Volume 20, Issue 3, March 2020, Page 1-5.

This article reviews the history of medical and research abuses experienced by American Indians since European colonization. This article examines the unethical research of American Indians/Alaska Natives in light of the Tuskegee Study of Untreated Syphilis in the Negro Male. Literature citations indicate that significant unethical research and medical care incidents occurred both before and after the Tuskegee Syphilis Study among American Indians/Alaska Natives. The majority of these unethical abuses were committed by the federal government and within the historical context (...) of a long-term contentious relationship between American Indians and the federal government. Although President Clinton issued a highly visible public apology to the African American survivors of the Tuskegee syphilis experiment in 1997, American Indians have yet to experience such visible federal acknowledgment. To ensure ethical research in which benefits outweigh risks and findings are not value-laden or misrepresented, tribes have instituted their own Institutional Review Boards coupled with community-participatory activities. (shrink)

Nurses have traditionally been regarded as clinicians that deliver compassionate, safe, and empathetic health care (Nurses again outpace other professions for honesty & ethics, 2018). Caring is a fundamental characteristic, expectation, and moral obligation of the nursing and caregiving professions (Nursing: Scope and standards of practice, American Nurses Association, Silver Spring, MD, 2015). Along with caring, nurses are expected to undertake ever‐expanding duties and complex tasks. In part because of the growing physical, intellectual and emotional demandingness, of nursing as well (...) as technological advances, artificial intelligence (AI) and AI care robots are rapidly changing the healthcare landscape. As technology becomes more advanced, efficient, and economical, opportunities and pressure to introduce AI into nursing care will only increase. In the first part of the article, we review recent and existing applications of AI in nursing and speculate on future use. Second, situate our project within the recent literature on the ethics of nursing and AI. Third, we explore three dominant theories of caring and the two paradigmatic expressions of caring (touch and presence) and conclude that AI—at least for the foreseeable future—is incapable of caring in the sense central to nursing and caregiving ethics. We conclude that for AI to be implemented ethically, it cannot transgress the core values of nursing, usurp aspects of caring that can only meaningfully be carried out by human beings, and it must support, open, or improve opportunities for nurses to provide the uniquely human aspects of care. (shrink)

There is a global shortage of nurses that affects healthcare delivery, which will be exacerbated with the increasing demand for healthcare professionals by the aging population. The growing shortage requires an ethical exploration on the issue of nurse migration. In this article, we discuss how migration respects the autonomy of nurses, increases cultural diversity, and leads to improved patient satisfaction and health outcomes. We also discuss the potential for negative impacts on public health infrastructures, lack of respect for cultural diversity, (...) and ethical concerns related to autonomy and justice, including coercion and discrimination. This analysis is written from a rights-based ethics approach by referring to rights held by nurses and patient populations. Nurse migration highlights conflicts between nurses and between nurses and healthcare systems. Increased awareness of ethical challenges surrounding nurse migration must be addressed to enhance the well-being of nurses and patient populations. (shrink)

In this issue, Ellen Fox and colleagues report on their national study on ethics consultation in U.S. hospitals, following up on the previous 1999–2000 landmark study. Th...

The prelims comprise: Rationality Morality Advance Directives Conclusion Notes References Suggested Further Reading.

Depuis sa fondation comme discipline indépendante, la psychologie semble contourner les questions épistémologiques constitutives d’une science de l’esprit. Cet article s’attache à présenter brièvement quelques-unes de ces questions, à travers la psychologie historique d’Ignace Meyerson.

At the beginning of "The Law of Mind," Charles S. Peirce makes this striking admission (W8:135):I may mention, for the benefit of those who are curious in studying mental biographies, that I was born and reared in the neighborhood of Concord—I mean in Cambridge—at the time when Emerson, Hedge, and their friends were disseminating the ideas that they had caught from Schelling, and Schelling from Plotinus, from Boehm, or from God knows what minds struck with the monstrous mysticism of the (...) East. But the atmosphere of Cambridge held many an antiseptic against Concord transcendentalism; and I am not conscious of having contracted any of that virus. Nevertheless, it is probable that some cultured bacilli, some benignant .. (shrink)

Death can be good— I’ll tell you how. Just have it come Decades from now.1 Full disclosure: The above poem expresses my outlook, and I have trouble empathising with people who want to die. But that does not make me unable to evaluate objections to the expressivist argument against PAS. Reed sets forth the expressivist argument as follows: ‘[W]hen we allow PAS for individuals who are terminally ill or facing some severe disease or disability, we send a message of disrespect (...) to all individuals who face such adversities in that we imply that they are inferior or their lives are not worth living (or at least less worth living than they otherwise would be) precisely insofar as they are diseased or disabled’.2 The passage of mine that Reed quotes, however, was not intended to set forth an expressivist view. Rather than saying the double standard of selective legalisation ‘send[s] a message of disrespect’,3 it says this double standard in fact involves a systematic devaluation of some people’s lives. I will argue that there are conditions under which this double standard does send a message of disrespect, but first I want to disassociate myself from the expressivist formulations of Coleman and Keown that …. (shrink)

Imagine a single musical tone—for instance, the A above middle C that the oboe plays to tune an orchestra. Now imagine this tone, with no variation in dynamics, pitch, or timbre, extended over the course of “an hour or a day,” existing, as Peirce describes in “How to Make Our Ideas Clear” (W3:262),1 “as perfectly in each second of that time as in the whole taken together; so that, as long as it is sounding, it might be present to a (...) sense from which everything in the past was as completely absent as the future itself” (W3:262). Imagine a world consisting of nothing but the sensation of this single oboe A, and having never consisted of anything but it. In such a world, Peirce indicates, there would be no .. (shrink)

The word ‘dignity’ is a staple of contemporary American medical ethics, where it often follows the words ‘death with’. People unfamiliar with this usage might expect it to apply to one’s manner of dying—for example, a stately exit involving ceremonial farewells. Instead, conventional usage generally holds that “death with dignity” ends or prevents life without dignity, by which is meant life marked not by buffoonery, but by illness and disability. Popular examples of dignity-depleters include dementia, incontinence, and being “dependent on (...) machines”—provided the machines are respirators rather than furnaces, refrigerators, and computers. (shrink)

Summary In about 1735, Emilie Du Châtelet began to translate Mandeville's Fable of the Bees. Her work, which is largely ignored by scholars, did, as this article demonstrates, turn out to be one of transformation rather than of translation and came at a crucial moment in the emerging French luxury debate. So far commercial society and luxury had been defended in purely economic terms, for instance in Melon's Essai politique, or as an aspect of divine providence for fallen man, by (...) Pierre Nicole amongst others. There was as yet no coherent defence on the level of secular ethics. As this article shows, Du Châtelet set out to remedy this. In co-operation with Voltaire, with whose recent praise of English society in the Lettres philosophiques she strongly identified, she rewrote the Fable to offer a defence of modern commercial society as both natural and moral. The article argues that she was able to do so by taking recourse to classic Epicureanism in the guise of Lucretius' De rerum natura, as an alternative to the Neo-Epicureanism, with its Augustinian overtones, as espoused by Mandeville. Voltaire in turn used her translation to lay the foundations for his defence of commercial society and progress in his Traité de métaphysique in which he uses the precise passages she had inserted into Mandeville's original. This article analyses the further aspects Voltaire adds to her arguments. Taken together, Du Châtelet's ?translation? and Voltaire's Traité offer a coherent defence of bourgeois society that would underlie Voltaire's later historiographical and philosophical works and which were crucial to his concept of ?Enlightenment? and ?progress? (shrink)

This article explores insights of physicist David Bohm on the source of thought and the creative intelligence that emerges from this source. It highlights a link that Bohm sees between this creativ...

Of the stories describing the adventures full of deep significances of the various rabbis from the glorious Talmudic era, the most famous but also the most exploited is undoubtedly that of the “four sages who entered the Pardes”. If in the Talmudic-Midrashic literature it was used to point out the dangers and achievements that were related to speculations, rather than experiences, and in the mystical literature it was used to point out the dangers that could befall the mystic on his (...) way to God, to the kabbalists, Pardes was an unexplained parable for an unrevealed secret, a generalized metaphor for the danger zones of religious experience, seen as something which was good for the few, but pernicious for others. This article traces the manner in which Moshe Idel analyzes, in his books and lectures, the meanings of this legend, taking the reader on a fascinating journey in time and space, throughout various types of kabbalistic thinking and even maimonidean philosophy. (shrink)

This commentary reflects on twelve stories of participants in clinical ethics consultations from the perspective of family members, some of whom are ethics consultants, and healthcare professionals. Together they reveal expectations of ethics consultations and suggest descriptions of the service. Some common themes emerge, including the role of the clinical ethics consultant in navigating complex situations, assuring all stake-holder voices are heard, attending to moral distress, addressing issues that seem beyond medical practice, and being accessible. They are almost uniformly positive (...) about the experience, with criticism primarily about lack of access to the service. (shrink)

Number terms and quantifiers share a range of linguistic (syntactic, semantic, and pragmatic) properties. On the basis of these similarities, one might expect these 2 classes of linguistic expression to pose similar problems to children acquiring language. We report here the results of an experiment that explicitly compared the acquisition of numerical expressions (two, four) and quantificational (some, all) expressions in younger and older 3-year-olds. Each group showed adult-like preferences for “exact” interpretations when evaluating number terms; however they did not (...) use the corresponding upper bounded interpretation when evaluating the quantifier some. Apparently, children follow different procedures for learning and evaluating numerals and quantifiers. These findings have implications for theories of number representation in child and adult grammars. (shrink)

A common contention of literary criticism is that literary forms can express, reflect, shape, represent or otherwise give form to human life. Literature can seem to offer the same idea as a promise of life’s meaningfulness; where expressive form is powerful, life need not be empty. Can literary forms give form to human life? I will argue for one sense in which this is true. As will become clear, at stake in this inquiry is not simply an idea about the (...) meaningfulness of literature’s poetry, but a way of answering the question of what it means to be human. (shrink)

Historically nurses have lacked significant input in end-of-life decision-making, despite being an integral part of care. Nurses experience negative feelings and moral conflict when forced to aggressively deliver care to patients at the EOL. As a result, nurses participate in slow codes, described as a limited resuscitation effort with no intended benefit of patient survival. The purpose of this study was to explore and understand the process nurses followed when making decisions about participation in limited resuscitation. Five core categories emerged (...) that describe this theory: (1) recognition of patient and family values at the EOL; (2) stretching time and reluctance in decision-making; (3) harm and suffering caused by the physical components of CPR; (4) nurse’s emotional and moral response to delivering aggressive care, and; (5) choosing limited resuscitation with or without a physician order. Several factors in end-of-life disputes contribute to negative feelings and moral distress driving some nurses to perform slow codes in order to preserve their own moral conflict, while other nurses refrain unless specifically ordered by physicians to provide limited care through tailored orders. (shrink)