Volume 25, Issue 2, February 2025, Page 145-148.

The overall goal of clinical ethics consultation is to “improve the quality of healthcare outcomes” (ASBH 2011, 3). I find this focus helps me avoid people pleasing, system allegiance, being swayed...

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 lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.3 (2003) 104-107 [Access article in PDF] Motivating Aesthetics Cynthia C. Rostankowski Humanities Department San Jose State University The territory of philosophical aesthetics remains a conceptual hinterland in the world of academic disciplines. It is not the only hinterland, but in comparison to other disciplines in arts and letters, few scholars engage in the subject professionally, and many people avoid the territory it (...) occupies as a place to visit, let alone to tarry or reside. Why is this? Usually people do not wish to visit places that are uncomfortable in some way. Frozen wastelands, blazing deserts, war zones, and places with nothing to do or see are usually avoided because they are perceived as unpleasant, dangerous, or boring,and the same is very likely true of their conceptual analogs. In what senses might some people perceive aesthetics as analogous to Siberia, Sudan, or central Kansas? I would like to investigate what it is about aesthetics that causes people to shy away from it more often than to flock to it. I have long been fascinated by the responses of students who express amazement or confusion when exposed to the field of aesthetics as a part of an introductory philosophy class, or of arts educators who do not know what to do with aesthetics since it does not seem quite to fit with the rest of what they do, or the responses of some artists or other arts practitioners who are occasionally disdainful of aesthetics. It would be easy to say that aesthetics has merely had bad press or inadequate exposure in the classroom, but I suspect there is more to it than that. I have experienced many of the situations I have just mentioned, and they have usually surprised and sometimes demoralized [End Page 104] me. They have always motivated me to think harder about my beloved field of interest, to try to reveal its attractions to those who do not find it as appealing and engaging as I do, or as you, my reader does. (I am presuming that one who is reading an essay in a journal about aesthetic education has already found his or her comfort zone in the field.) I will also presume to offer some thoughts about motivating an interest in aesthetics among the aesthetically uninterested — why one might want to do it, and what one might do. Please note, I am not speaking of the aesthetically disinterested 1 ; they too have already found their place in the discipline!It is likely that the problem of aesthetics has to do in part with misunderstandings, and those misunderstandings are multi-layered. If one looks up the word "aesthetic" in the Oxford English Dictionary, one finds the following: (F)rom the Greek for perception...and, being pre-occupied;...pertaining to things perceptible by the senses, things material;..."criticism of taste"...the science which treats of the conditions of sensuous perception...of or pertaining to the appreciation or criticism of the beautiful...Recent extravagances in the adoption of a sentimental archaism as the ideal of beauty have still further removed aesthetic and its derivatives from their etymological and purely philosophical meaning. There are varied suggestions about the use of the term, including the mention of its removal in contemporary parlance from its original meanings. If one looks up the keyword "aesthetic" on the Internet, one may find the following sites: skin care, plastic surgery, dentistry, exterior and interior design, tattoos, and some art, art theory, and philosophy among other things. An exemplification in practice of what is suggested in the OED. It is clear that the meaning of the word "aesthetic" has become at best imprecise, at worst confusing in common parlance.So, the first misunderstanding regarding aesthetics is the meaning of the term. What is philosophical aesthetics? It is not what some misconstrue as the imposition of value judgments on society. Unfortunately, some presume that because matters of taste or definitions of beauty are considered in the field, someone must be telling someone what they ought to think is pleasing or beautiful. This is not the focus... (shrink)

We all experience loneliness at some time in our lives and it often motivates people, consciously or otherwise, to enter treatment. Yet it is rarely explicitly addressed in psychoanalytic literature. _Loneliness and Longing_ rectifies this oversight by thoroughly exploring this painful psychological state. In this book contributors address the inner sense of loneliness – that is feeling alone even in the company of others – by drawing on different aspects of loneliness and longing. Topics covered include: loneliness in the consulting (...) room the relationship between loneliness and love the effects of social networking and the internet how loneliness changes throughout the life-cycle healing the analyst’s loneliness. _Loneliness and Longing_ draws on both theory and practice to discuss ways to help people to understand and cope with this important emotional state, encouraging them to make loneliness and longing less pervasive in their lives. This will be ideal reading for analysts, psychotherapists, and related practitioners facing the challenges of loneliness in their consulting rooms. (shrink)

8 March, now known as International Women’s Day, is a day for feminist claims where demonstrations are organized in over 150 countries, with the participation of millions of women all around the world. These demonstrations can be viewed as collective rituals and thus focus attention on the processes that facilitate different psychosocial effects. This work aims to explore the mechanisms involved in participation in the demonstrations of 8 March 2020, collective and ritualized feminist actions, and their correlates associated with personal (...) well-being and collective well-being, collective efficacy and collective growth, and behavioral intention to support the fight for women’s rights. To this end, a cross-cultural study was conducted with the participation of 2,854 people from countries in Latin America and Europe, with a retrospective correlational cross-sectional design and a convenience sample. Participants were divided between demonstration participants and non-demonstrators or followers who monitored participants through the media and social networks. Compared with non-demonstrators and with males, female and non-binary gender respondents had greater scores in mechanisms and criterion variables. Further random-effects model meta-analyses revealed that the perceived emotional synchrony was consistently associated with more proximal mechanisms, as well as with criterion variables. Finally, sequential moderation analyses showed that proposed mechanisms successfully mediated the effects of participation on every criterion variable. These results indicate that participation in 8M marches and demonstrations can be analyzed through the literature on collective rituals. As such, collective participation implies positive outcomes both individually and collectively, which are further reinforced through key psychological mechanisms, in line with a Durkheimian approach to collective rituals. (shrink)

Examining Metaphors in Biopolitical Discourse This essay argues that common metaphors and metaphoric phrases used in biopolitical discourse limit how meanings are constructed by framing messages narrowly: so much so, that alternate readings are delimited, resulting in less opportunity for cognitive scrutiny of such messages. We moor our discussion of metaphors in cognitive linguistics, building on three decades of research by scholars including Sam Glucksberg, George Lakoff and Mark Johnson, and Ray Gibbs, Jr., demonstrating how research in framing effects bolsters (...) our claims of limited entailments resulting from message construction. By situating our discussion of framing in biopolitics we make a case that metaphors including Frankenfood, designer baby, vegetative state and death tax address how life and death are "managed" in discourse. In this essay we demonstrate ways in which the framing of some metaphors in social discourse slip under readers' and viewers' cognitive radars, and thus become "under-the-radar metaphors.". (shrink)

Mindfulness for the High Performance World provides a unique approach to mindfulness training, built upon the principles of Buddhist philosophy written in line with the Dalai Lama’s description of meditation and mindfulness as “Science of the Mind”. This unique volume explores mindfulness as a learnable skill in context with the underpinnings of the teachings of Eastern psychology. The authors, Norm, a physician, cancer researcher and triathlete and Karolynn, a psychotherapist, mindfulness meditation teacher and marathoner, live and work in a high-stress, (...) high-expectation world. Their approach is rooted in an understanding that thoughts produce biochemical and physiological changes and provides a strategic framework to instruct an individual on how to categorize types of thoughts. After harnessing this ability, one is positioned to become both more aware of his or her thoughts as well as the specific patterns of sensations they produce, or Sentinel SitesSM. The awareness of what the mind is doing and the ability to interrupt a thought pattern and/or control the response almost instantly leads one to having a healthier life, improved relationships with others and better adaptability to one’s environment. Emphasizing the importance of physical activity and nutrition, the authors present a systematic approach for people who want to learn and incorporate mindfulness and transform how they live without having to divert their lives and careers. Offering itself as an accessible and skill-based introduction to the principles, practices, and benefits of mindfulness, Mindfulness for the High Performance World is a useful resource for students, athletes and professionals living and working in high-performance, high-stress environments and also for mindfulness practitioners seeking to deepen their skill level. (shrink)

Using data from a randomized field experiment within a Deliberative Poll, this paper examines deliberation’s effects on both policy attitudes and the extent to which ordinal rankings of policy options approach single-peakedness (a help in avoiding cyclical majorities). The setting was New Haven, Connecticut, and its surrounding towns; the issues were airport expansion and revenue sharing – the former highly salient, the latter not at all. Half the participants deliberated revenue sharing, then the airport; the other half the reverse. This (...) split-half design helps distinguish the effects of the formal on-site deliberations from those of other aspects of the treatment. As expected, the highly salient airport issue saw only a slight effect, while much less salient revenue-sharing issue saw a much larger one. (shrink)

Few figures of the Middle Ages command the attention of so many modern disciplines as Robert Grosseteste (c. 1170-1253). Theology, Philosophy, History, and Science are all areas which his life and thought continue to have significance and to inspire re-interpretation. Accompanied by a series of original commentaries, this new edition of Grosseteste's work, with English translation, draws together the perspectives of modern scientists and medieval specialists. Volume I of a six volume series, Knowing and Speaking presents two of the earliest (...) of Grosseteste's works, the treatises On the Liberal Arts and On the Generation of Sounds. These are accompanied by a significant Middle English treatise on the Seven Liberal Arts whose anonymous fifteenth-century author translated and excerpted passages from Grosseteste's treatises in a re-imagining of their structure and function.0Each work is treated separately within the volume, which is constructed in three parts. On the Liberal Arts sets Grosseteste's thoughts on the arts subjects and emphasises moral concerns about the purpose of learning. On the Generation of Sounds builds on the theories and statements of On the Liberal Arts in connection to the production of sound, elaborating the earlier position, relating the generation of sounds to human vocal and speech production. (shrink)

Requiring that a woman who is seeking an abortion be given the opportunity to view an ultrasound of her fetus has spread from anti-abortion “pregnancy resource centers” to state laws. Proponents of these laws claim that having access to the ultrasound image is necessary for a woman to make a medically informed decision. In this paper, we argue that ultrasound examinations frame fetuses visually and linguistically as persons and interpellate pregnant women as mothers, with all of the cultural meaning invested (...) in those two normative concepts. Presenting these judgments as medical information is misleading. Because women are being subjected to these cultural expectations unknowingly, mandatory ultrasound laws in fact undermine women’s autonomy. Fully informed consent would include a critical engagement with social norms around femininity and a recognition that such laws are meant to advance the state’s interest in preserving potential life. (shrink)

We conduct an experiment with 459 nonprofessional investors to examine whether they evaluate companies differently based on management’s stated purpose for undertaking corporate social responsibility activities in the presence versus absence of a company-specific negative event. Specifically, we vary whether or not management intends to achieve financial returns from CSR activities in addition to promoting social good. We address investors’ decision processes by investigating whether their judgments are mediated by perceptions of future cash flows and/or the underlying ethical culture of (...) the company. Results show that absent a negative event, investment judgments are stronger when CSR activities are intended to achieve financial returns, through expectations of higher future cash flows. However, when a negative event occurs, we find a moderating effect of independent assurance of CSR disclosures. When disclosures are not assured, investors prefer CSR undertaken only for societal benefit, mediated by perceptions of a stronger ethical culture. However, when disclosures are assured, ethical culture is viewed similarly regardless of management’s intention to achieve financial returns from CSR activities. This suggests that management’s willingness to obtain independent assurance on disclosures is viewed as a positive ethical signal. Thus, assurance complements disclosure of CSR activities by contributing to protection against the impact of negative events. (shrink)

ABSTRACT In public debates there are occasions on which persons might feel obligated to show disrespect in order to preserve integrity. In some public discourses interlocutors often show disrespect by “writing off” one another's reasons in an attempt to defend and preserve their own particular beliefs. To make better sense of the apparent discomfiture of intuitions concerning the connections between respect and integrity in such public confrontations, an “other-words orientation” to communication is proposed. The other-words orientation requires that individuals “stand (...) for something” but in a way that respects one's opposition as the living, breathing, reason-giving entities they are. The ancient art of double argument is central to this endeavor. (shrink)

We consider the motivation for the principle of bottom-up priority and its consequence for information flow in Merge. The relationship between the bottom-up priority rule and inhibitory effects is also discussed, along with data that demonstrate inhibitory influences in phoneme monitoring.

Few studies in sub-Saharan Africa evaluate Institutional Review Boards (IRBs) capacity. The study aims to explore the composition of IRBs, training, and challenges experienced in the ethics review processes by members of research institutions and universities in Addis Ababa, Ethiopia. Our findings indicate that most IRBs members were trained on research ethics and good clinical practice. However, majority perceived the trainings as basic. IRB members faced several challenges including: investigators wanting rapid review; time pressure; investigators not following checklists; limited expertise (...) in reviewing clinical trials, studies on genetics, and traditional medicine; lack of IRB offices for administrative work; competing tasks; limited staffing and the lack of a standardized review system. There is need for advanced training on research ethics to meet the evolving research needs. In addition, investments in IRBs are needed in terms of funding, and physical and human resources in Addis Ababa and Ethiopia in general. (shrink)

The Fractured Self in Freud and German Philosophy examines Freud's transformation of German philosophical approaches to freedom, history, and self-knowledge; defends a theory of situated knowledge and agency; and considers the relevance of Freudian thought for contemporary cultural issues.

Amid increasing demands from students and the public, universities have recently reinvigorated their efforts to increase the number of faculty from underrepresented populations. Although a myriad of piecemeal programs targeting individual recruitment and development have been piloted at several institutions, overall growth in faculty diversity remains almost negligible and highly localized. To bring about genuine change, we hypothesize a consortia approach that links individuals to hiring opportunities within a state university system might be more effective. Here we present a case (...) study describing the progress of the NSF-funded Alliances for Graduate Education and the Professoriate PROMISE Academy Alliance, a consortium within the University System of Maryland collaborating to develop, implement, self-study, evaluate, and disseminate a unique postdoc-to-faculty conversion model in the biomedical sciences. The initiative centers on diversifying faculty across five institutions in the USM, including teaching-focused institutions, comprehensive universities, research institutions, and professional schools. Components of this approach include enhanced recruiting and hiring practices to attract outstanding postdoctoral scholars from underrepresented backgrounds, multi-institutional networking and professional development, and facilitated processes to transition postdocs into tenure-track positions at their postdoctoral institution or another institution in the state system. This model is distinct from more deficit-based approaches because it goes beyond focusing on building the individual’s skills to enter the professoriate. This program restructures the traditionally short-term nature of postdoctoral employment and incorporates a pathway to a tenure-track professorship at the same institution or within the same statewide system where the postdoc is trained. This multi-institutional model leverages collaboration and distinct institutional strengths to create cross-institutional support, advocacy, and policy. Importantly, it uses a decentralized financial structure that makes this approach distinctly replicable. Recognizing the immediate need for more collaborative approaches to diversify faculty and a lack of literature about such approaches, this case study describes the development of, and potential benefits of, a state university system, as well as the qualitative lessons learned from self-study, internal evaluation, external evaluation, and NSF site visits. The AGEP PROMISE Academy can serve as a model for replication at other university systems hoping to diversify their faculty. (shrink)

Book reviewed in this article: Ethics and Critical Care Medicine. John C. Moskop and Loretta Kopelman, eds. Dordrecht: D. Reidel “Ethical Moments in Critical Care Medicine,” symposium issue of Critical Care Clinics. James P. Orlowski and George A. Kanoti, eds.

Drawing on the influence of primacy and recency effects in processing information about corporate social responsibility, the authors examine how internal and external factors impact the consumer-firm relationship in the presence of contradictory CSR information. Evaluating these factors provides a more comprehensive understanding of how consumers react to unethical and socially irresponsible actions. Contrary to recent research that suggests a reactive CSR communication strategy to be best due to recency effects, the present findings show that past customer experiences with the (...) firm facilitate a ‘primacy effect’. Thus, when corporate social irresponsibility occurs, a customer’s prior experiences mitigate negative consequences. Conversely, a firm’s positive CSR reputation may provide goodwill, although it does not guarantee that consumers will process CSR information differently. Therefore, firms cannot build a strong CSR reputation and expect to be immune from the consequences of CSI. Given these new findings of how consumers process contradictory CSR information, firms should implement a strategic and deliberate communication plan that delivers different messages to different stakeholders. Specifically, these findings suggest that firms benefit most from a proactive communication strategy with their current customers and a reactive communication strategy with the general public. (shrink)

When disaster disrupts healthcare and other systems, the ethical allocation of resources should follow principles of justice, defined as fairness, established for normal clinical practice. Standards of clinical practice may be altered during disaster, but ethical standards must remain centered on prioritizing the treatment of patients according to need and the effectiveness of treatment. Should resources become extremely limited, it is fair to restrict their use to patients who have the highest needs, provided that the intervention is effective. When resources (...) become more available, patients with lower priority can be increasingly accommodated. (shrink)

The conception of subjectivity that dominates the Western philosophical tradition, particularly during the Enlightenment, sets up a simple dichotomy: either the subject is ultimately autonomous or it is merely a causally determined thing. Fichte and Freud challenge this model by formulating theories of subjectivity that transcend this opposition. Fichte conceives of the subject as based in absolute activity, but that activity is qualified by a check for which it is not ultimately responsible. Freud explains the behavior of the self in (...) terms of biological drives and social pressures, yet both forces are actively interpreted by the subject itself. The tensions that arise from these very different approaches show that both Fichte and Freud are trying to overcome this deeply imbedded dichotomy between freedom and determinism. Although some would respond to these tensions by trying to forge a Hegelian synthesis, such a resolution covers over the paradoxical nature of finite subjectivity. (shrink)

This article addresses ethical issues in conducting randomized clinical trials with youth. Ethical considerations that occur prior to treatment, during treatment, and following treatment are reviewed. Recommendations, based on empirical evidence and clinical experience, are offered for conducting ethical treatment research with youth and future directions for carrying out research on the ethics of conducting RCTs with youth are offered.

Volume 20, Issue 3, March 2020, Page 46-50.

In recent years, scholars have documented the racial disparities of mass incarceration. In this paper we argue that, although retributivism and deterrence theory appear to be race-neutral, in the contemporary U.S. context these seemingly contrary theories function jointly to rationalize racial inequities in the criminal justice system. When people of color are culturally associated with criminality, they are perceived as both irresponsible and hyperresponsible, a paradox that reflects their status as what Charles Mills calls subpersons. Following from this paradox, criminality (...) is understood as an atemporal characteristic of people of color, such that they are conceived as pre-criminals, criminals, or post-criminals. In Frantz Fanon’s account, overdetermination expresses this exclusion of people of color from full agency by capturing them within a rigid, immutable essence, which then controls the social meaning of their actions. The backward-looking quality of retribution and the forward-looking quality of deterrence then treat people of color as more deserving of punishment (and more severe punishment) and as threats to the social order who have to be restrained. We should read the racialization of mass incarceration as a symptom of how precariously people of color participate in the social contract and as reflections of how theories of punishment have been racially deployed. (shrink)