Evolution in Four Dimensions claims that epigenetic, behavioral, and symbolic inheritance systems should be considered equal partners to genetics in evolutionary biology. The evidence for, and applicable scope of, these additional inheritance systems is limited, particularly with regard to areas involving learning. It is unclear how including these extra dimensions in mainstream evolutionary thinking translates into testable hypotheses for a productive research program.

It has become increasingly difficult for individuals to exercise meaningful control over the personal data they disclose to companies or to understand and track the ways in which that data is exchanged and used. These developments have led to an emerging consensus that existing privacy and data protection laws offer individuals insufficient protections against harms stemming from current data practices. However, an effective and ethically justified way forward remains elusive. To inform policy in this area, we propose the Ethical Data (...) Practices framework. The framework outlines six principles relevant to the collection and use of personal data—minimizing harm, fairly distributing benefits and burdens, respecting autonomy, transparency, accountability, and inclusion—and translates these principles into action-guiding practical imperatives for companies that process personal data. In addition to informing policy, the practical imperatives can be voluntarily adopted by companies to promote ethical data practices. (shrink)

Recent national and international debates on truth and reconciliation in Uganda have emphasized the importance of incorporating local-level mechanisms into a national transitional justice strategy. The Juba Peace Talks represented an opportunity to develop and articulate sufficient and just alternatives and complementary mechanisms to the international criminal model. The most commonly debated mechanism is the Acholi process known as mato oput (drinking the bitter root), a restorative justice approach to murder. Drawing on 2 months of research in nine internally displaced (...) persons’ camps in 2007, we examine local justice practices in the region of northern Uganda to consider their potential, promise and pitfalls to realizing a successful truth-telling process. We find that although local mechanisms could help facilitate reconciliation in the region, truth-telling is but one part of a conciliatory process complicated by a national context of fear and the complexity of the victim–perpetrator identity at the community level. These locally informed insights help move forward the debate on such mechanisms in Uganda and add useful insights into community processes in the field of transitional justice more generally. (shrink)

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...) of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted. (shrink)

Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic (...) injustice has received limited treatment in bioethics. In this paper, we examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. We critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. We also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration. We argue that providers ought to avoid epistemic injustice in pain management by striving toward epistemic humility. Epistemic humility, as a form of epistemic justice, may be the kind disposition required to correct the harmful prejudices that may arise through testimonial exchange in chronic pain management. (shrink)

BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs (HCEPs) that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online survey, 97% (...) of hospitals have HCEPs. Their scope includes clinical ethics functions in virtually all hospitals, but includes other functions in far fewer hospitals: ethical leadership (35.7%), regulatory compliance (29.0%), business ethics (26.2%), and research ethics (12.6%). HCEPs are responsible for providing ongoing ethics education to various target audiences including all staff (77.0%), nurses (59.9%), staff physicians (49.0%), hospital leadership (44.2%), medical residents (20.3%) and the community/general public (18.4%). HCEPs staff are most commonly involved in policy work through review of existing policies but are less often involved in development of new policies. HCEPs have an ethics representative in executive leadership in 80.5% of hospitals, have representation on other hospital committees in 40.7%, are actively engaged in community outreach in 22.6%, and lead large-scale ethics quality improvement initiatives in 17.7%. In general, major teaching hospitals and urban hospitals have the most highly integrated ethics programs with the broadest scope and greatest number of activities. Larger hospitals, academically affiliated hospitals, and urban hospitals have significantly more individuals performing HCEP work and significantly more individuals receiving financial compensation specifically for that work. Overall, the most common greatest challenge facing HCEPs is resource shortages, whereas underutilization is the most common greatest challenge for hospitals with fewer than 100 beds. Respondents’ strategies for managing challenges include staff training and additional funds.ConclusionsWhile this study must be cautiously interpreted due to its limitations, the findings may be useful for understanding the characteristics of HCEPs in US hospitals and the factors associated with these characteristics. This information may contribute to exploring ways to strengthen HCEPs. (shrink)

A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...) a consult. As one bioethicist commented:if you approach any endeavor as an amateur activity, you will get, in the end, an amateurish version of the activity. Without a sufficient commitment of personnel, time, support, and financial resources, a healthcare organization will get the ‘ethics’ program … it set out to create: an inept, unskilled, inefficient, and highly risky ‘program’ in healthcare ethics and bioethics. (shrink)

The paper defends the thesis that institutional virtue is properly modeled as a ‘‘consensual’’ property, along the lines of the Lehrer–Wagner model of consensus (LWC). In a first step, I argue that institutional virtue is not exhausted by duty-fulfilling, since institutions, contrary to natural individuals, are designed to fulfill duties. To avoid the charge of vacuity, virtue, if attributed to institutions, must be able to motivate supererogatory action. In a second step, I argue against dis- continuity of institutional virtue with (...) individual virtue. Two main arguments for discontinuity of collective properties display serious shortcomings when applied to virtues of institutions. Given that motivation for supererogatory action is neither inferred from statutory duties nor accommodates a right of reprobation, modeling institutional virtue on collective rationality or explaining it in terms of joint com-mitment both prove problematic. In a third step, I argue that LWC has the explanatory potential to account for institutional virtue. Due to its main features,iteration and evaluation, it provides a non-trivial analysis of continuity and thereby satisfies basic constraints on the notion of genuine institutional virtue. (shrink)

Background: After over 4 years since medical assistance in dying legalization in Canada, there is still much uncertainty about how this ruling has affected Canadian society. Objective: To describe the positive aspects of medical assistance in dying legalization from the perspectives of hospice palliative care providers engaging in medical assistance in dying. Design: In this qualitative descriptive study, we conducted an inductive thematic analysis of semi-structured interviews with hospice palliative care providers. Participants and setting: Multi-disciplinary hospice palliative care providers in (...) acute, community, residential, and hospice care in Vancouver and Toronto, Canada, who have engaged in end-of-life care planning with patients who have inquired about and/or requested medical assistance in dying. Ethical considerations: The research proposal was approved by University of British Columbia Research Ethics Board in Vancouver and University Health Network in Toronto. Participants were informed regarding the research goals, signed a written consent, and were assigned pseudonyms. Results: The 48 participants included hospice palliative care physicians (n = 22), nurses (n = 15), social workers (n = 7), and allied health providers (n = 4). The average interview length was 50 min. Positive aspects of medical assistance in dying legalization were identified at (1) the individual level: (a) a new end-of-life option, (b) patients’ last chance to express control over their lives, (c) patient and family comfort and relief, and (d) a unique learning experience for hospice palliative care providers; (2) the team level: (a) supportive collegial relationships, (b) broadened discussions about end-of-life and palliative care, and (c) team debriefs provide opportunities for education and support; and (3) the institutional level: (a) improved processes to facilitate the implementation logistics. Conclusion: While being involved in the medical assistance in dying process is complex and challenging, this study sheds light on the positive aspects of medical assistance in dying legalization from the hospice palliative care provider’s perspectives. Medical Assistance in Dying legalization has resulted in improved end-of-life conversations between hospice palliative care providers, patients, and their families. Improved communication leads to a better understanding of patients’ end-of-life care plans and bridges some of the existing gaps between hospice palliative care and medical assistance in dying. (shrink)

Artificial intelligence (AI) technologies in medicine are gradually changing biomedical research and patient care. High expectations and promises from novel AI applications aiming to positively impact society raise new ethical considerations for patients and caregivers who use these technologies. Based on a qualitative content analysis of semi-structured interviews and focus groups with healthcare professionals (HCPs), patients, and family members of patients with Parkinson’s Disease (PD), the present study investigates participant views on the comparative benefits and problems of using human versus (...) AI predictive computer vision health monitoring, as well as participants’ ethical concerns regarding these technologies. Participants presumed that AI monitoring would enhance information sharing and treatment, but voiced concerns about data ownership, data protection, commercialization of patient data, and privacy at home. They highlighted that privacy issues at home and data security issues are often linked and should be investigated together. Findings may help technologists, HCPs, and policymakers determine how to incorporate stakeholders’ intersecting but divergent concerns into developing and implementing AI PD monitoring tools. (shrink)

Uncertainty regarding potential disciplinary action may give physicians pause when considering whether to accept a chronic pain patient or how to treat a patient who may require long-term or high doses of opioids. Surveys have shown that physicians fear potential disciplinary acrion for prescribing controlled substances and that physicians will, in some cases, inadequately prescribe opioids due to fear of regulatory scrutiny. Prescribing opioids for long-term pain management, particularly noncancer pain management, has been controversial; and boards have investigated and, in (...) some cases, disciplined physicians for such prescribing. While in virtually all of these cases the disciplinary actions were successfully appealed, news of the success was not often as well-publicized as news of the disciplinary actions, leaving some physicians confused about their potential liability when prescribing opioids for pain. The confusion has perhaps increased as a result of two relatively recent cases, one where a physician was successfully disciplined by a state medical board for undertreatment of his patients’ pain, and another where the physician was successfully sued for inadequate pain treatment. (shrink)

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

To the woman, God said, “I will greatly multiply your pain in child bearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you.”Genesis 3:16There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country. There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed and treated for their (...) pain.One particularly troublesome study indicated that women are more likely to be given sedatives for their pain and men to be given pain medication. Speculation as to why this difference might exist has included the following: Women complain more than men; women are not accurate reporters of their pain; men are more stoic so that when they do complain of pain, “it's real”; and women are better able to tolerate pain or have better coping skills than men. (shrink)

Depression is a widespread concern in the United States. Neuromodulation treatments are becoming more common but there is emerging concern for racial disparities in neuromodulation treatment utilization. This study focuses on Transcranial Magnetic Stimulation (TMS), a treatment for depression, and the structural and attitudinal barriers that racialized individuals face in accessing it. In January 2023 participants from the Twin Cities, Minnesota engaged in focus groups, coupled with an educational video intervention. Individuals self identified as non-white who had no previous TMS (...) exposure but had tried at least one treatment for their depression. Results revealed that the intervention did not notably change knowledge or stigma about TMS, but attitudes surrounding traveling for treatment changed. Notably, barriers like affordability, frequency of treatment, and lack of knowledge persist. Participants expressed a desire for more information, personal connection, and a tailored educational approach. The study suggests a need for multifaceted strategies to reduce disparities, focusing on education, community-based resources, and policy interventions. Immediate actions that can be taken include the creation of a TMS education program focused on patient engagement and awareness about TMS. (shrink)

U.S. multinational enterprises must now follow the policies of Title VII of the Civil Rights Act of 1964 in their overseas operations, at least with respect to U.S. expatriate employees. Doing so in a culture which discourages gender equality in the workplace raises difficult issues, both practically and ethically. Vigorously importing U.S. attitudes toward gender-equality into a social culture such as Japan or Saudi Arabia may seem ethnocentric, a version of ethical imperialism. Yet adapting to host country norms risks a (...) kind of moral relativism. This article supports the view that MNEs which promote workplace equality in a host country such as Japan, which is actively involved in the international economic and political community, is not ethical imperialism in any pejorative sense and is preferable to a moral relativism or social contract approach.We hold these truths to be self-evident: that all men are created equal, and endowed by their creator with certain rights — life, liberty, and the pursuit of happiness. (shrink)

The aim of this analysis was to examine the concept of time to rejuvenate and extend existing narratives of time within the nursing literature. In particular, we hope to promote a new trajectory in nursing research and practice which focuses on time and person‐centred care, specifically of older people with cognitive impairment hospitalized in the acute care setting. We consider the explanatory power of concepts such as clock time, process time, fast care, slow care and time debt for elucidating the (...) relationship between ‘good care’ and ‘time use’. We conclude by offering two additional concepts of time, plurotemporality and person‐centred time (PCT) which we propose will help advance of nursing knowledge and practice. Nurse clinicians and researchers can use these alternative concepts of time to explore and describe different temporal structures that honour the patient's values and preferences using experiential, observation‐based nursing research approaches. (shrink)

In this paper we report on an investigation into the principles underlying the choice of a particular referential expression to refer to an object located in a domain to which both participants in the dialogue have visual as well as physical access. Our approach is based on the assumption that participants try to use as little effort as possible when referring to objects. This assumption is operational-ized in two factors, namely the focus of attention and a particular choice of features (...) to be included in a referential expression. We claim that both factors help in reducing the effort needed to, on the one hand, refer to an object and, on the other hand, to identify it. As a result of the focus of attention the number of potential target objects is reduced. The choice of a specific type of feature determines the number of objects that have to be identified in order to be able to understand the referential expression. An empirical study was conducted in which pairs of participants cooperatively carried out a simple block-building task, and the results provided empirical evidence that supported the aforementioned claims. Especially the focus of attention turned out to play an important role in reducing the total effort. Additionally, focus acted as a strong coherence-establishing device in the studied domain. (shrink)

We report specific heat and μSR measurements on Th and/or B substituted UBe13. The specific heat data show that either Th or B substitution reduces the Kondo temperature TK and increases the entropy at the superconducting transition by almost 20%, indicating an enhanced density of states. However, whereas μSR shows clear evidence for magnetic correlations for Th substitutions, no magnetism is observed for B substitutions. The enhanced specific heat jump in the B-substituted material is associated with a change in the (...) superconducting properties as TK is reduced. (shrink)

Diversos estudios internacionales indican que los pescadores sufren diferentes problemas de salud, entre los cuales son frecuentes las enfermedades cardiovasculares, accidentes laborales, heridas, ahogamientos, estrés laboral y problemas de salud mental. Objetivo: Con el estudio se pretendió identificar el nivel de bienestar sicológico y sedentarismo de pescadores artesanales de la Región de Los Lagos, Chile. Método: Se realizó un estudio cuantitativo que consistió en la aplicación de la escala de bienestar sicológico de Ryff y la versión breve del cuestionario de (...) actividad física IPAQ a 41 pescadores artesanales con una media de edad de 53,22 años. Resultados: Los resultados indican que un 68,3 % de pescadores son sedentarios, mientras que en las dimensiones del bienestar sicológico un 22 % muestra un alto nivel de crecimiento personal, seguido de un 14,7 % que presenta un alto nivel de dominio del entorno. No obstante, un alto porcentaje de los pescadores, 34,1 %, se encuentra en un nivel bajo de crecimiento personal, seguido de un 31,7 % con bajo nivel de autonomía y un 26,8 % con bajo nivel de relaciones positivas. Conclusiones: Los datos indican la necesidad de generar acciones preventivas de promoción y tratamiento oportuno de las patologías de salud mental para evitar que se conviertan en causas directas o indirectas de fallecimiento de los trabajadores. Diverse international studies show that artisanal fishermen suffer from different health issues, among which cardiovascular diseases, occupational accidents, injuries, drowning, work-related stress and mental health problems are the most frequent. Objective: the aim of the study was to identify the psychological well-being and sedentary lifestyle levels in artisanal fishermen from Los Lagos Region, Chile. Method: this was quantitative study consisting in applying Ryff's Psychological Well-being Scale and the short form of the International Physical Activity Questionnaire to 41 artisanal fishermen, whose mean age was 53.22 years. Results: the results reveal that 68.3 % of the fishermen have a sedentary lifestyle, while in the psychological well-being dimensions 22 % of them show a high level of personal development, followed by 14.7 % who have a high level of the control of the environment. Nevertheless, there is a considerable percentage of fishermen, 34.1 %, who have a low level od personal development, followed by 31.7 % with a low level of autonomy and 26.8 % with a low level of positive relationships. Conclusions: the data reveals a need to generate preventive healthcare measures and its promotion, and ensure an opportune treatment of mental pathologies in order to avoid that those become a direct or indirect cause for the demise of workers. (shrink)

Die Studie untersucht die systematischen Beziehungen der zentralen Begriffe in Bernard Bolzanos Erkenntnistheorie, die einen logisch-semantischen Realismus mit einer kausalistischen Metaphysik des Geistes verknüpft. Bolzano situiert grundlegende epistemische Aktivitäten wie Vorstellen, Urteilen und Ableiten im Spannungsfeld von logischen Relationen und dem Kausalnexus mentaler Episoden. Die Studie erläutert die Bedeutung der prominenten Begriffe 'Kraft' und 'Wahrscheinlichkeit' im Hinblick auf die erkenntnistheoretischen Belange von Wissen und Rechtfertigung. Der Begriff der Kraft begründet eine kausalistische Metaphysik von Geist und Welt und damit die Bedingungen (...) faktischer Erkenntnisverläufe. Der Begriff der Wahrscheinlichkeit bezeichnet Begründungsrelationen zwischen objektiven Propositionen, die für die rationale Berechtigung von Überzeugungen bestimmend sind. Zusammen konstituieren Faktivität und Normativität von Erkenntnisansprüchen die epistemische Wahrscheinlichkeit der "Zuversicht", die Urteilen einerseits assertive Kraft und andererseits die Berechtigung verleiht, sie als Erkenntnis anzunehmen. (shrink)

The research paper elaborates on the main concepts and terminology of strategic planning in education, including all the steps of building a strategic plan with mission and vision statements. Furthermore, it analyses and compares some successful strategic planning case studies in education by identifying the strengths and some weaknesses. The final results of this inquiry serve as recommendations for positive changes and reforms in North Macedonian education. Furthermore, this research paper emphasizes the importance of the SMART strategic goals for improving (...) education, articulated via the mission and vision statements. It is quite interesting that internationally accredited educational organizations like NOVA IS of Skopje have more successful improvement plans based on shared values and goals via their mission and vision. The implementation of their strategic plans is closely monitored and evaluated. Moreover, some successful educational reforms happened in Finland, Singapore, and Victoria, Australia, and their ministries of education are dedicated and accountable to aligning their mission and vision with all public schools in these countries. On the contrary, although the Ministry of Education of North Macedonia has clearly published the mission and vision statements, there is still a huge gap in the reality of implementation of those in all public schools, and rarely any school has a shared mission and vision on their web page. Browsing around, one primary school in North Macedonia, “Jan Amos Komenski” has recently started sharing their school’s mission and vision, values, and goals with the community which is a positive change toward SMART reforms. Strategic planning affects the improvement of learning and teaching; therefore it needs to be built inclusively and wisely. (shrink)

BackgroundThe COVID-19 pandemic has magnified pre-existing challenges in healthcare in Africa. Long-standing health inequities, embedded in the continent over centuries, have been laid bare and have raised complex ethical dilemmas. While there are very few clinical ethics committees (CECs) in Africa, the demand for such services exists and has increased during the COVID-19 pandemic. The views of African healthcare professionals or bioethicists on the role of CECs in Africa have not been explored or documented previously. In this study, we aim (...) to explore such perspectives, as well as the challenges preventing the establishment of CECs in Africa.MethodsTwenty healthcare professionals and bioethicists from Africa participated in this qualitative study that utilized in-depth semi-structured interviews with open-ended questions. Themes were identified through thematic analysis of interviews and open-ended responses.ResultsKenya and South Africa are the only countries on the continent with formal established CECs. The following themes emerged from this qualitative study: (1) Lack of formal CECs and resolution of ethical dilemmas; (2) Role of CECs during COVID-19; (3) Ethical dilemmas presented to CECs pre-COVID-19; (4) Lack of awareness of CECs; (5) Lack of qualified bioethicists or clinical ethicists; (6) Limited resources to establish CECs; (7) Creating interest in CECs and networking.ConclusionsThis study illustrates the importance of clinical ethics education among African HCPs and bioethicists, more so now when COVID-19 has posed a host of clinical and ethical challenges to public and private healthcare systems. The challenges and barriers identified will inform the establishment of CECs or clinical ethics consultation services (CESs) in the region. The study results have triggered an idea for the creation of a network of African CECs. (shrink)

Concerns have been raised around the alleged commercialisation of South African genetic material by various research institutes nationally and abroad. We consider whether the Protection of Personal Information Act in South Africa will conflict with or complement existing protections in health law and research ethics. The Act is not applicable to de‐identified samples that cannot be re‐identified but we question whether genetic samples can ever be truly de‐identified. The research participants in this matter provided consent for use of their samples (...) for research but did not consent to commercialisation by global research institutions, and neither did the researchers. We suggest that consent models incorporating broad consent as an option should include explicit discussions around benefit sharing and commercialisation. Mistrust between researchers and participants impedes scientific research and can harm relationships built up over the years between South African researchers and local communities. (shrink)

Volume 19, Issue 10, October 2019, Page 52-54.

Organizations are increasingly looking for ways to reap the benefits of cognitive diversity for problem solving. A major unanswered question concerns the implications of cognitive diversity for longer-term outcomes such as team learning, with its broader effects on organizational learning and productivity. We study how cognitive style diversity in teams—or diversity in the way that team members encode, organize and process information—indirectly influences team learning through collective intelligence, or the general ability of a team to work together across a wide (...) array of tasks. Synthesizing several perspectives, we predict and find that cognitive style diversity has a curvilinear—inverted U-shaped—relationship with collective intelligence. Collective intelligence is further positively related to the rate at which teams learn, and is a mechanism guiding the indirect relationship between cognitive style diversity and team learning. We test the predictions in 98 teams using ten rounds of the minimum-effort tacit coordination game. Overall, this research advances our understanding of the implications of cognitive diversity for organizations and why some teams demonstrate high levels of team learning in dynamic situations while others do not. (shrink)

Giubilini and Minerva ask why birth should be a critical dividing line between acceptable and unacceptable reasons for terminating existence. Their argument is that birth does not change moral status in the sense that is relevant: the ability to be harmed by interruption of one's aims. Rather than question the plausibility of their position or the argument they give, we ask instead about the importance to scholarship or policy of publishing the article: does it to any extent make a novel (...) or needed addition to the literature? Giubilini and Minerva's argument is remarkably similar to one advanced by Michael Tooley in ‘Abortion and Infanticide,’ almost 40 years ago. There have been immense changes in the intervening 40 years: in the ability to diagnose conditions early in pregnancy, in genetics and in the availability of in vitro fertilization; in understanding of the capabilities of persons with disabilities; in law; in economic support and access to healthcare for pregnant women and their children; in social customs and arrangements; and even in philosophy, with developments in feminist thought, bioethics and cognitive science. Some of these changes have been for the better, but others, such as the unravelling of social safety nets, have arguably been for the worse. Any or all of these changes might give rise to moral reasons for the relevance of birth that were not available 40 years ago. These changes might also be relevant to the identification of cases, if any, in which ‘after-birth abortion’ might be considered. If context is relevant to the applicability of moral reasons—as for theorists of justice in the non-idealised world it surely should be—it is questionable whether a view of the birth-line that ignores contextualising change can be adequate. (shrink)

The paper investigates semantic properties of expressions that suggest the possibility that emotions are shared. An example is the saying that a sorrow shared is a sorrow halved. I assume that such expressions on sharing an emotion refer to a specific mode of subjective experience, displayed in first person attributions of the form 'We share E'. Subjective attributions of this form are intrinsically ambiguous on all levels of their semantic elements: 'emotion', 'sharing' and 'We'. One question the paper seeks to (...) answer is whether and in what respect these semantic ambiguities mirror an indeterminacy of emotional experience. Discussing 'aggregate sharing' (of a determinate) in distinction of mere 'distributive sharing' (of a determinable), I argue that there is no sufficient criterion to determine which mode of sharing an emotional experience shaped as 'We feel E' displays. Disambiguation of this intrinsic indeterminacy must recur to situational parameters of individuals' de re relatedness. (shrink)

The paper discusses Bernard Bolzano’s epistemological approach to believing and knowing with regard to the epistemic requirements of an axiomatic model of science. It relates Bolzano’s notions of believing, knowing and evaluation to notions of infallibility, immediacy and foundational truth. If axiomatic systems require their foundational truths to be infallibly known, this knowledge involves both evaluation of the infallibility of the asserted truth and evaluation of its being foundational. The twofold attempt to examine one’s assertions and to do so by (...) searching for the objective grounds of the truths asserted lies at the heart of Bolzano’s notion of knowledge. However, the explanatory task of searching for grounds requires methods that cannot warrant infallibility. Hence, its constitutive role in a conception of knowledge seems to imply the fallibility of such knowledge. I argue that the explanatory task contained in Bolzanian knowing involves a high degree of epistemic virtues, and that it is only through some salient virtue that the credit of infallibility can distinguish Bolzanian knowing from a high degree of Bolzanian believing. (shrink)

Healthcare ethics consultants in the Veterans Health Administration (VHA) document consults in an enterprise-wide web-based database entitled IEWeb, serving as a system of record for healthcare ethics documentation at 1300 VA facilities. The need arose to evolve the database from an ethics process training resource into a more streamlined documentation repository that captures essential consult elements. A VHA National Center for Ethics in Health Care (NCEHC) Improvement Team convened for three tasks: (1) Specify and prioritize IEWeb changes (occurred via six (...) focus groups composed of “new user” and “super user” cohorts with analysis of existing documentation patterns); (2) Pilot the changes regionally (via regional communication, training, and reviews of pre-post use patterns); and (3) Measure the impact of national change implementation on user perspectives (via pre-and post-change implementation polls). Focus groups identified six implementable priority areas for ethics consult documentation improvement, including the development of a usable consult summary note for ready conversion from IEWeb fields into the electronic health record. Post-IEWeb updates showed an increased number of consults documented, a reduction in “time to consult documentation closure” by a mean of 4.5 days, and a clinically-meaningful improvement in the quality of documentation (78% of ethics questions scored “above-bar” on the validation tool pre- vs. 89% scored “above-bar” post-IEWeb changes, n = 140). According to national survey findings, the number of consultants documenting “all” consults in IEWeb increased, satisfaction increased, and perception of documentation difficulty decreased. IEWeb simplification enabled ethics consultants to re-focus their documentation completion efforts by decreasing perception of documentation burden while improving documentation frequency and quality in a clinically-meaningful way. (shrink)

Volume 24, Issue 8, August 2024, Page 90-93.

ABSTRACT Most pharmaceutical research carried out today is focused on the treatment and management of the lifestyle diseases of the developed world. Diseases that affect mainly poor people are neglected in research advancements in treatment because they cannot generate large financial returns on research and development costs. Benefit sharing arrangements for the use of indigenous resources and genetic research could only marginally address this gap in research and development in diseases that affect the poor. Benefit sharing as a strategy is (...) conceptually problematic, even if one, as we do, agrees that impoverished indigenous communities should not be exploited and that they should be assisted in improving their living conditions. The accepted concept of intellectual property protection envisages clearly defined originators and owners of knowledge, whereas the concept of community membership is fluid and indigenous knowledge is, by its very nature, open, with the originator(s) lost in the mists of time. The delineation of ‘community’ presents serious conceptual and practical difficulties as few communities form discrete, easily discernable groups, and most have problematic leadership structures. Benefit sharing is no substitute for governments’ responsibility to uplift impoverished communities. Benefit sharing arrangements may be fraught with difficulties but considerations of respect and equity demand that prior informed consent and consultation around commercialisation of knowledge take place with the source community and their government.1. (shrink)

We draw insights from Activity Theory within the field of human-computer interaction to quantitatively measure a mobile in-store experience (MIX), which includes the suite of shopping activities and retail services that a consumer can engage in when using their mobile device in brick-and-mortar stores. We developed and validated a nine-item, formative MIX index using survey data collected from fashion consumers in the United States (n= 1,267), United Kingdom (n= 370), Germany (n= 362), and France (n= 219). As survey measures of (...) consumer engagement in omnichannel retailing using a mobile device, the index items with stronger factor loadings described in-store shopping activities whereas those with weaker factor loadings described activities related to behavioral targeting and social networking. These results suggest that retailers should give consumers the autonomy to independently find, evaluate and purchase merchandise in brick-and-mortar stores, thereby enabling them to co-create personalized shopping experiences as active participants within an omnichannel retail servicescape. Our findings also suggest that retailers should provide consumers with more authentic ways to build community and brand affiliations than mobile marketing and social media promotions. In-store activities should not simply be a migration of pre-existing e-commerce capabilities onto mobile devices. An engaging mobile in-store experience should be an amalgam of physical and digital activities that produce a seamless shopping journey and leverage the unique properties of mobile devices – ultra-portability, location sensitivity, untetheredness, and personalization. Retail executives can use the validated MIX index to prepare strategic investments in mobile technology applications and capabilities for retail stores within their omnichannel operations. The nine-item MIX index is also well-suited for consumer surveys, which also makes it an attractive measure of consumer engagement in omnichannel retailing for future academic research. (shrink)

The proliferation of big data analytics in criminal justice suggests that there are positive frames and imaginaries legitimising them and depicting them as the panacea for efficient crime control. Criminological and criminal justice scholarship has paid insufficient attention to these frames and their accompanying narratives. To address the gap created by the lack of theoretical and empirical insight in this area, this article draws on a study that systematically reviewed and compared multidisciplinary academic abstracts on the data-driven tools now shaping (...) decision-making across several justice systems. Using insights distilled from the study, the article proposes three frames for understanding how the technologies are portrayed. Inherent in the frames are a set of narratives emphasising their ostensible status as vital crime control mechanisms. These narratives obfuscate the harms of data-driven technologies and evince idealistic imaginaries of their capabilities. The narratives are bolstered by unequal structural arrangements, specifically the unevenly distributed digital capital with which some are empowered to participate in technology development for criminal justice application and other forms of penal governance. In unravelling these issues, the article advances current understanding of the dynamics that sustain the depiction of data-driven technologies as prime crime prevention and law enforcement tools. (shrink)

Working at the bedside and within communities as patient advocates, nurses frequently intervene to advance individuals’ health and well-being. However, the International Council of Nurses’ Code of Ethics asserts that nurses should expand beyond the individual model and also promote a rights-enabling environment where respect for human dignity is paramount. This article applies the results of an ethnographic human rights study with displaced populations in Rwanda to argue for a rights-based social advocacy role for nurses. Human rights advocacy strategies include (...) sensitization, participation, protection, good governance, and accountability. By adopting a rights-based approach to advocacy, nurses contribute to health agendas that include more just social relationships, equitable access to opportunities, and health-positive living situations for all persons. (shrink)

Background: Due to the major changes occurring in the demographic composition of the world’s population, the number of older individuals is increasing, which puts pressure on the healthcare systems in many different countries. The involvement of volunteers and family members may become necessary to fulfil a patient’s needs for follow-up treatments and long-term care in their homes. Aim: This study aimed to explore how nurses and physicians experienced and addressed ethical challenges when they dealt with relatives in what have traditionally (...) been one-on-one consultations at two Norwegian hospital outpatient clinics. Research Design and Methods: A total of eight nurses and two physicians from two different hospitals participated in individual in-depth interviews. The transcribed interviews were analysed using an eclectic approach called ‘bricolage’ inspired by Kvale and Brinkmann. We combined cross-case thematic and theoretical normative analyses. Ethical considerations: The principles of voluntariness, confidentiality, withdrawal and anonymity were respected throughout the research process. In addition, the Norwegian Social Science Data Services approved this study. Findings: The findings showed that respect for a patient’s autonomy was used as an argument for delimiting the relatives’ access to the patient’s consultations. We found that there were insufficient routines in place for inviting and involving relatives in the patient consultations in the outpatient clinics. Discussion: The traditional Western attitudes towards the principles of patient autonomy will likely be challenged due to the growing need for family involvement in the care of a patient in the future. Conclusion: This study’s description of the nurses and physicians’ interpretations of ‘patient autonomy’ as a phenomenon uncover the need for systematic ethical deliberation in the clinical setting. On an organisational level, there is a strong indication of the need to discuss the routines that are in place to invite the next of kin to participate in such patient’s healthcare consultations. (shrink)

Management of effort is one of the biggest challenges in any team, and is particularly difficult in distributed teams, where behavior is relatively invisible to teammates. Awareness systems, which provide real-time visual feedback about team members’ behavior, may serve as an effective intervention tool for mitigating various sources of process-loss in teams, including team effort. However, most of the research on visualization tools has been focusing on team communication and learning, and their impact on team effort and consequently team performance (...) has been hardly studied. Furthermore, this line of research has rarely addressed the way visualization tool may interact with team composition, while comprehension of this interaction may facilitate a conceptualization of more effective interventions. In this article we review the research on feedback in distributed teams and integrate it with the research on awareness systems. Focusing on team effort, we examine the effect of an effort visualization tool on team performance in 72 geographically distributed virtual project teams. In addition, we test the moderating effect of team composition, specifically team members’ conscientiousness, on the effectiveness of the effort visualization tool. Our findings demonstrate that the effort visualization tool increases team effort and improves the performance in teams with a low proportion of highly conscientious members, but not in teams with a high proportion of highly conscientious members. We discuss the theoretical and practical implications of our findings, and suggest the need of future research to address the way technological advances may contribute to management and research of team processes. (shrink)

_In today's hyperconnected world, global supply chains underpin international trade and economic prosperity. However, these complex networks are inherently vulnerable to disruptions, exposing businesses and societies to significant risks. This article delves into the concept of global supply chain resilience, exploring its importance, key principles, and practical risk management strategies. Drawing upon diverse perspectives from social sciences, it analyzes the economic, political, and environmental factors that contribute to supply chain fragility, highlighting the need for multi-faceted approaches to building resilience._.

The contributions gathered in this volume present the state of the art in key areas of current social ontology. They focus on the role of collective intentional states in creating social facts, and on the nature of intentional properties of groups that allow characterizing them as responsible agents, or perhaps even as persons. Many of the essays are inspired by contemporary action theory, emotion theory, and theories of collective intentionality. Another group of essays revisits early phenomenological approaches to social ontology (...) and accounts of sociality that draw on the Hegelian idea of recognition. This volume is organized into three parts. First, the volume discusses themes highlighted in John Searle's work and addresses questions concerning the relation between intentions and the deontic powers of institutions, the role of disagreement, and the nature of collective intentionality. Next, the book focuses on joint and collective emotions and mutual recognition, and then goes on to explore the scope and limits of group agency, or group personhood, especially the capacity for responsible agency. The variety of philosophical traditions mirrored in this collection provides readers with a rich and multifaceted survey of present research in social ontology. It will help readers deepen their understanding of three interrelated and core topics in social ontology: the constitution and structure of institutions, the role of shared evaluative attitudes, and the nature and role of group agents. (shrink)