Background The experiences of clinical ethicists have recently begun to garner some attention, but very little is known about the emotional impact of clinical ethics work on clinical ethicists. The purpose of our study was to explore the experiences of clinical ethicists in the United States in order to better understand the impact that their professional responsibilities have on them as people, as well as to learn about the ways in which organizational structures and coping mechanisms help them navigate the (...) emotional impact of their work.Methods This was a primary analysis of 34 semi-structured interviews with clinical ethicists across the United States. The interviews were conducted from May-September 2023 and were recorded, transcribed, and de-identified. The qualitative themes explored in this paper are part of a larger study informed by principles derived from grounded theory.Results Four major themes emerged: particular features of clinical ethics work seem to significantly impact the emotional state of clinical ethicists, lack of clarity about the role of clinical ethicists appears to significantly impact their emotional experience, organizational structures appear to shape clinical ethicists’ professional and emotional experiences, and clinical ethicists employ a variety of professional and personal coping mechanisms when experiencing adverse emotions because of their professional responsibilities.Conclusion Our findings suggest that clinical ethicists are profoundly impacted by their work and that their emotional experience is shaped by a wide range of factors both at the individual and systemic level. (shrink)

Organ procurement organization (OPO) staff play an essential role in the facilitation of organ donation as they guide family members and loved ones of dying patients through the donation process. Throughout the donation process, OPO staff must assume the role of a dual advocate, considering both the interests of the donor (which often include the wishes of the donor’s family) and the interests of potential recipient(s). The benefits of this role are well established; however, minimal literature exists on the ways (...) this role can cause moral distress in OPO staff, who frequently face scenarios in which adhering to the wishes of a donor family may compromise donation potential but failing to honor donor family requests may result in further emotional burden for the family. Given the frequency with which these ethically complex situations exist during donation, OPO staff are at heightened risk for experiencing moral distress and burnout, yet they are seldom acknowledged in the existing moral distress literature. As a result, it is unclear whether the current practices available to mitigate moral distress are beneficial for this population. (shrink)

BackgroundThis paper represents a portion of the findings from one of the first research studies eliciting the lived experience of adults with an early diagnosis of Phenylketonuria living in Ireland. Ireland has one of the highest prevalence rates of PKU in Europe, however, little is known about the experience of Irish adults with PKU. Furthermore, Ireland is one of the first countries in the world to introduce neonatal screening followed by the introduction of long-term dietary therapy over 50 years ago. (...) This study presents the first comprehensive assessment of the lived experience of Irish adults with PKU on long term dietary therapy.MethodsNarrative data was collected from eleven self-selected participants, using semi-structured interviews. The interviews were divided into five sections focused on eliciting a holistic understanding of the lived experience of adults with PKU living in Ireland. Thematic analysis was guided by Colaizzi's Framework in conjunction with NVivo qualitative data analysis software.FindingsFindings from the original research encompassed a broad understanding of the lived experience of adults with PKU living in Ireland, including factors influencing dietary therapy and managing PHE blood levels. The themes being discussed within this article are those which appear to be least represented within current literature: living with PKU, including reproductive health, the importance of self-management and establishing routine, support networks in adulthood and concerns regarding aging with PKU.ConclusionIt was evident from the findings that a diagnosis of PKU can influence how adults with PKU may experience aging and their own mortality. These findings offer new insight into the vulnerability attached to the experience of aging with PKU and may be beneficial to advocacy groups and for future development of policy and practice. (shrink)

The extensive community use of complementary medicine can no longer be overlooked in the practice of hospital medicine. Protocols need to be developed and implemented so that health professionals can deal with the issues surrounding the use of CM. Policy development has generally focussed on the supply of CM in hospital but another approach, which is based on consideration of the ethical and legal context, is presented here. Such an approach demands clarification of institutional policy for individuals who are competent (...) and those who are incapable of self-administration or non-competent. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 29-31, June 2011.

An objective of this book is to discuss some of the contributions made by John Grote to philosophy. This work is an extension of a dissertation written for the doctorate at Boston University. The author wishes to acknowledge the invaluable assistance in many places to Professor Peter A. Bertocci and the late Professor Edgar S. Brightman both of whom read the entire manuscript in its original form. Also, the author acknowledges the encouraging interest and support of his wife, Helen, whose (...) many suggestions have improved the writing and without whose assistance this work would not have been accomplished. The author assumes complete responsibility for whatever errors or deficiencies appear in the book. All known writings of Grote are listed and the more important ones analyzed. LAUCHLIN D. MACDONALD CHAPTER I INTRODUCTION 1. JOHN GROTE'S LIFE i. Sketch of his life John Grote will remain best known by reason of the thought formu lated in the Exploratio Philosophica, or Rough Notes on Modern I ntellectu al Science. To the philosophical world of his own time he was well known as the teacher who ably held the chair of Moral Philosophy in the University of Cambridge from r855 until the year of his death, r866, to the Knightbridge Professor, William Whewell whose in succession Philosophy of Science is the subject of at least one chapter of the Exploratio Philosophica. Grote's birthplace was Beckenham in Kent, and the date, May 5, r8r3. (shrink)

When it originated in the late 19th century, psychometrics was a field with both a scientific and a social mission: psychometrics provided new methods for research into individual differences, and at the same time, these psychometric instruments were considered a means to create a new social order. In contrast, contemporary psychometrics - due to its highly technical nature and its limited involvement in substantive psychological research - has created the impression of being a value-free discipline. In this article, we develop (...) a contrasting characterization of contemporary psychometrics as a value-laden discipline. We expose four such values: that individual differences are quantitative (rather than qualitative), that measurement should be objective in a specific sense, that test items should be fair, and that utility of a model is more important than its truth. Our goal is not to criticize psychometrics for employing these values, but rather to bring them into the open and to show that these values are not inevitable and are in need of systematic evaluation. (shrink)

The works of Mary Wollstonecraft ranged from the early _Thoughts on the Education of Daughters_ to _The Female Reader_, a selection of texts for girls, and included two novels. But her reputation is founded on _A Vindication of the Rights of Woman_ of 1792. This treatise is the first great document of feminism—and is now accepted as a core text in western tradition. It is not widely known that the germ of Wollstonecraft’s great work came out of an earlier and (...) much shorter vindication—A Vindication of the Rights of Men, written in the context of the issues raised by the French Revolution. This edition, which follows the model of other Broadview Editions in including a range of materials that help the reader to see the work in the context of its era out of which it emerged, is arranged chronologically, opening with Wollstonecraft’s “other vindication.” It also includes a wide range of other documents in appendices, as well as a comprehensive and authoritative introduction, chronology, and full index. (shrink)

Mental state reasoning or theory-of-mind has been the subject of a rich body of imaging research. Although such investigations routinely tap a common set of regions, the precise function of each area remains a contentious matter. With the help of functional magnetic resonance imaging (fMRI), we sought to determine which areas are involved when processing mental state or intentional metarepresentations by focusing on the relational aspect of such representations. Using non-intentional relational representations such as spatial relations between persons and between (...) objects as a contrast, the results ascertained the involvement of the precuneus, the temporal poles, and the medial prefrontal cortex in the processing of intentional representations. In contrast, the anterior superior temporal sulcus and the left temporo-parietal junction were implicated when processing representations that refer to the presence of persons in relational contexts in general. The right temporo-parietal junction, however, was specifically activated for persons entering spatial relations. The level of representational complexity, a previously unexplored factor, was also found to modulate the neural response in some brain regions, such as the medial prefrontal cortex and the right temporo-parietal junction. These findings highlight the need to take into account the critical roles played by an extensive network of neural regions during mental state reasoning. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

Subject relative clauses (SRCs) are typically processed more easily than object relative clauses (ORCs), but this difference is diminished by an inanimate head‐noun in semantically non‐reversible ORCs (“The book that the boy is reading”). In two eye‐tracking experiments, we investigated the influence of animacy on online processing of semantically reversible SRCs and ORCs using lexically inanimate items that were perceptually animate due to motion (e.g., “Where is the tractor that the cow is chasing”). In Experiment 1, 48 children (aged 4;5–6;4) (...) and 32 adults listened to sentences that varied in the lexical animacy of the NP1 head‐noun (Animate/Inanimate) and relative clause (RC) type (SRC/ORC) with an animate NP2 while viewing two images depicting opposite actions. As expected, inanimate head‐nouns facilitated the correct interpretation of ORCs in children; however, online data revealed children were more likely to anticipate an SRC as the RC unfolded when an inanimate head‐noun was used, suggesting processing was sensitive to perceptual animacy. In Experiment 2, we repeated our design with inanimate (rather than animate) NP2s (e.g., “where is the tractor that the car is following”) to investigate whether our online findings were due to increased visual surprisal at an inanimate as agent, or to similarity‐based interference. We again found greater anticipation for an SRC in the inanimate condition, supporting our surprisal hypothesis. Across the experiments, offline measures show that lexical animacy influenced children's interpretation of ORCs, whereas online measures reveal that as RCs unfolded, children were sensitive to the perceptual animacy of lexically inanimate NPs, which was not reflected in the offline data. Overall measures of syntactic comprehension, inhibitory control, and verbal short‐term memory and working memory were not predictive of children's accuracy in RC interpretation, with the exception of a positive correlation with a standardized measure of syntactic comprehension in Experiment 1. (shrink)

The endoplasmic reticulum (ER) organelle is the key intracellular site of both protein and lipid biosynthesis. ER dysfunction, termed ER stress, can result in protein accretion within the ER and cell death; a pathophysiological process contributing to a range of metabolic diseases and cancers. ER stress leads to the activation of a protective signalling cascade termed the Unfolded Protein Response (UPR). However, chronic UPR activation can ultimately result in cellular apoptosis. Emerging evidence suggests that cells undergoing ER stress and UPR (...) activation can release extracellular signals that can propagate UPR activation to target tissues in a cell non‐autonomous signalling mechanism. Separately, studies have determined that the UPR plays a key regulatory role in the biosynthesis of bioactive signalling lipids including sphingolipids and ceramides. Here we weigh the evidence to combine these concepts and propose that during ER stress, UPR activation drives the biosynthesis of ceramide lipids, which are exported and function as cell non‐autonomous signals to propagate UPR activation in target cells and tissues. (shrink)

In anticipation of a new edition of the Passio apostolorum Petri et Pauli, this article analyzes the recensio conducted by Lipsius for his edition of 1891. The review of the main variants highlighted by the editor reverses his thesis: they depend on innovations by reduction, not by interpolation. Such innovations could perhaps depend on early medieval liturgical use of the work. With regard to the methodology, the comparison with the Greek tradition of the work, as an external criterion of evaluation, (...) appears misleading, since it is unlikely that Greek is the original language. (shrink)

Executive Summary There is a general perception that biomedical research has not given the same attention to the health problems of women that it has given ...