This paper offers a narrative approach to understanding the process of clinical reasoning in complex cases involving medical uncertainty, moral ambiguity, and futility. We describe a clinical encounter in which the pediatric health care team experienced a great deal of conflict and distrust as a result of an ineffective process of interpretation and communication. We propose a systematic method for analyzing the technical, ethical, behavioral, and existential dimensions of the clinical reasoning process, and introduce the Clinical Reasoning Discussion Tool—a dialogical (...) and interpretive device aimed at improving communication, understanding, empathy, and moral deliberation in the clinical setting. (shrink)

ABSTRACT:We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formal sanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

ABSTRACT:We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formal sanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

Sally Sedgwick presents a fresh account of Hegel's critique of Kant's theoretical philosophy. She argues that Hegel offers a compelling critique of and alternative to the conception of cognition that Kant defended in his 'Critical' period, and explores Hegel's claim to derive from Kantian doctrines clues to a superior form of idealism.

We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formalsanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

From the various discussions of Kant’s theoretical philosophy throughout Hegel’s works, it is not difficult to come away with the impression that Hegel thinks that the Kantian categories are derived from experience, and that the method of a “transcendental” investigation of the forms of subjectivity is nothing other than that of generalization upon observation. As early as the 1802-03 essay, Faith and Knowledge, for example, he characterizes the critical philosophy as the “completion and idealization” of Lockean “empirical psychology.” In § (...) 41 of the Encyclopedia he tells us that Kant’s systematization of the “special forms of the a priori element … of thought … is solely based upon psychological and historical grounds.” Moreover, in the Lectures on the History of Philosophy, he refers to Kant as going “psychologically,” i.e., “historically,” to work in his accounts of intuition, understanding, and reason in a manner that is “entirely empirical, and not developed out of the concept.”. (shrink)

ABSTRACT:We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formal sanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

In paragraph 135 of the Philosophy of Right Hegel formulates his well-known objection to the" empty formalism" of Kant's theory of morality:"[I] f the definition of duty is taken to be the absence of contradiction," he tells us,"... then no transition is possible to the specification ..

In this article, we use a corporate social responsibility (CSR) framework to analyze the payday loan industry by critically examining its practices from an economic, legal, and ethical perspective. Payday loans are essentially a very high cost, unsecured, short‐term personal loan. Given the inherent nature of the product being offered, the industry appears on the face of it to be in a position to potentially exploit vulnerable consumers in pursuit of profits. With this concern in mind, our analysis investigates the (...) following three issues: Can the payday loan industry currently be considered to be acting in a socially responsible manner? If the industry cannot be considered to be socially responsible, should it be further regulated? If the industry should be further regulated, how should it be regulated? To address these issues, we first provide a brief historical overview of payday loans. Second, we describe the important characteristics of payday loans and how the industry operates. Third, we draw on various sources of evidence to demonstrate that the payday loan industry, while fulfilling its basic economic obligations, falls outside of both the legal and ethical domains of the Three Domain Model of CSR. Based on our analysis, our conclusion is that the payday loan industry requires additional government legal regulation, particularly with respect to allowable fees, and we conclude that there is a strong ethical case for banning payday loans altogether. (shrink)

While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim to (...) fill this gap. Results indicate that there was no significant difference in the median number of monthly consultation cases during the first COVID-19 surge compared to the same period the year prior and that the characteristics of the ethics consults during the COVID-19 surge and same period the year prior were also similar. Through inductive analysis, we identified four themes related to ethics consults during the first COVID-19 surge including (1) prognostic difficulty for COVID-19 positive patients, (2) challenges related to visitor restrictions, (3) end of life scenarios, and (4) family members who were also positive for COVID-19. Cases were complex and often aligned with multiple themes. These patient case-related sources of ethical issues were managed against the backdrop of intense systemic ethical issues and a near lockdown of daily life. Healthcare ethics consultants can learn from this experience to enhance training to be ready for future disasters. (shrink)

Soma‐to‐germline feedback is forbidden under the neo‐Darwinian paradigm. Nevertheless, there is a growing realization it occurs frequently in immunoglobulin (Ig) variable (V) region genes. This is a surprising development. It arises from a most unlikely source in light of the exposure of co‐author EJS to the haplotype data of RL Dawkins and others on the polymorphism of the Major Histocompatibility Complex, which is generally assumed to be the most polymorphic region in the genome (spanning ∼4 Mb). The comparison between the (...) magnitude of MHC polymorphism with estimates for the human heavy chain immunoglobulin V locus (spanning ∼1 Mb), suggests IGHV could be many orders of magnitude more polymorphic than the MHC. This conclusion needs airing in the literature as it implies generational churn and soma‐to‐germline gene feedback. Pedigree‐based experimental strategies to resolve the IGHV issue are outlined. (shrink)

There are eleven previously unpublished letters between James Hutton and James Watt in the Doldowlod collection, which Birmingham City Archives acquires from Lord Gibson-Watt in 1994. They were written between 1774 and 1795. Very little of Hutton's other correspondence survives, so these letters add significantly to our knowledge. The earliest letters together with two letters from Hutton to George Clerk-Maxwell , describe geological tours that Hutton made through Wales, the Midlands, and the south-west of England in 1774. The correspondence after (...) 1774 reveals Watt's expertise in geology, and also discusses meteorology, varnish making, Symington's steam engines, the first experiments with steam navigation, pneumatic medicine, and other topics. (shrink)

(1994). The correspondence between James Hutton (1726–1797) and James Watt (1736–1819) with two letters from Hutton to George Clerk-Maxwell (1715–1784): Part I. Annals of Science: Vol. 51, No. 6, pp. 637-653.

The inconsistency between pro-environmental attitudes and behaviours, known as the “attitude-behaviour” gap, is exceptionally pronounced in scenarios associated with “green” choice. The current literature offers numerous explanations for the reasons behind the “attitude-behaviour” gap, however, the generalisability of these explanations is complex. In addition, the answer to the question of whether the gap occurs between attitudes and intentions, or intentions and behaviours is also unknown. In this study, we propose the moral dimension as a generalisable driver of the “attitude-behaviour” gap (...) and investigate its effectiveness in predicting attitudes, pro-environmental intentions and subsequent behaviours. We do so by using Hunt–Vitell’s moral philosophy-based framework of ethical decision-making, which conceptualises morality as the central decision-making parameter. The results from 557 US MTurk participants revealed that the manipulation of moral dimensions, specifically deontology and teleology, impacted ethical evaluation of presented dilemmas, however, failed to translate into subsequent intentions and behaviours. This finding suggests (i) that the moral dimension has an effect in shaping attitudes toward environmental issues, and (ii) that gap occurs between attitudes and intentions rather than intentions and behaviours. Further investigation of what strengthens and/or overrides the effects of the moral dimension would help understand the reasons why moral attitudes do not always translate into subsequent intentions and behaviours in the pro-environmental domain. (shrink)

The False Claims Act, 31 U.S.C. § 3729, a post-Civil War law inspired by cases of defense contracting fraud, was revitalized in 1986. Since then it has been used to sue both manufacturers and providers of pharmaceuticals. In some cases, these suits were meant to target offlabel marketing of pharmaceuticals. In 2009, the 11th Circuit rendered a decision in Hopper v. Solvay Pharmaceuticals that dramatically limits the ability of private plaintiff whistle-blowers to bring qui tam suits under the FCA for (...) such marketing. In June 2010, the Supreme Court denied certiorari, making the Circuit court decision final. The Solvay decision creates a significant barrier to certain kinds of qui tam suits, requiring the plaintiff to demonstrate the intent to market off-label, including by showing specific prescriptions that were written as a result of efforts to do so. (shrink)

In recent years there has been increased focus on supporting the safety and wellbeing of children and young people with disability. This paper reports on a study that asked children and young people with disability and adults who work with them about practices that support their wellbeing and safety, including barriers and enablers to ethical practice. We used the theory of practice architectures to unpack the practices. Findings point to a range of practices that both young people and adults regarded (...) as important in creating the cultural conditions for young people to feel happy, safe and well, albeit placing different emphases on particular practices. Several tensions within and between these practices and the evolving requirements of disability and safeguarding policy environments were also apparent. While often not well articulated, the inherent tensions have implications when considering what children and young people need, particularly those with higher support needs. Findings suggest closer attention needs to be given to the intersection between individual and systemic factors in shaping ethical practice aimed at supporting the wellbeing and safety of children and young people with disability. (shrink)

The relative reinforcing value of food measures how hard someone will work for a high-energy-dense food when an alternative reward is concurrently available. Higher RRV for HED food has been linked to obesity, yet this association has not been examined in low-income preschool-age children. Further, the development of individual differences in the RRV of food in early childhood is poorly understood. This cross-sectional study tested the hypothesis that the RRV of HED to low-energy-dense food would be greater in children with (...) obesity compared to children without obesity in a sample of 130 low-income 3- to 5-year-olds enrolled in Head Start classrooms in Central Pennsylvania. In addition, we examined individual differences in the RRV of food by child characteristics and food security status. The RRV of food was measured on concurrent progressive-ratio schedules of reinforcement. RRV outcomes included the last schedule reached for cookies and fruit, the breakpoint for cookies in proportion to the total breakpoint for cookies and fruit combined, and response rates. Parents completed the 18-item food security module to assess household food security status and the Behavioral Activation System scale to assess reward sensitivity. Pearson’s correlations and mixed models assessed associations between continuous and discrete child characteristics with RRV outcomes, respectively. Two-way mixed effects interaction models examined age and sex as moderators of the association between RRV and Body Mass Index z-scores. Statistical significance was defined as p < 0.05. Children with obesity had a greater cookie Pmax [F = 4.95, p = 0.03], higher RRV cookie [F = 4.28, p = 0.04], and responded at a faster rate for cookies [F = 17.27, p < 0.001] compared to children without obesity. Children with higher cookie response rates had higher BMIZ ; and RRV cookie was positively associated with BMIZ for older children and boys, but not younger children or girls. The RRV of food did not differ by household food security status. Low-income children with obesity showed greater motivation to work for cookies than fruit compared to their peers without obesity. The RRV of HED food may be an important contributor to increased weight status in boys and future research is needed to better understand developmental trajectories of the RRV of food across childhood. (shrink)

Silent thinking is often accompanied by subvocal sayings to ourselves, imagery, emotional feelings, and non-sensory experiences such as familiarity, rightness, and confidence that we can go on in certain ways. Phenomenological materials of these kinds, along with our dispositions to give explanations or draw inferences, provide resources that are sufficient to account for our knowledge of what we think, desire, and so on. We do not need to suppose that there is a distinctive, non-imagistic 'what it is like' to think (...) that p, and a different non-imagistic 'what it is like' to think that q. Nor need we suppose that there is a proprietary 'what it is like' to have one propositional attitude type rather than another. (shrink)

Rationale: Deep brain stimulation (DBS) of the hippocampus is proposed for enhancement of memory impaired by injury or disease. Many pre-clinical DBS paradigms can be addressed in epilepsy patients undergoing intracranial monitoring for seizure localization, since they already have electrodes implanted in brain areas of interest. Even though epilepsy is usually not a memory disorder targeted by DBS, the studies can nevertheless model other memory-impacting disorders, such as Traumatic Brain Injury (TBI). Methods: Human patients undergoing Phase II invasive monitoring for (...) intractable epilepsy were implanted with depth electrodes capable of recording neurophysiological signals. Subjects performed a delayed-match-to-sample (DMS) memory task while hippocampal ensembles from CA1 and CA3 cell layers were recorded to estimate a multi-input, multi-output (MIMO) model of CA3-to-CA1 neural encoding and a memory decoding model (MDM) to decode memory information from CA3 and CA1 neuronal signals. After model estimation, subjects again performed the DMS task while either MIMO-based or MDM-based patterned stimulation was delivered to CA1 electrode sites during the encoding phase of the DMS trials. Each subject was sorted (post hoc) by prior experience of repeated and/or mild-to-moderate brain injury (RMBI), TBI, or no history (control) and scored for percentage successful delayed recognition (DR) recall on stimulated vs. non-stimulated DMS trials. The subject’s medical history was unknown to the experimenters until after individual subject memory retention results were scored. Results: When examined compared to control subjects, both TBI and RMBI subjects showed increased memory retention in response to both MIMO and MDM-based hippocampal stimulation. Furthermore, effects of stimulation were also greater in subjects who were evaluated as having pre-existing mild-to-moderate memory impairment. Conclusion: These results show that hippocampal stimulation for memory facilitation was more beneficial for subjects who had previously suffered a brain injury (other than epilepsy), compared to control (epilepsy) subjects who had not suffered a brain injury. This study demonstrates that the epilepsy/intracranial recording model can be extended to test the ability of DBS to restore memory function in subjects who previously suffered a brain injury other than epilepsy, and support further investigation into the beneficial effect of DBS in TBI patients. (shrink)

Silent thinking is often accompanied by subvocal sayings to ourselves, imagery, emotional feelings, and non-sensory experiences such as familiarity, rightness, and confidence that we can go on in certain ways. Phenomenological materials of these kinds, along with our dispositions to give explanations or draw inferences, provide resources that are sufficient to account for our knowledge of what we think, desire, and so on. We do not need to suppose that there is a distinctive, non-imagistic ‘what it is like’ to think (...) that p, and a different non-imagistic ‘what it is like’ to think that q. Nor need we suppose that there is a proprietary ‘what it is like’ to have one propositional attitude type rather than another. (shrink)

There was a deep continuity in Wollheim’s thought from his book on F. H. Bradley onward. His notion of the concept of art as deeply interiorized was inextricable from his sense of the psychological unity of the mind and the historical continuity of artistic tradition, seen on analogy with an inherited language. His study of pictorial representation pivoted on the innate psychological capacity of ‘seeing-in’, perceiving the represented subject in a surface from which it was seen as distinct but to (...) which it could be related. The expressiveness of depiction he explained through a psychoanalytic concept of projection in which we come to see a piece of the external world as corresponding to an inward state of mind. He reserved the use of the term ‘imagination’ for the artist’s elaboration of ‘seeing-in’. This he exemplified in accounts of painting by Manet, Friedrich, Titian, and Ingres among others. His critical stance has a close affinity with certain essays by Pater. (shrink)