This essay dwells in the interstitial space between human and nonhuman species attributions to consider the dense political and theoretical activity that the domain capacitates. It begins by discussing the bifurcated funding work of the Arcus Foundation – LGBT rights and great ape conservation – as a means of examining how currently prevailing species divisions that putatively work through expansive notions of embodiment in actuality deploy the same logics present in colonial schemes of bodily division. It then relatedly considers an (...) intimate transspecies relationship between a human, Sandra Herold, and a chimpanzee, Travis, which ended tragically. The essay then puts the concepts of trans* and animacy into productive tension to explore how life and liveness become contingently associated with certain bodies through shifting processes of racial and sexual division. Building from these conceptual framings, it preliminarily introduces a new analytic tool, trans*plant, to facilitate more comprehensive analyses of how bodies move across media, and what those movements facilitate in terms of reproducing or disrupting embodiment categories that rely on naturalized understandings of bodily difference. (shrink)

OBJECTIVES: To investigate the need for hospital clinical ethics committees by studying the frequency with which ethical dilemmas arose, the perceived adequacy of the process of their resolution, and the teaching and training of staff in medical ethics. DESIGN: Interviews with individuals and three multidisciplinary teams; questionnaire to randomly selected individuals. SETTING: Two major London children's hospitals. RESULTS: Ethical dilemmas arose frequently but were resolved in a relatively unstructured fashion. Ethical concerns included: the validity of consent for investigations and treatment; (...) lack of children's involvement in consent; initiation of heroic or futile treatments; resource allocation. Staff expressed the need for a forum which would provide consultation on ethical issues, develop guidelines for good ethical practice, undertake teaching and training, and provide ethical reflection outside the acute clinical setting. CONCLUSION: Multidisciplinary, accountable and audited clinical ethics committees with predominantly advisory, practice development and educational roles could provide a valuable contribution to UK clinical practice and perhaps in other countries that have not developed hospital clinical ethics committees. (shrink)

Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)

We link the corporate governance literature in financial economics to the agency cost perspective of corporate social responsibility to derive theoretical predictions about the relationship between corporate governance and the existence of executive compensation incentives for CSR. We test our predictions using novel executive compensation contract data, and find that firms with more shareholder-friendly corporate governance are more likely to provide compensation to executives linked to firm social performance outcomes. Also, providing executives with direct incentives for CSR is an effective (...) tool to increase firm social performance. The findings provide evidence identifying corporate governance as a determinant of managerial incentives for social performance, and suggest that CSR activities are more likely to be beneficial to shareholders, as opposed to an agency cost. (shrink)

A long-standing position in philosophy, law, and theology is that a person can be held morally responsible for an action only if they had the freedom to choose and to act otherwise. Thus, many philosophers consider freedom to be a necessary condition for moral responsibility. However, empirical findings suggest that this assumption might not be in line with common sense thinking. For example, in a recent study we used surveys to show that – counter to positions held by many philosophers (...) – lay people consider actions to be free when they are spontaneous rather than being based on reasons. In contrast, responsibility is often considered to require that someone has thought about the alternative options. In this study we use an online survey to directly test to which degree lay judgements of freedom and responsibility match. Specifically, we test whether manipulations of deliberation affect freedom and responsibility judgements in the same way. Furthermore, we also test the dependency of these judgements on a person’s belief that their decision had consequences for their personal life. We find that people are generally considered to be more responsible for their actions than they are considered free, across most of the conditions tested. Furthermore, we found that deliberation had an opposite effect on freedom and responsibility judgements. People were considered more free when they acted spontaneously, whereas they were considered more responsible when they deliberated about their actions. These results seem to suggest that deliberating about reasons is crucially important for the lay concept of responsibility, while it is not obviously …. (shrink)

The subject of musical emotions has emerged only recently as a major area of research. While much work in this area offers fascinating insights to musicological research, assumptions about the nature of emotional experience seem to remain committed to appraisal, representations, and a rule-based or information-processing model of cognition. Over the past three decades alternative ‘embodied’ and ‘enactive’ models of mind have challenged this approach by emphasising the self-organising aspects of cognition, often describing it as an ongoing process of dynamic (...) interactivity between an organism and its environment. More recently, this perspective has been applied to the study of emotion in general, opening up interesting new possibilities for theory and research. This new approach, however, has received rather limited attention in musical contexts. With this in mind, we critically review the history of music and emotion studies, arguing that many existing theories offer only limited views of what musical-emotional experience entails. We then attempt to provide preliminary grounding for an alternative perspective on music and emotion based on the enactive/dynamic systems approach to the study of mind. (shrink)

Are countries especially entitled, if not obliged, to prioritize the interests or well-being of their own citizens during a global crisis, such as a global pandemic? We call this partiality for compatriots in times of crisis “crisis nationalism”. Vaccine nationalism is one vivid example of crisis nationalism during the COVID-19 pandemic; so is the case of the US government’s purchasing a 3-month supply of the global stock of the antiviral Remdesivir for domestic use. Is crisis nationalism justifiable at all, and, (...) if it is, what are its limits? We examine some plausible arguments for national partiality, and conclude that these arguments support crisis nationalism only within strict limits. The different arguments for partiality, as we will note, arrive at these limits for different reasons. But more generally, so we argue, any defensible crisis nationalism must not entail the violation of human rights or the worsening of people’s deprivation. Moreover, we propose that good faith crisis nationalism ought to be sensitive to the potential moral costs of national partiality during a global crisis and must take extra care to control or offset these costs. Thus, crisis nationalism in the form of vaccine nationalism or the hoarding of global supplies of therapeutics during a global pandemic exceeds the bounds of acceptable partiality. (shrink)

Background: The field of clinical ethics is examining ways of determining competency. The Assessing Clinical Ethics Skills (ACES) tool offers a new approach that identifies a range of skills necessary in the conduct of clinical ethics consultation and provides a consistent framework for evaluating these skills. Through a training website, users learn to apply the ACES tool to clinical ethics consultants (CECs) in simulated ethics consultation videos. The aim is to recognize competent and incompetent clinical ethics consultation skills by watching (...) and evaluating a videotaped CEC performance. We report how we set a criterion cut score (i.e., minimally acceptable score) for judging the ability of users of the ACES tool to evaluate simulated CEC performances.Methods: A modified Angoff standard-setting procedure was used to establish the cut score for an end-of-life case included on the ACES training website. The standard-setting committee viewed the Futility Case and estimated the probability that a minimally competent CEC would correctly answer each item on the ACES tool. The committee further adjusted these estimates by reviewing data from 31 pilot users of the Futility Case before determining the cut score.Results: Averaging over all 31 items, the proposed proportion correct score for minimal competency was 80%, corresponding to a cut score that is between 24 and 25 points out of 31 possible points. The standard-setting committee subsequently set the minimal competency cut score to 24 points.Conclusions: The cut score for the ACES tool identifies the number of correct responses a user of the ACES tool training website must attain to “pass” and reach minimal competency in recognizing competent and incompetent skills of the CECs in the simulated ethics consultation videos. The application of the cut score to live training of CECs and other areas of practice requires further investigation. (shrink)

Although researchers have investigated the impact of social isolation on well-being, the recent quarantines due to COVID-19 resulted in a social isolation environment that was unique to any examined in the past. Because sleep is one of the endogenous drives that impacts short and long-term health and well-being, it is important to consider how social isolation during the COVID-19 government-mandated quarantines affected sleep and sleep habits. A number of researchers have addressed this question during the last 2 years by examining (...) several concepts related to possible changes in sleep during the quarantines. To best understand these recent results, the current mini review provides a background on the pre-pandemic literature on the effects of social isolation and loneliness with a focus on sleep and then summarizes the recent literature on sleep and sleep habits. In general, sleep was negatively impacted for many people during the pandemics but not all. One group that seemed to benefit from the pandemic in terms of sleep patterns, were younger people who could more easily adapt their sleep times to match their internal chronobiology. Given the potential broad impact of sleep on health and well-being, better understanding how social isolation impacts sleep is an important consideration for individuals, work organizations, and governments. (shrink)

Our purpose in this essay is twofold: to explore John Deely’s “semiotic” or “contextualized animal” as also a “contextualizing animal”, one that not only responds in context but one that changes first the context so as later to change itself—as all living things do; and to explore how this context-shifting “semiotic animal” has caused to emerge the very “signs upon which”, as Deely writes, “the whole of life depends”. Environmental ethics are inseparable from personal ethics, then, because (1) we are (...) in fact ourselves environments for others, (2) we carry models of our environments within us (our genetic / ontogenetic selves), and (3) even our free will (the basis of ethical choice) is an “environmental” phenomenon, as Martin Heisenberg argues in Nature (14 May 2009: 164–165) and as Deely writes in Semiotic Animal: “signs do not fall strictly among the things objectified by perceptions of sense but act prior to that perception to enable it to reconstruct the physical environment along objective lines that are meaningful to the species” (Semiotic Animal: A Postmodern Definition of Human Being Transcending Patriarchy and Feminism [2010]: 119). (shrink)

Catholic health care has long been a key place where the Church embodies its social doctrine. However, the moral methodology that shapes Catholic bioethics relies on an act-based approach to decision making, which is rooted in the pre–Vatican II manualist tradition, focusing primarily on clinical issues related to the beginning and end of life. This essay argues that given the doctrinal status of Catholic social thought, Catholic bioethics must revisit its scope and methodology. It proceeds in three steps: a meta-analysis (...) of traditional Catholic bioethics, validating the claim made above; an overview of the limited literature published since 1980 engaging Catholic bioethics and CST; and a map of a Catholic bioethics informed by CST generated from a dual starting point. The essay concludes by focusing on both the places where marginalized persons encounter Catholic health care and the ethical issues presented, including race, health care disparities, immigration status, and gender inequality, as well as the interrelated perspective of the common good, expanding the array of issues to include environmental degradation, unions, health care financing, and more. (shrink)

Translating ethical theories into clinical practice presents a perennial challenge to educators. While many suggestions have been put forth to bridge the theory-practice gap, none have sufficiently remedied the problem. We believe the ascendance of hospital medicine, as a dominant new force in medical education and patient care, presents a unique opportunity that could redefine the way clinical ethics is taught. The field of hospital medicine in the United States is comprised of more than 50,000 hospitalists—specialists in inpatient medicine—representing the (...) fastest growing subspecialty in the history of medicine, and its members have emerged as a dominant new force around which medical education and patient care pivot. This evolution in medical education presents a unique opportunity for the clinical ethics community. Through their proximity to patients and trainees, hospitalists have the potential to teach medical ethics in real time on the wards, but most hospitalists have not received formal training in clinical ethics. We believe it is time to strengthen the ties between hospital medicine and medical ethics, and in this article we outline how clinical ethicists might collaborate with hospitalists to identify routine issues that do not rise to the level of an “ethics consult,” but nonetheless require an intellectual grounding in normative reasoning. We use a clinical vignette to explore how this approach might enhance and broaden the scope of medical education that occurs in the inpatient setting: A patient with an intra-abdominal abscess is admitted to the academic hospitalist teaching service for drainage of the fluid, hemodynamic support, and antimicrobial therapy. During the initial encounter with the hospitalist and his team of medical students and residents, the patient reports night sweats and asks if this symptom could be due to the abscess. How should the hospitalist approach this question? (shrink)

BackgroundThe U.S. Food and Drug Administration traditionally has kept confidential significant amounts of information relevant to the approval or non-approval of specific drugs, devices, and biologics and about the regulatory status of such medical products in FDA’s pipeline.ObjectiveTo develop practical recommendations for FDA to improve its transparency to the public that FDA could implement by rulemaking or other regulatory processes without further congressional authorization. These recommendations would build on the work of FDA’s Transparency Task Force in 2010.MethodsIn 2016-2017, we convened (...) a team of academic faculty from Harvard Medical School, Brigham and Women’s Hospital, Yale Medical School, Yale Law School, and Johns Hopkins Bloomberg School of Public Health to develop recommendations through an iterative process of reviewing FDA’s practices, considering the legal and policy constraints on FDA in expanding transparency, and obtaining insights from independent observers of FDA.ResultsThe team developed 18 specific recommendations for improving FDA’s transparency to the public. FDA could adopt all these recommendations without further congressional action.FundingThe development of the Blueprint for Transparency at the U.S. Food and Drug Administration was funded by the Laura and John Arnold Foundation. (shrink)

This study examined the influence of 7 high school esports developmental programs on student self-regulation, growth mindset, positive youth development, perceived general health and physical activity, and sport behaviour. A total of 188 students originally participated, with 58 participants completing both pre- and post-program information. At baseline, no significant differences were found between youth e-athletes and their aged-matched controls. The analysis for the observation period showed a significant interaction effect for the PYD confidence scale, with post-hoc comparisons showing a significant (...) decrease in the control group from pre- to post assessment whereas the esports group remained the same. Time main effects showed a decrease in the self-regulation motivation factor, PYD connection factor and PA for all participants. Overall, this study showed that students enrolled in their respective school esports program did not differ from those who did not in self-regulation, growth mindset, PYD, perceived health and PA, and sport behaviour. It was likely that all participants showed a decrease in motivation, connection, and PA due to COVID19 lockdown during the study period. This study is the first to investigate the longitudinal impact of student involvement in high school esports and showed that esports participation did not have a negative impact on any health or psychological factors. (shrink)

Gifts have served as a fundamental aspect of the human experience across time, even as their precise roles and functions have shifted. In the past, bioethicists and others have drawn upon anthropol...

As social media becomes increasingly popular, human subjects researchers are able to use these platforms to locate, track, and communicate with study participants, thereby increasing participant retention and the generalizability and validity of research. The use of social media; however, raises novel ethical and regulatory issues that have received limited attention in the literature and federal regulations. We review research ethics and regulations and outline the implications for maintaining participant privacy, respecting participant autonomy, and promoting researcher transparency when using social (...) media to locate and track participants. We offer a rubric that can be used in future studies to determine ethical and regulation-consistent use of social media platforms and illustrate the rubric using our study team’s experience with Facebook. We also offer recommendations for both researchers and institutional review boards that emphasize the importance of well-described procedures for social media use as... (shrink)

Exploring the Illusion of Free Will and Moral Responsibility is an edited collection of new essays by an internationally recognized line-up of contributors. It is aimed at readers who wish to explore the philosophical and scientific arguments for free will skepticism and their implications.

Through discourse with international groups of physicians, we conducted a cross-cultural analysis of the types of ethical dilemmas physicians face. Qualitative analysis was used to categorise the dilemmas into seven themes, which we compared among the physicians by country of practice. These themes were a-theoretically-driven and grounded heavily within the text. We then subjected the dilemmas to an analysis of moral intensity, which represents an important theoretical perspective of ethical decision making. These constructs represent salient determinants of ethical behaviour and (...) our cross-cultural sample afforded us the opportunity to consider both the pragmatic aspects of culture, as they are perceived by physicians, as well as the theory-driven concept of moral intensity. By examining both culture and moral intensity, we hope to better elucidate the complexities of ethical decision-making determinants among physicians in their daily practice. Doing so may potentially have practical implications for ethics training of medical students and foreign physicians. (shrink)

Heidegger’s two modes of thinking, calculative and meditative, were used as the thematic basis for this qualitative study of physicians from seven countries . Focus groups were conducted in each country with 69 physicians who cared for the elderly. Results suggest that physicians perceived ethical issues primarily through the lens of calculative thinking with emphasis on economic concerns. Meditative responses represented 24% of the statements and were mostly generated by Canadian physicians whose patients typically were not faced with economic barriers (...) to treatment due to Canada’s universal health care system. (shrink)

The goal of this study was to assess the relationships between computational approaches to analyzing constructed responses made during reading and individual differences in the foundational skills of reading in college readers. We also explored if these relationships were consistent across texts and samples collected at different institutions and texts. The study made use of archival data that involved college participants who produced typed constructed responses under thinking aloud instructions reading history and science texts. They also took assessments of vocabulary (...) knowledge and proficiency in comprehension. The protocols were analyzed to assess two different ways to determine their cohesion. One approach involved assessing how readers established connections with themselves. The other approach involved assessing connections between the constructed responses and the texts that were read. Additionally, the comparisons were made by assessing both lexical and semantic comparisons. The result showed that both approaches for analyzing cohesion and making the comparisons were correlated with vocabulary knowledge and comprehension proficiency. The implications of the results for theory and practice are discussed. (shrink)

Although living conditions have improved throughout history, protest, at least in the last few decades, seems to have increased to the point of becoming a normal phenomenon in modern societies. Contributors to this volume examine how and why this is the case and argue that although problems such as poverty, hunger, and violations of democratic rights may have been reduced in advanced Western societies, a variety of other problems and opportunities have emerged and multiplied the reasons and possibilities for protest.

Aim: To explore healthcare chaplains’ experience of providing spiritual support to individuals and families from minority religious and non-religious faiths and to identify key elements of the role. Background: Currently, there is limited research uncovering the essential elements of healthcare chaplaincy, specifically with reference to religious and/or spiritual diversity, and as interprofessional collaborators with nurses and midwives in healthcare. Research design and participants: Using phenomenology, we interviewed eight healthcare chaplains from a variety of healthcare settings in the Republic of Ireland. (...) Data were analysed using a seven-step framework comprising Moustakas’ (1994) modification of the Van Kaam method of data analysis. Ethical considerations: Ethical approval was granted by the university and the principles of informed consent applied. Findings: Three main themes emerged: what the chaplain brings; components of ritual, minority faith or no faith; and practising chaplaincy. Subthemes included ‘offering’, ‘awareness and insight’, ‘acceptance and empathy’, ‘skilled companionship’, ‘presence’, ‘a confidant and holder of hope’ and ‘a vital resource’. Discussion and conclusions: The healthcare chaplain is a key collaborator in facilitating holistic person-centred care and in supporting healthcare professionals. Chaplaincy services are an essential but largely unrecognised and potentially cost-effective component of interprofessional team working. Relevance to clinical practice: This study has illuminated key aspects of the healthcare chaplain’s role as interprofessional collaborator in person-centred care, in navigating diversity and ensuring respect and dignity for the person irrespective of religious or spiritual care needs. (shrink)

BackgroundScientific literature on posttraumatic growth after terrorist attacks has primarily focused on persons who had not been directly exposed to terrorist attacks or persons who had been directly exposed to them, but who were assessed few months or years after the attacks.MethodsWe examined long-term PTG in 210 adults directly exposed to terrorist attacks in Spain a mean of 29.6 years after the attacks. The participants had been injured by a terrorist attack or were first-degree relatives of people who had been (...) killed or injured by a terrorist attack. They completed diagnostic measures of emotional disorders and measures of PTSD and depression symptomatology, optimism, and PTG.ResultsMultiple regression analyses revealed gender differences and a positive linear relationship between PTG and cumulative trauma after the terrorist attack. Some PTG dimensions were significantly associated with PTSD symptomatology, these associations being linear, not curvilinear. However, PTG was not associated with depression symptomatology, diagnosis of emotional disorders, age, elapsed time since the attack, or optimism. In comparison with survivors assessed 18 years after the 1995 Oklahoma City bombing, Spanish victims of terrorism showed higher levels of appreciation of life, but lower levels of relating to others and spiritual change.ConclusionThe findings underscore the influence of gender on PTG and provide support to the hypothesis that some emotional distress may be a necessary condition of PTG. Future studies on PTG after terrorist attacks should take into consideration the characteristics of the terrorist attack itself and the contexts of violence and threat in which it occurred. The political, social, and cultural characteristics of the community affected by it and the profile and characteristics of other traumatic events suffered after the attack should also be taken into account in further research. (shrink)