The ethical challenges of caring for the chronically ill are of increasing concern to nurses as they attempt to create humanitarian environments for long-term care. This article suggests two ethical perspectives to guide the agenda of the nursing profession to achieve social change in the care of the chronically ill and aging. First, a reemphasis on the public duties of the professions is recommended which extends beyond serving the interests of the nursing profession to recognizing the need to serve the (...) common good. Second, the limitations of the autonomy paradigm are explored and the foundation for the development of a new moral paradigm is analyzed in terms of its' potential usefulness in addressing ethical problems of chronic illness. Several initiatives that nursing must undertake to facilitate the emergence of this paradigm are proposed. (shrink)

There is a growing consensus in Britain on the importance of character, and on the belief that the virtues that contribute to good character are part of the solution to many of the challenges facing modern society. Parents, teachers and schools understand the need to teach basic moral virtues to pupils, such as honesty, self-control, fairness, and respect, while fostering behaviour associated with such virtues today. However, until recently, the materials required to help deliver this ambition have been missing in (...) Britain. The Knightly Virtues Programme, devised by the Jubilee Centre for Character and Virtues, aims to help solve this challenge. The programme, designed for 9 to 11 year olds, draws on selected classic stories to help teach moral character in schools. This approach has proved to be popular with children and teachers, with more than 5,000 pupils from one hundred schools having participated in the programme so far. Fifty-five of these schools and 3,272 pupils were directly involved in different stages of the research. Based at the University of Birmingham, the Jubilee Centre houses leading academics dedicated to researching the various ways in which good character, which underpins the building blocks of society, can be developed. Recent research from the Centre has shown that the qualities that make up character can be learnt and taught, and suggests that we need a new emphasis on their importance in schools and in professional education. This report from the Centre into the use of classic literature within schools sets out the ways in which the Knightly Virtues Programme is able to develop the virtue literacy of school pupils, and the extent to which an understanding and awareness of good moral character can make positive changes to behaviour. The impact of the programme has been tested using several rigorous research methods, detailed in this report alongside their findings, which provide substantial empirical evidence for the effectiveness of using stories to develop virtue literacy. (shrink)

The aim of the My Character project was to develop a better understanding of how interventions designed to develop character might enhance moral formation and futuremindedness in young people. Futuremindedness can be defined as an individual’s capacity to set goals and make plans to achieve them. Establishing goals requires considerable moral reflection, and the achievement of worthwhile aims requires character traits such as courage and the capacity to delay gratification. The research team developed two new educational interventions – a website (...) and a hard-copy journal – with the specific aim of developing future-mindedness. After development, the website and journal were piloted over a one-year period by over 1,000 11–14 year olds in six schools across England. Various research methods, including group interviews and case studies, were implemented to assess impact. In addition, a pilot RCT was conducted to assess the feasibility of using experimental methods to measure character. The main findings from the research are that: - Students benefit from opportunities in school to think about future-mindedness; this can be successfully taught through character education. - Harnessing new technology, such as the Internet, offers exciting opportunities for character education. - It is beneficial to investigate the impact of new character education resources in order to bring greater clarity about ‘what works’. The most useful approach is a mixed methods one that allows for triangulation of evidence. - It is possible to run RCTs and other experimental research in schools to assess developmental projects of this kind, but applying the method in schools and creating suitable outcome measures present challenges for researchers. - A positive indicator of the success is that five out of the six pilot schools have embedded My Character into their curriculum. In addition, many new schools, both in Britain and internationally, have started to use the website and / or journal. This report describes the research, analyses the impact of My Character and concludes with recommendations for policy makers, practitioners and researchers embarking on similar projects. These recommendations include: i) advocating that schools create space in the curriculum to teach future-mindedness through character education; ii) enhancing traditional character education teaching methods with opportunities brought by Internet technologies; iii) evaluating character education interventions using triangulated evidence drawn from a mixture of research methods. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

ABSTRACT:Promoting dignity is at the heart of the human capability approach to development. We introduce the concept of stakeholder capability enhancement, beginning with a discussion of the capability approach to development proposed by Sen (1985) and further advanced by Nussbaum (1990) to incorporate notions of dignity. Thereafter follows a review of the literature on value creation stakeholder management and convergent stakeholder theory (Freeman, 1984; Freeman, Harrison, Wicks, Palmer, & DeColle, 2010; Harrison & Wicks, 2013; Jones & Wicks, 1999), (...) as the foundation for our concept of stakeholder capability enhancement. The remainder of this article develops a model that integrates stakeholder management with the human capability approach to detail the cooperative advantage that accrues to business and its stakeholders, as well as the gains in social wellbeing and dignity, when stakeholder capability enhancement becomes a common enterprise strategy. The model also explores the risks and boundary conditions firms face when seeking to profit from stakeholder capability tradeoffs. In explaining the model, we explore normative responsibilities and consequences with regard to human capabilities and dignity. We conclude with implications for future research. (shrink)

A commentary on the arguments whereby Hume endeavored to delimit the role of reason in morality. Harrison’s procedure is largely one of logical analysis: he identifies individual arguments, examines inferences, asks whether there are reasons to believe premises. Throughout, he displays a balanced, appreciative approach, and when obliged to draw attention to Hume’s mistakes, he does so only reluctantly. Over half of the book is taken up in a careful examination of the text which, in terms of clarity and (...) penetration, goes beyond previous studies of Hume’s ethics. Additionally, Harrison offers chapters on Hume’s general epistemology and on the classical is/ought passage. In the latter he declares that Hume quite obviously thought that the derivation of an ought from an is was impossible, and then goes on, in what he labels an independent treatment of the problem, to offer a subtle exploration on the contours of our usage of the language of evaluation and obligation. But perhaps the most valuable contribution of the book is the closing section in which Harrison endeavors to arrive at a depiction of Hume’s alternative to rationalism. He puts forward five distinct interpretations of Hume’s positive moral philosophy, each of which has textual support as well as its own advocates. Harrison finds no grounds for affirming that any one of these interpretations defeats the others. Concluding with the judgment that Hume was confused in expounding his own position, the author notes that "Hume himself would not have approved of a reverence which substituted a superficial acceptance for a thorough grasp and realistic appraisal of his opinions." Despite the opposition which his work may provoke from those who defend some single interpretation of Hume’s moral philosophy, Harrison’s study may be expected to become a standard reference work on Hume’s ethics.—J.T.K. (shrink)

When I read, rather belatedly, Professor Davison's article on Theognis 257–66 in C.R. ix , 1–5, I found myself remembering somewhat uncomfortably that I have an article awaiting publication in Mnemosyne in which I present a new interpretation of Theognis 1209–16 as a griphos. Against Carriere, Davison remarks that it would be easier to accept 261–6 as a griphos ‘if there were any serious evidence for the prevalence of in the Theognidean corpus’ ; this is an eminently sane attitude and (...) leaves the question open for later consideration. But lower on the same page E. Harrison's dictum that ‘sweeping emendations’ are ‘the last infirmity of exegesis’ has given birth to a pronouncement that ‘recourse to riddles’ is one of two ‘penultimate infirmities of academic minds’. This is really too much. I have not yet acquired a fixation on this subject, but I am sufficiently impenitent to maintain that the griphos appears at least twice in the corpus, at 1209–16 and 261–6. I have no opinion on 257–60, which seems at any rate to be in its proper place. (shrink)

ADDRESS ETHICS WITHOUT PROPOSITIONS. By WINSTON H. F. BARNES 1 SYMPOSIUM : ARE ALL PHILOSOPHICAL QUESTIONS, QUESTIONS OF LANGUAGE I. By STUART HAMPSHIRE 31 II. By AUSTIN DUNAN JONES 49 III. By S. KORNER 63 SYMPOSIUM : THE EMOTIVE THEORY OF ETHICS. f. By RICHARD ROBINSON 79 II. ByH. J. PATON 107 III. ByR.C. CROSS 127 SYMPOSIUM : WHAT CAN LOGIC DO FOR PHILOSOPHY I. By K. K. POPPER 141 II. By WILLIAM KNEALE 155 III. By PROFESSOR A. J. AYER (...) 167 SYMPOSIUM : THINGS AND PERSONS. I. By PROFESSOR D. M. MACKINNON 179 II. By PROFESSOR H. A. HODGES 190 III. BY J. WISDOM 202. (shrink)

Many of the papers in this volume originated in a colloquium at the University of Western Ontario in 1967. These include a paper on the logic of norms by G. H. Von Wright, a paper on the logic of questions by L. Åqvist, a paper on the logic of belief by W. Sellars, and a paper on inductive logic by R. Ackermann. The commentaries by Anderson and Sosa have been revised for the volume and a further commentary to Ackermann's paper (...) by Wesley Salmon has been added. In addition to the colloquium papers a number of further papers are published here for the first time: J. Hintikka on the semantics of propositional attitudes, R. Hilpinen on relativized modalities, C. Harrison on the unanticipated examiner and H. Smokler and M. Rohr on confirmation and translation. The volume is completed by two papers published in Synthese and a well-known paper in modal logic by Lemmon, Meredith, Meredith, Prior, and Thomas published complete with a new postscript by Prior. Although the collection is somewhat haphazard and seems to have no unifying theme, philosophers interested in these topics in philosophical logic will be thankful for the availability of the papers, both old and new.--R. H. K. (shrink)

A set is said to be amorphous if it is infinite, but is not the disjoint union of two infinite subsets. Thus amorphous sets can exist only if the axiom of choice is false. We give a general study of the structure which an amorphous set can carry, with the object of eventually obtaining a complete classification. The principal types of amorphous set we distinguish are the following: amorphous sets not of projective type, either bounded or unbounded size of members (...) of partitions of the set into finite pieces), and amorphous sets of projective type, meaning that the set admits a non-degenerate pregeometry, over finite fields either of bounded cardinality or of unbounded cardinality. The hope is that all amorphous sets will be of one of these types. Examples of each sort are constructed, and a reconstruction result for bounded amorphous sets is presented, indicating that the amorphous sets of this kind constructed in the paper are the only possible ones. The final section examines some questions concerned with the resulting cardinal arithmetic. (shrink)

Originally published in 1926, this book attempts to state 'what has been believed with regard to God's incapacity for suffering'. Mozley charts the development of the doctrine from the Apostolic Fathers through the Reformation to the modern influence of metaphysical philosophy and concludes with six questions intended to prompt further theological discussion on this point. This book will be of value to anyone with an interest in the history of Christian theology.

In this paper I describe and analyze an economic situation involving two competitive organizations. I put forth the argument that because of the systemic nature of decision making relative to managing the requirements of utilizing a descriptive equation that determines how many people an economic system can support, that even if all the players in the situation act ethically, the results will still be harmful, and necessarily so, to the system and to many innocent people. I will demonstrate that harming (...) innocent people is required and morally defensible given the choices available. The best one can do is slow down the increase in disutilities and possibly operate the system within a range of acceptable behavior that minimizes the resulting harm to innocent people, even if we cannot entirely remove this harm. In this context ethics becomes the study of the acceptable as opposed to the preferable. (shrink)

The advent of personal genomics companies offering direct translation of scientific data into personal health information, calls into question traditional policies to refuse disclosure of such scientific data to research participants. This seems especially true for population biobanks, as they collect not only genotype information but also associated phenotype information, and thus may be in a unique position to translate their scientific findings into personal health information for their participants. Disclosure of such information seems mandated by the expectations raised by (...) biobanks and their participants' rights to know health information, to know clinical research results, to life and health and particularly their right to benefit. Refusals to disclose such information can be grounded in the lack of analytical validity and/or clinical utility of most findings, the need to avoid the therapeutic misconception, the complexity and costs involved in translation and disclosure and the disproportionate burden resulting from the obligation to respect participants' right not to know before any disclosure can be made. Currently, any demands by participants in population biobanks for full disclosure of all pertinent personal health information potentially resulting from the biobank's scientific findings are unlikely to be granted by a Dutch court under Dutch and international law. As the law stands now, a population biobank is neither a doctor nor a personal genomics company. However, in view of the rapid scientific, medical, technological, commercial and social developments, population biobanks must prepare to take more care of their participants' legitimate interest in receiving as much validated personal health information as reasonably possible, in a timely fashion, by developing appropriate translation and disclosure mechanisms. This paper examines whether population biobank participants have the right, under Dutch civil law and international law, to full disclosure, i.e. to all information generated by the biobank that is pertinent to their present and future health. It pioneers the format of a hypothetical court case to elucidate the legal and policy arguments" for and against full disclosure. (shrink)

This chapter contains sections titled: “I'm shocked, I tell you, shocked!” The Preacher and the Porn Star Picnic Sex and the Prudes “Don't look, Ethel!” Tease Me, Whip Me, Persuade Me Biting the Bullet Hard Cases If Porn Isn't Free Speech, What Is It? Notes.

Robert F. is an eighty-five-year-old who suffered a heart attack at home in a rural location some thirty minutes from any major hospital. By the time the paramedics arrived, he was unconscious and nonresponsive. After spontaneous return of circulation, they began their standard procedure of therapeutic hypothermia. Robert's core temperature was lowered using ice packs, and cold intravenous fluids were initiated. Soon afterward, Robert started to shiver when his body temperature reached 35.6° Celsius. He was then given a bolus of (...) vecuronium as a neuromuscular blockade, sedated, and intubated. He was also given a low-dose vasopressin for blood-pressure control. Shortly after Robert arrived in the emergency room, his daughter, his medical decision-maker, produced an advance directive documenting that her father has a do-not-resuscitate order, and she demanded that the breathing tube and any other life-sustaining treatments be withdrawn immediately. The medical staff is very reluctant to comply with this demand for immediate action. Until the neuromuscular blockade wears off, removing the ventilator will prevent Robert from breathing. Furthermore, it may take some time to reverse the therapeutic hypothermia procedure to the point that the patient is at normal temperature. In addition, therapeutic hypothermia itself often causes arrest, so the patient may need to be resuscitated again. Should the staff wait until the patient is warm or honor the decision of his daughter, who holds his medical power of attorney? (shrink)