This book is the most comprehensive treatment available of one of the most urgent - and yet in some respects most neglected - problems in bioethics: decision-making for incompetents. Part I develops a general theory for making treatment and care decisions for patients who are not competent to decide for themselves. It provides an in-depth analysis of competence, articulates and defends a coherent set of principles to specify suitable surrogate decisionmakers and to guide their choices, examines the value of advance (...) directives, and investigates the role that considerations of cost ought to play in decisions concerning incompetents. Part II applies this theoretical framework to the distinctive problems of three important classes of individuals, many of whom are incompetent: minors, the elderly and psychiatric patients. The authors' approach combines a probing analysis of fundamental issues in ethical theory with a sensitive awareness of the concrete realities of health care institutions and the highly personal and individual character of difficult practical problems. Its broad scope will appeal to health professionals, moral philosophers and lawyers alike. (shrink)

When firms face crisis, the instant and open channels of social media communication create a double-edged sword. While corporations can more quickly communicate with stakeholders, any missteps will have drastic and nearly immediate repercussions. What are the relationships among social media, subjective norms, attitudes, and intentions during corporate crisis? We explore this phenomenon via a study of a crisis faced by Lowe’s, an international home improvement store, and how current and potential customers reacted. By utilizing a structural equations model to (...) examine an integrated model of multiple constructs, we find that Facebook usage is associated with behavioral intent, perceptions of ethicality, and attitudes toward the organization. Counter intuitively, we find that an increase in participant Facebook usage is negatively related to felt subjective norms. Our findings indicate that beyond the traditional relationships examined by the Theory of Reasoned Action (e.g., norms, attitudes, and behavioral intent), that social media and subjective norms have a strong relationship with general attitudes and ethical attitudes toward an organization. (shrink)

ABSTRACT Between 1920 and 1922, the University of Bristol biochemist, Maximilian Nierenstein, published four papers in a series exploring the structure of catechin in the Journal of the Chemical Society. The Society then abruptly refused to accept any more of his papers on catechin, or any other subject. It provided him with no reasons for the embargo until 1925. It then transpired that Nierenstein was boycotted because it was deemed that he had not responded adequately to criticisms of his work (...) made by his rival in catechin research, the German natural products chemist, Karl Freudenberg. It was not until 1929 that, as a result of a petition by a group of his former Bristol pupils and friends, that Nierenstein was again permitted to publish in the Society’s journal. The paper explores the Chemical Society’s treatment of Nierenstein in detail, sheds new light on his career and his reaction to the Society’s unprecedented boycott, examines some of the structural chemistry involved in the disputes, and discusses whether Nierenstein’s research deserves the label of ‘bad science’. (shrink)

Psychologists have demonstrated the value of diversity – particularly diversity of viewpoints – for enhancing creativity, discovery, and problem solving. But one key type of viewpoint diversity is lacking in academic psychology in general and social psychology in particular: political diversity. This article reviews the available evidence and finds support for four claims: (1) Academic psychology once had considerable political diversity, but has lost nearly all of it in the last 50 years. (2) This lack of political diversity can undermine (...) the validity of social psychological science via mechanisms such as the embedding of liberal values into research questions and methods, steering researchers away from important but politically unpalatable research topics, and producing conclusions that mischaracterize liberals and conservatives alike. (3) Increased political diversity would improve social psychological science by reducing the impact of bias mechanisms such as confirmation bias, and by empowering dissenting minorities to improve the quality of the majority's thinking. (4) The underrepresentation of non-liberals in social psychology is most likely due to a combination of self-selection, hostile climate, and discrimination. We close with recommendations for increasing political diversity in social psychology. (shrink)

In spite of the wide variety of approaches to ethics training it is still debatable which approach has the highest potential to enhance professionals’ integrity. The current effort assesses a novel curriculum that focuses on metacognitive reasoning strategies researchers use when making sense of day-to-day professional practices that have ethical implications. The evaluated trainings effectiveness was assessed by examining five key sensemaking processes, such as framing, emotion regulation, forecasting, self-reflection, and information integration that experts and novices apply in ethical decision-making. (...) Mental models of trained and untrained graduate students, as well as faculty, working in the field of physical sciences were compared using a think-aloud protocol 6 months following the ethics training. Evaluation and comparison of the mental models of participants provided further validation evidence for sensemaking training. Specifically, it was found that trained students applied metacognitive reasoning strategies learned during training in their ethical decision-making that resulted in complex mental models focused on the objective assessment of the situation. Mental models of faculty and untrained students were externally-driven with a heavy focus on autobiographical processes. The study shows that sensemaking training has a potential to induce shifts in researchers’ mental models by making them more cognitively complex via the use of metacognitive reasoning strategies. Furthermore, field experts may benefit from sensemaking training to improve their ethical decision-making framework in highly complex, novel, and ambiguous situations. (shrink)

The ethical implications of the growth of for-profit health care institutions are complex. Two major moral criticisms of for-profit medicine are analyzed. The first claim is that for-profit health care institutions fail to fulfill their obligations to do their fair share in providing health care to the poor and so exacerbate the problem of access to health care. The second claim is that profit seeking in medicine will damage the physician-patient relationship, creating conflicts of interest that will diminish the quality (...) of care and erode patients' trust in their physicians and the public's trust in the medical profession. The authors conclude that while the continued expansion of for-profit health care may exacerbate in some respects problems of access, trust and conflicts of interest, it is a mistake to consider these problems as unique to for-profit health care; they are problems for not for-profit health care as well. Though these issues justify continuing moral concern, they do not at this time provide decisive grounds for substantially curbing or eliminating for-profit enterprise in health care. (shrink)

Teaching Joe Kincheloe is one of a handful of important recent books posthumously pushing Kincheloe's work further into the twenty-first century. Written and edited by former students and colleagues, the book underscores the depth and breath of his extraordinarily productive career. The text offers students and educators alike invaluable insights into transformative ways of seeing conducive to challenging the technocratic, imperialistic purpose of dominant forms education in an era marked by ruling elite desperation as U.S. power wanes globally. Through this (...) and other projects, Kincheloe would surely have been pleased to see his many postformal contributions counter-hegemonically providing critical pedagogy the theoretical and practical strength to contribute to the global uprising currently challenging the imperialist project of wealth extraction and cultural domination from Cuba; Venezuela; Peru; Chiapas, Mexico; Tunisia; Libya; Egypt; Yemen; and Iran, to regions in the United States. Teaching Joe L. Kincheloe will surely gain relevancy as the global movement against authoritarianism and domination intensifies and citizens begin to search for new ways to better understand their worlds and how those contexts interrelate with the historical development of their own identities. (shrink)

We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)

If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.

The dominant methodology in health policy for prioritizing and rationing health care resources is cost-effectiveness analysis, typically using quality adjusted life years (QALYs) or disability adjusted life years (DALYs) to measure health outcomes. The construction of these measures involves a number of moral or value choices, including: How should states of health and disability be evaluated, and whose preferences (e.g., the disabled or non-disabled) should be used? How should these evaluations reflect that prioritization will involve tradeoffs between health benefits for (...) different persons or groups? Do all QALYs count equally, no matter what age at which they are received? Should discount rates be applied to health benefits? I will show the nature of the moral issues at stake in answering these questions, and briefly argue how they should be answered. (shrink)

What kind of role, if any, can immigration policies play in moving us towards global justice? On one view, the removal of restrictions on immigration might seem to constitute great progress in realizing the desired goal. After all, people want to emigrate mainly because they perceive that their prospects for better lives are more likely to be secured elsewhere. If we remove restrictions on their ability to travel, would this not constitute an advance over the status quo in which people (...) are significantly prevented, through tough immigration restrictions, from seeking a better life for themselves and their dependants? In particular, it might seem that a cosmopolitan must be committed to reducing restrictions on immigration. On one common account of what cosmopolitanism is, the central idea is that every person has global stature as the ultimate unit of moral concern and is therefore entitled to equal respect and consideration no matter what her citizenship status or other affiliations happen to be. It is frequently supposed that a cosmopolitan must be committed to more open borders, and that developed countries restricting entry to people from developing countries is unjust and inconsistent with a commitment to our equal moral worth. However, as I argue, removing restrictions on immigration could constitute a considerable step backward for global justice. In order to appreciate why this is the case, we need to review some relevant empirical evidence that our policy recommendations must take into account. As we see, considerable benefits accrue to the immigrant and host nation, but significant costs must often be born in states of origin. As one example, we consider the effects of remittances often believed to be highly beneficial to the global poor. I discuss evidence indicating that patterns associated with remittances are not always at all desirable. Migration policies need to be better managed so that they do benefit the relevant stakeholders. In section 4 I give examples of how this might work. In section 5 we investigate what kinds of policy recommendations would be best given our findings. (shrink)

Since Hume, there has been broad consensus that if the notion of the good has any intelligible foundation, it is not “ontological”, in the natures of things. Today however this view is being challenged. After a sketch of the positions of Kant and Hume, and a glance at some of the recent challenges, the paper examines a key element in Thomas Aquinas’s ontol- ogy of the good: the notion of nal causality. For Thomas nal causality presupposes formal and e cient (...) causality. Hume’s denial of the intelligibility of the good, it is su ested, presup- poses his denial of that of these other causes. (shrink)

We revisit the notion of intuitionistic equivalence and formal proof representations by adopting the view of formulas as exponential polynomials. After observing that most of the invertible proof rules of intuitionistic (minimal) propositional sequent calculi are formula (i.e., sequent) isomorphisms corresponding to the high‐school identities, we show that one can obtain a more compact variant of a proof system, consisting of non‐invertible proof rules only, and where the invertible proof rules have been replaced by a formula normalization procedure. Moreover, for (...) certain proof systems such as the G4ip sequent calculus of Vorob'ev, Hudelmaier, and Dyckhoff, it is even possible to see all of the non‐invertible proof rules as strict inequalities between exponential polynomials; a careful combinatorial treatment is given in order to establish this fact. Finally, we extend the exponential polynomial analogy to the first‐order quantifiers, showing that it gives rise to an intuitionistic hierarchy of formulas, resembling the classical arithmetical hierarchy, and the first one that classifies formulas while preserving isomorphism. (shrink)

Jeder Gegenstand oder jedes Ereignis, inbezug auf die das Tier ein Gebaren zeigt, wird als “valent” bezeichnet, es wird gesagt, dass sie „Valenz” besitzen. Auf Grund der Analyse einer Experimentaluntersuchung vonF. Brock über die „Umwelt” des EinsiedlerkrebsesPagurus arrosor wird gezeigt, dass diese „Valenz” sich auf die Bedürfnisse des Tiers und die Beachtung durch das Tier bezieht. Die Folgerungen des Begriffs der „Valenz” werden entwickelt und die Notwendigkeit wird erwiesen, das Gebaren der Tiere in seiner Bezogenheit auf ihre eigenen Merkwelten, (...) nicht auf die unsrige, zu betrachten.L'auteur dit de chaque objet ou de chaque événement par rapport auquel l'animal montre du „behaviour”, qu'il est „valent”, qu'il possède de la „valence”. En se basant sur l'analyse des recherches expérimentales deF. Brock sur le „Umwelt” de l'hermitePagurus arrosor, l'auteur démontre que la „valence” est relative aux besoins de l'animal et à l'attention de la part de l'animal. Il développe ensuite les conséquences diverses que l'idée de „valence” implique et il prouve qu'il est nécessaire d'observer le „behaviour” de l'animal par rapport à sa propre perception et non pas par rapport à la nôtre. (shrink)

Brock Macdonald1, Evi Vakiani2, Rhonda K Yantiss3, Jun Lee4, Robert S Brown Jr5, Samuel H Sigal61Division of Gastroenterology, Department of Medicine, University of California-San Francisco, San Francisco, CA, 2Department of Pathology, Memorial Sloan–Kettering Cancer Center, New York, NY, 3Department of Pathology and Laboratory Medicine, New York Weill Cornell Medical College, New York, NY, 4Division of Nephrology, Department of Medicine, Weill Cornell Medical College, New York, NY, 5Division of Gastroenterology, Department of Medicine, Columbia University College of Physicians and Surgeons, New (...) York, NY, 6Division of Gastroenterology and Hepatology, Department of Medicine, New York University, New York, NY, USA: The use of sirolimus as an alternative to calcineurin inhibitors for posttransplant immunosuppression is associated with a variety of inflammatory conditions. In this report, we describe the case of a 34-year-old man who developed abnormal liver tests 6 years after live-donor kidney transplantation and 5 years after initiation of sirolimus-based immunosuppression. Elevated aminotransferase levels persisted after withdrawal of potentially hepatotoxic medications, and serologic evaluation for viral hepatitis, autoimmune disease, and genetic disorders was unrevealing. Liver biopsy revealed prominent hepatocellular injury associated with a mixed inflammatory infiltrate and liver tests normalized within 2 weeks of discontinuation of sirolimus. In this report, we review previous reports of sirolimus hepatotoxicity and propose a unifying hypothesis for the various inflammatory conditions that have been attributed to sirolimus.Keywords: sirolimus, immunosuppression, transplant, inflammatory conditions, hepatotoxicity. (shrink)

Heidegger commentator J. L. Mehta includes in his book the following quote from Heidegger: “Der Wanderschaft in der Wegrichtung zum Fragwürdigen ist nicht Abenteur sondern Heimkehr.” Adapting this idea to the purpose of my own project in this article, I propose: Wandering on the Footpath of Freedom is both an Adventure and a Homecoming! The aim of this article is to explore the idea of freedom as it is developed in the philosophy of Martin Heidegger. The strategy here is to (...) examine the salient remarks of several commentators, including Mehta, William Richardson, Werner Brock, Charles Guignon, Rüdiger Safransky, and others. Some of the ideas explored here are: transcendence, overtness, authenticity, poetry and resoluteness. (shrink)