Pragmatic clinical trials offer important benefits, such as generating evidence that is suited to inform real-world health care decisions and increasing research efficiency. However, PCTs also present ethical challenges. One such challenge involves the management of information that emerges in a PCT that is unrelated to the primary research question, yet may have implications for the individual patients, clinicians, or health care systems from whom or within which research data were collected. We term these findings as?pragmatic clinical trial collateral findings,? (...) or?PCT-CFs?. In this article, we explore the ethical considerations associated with the identification, assessment, and management of PCT-CFs, and how these considerations may vary based upon the attributes of a specific PCT. Our purpose is to map the terrain of PCT-CFs to serve as a foundation for future scholarship as well as policy-making and to facilitate careful deliberation about actual cases as they occur in practice. (shrink)

In the last few decades, the emergence of mid-scale, intermediated marketing channels that fall between commodity and direct markets has attracted growing interest from scholars for their potential to preserve small and mid-sized farms while scaling up alternative agrifood sourcing. When such mid-scale supply chains are formed among multiple business partners with shared ethics or values related to the qualities of the food and the business relationships along the supply chain, they may be termed “values-based supply chains (VBSCs).” Most of (...) the research on VBSCs to date has relied primarily on a case study approach that investigates the performance of VBSCs from the perspective of VBSC founders or leaders. In contrast, this research seeks out the perspectives of farmers who participate in VBSCs. A nationwide farmer survey conducted in 2017 offers original insights on farmer motivations for participating in VBSCs and how they are being used by farmers relative to other marketing channels. We find that VBSCs serve farms of all sizes. Overall, smaller farms were more likely to market a higher percentage of overall sales through their VBSC and more likely to rank their VBSC as one of the top three marketing channels in their portfolio. But it was the larger farms that were more likely to perceive VBSC-specific benefits. Our findings confirm that while there is a limited volume of product that such regional supply chains can currently handle, farmers view VBSCs as a valuable marketing option that aligns with their own values and preserves their product’s identity. (shrink)

Background: The factors influencing parents’ willingness to enroll their children in biobanks are poorly understood. This study sought to assess parents’ willingness to enroll their children, and their perceived benefits, concerns, and information needs under different consent and data-sharing scenarios, and to identify factors associated with willingness. Methods: This large, experimental survey of patients at the 11 eMERGE Network sites used a disproportionate stratified sampling scheme to enrich the sample with historically underrepresented groups. Participants were randomized to receive one of (...) three consent and data-sharing scenarios. Results: In total, 90,000 surveys were mailed and 13,000 individuals responded (15.8% response rate). 5737 respondents were parents of minor children. Overall, 55% (95% confidence interval 50–59%) of parents were willing to enroll their youngest minor child in a hypothetical biobank; willingness did not differ between consent and data-sharing scenarios. Lower educational attainment, higher religiosity, lower trust, worries about privacy, and attitudes about benefits, concerns, and information needs were independently associated with less willingness to allow their child to participate. Of parents who were willing to participate themselves, 25% were not willing to allow their child to participate. Being willing to participate but not willing to allow one’s child to participate was independently associated with multiple factors, including race, lower educational attainment, lower annual household income, public health care insurance, and higher religiosity. Conclusions: Fifty-five percent of parents were willing to allow their youngest minor child to participate in a hypothetical biobank. Building trust, protecting privacy, and addressing attitudes may increase enrollment and diversity in pediatric biobanks. (shrink)

Career sustainability is a well-researched issue in academics and other sectors. Technology advancements and COVID-19 have jeopardized career sustainability. Numerous studies have explored the influence of individual characteristics on career sustainability, but few have focused on leadership. In addition, cultural factors must be considered because leadership is rooted in culture. In particular, inclusive leadership reflects traditional Chinese culture. Therefore, based on self-determination social exchange theories, we analyzed the effects of inclusive leadership on career sustainability as well as the roles of (...) thriving at work and supervisor developmental feedback in career sustainability. In total, 363 samples were collected from China. The results revealed that inclusive leadership improves career sustainability through SDF and thriving at work. Theoretically, our study fills the research gap and establishes a mechanism and theoretical framework for inclusive leadership and career sustainability. Practically, we offer guidance for enterprises to cultivate inclusive leadership and improve career sustainability. (shrink)

The three important target articles make a strong case for regarding racism as a public health crisis. Each calls for advocacy by the bi...

When there have been substantial failures by institutional leadership in their oversight responsibility to protect research integrity, the public should demand that these be recognized and addressed by the institution itself, or the funding bodies. This commentary discusses a case of research failures in developing genomic predictors for cancer risk assessment and treatment at a leading university. In its review of this case, the Office of Research Integrity, an agency within the US Department of Health and Human Services, focused their (...) report entirely on one individual faculty member and made no comment on the institution’s responsibility and its failure to provide adequate oversight and investigation. These actions missed an important opportunity to emphasize the institution’s critical responsibilities in oversight of research integrity and the importance of institutional transparency and accountability. (shrink)

In a healthcare setting, a multitude of ethical and moral challenges are often present when patients and families direct uncivil behavior toward clinicians and staff. These negative interactions may elicit strong social and emotional reactions among staff, other patients, and visitors; and they may impede the normal functioning of an institution. Ethics Committees and Clinical Ethics Consultation Services (CECSs) can meaningfully contribute to organizational efforts to effectively manage incivility through two distinct, yet inter-related channels. First, given their responsibility to promote (...) a humane, respectful, and professional climate, many CECSs and Ethics Committees may assist institutional leadership in evaluating and monitoring incivility policies and procedures. Second, when confronted with individual incidents of patient/family incivility, Ethics Consultants can and often do work with all stakeholders to address and mitigate potentially deleterious impacts. This manuscript presents an overview of the multifaceted ethical implications of incivility in the healthcare environment, discusses the inherent qualifications of Ethics Consultants for assisting in the management of incivility, and proposes specific mitigating actions within the purview of CECSs and Ethics Committees. We also invite healthcare organizations to harness the skills and reputation of their CECSs and Ethics Committees in confronting incivility through comprehensive policies, procedures, and training. (shrink)

End-of-life decision making frequently occurs in the intensive care unit (ICU). There is a lack of information on how a do-not-resuscitate (DNR) order affects treatments received by critically ill patients in ICUs. The objectives of this study were: (1) to compare the use of life support therapies between patients with a DNR order and those without; (2) to examine life support therapies prior to and after the issuance of a DNR order; and (3) to determine the clinical factors that influence (...) the initiation of a DNR order in ICUs in Taiwan. A prospective, descriptive, and correlational study was conducted. A total of 202 patients comprising 133 (65.8%) who had a DNR order, and 69 (34.1%) who did not, participated in this study. In the last 48 hours of their lives, patients who had a DNR order were less likely to receive life support therapies than those who did not have a DNR order. Older age, being unmarried, the presence of an adult child as a surrogate decision maker, a perceived inability to survive ultimate discharge from the ICU, and longer hospitalization in the ICU were significant predictors of issuing a DNR order for critically ill patients. This study will draw attention to how, when, and by whom, critically ill patients’ preferences about DNR are elicited and honored. (shrink)

Volume 46, Issue 6, November 2020, Page 658-675.

This paper examines how industrial buyers’ attributions of their suppliers’ actions of corporate social responsibility are related to both the brand advocacy and brand equity. Using a sample of 173 questionnaires gathered in Taiwan, we find that CSR perceptions of industrial buyers are more strongly and positively related to brand advocacy and brand equity when industrial buyers interpret CSR activities of their suppliers as driven more by intrinsic motives and less by extrinsic motives. Furthermore, brand advocacy mediates the interactive effects (...) of CSR and CSR attribution on industrial brand equity. (shrink)

This paper is a counter to the view that names are always predicates with the same extension as a metalinguistic predicate with the form “is a thing called “N”” (the Predicate View). The Predicate View is in opposition to the Referential View of names. In this paper, I undermine one argument for the Predicate View. The Predicate View’s adherents take examples of uses of names that have the surface appearance of a predicate and generalise from these to treat uses of (...) names that do not have the surface appearance of a predicate. They show that the Predicate View can provide a unified account of these two uses and assume that the Referential account cannot. I propose an alternative view of names, the Polysemy View. This view allows one to resist the pressure to generalise from the cases with the surface appearance of predicates to all uses of names while nevertheless providing connections between the uses. On the Polysemy View names are not, in their core use, metalinguistic predicates. Names are predominantly referring expressions but they also freelance as metalinguistic predicates on occasion. They have a double life. This double life is possible because of the pragmatic and conventional connections between the two aspects of that life. My main aim in this paper is to show that the Predicate View is not the only view that can give a good account of apparently predicative uses of names. In addition, I offer some inconclusive reasons to prefer the Polysemy View over the Predicate View. My paper assumes a background framework that the Predicate and Referentialist Views share and I do not attempt to justify that framework. I ignore many other views of names (notably descriptivist views and relevance theoretic views) in order to focus on the debate between these two opponents. (shrink)

This study empirically examined the effects of ethical leadership and ethical climate on employee ethical behavior in the international port context using survey data collected from 128 respondents who worked in Taiwan International Ports Corporation in Taiwan. Research hypotheses were formulated from the previous literature and tested using structural equation modeling. Results indicated that ethical leadership had a significant impact on ethical climate and the ethical behavior of TIPC employees. Ethical climate was found to be positively associated with employee ethical (...) behavior. The theoretical and practical implications of the research findings are discussed. (shrink)

An interview with Gail Weiss concerning her interests and influences, especially the body and embodiment.

Narrative inquiry in a nursing practicum One approach to creating research‐based nursing education is to think and write narratively about the daily life of a BScN program student and her teacher in diverse settings and over time. Gail, as a nurse‐teacher, and Faith, as a nursing student and now Public Health Nurse, reconstruct their teaching–learning experiences in an integrated practicum in maternal–child health services as a narrative inquiry. After presenting this reconstruction of experience at a conference on maternal scholarship, (...) further inquiry into their experiences shows how narrative inquiry matters to construction of nursing praxis and to life‐long learning as a nurse. Teaching–learning relationships are seen as a template for a student's connections to people experiencing nursing care and to other clinicians. Construction of stories to live by that take into account becoming a nurse, constructing knowledge and enacting caring–healing nursing practices is illuminated through narrative inquiry. (shrink)

This volume draws together a series of thirteen essays on ancient epistemology by Gail Fine. She discusses knowledge, belief, subjectivity, and scepticism in Plato, Aristotle, and the Pyrrhonian sceptics. They consider such questions as: is episteme knowledge? Is doxa belief? Do the ancientshave the notion of subjectivity? Do any of them countenance external world scepticism? Several essays compare these philosophers with one another, as well as with more recent discussions of knowledge, belief, subjectivity, and scepticism, asking how if at (...) all the ancient discussions of these topicsdiffer from more recent ones. In exploring these issues, the essays often make use of the distinction between concepts and conceptions, between an abstract account of something, and more determinate ways of filling it in. Together they compose a rich set of investigations, illuminating ancientperspectives on the central questions in epistemology. (shrink)

This review offers a critical analysis of Shannon Sullivan's “feminist pragmatist standpoint theory” as a framework for thinking about issues of identity and truth. Sullivan claims that Maurice Merleau-Ponty's emphasis on an anonymous or pre-personal quality to bodily experience commits him to a false universality and that his understanding of bodily intentionality traps him in a subjectivist philosophy that is incapable of doing justice to difference. She suggests that phenomenology in general is theoretically limited because of its alleged subjectivism and (...) universalism, and she turns to Dewey's pragmatism to develop a “transactional model” of identity and truth. In response, I argue that Merleau-Ponty's descriptions of anonymity and intentionality do not entail either subjectivism or a false universality. I also challenge Sullivan's conception of truth as transactional flourishing by appealing to the “terrible truths” of violence and oppression. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

This essay argues that Merleau-Ponty’s phenomenology of embodiment can be an extremely helpful ally for contemporary feminist theorists, critical race theorists, and disability studies scholars because his work suggests that the gender, race, and ability of bodies are not innate or fixed features of those bodies, much less corporeal indicators of physical, social, psychic, and even moral inferiority, but are themselves dynamic phenomena that have the potential to overturn accepted notions of normalcy, naturalness, and normativity. Taking seriously Merleau-Ponty’s insistence that (...) our bodies are the means by which we directly engage with the world, I suggest, encourages us to be attentive to how an individual’s or group’s gender, race, and bodily abilities differentially affect how their bodies are responded to by other bodies. The responses of others, in turn, directly influences the significance of an individual’s actions within that situation. This essay provides a critical examination of specific feminist philosophers, critical race scholars, and disability theorists who creatively utilize Merleau-Pontian insights to illustrate, and ultimately combat, the insidious ways in which sexism, racism, and “compulsory able-bodiedness”, impoverish the lived experience of both oppressors and the oppressed, largely by predetermining the meaning of their bodily interactions in accordance with institutionalized cultural expectations and norms. (shrink)

This article explores the development of a novel biomedical research organism, and its potential to remake the species and spaces of translational medicine. The humanized mouse is a complex experimental object in which mice, rendered immunodeficient through genetic alteration, are engrafted with human stem cells in the hope of reconstituting a human immune system for biomedical research and drug testing. These chimeric organisms have yet to garner the same commentary from social scientists as other human–animal hybrid forms. Yet, they are (...) rapidly being positioned as central to translational medicine in immunological research and pharmaceutical development. This article explores the complex relations between species and spaces they seek to enact. Humanizing mice simultaneously moves these animal forms towards the intimate geographies of corporeal equivalence with humans and the expansive geographies of translational research. These multiple trajectories are achieved by the way humanized mice function as both uncertain ‘epistemic things’ and as expansive ‘collaborative things’, articulating mouse genetics with other research, notably stem cell science. In the context of post-genomics, their indeterminacy is critical to their collaborative value; their expansive potential follows as much from their biological openness as from specific expectations. Yet, these new research organisms have both accumulative and disruptive capacities, for there are patterns of interference between these trajectories, remaking boundaries between experimental practices and clinical contexts. (shrink)

The literature on epistemic injustice has been helpful for highlighting some of the epistemic harms that have long troubled those working in area studies that concern oppressed populations. Nonetheless, a good deal of this literature is oriented toward those in a position to perpetrate injustices, rather than those who historically have been harmed by them. This orientation, I argue, is ill-suited to the work of epistemic decolonization. In this essay, I call and hold attention to the epistemic interests of those (...) who are epistemically marginalized on account of relations of dominance and oppression. To do so, I draw on Kristie Dotson’s work, which uses a systems approach focused on epistemic agency. I develop Dotson’s insights further to argue that epistemic inclusions may be just as pernicious as epistemic exclusions Specifically, I highlight some of the ways in which epistemic agents can be included in epistemic systems in a manner that is epistemically exploitative—extracting epistemic labor coercively or in ways that are distinctly non-reciprocal. I then turn to María Lugones’ distinction between horizontal and vertical practices to discuss avenues of resisting both exclusions and inclusions that thwart the epistemic agency of marginalized knowers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Sexual Difference as Model: An Ethics for the Global FutureGail SchwabIn Éthique de la différence sexuelle (1984), Luce Irigaray targeted language and love—for her, inseparable from each other—as the two areas of focus for the elaboration of an ethics of sexual difference. The heterosexual couple seemed to have taken on a new, and somehow inappropriately central, importance in Irigaray’s thought in the early eighties; however, the projected mutations in (...) language and love theorized in Éthique did not exclusively concern the heterosexual relationship, even though many readers of Irigaray expressed just such reservations about the book. Éthique foregrounded the couple in the love relationship in order to rethink the philosophical basis of ethics in general, to develop new paradigms, beyond or outside of Western totalizing phallo- and logocentrism, for human relations—not only relations between women and men, but also, and perhaps even more importantly, relations among women and relations among men. Irigaray carried on this project in subsequent works, in Sexes et parentés (1987), which as the title explicitly indicates, opens up the ethical debate to familial and genealogical issues and broadens her focus to include children and the ethical basis of their relationships to parents and more generally to adults of both sexes, and in Sexes et genres à travers les langues (1990), a cross-cultural report on her empirical studies of gender differences in language usage, which sheds new light on the linguistic and communicational issues she had presented in Éthique and even before, in several seldom read and even more rarely analyzed works of the late seventies and early eighties. J’aime à toi (I Love to You) (1992) returns specifically to the more traditionally philosophical approach to the problems of language and love and their intertwining, and carries on the work projected in Éthique, but it goes much further in both the theoretical and the practical development of the concept of sexual difference as the foundation for a new ethics, a new culture of universal validity. J’aime à toi can be read as a follow-up to Éthique and as a founding text for the construction of an ethics of difference modeled on sexual difference, an ethics for the future of humanity in all of its diversity.Western Feminism and the Global FutureIrigaray is very much aware of the limits of the various Western political and academic feminisms, of the need to broaden their scope, both horizontally across cultures and vertically within specific cultures, before they can serve as the basis for a new ethics. Irigaray expresses the concern that Western feminists, rather than represent the exploited women of the world, may exploit them ideologically for their own personal or political purposes, at the risk of preventing them from coming to a feminism of their own making, appropriate to their own cultures and historical moments. “Certain women do implement power strategies—including the power of the media—but not solely for the benefit of the exploited women they use as an alibi. They thus run the risk of clouding the issues and [End Page 76] preventing their consciousness from being raised” [Irigaray, J’aime à toi 15]. 1 Irigaray calls this “egological” feminism (Dare I invent a new term here? Now we have “egofeminists” as well as “ecofeminists”...) and demonstrates its totally undemocratic orientation, despite its representative claims.Certain militants..., practicing direct democracy or an egological feminism, based on their own real, or imagined, needs and desires, rather than on those of all women, leave women subject to existing legislation. Indifferent to the rights necessary for all women—including the little girls of the present and the future, and the women of other cultures—they make decisions that perpetuate, and even aggravate, through unnecessary misunderstandings, the injustices done the female gender.[J’aime à toi 13]As a feminist, in general, it always pains me to read criticisms of feminism, even cogent and theoretically valid criticisms, and I am even now painfully aware of the political dangers of criticizing feminism myself in a public forum such as this one. However, if I have managed to learn anything from the works of Western feminists of color and from Third World feminists, it is... (shrink)

In The Alchemy of Race and Rights Patricia Williams notes that when people of color are asked to understand such practices as racial profiling by putting themselves in the shoes of white people, they are, in effect, being asked to, ‘look into the mirror of frightened white faces for the reality of their undesirability’ (1992, 46). While we often see understanding another as ethically and epistemically virtuous, in this paper I argue that it is wrong in some cases to ask (...) another to attempt to understand certain positions or lines of thought. In developing my argument I draw on the work of María Lugones to argue for a view of agency that is epistemically interdependent. I examine the case described by Patricia Williams to demonstrate specifically how the understanding requested in this case unfairly undermines both epistemic and non-epistemic agency. I distinguish appropriate requests for understanding from inappropriate requests so as to make clear that I am not suggesting that it is wrong to make such requests when the understanding sought after is difficult, painful, or even when it forces one to reconsider the meaning of one’s actions. Finally, I examine an example from Susan Brison to show how strategic refusals to understand may provide a pathway toward new ways of knowing and being in resistance to oppressive regimes. (shrink)