Background: Nurses, social workers, and medical residents are ethically mandated to engage in policy advocacy to promote the health and well-being of patients and increase access to care. Yet, no instrument exists to measure their level of engagement in policy advocacy. Research objective: To describe the development and validation of the Policy Advocacy Engagement Scale, designed to measure frontline healthcare professionals’ engagement in policy advocacy with respect to a broad range of issues, including patients’ ethical rights, quality of care, culturally (...) competent care, preventive care, affordability/accessibility of care, mental healthcare, and community-based care. Research design: Cross-sectional data were gathered to estimate the content and construct validity, internal consistency, and test–retest reliability of the Policy Advocacy Engagement Scale. Participants and context: In all, 97 nurses, 94 social workers, and 104 medical residents (N = 295) were recruited from eight acute-care hospitals in Los Angeles County. Ethical considerations: Informed consent was obtained via Qualtrics and covered purposes, risks and benefits; voluntary participation; confidentiality; and compensation. Institutional Review Board approval was obtained from the University of Southern California and all hospitals. Findings: Results supported the validity of the concept and the instrument. In confirmatory factor analysis, seven items loaded onto one component with indices indicating adequate model fit. A Pearson correlation coefficient of.36 supported the scale’s test–retest stability. Cronbach’s α of.93 indicated strong internal consistency. Discussion: The Policy Advocacy Engagement Scale demonstrated satisfactory psychometric properties in this initial test. Findings should be considered within the context of the study’s limitations, which include a low response rate and limited geographic scope. Conclusion: The Policy Advocacy Engagement Scale appears to be the first validated scale to measure frontline healthcare professionals’ engagement in policy advocacy. With it, researchers can analyze variations in professionals’ levels of policy advocacy engagement, understand what factors are associated with it, and remedy barriers that might exist to their provision of it. (shrink)

“Hooking up,” a popular type of sexual behavior among college students, has become a pathway to dating relationships. Based on open-ended narratives written by 273 undergraduates, we analyze how students interpreted a vignette describing a heterosexual hookup followed by a sexless first date. In contrast to the sexual script which holds that women want relationships more than sex and men care about sex more than relationships, students generally accorded women sexual agency and desire in the hookup and validated men’s post-hookup (...) relationship interest. However, in explaining the sexless date, students typically reasoned the woman was being chaste and withholding sex to redeem her reputation whereas they often characterized the man’s abstinence in terms of a pity date. The findings underscore the tenacity of gendered sexual scripts around heterosexual dates and hookups but also reveal fissures and contradictions that suggest some changes to the sexual double standard. (shrink)

Decision making is a crucial element in the field of medicine. The physician has to determine what is wrong with the patient and recommend treatment, while the patient has to decide whether or not to seek medical care, and go along with the treatment recommended by the physician. Health policy makers and health insurers have to decide what to promote, what to discourage, and what to pay for. Together, these decisions determine the quality of health care that is provided. Decision (...) Making in Health Care is an up-to-date, comprehensive overview of the field of medical decision making. It includes quantitative theoretical tools for modeling decisions, psychological research on how decisions are actually made, and applied research on how physician and patient decision making can be improved. (shrink)

When using sample data to decide whether two populations differ, laypeople attend to the difference between group means, but largely overlook within-group variability (Obrecht, Chapman, & Gelman, 2007). We show, first, that laypeople know about and use story-implied variability when making pairwise comparisons. Then we demonstrate that participants' sensitivity to variance in a dataset is boosted when presented in a context that implies consistent variance information. Statistical data were couched in stories about electrical conductivity measurements obtained from element samples (low-variability (...) category) or body weight measurements from samples of peoples (high-variability category). We manipulated, between participants, whether the data variance matched or mismatched the story-implied variability. Participants who received data in a matching context showed high sensitivity to variance, while those in the mismatching condition did not. Laypeople use statistical data to make reasonable inferences when those data are provided in a context that makes sense. (shrink)

'Ugly as sin', 'ugly duckling', 'rear its ugly head'. The word 'ugly' is used freely, yet it is a loaded term: from the simply plain and unsightly to the repulsive and even offensive, definitions slide all over the place. Hovering around 'feared and dreaded', ugliness both repels and fascinates. But the concept of ugliness has a lineage that has long haunted our cultural imagination. Gretchen E. Henderson explores perceptions of ugliness through history, from ancient Roman feasts to medieval grotesque (...) gargoyles, from Mary Shelley's monster cobbled from corpses to the Nazi Exhibition of Degenerate Art. Covering literature, art, music and even Uglydolls, Henderson reveals how ugliness has long posed a challenge to aesthetics and taste. Henderson digs into the muck of ugliness, moving beyond the traditional philosophic argument or mere opposition to beauty, and emerges with more than a selection of fascinating tidbits. Following ugly bodies and dismantling ugly senses across periods and continents, [this book] draws on a wealth of fields to cross cultures and times, delineating the changing map of ugliness as it charges the public imagination. Illustrated with a range of artefacts, this book offers a refreshing perspective that moves beyond the surface to ask what 'ugly' truly is, even as its meaning continues to shift. (shrink)

The notion that genetics, through natural selection, determines innate traits has led to much debate and divergence of thought on the impact of innate traits on the human phenotype. The purpose of this synthesis was to examine how innate theory informs genetic research and how understanding innate theory through the lens of Martha Rogers’ theory of unitary human beings can offer a contemporary view of how innate traits can inform epigenetic and genetic research. We also propose a new conceptual model (...) for genetic and epigenetic research. The philosophical, theoretical, and research literatures were examined for this synthesis. We have merged philosophical and conceptual phenomena from innate theory with the theory of unitary beings into the University of Illinois at Chicago model for genetic and epigenetic research. Innate traits are the cornerstone of the framework but may be modified epigenetically by biological, physiological, psychological, and social determinants as they are transcribed. These modifiers serve as important links between the concept of innate traits and epigenetic modifications, and, like the theory of unitary human beings, the process is understood in the context of individual and environmental interaction that has the potential to evolve as the determinants change. (shrink)

Leader behavioral integrity (BI) is central to perceived credibility and thus to leaders’ effectiveness at fostering ethical and other climates. Our research broadens the theoretical foundation for BI research by integrating the cognitive–attributional role of trust in the formation and maintenance of leader BI perceptions. Guided by recent research on trust primacy and prior theories of fairness used to examine ethical behavior, we examine how perceptions of leader BI can be either diminished or maintained through trust velocity following a psychological (...) contract breach. Using a field and an experimental study, we explore the manner in which followers perceive leader’s actions when conflicting interests lead to unfulfilled promises. We found that trust velocity mediates the relationship between a psychological contract breach and leader BI (study 1), and that informational justice moderates this relationship (study 2), suggesting that leaders can attenuate the impact of broken promises on ascribed BI. Our findings offer a pathway for leaders operating in dynamic contexts to preserve BI and also help address concerns that have been raised about the behavioral integrity construct regarding its conceptual overlap with related constructs such as trust, psychological contracts, and informational justice. (shrink)

A curriculum guide and reference, detailing sequentially, according to age level, learning activities and selected resources and intended to facilitate classroom projects and discussions conducive to an understanding of death, dying, and bereavement.

Hymenoplasty is a practice that must be judged from within its cultural confines and not only from outside. It offers women who have grown up within the sexual norms of a Western society the chance to return to their parental culture, with its female-specific virginity expectations. Hymenoplasty allows women to be sexually active prior to marriage, which equalizes the discrepancy between gender norms on premarital sexual experience. Caution is needed when comparing hymenoplasty to female genital mutilation. However, comparing hymenoplasty to (...) other cosmetic genital modification procedures raises unique ethical, social, and medical quandaries that highlight the importance of patient’s autonomy. (shrink)

We, in the rare disease community are grateful to Halley et al. (2023) for highlighting some of the long-overlooked barriers to care. As the parent of a non-ambulatory, teenage boy living with Duch...

Both moral and legal theory feature prominent talk about rights. Yet there is very little agreement about what rights are, about why we use rights in our moral or legal theories, or about what to do when there is a conflict between rights. This article surveys many of the popular theory for analysing rights and explaining their scope.

This paper is concerned with the inverted gender roles portrayed in the Middle English Partonope of Blois, and the part played by Urake in realigning them. The relationship between hero and heroine begins with Partonope in a female passive role as a "kept man," and Melior in a male dominating role as a sexually self-assured woman who chooses the man she wants and controls him. Urake, one of the most unusually interventionistic of romance go-betweens, saves Partonope's life and prepares him, (...) both physically and psychologically, to assume his position as the triumphal hero; she also torments Melior into accepting a less controlling form of love more suitable for a medieval woman. In this way the conventional ending to the romance is enhanced by the satisfaction of seeing the inverted gender roles of hero and heroine put to rights. (shrink)

Histories of nursing that disregard their linkage to broader historical movements often lead to historically detached versions of nursing identity that omit the perspective of their sources and the ideas of their time. Drawing on materials retrieved through a multilayered research strategy comprising internal and external sources, this article examines the development of a nursing identity in Chile during the period starting in the 1950s through the early 2000s. We analysed the sociopolitical contexts in which the nursing profession grew, the (...) changing direction of its role and how the nursing identity transformed itself. Through the use of historical sources and oral testimonies, we aim to give a nuanced account of how the history of public health and that of the country more broadly changed the object of identification of nurses, creating only relatively recently a sense of nursing community. Processes of identification, fragmentation and integration are highlighted, which challenge usual notions of history as a linear process. (shrink)

Background High levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention. Aim “Positive Attitudes Striving to Rejuvenate You: PASTRY” was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurses. Research Design A Quality Improvement (QI) initiative was conducted using a pre- and post-intervention design, to launch PASTRY and measure its impact on moral distress of the nursing unit, using Hamric’s (...) Moral Distress Scale–Revised (MDS-R.) This program consisted of monthly 60-minute sessions allowing nurses to address morally distressing events and themes, such as clinicians giving “false hope” to patients or families. The PASTRY program sessions were led by certified clinicians utilizing strategies of discussion and mind-body practices. Participants Clinical nurses working on an adult leukemia/lymphoma unit. Ethical considerations This was a QI initiative, participation was voluntary, MDS-R responses were collected anonymously, and the institution’s Ethics Committee oversaw PASTRY’s implementation. Findings While improvement in moral distress findings were not statistically significant, the qualitative and quantitative findings demonstrated consistent themes. The PASTRY program received strong support from nurses and institutional leaders, lowered the nursing unit’s moral distress, led to enhanced camaraderie, and improved nurses’ coping skills. Discussion Measurement of moral distress is innately challenging due to its complexity. This study reinforces oncology nurses have measurable moral distress. Interventions should be implemented for a safe and healing environment to explore morally distressing clinical experiences. Poor communication among multidisciplinary team members is associated with moral distress among nurses. Programs like PASTRY may empower nurses to build support networks for change within themselves and institutions. Conclusion This QI initiative shows further research on moral distress reduction should be conducted to verify findings for statistical significance and so that institutional programs, like PASTRY, can be created. (shrink)

Alan Gewirth extends his fundamental principle of equal and universal human rights, the Principle of Generic Consistency, into the arena of social and political philosophy, exploring its implications for both social and economic rights. He argues that the ethical requirements logically imposed on individual action hold equally for the supportive state as a community of rights, whose chief function is to maintain and promote the universal human rights to freedom and well-being. Such social afflictions as unemployment, homelessness, and poverty are (...) basic violations of these rights, which the supportive state is required to overcome. A critical alternative to both "liberal" and "communitarian" views, this book will command the attention of anyone engaged in the debate over social and economic justice. (shrink)

The “Authority Problem” is the problem that arises when speakers who lack authority successfully perform speech acts that require speaker authority in order to be felicitous. One solution that has been offered to the Authority Problem holds that the non-authoritative speaker of a successful authoritative illocution comes to have authority through a process of presupposition accommodation. I call this solution the Authority Accommodation Analysis, or AAA. In this paper, I argue that there is no Authority Problem, and thus, no need (...) for an AAA. The appearance of the problem relies on a conflation between the _felicity_ of speech acts and their _success_. Yet a speech act can be successfully performed even in the absence of felicity. While authority is often a felicity condition for certain speech acts, I argue that it need not be a success condition. Ultimately, the consequence of my argument is that I must reject conventionalism about illocutionary success. (shrink)

Care left undone, interchangeably referred to as missed care, unfinished nursing care and task incompletion, is pervasive in contemporary healthcare systems. Care left undone can result in adverse outcomes for the patient, nurse and organization. The rhetoric that surrounds care left undone infers it is a contemporary nursing phenomenon; however, a seventeenth‐century Spanish nursing treatise, Instruccion de Enfermeros (Instructions for Nurses), challenges this assumption. Instruccion de Enfermeros was an instructional guide that was written for members of the Congregation of (...) Bernardino de Obregon who worked as nurses at the Madrid General Hospital. The treatise provides a historical commentary on the daily roles, responsibilities and working conditions of the Obregonian nurses. Its content and context suggest the Obregonian nursing resource was consistently time poor due to a confluence of internal and external stressors. Consequently, the Obregonians were under considerable role strain resulting in inferior patient care. This article explores the antecedents of care left undone through a historical lens using exemplars from the 1625 edition of Instruccion de Enfermeros. Factors contributing to care left undone in Obregonian nursing will then be examined to offer insights into the similarities between what a nurse suffered 400 years ago and what exists in contemporary nursing practice. (shrink)

Humans have been called “cooperative breeders” because mothers rely heavily on alloparental assistance, and the grandmother life stage has been interpreted as an adaptation for alloparenting. Many studies indicate that women invest preferentially in their daughters’ children, but little research has been conducted where patrilocal residence is normative. Bangladesh is such a place, but women nevertheless receive substantial alloparental investment from the matrilateral family, and child outcomes improve when maternal grandmothers are alloparents. To garner this support, women must maintain contact (...) with their natal families. Here, the visiting behavior of 151 interviewed mothers was analyzed. Despite the challenges of patrilocality and purdah, almost all respondents visited their own mothers, and mothers-in-law were visited far less. This contrast persists in analyses controlling for proximity, respondent age, postmarital residence, family income, and marital status. These results affirm the importance women place on matrilateral ties, even under a countervailing ideology. (shrink)

The discussion paper synthesises the insights shared during a keynote panel at the 26th International Philosophy of Nursing Conference, themed “Reimagining a nursing ecosystem in an uncertain world.” It delves into the substantial impact uncertainty has on nursing, offering innovative strategies for reconceptualization. Through a critical examination of evidence‐based practice, the tendency to homogenise nursing is discussed, prompting advocacy for a Nietzschean political framework as a form of resistance and emancipation. Drawing inspiration from Donna Haraway, a transition from individualistic to (...) relational approaches is needed, especially amidst social and economic instability. Furthermore, the integration of caritas and Indigenous epistemologies underscore the significance of cultural sensitivity in nursing. Meanwhile, Ubuntu philosophy champions empathy and collective values, while a convergence of Eastern and Western philosophical traditions promises to enrich nursing practice. Ultimately, the panellists advocate for overcoming rigid ideologies in favour of a pluralistic approaches, ontologies, epistemologies and ethics to address contemporary challenges, and signal for a philosophical reorientation to engage uncertainty and reshape nursing roles in an ever‐evolving and world. (shrink)

Nursing acts occur in thousands of instances daily, being a major component of professional health care delivery in institutions, communities and homes. It follows that the ethical practice of most nurses is put to the test on an everyday rather than an occasional basis. Hence, within nursing practice there must be a rich and deep seam of reflective interpretation and practical wisdom that is 'embedded' within the experiences of every experienced nurse. This article presents discussion on some of the (...) main findings of a recently completed study on nursing ethics in New Zealand. An interpretation of a nurse's story taken from the study is offered and suggestions are made for nursing ethics education. (shrink)

Human diploid fibroblasts have a finite proliferative lifespan in culture, at the end of which they are ararrested with G1 phase DNA contents. Upon serum stimulation, senescent cells are deficient in carrying out a subset of early signal transduction events such as activation of protein kinase C and induction of c‐fos. Later in G1, they uniformly fail to express late G1 genes whose products are required for DNA synthesis, implying that they are unable to pass the R point. Failure to (...) pass the R point may occur because senescent cells are unable to phosphorylate the retinoblastoma protein, owing to the accumulation of inactive complexes of cyclin E/Cdk2 and possibly cyclin D/Cdk4. Senescent cells contain high amounts of p21, a potent cyclin‐dependent kinase inhibitor whose levels are also elevated in cells arrested in G1 following DNA damage, suggesting that both arrests might share a common mechanism. Cell aging is accompanied by a progressive shortening of chromosomal telomeres, which could be perceived by the cells as a form of DNA damage that gives rise to the signals that inactivate the cell cycle machinery. (shrink)

This paper seeks to provide a noetic analysis of emotional trauma. It highlights three essential features of trauma, as well as one non-essential feature, and attempts to make sense of them phenomenologically. The first essential feature of trauma that the paper considers is the disbelief that pervades traumatic experience. When traumatized, we cannot believe that the traumatic event has taken place. This is because we will, not for the event not to have happened—we cannot will something that is in the (...) past—but to believe that it did not happen so as to shield ourselves from our painful emotional response to it. The second essential feature of trauma is our inability to distinctly categorially intuit the central state of affairs around which our trauma revolves. The traumatic situation is literally unthinkable by us, for it is incongruent with both our expectations regarding the subject of the trauma and our horizon of sense more generally. The third essential feature of trauma is the temporal disorientation that it brings about. Such disorientation arises from our prolonged and single-minded attention to an increasingly complex categorial object: the traumatic situation. Finally, the paper considers a non-essential feature of trauma, namely, how traumatic experience can motivate phenomenological and scientific reactions. (shrink)

This paper examines the characteristics of infectious diseases that raise special medical and social ethical issues, and explores ways of integrating both current bioethical and classical public health ethics concerns. Many of the ethical issues raised by infectious diseases are related to these diseases’ powerful ability to engender fear in individuals and panic in populations. We address the association of some infectious diseases with high morbidity and mortality rates, the sense that infectious diseases are caused by invasion or attack on (...) humans by foreign micro‐organisms, the acute onset and rapid course of many infectious diseases, and, in particular, the communicability of infectious diseases. The individual fear and community panic associated with infectious diseases often leads to rapid, emotionally driven decision making about public health policies needed to protect the community that may be in conflict with current bioethical principles regarding the care of individual patients. The discussion includes recent examples where dialogue between public health practitioners and medical‐ethicists has helped resolve ethical issues that require us to consider the infected patient as both a victim with individual needs and rights and as a potential vector of disease that is of concern to the community. (shrink)

Transactions in the U.S. garage sale range from the commercial to the giftlike, in a Maussian sense. As two-thirds of the participants, women create a sense of community through garage sale exchange. This article explores how women, partly differentiated along lines of race and class, solidify their personal relationships, transmit something of themselves with their possessions, transform their own lives in the process, and contribute to a broader spirit of community through the generalized reciprocity and even moral economy that manifests (...) in giftlike exchange. There is an important link, both material and symbolic, between women's relational skills, their association with the home and the moral, and the creation of community in the garage sale. (shrink)

Background: Nursing students, during their study, experience significant changes on their journey to become nurses. A major change that they experience is the development of their moral competency. Objective: The purpose of this study is to explore the process of moral development in Iranian nursing students. Research design: A constructivist grounded theory method was adopted. Twenty-five in-depth, semi-structured, face-to-face intensive interviews with 22 participants were conducted from September 2013 to October 2014. All interviews were audio-taped, transcribed, and analyzed using writing (...) memos and the constant comparative method. Participants and research context: The setting was three major nursing schools within Tehran, the capital of Iran. Nineteen nursing students and three lecturers participated in the study. Ethical considerations: The study was approved by the Tehran University of Medical Sciences Committee for Medical Research Ethics (92/D/130/1781). It was explained to all participants that their responses would be treated with confidentiality and that they would not be identified in any way in the research and any publication ensuing from the research. All participants agreed to be interviewed and signed written consent forms agreeing to the recording and analyses of the interview data gathered. Findings: Findings indicated three levels of moral development along with the formation of professional identity. The three levels of moral development, getting to know the identity of nursing (moral transition), accepting nursing identity (moral reconstruction), and professional identity internalization (professional morality), were connected to the levels of professional identity formation. Discussion: The proposed model added a new insight to professionalism in nursing. Conclusion: From the findings, it was concluded that to enhance higher moral practice, nursing instructors should promote the professional identity of nursing students. Reinforcement of moral characteristics and professional identity within registered nurses occurs over a series of phases and, once fully integrated into the identity of nursing students, the moral characteristics that they acquire become part of their both professional and personal identities. (shrink)

The postconflict Rwandan state has crafted a “we are all Rwandans” national identity narrative without ethnicity, in the interest of maintaining a delicate, postgenocide peace. The annual genocide commemoration period called Kwibuka—“to remember”—which takes place over the course of one hundred days every year, is an underresearched part of this narrative. During the commemoration period, génocidaires’ confessions increase dramatically; these confessions lead the government to previously undiscovered graves all over the country, just as confessions given during the grassroots justice system—gacaca—did (...) in the more immediate aftermath of the genocide. According to a prominent government official known for his prison outreach, the Rwandan government no longer provides incentives for prisoners to confess. Instead, he stated in a 2017 interview, those who speak up over twenty years later are simply “moved by the spirit of Kwibuka.” When confessions are made, memories of past action are used by the state, seemingly toward an ultimate end of reinforcing the national master narrative, to subsume the individual memories of innocent survivors into the national collective memory. This paper explores the questions around the state’s evolving use of prisoner confessions, both how those confessions are obtained, and how they factor into commemoration practices now. (shrink)

What does it look like when an organization tentatively steps away from an exclusively rules-based regime and begins to attend to both rules and principles? What insights and guidance can ethicists and ethical theory offer? This paper is a case study of an organization that has initiated such a transition. The American Institute of Certified Public Accountants has begun a turn toward the promotion of ethical principles and best practices by adding a “conceptual framework” to its existing Code of Professional (...) Conduct. This conceptual framework calls upon its members to intentionally increase their awareness of significant threats to their compliance with its rules of conduct and to establish safeguards to offset or eliminate those threats. To this end, each member is required to regard every questionable situation, circumstance, transaction or relationship by attempting to view it through the eyes of an imagined reasonable third party. This paper examines this protocol theoretically and practically. First, we frame this analysis within the principles and ethical concepts that inform the professional ethics of accountants. Second, we critique the AICPA’s long-standing rules-based approach to its Code. Third, we examine the new conceptual framework with a view toward its potential for the promotion of a more principles-based approach to the professional ethics of the accounting profession. Fourth, we give attention to the notion of the “reasonable and informed third party,” which has been embedded in the new conceptual framework, and consider how two schools of thought—Adam Smith’s modernist “impartial spectator” concept and Emmanuel Lévinas’ postmodern phenomenology in regard to “the Other”—may offer theoretical support and clarity for this epistemic exercise. Finally, we point out several ways in which the AICPA’s commitment to its new conceptual framework could be strengthened and enhanced. (shrink)

In this article, the nursing health history is revisited with a hermeneutic lens to uncover means by which this tool can better serve nursing practice. It is argued that further distanciation from the developmental and medical model is necessary to accurately uncover health and history in the nurse–client encounter. Based on the works of prominent hermeneutic philosophers, such as Heidegger, Gadamer, Merleau‐Ponty, Ricoeur, and Taylor, four orientations to health history and nursing are explored: orientation to caring, orientation to narrative, (...) orientation to time, and orientation to the body. The nursing health history is used as a vehicle for illuminating the usefulness of a hermeneutic perspective in everyday nursing practice. This article reveals views of health, history, and health history that are already known to nurses and the nursing milieu but are concealed by more dominant outlooks. The hermeneutical perspective presented in this article can help to reveal the important dimensions of everyday nursing practice and foster a richer attunement with the complex health experiences of individuals. (shrink)

It is commonly accepted that conversation is, in some sense, cooperative. This is due in part to Paul Grice’s articulation of the Cooperative Principle, which states that participants should “make [their] conversational contributions such as is required...” (1989, 26). Yet the significance of this principle, as well as the notion of cooperation that is entailed, is up for interpretation. For example, there are several ways of understanding what kind of force the Cooperative Principle is supposed to have: it could be (...) meant as a requirement on the behavior of speakers, a description of the way speakers behave, or an articulation of what speakers assume of one another’s contributions. I consider each of these options, and I argue that the first, which is often seen as a naïve interpretation, is worth considering. Although I ultimately reject the prescriptive interpretation of the Cooperative Principle, it offers a jumping off point for exploring other prescriptions on conversational behavior, such as the Requirement of Interlocutor Responsiveness, which I offer as an explicitly prescriptive conversational principle. (shrink)

This essay critically evaluates the claim that competition in medicine destroys the moral integrity of the traditional patient-physician relationship. The author argues that the traditional patient-centered ethic is indefensible on moral grounds, and that it should be jettisoned in favor of a fiduciary ethic. A fiduciary ethic is found to provide the best defensible account of the patient-physician relationship because it takes seriously the roles economic efficiency, competition, and respect for individual self-determination play in fashioning moral health care delivery. Keywords: (...) competition, patient-physician relationship, fiduciary ethic, patient-centered ethic CiteULike Connotea Del.icio.us What's this? (shrink)

Peter Abelard (1079–1142 ce) was the most wide‐ranging philosopher of the twelfth century. He quickly established himself as a leading teacher of logic in and near Paris shortly after 1100. After his affair with Heloise, and his subsequent castration, Abelard became a monk, but he returned to teaching in the Paris schools until 1140, when his work was condemned by a Church Council at Sens. His logical writings were based around discussion of the “Old Logic”: Porphyry's Isagoge, aristotle'S Categories and (...) On Interpretation and boethius'S textbook on topical inference. They comprise a freestanding Dialectica (“Logic”; probably c.1116), a set of commentaries (known as the Logica [Ingredientibus], c. 1119) and a later (c. 1125) commentary on the Isagoge (Logica Nostrorum Petititoni Sociorum or Glossulae). In a work Abelard called his Theologia, issued in three main versions (between 1120 and c.1134), he attempted a logical analysis of trinitarian relations and explored the philosophical problems surrounding God's claims to omnipotence and omniscience. The Collationes (“Debates,” also known as “Dialogue between a Christian, a Philosopher and a Jew”; probably c.1130) present a rational investigation into the nature of the highest good, in which the Christian and the Philosopher (who seems to be modeled on a philosopher of pagan antiquity) are remarkably in agreement. The unfinished Scito teipsum (“Know thyself,” also known as the “Ethics”; c.1138) analyses moral action. (shrink)

Critical thinking and arguments -- What makes a good argument? -- Premises and conclusions -- Language -- Propositional arguments -- Categorical arguments -- Analogical arguments -- Statistical arguments -- Causal arguments -- Moral arguments -- Answers to selected exercises -- Reference guide.

For the last 50 years the idea of consumer rights has formed an essential element in the formulation of policy to guide the workings of the marketplace. The extent and coverage of these rights has evolved and changed over time, yet there has been no comprehensive analysis as to the purpose and scope of consumer rights. In moral and ethical philosophy, rights are integrally linked to the notion of justice. By reassessing consumer rights through a justice-based framework, a number of (...) key issues emerge regarding the way in which markets enable justice for consumers. The consumer rights which underpin the United Nations consumer protection guidelines address all forms of justice to some degree, but the predominant focus is on procedural justice. Our conclusions question whether this is sufficient and also whether there is a case to develop the notion of consumer ‘duties’ that complement the idea of rights. (shrink)

Despite achieving broad acceptance of the moral case for treating animals fairly, the animal rights movement has reached an impasse concerning legal rights for animals. Zoopolis proposes a new approach to addressing this failure: integrating animal interests into human society via political institutions and practices. Zoopolis’s central theory that humans owe animals citizenship rights in a shared human-animal society, but that acceptance of responsibilities by animals also is required, has merit for the advancement of animal rights discourse. But its anthropocentric (...) approach, which itself exerts power over animals, necessitating suppression and policing of animals’ natural behavior, is problematic. (shrink)

BackgroundEvidence suggests that organizational models that provide care interventions including patient support programs may increase patient adherence to multiple sclerosis therapies by providing tailored symptom management, informational support, psychological and/or social support, lifestyle changes, emotional adjustment, health education, and tailored coaching, thus improving patients' overall quality of life across the disease course.ObjectiveThe main objective of this study was to describe MS patients' self-reported experience of a nurse-led, telephone-based PSP and to explore its potential role in improving disease and therapy (...) management skills.MethodsSurvey data were analyzed from a subset of patients relapsing–remitting MS using interferon beta-1a already registered in the adveva® PSP from three Italian multiple sclerosis centers with a consolidated experience in RRMS disease, treatment management, and PSP programs.ResultsIn total, 244 patient data at baseline were analyzed, of which 115 had a follow-up of at least 6 months. Results from this study provide an early view into the role of this PSP in improving the patients reported overall experience regarding disease management and injectable therapy, thus potentially ameliorating treatment adherence and decreasing health care cost. Moreover, study findings confirm the role of providing a patient-focused support by addressing non-medication-related topics in the PSP consultations. Indeed, patients involved in the adveva® PSP program reported a better psychological status in the follow up as demonstrated by an increased optimism regarding their future, tolerance of disease uncertainty, and their perceived ability to benefit from external help and social support.ConclusionsAs such, it is reasonable to conclude that the involvement in the adveva® PSP and the PSP's assistance in guiding patients on proper treatment self-management techniques is of great value to patients as it might contribute to improving engagement in their health care journey in terms of perceived self-care skills, emotional coping toward the future and the unpredictability of the disease course and their general attitudes toward the injection itself, involving pain tolerance. (shrink)