The purpose of this study was to assess the effectiveness of the Reach to Recovery Program of volunteers sponsored by the American Cancer Society. Effectiveness was defined as enhancing the quality of life and rehabilitation of women who had had a mastectomy, through increasing knowledge of rehabilitative procedures, post-surgery activities and level of self-esteem.The investigation was held in twelve community hospitals in Northeastern Massachusetts. Results of the investigation are reported here. It is recommended that post-operative teaching regarding proper management of (...) rehabilitation procedures should be increased and that Reach to Recovery should be available to every woman who has a mastectomy. (shrink)

The purpose of this article is to assess Rosabeth Moss Kanter's work on tokenism in light of more than a decade of research and discussion. While Kanter argued that performance pressures, social isolation, and role encapsulation were the consequences of disproportionate numbers of women and men in a workplace, a review of empirical data concludes that these outcomes occur only for token women in gender-inappropriate occupations. Furthermore, Kanter's emphasis on number balancing as a social-change strategy failed to anticipate backlash from (...) dominants. Blalock's theory of intrusiveness suggests that surges in the number of lower-status members threaten dominants, thereby increasing gender discrimination in the forms of sexual harassment, wage inequities, and limited opportunities for promotion. Although Kanter's analysis of the individual consequences of tokenism was compelling to researchers and organizational change agents, continued reliance on numbers as the theoretical cause of, and as the solution to, gender discrimination in the workplace neglects the complexities of gender integration. (shrink)

The aim of this study was interpret the existential construct of family caring following Acute Coronary Syndrome. Family support is known to have a positive impact on recovery and adjustment after cardiac events. Few studies provide philosophically-based, interpretative explorations of carer experience following a spouse’s ischaemic event. As carer experiences, behaviours and meaning-making may impact on the quality of the support they provide to patients, further understanding could improve both patient outcomes and family experience. Fourteen spouses of people experiencing Acute (...) Coronary Syndrome in Sydney, Australia were engaged in a single, semi-structured interview. Interviews were audio-recorded and transcribed verbatim. Data were analysed using hermeneutic interpretation within a Heideggerian phenomenological framework. Acute Coronary Syndrome disrupts lived temporality, and the projected potential for carers’ being-alongside. Carers experienced an existential uncertainty that arose from difficulty in diagnosis, and situated fear as an attuned, being-towards-death. They constructed protective strategies to insulate their partner and themselves from further stress and risk, however, unclear boundaries for protection heightened carer anxiety. The existential structure of care included one of two possible Heideggerian modes: leaping-in care was a dominating mode that required a high level of carer vigilance; leaping-ahead care was a metaphorical walking alongside, as carers gave back control, freeing opportunities for the person to ‘own’ care. Supporting carers through the intensive phase of leaping-in care, and equipping them for informed leaping-ahead care should be a focus in both the acute and post-discharge care phases. (shrink)

Over the last decade, cities, counties, and states across the United States have enacted higher minimum wages, paid sick leave and family leave, domestic worker protections, wage theft laws, “Ban the Box” removal of questions about conviction history from job applications, and fair scheduling laws. Nevertheless, vulnerable workers still do not trust government to come forward and report labor law violations. The article argues that while increasing the size of the labor inspectorate and engaging in strategic enforcement are necessary, they (...) are not sufficient. It argues that co-enforcement, in which government partners with organizations that have industry expertise and relationships with vulnerable workers, has the potential to manage the shifting and decentralized structures of twenty-first-century production, which were explicitly designed to evade twentieth-century laws and enforcement capabilities. The article aims to contribute to a broader understanding of the role of organizations in enforcement and the circumstances in which their effectiveness can be maximized. It sets forth a set of scope conditions and mechanisms and examines empirical cases of co-enforcement in Austin, Los Angeles, and San Francisco. The main findings are that co-enforcement is most enduring when government agencies and worker organizations recognize each other’s unique capacities, rather than attempt to substitute for one another ; the effort focuses on a specific industry; and the collaboration receives strong political support. Sustaining the impacts of co-enforcement is found to require greater formalization of the partnership and funding streams. (shrink)

This is a comprehensive examination of the ideas of the early modern philosophers on the nature of mind. Taking Descartes, Spinoza, Leibniz, Locke, Berkeley, and Hume in turn, Janice Thomas presents an authoritative and critical assessment of each of these canonical thinkers' views of the notion of mind. The book examines each philosopher's position on five key topics: the metaphysical character of minds and mental states; the nature and scope of introspection and self-knowledge; the nature of consciousness; the problem (...) of mental causation and the nature of representation and intentionality. The exposition and examination of their positions is informed by present-day debates in the philosophy of mind and the philosophy of psychology so that students get a clear sense of the importance of these philosophers' ideas, many of which continue to define our current notions of the mental.Again and again, philosophers and students alike come back to the great early modern rationalist and empiricist philosophers for instruction and inspiration. Their views on the philosophy of mind are no exception and as Janice Thomas shows they have much to offer contemporary debates. The book is suitable for undergraduate courses in the philosophy of mind and the many new courses in philosophy of psychology. (shrink)

Quelle est la signification du « corps anonyme » ou, plus simplement, de l’anonymat dans l’usage qu’en fait Merleau-Ponty? Peut-elle offrir des ressources pour une critique féministe radicale et une politique émancipatrice? Certaines philosophes féministes en ont traité comme un idéal universel abstrait du corps qui est à la fois exempt de toute particularité et qui présume tacitement que le corps blanc masculin servirait de norme et aurait une puissance normative. D’autres ont voulu montrer que l’anonymat éclaire les manières dont (...) la domination et la normativité sont intrinsèques à la constitution corporelle. Je soutiens que le « corps anonyme » peut être lu d’une manière productive pour la compréhension des manières dont le corps vécu est fondamentalement constitué par des relations concrètes de pouvoir. Plus particulièrement, je reprends deux lectures de l’anonymat, l’une comme temporalité vécue – un passé sédimenté – et l’autre comme intériorité corporelle. Prises ensemble, ces lectures montrent que l’anonymat soutient le champ intersubjectif, qui joue un rôle clé dans la description de la constitution corporelle de Merleau-Ponty. Je reprends ensuite cette description pour lire la théorie du schéma corporel de Frantz Fanon et les histoires autobiographiques de l’écrivaine et activiste yankton Zitkála-Šá, le tout afin de montrer que le déni de l’anonymat, qui dérange le champ intersubjectif, a pour résultat une violence et des maux considérables. Le tout servira à montrer que la description du corps anonyme par Merleau-Ponty fournit d’importantes ressources pour une politique émancipatrice et une critique philosophique radicale. (shrink)

The Tibetan Plateau’s Permafrost is melting at an alarming rate. Six of the world’s major rivers are sourced in the Tibetan Himalayas that are warming at a faster rate than the rest of the earth. If the temperature of the region continues to increase, the rivers will dry up and the earth will warm at an even faster rate. Buddha Yeshe Tsogyal, long considered the Mother of Tibetan Tantric Buddhism, was the consort of Padmasambhava. She reached “complete liberation” or Nirvana (...) in a single lifetime. Her stories are preserved in rman thar. Her life was an exemplary practice of compassion, responsible care, and non-violence toward all sentient beings and the world. Can we follow her proto-eco-feminist example? Can we build responsible care for our planet and humanity across disciplines and faith traditions? What does compassionate, non-violent Buddhist thought and Roman Catholic pastoral care bring to eco-feminism? Can an eco-feminist epistemology informed by Buddhist EcoDharma construct programs of sustainability into humanity’s excessive habits integrating science’s ability to quantify, with Buddha nature? Can Catholicism’s pastoral ability to show dependence on God, the peaceful, compassionate Creator of all allow us to see our dependence on God and our earth? Many women have already begun this work around the globe. In 2002, Rosemary Radford Ruether brought 16 women together from around the globe in Women Healing Earth: Third World Women on Ecology, Feminism, and Religion to tell us how they are doing it and succeeding. Each is highlighted here for their visions on how to heal the planet at the grassroots level. From their insights, this article explores their contributions as being still relevant today and adding new concerns about the dangers arising on the Tibetan Plateau. The article emphasizes their ideas, provides a warning and other ideas that collective activation might inspire to address climate change. (shrink)

There has been a marked increase in the active involvement of children and young people in social research. This move is underpinned by rights based arguments that children and young people should have a voice, and that this voice should be listened to. However, concerns have been raised about the appropriateness of children’s and young people’s rights and participation in research. This is primarily due to queries over whether they have enough capacity to enact the individual agency required to be (...) rights holders and participate in research. In addition, a focus on their inherent vulnerability continues to be a key feature of research ethics protocols. In this paper I argue that both capacity and vulnerability should be seen as socially produced, meaning that the scope for capacity to be increased and vulnerability decreased also lies within the social. I draw from notions of relational autonomy or ‘associational presence’ to argue that what children and young people need to be active participants in research is the creation of spaces within which relational agency can be nurtured and sustained. Such techniques and values are found in participatory research approaches and can be used to create such emancipatory environments. (shrink)

Contrary to longstanding opinion, Descartes does not deny all feeling and awareness to non-human animals. Though he undoubtedly denies that animals think, a case can be made that he nonetheless would allow them organism consciousness, perceptual consciousness, access consciousness and even phenomenal con- sciousness. Descartes does not employ or accept an ‘all-or-nothing’ view of consciousness. He merely denies (not that this is a small thing) that animals have the capacity for self-conscious reflective reception or awareness of sensations and feelings.

In lieu of an abstract, here is a brief excerpt of the content:Narrative Symposium:Living Organ DonationLaura Altobelli, Sherri Bauman, Janice Flynn, Andy Heath, Joseph Jacobs, Tim Joos, Amy K. Lewensten, Donna L. Luebke, Sarah A. McDaniel, Donald Olenick, Laurie E Post, Vicky Young, Blake Adams, Anonymous One, Michael Sauls, Christine Wright, Shannon D. Wyatt, and Cara Yesawich• An Altruistic Living Donor’s Story• Surgery for the Soul• Kidney Donation Story• The Essence of Giving—A Transplant Story• Love—the Risk Worth Taking• My (...) Donation Journey• A Life For A Life: My Gift To My Dad• Lessons Learned: The Realities of Living Organ Donation• Sarah’s List Exchange Experience• Accelerated Living Donation• Liver Donor Nightmare• Adrift After Donation• Getting Our Child Off Dialysis• A Living Donor’s Journey• The Spare Kidney• Living Donors are People Too• The Gift of Life—Walking by Faith• Journey of an Altruistic, Non–designated Living DonorCopyright © 2012 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 13.1 (2005) 111-114 [Access article in PDF] Response to Elvira Panaiotidi, "The Nature of Paradigms and Paradigm Shifts in Music Education" Janice Waldron Michigan State University Elvira Panaiotidi makes a strong case that MEAE and praxialism represent, respectively, the poesis and praxis strands of the Aristotelian conception of art and that, consequently, one cannot conclude that the two accounts are ontologically incompatible. At (...) this point I wish only to respond to an implication which I believe may be present and discuss its relevance. That is that the search for ontological explanations has historically preceded (or at least should precede) the development of music education theory. A brief look at the historical record indicates that the development of music education theory seems to have been dominated by the search for axiological more than ontological explanations. Panaiotidi lists both aspects as integral parts of the theoretical kernel, however, the need to justify music education in terms of value has, at least in the United States, apparently preceded any search for meaning.Michael Mark recounts a report of the Boston School Committee in 1837, at which certain arguments of Aristotle were invoked in order to persuade the commitee of the value of music instruction.1 The entire transcript of that meeting amounts to a polemic about the value of music, resulting from its supposed effects on the spirit, character, or health, yet the record is devoid of any discussion of what might actually constitute music.2 Marie McCarthy describes how the search for aesthetic foundations over a century later was fostered by a need to "explain [music education's] importance in the curriculum."3 Of the scholars of this period, Abraham Schwadron in particular was quite explicit in articulating how his theory of aesthetics was motivated by what he considered an appalling inability for music educators to validate their field's existence.4This is not to imply that the authors of our current philosophies were not searching for or failed to provide strong ontological arguments for music education or to insist that they have always framed the question: What is valuable about music? as the question: What is music? in order to address these ideological [End Page 111] and political pressures. I am merely suggesting that the search for ontological explanations has generally followed the search for value. The historical pattern is one of reaction to various pressures, followed by the eventual development of an aesthetic philosophical framework which was intended, directly or indirectly, to respond to those pressures. The magnitude of such pressures to justify the place of music in the curriculum would seem to differentiate music education paradigms from those of the social sciences and humanities, of which, the author asserts, they are hybrids. Combined with the marked differences in social and political pressures which are found in various times and places in America, it would also account for the emotional tone of the debate, to which the author also alludes. Presumably, such emotion results not only from various scholars' attachments to their ontological beliefs, but from the practical consequences which occur when a theory is ultimately rejected or implemented at the classroom level, based on its perceived ability to define what is valuable in music education.Although this differentiation is subtle and does not detract from the strength of Panaiotidi's central argument, it has implications for the eventual implementation of any unitary theory. Specifically, if we accept that, ontologically speaking, praxialism and aestheticism are two sides of the same coin, it is likely that the argument will simply transform into an axiological question concerning which side is more valuable, a fact to which the author also alludes. Considering past evidence, the overriding concern for value justification may make implementing any unitary theory difficult, regardless of the benefits that could potentially be gained through such a "balanced music education." Consider, for example, that a unitary theory would be less susceptible to ideological use because of its breadth. In other fields such as literature or science, this would be a... (shrink)

Employs philosophy to help illuminate the nature of nursing and provide a holistic view of both nursing and persons.

The Cultural Career of Coolness: Discourses and Practices of Affect Control in European Antiquity, the United States, and Japan. Edited by Ulla Haselstein, Irmela Hijiya-Kirschnereit, Catrin Gersdorf, and Elena Giannoulis. Lanham, Md.: Lexington Books, 2013. Pp. vi + 283. $100.

Kindheit in der japanischen Geschichte: Vorstellungen und Erfahrungen / Childhood in Japanese History: Concepts and Experiences. Edited by Michael Kinski, Harald Salomon, and Eike Grossmann. Wiesbaden: Harrassowitz Verlag, 2015. Pp. xv + 542. $133.

Research studies have shown that as many as 80 percent of students are sexually harassed by their peers, ranging from minor, isolated incidences to repeated, criminal actions. Students Harassing Students deals with definitions, problems, suggested solutions and preventions. Each chapter begins with a scenario or case study that demonstrates what educators need to be aware of and address. Cantrell presents liability issues in language easily understood by readers who are not legal scholars. Accessible to non-educators as well as administrators and (...) teachers, this book provides potential policies for preventing and dealing with sexual harassment. (shrink)

This important text introduces students to both feminism and other social and political theories via an examination of the inter-relationship between different feminist positions and key contemporary debates. The book takes each debate in turn, outlines the main themes, discusses different feminist responses and evaluates the implications for real-life political and social issues. This user-friendly structure effectively redraws the map of contemporary feminist thought, offering a fresh and succinct summary of an extensive range of material and graphically demonstrating the ongoing (...) relevance and value of a feminist perspective. (shrink)

This lively collection of interdisciplinary essays engages the theology of Craig Keen. Keen’s work responds to the violence of metaphysics through a still and considered focus on divesting oneself of power. Acutely aware of the problems of modern theology, Keen does not set out to solve every puzzle, but instead responds to difficult questions with hope and prayer. For Keen, theology is never to be the acquisition of knowledge, but the giving of love. He writes in such a way as (...) to create space for voices of difference and dissent. The essays included in this volume do not just interpret, explain, or critique Keen’s thought, but they seek to accompany him in attentiveness to difference and pain. As such, they engage with the same concerns as Keen: the violence of concepts, the suffering of individuals, the divestment of power, and the embodiment of prayer and doxology. (shrink)

In this article I explore the usefulness of Spinoza’s ethics for feminism by considering ways in which it allows feminists to rethink privacy. I draw upon some of Spinoza’s central ideas to address the following question: when should information be classed as private and when should it be communicated? This is a question that is considered by the common law courts. Attempts to find a moral underpinning for such a tortious action against invasions of privacy have tended to draw upon (...) Kant’s categorical imperative. In contrast, I want to consider how Spinoza provides an immanent ethics that reconfigures how privacy is understood. (shrink)

While the richness of Heideggerian philosophy is attractive as a healthcare research framework, its density means authors rarely utilise its fullest possibilities as an hermeneutic analytic structure. This article aims to clarify Heideggerian hermeneutic analysis by taking one discrete element of Heideggerian philosophy (Being-towards-death), and using it’s clearly defined structure to conduct a meta-synthesis of Heideggerian phenomenological studies on the experience of living with a potentially life-limiting illness. The findings richly illustrate Heidegger’s philosophy that there is either an inauthentic positioning (...) towards death, or an authentic positioning towards death with a proposition that (1) death is certain; (2) death is indefinite; (3) death is non-relational; and (4) death is not-to-be-outstripped. None of the 29 included studies on the experience of a confrontation with death fully utilised this framework, despite claiming a grounding in Heideggerian thought. This demonstrates the value in modelling how Heideggerian existential structures can be used proactively as analytical ‘hooks’ for data in research claiming a basis in this philosophy and/or method. By modelling the potential application of an important Heideggerian philosophical construct to published qualitative data, this meta-synthesis has revealed new domains and more nuanced understandings of the temporal structure of Being-towards-death. Such an approach helps to more fully unveil the existential concerns of people at the core of interpretative phenomenological enquiry and may provide a blueprint to map either primary or synthesised data to other key ontological existentials. (shrink)

Heideggerian philosophy is frequently chosen as a philosophical framing, and/or a hermeneutic analytical structure in qualitative nursing research. As Heideggerian philosophy is dense, there is merit in the development of scholarly resources that help to explain discrete Heideggerian concepts and to uncover their relevance to contemporary human experience. This paper uses a meta-synthesis methodology to pool and synthesise findings from 29 phenomenological research reports on Being-with in the nurse–patient relationship. We firstly considered and secured the most relevant Heideggerian elements to (...) nurse–patient Being-with. Under these deductive codes, we then inductively developed sub-themes that seemed to explain the multifaceted nature of Being-with, through a secondary analysis and synthesis of published data from 417 patient, carer and nurse participants. Dasein-with was enhanced when nurses had first-hand experience with a phenomenon. Nurses moved between the inauthentic they-mode, and the authentic self-mode. Through circumspection, technology and people were encountered environmentally feeding into nursing attention, assessment and communication. Nursing as a social arrangement was expressed through either leaping-in care or leaping-ahead care. There was a place for both inauthentic and authentic discourse that nurses wove through the ontic everydayness of nursing tasks. (shrink)

The evolution of a relevant nosological concept reflects changes in the distinction between what is recognized and defined as normal and pathologic. Attention is directed to the rationale and value of detecting subclinical aging-related modifications in cognitive performance. The position that different kinds of dementias may have precedents in etiological-specific kinds of early or mild cognitive impairments (MCI) supports targeting people earlier for study of these subclinical symptoms. Because heterogeneous disorders can be expected to have multiple patterns of cognitive and (...) behavioral changes, useful conceptual nosologies should be flexible. Yet clinical research primarily restricts its focus to a single pathway where MCI leads to Alzheimer's disease (AD), and uses selective recruitment, washout screenings, repeated trialing of similar compounds, and other methods that bank the published evidence in favor of the existing therapies and their modest efficacy. This focus on AD recursively colors MCI, not as a flexible "human kind" in need of more careful research, but like AD, as an essential "natural kind." Early determination of MCI targets a potential pharmaceutical market of a quarter to a half of the population over sixty-five and the individual experiencing cognitive decline in its early stages is aware and sensitive to their surroundings, to a linked sociodegeneration with neurodegeneration. This paper examines how classifying people changes both the classifier and the subject of classification. The potential for conflict of interest is raised regarding what new causal knowledge and techniques for ascertainment are selected. Reading evidence from epidemiology, neurology, and clinical studies through science studies and bioethics lenses, we explore the possibility of a pluralistic model of cognitive impairment nosology where biological/pathologic processes respond and interrelate with a normal healthy state. (shrink)

This provocative book paved the way for nursing research informed by f eminist scholarship, critical theory, and post-modern thought. Controv ersial then, relevant today.

This article examines birthday party decorations as a way of understanding the materiality and religious place-making of an expanding Baptist congregation in central Sweden in the early twentieth century. The fiftieth birthday party for Magnus Johanson, held at Salem Chapel in Falun, Dalarna county, in 1906, was decorated with birch branches, large Swedish flags and bunting and an elaborately laid table featuring coffee cups and refreshments. From an analysis of these material elements and a deeper investigation into the lives of (...) Johanson and his wife Kristina, it can be seen that evangelicals had a flexible approach to their ‘sacred’ spaces. Social activities and the act of decorating them created not only a sense of congregational fellowship and belonging but also the opportunity for congregations to display their connection to external cultural and political identities. Through the construction of chapel buildings and their subsequent decoration, male and female members were able to demonstrate a complementary creativity. Together they contributed to the cre-ation of Salem as a multi-purpose, comfortable and accepted place within Falun’s evolving religious landscape. (shrink)

By focusing upon three figures: a trade unionist, who can no longer understand or reconcile himself with his past misogynist behaviour; Spinoza’s Spanish poet, who loses his memory and can no longer write poetry or even recognise his earlier work; and Spinoza’s lost friend, Burgh, who became a devout Catholic, I draw out Spinoza’s description of radical change in beliefs. I explore how, for Spinoza, radical changes that involve an increase in our powers of acting are conceived differently from those (...) changes that reduce our power. These transitions—which can be viewed as both personal and political—are not symmetrical because of the way in which they can be understood in relation to selfhood. To highlight the originality of Spinoza’s argument on personal change, I then compare it with that of his contemporary John Locke, who in Chapter 27 of the Essay Concerning Human Understanding famously theorises the maintenance of personal identity. I draw out one common aspect of the work of Étienne Balibar and of Janet Coleman to compare the ways in which Spinoza and Locke produce different answers to the same questions: how do we conceptualise our encounters with bodies and with ideas? How do these encounters affect our identity over time? In the final section, I switch from analysing personal (but also political) change to consider political change itself, by juxtaposing Warren Montag’s Spinozist analysis of the will, with Carole Pateman’s feminist critique of contract and consent. (shrink)

The mechanism(s) by which lentiviruses and related non‐oncogenic retroviruses (e.g. HTLV‐III, the etiologic agent of AIDS) escape immune surveillance, and thereby create long term progressive disease conditions, has been unknown until recently. Studies with two lentiviruses have begun to illuminate the mechanisms. In one, antigenic drift in the virus appears to be the primary mechanism of escape from immune surveillance; in the second, selective masking of the viral envelope glycoprotein epitope, which normally elicits neutralizing anti‐body, appears to provide the means (...) of escape. (shrink)

One of the most important cell–cell interactions is that of the sperm with the egg. This interaction, which begins with cell adhesion and culminates with membrane fusion, is mediated by multiple molecules on the gametes. One of the best-characterized of these molecules is fertilin β, a ligand on mammalian sperm and one of the first ADAMs (A Disintegrin and A Metalloprotease domain) to be identified. Fertilin β (also known as ADAM2) participates in sperm–egg membrane binding, and it has long been (...) hypothesized that this function is achieved through the interaction of the disintegrin domain of fertilin β with an integrin on the egg surface. There are now approximately 30 members of the ADAM family and, to date, five different ADAMs (fertilin β, ADAM9, ADAM12, ADAM15, ADAM23) have been described to interact with integrins (specifically α6β1, αvβ3, α9β1, αvβ5, and/or α5β1). This field will be discussed with respect to what is known about specific ADAMs and the integrins with which they interact, and what the implications are for sperm–egg interactions and for integrin function. These data will also be discussed in the context of recent knockout studies, which show that eggs lacking the α6 integrin subunit can be fertilized, and eggs lacking the integrin-associated tetraspanin protein CD9 fail to fertilize. Key issues in cell adhesion that pertain to gametes and fertilization will also be highlighted. BioEssays 23:628–639, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

IntroductionDespite the need for trained physician ethicists, fellowships in clinical ethics are limited and primarily offered to thosewho have completed a graduate degree. The standardization of credentialing for clinical ethics consultants (CECs) and the restructuring of undergraduate medical education allow innovative models to train CECs that can provide an expanded opportunity for formal ethics training at an earlier stage.MethodsAt the University of Michigan Medical School we developed, implemented, and evaluated a pre-doctoral clinical ethics fellowship program from 2017 to 2019 for (...) senior medical students, designed to meet established competencies for CECs. Consultation notes from the beginning and end of the fellowship program were randomly selected for each fellow and independently rated by two faculty ethicists who used the validated Ethics Consultation Quality Assessment Tool (ECQAT).1 Inter rater reliability and trends in scores over time were calculated.ResultsThree students successfully completed the fellowship at the University of Michigan Medical School, conducted at least 50 formal ethics consultations, and spent approximately 40 hours a week on service for a minimum of six months. All students finished the fellowship with teaching and policy development experience, first-authored peer-reviewed manuscripts, and national presentations. The fellows demonstrated improvement in their ECQAT overall holistic rating score; all ended their fellowship with a holistic score of adequate or above. There was 92 percent agreement between raters withrespect to the acceptability of the fellows’ ethics consult notes. Two fellows have taken and passed the Healthcare Ethics Consultant-Certification (HEC-C) exam offered by the American Society for Bioethics and Humanities (ASBH).ConclusionsIntegration of a pre-doctoral fellowship model that meets professional certification standards for clinical ethics consultation creates an opportunity for medical students to become trained CECs early in their career. (shrink)