For all of the emphasis on quality improvement—as well as the acknowledged overlap between assessment of the quality of healthcare services and clinical ethics—the quality of clinical ethics consultation has received scant attention, especially in terms of empirical measurement. Recognizing this need, the second edition of Core Competencies for Health Care Ethics Consultation identified four domains of ethics quality: (1) ethicality, (2) stakeholders’ satisfaction, (3) resolution of the presenting conflict/dilemma, and (4) education that translates into knowledge. This study is the (...) first, to our knowledge, to directly measure all of these domains. Here we describe the quality improvement process undertaken at a tertiary care academic medical center, as well as the tools developed to measure the quality of ethics consultation, which include post-consultation satisfaction surveys and weekly case conferences. The information gained through these tools helps to improve not only the process of ethics consultation, but also the measurement and assurance of quality. (shrink)

With this issue we initiate the policy of expanding the scope of Tulane Studies in Philosophy to include, in addition to the work of members of the department, contributions from philosophers who have earned advanced degrees from Tulane and who are now teaching in other colleges and universities. The Editor THE LOGIC OF OUR LANGUAGE ROBERT L. ARRINGTON Wittgenstein wrote in the Tractatus that "logic is not a body of doctrine, but a mirror-image of the world. " 1 In line (...) with his suggestion that a proposition is a 'picture', Wittgenstein argued that propositions 'show' the logical structure of the real. He was insistent, however, that "the apparent logical form of a proposition need not be its real one. " 2 As a result of this we can misunderstand the structure of fact. Philosophical problems arise just when "the logic of our language is mis understood. " 3 It is common knowledge that much of this view of logic was rejected by Wittgenstein himself in the Philosophical Investi gations. There we are told that language has no ideal or sublime 4 logic which mirrors the structure of the extra-linguistic world. Consequently, inferences from the structure of language to the structure of that extra-linguistic world are invalid. Reality can be 'cut up' in any of a number of ways by language. Wittgenstein adopted a view of philosophy which would render that discipline a non-explanatory, non-critical study of the multiple ways in which language can be used. (shrink)

The gastrointestinal tract is an asymmetrically patterned organ system. The signals which initiate left‐right asymmetry in the developing embryo have been extensively studied, but the downstream steps required to confer asymmetric morphogenesis on the gut organ primordia are less well understood. In this paper we outline key findings on the tissue mechanics underlying gut asymmetry, across a range of species, and use these to synthesise a conserved model for asymmetric gut morphogenesis. We also discuss the importance of correct establishment of (...) left‐right asymmetry for gut development and the consequences of perturbations in this process. (shrink)

Many private business relationships are increasingly characterized by claims that certain actions should not be permitted since particular right claims are involved. Such claims should be taken seriously, but are they always ethically legitimate? This paper analyzes one context, the use of age as a rating variable in the pricing of automobile insurance, where such claims are made. By identifying, evaluating and assessing the relevant basis for the differentiation, actuarial equity, it is concluded that there is an ethical basis for (...) such a practice. The analysis also provides an equivalent means for considering other such analogous claims where actuarial equity is involved. (shrink)

Typically, the determination of death by neurological criteria follows a very specific protocol. An apnea test is performed with further confirmation as necessary, and then mechanical ventilation is withdrawn with the consent of the family after they have had an opportunity to “say goodbye,” and at such a time to permit organ retrieval (with authorization of the patient or consent of the next of kin). Such a process maximizes transparency and ensures generalizability. In exceptional circumstances, however, it may be necessary (...) to deviate from this protocol in order to spare family members unnecessary suffering and to reduce moral distress felt by clinical staff. It may also be appropriate, we argue, to refrain from even inquiring about organ donation when the next-of-kin is not only certain to refuse, but lacks the decision-making capacity to potentially consent. The case described in this article calls into question generally reliable assumptions about determination of death by neurological criteria, where the best the clinical team could do for the patient and his family was “the least bad option.”. (shrink)

Exploring nursing expertise: nurses talk nursing It has become increasingly important for practitioners to articulate their expertise in modern healthcare settings that demand high levels of accountability and evidence‐based practice. The material presented within this article has been interpreted drawing from discourse analysis1 to help explore the discourses that shape and influence understandings of nursing practice. What we present are extracts from four of the 35 participant nurses who applied to take part in the Royal College of Nursing Institute's Expertise (...) in Practice (pilot) Project (EPP). The material presented is used to provide a starting point for exploring how nurses talk about and construct expertise in nursing practice. The four nurse participants’ clinical practice areas cover palliative care, mental health, intensive care and fertility care. The material reveals high levels of intensity in the nurse–patient relationship, ‘maverick’ nursing practices and ongoing reflexivity. All of these aspects appear to capitalize on expertise as a ‘catalyst’ that alters treatment pathways and maximizes patient‐centred outcomes. Exploring a discourse of nursing expertise exposes the tacit situated nature of professional practice that is heterogeneous and most difficult to articulate and explain. It is proposed that expertise tends to be understood from traditional and dominant discourses of medicine, management and technology. Explaining expertise in practice exposes non‐conventional practice that in itself can be isolating and challenging to the status quo of contemporary health‐care. (shrink)

The role of corporate counsel in the corporate governance process has been long overlooked. This paper uses recent comments by Breeden as the springboard for a discussion of the issues surrounding significant roles for lawyers in corporations. It considers these both from a practical and a theoretical perspective and identifies why it is problematic merely to assume hiring lawyers will ensure good compliance both in terms of legal and ethical obligations.

Introduction : kith, kin, and family / Sally Haslanger and Charlotte Witt Adoption and its progeny : rethinking family law, gender, and sexual difference / Drucilla Cornell Open adoption is not for everyone / Anita L. Allen Methods of adoption : eliminating genetic privilege / Jacqueline Stevens Several steps behind : gay and lesbian adoption / Sarah Tobias A child of one’s own : property, progeny, and adoption / Janet Farrell Smith Family resemblances : adoption, personal identity, and genetic (...) essentialism / Charlotte Witt Being adopted and being a philosopher : exploring identity and the "desire to know" differently / Kimberly Leighton Real othering : the metaphysics of maternity in children’s literature / Shelley Park Accidents and contingencies of love / Songsuk Hahn ; comments by Harry Frankfurt Abuse and neglect, foster drift, and the adoption alternative / Elizabeth Bartholet Feminism, race, and adoption policy / Dorothy Roberts Racial randomization / Hawley Fogg-Davis You Mixed?: racial identity without racial biology / Sally Haslanger. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 20 (2000) 127-150 [Access article in PDF] They Who Burned Themselves for Peace: Quaker and Buddhist Self-Immolators during the Vietnam War Sallie B. KingJames Madison UniversityNhat Chi Mai was a lay disciple of Thich Nhat Hanh and member of the Order of Interbeing, an Engaged Buddhist order founded by Nhat Hanh. On May 16, 1967, Vesak, the celebration of the birth of the Buddha, she burned herself (...) to death outside the Tu Nghiem Temple, a nunnery. An idealistic young student with much to live for, she sacrificed herself in an effort to bring the war to an end. In a letter to the U.S. government she wrote, I offer my body as a torch to dissipate the dark to waken love among men to give peace to Vietnam the one who burns herself for peace. 1In her farewell letter to Thich Nhat Hanh she wrote, "Thay, don't worry too much. We will have peace soon." 2On November 2, 1965, Norman Morrison, a devout Quaker and ardent pacifist, drove from Baltimore to Washington and burned himself to death at the Pentagon, at a spot estimated to be 40 to 100 feet from the window of Robert S. McNamara, then Secretary of Defense and one of the chief American prosecutors of the war. Shortly before his death, he wrote to his wife, "For weeks even months I have been praying only that I be shown what I must do. This morning with no warning I was shown.... Know that I love thee but must act...." 3 Morrison took his baby daughter, Emily, along with him and held her in his arms as he prepared for his act. Somehow--accounts differ as to how it happened--she was separated from her father before the flames engulfed him and she emerged entirely unharmed, though her clothing smelled strongly of the kerosene with which Morrison had soaked himself. 4There were others who burned themselves to death during the war in Vietnam. The venerable Buddhist monk Thich Quang Duc was the first. On June 11, 1963, [End Page 127] at a downtown crossroads in Saigon, he sat in the lotus posture and, in a state of meditative control, burned himself to death in protest of the Diem regime's repression of the Buddhist religion. Many Vietnamese Buddhist monks and nuns followed his example; I do not know all their names, or exactly how many they were.In America, to my knowledge, eight people burned themselves to death during the war. Two were Quakers: Norman Morrison and Alice Herz. Roger LaPorte, a former Trappist seminarian who had become a Catholic worker, burned himself to death one week after Norman Morrison. The others were: Hiroko Hayasaki, a Japanese-American Buddhist; Erik Thoen, a student of Zen Buddhism; another university student, George Winne; a high school student, Ronald Brazee; and Florence Beaumont, described as a "housewife." A number of others attempted self-immolation but survived. 5In this paper I will focus upon the self-immolations of Norman Morrison and Nhat Chi Mai. I will also have a few comments on Thich Quang Duc. My remarks are intended, however, to have relevance to all the Buddhist and Quaker self-immolators. 6Let us now consider in more detail some of the features of the self-immolations of Norman Morrison and Nhat Chi Mai, and some of the issues they pose to the Quaker and Buddhist communities, respectively. Precipitating Events While neither act was the result of a moment's impulse, we still would do well to ask what events most proximately precipitated the two self-immolations. In Norman Morrison's case, the precipitating events were two. The morning of the day he immolated himself he read a report of the American bombing of a village in Vietnam. Paris Match had published an interview with a French priest, recuperating in a Saigon clinic, who had witnessed and survived the bombing raid. The priest said, "I have seen my faithful burned up in napalm.... I have seen... (shrink)

Being, Seeking and Telling: Expressive Approaches to Qualitative Adult Education Research . Flaxton, Queensland: Post Pressed. ISBN 1 876682 07 8 Indo-Pacific Journal of Phenomenology , Volume 1, Edition 1 April 2001.

The author of this article challenges a central thesis of Robert Pippin's book, "Hegel's Idealism": namely, that Hegel's idealism is a "completion" or "extension" of an insight first discovered but inadequately developed and appreciated by Kant. It is argued that Pippin does not establish his claim that implicit in the very idea of the transcendental unity of a perception as it is presented in the Transcendental Deduction of the "Critique of Pure Reason" is the key to a form of idealism (...) which resolves the contradictions and dualisms of the Critical philosophy. (shrink)

One will never be able to interrogate wonder philosophically except by way of a questioning that the operation of wonder will already have determined. It is a well-known teaching in the writings of both Plato and Aristotle that wonder (thauma) is the beginning of philosophy. But few philosophers have given wonder much thought—certainly, no philosopher that I am aware of has, like Professor Sallis, returned time and again to think through wonder. Sallis’s thinking through wonder is guided by his reading (...) of ancient Greek philosophy, and furthermore, as I hope to show, it opens up a reengagement with Greek philosophers—in particular, with those early Greek thinkers who are known collectively as the .. (shrink)

Husserl and Contemporary Thought contains twelve essays that address certain key themes in Husserl's thought, each in some way confronting issues critical to the Husserlian project. The essays first appeared in the 1982 volume of Research in Phenornenology. The "contemporary thought" in the title should be understood in a limited sense as refer- ring to certain strains of thinking pursued in the present decade, build- ing however on past research. The volume shows several directions in which contemporary thinkers are taking (...) Husserlian phenomenology. The most common direction is through an evaluative contrast between Husserl's vision and the ideas of other philosophers, some of whom listened to Husserl but went their own ways. The second direction taken is represented in a series of current works by active phenomenol- ogists. Some of these essays - and here we have the greatest concentra- tion on a single theme - expand upon Husserl's analyses concerning the temporality of human experience. Other essays take up the threads of long-standing debates among Husserl scholars. I will treat each group of essays - on other philosophers, on time, and on topics other than time in turn, although the essays do not follow this order in the volume. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:February 19, 2011 (11:48 am) E:\CPBR\RUSSJOUR\TYPE3002\russell 30,2 040 red.wpd 168 Reviews A CONSCIENCE IN ACTION Chad Trainer 1006 Davids Run Phoenixville, pa 19460, usa [email protected] Reiner Braun, Robert Hinde, David Krieger, Harold Kroto, and Sally Milne, eds. Joseph Rotblat: Visionary for Peace. Weinheim, Germany: Wiley-vch Verlag GmbH & Co. KGaA, 2007. Pp. xiv, 355. isbn 978-3-527-40690-6 (hb). us$60. People who detest barbarism start to act in a barbaric (...) way. This is the insanity of war. (zJoseph Rotblat, p. 168) Bertrand Russell’s famous 1954 bbc broadcast “Man’s Peril” concerned humanity ’s fate in an era of nuclear weaponry. Soon after this event, it occurred to Russell that a further course of action would be to persuade prominent scientists from both sides of the Iron Curtain to sign a statement emphasizing the importance of joint action in addressing the spectre of a world in which there was availability of and even will to use nuclear armaments. He sent a draft of his petition to Albert Einstein for approval. Shortly thereafter, on a Xight from Rome to Paris, Russell heard the pilot’s announcement that Einstein had February 19, 2011 (11:48 am) E:\CPBR\RUSSJOUR\TYPE3002\russell 30,2 040 red.wpd Reviews 169 1 Rotblat was the recipient of the 1983 Bertrand Russell Society Award (McCoy, Visionary for Peace, p. 205, and Rotblat’s c.v., ibid., p. 346). died. Upon arriving at his Paris hotel, Russell found a letter from Einstein agreeing to sign Russell’s statement. In his autobiography, Russell reports: “This was one of the last acts of his [Einstein’s] public life.” Joseph Rotblat (1908–2005)1 met Russell in 1954 at a dinner-discussion given by the bbc on the results of the Bikini test and the future of nuclear weapons. Rotblat went on to become an adviser to Russell on the details of nuclear weapon science and was subsequently recruited by the latter to sign the same document Einstein had. Rotblat chaired the press conference on 9 July 1955 at Caxton Hall in London, presenting the world with what became known as the Russell– Einstein Manifesto. Rotblat was the Manifesto’s youngest and, until his death in 2005, the last surviving signatory. Although Rotblat was not a Nobel Laureate, Russell predicted, correctly, that he would eventually become one. In reference to Rotblat and his activities, Russell remarked: He can have few rivals in the courage and integrity and complete self-abnegation with which he has given up his own career (in which, however, he still remains eminent) to devote himself to combatting the nuclear peril as well as other, allied evils. If ever these evils are eradicated and international aTairs are straightened out, his name should stand very high indeed among the heroes. (Auto. 3: 77–8) Joseph Rotblat: Visionary for Peace is a compilation of tributes to the late Joseph Rotblat published by Wiley-vch. It features no less than 45 contributors. The volume is a celebration of one of the truly great activists for nuclear disarmament. It also features as an 84-page appendix eight of his most historic writings. There is also a new photograph of Russell (p. 89). As justly famous as Rotblat is for his eTorts to prevent nuclear war, though, his distinction in this arena tends to eclipse his other impressive achievements, most notably those in nuclear and medical physics. Joseph Rotblat: Visionary for Peace is valuable for the attention it draws to both the more and less famous aspects of his legacy. In the present reviewer’s opinion, the book’s reminiscences have some unnecessary overlap and the editors could perhaps have more strongly encouraged each contributor to further develop instead the distinctivez things they had to say about Rotblat. Somewhat less forgivable, considering the rich details of Rotblat’s life, is the book’s lack of an index. A Polish Jew, Rotblat earned his doctorate in physics from the University of Warsaw. Among the Wrst to conclude in the late 1930s that the huge energy released by Wssion together with neutron multiplication led to the possibility of a chain reaction, Rotblat realized... (shrink)

The impressive variation amongst biological individuals generates many complexities in addressing the simple-sounding question what is a biological individual? A distinction between evolutionary and physiological individuals is useful in thinking about biological individuals, as is attention to the kinds of groups, such as superorganisms and species, that have sometimes been thought of as biological individuals. More fully understanding the conceptual space that biological individuals occupy also involves considering a range of other concepts, such as life, reproduction, and agency. There has (...) been a focus in some recent discussions by both philosophers and biologists on how evolutionary individuals are created and regulated, as well as continuing work on the evolution of individuality. (shrink)

"Being and Logos" is... a philosophical adventure of rare inspiration.... Its power to illuminate the text..., its ecumenicity of inspiration, its methodological rigor, its originality, and its philosophical profundity—all together make it one of the few philosophical interpretations that the philosopher will want to re-read along with the dialogues themselves. A superadded gift is the author's prose, which is a model of lucidity and grace." —International Philosophical Quarterly "Being and Logos is highly recommended for those who wish to learn how (...) a thoughtful scholar approaches Platonic dialogues as well as for those who wish to consider a serious discussion of some basic themes in the dialogues." —The Academic Reviewer. (shrink)

In this collection of previously published essays, Sally Haslanger draws on insights from feminist and critical race theory and on the resources of contemporary analytic philosophy to develop the idea that gender and race are positions ...

This paper offers an overview of "the species problem", arguing for a view of species as homeostatic property cluster kinds, positioning the resulting form of realism about species as an alternative to the claim that species are individuals and pluralistic views of species. It draws on taxonomic practice in the neurosciences, especially of neural crest cells and retinal ganglion cells, to motivate both the rejection of the species-as-individuals thesis and species pluralism.

This paper explores the relationship between eugenics, disability, and dehumanization, with a focus on forms of eugenics beyond Nazi eugenics.

Are interpersonal comparisons of desire possible? Can we give an account of how facts about desires are grounded, that underpins such comparisons? This paper supposes the answer to the first question is yes, and provides an account of the nature of desire that explains how this is so. The account is a modification of the interpretationist metaphysics of representation that the author has recently been developing. The modification is to allow phenomenological affective valence into the “base facts” on which correct (...) interpretation is grounded. To use this extra resource within that theory to vindicate interpersonal comparisons, we will need to appeal rational connections between level of valence and level of desire, which this paper sets out and examines. (shrink)