Cancer rates in men and women of reproductive age have continued to increase in recent years; however, therapy has dramatically decreased the mortality rates. Since 1990, the prevalence of cancer survivors in young adults increased from 1 in 1,000 to 1 in 250 patients due to more aggressive therapies. Current therapies may have profound toxic effects on gamete function with infertility as an expected consequence of cancer therapy. Depending on the site and stage of cancer, age of the patient, and (...) the type of treatment, approximately 90% of men and women diagnosed with cancer may be at risk of permanent infertility.Fertility preservation has emerged as a discipline dedicated to improving the future reproductive potential of cancer survivors. Significant progress in the advancement of fertility preservation therapies and a heightened awareness of the availability of therapies has occurred in the past 10 years. The American Society of Clinical Oncology and the American Society of Reproductive Medicine have advanced these efforts by formally recognizing the importance of fertility awareness. (shrink)

Background: The Clinical Ethics Residency for Nurses was offered selectively to nurses affiliated with two academic medical centers to increase confidence in ethical decision-making. Research Question/Aim: To discover how effective the participants perceived the program and if their goals of participation had been met. Research design: A total of 65 end-of-course essays (from three cohorts) were analyzed using modified directed content analysis. In-depth and recursive readings of the essays by faculty were guided by six questions that had been posed to (...) graduates. Ethical considerations: Institutional review board approval was granted for the duration of the program and its reporting period. Confidentiality was maintained via the use of codes for all evaluations including the essays and potentially identifying content redacted. Findings: An umbrella theme emerged: participants had developed ethical knowledge and skills that provided a “moral compass to navigate the many gray areas of decision-making that confront them in daily practice.” Six major themes corresponding to questions posed to the participants included the ability to advocate for good patient care; to support and empower colleagues, patients, and families; they experienced personal and professional transformation; they valued the multimodal nature of the program; and were using their new knowledge and skills in practice. However, they also recognized that their development as moral agents was an ongoing process. Discussion: Findings support that enhancing nurse confidence in their moral agency with a multimodal educational approach that includes mentored practice in ethical decision-making, enhancing communication skills and role-play can mitigate moral distress. A majority found the program personally and professionally transformative. However, they recognized that ongoing ethics discussion involvement and supportive environments would be important in their continued development of ethical agency. Conclusion: Multimodal ethics education programs have potential to be transformative and enhance nurse confidence in their ethical decision-making. (shrink)

This study explores ethnic variations in animal companion attachment among 133 students enrolled in a school of veterinary medicine. The 57 White and 76 African American participants completed surveys that included background information, several questions about their animal companions, and a pet attachment questionnaire .White students had significantly higher PAQ scores than did African American students . White students also had significantly more pets and more kinds of pets and were more likely to allow pets to sleep on their beds (...) . Although keeping pets is a universal cultural phenomenon, how that attachment is expressed may vary from culture-to-culture. This study explores possible explanations and implications for these variations. (shrink)

Twentieth-century ideologies, from liberalism to fascism, are rooted in humanism—the faith in the sovereignty of human reason and potential that grew out of Renaissance thought and discovery. This special issue asks if it is true that all vestiges of humanism have been dismantled, or whether humanism has taken on new forms. Have new versions of historical analysis and cultural studies reanimated humanist themes? What is posthumanism? These essays examine relationships among structuralism, poststructuralism, and the subject; explore the challenge of anticolonialist (...) critique to the coherence of antihumanism; reconsider the canon of antihumanists such as Heidegger and Foucault, and broach the intractable problems posed by efforts to comprehend the Holocaust, the camps, and ethnic cleansing. _Contributors_. Athena Athanasiou, Etienne Balibar, Mara de Gennaro, Carolyn J. Dean, Brady Thomas Heiner, Lynne Joyrich, Jacques Lezra. (shrink)

Barbara Taylor, Mary Wollstonecraft and the Feminist Imagination Ruth H. Bloch, Gender and Morality in Anglo-American Culture, 1650–1800 Barbara Taylor entitles her new book Mary Wollstonecraft and the Feminist Imagination. The imagination in question is Wollstonecraft's, but, like Wollstonecraft, Taylor is interested in the imagination more generally, both the problems that the imagination gets women into and the ways in which the feminist imagination can get women out of those problems and help them imagine a more just and equitable future. (...) Ruth H. Bloch's aim in Gender and Morality in Anglo-American Culture, 1650–1800, the newly published collection of her essays, is somewhat more modest. Although her chief objective is to analyze the transformation in American views about women, gender, the family, and religion in the era of the American Revolution, she also offers case studies in the use of a culturalist approach to feminist history. Although there are important differences in approach and subject matter between these two books, their similarities and areas of overlap—not the least of which is that their authors are two of the best feminist intellectual historians at work today—make it instructive to review them together. (shrink)

Teachers and teacher educators in the US struggle with conflicting needs. They must think critically and adaptively in response to the rapidly changing demographics of their students and adjust to a policy climate that emphasizes standardization, measurement, and disregard for teachers as professionals. Embattled pre-service teacher education programs in institutions of higher education have traditionally sought to develop teacher candidates’ knowledge, skills, and dispositions. The authors argue that in the current climate pre-service teachers also must appropriate conceptual frameworks to support (...) their development as responsive professionals. While dispositions are beliefs and attitudes the origin and teaching of which remain in dispute, concepts like social justice, political-economic equity, and formative assessment are abstract ideas or concepts that inform practice. Conceptual tools, i.e., concepts, theories, and frameworks, guide novice teachers in making decisions in response to the growing and rapidly changing student populations they will teach as well as the policy contexts that constrain their teaching practice. The appropriation of conceptual tools contributes to development of vision and adaptive expertise required by responsive teacher professionals. Using an activity theory framework developed by Wartofsky that draws in particular on the classification of artifacts, or tools, this article frames and critically examines teachers’ need for conceptual tools, the appropriation of those tools, and a mixed methods study of that appropriation. The study demonstrates that teacher candidates do appropriate conceptual tools, but that measurement of that process, though desirable in the current policy context, requires the development of a systematic and replicable methodology. (shrink)

Many new genetic tests are used in clinical practice, and the number of available tests is growing. Two important health policy questions arise as these genetic tests become available. The first question, whether a new test should be made available, has been the focus of much recent discussion. The second question concerns defining the appropriate standards surrounding the use of these tests, including patient selection, education, informed consent, test interpretation and counseling.Genetic tests currently move from the research arena, where strategies (...) are put in place to minimize risks,into the clinical context where the practice of medicine is more variable and the risks to patients less understood. In the research setting, risks can be minimized through safeguards including education, consent, and counseling. The frequency and magnitude of psychosocial and clinical risks canbe assessed. In the clinical setting, however, these safeguards may not be used consistently, creating unknown risksfor patients. (shrink)

Attention is being focused on the tone at the top in businesses in the United States with the publication of the Report of the Commission on Fraudulent Financial Reporting. There has been growing discontent with the quality of ethcial behavior in the business society and at the present moment many American companies are developing — or revising — codes of ethics and establishing procedures for their implementation. Yet, there is some question about the success of such efforts.This article describes the (...) efforts of an early American entrepreneur to develop a code of ethics and to implement it throughout his organization during the early years of relatively rapid growth. The code was introduced in 1913 and was supported through a variety of means in which the leader himself participated. That early code continues to be reissued as the company updates its overall code of ethics. The persistent and seemingly genuinc commitment to ethical behavior throughout the company was evident in all aspects of the leader's behavior. (shrink)

Ellen Meiksins Wood is a leading contemporary political theorist who has elaborated an innovative approach to the history of political thought, the social history of political theory .

A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...) median number of consults per hospital was unchanged at 3, but more than doubled for hospitals with 400+ beds. The level of education of EC practitioners was unchanged, while the percentage of hospitals formally evaluating their ECS decreased from 28.0% to 19.1%. The gap between large, teaching hospitals and small, nonteaching hospitals widened since the prior study. We suggest targeting future improvement efforts to hospitals where needs are not being met by current approaches to EC. (shrink)

Although affective facial pictures are widely used in emotion research, standardised affective stimuli sets are rather scarce, and the existing sets have several limitations. We therefore conducted a validation study of 490 pictures of human facial expressions from the Karolinska Directed Emotional Faces database (KDEF). Pictures were evaluated on emotional content and were rated on an intensity and arousal scale. Results indicate that the database contains a valid set of affective facial pictures. Hit rates, intensity, and arousal of the 20 (...) best KDEF pictures for each basic emotion are provided in an appendix. (shrink)

One antidote to moral distress is stronger moral agency—that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses’ moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN (...) sought to change attitudes, increase knowledge, and develop skills to act on one's knowledge. One of the key insights the faculty members brought to the design of this program is that knowledge of clinical ethics is not enough to develop moral agency. In addition to lecture‐style classes, CERN employed a variety of methods based in adult learning theory, such as active application of ethics knowledge to patient scenarios in classroom discussion, simulation, and the clinical practicum. Overwhelmingly, the feedback from the participants (sixty‐seven over three years of the program) indicated that CERN achieved transformative learning. (shrink)

There is strong theoretical support for a relationship between various characteristics of religiousness and attitudes towards business ethics. This paper examines three frequently- studied dimensions of religiousness (fundamentalism, conservatism, and intrinsic religiousness) and their ability to predict students' willingness to behave unethically. Because prior research indicated a possible relationship between the religious affiliation of an institution and its members' ethical orientation, we studied students at universities with three different types of religious affiliation: evangelical, Catholic, and none.Results of the study lend (...) support to a negative relationship between the above-mentioned dimensions of religiousness and willingness to behave unethically. In addition, students at the Evangelical university were far less willing to engage in unethical behavior than were students at either the Catholic or the unaffiliated institutions. (shrink)

Ellen Feder's monograph is an attempt to think about the categories of race and gender together. She explains and then employs some critical tools derived from Foucault, in order to advance her main argument: that the institution of the family is the locus of the production of gender and race, and that gender is best understood as a function of a "disciplinary" power that operates within the family, while race is the function of a "regulatory" power acting upon the (...) family from outside. Her interdisciplinary work will be of interest to feminist philosophers and theorists because it plays into a recent expansion of interest in the family, as well as to literary scholars of Foucault, to scholars of race and race theory, and to other feminist scholars in political science, sociology, anthropology, and cultural studies. (shrink)

In this paper, I submit that it is the controlled part of skilled action, that is, that part of an action that accounts for the exact, nuanced ways in which a skilled performer modifies, adjusts and guides her performance for which an adequate, philosophical theory of skill must account. I will argue that neither Jason Stanley nor Hubert Dreyfus have an adequate account of control. Further, and perhaps surprisingly, I will argue that both Stanley and Dreyfus relinquish an account of (...) control for precisely the same reason: each reduce control to a passive, mechanistic, automatic process, which then prevents them from producing a substantive account of how controlled processes can be characterized by seemingly intelligent features and integrated with personal-level states. I will end by introducing three different kinds of control, which are constitutive of skilled action: strategic control, selective, top–down, automatic attention, and motor control. It will become clear that Dreyfus cannot account for any of these three kinds of control while Stanley has difficulty tackling the two latter kinds. (shrink)