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)

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)

“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)

'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)

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)

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)

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.

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)

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)

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)

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)

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)

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.

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)

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)

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...

Roman Stoics of the imperial period developed a distinctive model of social ethics, one which adapted the ideal philosophical life to existing communities and everyday societal values. Gretchen Reydams-Schils’s innovative book shows how these Romans—including such philosophers as Marcus Aurelius, Seneca, Hierocles, and Epictetus—applied their distinct brand of social ethics to daily relations and responsibilities, creating an effective model of involvement and ethical behavior in the classical world. _The Roman Stoics_ reexamines the philosophical basis that instructed social practice in (...) friendship, marriage, parenting, and community life. From this analysis, Stoics emerge as neither cold nor detached, as the stereotype has it, but all too aware of their human weaknesses. In a valuable contribution to current discussions in the humanities on identity, autonomy, and altruism, Reydams-Schils ultimately conveys the wisdom of Stoics to the citizens of modern society. (shrink)

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.

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)

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)

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)

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 critical look at hospice care by Felicia Ackerman in Vol. 6 of the CambridgeQuarterly requires a response, since the author presents her view as having major implications for health policy. As a healthcare executive with over 25 years experience, and as a spokesperson for both my own program and others in the National Hospice Work Group, twelve of the nation's largest nonprofit hospices, I submit that her analysis of hospice care is naive. Ackerman's lack of practical understanding concerning the (...) care of the terminally ill results in a discussion that misses the key policy issues. (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)

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)

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)

The purpose of this study was to explore and interpret the meaning of relatives’ experiences of encounters with nurses when visiting residents in nursing homes. Thirteen relatives of residents in three nursing homes in Sweden were interviewed. The interviews were tape‐recorded and transcribed verbatim. The method used was hermeneutical text analysis. Four themes emerged in the analysis and interpretation of the whole text: ‘being paid attention to’, ‘being ignored’, ‘being involved’ and ‘being safe and secure’. A further interpretation of the (...) findings shows a deeper understanding of the meaning of relatives. This meaning was revealed as being invited into an encounter with nurses and gave a sense of community but the opposite was being ignored and left outside. This study gives a deeper understanding of the meaning of encounters between relatives and nurses in nursing homes; it also illuminates how these encounters also can affect the care of the residents. This new understanding can hopefully offer support for nurses during their encounters with relatives and optimise the ability to provide a positive outcome for residents in nursing homes. (shrink)

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)

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)

Grainger, Joanne This article explores the proposed Victorian Medical Treatment (Physician Assisted Dying) Bill from a nursing perspective. Public trust of the nursing profession will be lessened with the introduction of any law that permits euthanasia or assisted suicide. In Australian society, care of the dying is a compelling social duty and responsibility. In health and social terms, this is known as palliative care, whereby the provision of physical, psychological, spiritual and emotional support to terminally ill people and their families (...) ensures that suffering at life's end is lessened and minimised. (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)

Part-time work schedules are a popular option for many women struggling to reconcile the competing demands of employment and motherhood. They are controversial among feminists because they are associated with job penalties that promote gender inequality. Previous research on this topic has focused on issues confronting women workers in professional and managerial jobs. In this article, we compare and contrast the experiences of women in professional and secondary part-time jobs, drawing on 60 in-depth interviews with mothers working in such “good” (...) and “bad” jobs. We find that mothers at the top and at the bottom of the employment hierarchy face unique disadvantages from their part-time employment to which they respond in different ways. Yet in both instances, mothers assume responsibility for their “choices,” which absolves organizations of blame for exploitation and discrimination against part-time workers. We suggest alternative possibilities for the organization of work in the conclusion. (shrink)

Many countries project that they will have difficulty to meet their demand for primary care based on an inadequate supply of primary care doctors. There are many reasons for this, and they tend to vary by country. The policy options available to these countries are to increase the number of local primary care doctors, recruit doctors from other countries, ration primary care, shift more primary care to specialists, or authorize other disciplines to provide primary care. This article examines lessons learned (...) in the United States over the past 50 years and proposes that expanding the use of nurse practitioners is the best solution when measured by feasibility, costs, ethics, and scope of the care delivered. Using nurse practitioners trained in country meets the World Health Organization global code of practice regarding the international recruitment of health personnel. (shrink)

The purpose of this paper is to present the theoretical and philosophical assumptions of the Nursing Manifesto , written by three activist scholars whose objective was to promote emancipatory nursing research, practice, and education within the dialogue and praxis of social justice. Inspired by discussions with a number of nurse philosophers at the 2008 Knowledge Conference in Boston, two of the original Manifesto authors and two colleagues discussed the need to explicate emancipatory knowing as it emerged from the Manifesto (...) . Our analysis yielded an epistemological framework based on liberation principles to advance praxis in the discipline of nursing. This paper adds to what is already known on this topic, as there is not an explicit contribution to the literature of this specific Manifesto , its significance, and utility for the discipline. While each of us have written on emancipatory knowing and social justice in a variety of works, it is in this article that we identify, as a unit of knowledge production and as a direction towards praxis, a set of critical values that arose from the emancipatory conscience-ness and intention seen in the framework of the Nursing Manifesto. (shrink)

The purpose of this paper is to present the theoretical and philosophical assumptions of the Nursing Manifesto, written by three activist scholars whose objective was to promote emancipatory nursing research, practice, and education within the dialogue and praxis of social justice. Inspired by discussions with a number of nurse philosophers at the 2008 Knowledge Conference in Boston, two of the original Manifesto authors and two colleagues discussed the need to explicate emancipatory knowing as it emerged from the Manifesto. Our (...) analysis yielded an epistemological framework based on liberation principles to advance praxis in the discipline of nursing. This paper adds to what is already known on this topic, as there is not an explicit contribution to the literature of this specific Manifesto, its significance, and utility for the discipline. While each of us have written on emancipatory knowing and social justice in a variety of works, it is in this article that we identify, as a unit of knowledge production and as a direction towards praxis, a set of critical values that arose from the emancipatory conscience-ness and intention seen in the framework of the Nursing Manifesto. (shrink)