Teaching ethics is crucial to health sciences education. Doing it well requires a willingness to engage contentious social issues. Those issues introduce conflict and risk, but avoiding them ignores moral diversity and renders the work of ethics education irrelevant. Therefore, when (not if) contentious issues and moral differences arise, they must be acknowledged and can be addressed with humility, collegiality, and openness to support learning. Faculty must risk moments when not everyone will “feel safe,” so the candor implied in psychological (...) safety can emerge. The deliberative and social work of ethics education involves generous listening, wading into difference, and wondering together if our beliefs and arguments are as sound as we once thought. By forecasting the need for candid engagement with contentious issues and moral difference, establishing ground rules, and bolstering due process structures for faculty and students, a riskier and more relevant ethics pedagogy can emerge. Doing so will prepare everyone for the moral diversity they can expect in our common life and in practice. (shrink)

The aim of this study was to initiate the exploration of debiasing methods applicable in real-life settings for achieving lasting improvement in decision making competence regarding multiple decision biases. Here, we tested the potentials of the analogical encoding method for decision debiasing. The advantage of this method is that it can foster the transfer from learning abstract principles to improving behavioral performance. For the purpose of the study, we devised an analogical debiasing technique for 10 biases (covariation detection, insensitivity to (...) sample size, base rate neglect, regression to the mean, outcome bias, sunk cost fallacy, framing effect, anchoring bias, overconfidence bias, planning fallacy) and assessed the susceptibility of the participants ( N = 154) to these biases before and 4 weeks after the training. We also compared the effect of the analogical training to the effect of ‘awareness training’ and a ‘no-training’ control group. Results suggested improved performance of the analogical training group only on tasks where the violations of statistical principles are measured. The interpretation of these findings require further investigation, yet it is possible that analogical training may be the most effective in the case of learning abstract concepts, such as statistical principles, which are otherwise difficult to master. The study encourages a systematic research of debiasing trainings and the development of intervention assessment methods to measure the endurance of behavior change in decision debiasing. (shrink)

Neuropalliative care developed to address the needs of patients living with life‐limiting neurologic disease. One critical consideration is that disease‐related changes to cognition, communication, and function challenge illness experiences and care practices. We conducted an ethnography to understand neuropalliative care as a phenomenon; how it was experienced, provided, conceptualized. Personhood served as our conceptual framework; with its long philosophical history and important place in nursing theory, we examined the extent to which it captured neuropalliative experiences and concerns. Personhood contextualized complex (...) losses, aligning the impact of functional and relational changes. Cognition, communication, and functional alterations stretched conceptions of personhood, insinuating it can be relational, fluid, adaptive. Although normative conceptions of personhood guided research and decision‐making, ethical considerations suggested personhood could be transformed, remade. We consider the implications of our findings through three themes. First, we examine how literature on illness experience fails to integrate the realities of people living with and dying from neurologic disease; we counter this by interrogating the concept of experience. Second, we turn to Ricoeur's work on recognition to illuminate relational conceptions of personhood to inform care practices. Finally, we reflect on how personhood can bridge the gap left by functional changes, enhance relational engagement, and promote dignity at the end of life. (shrink)

We explore how the Sarbanes–Oxley Act of 2002 created pressure for firms to take more visible and costly corrective action following the announcement of an earnings restatement. Building on theory about focusing events, the institutional effects of legislative change, and the agenda-setting role of the media, we propose that Sarbanes–Oxley created reactive normative pressure on firms that announce earnings restatements, increasing the likelihood of CEO replacement in their aftermath. We theorize that Sarbanes–Oxley changed the meaning—and therefore the impact—of media coverage (...) of earnings restatements. Our findings show that firm behavior after Sarbanes–Oxley did change in ways that are consistent with the intent of the legislation: to increase executives’ accountability for the reliability of their firms’ financial statements. Moreover, we show this change is a result both of the direct effect of the legislation on increasing CEO accountability as well as through intensifying the effect of the media spotlight on misconduct. (shrink)

The Norwegian National Committee for Research Ethics inScience and Technology (NENT), collaborating with The NorwegianFisherman''s Association and The Research Council of Norway,started in 1999 a project aiming at an ethical assessment of Norwegian fisheries for the year 2020. The project was to preparethe ground for ethical debate in and of the fishery sector inview of pending important decisions on long term strategies. Thispaper has its focus on the method used for achieving these aims,rather than the substantive results concerning the fisheries. (...) Amethod was developed for this purpose, called the ethicalscenario process. This included the construction of scenarios forthe future of Norwegian fisheries, using an ethical matrix for evaluating strategies, and organizing a ``value workshop'''' whereparticipants from different stakeholder groups came together todo ethical evaluations. The positive achievements and theshortcomings of this method are discussed in this paper. The useof an ethical matrix was meant to combine a participatory approachwith insights from theoretical ethics. The project revealedinherent tensions between these two objectives. Possible ways ofdealing with this tension are indicated, but in general a goodgrasp of the socio-political context might be the best guardianagainst the possible pitfalls involved in such an approach. (shrink)

Research on the cognitive consequences of bilingualism typically proceeds by labeling participants as “monolingual” or “bilingual” and comparing performance on some measures across these groups. It is well-known that this approach has led to inconsistent results. However, the approach assumes that there are clear criteria to designate individuals as monolingual or bilingual, and more fundamentally, to determine whether a communication system counts as a unique language. Both of these assumptions may not be correct. The problem is particularly acute when participants (...) are asked to classify themselves or simply report how many languages they speak. Participants' responses to these questions are shaped by their personal perceptions of the criteria for making these judgments. This study investigated the perceptions underlying judgments of bilingualism by asking 528 participants to judge the extent to which a description of a fictional linguistic system constitutes a unique language and the extent to which a description of a fictional individual's linguistic competence qualifies that person as bilingual. The results show a range of responses for both concepts, indicating substantial ambiguity for these terms. Moreover, participants were asked to self-classify as monolingual or bilingual, and these decisions were not related to more objective information regarding the degree of bilingual experience obtained from a detailed questionnaire. These results are consistent with the notion that bilingualism is not categorical and that specific language experiences are important in determining the criteria for being bilingual. The results impact interpretations of research investigating group differences on the cognitive effects of bilingualism. (shrink)

To explore the limits of quantification as a form of rationalization, we examine a rare case of dequantification: race-based affirmative action in undergraduate admissions at the University of Michigan. Michigan adopted a policy of holistically reviewing undergraduate applications in 2003, after the US Supreme Court ruled unconstitutional its points-based admissions policy. Using archival and ethnographic data, we trace the adoption, evolution, and undoing of Michigan’s quantified system of admissions decision-making between 1964 and 2004. In a context in which opponents of (...) the system had legal avenues to engage a powerful outside authority, we argue that three internal features of the University’s quantified admissions policy contributed to its demise: its transparency, the instability of the categories it quantified, and the existence of qualitative alternatives. Our analysis challenges the presumed durability and inevitability of quantification by identifying its vulnerabilities and suggests that quantification should be understood as a matter of degree rather than a simple binary. (shrink)

This book presents a multidisciplinary perspective on chance, with contributions from distinguished researchers in the areas of biology, cognitive neuroscience, economics, genetics, general history, law, linguistics, logic, mathematical physics, statistics, theology and philosophy. The individual chapters are bound together by a general introduction followed by an opening chapter that surveys 2500 years of linguistic, philosophical, and scientific reflections on chance, coincidence, fortune, randomness, luck and related concepts. A main conclusion that can be drawn is that, even after all this time, (...) we still cannot be sure whether chance is a truly fundamental and irreducible phenomenon, in that certain events are simply uncaused and could have been otherwise, or whether it is always simply a reflection of our ignorance. Other challenges that emerge from this book include a better understanding of the contextuality and perspectival character of chance (including its scale-dependence), and the curious fact that, throughout history (including contemporary science), chance has been used both as an explanation and as a hallmark of the absence of explanation. As such, this book challenges the reader to think about chance in a new way and to come to grips with this endlessly fascinating phenomenon. (shrink)

The Holocaust takes on a riveting immediacy in these true stories of the everyday, understated heroism that saved thousands of Jews from annihilation at the hands of the Third Reich. Combining personal interviews with contemporary and vintage photographs, To Save a Life pairs the stories of a handful of rescuers with those of people they saved. Ellen Land-Weber creates a moving, multidimensional picture of the evasive strategies and heartstopping close calls that filled the years of the Holocaust for both (...) rescuers and rescued. In paperback for the first time, the rescues narrate their growing awareness of the tightening circle of Nazi terror, their experiences in hiding, often being shunted from one safehouse to another, and their hair's-breadth separation from friends and family who did not escape. Promotional Information: Life-saving acts of heroism by ordinary people in the face of Nazi tyranny. (shrink)

The philosophy of family‐centered care (FCC) promotes partnerships between families and staff to plan, deliver, and evaluate services for children and has been officially adopted by a majority of pediatric hospitals throughout North America. However, studies indicated that many parents have continued to be dissatisfied with their decision‐making roles in their child's care. This is particularly salient for parents of children with chronic ongoing complex health problems. These children are dependent upon medical technology and require frequent hospitalizations during which parents (...) must contribute to difficult decisions regarding their child's care. Given this clinical issue, an alternative theoretical perspective was explored to redress this problem. Pierre Bourdieu's theoretical concepts of field, capital, and habitus were used to analyze the hierarchical relationships in pediatric acute care hospitals and to design a briefing intervention aimed at improving parents' satisfaction with decision making in that health care setting. (shrink)

The practice of viticulture in Israelite culture is the focus of Walsh's investigation. Viticulture, no less than drinking, marked the social sphere of Israelite practitioners, and so its details were often enlisted to describe social relations in the Hebrew Bible.

In this special issue of _difference_s, leading feminist theorists acknowledge Derrida’s contribution to feminist theory, discuss the crucial place of difference in both Derridian deconstruction and feminist theory, and reflect on the ethical, professional, and epistemological implications of Derrida’s thought for the discipline of women’s studies. In bringing together major feminist critics whose work has been touched by the writings of Derrida, this issue both pays tribute to and reflects upon Derrida’s ideas. Among the essayists included, Jane Gallop considers Derrida’s (...) writings on Levinas; Judith Butler reads Derrida’s final interview in _Le Monde_ in 2004; Elizabeth Grosz signals Derrida as a rare philosopher for whom sexual difference was crucial; Gayatri Chakravorty Spivak explores the figure of the mother’s child in Derrida, focusing on the critique of reproductive heteronormativity and the question of agency in feminism; and Joan Wallach Scott argues for the importance of critique in the academy. The issue also includes an edited transcription of a vibrant discussion between feminist theorists and Derrida called “Women in the Beehive: A Seminar with Jacques Derrida,” which took place at Brown University’s Pembroke Center for Teaching and Research on Women in 1984. _Contributors_. Fran Bartkowski, Anne-Emmanuelle Berger, Susan Bernstein, Judith Butler, Pheng Cheah, Drucilla Cornell, Jane Gallop, Elizabeth Grosz, Peggy Kamuf, Christie McDonald, Joan Wallach Scott, Gayatri Chakravorty Spivak. (shrink)

Twentieth-century ideologies, from liberalism to fascism, are rooted in humanism—the faith in the sovereignty of human reason and potential that grew out of Renaissance thought and discovery. This special issue asks if it is true that all vestiges of humanism have been dismantled, or whether humanism has taken on new forms. Have new versions of historical analysis and cultural studies reanimated humanist themes? What is posthumanism? These essays examine relationships among structuralism, poststructuralism, and the subject; explore the challenge of anticolonialist (...) critique to the coherence of antihumanism; reconsider the canon of antihumanists such as Heidegger and Foucault, and broach the intractable problems posed by efforts to comprehend the Holocaust, the camps, and ethnic cleansing. _Contributors_. Athena Athanasiou, Etienne Balibar, Mara de Gennaro, Carolyn J. Dean, Brady Thomas Heiner, Lynne Joyrich, Jacques Lezra. (shrink)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based on the well-documented (...) tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed “medically inappropriate” will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

Introduction It is increasingly considered important that people make an autonomous and informed decision concerning colorectal cancer screening. However, the realisation of autonomy within the concept of informed decision-making might be interpreted too narrowly. Additionally, relatively little is known about what the eligible population believes to be a 'good' screening decision. Therefore, we aimed to explore how the concepts of autonomous and informed decision-making relate to how the eligible CRC screening population makes their decision and when they believe to have (...) made a 'good' screening decision. Methods We conducted 27 semi-structured interviews with the eligible CRC screening population. The general topics discussed concerned how people made their CRC screening decision, how they experienced making this decision and when they considered they had made a 'good' decision. Results Most interviewees viewed a 'good' CRC screening decision as one based on both reasoning and feeling/intuition, and that is made freely. However, many CRC screening non-participants experienced a certain social pressure to participate. All CRC screening non-participants viewed making an informed decision as essential. This appeared to be the case to a lesser extent for CRC screening participants. For most, experiences and values were involved in their decision-making. Conclusion Our sample of the eligible CRC screening population viewed aspects related to the concepts of autonomous and informed decision-making as important for making a 'good' CRC screening decision. However, in particular the existence of a social norm may be affecting a true autonomous decision-making process. Additionally, the present concept of informed decision-making with its strong emphasis on making a fully informed and well-considered decision does not appear to be entirely reflective of the process in practice. More efforts could be made to attune to the diverse values and factors that are involved in deciding about CRC screening participation. (shrink)

Apology is arguably the central act of the reparative work required after wrongdoing. Claudia Card’s (1940-2015) analysis of complicity in collectively perpetrated evils moves one to ask whether apology ought to be requested of persons culpably complicit in institutional evils. To better appreciate the benefits of and barriers to apologies offered by culpably complicit wrongdoers, this article examines doctors’ complicity in a practice that meets Card’s definition of an evil, namely, the non-medically necessary, nonconsensual “normalizing” interventions performed on babies born (...) with intersex anatomies. It argues that in this instance, the complicity of doctors is culpable on Card’s terms, and that their culpable complicity grounds rightful demands for them to apologize. (shrink)

In this Chapter I present early Mesopotamian philosophical views and contrast them to En Hedu’Anna’s account of metaphysics, epistemology, ontology, philosophy of religion and her views on several socio-political issues. Through her writings we see her views of the cosmos, of deities, of women’s nature, gender fluidity, justifications for violence, and other significant concepts. Lastly, I summarize her influence and suggest that her work marks a new dawn, a first, for Philosophy.

The Patient Self Determination Act of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient’s preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity. In general, patients are presumed to have DMC. A patient’s DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified or suspected. (...) Physicians and other healthcare professionals working in hospital settings where medical illness is frequently comorbid with depression, adjustment disorders, demoralization and suicidal ideation, can expect to encounter ethical tension when medically sick patients who are also depressed or suicidal request do not resuscitate orders. (shrink)

Recent developments in children's rights have led to increased criticism of the presumption of total incompetency until adulthood, a concept inconsistently defined by state law. Citing proposals from several disciplines, this article calls for increasing actual competency in decision-making through systematic education in conjunction with developmental levels and experience. The elements of informed consent are suggested as one mechanism for learning to make educated decisions in a variety of settings. The treatment of hyperkinetic children is discussed as a case example.

In this seminal study, Barbara Galli explores Rosenzweig's statement that his notes to Halevi's poems exemplify a practical application of the philosophic ...

Confidentiality is a cornerstone of the physician-patient relationship. Breaches of confidentiality in the context of genetic testing are of particular concern for a number of reasons. First, genetic testing reveals information not only about a particular patient, but also about his or her family members. Second,genetic testing can label healthy people as “at risk,” subjecting them to possible stigmatization or discrimination by third parties. Third, as genetic testing becomes more widespread and is incorporated into primary care, breaches of confidentiality might (...) inadvertently occur more frequently because primary care providers may not be trained to understand the uniqueness of genetic information. Until now, genetic services have been provided primarily by medical geneticists and genetic counselors. However, with the proliferation of new genetic presymptomatic and carrier tests, primary care physicians are going to become increasingly involved in genetic testing. Currently, little is known about physicians’ attitudes toward disclosure of confidential genetic information to third parties. (shrink)

Confidentiality is a cornerstone of the physician-patient relationship. Breaches of confidentiality in the context of genetic testing are of particular concern for a number of reasons. First, genetic testing reveals information not only about a particular patient, but also about his or her family members. Second,genetic testing can label healthy people as “at risk,” subjecting them to possible stigmatization or discrimination by third parties. Third, as genetic testing becomes more widespread and is incorporated into primary care, breaches of confidentiality might (...) inadvertently occur more frequently because primary care providers may not be trained to understand the uniqueness of genetic information. Until now, genetic services have been provided primarily by medical geneticists and genetic counselors. However, with the proliferation of new genetic presymptomatic and carrier tests, primary care physicians are going to become increasingly involved in genetic testing. Currently, little is known about physicians’ attitudes toward disclosure of confidential genetic information to third parties. (shrink)

The neuropsychological and functional characterisation of mental state attribution (‘‘theory of mind’’ (ToM)) has been the focus of several recent studies. The literature contains opposing views on the functional specificity of ToM and on the neuroanatomical structures most relevant to ToM. Studies with brain-lesioned patients have consistently found ToM deficits associated with unilateral right hemisphere damage (RHD). Also, functional imaging performed with non-braininjured adults implicates several specific neural regions, many of which are located in the right hemisphere. The present study (...) examined the separation of ToM impairment from other deficits associated with brain injury. We tested 11 patients with unilateral right hemisphere damage (RHD) and 20 normal controls (NC) on a.. (shrink)

First Published in 2005. Routledge is an imprint of Taylor & Francis, an informa company.

During the fall of 2001 (October 22–25), The Norwegian Radiation Protection Authority (NRPA) and the Agricultural University of Norway arranged a consensus conference on the protection of the environment against ionising radiation. The motive for the conference was the need to study the ethical and philosophical basis for protection of nature in its own right. The conference was funded by Nordic Nuclear Safety Research (NKS), in cooperation with the International Union of Radioecology (IUR). The National Committee for Research Ethics in (...) Science and Technology (NENT) was hired as facilitators for the consensus process. This paper will give a brief outline of the aims and method of the conference, distinguishing these from other kinds of consensus conferences. The paper ends with some general reflections on the appropriateness of seeking consensus on ethics-related issues among experts. (shrink)

This article examines the Dobsonian Telescope as an object of material culture, showing how starting with the materiality of a scientific instrument opens up new perspectives that are lost by focusing purely on its instrumentality. It argues that the simple design and homely materials of the Dobsonian telescope, as well as the gestures that it requires from its users, are at the core of its significance to the popularization of amateur astronomy and amateur telescope making.