For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based (...) on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed "medically inappropriate" will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

This paper investigates how deans and directors at the top 50 global MBA programs (as rated by the "Financial Times" in their 2006 Global MBA rankings) respond to questions about the inclusion and coverage of the topics of ethics, corporate social responsibility, and sustainability at their respective institutions. This work purposely investigates each of the three topics separately. Our findings reveal that: (1) a majority of the schools require that one or more of these topics be covered in their MBA (...) curriculum and one-third of the schools require coverage of all three topics as part of the MBA curriculum, (2) there is a trend toward the inclusion of sustainability-related courses, (3) there is a higher percentage of student interest in these topics (as measured by the presence of a Net Impact club) in the top 10 schools, and (4) several schools are teaching these topics using experiential learning and immersion techniques. We note a fivefold increase in the number of stand-alone ethics courses since a 1988 investigation on ethics, and we include other findings about institutional support of centers or special programs; as well as a discussion of integration, teaching techniques, and notable practices in relation to all three topics. (shrink)

Recent experiments have shown that when individuals with a substance use disorder are confronted with drug-related cues, they exhibit an automatically activated tendency to approach these cues. The strength of the drug approach bias has been associated with clinically relevant measures, such as increased drug craving and relapse, and activations in brain reward areas. Retraining the approach bias by means of cognitive bias modification has been demonstrated to decrease relapse rates in patients with an alcohol use disorder and to reduce (...) alcohol cue-evoked limbic activity. Here, we review empirical and theoretical literature on the drug approach bias and explore two distinct models of how the drug approach bias may be embodied. First, we consider the “biological meaning” hypothesis, which grounds the automatic approach bias in the natural meaning of the body. Second, we consider the “sensorimotor hypothesis,” which appeals to the specific sensorimotor loops involved in the instantiation of addictive behaviors as the basis of the automatic approach bias. In order to differentiate between the adequacies of these competing explanations, we present specific, predictions that each model should make. (shrink)

This article is a précis of the book, Living well now and in the future: Why sustainability matters. It provides an overview of the book, focusing especially on its conceptualization of the nature and normative dimensions of sustainability. The latter include its formulation of an ethic of sustainability and eudaimonic theory of justice. Some central claims are that the fundamental normative concern of sustainability is the long-term preservation of opportunity to live well, and that the conceptualization of preservation of opportunity (...) should be focused on the satisfaction of basic psychological needs associated with fulfillment of potential. (shrink)

Although there is a significant amount of research on organizational citizenship behavior and its importance to individual and organizational outcomes, relatively little research has explored the process by which such behavior emerges and is established within an organization. Against this backdrop, we combine the perspectives offered by contextualist inquiry and actor–network theory to propose an integrative framework for investigating how organizational citizenship behavior develops in a large, heterogeneous organization. In order to illustrate the framework, we present a detailed case study (...) of recycling at a large university. Like many other organizations, the university does not have a formal organizational structure to address sustainability concerns and the initiatives are therefore mainly voluntary and emerging in nature, and outcomes are, as a consequence, highly uncertain, and fragile. We argue that contextualist inquiry in combination with actor–network theory provides new and important insights into the emergence and establishment of organizational citizenship behaviors, and that outcomes are contingent upon interactions between the context, process, and content of the behaviors in question and the related networks of human and non-human actors. (shrink)

Recent empirical work suggests that intuitions may be less reliable than previously assumed. However, given the ubiquity of intuition in philosophical reasoning, it is tempting to give intuitions some evidential weight. This chapter develops an account called ‘moderate intuitionism’, a view whereby intuitions are generally reliable, but nonetheless capable of substantial degrees of error. Believing that the general reliability of intuition emerges from the nature of language, the chapter develops an outline for a disposition-based metasemantic theory which can ground the (...) link between intuition and truth: terms refer to whatever a speaker would be disposed to apply them to when in possession of all relevant information. Well-constructed thought experiments can elicit intuitions and generally reflect the semantic facts but this account can also explain why intuitions occasionally err — i.e. when a thought experiment fails to specify information that would influence the speaker’s dispositions. (shrink)

Following extensive examination of published and unpublished materials, we provide a history of the use of dexamethasone in pregnant women at risk of carrying a female fetus affected by congenital adrenal hyperplasia (CAH). This intervention has been aimed at preventing development of ambiguous genitalia, the urogenital sinus, tomboyism, and lesbianism. We map out ethical problems in this history, including: misleading promotion to physicians and CAH-affected families; de facto experimentation without the necessary protections of approved research; troubling parallels to the history (...) of prenatal use of diethylstilbestrol (DES); and the use of medicine and public monies to attempt prevention of benign behavioral sex variations. Critical attention is directed at recent investigations by the U.S. Food and Drug Administration (FDA) and Office of Human Research Protections (OHRP); we argue that the weak and unsupported conclusions of these investigations indicate major gaps in the systems meant to protect subjects of high-risk medical research. (shrink)

The impact of induced mild positive feelings on working memory and complex decision making among older adults (aged 63–85) was examined. Participants completed a computer administered card task in which participants could win money if they chose from “gain” decks and lose money if they chose from “loss” decks. Individuals in the positive-feeling condition chose better than neutral-feeling participants and earned more money overall. Participants in the positive-feeling condition also demonstrated improved working-memory capacity. These effects of positive-feeling induction have implications (...) for affect theory, as well as, potentially, practical implications for people of all ages dealing with complex decisions. (shrink)

This is the first systematically organized anthology on responsible conduct in scientific research aimed at students and practicing researchers in the biological sciences. It has been designed in response to the increasing concern to teach graduate students about ethical issues in the biological sciences. The book contains classic essays and other published material and is carefully structured to explore a range of subjects: the qualifications for authorship; plagiarism; the use of human beings and animals in research; the norms of ethical (...) conduct in science; scientific honesty and its relationship to gullibility and self-deception; ethical issues in laboratory work; the relation between science and society; the ethics of teaching and learning. The volume also provides insights into issues often not formally considered in graduate science education such as methods of scientific investigation, scientific paradigms, and the creative process. (shrink)

When the University of Chicago opened its four-year medical program in 1929, the medical departments were established on the same footing as other biological departments. One of the first priorities was to build a department of psychiatry based on an interdisciplinary and holistic research program with important social implications. This plan was soon frustrated by structural factors and conflicts of interest both internal and external to the university. The story illuminates crucial dilemmas of neuropsychiatry in the interwar years and suggests (...) some of the limits to the pursuit of biology at the University of Chicago. (shrink)

Over the past two decades, the competency movement has been gathering momentum internationally within the ranks of professional nursing. It can be argued that this momentum is in response to government initiatives aimed at improving consistency in workforce training and accreditation, and fostering national and international portability of qualifications. At the same time, the competency movement has provided the opportunity for regulators, service providers and government to develop mechanisms to reconstitute competent nurses as accountable, self‐regulating subjects and to monitor this (...) transformation in particular ways. The ways in which competencies have been taken up to do this transforming work in Canada are unique and deserving of some detailed description and analysis.We argue that Canadian nursing regulatory authorities have chosen to view competence as the rehearsal of ethical attributes consonant with the professional role,as opposed to the enactment of skilled conduct. As a result, reflective practices rather than skill and knowledge have become the cornerstone of nursing competency formulation and review. We argue that this distinctly Canadian approach to competency serves three ends. First, it privileges the ‘attribute’ element of the nursing competency model and side steps the ever‐problematic ‘nursing knowledge’ issue; second, self‐surveillance by nurses shifts the onus for professional development from industry to the individual; and third, it concedes responsibility for skill assessment by the regulatory authorities to industry control, leaving employers free to determine skill base and skill mix requirements for practice. Finally, we argue that the reflective component of the regulatory framework for Canadian nurses radically fails as a tool for auditing quality and assessing competency. Rather, it functions as a governmental practice that furthers the deregulatory and economic rationalist aims of the Canadian health reform agenda. (shrink)

Recent ethical misconduct in American business has resulted in volumes of written commentary, various legislative responses, as well as litigation by those identified as victims. While legislators, judges, juries, and the Securities and Exchange Commission (SEC) pursue an increasing number of cases, there is little attention devoted to understanding what drives executives and other leaders to behave in ways that violate the ethical and legal standards of business in the United States. This understanding is a prerequisite to selecting leaders and (...) designing interventions that prevent future misconduct. Understanding leadership’s nature and functioning is one key to understanding the ethical behavior of an organization as a system and of the people who lead the organization. Two models or frameworks provide the foundation for this paper. The first is a model of leadership competencies. This model identifies five key areas of competence related to overall, long-term leadership success. The second model targets leadership effectiveness. This model has three components – motivational patterns, decision criteria, and competencies. Using the Leadership Effectiveness Model to frame the discussion, the authors describe the nature and importance of the models, with particular focus on motivational patterns. Research suggests these patterns often account for 40–60% of overall leadership effectiveness. This article defines motivational patterns and describes key patterns that may impact ethical behavior of leaders. The article concludes with a discussion of how to use data on motivational patterns in leadership selection, development, and evaluation processes. (shrink)

The promises of precision medicine are often heralded in the medical and lay literature, but routine integration of genomics in clinical practice is still limited. While the “last mile” infrastructure to bring genomics to the bedside has been demonstrated in some healthcare settings, a number of challenges remain — both in the receptivity of today's health system and in its technical and educational readiness to respond to this evolution in care. To improve the impact of genomics on health and disease (...) management, we will need to integrate both new knowledge and new care processes into existing workflows. This change will be onerous and time-consuming, but hopefully valuable to the provision of high quality, economically feasible care worldwide. (shrink)

This research focuses on dinner conversations in family-style group care. Children, who cannot live with their biological families anymore, are given shelter in these family-style group care settings. For the development of an attachment relationship between children and their Professional Foster Parents, it is important that the children feel that they are listened to in order to get an affective and intimate relationship with the parents. In this conversation-analytic research we analysed PFPs’ involvement in multiple activities simultaneously, namely listening and (...) eating, which is referred to as ‘multi-activity’. The analyses have shown systematic ways in which PFPs coordinate their involvement in the activities of ‘doing’ listening and eating, which are when parents avert their gaze from the telling child, they break the social rule which states that hearers need to look at speakers during the telling. We found that when averting their gaze, PFPs do head nods and linguistic means or positioning their bodies in the direction of the telling child. This research contributes to knowledge about interaction between adolescents and PFPs. It further contributes to knowledge about how human beings are able to coordinate multiple activities simultaneously. (shrink)

BackgroundThis paper represents a portion of the findings from one of the first research studies eliciting the lived experience of adults with an early diagnosis of Phenylketonuria living in Ireland. Ireland has one of the highest prevalence rates of PKU in Europe, however, little is known about the experience of Irish adults with PKU. Furthermore, Ireland is one of the first countries in the world to introduce neonatal screening followed by the introduction of long-term dietary therapy over 50 years ago. (...) This study presents the first comprehensive assessment of the lived experience of Irish adults with PKU on long term dietary therapy.MethodsNarrative data was collected from eleven self-selected participants, using semi-structured interviews. The interviews were divided into five sections focused on eliciting a holistic understanding of the lived experience of adults with PKU living in Ireland. Thematic analysis was guided by Colaizzi's Framework in conjunction with NVivo qualitative data analysis software.FindingsFindings from the original research encompassed a broad understanding of the lived experience of adults with PKU living in Ireland, including factors influencing dietary therapy and managing PHE blood levels. The themes being discussed within this article are those which appear to be least represented within current literature: living with PKU, including reproductive health, the importance of self-management and establishing routine, support networks in adulthood and concerns regarding aging with PKU.ConclusionIt was evident from the findings that a diagnosis of PKU can influence how adults with PKU may experience aging and their own mortality. These findings offer new insight into the vulnerability attached to the experience of aging with PKU and may be beneficial to advocacy groups and for future development of policy and practice. (shrink)

This book presents a multidisciplinary perspective on chance, with contributions from distinguished researchers in the areas of biology, cognitive neuroscience, economics, genetics, general history, law, linguistics, logic, mathematical physics, statistics, theology and philosophy. The individual chapters are bound together by a general introduction followed by an opening chapter that surveys 2500 years of linguistic, philosophical, and scientific reflections on chance, coincidence, fortune, randomness, luck and related concepts. A main conclusion that can be drawn is that, even after all this time, (...) we still cannot be sure whether chance is a truly fundamental and irreducible phenomenon, in that certain events are simply uncaused and could have been otherwise, or whether it is always simply a reflection of our ignorance. Other challenges that emerge from this book include a better understanding of the contextuality and perspectival character of chance (including its scale-dependence), and the curious fact that, throughout history (including contemporary science), chance has been used both as an explanation and as a hallmark of the absence of explanation. As such, this book challenges the reader to think about chance in a new way and to come to grips with this endlessly fascinating phenomenon. (shrink)

Service-learning has received a great deal of attention in the management education literature over the past decade, as a method by which students can acquire moral and civic values as well as gain academic knowledge and practice real-world skills. Scholars focus on student and community impact, curricular design, and rationale. However, the educational environment (“context”) in which service-learning occurs has been given less attention, although experienced educators know that the classroom is hardly a vacuum and that students learn a great (...) deal from the non-curricular aspects of their educational experience. Moral values in particular are conveyed by what is not said. Given this, I argue that the contexts in which service-learning takes place are as important as the activity itself. Three perspectives on context will be described and assessed: the “hidden” curriculum, the educational atmosphere, and the university’s orientation towards social responsibility. (shrink)

This chapter contains sections titled: Mothering and the Quest for Certainty Finding Answers to Mothering Questions Both/And Not Either/Or Toward a Pragmatic Approach to Mothering Notes.

First Published in 2005. Routledge is an imprint of Taylor & Francis, an informa company.

Domain experts regularly teach novice students how to perform a task. This often requires them to adjust their behavior to the less knowledgeable audience and, hence, to behave in a more didactic manner. Eye movement modeling examples (EMMEs) are a contemporary educational tool for displaying experts’ (natural or didactic) problem‐solving behavior as well as their eye movements to learners. While research on expert‐novice communication mainly focused on experts’ changes in explicit, verbal communication behavior, it is as yet unclear whether and (...) how exactly experts adjust their nonverbal behavior. This study first investigated whether and how experts change their eye movements and mouse clicks (that are displayed in EMMEs) when they perform a task naturally versus teach a task didactically. Programming experts and novices initially debugged short computer codes in a natural manner. We first characterized experts’ natural problem‐solving behavior by contrasting it with that of novices. Then, we explored the changes in experts’ behavior when being subsequently instructed to model their task solution didactically. Experts became more similar to novices on measures associated with experts’ automatized processes (i.e., shorter fixation durations, fewer transitions between code and output per click on the run button when behaving didactically). This adaptation might make it easier for novices to follow or imitate the expert behavior. In contrast, experts became less similar to novices for measures associated with more strategic behavior (i.e., code reading linearity, clicks on run button) when behaving didactically. (shrink)

In this seminal study, Barbara Galli explores Rosenzweig's statement that his notes to Halevi's poems exemplify a practical application of the philosophic ...

The question, “Why has Harriet Taylor MM appeared in the history of philosophy as she has?” has several answers. The answers intertwine the personality and polities of Harriet, the sexism of those who wrote of her, misunderstandings of the means and meaning of her collaboration with John Stuart Mill, and the disturbing challenge of her questioning.

Although beef and dairy production in Alberta, Canada, enjoys strong public support, there are enduring public concerns, including farm animal welfare. Evolving codes of practice and animal care councils prescribe changes and improvements to many areas of farm management, and may be seen by farmers as an appropriate response to public animal welfare concerns. However, codes of practice do not address every animal welfare concern, and new concerns can arise over time. Drawing on social practice theory and in-depth field research (...) with 36 cattle and dairy farmers, this paper explores the materials, competencies, and meanings of four animal husbandry practices: branding, dehorning, weaning, and on-farm handling and moving. Findings show that branding and dehorning are evolving slowly with attention to pain management, but remain firmly rooted in ranching tradition and communities of practice. Weaning and animal handling practices are evolving more quickly with attention to changing materials, attitudes, and values that are more prevalent within producer communities. (shrink)