This article draws on recent research in the medical humanities to analyze two contemporary Chinese films: Zhang Yuan's Sons (1996) and Zhou Xiaowen's The Common People (1998). By portraying psychic and physical anguish in ways that refuse to divorce biology from culture, such films offer rare moral dialogues on biomedical issues and contribute a cross-cultural perspective invaluable to the task of responding to illness and suffering.

This essay analyzes two types of patient‐experience data to broaden and deepen understanding of trust in health care. Analysis of patients’ open‐ended comments shows a close connection between patients’ feelings of trust and their intent to recommend providers and provider organizations—a global measure to evaluate patients’ perceptions of care experiences. Patients’ comments also reveal the bidirectional building of trust between the patient and the caregiver. Trust gets built when patients perceive their caregivers to trust their knowledge of their bodies as (...) well as when caregivers demonstrate caring behaviors that earn the patients’ trust. Patients’ ratings of a closed‐ended survey item on “confidence in provider” create the greatest differentiation for the global measure of patient experience—whether patients did or did not recommend a practice or provider. The essay also discusses related findings on pre‐visit friction and the use of humor by the caregiver to expand understanding of trust. (shrink)

For a century and a half, the artists and intellectuals of Europe have scorned the bourgeoisie. And for a millennium and a half, the philosophers and theologians of Europe have scorned the marketplace. The bourgeois life, capitalism, Mencken’s “booboisie” and David Brooks’s “bobos”—all have been, and still are, framed as being responsible for everything from financial to moral poverty, world wars, and spiritual desuetude. Countering these centuries of assumptions and unexamined thinking is Deirdre McCloskey’s _The Bourgeois Virtues_, a magnum (...) opus that offers a radical view: capitalism is good for us. McCloskey’s sweeping, charming, and even humorous survey of ethical thought and economic realities—from Plato to Barbara Ehrenreich—overturns every assumption we have about being bourgeois. Can you be virtuous and bourgeois? Do markets improve ethics? Has capitalism made us better as well as richer? Yes, yes, and yes, argues McCloskey, who takes on centuries of capitalism’s critics with her erudition and sheer scope of knowledge. Applying a new tradition of “virtue ethics” to our lives in modern economies, she affirms American capitalism without ignoring its faults and celebrates the bourgeois lives we actually live, without supposing that they must be lives without ethical foundations. _High Noon_, Kant, Bill Murray, the modern novel, van Gogh, and of course economics and the economy all come into play in a book that can only be described as a monumental project and a life’s work. _The Bourgeois Virtues _is nothing less than a dazzling reinterpretation of Western intellectual history, a dead-serious reply to the critics of capitalism—and a surprising page-turner. (shrink)

Advance care planning (ACP) is promoted as beneficial practice internationally. This article critically examines different ways of understanding and measuring success in ACP. It has been 50 years since Luis Kutner first published his original idea of the Living Will, which was thought to be a contract between health carers and patients to provide for instructions about treatment choices in cases of mental incapacity. Its purpose was to extend a patient's right to autonomy and protect health carers from charges of (...) wrong-doing. Yet, it can be doubtful whether different types of ACP achieve these goals rather than aiming at secondary gains. My discussion suggests that the current promotion of ACP is not always engaging critically with the original ACP intentions and may even pursue notions of success that may run contrary to respecting autonomy. The risk of this may especially be the case when high participation rates are taken as indicators of success for institutional ACP programs. I further suggest that Kutner's two original aims of protecting patient autonomy and preventing charges of wrong-doing are near impossible to achieve in conjunction, because their simultaneous pursuit fails to acknowledge that patients and carers have opposing needs for reassurance about possible judgment errors. I conclude that the most realistic idea of success of modern ACP is an acknowledgement of the importance of ongoing dialogue about what constitutes appropriate care and a diversity of aims rather than any kind of advance, contractual insurance in the face of controversy. (shrink)

Are all norms cognized in the same way? I present experimental evidence suggesting that they are not. I propose a distinction between two main classes of violations—the victimful and the victimless—and show that while people tend to rate acts belonging to either category as impermissible, the justifications for their judgments refer to salient features of the act only in the former case. I further show that Feinberg's distinction between harmful and offensive acts is useful in discriminating between different types of (...) victimful violations. (shrink)

In this commentary on Michael Hand’s paper ’Moral education in the community of inquiry’, I argue that Hand is right to call for the Community of Inquiry method to include directive moral teaching. I do so in the light of having worked with this broader conception, or something very like it, in the writing of the NSW Primary Ethics Curriculum. Using examples from this curriculum, I aim to show the necessity of a broader Col, and to argue for a process (...) that involves even more direction. (shrink)

Human right-handedness does not originate in vocalisation as such but in selection pressures for structuring complex sequences of digital signals internally, as if in a vacuum. Cautious receivers cannot automatically accept signals in this way. Biological displays are subjected to contextual scrutiny on a signal-by-signal basis – a task requiring coordination of both hemispheres. In order to explain left cerebral dominance in human manual and vocal signalling, we must therefore ask why it became adaptive for receivers to abandon caution, processing (...) zero-cost signals rapidly and on trust. (shrink)

This article argues that Augustine’s understanding of the internal dynamics of number, order, and weight as they pertain to corporeal creatures supplies the basis for an analogy which characterizes the process of the soul’s reformation. In other words, Augustine understands the soul’s simplicity in an analogous manner to the simplicity of corporeal creatures, and the simplicity of corporeal creatures is determined by the relations between number, order, and weight. This analogy shows that Augustine conceives of the soul as a composite (...) entity with different loves as its constituent parts. In the process of reformation, the soul acquires an ordered disposition as those loves become more like one another. By virtue of this ordered disposition, the soul also acquires a greater degree of integration or number because the likeness of weight among its constituent parts allows the soul to move as a unity toward God as its final end. (shrink)

Thomas Talbott has recently argued in this journal that the three propositions 1) God wills universal salvation 2) God has the power to produce universal salvation and 3) some persons are not saved are inconsistent. I contend that this claim is only true if God has no overriding purposes that would place restrictions on the means God uses to achieve God’s ends. One possible example of such an overriding purpose would be God’s aim to produce the most good. I end (...) by suggesting that while God’s purpose of universal salvation does render the achievement of this end probable, it is by no means necessary. (shrink)

In this paper I argue that the denial of middle knowledge and emphasis on human freedom characteristic of open theism makes the traditional concept of hell even more morally problematic than it would otherwise be. But these same features of open theism present serious difficulties for the view that all will necessarily be saved. I conclude by arguing that the most promising approach for open theists is to adopt a version of contingent, as opposed to necessary, universalism. (Published Online April (...) 7 2006). (shrink)

PurposeThis paper aims to inform and improve the quality of electronic products and services by outlining an approach to ethically grounded design.Design/methodology/approachA number of design disciplines were investigated using desk research and also learning from experience in commercial design practice in the mobile phone, Internet and software industries.FindingsIt is suggested that design “scripts” specific behaviours with either good or bad results. Scripts have a behavioural element and they define the physical, social and individual impact of products and services. This suggests (...) that designers should be aware of the impact design decisions have throughout the product lifecycle. In order to achieve this, three ethical design principles (situated research, reflexivity and participation) are proposed to frame ethical design practice.Research limitations/implicationsIt is suggested that measuring impact alone is insufficient to minimise harm caused by electronic products and services. Instead, research should focus on positively informing design through actionable results in the participatory design tradition. Conversely, design needs to accommodate research into measuring the impact of products in order to deliver long‐term benefits to users rather than perpetuating passive consumption.Practical implicationsThe paper provides an overview of methods for value‐centred interaction design based on the analysis of alternative approaches to ethical design.Originality/valueThe research in the paper spans a number of related but heretofore separate disciplines pertinent to deepening design thinking. These disciplines are critiqued on the basis of their appropriateness and applicability to an ethical design approach and the concept of scripting, used in traditional design, is applied to interactivity. Lastly, three new principles are proposed for ethically grounded design. (shrink)

Only by misconstruing the term performative are the authors able to argue that males surpass females in “performative applications” of language. Linguistic performatives are not costly displays of quality, and syntax cannot be explained as an outcome of behavioural competition between pubertal males. However, there is room for a model in which language co-evolves with the unique human life-history stage of adolescence.

Atran & Norenzayan (A&N) rightly criticize cognitive theories for failure to explain sacrifice and commitment. But their attempt to reconcile cognitivism with commitment theory is unconvincing. Why should imaginary entities be effective in punishing moral defectors? Heavy costs are entailed in enforcing community-wide social contracts, and behavioural ecology is needed to explain how and why evolving humans could afford these costs.

The Greeks could never have asked, "Why is there something; why not nothing?" Parmenides and Plato both held Absolute Non-Being to be inconceivable, and Aristotle's emphasis on the priority of the actual also excluded this question. The ex nihilo nihil fit of classical metaphysics may be taken as an implicit rejection of the why of Being. To say that nothing can come from nothing is to deny any priority for, or any ontological status to, Nothing.

Analytic philosophy began in G.E. Moore's critique of idealist accounts of reality, implicating as dilemmatic F.H. Bradley's identification of the good with self-realization. Neither the tradition of British idealism nor the successor tradition of analytic metaethics was able to sustain the salience previously enjoyed by the concept of good. The essay's second part analyzes Alasdair MacIntyre's account of that longer tradition, and his argument that Aristotelianism's conceptual scheme provides the best solution to modern moral philosophy's dilemma about the human good.