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

ABSTRACTAn essential and yet often neglected motivation of Bernard Suits’ elevation of gameplay to the ideal of human existence is his account of capacities along perfectionist lines and the function of games in eliciting them. In his work Suits treats the expression of these capacities as implicitly good and the purest expression of the human telos. Although it is a possible interpretation to take Suits’ utopian vision to mean that gameplay in his future utopia must consist of the logically inevitable (...) replaying of activities we conduct in the present for instrumental reasons, because gameplay for Suits is identical with the expression of sets of capacities specifically elicited by game rules, it is much more likely that he intends utopian gameplay to be an endless series of carefully crafted opportunities for the elicitation of special capacities, and thus embody his ideal of existence. This article therefore provides a new lens for understanding both... (shrink)

BackgroundTo help inform the development of more accessible, acceptable, and effective ethics consultation (EC) training programs, we conducted an EC training needs assessment, exploring ethics practitioners’ opinions on: the relative importance of various EC practitioner competencies; the potential market for EC training (that is, how many individuals would benefit and how much individuals and hospitals would be willing to pay); and the preferred content, format, and characteristics of EC training.MethodsAs part of a multipart study, we surveyed “best informants” who self-identified (...) as the person most actively involved in EC or healthcare ethics in a random sample of 600 U.S. general hospitals, stratified for bed size.ResultsThe competency that was ranked most important for a lead or solo ethics consultant was knowledge of ethics, while common sense was ranked least important. The median estimated number of individuals at each hospital who would benefit from EC training was six at the basic level, three at the advanced level, and two for EC management training. In 19.1 percent of hospitals, respondents thought their hospital would not be willing to pay anything for EC training within the next two years. Respondents thought potential trainees would be likely to participate in EC training on multiple different topics. Opinions varied widely on preferred formats. Most respondents thought it very important to be able to interact with instructors and with other trainees, practice EC skills, receive a certificate for completing EC training, and complete EC training during work hours.ConclusionsThese findings provide U.S. population data that may be useful to healthcare educators and bioethics leaders in their efforts to develop EC training programs and products that match trainees’ preferences and needs. (shrink)

Prowse, Christopher C On 27 October 2010, His Holiness, Pope Benedict XVI, announced that the topic for the XIII Ordinary General Assembly in Rome (7-28 October 2012) would be 'The New Evangelisation for the Transmission of the Christian Faith.' This was not entirely unexpected given the importance this topic has generated in the documents of the Second Vatican Council, and in the teachings of Popes Paul VI, John Paul II and now Benedict XVI. Clearly, with the establishment of the (...) ad hoc dicastery (21 September 2010) on evangelisation, the Holy Father, Benedict XVI, wishes to raise the promotion of this vital topic to an even higher level. (shrink)

C. Thi Nguyen – the author whose new book, Games: Agency as Art, is the main provocation for co-editor John Russell and I putting together this special issue of the Journal of the Philosophy of Spo...

I argue that we have good reason to reject Bernard Suits’ assertion that game-playing is the ideal of human existence, in the absence of a suitably robust account of utopian games. The chief motivating force behind this rejection rests in the fact that Suits begs the question that there exists some possible set of games-by-design in his utopia, such that the playing of its members would sustain an existentially meaningful existence for his utopians, in the event of a hypo-instrumental culture (...) of material superabundance obtaining. But the set of utopian games is unknown and unknowable. Thus any implications of Suits’ vision for the utilization of our leisure time in the present are vitiated by the collapse of his normative ideal: his ‘metaphysics of leisure’ misses its mark. (shrink)

This chapter examines Eastern Orthodox perspectives on natural theology. The discussions cover the classical roots Orthodox understanding of knowledge of God; worship and eschatology; creation and the limits of natural theology; panentheism and the structure of theophany; and science and theology in Orthodoxy.

Freedom to innovate in teaching and learning are essential to meaningful higher education. Universities’ rhetorical commitments to freedom and innovation are ubiquitous and quite homogenous. Beneath the rhetoric, however, lie sharp divides between neo-liberal and Humboldtian approaches to innovation, course design, teaching and learning. This article argues that to understand the authentic approach of a university to innovation requires going beyond the rhetoric. We must instead examine context-specific experiences and understandings of the curriculum, especially in terms of teaching, learning, assessment (...) and evaluation. Making this critical examination, we see that Humboldtian frameworks rely on broad understandings of value connected to learners and their communities. Neoliberal frameworks by contrast reduce and essentialise these understandings to customer service provision. Treating students as customers has significant implications for how innovation is defined and enacted through increasing aversion to the risks inherent to attempting innovation. Quality evaluation and assurance processes inevitably align with an institution’s authentic approach, regardless of what rhetorical commitments suggest. The article concludes by suggesting ways forward grounded in teaching, learning and evaluation. These are congruent with a Humboldtian approach and may, through their application bring the rhetoric of teaching and learning innovation into alignment with experienced reality. (shrink)

Provides an orientation and an array of conceptual & critical tools for scholars theorising political life today. Christopher Robinson connects Wittgenstein's philosophy to strategies for achieving political vision in this age where politics has been replaced by bureaucracy as the predominant form of public order, and now takes the form of dissent.In particular, Wittgenstein's remarks on perception are brought to bear on theory's historical and etymological roots in clear seeing. This frees the theorist to explore the city of language (...) and sheds fresh light on political concepts such as liberty, dignity, dissent, and ideology. (shrink)

The model identifies a spatial coordinate frame within which the sensorimotor apparatus produces movement. Its spatial nature simplifies its coupling with spatial reference frames used concurrently by vision and proprioception. While the positional reference frame addresses the performance of spatial tasks, it seems to have little to say about movements involving energy expenditure as the principle component of the task.

The attempt to understand and develop Plato's philosophical views has a long history, starting with Aristotle and Plato's institutional successors in the academy towards the end of the fourth century bc. This article traces the history and development of the idea of Platonism. The development of a specifically Platonic philosophy took place mainly within the academy. As a result, the idea that Plato's dialogues already presented a well defined, comprehensive, and essentially correct philosophical system seems not to have arisen until (...) the first century bc. And it was probably not until toward the beginning of the second century ad that a disparate set of philosophers who identified themselves as “Platonists” conceived the project of advocating and defending a specifically Platonic philosophy of this kind by systematically interpreting and explaining Plato's texts. (shrink)

Do famous athletes have special obligations to act virtuously? A number of philosophers have investigated this question by examining whether famous athletes are subject to special role model obligations (Wellman 2003; Feezel 2005; Spurgin 2012). In this paper we will take a different approach and give a positive response to this question by arguing for the position that sport and gaming celebrities are ‘ambassadors of the game’: moral agents whose vocations as rule-followers have unique implications for their non-lusory lives. According (...) to this idea, the actions of a game’s players and other stakeholders—especially the actions of its stars—directly affect the value of the game itself, a fact which generates additional moral reasons to behave in a virtuous manner. We will begin by explaining the three main positions one may take with respect to the question: moral exceptionalism, moral generalism, and moral exemplarism. We will argue that no convincing case for moral exemplarism has thus far been made, which gives us reason to look for new ways to defend this position. We then provide our own ‘ambassadors of the game’ account and argue that it gives us good reason to think that sport and game celebrities are subject to special obligations to act virtuously. (shrink)

ABSTRACTI argue that the apparently exclusive choice between Suits’ utopia of gameplay and death by suicide is a false dilemma, one which obscures a ‘third way’ of positive boredom. Further, I offe...

The introduction charts Hans-Johann Glock’s academic career, introduces some of his core philosophical views, and provides an overview of the chapters included in the festschrift.

The dialectic of private desire and public imperative — their conflict and interpenetration and mutual causation — has been the theme of the Troy story through three millennia. When W. B. Yeats wrote a poem about the irruption of sexual passion in the pattern of human events, and its incalculable aftermath in history, he restated powerfully for the twentieth century a perception which nevertheless goes back to Homer.

We investigate the association between a wide range of community-level environmental, social, and governance (ESG) outcomes and the credit risk of U.S. municipal finance fixed-income securities. We develop a novel dataset of multiple ESG outcomes for U.S. counties and connect it to a 2001-2020 panel of municipal bonds issued within those counties. Overall, we find supportive evidence that collective increases in community-level ESG factors (i.e., ESG outcomes) are associated with reductions in credit risk for U.S. municipal finance instruments over time. (...) We theorize that these associations arise from variations in investor perceptions and manifested changes in fiscal health over time as a function of changing ESG outcomes. Post hoc analyses leveraging quasi-exogenous shocks to uncertainty, as well as connecting ESG outcomes to various measures of fiscal health at the county-year level, and credit ratings at the bond-year level, help validate this theory. Our research suggests that even socially agnostic investors should investigate the environmental and social performance of a municipality as part of their credit due diligence. (shrink)

On the basis of both philosophical arguments and the theological perspectives of Eastern Orthodox Christianity, a critique of two beliefs that are common within the mainstream science–theology dialogue is outlined. These relate to critical realism in understanding language usage and to naturalistic perspectives in relation to divine action. While the naturalistic perspectives on the history of the cosmos that are predominant within the dialogue are seen as generally acceptable from an Orthodox perspective, it is argued that they require theological expansion. (...) This expansion suggests an understanding other than the “causal joint” model commonly adopted in relation to “special” divine action. This alternative model renders the distinction between “special” and “general” divine action redundant, and is based on what has been called a “teleological-Christological” understanding of the cosmos, rooted in the fourth gospel's notion of the divine Logos. The relevance of this critique to scholars outside of the Orthodox community is urged. (shrink)

The paper examines Davidson′s discussion of Frege on the problem of predication. Simple declarative sentences are unities that are true or false; how do predicates contribute to this kind of semantic unity? According to Davidson, the problem cannot be solved by assigning referents to predicates, since this leads to an infinite regress. Frege famously contributes the idea that predicates are “incomplete” or “unsaturated” functional expressions, mapping objects to truth-values. However, he takes predicates to refer to concepts and thus is exposed (...) to Davidson′s argument. I will show that Davidson is only right with regards to “Frege′s semantics”. Yet Frege′s logical doctrine of the decomposition of a sentence – I shall argue – allows for a resolution of this problem. (shrink)

Ideal families defined on a cardinalk often exhibit reflection properties. IfC ⫅k is a club, for example, thenC∩α is a club-in-α club-in-k often. In this paper we generalize this notion to ideal families defined on℘ kλ and exhibit some examples.

Over the past two decades many social studies educators have called for history to be taught as interpretation, which has included arguments for the teaching of history through inquiry. This case study examined four secondary social studies teachers and their development of beliefs and practices related to teaching history as interpretation. The data were collected longitudinally from their student teaching through the completion of their first year in the classroom. Corroborating arguments found in the pre-existing research, this study found that (...) classroom control and a limited understanding of history content were major barriers preventing teachers from teaching history as interpretation. However, the results also revealed that teachers desired a better development of their own practical “toolkit” and they believed this would have helped them overcome many of the barriers to teaching history as interpretation. (shrink)

(2002). Speaking Across Time and Cultures in Bioethics and Environmental Ethics. Ethics, Place & Environment: Vol. 5, No. 3, pp. 271-280. doi: 10.1080/1366879022000077804.

Theorizing has been conceived historically in illuminative and ocular metaphors, and as an activity that occurs in a fixed and privileged relation to political society that permits a panoramic perspective. These elements of light, sight, and distance, are supportable existentially and ethically in post-war, post-Holocaust world. One of the first to explore the challenges to theorizing in this era was Albert Camus. He provided phenomenological and existential investigations of the obstacles to theorizing politics in his literary works, particularly his trilogy (...) of novels: The Stranger , The Plague , and The Fall . In this paper, I offer a reading of these novels that isolates theorizing as an activity performed not from a transcendent perceptual vantage of perfect light and vision, but from the immanent perspectives achieved in the city, among friends, or by exile. (shrink)

This chapter, which concentrates on the violent imaginaries that informed the reports and deeds of the 1994 Rwandan genocide, reviews the perseverance of pre-colonial notions of a sacred king whose “wild sovereignty” and inability to promote the flow of imaana earns him fateful sacrifice. The term imaana denotes a supreme being and, in a more generalized way, a “diffuse, fecundating fluid” of celestial origin whose activity upon livestock, land, and people brought fertility and abundance. As imaana's earthly representative, the king (...) channeled fertility to the rest of humanity. The chapter also discusses symbolism of the sovereign's body and its implicit link with the process of liquid flow. Habyarimana is an inadequate conduit of imaana and thus not a worthy king. He is the antithesis of Ruganzu Ndori. -/- . (shrink)

The annual volume of ethics consultations (ECs) has been a topic of interest in the bioethics literature, in part because of its presumed relationship to quality. To better understand factors associated with EC volume, we used multiple linear regression to model the number of case consultations performed in the last year based on a national survey. We found that hospital bed size, academic affiliation, and urban/rural location were all associated with EC volume, but were not the primary drivers. Instead, these (...) variables affected EC volume through three other variables, all of which relate to ethics staffing: the percentage of case consultations performed by a single individual; whether the survey respondent’s main role at the hospital contained the word “ethics”; and especially, the number of full-time ethics program staff. We conclude that EC is an example of supply-sensitive care, and further research is needed to determine the optimal level of EC activity. (shrink)

This paper will compare the concept of nature as it appears in the philosophies of the American pragmatist John Dewey and the Chinese text known as the Zhuangzi, with an aim towards mapping out a heuristic program which might be used to correct various interpretive difficulties in reading each figure. I shall argue that Dewey and Zhuangzi both held more complex and comprehensive philosophies of nature than for which either is typically credited. Such a view of nature turns on the (...) notion of continuity, particularly that between an experiencing organism [Dewey’s “live creature”] and the conditioning environment [Zhuangzi’s “crooked tree”]. Where Dewey’s and Zhuangzi’s ideas about nature converge, one finds similarities in prescriptions made for human action, and in the few places where they differ, one finds mutually complementary insights. (shrink)

The sublime has been a baffling concept since its introduction by Longinus nearly two thousand years ago. What do we mean when we say something is sublime? This paper will attempt to answer that question by proposing a radical new theory of the sublime, examining the aesthetic experience called the sublime through the lens of the Madhyamaka Buddhist philosophical view of emptiness (Skt. śūnyatā). Drawing on Guy Sircello’s work (1993), I critique traditional Western accounts of the sublime, with their explicit (...) or implicit—but always problematic—commitments to epistemological and ontological transcendence. A brief summary of the Madhyamaka Buddhist view of emptiness, as elucidated in the Prajñāpāramitā literature, Nāgārjuna’s Mūlamadhyamakakārikā, and elsewhere, provides a context for examining the dialectic of the sublime and emptiness. I make the argument that the sublime experience is, in fact, an experience of emptiness. I conclude by surveying five years of the early work of visual artist Robert Rauschenberg, which express the open, clear, vivid, and unselfconscious space of emptiness in his approach to, and process of, artistic expression. (shrink)

The thesis of this paper is that utopianism is a theoretical necessity—we couldn’t, for example, engage in normative political philosophy without it—and, further, that in consciously embracing utopianism we will consequently experience an enrichment of our political lives. Thus, the title of my paper has a double meaning: it highlights the fact that utopianism always plays a normative role in political philosophy, as its concern is inevitably the promotion of a certain vision of the good life; and secondly it suggests (...) that there normatively ‘ought to be’ a recognized and respectable role for utopianism within political philosophy. The first meaning, I believe, is self-explanatory. Regarding the second, it expresses my hope to— in short— take what is old, and through a modest process of rehabilitation, make it new again. (shrink)