In lieu of an abstract, here is a brief excerpt of the content:How Policies and Practices in Medical Settings Impact Communication Access with Deaf Patients and CaregiversKelley Cooper, Maggie Russell, Debra Chaiken, Michael W. Mazzaroppi, and Gretchen RomanIntroductionWe are a group of Deaf community members, sign language interpreters, organizational leaders, and academic partners. We have a collective point of view about how policies and practices in medical settings impact communication access with Deaf patients and caregivers. Here, we account (...) multiple stories from our respective experiences in an effort to improve healthcare institutions' awareness of the recommended modalities when communicating with Deaf patients accessing care. Our stories clarify any misunderstandings about communication with Deaf patients who expressively use spoken language and receptively use sign language. We convey that it is imperative to use visual language when explaining discharge paperwork and emphasize that it is critical for a Deaf caregiver to be fully aware of the plan of care when offering support to their loved one. We illustrate the importance of honoring the requests for in-person sign language interpreting versus video remote interpreting (VRI) as well as requests for Deaf-Hearing sign language interpreter teams. Deaf interpreters bring formative cultural, linguistic, and life experiences and work in partnership with a hearing interpreter to provide a more nuanced communication exchange across a wide range of visual languages.Maggie Russell: Anecdote 1The hospital recidivism rate for a Deaf Nepali male patient continues to increase. As the Interpreter Referral Service Director, I am aware of this patient because he receives care management services from our organization. He has several life-threatening conditions, attends dialysis, is on multiple medications, and is frequently in and out of the local hospital. The hospital considers him as someone who identifies as an oral Deaf person, as he has severe to profound hearing loss with little or no residual hearing and visually receives signed language but expressively uses spoken language. Three interpreters, a spoken Nepalese interpreter, a Deaf Nepali Sign Language (NSL) interpreter, and a hearing American Sign Language (ASL) interpreter, working together as a team are recommended for effective communication with this patient and the medical team of providers. However, interpreting services at the hospital provide only one interpreter, a spoken Nepalese interpreter, which [End Page E3] does not satisfy the necessary accommodations for access. A plethora of prescriptions were added to his regimen to counter the condition that caused a recent inpatient stay. The patient's wife is his primary caregiver. She communicates receptively and expressively using NSL. A Deaf NSL and hearing ASL interpreter team creates effective communication with his wife and the medical team of providers. Since she is expected to follow the doctor's recommendations as explained in the discharge instructions, she also requires accommodations for communication access. Neither the patient nor his wife received a formal education, and they do not read or write English or the language of their country of origin. Therefore, information in English or Nepalese conveyed in the printed discharge paperwork is inaccessible. The new medications were not incorporated into his already established monthly "pill pack," and the couple was unable to read the information on the pill bottles that were delivered to their home. Subsequently, incorrect use of the newly prescribed medications significantly delayed the patient's course of recovery. This couple also had minimal exposure to medical information and medical processes prior to living in the United States; the medical services in the refugee camps in Nepal were typically non-existent. Utilizing a hearing ASL interpreter alone does not constitute barrier-free access for either of these individuals. Interpreting medical documents in a visual format is so critical for providing access, but it doesn't necessarily guarantee comprehension because of their limited health literacy. In addition to employing the recommended interpreting team, using teach-back methods during an encounter is a good way for medical providers to ensure the patient and caregiver's understanding of the plan of care.Maggie Russell: Anecdote 2As the Interpreter Referral Service Director at our organization, I served as the hearing interpreter on a Deaf-Hearing ASL interpreter team at a follow-up gastrointestinal appointment from a gall bladder biopsy for a Deaf male patient, along with his Deaf... (shrink)

In Why Some Things Should Not Be for Sale, philosopher Debra Satz takes a penetrating look at those commodity exchanges that strike most of us as problematic. What considerations, she asks, ought to guide the debates about such markets? What is it about a market involving prostitution or the sale of kidneys that makes it morally objectionable? How is a market in weapons or pollution different than a market in soybeans or automobiles? Are laws and social policies banning the (...) more noxious markets necessarily the best responses to them? Satz contends that categories previously used by philosophers and economists are of limited utility in addressing such questions because they have assumed markets to be homogenous. Accordingly, she offers a broader and more nuanced view of markets--one that goes beyond the usual discussions of efficiency and distributional equality--to show how markets shape our culture, foster or thwart human development, and create and support structures of power. (shrink)

"In seventy-two essential texts from the nineteenth century to the present day, this anthology collects key writings that have influenced both the philosophical and the practical aspects of conserving photographs"--P. [4] of cover.

We live in a death-denying culture where, despite the fact death happens to everyone, individuals prefer to deny death, facing it only when necessary. There exists a myth that death can be delayed, or perhaps redefined, or controlled in some fashion. The stories in this issue serve as examples of how healthcare professionals encounter death and how they learn to cope with it.

Agora, Academy, and the Conduct of Philosophy offers extremely careful and detailed criticisms of some of the most important assumptions scholars have brought to bear in beginning the process of (Platonic) interpretation. It goes on to offer a new way to group the dialogues, based on important facts in the lives and philosophical practices of Socrates - the main speaker in most of Plato's dialogues - and of Plato himself. Both sides of Debra Nails's arguments deserve close attention: the (...) negative side, which exposes a great deal of diversity in a field that often claims to have achieved a consensus; and the positive side, which insists that we must attend to what we know of these philosophers' lives and practices, if we are to make a serious attempt to understand why Plato wrote the way he did, and why his writings seem to depict different philosophies and even different approaches to philosophizing. From the Preface by Nicholas D. Smith. (shrink)

While the bioethics literature demonstrates that the field has spent substantial time and thought over the last four decades on the goals, methods, and desired outcomes for service and training in bioethics, there has been less progress defining the nature and goals of bioethics research and scholarship. This gap makes it difficult both to describe the breadth and depth of these areas of bioethics and, importantly, to gauge their success. However, the gap also presents us with an opportunity to define (...) this scope of work for ourselves and to help shape the broader conversation about the impact of academic research. Because of growing constraints on academic funding, researchers and scholars in many fields are being asked to demonstrate and also forecast the value and impact of their work. To do that, and also to satisfy ourselves that our work has meaningful effect, we must understand how our work can motivate change and how that change can be meaningfully measured. In a field as diverse as bioethics, the pathways to and metrics of change will likewise be diverse. It is therefore critical that any assessment of the impact of bioethics research and scholarship be informed by an understanding of the nature of the work, its goals, and how those goals can and ought to be furthered. In this paper, we propose a conceptual model that connects individual bioethics projects to the broader goals of scholarship, describing the translation of research and scholarly output into changes in thinking, practice, and policy. One of the key implications of the model is that impact in bioethics is generally the result of a collection of projects rather than of any single piece of research or scholarship. Our goal is to lay the groundwork for a thoroughgoing conversation about bioethics research and scholarship that will advance and shape the important conversation about their impact. (shrink)

Discerning adaptations from by-products is a defining feature of evolutionary science. Mehr, Krasnow, Bryant, and Hagen posit that music is an adaptation that evolved to function as a credible signal. We counter this claim, as we are not convinced they have dispelled the possibility that music is an elaboration of extant features of language.

The People of Plato is the first study since 1823 devoted exclusively to the identification of, and relationships among, the individuals represented in the complete Platonic corpus. It provides details of their lives, and it enables one to consider the persons of Plato's works, and those of other Socratics, within a nexus of important political, social, and familial relationships. Debra Nails makes a broad spectrum of scholarship accessible to the non-specialist. She distinguishes what can be stated confidently from what (...) remains controversial and--with full references to ancient and contemporary sources--advances our knowledge of the men and women of the Socratic milieu. Bringing the results of modern epigraphical and papyrological research to bear on long-standing questions, The People of Plato is a fascinating resource and valuable research tool for the field of ancient Greek philosophy and for literary, political, and historical studies more generally. In discrete sections, Nails discusses systems of Athenian affiliation, significant historical episodes that link lives and careers of the late fifth century, and their implications for the dramatic dates of the dialogues. The volume includes a rich array of maps, stemmata, and diagrams, plus a glossary, chronology, plan of the agora in 399 B.C.E., bibliography, and indices. (shrink)

ABSTRACT This essay analyses the visual representation of melancholy and related themes in the work of American artist Thomas Eakins (1844–1916). Its particular focus is Home Scene (1870–1871), an intimate portrait of two of the artist’s sisters in the parlour of their family home in Philadelphia. Through a close examination of Home Scene in relation to later portraits by and of the artist, my analysis sheds new light on how and why Eakins reshaped ideations of melancholy based in European art (...) and intellectual history within the context of nineteenth century American culture. While representing both the appearance and effects of melancholy in Home Scene and many other of his portraits, Eakins also constructed aspects of his own artistic identity in accordance with this theme. Analysing the ideas and practices that impacted these processes, this study shows how the artist’s life-long fascination with the intertwined subjects of melancholy, mental illness, and the trope of the misunderstood artist-genius informed his personal and professional lives as it intersected with prominent discourses on women, gender, and medicine in post-Civil War America. (shrink)

(1995). Synthesizing disciplinary narratives: George Gaylord Simpson's tempo and mode in evolution. Social Epistemology: Vol. 9, Boundary Rhetorics and the Work of Interdisciplinarity, pp. 113-150.

In this article I make links between melancholia, creativity and communion with God at a personal level, referencing John’s gospel, ‘God’s house has many rooms’ and ‘The Mansions’, a text written by Theresa of Avila where the ‘mansion’ is an analogy for the space in which God’s omniscient love is realized. My paintings were formed from the day-to-day lived experience of ‘psycheache’ and are a graphic representation of a non-explainable reality. I see in these paintings a transcendent reality for they (...) are the markings I made to express a state-of-being that could not be articulated. During this episode of Depression I painted dark interiors with rambling corridors, flights of steps and doorways leading into rooms empty of people. (shrink)

Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and (...) a thematic analysis. Each line of the data was reviewed and coded, and the codes were collapsed into themes. Methodological rigor was established. Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families. (shrink)

Congdon (2017), Giladi (2018), and McConkey (2004) challenge feminist epistemologists and recognition theorists to come together to analyze epistemic injustice. I take up this challenge by highlighting the failure of recognition in cases of testimonial and hermeneutical injustice experienced by victims of sexual harassment and sexual assault. I offer the #MeToo movement as a case study to demonstrate how the process of mutual recognition makes visible and helps overcome the epistemic injustice suffered by victims of sexual harassment and sexual assault. (...) I argue that in declaring “me too,” the epistemic subject emerges in the context of a polyphonic symphony of victims claiming their status as agents who are able to make sense of their own social experiences and able to convey their knowledge to others. (shrink)

Dissecting Bioethics, edited by Tuija Takala and Matti Hayry, welcomes contributions on the conceptual and theoretical dimensions of bioethics. The department is dedicated to the idea that words defined by bioethicists and others should not be allowed to imprison people’s actual concerns, emotions, and thoughts. Papers that expose the many meanings of a concept, describe the different readings of a moral doctrine, or provide an alternative angle to seemingly self-evident issues are particularly appreciated. To submit a paper or to discuss (...) a suitable topic, contact Tuija Takala [email protected].:This article examines some of the assumptions and implications associated with the Belmont era context in which the concept of therapeutic misconception was forged. We argue that the justification of therapeutic misconception should be reconsidered based on less paternalistic and more participatory models of research. Finally, we identify conceptual and practical approaches that might better reflect contemporary research practice. (shrink)

Casuistry, or case-based reasoning, should be used in environmental ethics. Casuistry came to prominence during the transition from medieval to modern, when historical circumstances challenged settled moral perspectives. Similarly, environmental ethics arose in response to real-life dilemmas that also challenged existing moral theories. Casuistry’s focus on cases means that it can resolve individual environmental dilemmas without needing to solve every other problem (theoretical or practical) in the field. It is a “taxonomic” form of moral reasoning that operates by analogy to (...) paradigm cases, appeals to authorities in the field, and application of moral rules of thumb. Analogy to just-war reasoning and medical ethics and appeal to ecological reasoning yields four basic principles for environmental casuistry, justice, prudence, diversity, and a presumption toward preservation, and provides guidance in selecting paradigms and sources of authority within the field of environmental ethics. (shrink)

At the end of their article in the September 2014 issue of the Journal of Business Ethics, Douglas R. May, Matthew T. Luth, and Catherine E. Schwoerer state that they are “hopeful in outlook” about the “evidence that business ethics instructors are….able to encourage students…to develop the courage to come forward even when pressures in organizations dictate otherwise”. We agree with May et al. that it is essential to augment students’ moral courage. However, it seems overly optimistic to believe that (...) this improvement will result from any course in business ethics. Indeed, we question the appropriateness of their measure of moral courage and assert that business ethics educators must purposely design their courses to develop students’ moral courage. In particular, we advocate introducing business ethics students to works of literature featuring protagonists who exercise moral courage in organizations. Fiction provides rich accessible narratives that show students worlds beyond their experience, awaken their imaginations, and evoke their emotions. Further, we highlight morally courageous exemplars because they inspire the cultivation of character. Joining those who underscore the role of virtue in business ethics education, we argue that exposure to moral exemplars in fiction will help students to build the moral courage they need to carry out ethical decisions in the workplace. Results from 46 students at the end of an MBA ethics course featuring moral courage provide preliminary evidence of the effectiveness of our approach. (shrink)

This paper examines the ways that feminists have built on and transformed Mary Wollstonecraft’s Enlightenment idea that women’s rights are human rights. It argues that Wollstonecraft’s marginal attention to the issue of sexual violence reflects the mind-body dualism of her era where reason divorced from the body established our dignity as persons. Today’s feminists reject this dualism. They have adopted and retooled Wollstonecraft’s idea that women’s rights are human rights to (1) create solidarity among women of different places, races, classes, (...) religions etc., (2) break the silence surrounding the experience and meaning of rape, and (3) create grassroots, national and international forums that expose the fact that sexual violence is one of the crucial anchors of patriarchy. Wollstonecraft believed that human rights were guaranteed by reason and God. We find that these rights are embodied and fragile. They depend on us to make them real. Addressing this responsibility, the paper ends with a question: Are we up to the task? (shrink)

In July 2015, Rihanna released a seven-minute long video for her new single, entitled ‘Bitch Better Have My Money’ (more widely known as ‘BBHMM’), the violent imagery in which would divide feminist media commentators for its representation of graphic and sexualised violence against a white couple. The resulting commentary would become the focus of much popular and academic feminist debate over the intersectional gendered and racialised politics of popular culture, in particular coming to define what has been termed ‘white feminism’. (...) ‘BBHMM’ is not the first time Rihanna’s work has been considered in relation to these debates: not only has she herself been very publicly outed as a survivor of male violence, but she has previously dealt with themes of rape and revenge in an earlier video, 2010’s ‘Man Down’, and in her lyrics. In this article I explore the multiple and layered ways in which Rihanna, and by extension other female artists of colour, are produced by white feminism as both responsible for perpetrating gender-based violence, and as victims in need of rescue. The effect of such liberal feminist critique, I argue, is to hold black female artists responsible for a rape culture that continually subjects women of colour to symbolic and actual violence. In this context, the fantasy violence of ‘Man Down’ and to a greater extent ‘BBHMM’ dramatises the impossibility of ‘being paid what one is owed’ in a culture that produces women of colour’s bodies, morality and personal trauma as abjected objects of consumption. I read these two videos through the lens of feminist film theory in order to explore how such representations mobilise affective responses of shame, identification and complicity that are played out in feminist responses to her work, and how their attachment to a simplistic model of representation conceals and reproduces racialised relations of inequality. (shrink)