStructured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or not stating (...) how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.MethodsThe ACCORD project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.DiscussionThe ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes. (shrink)

L'auteure, riche de son expérience de scripte cinéma, analyse l'organisation spatio-temporelle des éléments constituants un film de fiction pour définir le concept de continuité apparente. Celui-ci est ensuite réinvesti dans l'étude de la stéréoscopie au cinéma. Ces deux notions sont à l'origine de la création de deux courts-métrages en 3D visant à les réunir.

This paper is about love of one’s neighbour near and far given humanity’s division into nations. The primary dialogue partner is Peter Singer and his preference utilitarian approach to moral reasoning wherein the challenge is to count the welfare of individuals impartially, regardless—or, at least, with far less regard than is often given—of divisions into nation-states. The claim is made that, despite the considerable and proper challenges from Singer and other so-called new cosmopolitans, it remains possible and, indeed, necessary at (...) the present time for Christian people to work with an account of nation and nationhood as permitted within divine providence. This claim is cast in terms of traditional Christian teaching about the order of love (L. ordo amoris). (shrink)

This article tests the proposition that new weapons technology requires Christian ethics to dispense with the just war tradition (JWT) and argues for its development rather than dissolution. Those working in the JWT should be under no illusions, however, that new weapons technologies could (or do already) represent threats to the doing of justice in the theatre of war. These threats include weapons systems that deliver indiscriminate, disproportionate or otherwise unjust outcomes, or that are operated within (quasi-)legal frameworks marked by (...) accountability gaps. The temptation to abrogate (L. abrogare—repeal, evade) responsibility to the machine is also a moral threat to the doing of justice in the theatre of war. (shrink)

La méthodologie est pertinente pour la science économique, car beaucoup d'économistes se demandent non sans angoisse si leur objet est une science, ou l'amorce d'une science, ou bien désirent ardemment imiter les sciences. Ce texte donne un bref aperçu des développements en philosophie des sciences, en général, et plus particulièrement en ce qui concerne l'economie. Partant de problèmes liés à l'échec de tentatives pour établir l'asymétrie dans ces domaines, il s'en saisit pour faire mouvement vers la sociologie de la connaissance (...) scientifique et son appréhension du principe de symétrie, théme inspiré par l'intérêt croissant que les universitaires travaillant sur les sciences portent à la culture et à la pratique scientifiques. Réagissant à ce mouvement, ceux qui s'interessent à la méthodologie économique commencent à engager des études d'histoire de la science économique très pointues, essayant d'éviter une histoire qui donnerait dans le style « Whig », consistant à voir dans les développements de l'economie un progrès inéluctable vers une analyse économique sans cesse améliorée. Plutôt que de se livrer à une description du savoir économique, ils proposent une illustration de ce qui lui est arrivé, en le rapportant à la présence d'économistes dans uncontexte à facettes multiples de personnes et d'idees. Plutôt que de fournir des rationalisations après-coup, ils font une analyse historique de certaines négociations et alliances mouvantes ayant des retombées sur la science économique. Travaux qui, tels qu'ils sont discutés dans ce texte, doivent être encouragés, car ils sont en symétrie avec les changements de la science économique. (shrink)