The ubiquity of family dominated firms in economies worldwide suggests that inquiry into the nature of the ethical frames of these types of firms is increasingly important. In the context of a social exchange approach and the norm of reciprocity, this manuscript addresses social cohesion in a dominant family firm coalition. It is argued that the factors underlying this cohesion, direct versus indirect reciprocity, shape unique attributes of family firms such as intentions for transgenerational sustainability, the pursuit of non-economic goals, (...) and strong interpersonal ties. Exchange structures, represented by direct and indirect reciprocity, lead family and non-family firms toward development of distinctive ethical frames of reference. (shrink)

In this essay, I examine how Plato’s Symposium can be helpful for teachers who are interested in encouraging introductory students to develop a sense of wonder in their early encounters with philosophical texts. Plato’s work is helpful, I argue, in two ways. First, as teachers of philosophy, the Symposium contains important pedagogical lessons for us about the roles of creativity and affectivity in philosophical pedagogy. Second, the dialogue lends itself well to the pedagogical methods that Plato’s work recommends. That is, (...) the Symposium invites students to engage with it in ways that involve them as affective and creative learners. I begin by providing the theoretical basis for my pedagogical approach, which is inspired by phenomenology. Next, I offer my interpretation of the Symposium, indicating what we can learn from the text about how to teach philosophy. And finally, I describe three classroom activities based on Plato’s text that are aimed at accomplishing the pedagogical ends I have outlined. (shrink)

Studies with humans have failed to produce evidence that any direct causal relation exists between the asymmetry of one function in an individual and the asymmetry of a different function in that individual. Without such evidence, factors external to an individual's nervous system, such as social interactions, may play crucial roles in explaining the directions of all asymmetries at all levels.

The dominant unspoken philosophical basis of medical care in the United States is a form of Cartesian reductionism that views the body as a machine and medical professionals as technicians whose job is to repair that machine. The purpose of this paper is to advocate for an alternative philosophy of medicine based on the concept of healing relationships between clinicians and patients. This is accomplished first by exploring the ethical and philosophical work of Pellegrino and Thomasma and then by connecting (...) Martin Buber's philosophical work on the nature of relationships to an empirically derived model of the medical healing relationship. The Healing Relationship Model was developed by the authors through qualitative analysis of interviews of physicians and patients. Clinician-patient healing relationships are a special form of what Buber calls I-Thou relationships, characterized by dialog and mutuality, but a mutuality limited by the inherent asymmetry of the clinician-patient relationship. The Healing Relationship Model identifies three processes necessary for such relationships to develop and be sustained: Valuing, Appreciating Power and Abiding. We explore in detail how these processes, as well as other components of the model resonate with Buber's concepts of I-Thou and I-It relationships. The resulting combined conceptual model illuminates the wholeness underlying the dual roles of clinicians as healers and providers of technical biomedicine. On the basis of our analysis, we argue that health care should be focused on healing, with I-Thou relationships at its core. (shrink)

Contemporary Western societies are obsessed with the “obesity epidemic,” dieting, and fitness. Fat people violate the Western conscience by violating a thinness norm. In virtue of violating the thinness norm, fat people suffer many varied consequences. Is their suffering morally permissible, or even obligatory? In this paper, I argue that the answer is no. I examine contemporary philosophical accounts of oppression and draw largely on the work of Sally Haslanger to generate a set of conditions sufficient for some phenomena to (...) count as oppression, and I illustrate the account’s value using the example of gender oppression. I then apply the account to fat people, examine empirical evidence, and argue that the suffering of fat people counts as oppression. (shrink)

Bluffing, a common and consequential form of competitive behavior, has been comparably ignored in the management literature, even though misleading one's rivals is suggested to be an advantageous skill in a multifaceted and highly competitive environment. To address this deficiency and advance scholarship on competitive dynamics, our study investigates the moral reasoning behind competitive bluffing and, using a simulated market-entry game, examines the performance effects of bluffing. Findings suggest that decision makers' views on the ethicality of bluffing competitors differ from (...) their beliefs on the ethicality of misleading other organizational stakeholders. Analysis also indicates that decision makers who view competitor bluffing as more ethical (less unethical) are more willing to engage in competitive bluffing. Finally, while bluffing is often thought to be an effective business practice, results show that in the context of repeated interaction, bluffing is not conducive to high levels of performance and, in fact, can have undesirable consequences. (shrink)

Objective Standards of care regarding obstetric management of life-threatening anomalies are not defined. It is hypothesised that physicians' management of these pregnancies is variable and influenced by demographic factors. Design A questionnaire was mailed to members of the Society of Maternal–Fetal Medicine with valid US addresses assessing obstetric management of both ‘uniformly lethal’ (eg, anencephaly, renal agenesis) and ‘uniformly severe, commonly lethal’ (eg, trisomy 13 and 18) anomalies. Respondents were asked to answer as if not limited by state/institutional restrictions. Fisher's (...) exact or χ2 tests were used as appropriate and correction made for multiple comparisons in analyses that were not prespecified. Results The response rate was 36% (732/2038). Nearly 100% of respondents discuss termination for both uniformly and commonly lethal anomalies. In continuing pregnancies, with patient request for obstetric non-intervention 99% of providers would comply for either uniformly or commonly lethal anomalies. The majority ‘encourage’ such management, but some were non-directive or discouraged this management. In continuing pregnancies, with patient request for full obstetric intervention the majority of respondents was willing to comply for both uniformly (71%) and commonly (82%) lethal anomalies. While most practitioners ‘discouraged’ full intervention, some were non-directive or encouraged this management. Demographics and severity of anomaly influenced counselling. Conclusion Discrepancies exist regarding the management of life-threatening fetal anomalies. Patients may be offered different options based on practitioner demographics. The majority of physicians comply with patient wishes. Differences were noted when comparing the management of lethal with that of severe commonly lethal anomalies, suggesting that practitioners make a distinction when counselling patients. (shrink)

Despite some improvements in access to evidence-based medications for opioid use disorder, treatment rates remain low at under a quarter of those with need. High costs for brand name products in these medication markets have limited the volume of drugs purchased, particularly through public health insurance and grant programs. Brand firm anti-competitive practices around the leading buprenorphine product Suboxone — including product hops, citizen petitions and Risk Evaluation and Mitigation Strategy abuses — helped to maintain high prices by extending brand (...) exclusivity periods and hindering generic drug entry. Remedies to address costly anti-competitive activities include adoption of the proposed CREATES Act and modernization of the Hatch-Waxman Act by the Congress, and implementation of substantive modifications to the Food and Drug Administration citizen petition filing procedures. Given the persistence of these abuses, prescriptive changes are favorable to the procedural and clarifying steps thus far favored by the federal government. Extrapolating from the 37% price declines attributable to generic entry for buprenorphine tablets in 2011, our calculations suggest that implementing these remedies to facilitate generic competition with Suboxone film would have resulted in savings of approximately $703 million overall and $203 million to Medicaid in 2017. (shrink)

In this classic work, best-selling author Harry Frankfurt provides a compelling analysis of the question that not only lies at the heart of Descartes's Meditations, but also constitutes the central preoccupation of modern philosophy: on what basis can reason claim to provide any justification for the truth of our beliefs? Demons, Dreamers, and Madmen provides an ingenious account of Descartes's defense of reason against his own famously skeptical doubts that he might be a madman, dreaming, or, worse yet, deceived by (...) an evil demon into believing falsely.Frankfurt's masterful and imaginative reading of Descartes's seminal work not only stands the test of time; one imagines Descartes himself nodding in agreement. (shrink)

Different types of consent are used to obtain human biospecimens for future research. This variation has resulted in confusion regarding what research is permitted, inadvertent constraints on future research, and research proceeding without consent. The National Institutes of Health Clinical Center's Department of Bioethics held a workshop to consider the ethical acceptability of addressing these concerns by using broad consent for future research on stored biospecimens. Multiple bioethics scholars, who have written on these issues, discussed the reasons for consent, the (...) range of consent strategies, and gaps in our understanding, and concluded with a proposal for broad initial consent coupled with oversight and, when feasible, ongoing provision of information to donors. This article describes areas of agreement and areas that need more research and dialogue. Given recent proposed changes to the Common Rule, and new guidance regarding storing and sharing data and samples, this is an important and tim.. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: providing transparency; allowing control and authorization; promoting concordance with participants' values; and protecting and promoting welfare interests. Three other functions are systemic or policy focused: promoting trust; satisfying regulatory requirements; and promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Using a sample of 652 college students, we examined several implications of the hypothesis that the shape of the human penis evolved to enable males to substitute their semen for those of their rivals. The incidence of double mating by females appears sufficient to make semen displacement adaptive (e.g., one in four females acknowledge infidelity, one in eight admit having sex with two or more males in a 24-hour period, and one in 12 report involvement in one or more sexual (...) threesomes with two males). We also document several changes in post-ejaculatory behavior (e.g., reduced thrusting, penis withdrawal, loss of an erection) which may have evolved to minimize displacement of the male’s own semen. Consistent with predictions derived from a theoretical model (Gallup and Burch 2006), we discovered that most females report waiting at least 48 hours following an instance of infidelity before resuming sex with their in-pair partners. (shrink)

The resurgence of tuberculosis in the United States is due, in part, to the dismantling of large-scale treatment systems that were a critical part of the disease control effort for the better part of the twentieth century. As the number of cases grows, clinicians, politicians, public health officials and community advocates have grappled with the difficult problem of building systems to care for infected people that are consonant with current knowledge and beliefs about quality care. As an example, the United (...) Hospital Fund’s 1992 report, The Tuberculosis Revival: Individual and Societal Obligations in a Time of AIDS, discussed policies to guarantee adequate treatment that protects patients’ civil rights, needs for special facilities for care of TB patients, and the special problems faced by infected prisoners. This thoughtful report highlighted many areas of social policy that require further examination. (shrink)

A 2011 National Academies of Sciences report called for an “Information Commons” and a “Knowledge Network” to revolutionize biomedical research and clinical care. We interviewed 41 expert stakeholders to examine governance, access, data collection, and privacy in the context of a medical information commons. Stakeholders' attitudes about MICs align with the NAS vision of an Information Commons; however, differences of opinion regarding clinical use and access warrant further research to explore policy and technological solutions.

The resurgence of tuberculosis in the United States is due, in part, to the dismantling of large-scale treatment systems that were a critical part of the disease control effort for the better part of the twentieth century. As the number of cases grows, clinicians, politicians, public health officials and community advocates have grappled with the difficult problem of building systems to care for infected people that are consonant with current knowledge and beliefs about quality care. As an example, the United (...) Hospital Fund’s 1992 report, The Tuberculosis Revival: Individual and Societal Obligations in a Time of AIDS, discussed policies to guarantee adequate treatment that protects patients’ civil rights, needs for special facilities for care of TB patients, and the special problems faced by infected prisoners. This thoughtful report highlighted many areas of social policy that require further examination. (shrink)

During the past decade, patient participation became an important issue in the medical field, and patient participation in biomedical research processes is increasingly called for. One of the arguments for this refers to the specific kind of knowledge, called experiential knowledge, patients could contribute. Until now, participation of patients in biomedical research has been rare, and integration of patients’ experiential knowledge with scientific knowledge—in the few cases it takes place—occurs implicitly and on an ad hoc basis. This is illustrated by (...) describing and analyzing the activities of the German patient group on retinitis pigmentosa. The authors argue that to be able to optimize the use of experiential knowledge of patients in biomedical research, a systematic approach is required. Transdisciplinary research provides such an approach, systematically, explicitly, and deliberately integrating knowledge from different scientific and nonscientific sources. In this article, the concept of transdisciplinarity is elaborated upon. The authors propose a possible procedure, identify necessary conditions and skills, and evaluate the feasibility of its implementation and institutionalization. Finally, the authors introduce a recent research project to further investigate and implement transdisciplinary research in the biomedical field. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics and in vivo nanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

I defend a novel view of how social kinds (e.g., money, women, permanent residents) depend on our mental states. In particular, I argue that social kinds depend on our mental states in the following sense: it is essential to them that they exist (partially) because certain mental states exist. This analysis is meant to capture the very general way in which all social kinds depend on our mental states. However, my view is that particular social kinds also depend on our (...) mental states in more specific ways—some of them causal, others metaphysical. I defend a minimal but metaphysically important notion of essence—one that takes as primary that the essential properties of a kind constitute its identity—and argue that this minimal notion of essence is all that is needed to vindicate my claim that social kinds are essentially mind-dependent. (shrink)

The view that social kinds (e.g., money, migrant, marriage) are mind-dependent is a prominent one in the social ontology literature. However, in addition to the claim that social kinds are mind-dependent, it is often asserted that social kinds are not real because they are mind-dependent. Call this view social kind anti-realism. To defend their view, social kind anti-realists must accomplish two tasks. First, they must identify a dependence relation that obtains between social kinds and our mental states. Call this the (...) Dependence Task. Second, they must show that social kinds are not real because they are mind-dependent. Call this the Anti-Realist Task. In this paper, I consider several different ways of defining the relation that is supposed to obtain between social kinds and our mental states. With respect to each relation, I argue that either it fails to accomplish the Dependence Task, or it fails to accomplish the Anti-Realist Task. As such, anyone who wishes to defend social kind anti-realism must provide an alternative explanation of how social kinds depend on our mental states in a way that impugns their reality. In the absence of such an explanation, there is no reason to endorse social kind anti-realism. (shrink)

Prior research supports the learnability of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Alternative Model of Personality Disorders. However, researchers have yet to compare novice ratings on the AMPD’s Level of Personality Functioning Scale and the 25 pathological personality traits with expert ratings. Furthermore, the AMPD has yet to be examined with the idiographic Shedler-Westen Assessment Procedure. We compared the aggregated AMPD clinical profile of a group of psychology doctoral students who learned the AMPD to high levels (...) of reliability to that of an expert rater using the crucible of the classical case of “Madeline G.” Examination of AMPD and SWAP ratings of “Madeline G.” revealed excellent overall concordance but suggests that novice raters tend to perceive lower levels of personality impairment. (shrink)

Women who are abused by their male intimate partners incur many costs, ranging in severity from fleeting physical pain to death. Previous research has linked the presence of children sired by a woman’s previous partner to increased risk of woman abuse and to increased risk of femicide. The current research extends this work by securing data from samples of 111 unabused women, 111 less severely abused women, 128 more severely abused women, and 26 victims of intimate partner femicide from the (...) Chicago Women’s Health Risk Study to document an ordinal trend in the risk of experiencing more severe forms of violence for women who have children in the household sired by a previous partner. The discussion addresses two potential explanations for this trend and highlights directions for future research. (shrink)

Should monkeys be used in painful and often deadly infectious disease research that may save many human lives? This is the challenging question that Anne Barnhill, Steven Joffe, and Franklin G. Miller take on in their carefully argued and compelling article “The Ethics of Infection Challenges in Primates.” The authors offer a nuanced and even-handed position that takes philosophical worries about nonhuman primate moral status seriously and still appreciates the very real value of such research for human welfare. Overall, they (...) argue for an extension and revision of the recommendations regarding chimpanzee research offered by the Institute of Medicine in 2011; the practical upshot of their argument would allow for infection challenge research for promising interventions for Ebola and Marburg virus diseases but not for smallpox or the common cold. The IOM recommendations regarding chimpanzee research put in motion an exceptionalist policy for this great ape population. Barnhill and colleagues’ proposal would enlarge the scope of that exceptionalism to embrace NHPs other than great apes. But is such exceptionalism warranted? It is not obvious to me either that the more sophisticated capacities of a species as a whole give it greater ethical protections or that less intellectually or socially sophisticated animals ought to therefore receive less protection when it comes to painful experimental interventions. (shrink)