BackgroundNo standard method exists to assess how many consults a healthcare ethics consultation (HCEC) service should perform. To address this, we developed a method to estimate the volume of HCEC services based on a mixed-methods approach that included a systematic review and survey data on the volume of consult services requested.MethodsOur investigation included a systematic review of studies that reported the volume of HCEC services that were requested from 2000 to 2017, institutional surveys, and statistical analyses that estimated the volume (...) of HCEC services that were adjusted to the size of the hospitals in the survey and to population acuity.ResultsWe contacted the authors of 19 studies that met our inclusion criteria; 17 authors responded to the institutional survey and five provided annualized data points. We found that standard methods of reporting the volume of HCEC services led to inaccuracies in estimating the growth of HCEC services over time. To rectify this, we proposed two means to estimate volume based on either the service goals of HCEC services or hospital size and acuity.DiscussionThe statistical limitations of our study highlight the need to standardize the sharing and reporting of data in clinical ethics. Future work should further standardize methods of HCEC quality assessment using measures similar to those we describe. (shrink)

Scholars and professional organizations in bioethics describe various approaches to “quality assessment” in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes “quality” in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent (...) evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, in this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction. (shrink)

In follow-up to a large-scale ethics survey of neuroscientists whose research involves neuroimaging, brain stimulation and imaging genetics, we conducted focus groups and interviews to explore their sense of responsibility about integrating ethics into neuroimaging and readiness to adopt new ethics strategies as part of their research. Safety, trust and virtue were key motivators for incorporating ethics into neuroimaging research. Managing incidental findings emerged as a predominant daily challenge for faculty, while student reports focused on the malleability of neuroimaging data (...) and scientific integrity. The most frequently cited barrier was time and administrative burden associated with the ethics review process. Lack of scholarly training in ethics also emerged as a major barrier. Participants constructively offered remedies to these challenges: development and dissemination of best practices and standardized ethics review for minimally invasive neuroimaging protocols. Students in particular, urged changes to curricula to include early, focused training in ethics. (shrink)

BackgroundDeveloping a comprehensive, reproducible literature search is the basis for a high-quality systematic review (SR). Librarians and information professionals, as expert searchers, can improve the quality of systematic review searches, methodology, and reporting. Likewise, journal editors and authors often seek to improve the quality of published SRs and other evidence syntheses through peer review. Health sciences librarians contribute to systematic review production but little is known about their involvement in peer reviewing SR manuscripts.MethodsThis survey aimed to assess how frequently librarians (...) are asked to peer review systematic review manuscripts and to determine characteristics associated with those invited to review. The survey was distributed to a purposive sample through three health sciences information professional listservs.ResultsThere were 291 complete survey responses. Results indicated that 22% (n = 63) of respondents had been asked by journal editors to peer review systematic review or meta-analysis manuscripts. Of the 78% (n = 228) of respondents who had not already been asked, 54% (n = 122) would peer review, and 41% (n = 93) might peer review. Only 4% (n = 9) would not review a manuscript. Respondents had peer reviewed manuscripts for 38 unique journals and believed they were asked because of their professional expertise. Of respondents who had declined to peer review (32%, n = 20), the most common explanation was “not enough time” (60%, n = 12) followed by “lack of expertise” (50%, n = 10).The vast majority of respondents (95%, n = 40) had “rejected or recommended a revision of a manuscript| after peer review. They based their decision on the “search methodology” (57%, n = 36), “search write-up” (46%, n = 29), or “entire article” (54%, n = 34). Those who selected “other” (37%, n = 23) listed a variety of reasons for rejection, including problems or errors in the PRISMA flow diagram; tables of included, excluded, and ongoing studies; data extraction; reporting; and pooling methods.ConclusionsDespite being experts in conducting literature searches and supporting SR teams through the review process, few librarians have been asked to review SR manuscripts, or even just search strategies; yet many are willing to provide this service. Editors should involve experienced librarians with peer review and we suggest some strategies to consider. (shrink)

This paper explores the relationship between teaching and consulting in clinical ethics teaching and the role of the ethics teacher in clinical decision-making. Three roles of the clinical ethics teacher are discussed and illustrated with examples from the authors' experience. Two models of the ethics consultant are contrasted, with an argument presented for the ethics consultant as decision facilitator. A concluding section points to some of the challenges of clinical ethics teaching.

LSJ s.v. πρεσβεω II.3.b recorded, on the strength of Thuc. 5.39.2, the meaning ‘go as ambassador’ for the middle voice, in addition to the well-attested ‘send ambassadors’. The passage, however, does not on inspection support the meaning ; it was deleted from the Supplement to LSJ.

This study extends the examination of moral content in the media by exploring moral messages in television programming and viewer characteristics predictive of the ability to perceive such messages. Generalisability analyses confirmed the reliability of the Media’s Moral Messages (MMM) rating form for analysing programme content and the existence of 10 moral themes prevalent in television media. Standard regression analyses yielded evidence indicating viewers’ moral expertise, as measured by the Defining Issues Test (DIT), familiarity with the programme and level of (...) education predicted their ability to perceive moral messages in a television drama popular in the USA at the time of data collection. Identification of patterns in moral content represented in television programming, as well as knowledge of how viewer characteristics relate to their ability to perceive such content, can provide parents and educators with a means for better comprehending messages regarding human interaction to which they or their children are exposed. (shrink)

Countries are ranked on many criteria, the results of which can have far-reaching ethical and practical implications, particularly for emerging nations seeking role models. One highly influential ranking, the World Economic Forum’s Global Competitiveness Report, has been criticized for containing multiple methodological, conceptual, and logical flaws that bias competitiveness rankings toward countries that favor neoliberalism. Using datasets not afflicted by such flaws, we examine Bergsteiner and Avery’s :391–410, 2012) prediction that competitiveness scores of the USA and the UK are (...) substantially overstated. Results of re-ranking 104 countries using 29 economic, environmental, and social datasets from reputable sources support this assertion, with the USA showing the greatest discrepancy on a 100-point scale between its 2013–2014 GCR score and our study’s 2013 score, and the UK falling from GCR score 9 to 40. We explore reasons for this discrepancy, including examining the relationship between a country’s neoliberal traditions and its rankings on the indicators. (shrink)

Our recent paper reported that 43% of reviewer comment sets shared with authors contained at least one unprofessional comment or an incomplete, inaccurate of unsubstantiated critique. Publication of this work sparked an online conversation surrounding professionalism in peer review. We collected and analyzed these social media comments as they offered real-time responses to our work and provided insight into the views held by commenters and potential peer-reviewers that would be difficult to quantify using existing empirical tools. Overall, 75% of comments (...) were positive, of which 59% were supportive and 16% shared similar personal experiences. However, a subset of negative comments emerged, that provided potential insight into the reasons underlying unprofessional comments were made during the peer-review process. These comments were classified into three main themes: forced niceness will adversely impact the peer-review process and allow for publication of poor-quality science ; dismissing comments as not offensive to another person because they were not deemed personally offensive to the reader ; and authors brought unprofessional comments upon themselves as they submitted substandard work. Here, we argue against these themes as justifications for directing unprofessional comments towards authors during the peer review process. We argue that it is possible to be both critical and professional, and that no author deserves to be the recipient of demeaning ad hominem attacks regardless of supposed provocation. Suggesting otherwise only serves to propagate a toxic culture within peer review. While we previously postulated that establishing a peer-reviewer code of conduct could help improve the peer-review system, we now posit that priority should be given to repairing the negative cultural zeitgeist that exists in peer-review. (shrink)

The Global Competitiveness Report raises ethical issues on multiple levels. The traditional high ranking accorded the US is largely attributable to fallacies, poor science and ideology. The ideological bias finds expression in two ways: the inclusion of indices that do not provide competitive advantage, but that fit the Anglo/US ideology; and the exclusion of indices that are known to offer competitive advantage, but that do not fit the Anglo/US ideology. This flaw is compounded by methodological problems that raise further doubt (...) as to the reliability and validity of the survey results. The resultant false high ranking of the US, a strong proponent of Anglo/US capitalism, pseudo-legitimizes the propensity of US-dominated institutions and entities to persuade, coerce and, in the worst-case force other countries and their constituents to adopt Anglo/US practices and behaviours. This is ethically reprehensible because research shows that these practices and behaviours, when compared with other approaches, are sub-optimal in the results they produce for individuals, corporations and nations. The report also unjustly and unnecessarily stigmatizes entire groups of countries with little conceivable benefit to anyone. Given the report’s gravitas through the profound global influence it exerts on the decisions of top government and business leaders, these are serious ethical and economic issues. (shrink)

BackgroundThe process of peer-review in academia has attracted criticism surrounding issues of bias, fairness, and professionalism; however, frequency of occurrence of such comments is unknown.MethodsWe evaluated 1491 sets of reviewer comments from the fields of “Ecology and Evolution” and “Behavioural Medicine,” of which 920 were retrieved from the online review repository Publons and 571 were obtained from six early career investigators. Comment sets were coded for the occurrence of “unprofessional comments” and “incomplete, inaccurate or unsubstantiated critiques” using an a-prior rubric (...) based on our published research. Results are presented as absolute numbers and percentages.ResultsOverall, 12% of comment sets included at least one unprofessional comment towards the author or their work, and 41% contained incomplete, inaccurate of unsubstantiated critiques.ConclusionsThe large number of unprofessional comments, and IIUCs observed could heighten psychological distress among investigators, particularly those at an early stage in their career. We suggest that development and adherence to a universally agreed upon reviewer code of conduct is necessary to improve the quality and professional experience of peer review. (shrink)

Climate change presents a fundamental challenge to the current global energy regime. Under the Framework Convention on Climate Change, the international community is developing the architecture of a policy response. Three serious flaws are examined: (a) the potential sacrifice of small island states, (b) the use of market-based policy measures to commodify the atmospheric commons, and (c) the substitution of carbon sequestration for meaningful reductions in energy use. The authors’ analysis of the politics of climate change, based on these issues, (...) suggests a new understanding of ecology is emerging—what they term postmodern ecology—in which a global environmental crisis is risked to secure the future of the world energy regime. An alternative, based on principles of sustainability and equity, is proposed that would require abandoning the global energy status quo. (shrink)

Given the recent call to strengthen collaboration between researchers and relevant practitioners, we consider participatory design as a way to advance Cognitive Science. Building on examples from the Learning Sciences and Human−Computer Interaction, we (a) explore what, why, who, when, and where researchers can collaborate with community members in Cognitive Science research; (b) examine the ways in which participatory‐design research can benefit the field; and (c) share ideas to incorporate participatory design into existing basic and applied research programs. Through this (...) article, we hope to spark deeper discussions on how cognitive scientists can collaborate with community members to benefit both research and practice. (shrink)

Nous introduisons ici un Cahier spécial consacré au philosophe britannique Jonathan Glover. Reconnu comme une figure importante de l’éthique appliquée dans le monde anglophone, Jonathan Glover commence fort heureusement à susciter de l’intérêt dans le monde académique francophone. C’est la notion de cohérence pratique qui sera au cœur des trois contributions composant ce dossier. En quels sens peut-on parler de cohérence dans le domaine de la pratique? Et quel type d’exigences implique-t-elle? Dans cet éditorial nous nous efforçons de (...) montrer que le souci d’introduire de l’ordre et de l’harmonie parmi nos jugements moraux conduit Glover à défendre un pluralisme au niveau des principes. (shrink)

In this paper I present a model of rational belief change, and I show how to use it to obtain a better insight into the debate about the nature of pneumococcal transformation, genes and DNA that took place in the forties, as a result of Oswald T. Avery’s work. The model offers a particular elaboration of the concept of inference to the best explanation, along decision theoretic lines. Within this framework, I distinguish different senses in which Avery’s team (...) can be said to have proceeded with caution, thus throwing some light upon a persistent source of disagreement among researchers in the history of genetics. In addition, I explain why we are entitled to say that rival parties such as physicist Maclyn McCarty and biochemist Alfred Mirsky were epistemically rational, in spite of the fact that they reached different conclusions on the basis of the same evidence. (shrink)

Glover's planning–control model is based on his finding that visual illusions exert a larger effect in early phases than in late phases of a movement. But evidence for this dynamic illusion effect is weak, because: (a) it appears difficult to replicate; (b) Glover overestimates the accuracy of his results; and (c) he seems to underestimate the illusion effect at late phases.

C. S. Lewis' article addresses a critically important issue on which Howard Ahmanson comments. Professor Oliver O'Donovan addresses the same issue in a sermon in Christ Church Oxford on Trinity Sunday 1997. We publish the three articles together in the year of the fiftieth anniversary of the independence of India and Pakistan and invite correspondence on the issues at stake. Eds.

The Battle of Drepana in 249 b.c. marks the most significant defeat of Roman naval forces at the hands of their Carthaginian opponents during the First Punic War. Attempting to take the Punic fleet in the harbour of Drepana by surprise, the consul P. Claudius Pulcher sailed with his ships from Lilybaeum about midnight, and reached Drepana at dawn. Yet, owing to swift and level-headed counter-measures taken by the Punic commander, Adherbal, the unfolding fight – partly in the harbour, mostly (...) off the shore – turned into a fiasco for the Romans. The consul got away; he returned to Rome, where the Senate instructed him to appoint a dictator. How soon he returned, and by what route, is the question. (shrink)

A critical and detailed introduction to Kant's philosophy, with particular reference to the Critique of Pure Reason. Since Broad's death there have been many publications on Kant but Broad's 1978 book still finds a definite place between the very general surveys and the more specialised commentaries. He offers a characteristically clear, judicious and direct account of Kant's work; his criticisms are acute and sympathetic, reminding us forcefully that 'Kant's mistakes are usually more important than other people's correctitudes'. C.D. Broad was (...) Knightsbridge Professor of Moral Philosophy at Cambridge from 1933 to 1953, and this book is based on his undergraduate lectures on Kant. Broad died in 1971 and Dr Lewy has since edited the book for publication. (shrink)

This essay argues that retrieving insights from the ancient Stoic philosophers for Christian ethics is much more difficult than is often assumed and, further, that the "ethics of retrieval" is itself something worth prolonged reflection. The central problem is that in their ancient sense both Christianity and Stoicism are practically dense patterns of reasoning and mutually incompatible forms of life. Coming to see this clearly requires the realization that the encounter between Stoicism and Christianity is a conflict of lived traditions. (...) Precisely because we cannot simply extract Stoic insights from the lives in which they belong, the task of determining how Stoicism is useful for Christianity is exceptionally challenging. Indeed, doing justice to the Stoics has more to do with facing an alternative to Christianity than it does with appropriating insights for our own use. These points are developed in conversation with Elizabeth Agnew Cochran's recent article on the Stoic influence upon Jonathan Edwards. This essay is a response to C. Kavin Rowe's critique of my 2011 argument that certain dimensions of Roman Stoic ethics are at work in Jonathan Edwards's moral thought. Rowe raises questions about the act of selectively retrieving ideas from a philosophical tradition to support constructive work in another tradition. I argue for the importance of acknowledging how Christian thought has been shaped by what Jeffrey Stout describes as moral bricolage, the selective retrieval of ideas from various traditions, and I contend that this bricolage can continue to be a fruitful means through which Christian ethics engages external traditions. Moreover, the importance of Stoicism's retrieval in early modern philosophy makes the work of eighteenth-century theologians such as Edwards a particularly valuable resource for exploring the plausibility of Christian engagement with the Stoics. (shrink)

A coordinate-free formulation is established for (semi) classical particle-field interactions. The exterior language of spacetime chains and De-Rham currents enables the description to include extended strings and membranes besides point particles. Treating physical fields in terms of sections of particular bundles, a unified account of interactions is presented in terms of an intrinsic action principle on a bundle of jets over spacetime. The theory is illustrated by considering the specific model of point particles with intrinsic spin covariantly coupled to theU(1) (...) andSL(2, C) connections describing the electromagnetic and gravitational fields, respectively. The notion of dual spin is examined in this context and coupled equations for this particle-field system are explicitly derived in a local chart. Attention is drawn to the global implications of the theory. (shrink)

The 65th year of a scholar who has devoted 40 years to editing and elucidating Robert Grosseteste provides us with a collection of essays. Not surprisingly, they emanate from colleagues and former students of Richard Dales and reflect his interest, among other concerns, in Grosseteste's aspectus et affectus - range of vision and disposition of mind - those twin peaks with which the 13th century thinker helped to get Christian thought through Aristotle without mutual destruction.