Everyone knows that a tiny acorn grows into a mighty oak and a caterpillar becomes a butterfly. But in this clever, visually enchanting volume, it's also true that a cow can result in both a bottle of milk and a painting of a cow, and an ape in a jungle may become an urban King Kong. Just as day turns into night and back again, a many-tiered cake is both created and eaten down to a single piece. With simple, graphic (...) illustrations sure to appeal to even the youngest of children, this beautiful rumination on the passage of time will please the most discerning adult readers, too. (shrink)

Emerging from the intersection of the virtual world with the real."--BOOK JACKET.

This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach “PRIMA” which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, (...) the study aims to assess potential moderators including the level of intervening, process variables and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions seem essential to also improve well-being. (shrink)

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

The current pandemic period has triggered a series of changes in society, at both individual and collective behavioral levels. These changes were perceived as either positive or negative by the impacted bodies, leading to both social change and positive interactions in a tense context. In this paper, the authors will deal with Pandemica Panotpica, subjugation infiltrating all levels of society, and the approach adopted by several countries in trying to find countermeasures to combat the virus' proliferation. Our research scope began (...) at the onset of the pandemic and ended on early January 2021. (shrink)

Who gets to decide what it means to live a healthy lifestyle, and how important a healthy lifestyle is to a good life? As more governments make preventing obesity and diet-related illness a priority, it's become more important to consider the ethics and acceptability of their efforts. When it comes to laws and policies that promote healthy eating--such as special taxes on sugary drinks and the banning of food deemed unhealthy--critics argue that these policies are paternalistic, and that they limit (...) individual autonomy over food choices. In Healthy Eating Policy and Political Philosophy: A Public Reason Approach, Anne Barnhill and Matteo Bonotti show that both paternalistic justifications for healthy eating efforts and anti-paternalistic arguments against them can be grounded in perfectionist views that overly prioritize some values over others. The authors therefore propose a more inclusive, public reason approach to healthy eating policy that will be appealing to those who take pluralism and cultural diversity seriously, by providing a framework through which different kinds of values, including but not limited to autonomy and health, can be factored into the public justification for healthy eating efforts. Additionally, the book adopts a 'farm to fork' approach to the ethics of healthy eating efforts: it engages with theories and debates in political philosophy, considers the implications of different theoretical positions for healthy eating efforts, and then develops a concrete tool for assessing policies that will be of interest to both scholars and policymakers. As well as offering a novel normative analysis of healthy eating policy, the authors offer a new theoretical framework that will be applicable to a wide range of public policy scenarios. (shrink)

Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO (Population, Intervention, Comparison, and (...) Outcome) worksheet. A total of 40 articles were included. The review is conducted according to the Vancouver Protocol. The main findings from the systematic literature review show that ethical challenges experienced by healthcare and social care providers in home-based care are related to autonomy and balancing ethical principles, decisions regarding intensity of care, challenges related to priority settings, truth-telling, and balancing the professional role. Findings regarding ethical challenges within home-based care are in line with findings from institutional healthcare and social care settings. However, some significant differences from the institutional context are also highlighted. (shrink)

Background: In accordance with ethical guidelines for nurses, leaders for nurse services in general are responsible for facilitating professional development and ethical reflection and to use ethical guidelines as a management tool. Research describes a gap between employees’ and nurse leaders’ perceptions of priorities. Objective: The purpose of this article is to gain deeper insight into how nurses as leaders in somatic hospitals describe ethical challenges. Design and method: We conducted individual, quality interview with 10 nurse leaders, nine females and (...) one male nurse aged 34–64 years. We used a hermeneutical approach to analyse the data. Ethical considerations: The participants received oral and written information about the study. Participation in the study was voluntary, and the participants were given the opportunity to withdraw. All of them gave written consent. The Norwegian Centre for Research Data approved the research project. In addition, the head of the hospitals gave permission to conduct our study. Findings: Four main areas were identified: deficient ethical language, conflicting demands on nurse leaders regarding staff management, concerns regarding young nurses’ ethical consciousness and restricting factors on the creation of a climate of ethics. The nurse leaders experienced considerable pressure. An unexpected finding was the lack of – and even disregard for – an ethical language. Discussion and conclusion: It is crucial to recognise ethics in all types of nursing approaches and to make it explicit. Ethical language must be implemented in nursing education. It must be recognised and used in clinical practice. Recommendations: We recommend further research be conducted into how nurses understand the concept of ethics and how to incorporate ethical principles into clinical nursing and nurse leadership. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.2 (2002) 456-458 [Access article in PDF] Quarrel & Quandary, by Cynthia Ozick; xiii & 247 pp. New York: Alfred A. Knopf, 2000, $25.00. Ask Cynthia Ozick to define a Jewish book and she launches into an extended defense of the integrity of the body of traditional Jewish writing: Torah, Talmud, liturgy, ethics, and philosophy. Ozick takes her Judaism seriously; its literature, in the broad sense, (...) for her, is didactic and dedicated to the promotion of virtue attained through study. She takes literature seriously too and strenuously defends fiction as an act of the "free imagination," with an equal emphasis on both elements of that phrase although, Ozick rightly argues, the imagination by definition is free. Thus, a Jewish book and Jewish fiction are contradictory. To different degrees, emphasis, and purpose, both are freighted by moral purpose.So are the various Ozicks! A traditional Jew, a Jewish American writer, a novelist, an essayist, a classical feminist—all describe Ozick who obviously belies all simple categories save one: writer. Yet even as a writer, Ozick is complex and conflicted, lamenting that she hasn't written enough fiction but claiming that it simply could not have been different.While Ozick may not be as prolific as she would like, she is a commanding presence in American fiction and belles lettres. Her latest collection of non-fiction work, Quarrel & Quandary, demonstrates her clear thinking, breadth of expertise, seriousness, and intelligence. Ranging from the autobiographical to the political, each essay is informed by history and none is light nor nostalgic. "Dostoyevsky's Unabomber" is perceptive and regrettably prescient in its depiction of the philosopher-murderer. In "The Posthumous Sublime," Ozick walks us through the "grieving that has been made beautiful" in the four stories of Sebald's The Emigrants. "A Drug Store Eden" is a warm and familiar but never sentimental portrait of her hard-working parents and her Uncle Ruby. The humor of "Lovesickness" and "How I Got Fired from My Summer Job" resonate for middle-class, studious, awkward young girls. In another essay, awe-inspired respect for Kafka is balanced by reverent awe of God, which is tempered by an uncomfortable acceptance of Job's acquiescence. Where is Job's "impious impatience" in the face of his renewed prosperity and health?, she asks. Where is "the father's bitter grief over the loss" of his first family? In quintessential [End Page 456] Ozick, she acknowledges the staying power of the ancient sages who argued God's majesty at the same time reserving her right to "philosophic doubt," especially in light of the Shoah.Two essays in this volume are exceptional in their insight and influence. "Who Owns Anne Frank?" should put to rest the sentimentalization of Anne Frank and her diary. It should stop the shameless marketing of the Holocaust—the catastrophe that marked a century—as yet another genocide. Ozick's relentless focus on the reality of Nazi evil and its consequent waste of human lives and potential should abort further distortions about Anne's short life, but it probably won't. The diary has been "bowdlerized, distorted, transmuted, traduced, reduced... infantilized, Americanized, homogenized, sentimentalized, falsified, kitschified, and, in fact, blatantly and arrogantly denied." It has "nonsensically" been described as cheerful and optimistic, even in the face of the fact that Anne, along with other members of the attic community, were targeted for murder and that, one month before liberation, Anne and her sister Margot died as prisoners in the unimaginable horror of Bergen Belsen, a camp so lice-ridden and disease-infested that it was burned to ashes by the British rather than cleansed, disinfected, or rehabilitated.Ozick tracks the controversy centered on the transformation of Anne's diary into the Americanized, christianized, perky Junior Miss that American audiences would accept, including the fabrication of lines that rendered the targeting of the Jews as one victim among many: "We're not the only people that've had to suffer" instead of Anne's more thoughtful and complex—and potentially problematic—"In the eyes of the world, we're doomed.... Who knows, maybe our religion will teach... (shrink)

Sea-level rise (SLR) is a threat to coastal areas and there is growing interest in how social values, risk perception and fairness can inform adaptation. This study applies these three concepts to an urban community at risk of SLR in Botany Bay, Australia. The study engaged diverse groups of residents via an online survey. Cluster analysis identified four interpretive communities: two groups value work-life balance, are concerned about SLR and would likely engage in collective adaptation. The third group value everything (...) about Botany Bay and are active in organisations that could prove to be an important outreach. The fourth group were older men, disengaged from both SLR and policy but could respond to individual consultation and targeted communication. Thus, multifarious approaches can engage diverse communities in fair decision-making and transform community-facilitated adaptation. (shrink)

Dignified care is a central issue in the nursing care of older adults. Nurses are expected to treat older adults with dignity, and older adults wish to be treated in a dignified manner. Researchers have recommended investigating the concept of dignity based on specific contexts and population groups. This meta-synthesis study aims to explore the understandings of dignity from the perspective of older adults in the Nordic countries. Synthesising findings from qualitative studies on older adults’ experiences of dignity has provided (...) important insight into what can be essential for dignified care in a Nordic context. The importance of visibility and recognition for the experience of dignity is an overarching theme in all the studies. The participants’ descriptions mostly implicated an existence dominated by a lack of recognition. The older adults do not feel valued as people or for their contribution to society and strive to tone down their illnesses in an attempt to become more visible and acknowledged as people. Toning down their illnesses and masking their needs can protect their independence. At the same time, becoming less visible can leave them without a voice. The metaphorical phrase protected and exposed by a cloak of invisibility is used to express the authors’ overall interpretation of the findings. Lack of recognition and being socially invisible is a genuine threat to older adults’ dignity. (shrink)

In this paper, I reflect on an important article by Bob Veatch in the inaugural issue of the Hastings Center Report, entitled “Experimental Pregnancy.” It is a report and elegant analysis of the Goldzieher Study, in which nearly 400 women were randomized to receive hormonal contraception or placebo absent consent or disclosure about placebo use, resulting in several pregnancies. Noting the study’s limited notoriety, I first consider the narratives that have instead dominated bioethics’ approach to pregnancy and research: thalidomide and (...) diethylstibesterol. These narratives have facilitated a narrow focus on avoiding fetal risk, to the exclusion of other ethically relevant considerations. I then revisit “Experimental Pregnancy” and offer two ways in which Bob’s analysis serves as an important corrective, first, by foregrounding research subjects, and second, by normalizing pregnancy and thus foregrounding foundational ethical considerations that are sometimes lost amidst pregnancy’s presumed exceptionalism. (shrink)

BIEN’s definitive statement of a Basic Income (BI) and the commentaries on its five characteristics are examined in turn, to identify potential clarifications, revisions and omissions. The following amendments are proposed as a basis for further discussion: to shift the position of ‘unconditionally’ in the definitive statement so that it refers to the cash payment rather than to its delivery; some clarifications to characteristics 3 ‘individual’ and 4 ‘universal’; to introduce ‘uniform’, without which BIs could be used to endorse flagrant (...) discrimination against, or even zero amounts for, less favoured groups; to restore the comprehensive nature of ‘unconditionality’ (which is now characteristic 6), by substituting ‘behavioural requirement’ in place of ‘work requirement’; to give the characteristic ‘without means test’ its own commentary (no. 7). The introduction of ‘uniform’ and ‘behavioural’ into the definitive statement should help to prevent BIEN’s definition from being regarded as male orientated. (shrink)

Eric Olson distinguishes his animalistic account of transtemporal personal identity from the apparently similar Bodily Criterion, among other things, by accusing the latter of being contaminated with Cartesian implications owing to its usage of the term ‚body‘. In contrast, Olson argues, Animalism is able to avoid these implications by substituting the concept of body for the concept of organism, which makes Animalism not only a distinct position, but also the better alternative to the Bodily Criterion. The paper critically reconstructs Olson’s (...) charge of Cartesianism against the Bodily Criterion, thereby differentiating between several variants of it. This eventually adds up to an evaluation of how suitable these criticisms are for defending Animalism at the expense of the Bodily Criterion. (shrink)

Purpose – The purpose of this paper is to explore artificial moral agency by reflecting upon the possibility of a Moral Turing Test and whether its lack of focus on interiority, i.e. its behaviouristic foundation, counts as an obstacle to establishing such a test to judge the performance of an Artificial Moral Agent. Subsequently, to investigate whether an MTT could serve as a useful framework for the understanding, designing and engineering of AMAs, we set out to address fundamental challenges within (...) the field of robot ethics regarding the formal representation of moral theories and standards. Here, typically three design approaches to AMAs are available: top-down theory-driven models and bottom-up approaches which set out to model moral behaviour by means of models for adaptive learning, such as neural networks, and finally, hybrid models, which involve components from both top-down and bottom-up approaches to the modelling of moral agency. With inspiration from Allen and Wallace as well as Prior, we elaborate on theoretically driven approaches to machine ethics by introducing deontic tense logic. Finally, within this framework, we explore the character of human interaction with a robot which has successfully passed an MTT. Design/methodology/approach – The ideas in this paper reflect preliminary theoretical considerations regarding the possibility of establishing a MTT based on the evaluation of moral behaviour, which focusses on moral reasoning regarding possible actions. The thoughts reflected fall within the field of normative ethics and apply deontic tense logic to discuss the possibilities and limitations of artificial moral agency. Findings – The authors stipulate a formalisation of logic of obligation, time and modality, which may serve as a candidate for implementing a system corresponding to an MTT in a restricted sense. Hence, the authors argue that to establish a present moral obligation, we need to be able to make a description of the actual situation and the relevant general moral rules. Such a description can never be complete, as the combination of exhaustive knowledge about both situations and rules would involve a God eye’s view, enabling one to know all there is to know and take everything relevant into consideration before making a perfect moral decision to act upon. Consequently, due to this frame problem, from an engineering point of view, we can only strive for designing a robot supposed to operate within a restricted domain and within a limited space-time region. Given such a setup, the robot has to be able to perform moral reasoning based on a formal description of the situation and any possible future developments. Although a system of this kind may be useful, it is clearly also limited to a particular context. It seems that it will always be possible to find special cases in which a given system does not pass the MTT. This calls for a new design of moral systems with trust-related components which will make it possible for the system to learn from experience. Originality/value – It is without doubt that in the near future we are going to be faced with advanced social robots with increasing autonomy, and our growing engagement with these robots calls for the exploration of ethical issues and stresses the importance of informing the process of engineering ethical robots. Our contribution can be seen as an early step in this direction. (shrink)

This paper assesses great apes’ abilities for pantomime and action imitation, two communicative abilities proposed as key contributors to language evolution. Modern great apes, the only surviving nonhuman hominids, are important living models of the communicative platform upon which language evolved. This assessment is based on 62 great ape pantomimes identified via data mining plus published reports of great ape action imitation. Most pantomimes were simple, imperative, and scaffolded by partners’ relationship and scripts; some resemble declaratives, some were sequences of (...) several inter-related elements. Imitation research consistently shows great apes perform action imitation at low fidelity, but also that action imitation may not represent a distinct process or function. Discussion focuses on how findings may advance reconstruction of the evolution of language, including what great apes may contribute to understanding ‘primitive’ forms of pantomime and imitation and how to improve their study. (shrink)

In Ludwig Wittgenstein's writings, ethics takes a central place in his thinking. This element investigates his engagement with ethics in both early and later thinking. Starting from the remarks on ethics in the Tractatus Logico-Philosophicus and the framing of these remarks, it presents two influential approaches to Tractarian ethics, before it develops a coherent reading of ethics in the early thinking, focusing on ethical silence and the relationship notions of world and the philosophical 'I'. The reading of 'A Lecture on (...) Ethics' focuses on the critique of ethical theory and the personal dimension of ethics, two themes also running through Wittgenstein's later thinking. It considers Wittgenstein's later ethical investigations, of ethical examples, ethically relevant language uses of language and the connections between reflections on ethics and living. It also considers the role of the other in Wittgenstein's later thinking. (shrink)

Hannah James makes a persuasive case for the use of donated bodies and body parts in surgical training, enabling high fidelity training, improved competency of surgeons and reduced risk of harm to patients from trainees ‘learning on the job’.1 She also identifies some pertinent ethical questions that arise from this practice that should be considered by training organisations, regulatory authorities and the trainees themselves. Many countries throughout the world have regulated programmes, governed by strict ethical principles, for donating bodies, usually (...) to academic institutions for the purposes of medical education.2 In the UK the Human Tissue Authority sets out guiding principles for institutions licensed to handle human tissue including donation of bodies for anatomical examination, education and research; consent, dignity, quality, and honesty and openness.3 The Nuffield Council on Bioethics, in its 2011 report, Human Bodies: donation for medicine and research, identified a number of relevant ethical values including autonomy, altruism, justice, dignity, reciprocity, maximising welfare, and honesty and respect.4 While this report did not focus specifically on donation of human tissue for education and training the principles identified are equally relevant in this context. In terms of maximising welfare whole body donation for education and training provides benefit to many patients over a relatively short time frame …. (shrink)

The principled approach to theory building that has been a conspicuous mark of bioethical theory for the past generation has in recent years fallen under considerable critical scrutiny. Although some critics have confined themselves to reordering the dominant principles, others have rejected a principled approach entirely and turned to alternative paradigms. Prominent among critics are antiprin-ciplists, who want to jettison the principle-based approach altogether and adopt a casuistic model, and communitarians, who favor an eclectic model combining features of both the (...) casuistic model and a modified principled approach. Particularly conspicuous in virtually all such critiques is their challenge to the preeminence of the principle of autonomy. Critical barbs have been aimed not only at theories favoring a hierarchical ordering of moral principles that give first place to autonomy, but also at those that include autonomy among a set of ostensibly coequal principles. Though these critics have performed a valued function by displacing bioethical principles from their Olympian perch beyond actual decision-making contexts, some version of the principle of autonomy may, nonetheless, be well worth defending but for very different reasons than those put forward by its supporters. (shrink)

The Legendary Biographies of Tamerlane: Islam and Heroic Apocrypha in Central Asia. By Ron Sela. Cambridge Studies in Islamic Civilization. New York: Cambridge University Press, 2011. Pp. xvii + 164. $85.