The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...) in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists. (shrink)

Business and society scholars have analyzed the citizenship activities of private firms, but what of their own institutions? This article introduces the concept of business school citizenship (BSC), examining it as a response to the legitimacy pressures created by competing corporate and university interests in the U.S. management-education context. Theories of corporate and of university social responsibility are used to explain BSC, and these theories form the basis of the argument that such activities can be justified and should be increased.

Max Deutsch’s new book argues against the commonly held ‘myth’ that philosophical methodology characteristically employs intuitions as evidence. While I am sympathetic to the general claim that philosophical methodology has been grossly oversimplified in the intuition literature, the particular claim that it is a myth that philosophers rely on intuitions as evidence is open to several very different interpretations. The plausibility and consequences of a rejection of the ‘myth’ will depend on the notion of evidence one employs, the notion of (...) intuition one holds, and how one understands the idea of ‘relying on’ or ‘employing’ something as evidence. I describe what I take to be the version of The Myth which is most plausibly undermined by Deutsch’s arguments; however, I also argue that the falsity of this myth has only minimal consequences for the viability of the experimental philosophy research project. (shrink)

Economic growth requires a focus on building the assets of the poor, a strategic approach that is considerably broader than developing the poor only asconsumers and workers. The long-term sustainability of business and society will be enhanced if corporate investments that impact on poverty alleviation are far reaching, multi-faceted, and built through multi-sector partnerships. Emerging evidence indicates that corporations are increasingly involved on two important fronts: directly investing in ways that reduce poverty, and advocating for public policy investments to build (...) the assets of the poor. Corporate involvement in asset policy can be understood as a new manifestation of corporate/business citizenship. (shrink)

ANGUS J, HODNETT E and O’BRIEN-PALLAS L. Nursing Inquiry 2003; 10: 218–228Implementing evidence-based nursing practice: a tale of two intrapartum nursing unitsDespite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the outcomes as (...) the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations. (shrink)

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)

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)

Boccalini’s Ragguagli di Parnasso (1612) provides us with a satirically inflected view of how Tacitean quotation was used throughout the sixteenth century as a medium of political knowledge. A detailed analysis of some Tacitean scenes in Ragguagli will help us to elicit some of the issues underlying the turn to Tacitus in the intellectual climate of the period: the search for truth in a new era of moral relativism; debates about the applicability of ancient maxims to contemporary realities; and the (...) connection between externally acquired techniques and internalized wisdom. In both Ragguagli and Comentarii Tacitus’ characterization of the emperor Galba becomes emblematic of the gulf that can open up between theoretical knowledge and practical understanding. When the same model is used to measure Tacitus’ own unsuccessful tenure of power over Lesbos in Ragguagli, Boccalini presents a case study of how ‘properly’ to make use of Tacitean political insight. (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)

Films provide many memorable scenes of care that both shape and reinforce ideas about who deserves care, how carers should behave, and what kinds of people appear ‘naturally’ suited to the labors of caring for children, the sick, the elderly and the disabled (namely women). My specific interest here is in films about migrant domestic workers in Hong Kong and Singapore. from the Philippines and Indonesia, who take up live-in housekeeping positions. The films about their lives range from documentary to (...) popular, low-budget horror to independent art cinema. While surveying the strengths and limitations of a handful of these films, I offer strategies for how to frame each film in terms of its director, production methods, distribution, and target audience. How and when might different genres be best used to engage students in critical thinking about care work and migrant labor? What stereotypes exist about migrant workers and what blind spots emerge in understanding paid care work? How can we promote dialogue about the often ambivalent relationship between caregiver and cared-for? (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)

The mutual interaction and interdependence of race, class, and gender create profound political dilemmas for feminist activists. How can we create coherent, inclusive political movements when the very oppressions we seek to dismantle also divide us internally? This article seeks answers to this question by exploring the history of the Southeast Women's Employment Coalition, which throughout the 1980s sought to unify working-class women in the South across the divide of race. The article concludes that gender is insufficient to effect political (...) unity among racially diverse women, but that a “politics of solidarity,” based on an appreciation of the intersections of race, gender, and class, is possible. (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 .

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...) in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (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)

Philosophical questions surrounding skill and expertise can be traced back as far as Ancient Greece, China, and India. In the twentieth century skilled action was an important factor in the work of phenomenologists such as Heidegger and Merleau-Ponty and analytic philosophers including Gilbert Ryle. However, as a subject in its own right it has, until now, remained largely in the background. The Routledge Handbook of Philosophy of Skill and Expertise is an outstanding reference source and the first major collection of (...) its kind, reflecting the explosion of interest in the topic recent years. Comprising thirty-nine chapters written by leading international contributors, the Handbook is organised into six clear parts: Skill in the History of Philosophy Skill in Epistemology Skill, intelligence, and agency Skill in Perception, Imagination, and Emotion Skill, Language, and, Social Cognition Skill and Expertise in Normative Philosophy. Essential reading for students and researchers in philosophy of mind and psychology, epistemology and ethics, The Routledge Handbook of Philosophy of Skill and Expertise is also suitable for those in related disciplines such as social psychology and cognitive science. It is also relevant to those who are interested in conceptual issues underlying skill and expertise in fields such as sport, the performing arts, and medicine. (shrink)

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)

The formation of the modern state, the rise of capitalism, the Renaissance and Reformation, the scientific revolution and the Age of Enlightenment have all been attributed to the “early modern” period. Nearly everything about its history remains controversial, but one thing is certain: it left a rich and provocative legacy of political ideas unmatched in Western history. The concepts of liberty, equality, property, human rights and revolution born in those turbulent centuries continue to shape, and to limit, political discourse today. (...) Assessing the work and background of figures such as Machiavelli, Luther, Calvin, Spinoza, the Levellers, Hobbes, Locke and Rousseau, Ellen Wood vividly explores the ideas of the canonical thinkers, not as philosophical abstractions but as passionately engaged responses to the social conflicts of their day. (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)