Background: Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings. Research question/aim: The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels (...) of hospitals in Botswana (referral, district, and primary). Ethical considerations: Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants’ written informed consent was obtained. Findings: Respondents’ ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse–doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants’ views about how their work experiences could be improved. Discussion: Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom—and not a sufficient number of nursing staff. Conclusion: Collaboration between physicians and nurses is critical to optimizing patients’ health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Death in the Greek World: From Homer to the Classical Age by Maria Serena MirtoJoseph W. DayMaria Serena Mirto. Death in the Greek World: From Homer to the Classical Age. Trans. by A. M. Osborne. Oklahoma Series in Classical Culture 44 Norman: University of Oklahoma Press, 2012. x + 197 pp. 10 black-and-white figs. Paper, $19.95.Mirto (with Osborne) has given us a readable book on a topic of (...) perennial interest, full of learning but unencumbered by the development of a comprehensive argument with full scholarly apparatus (there are no footnotes or endnotes). I devoured it on a couple of airplane rides, during which its intelligent presentation thoroughly distracted me from my physical discomfort. The book provided a clear and concise review of important topics which I have not studied intensely for years, and it initiated me into recent trends and made me thirsty to approach its suggestions for further reading—while avoiding the spring by the white cypress, of course.The volume is an expansion and updating, as well as a translation, of the Italian original, La morte nel mondo greco (Rome 2007). Much scholarship from 2007 and later is cited, especially in discussions of Dionysian and “Orphic” material (chap. 2). Important additions are a useful section on the confusing (to the uninitiated) topic of hero cults and “an appendix outlining fundamental developments in modern studies of death in the Greek world” (x). The latter traces an interesting journey through the history of mentalities from R. Hertz (Durkheim’s student), through E. de Martino and P. Ariès, on to C. Sourvinou-Inwood’s disagreement with I. Morris about change and stability in early Greek attitudes toward death.Mirto articulates her goal in the preface as “a general synthesis of people’s relationships with death in the Greek world... [a] survey of the ways in which archaic and classical Greek culture dealt with the trauma of death” (ix). One does not judge such a book on its original interpretations and scholarly arguments; other criteria apply. For example, how comprehensive (or representative) is the selection of topics, approaches, and examples? How useful (or user-friendly) is the selection, especially for the audience to which it is addressed?At the level of overall structure, Mirto scores high for comprehensiveness. Any treatment of Greek death must devote major attention to the three topics she announces : (1) “beliefs about the afterlife, on the boundary between literary imagination and religious faith”; (2) “funerary rituals and material evidence of the cult of the dead”; (3) “ideologies... that construct an ideal model of death, making it an acceptable, perhaps even desirable, event” (ix). Chapter 1 on traditional views, mostly derived from Homer (also treated in chap. 5.1), commences Mirto’s discussion of the first topic, which is continued in chapter 2 on more [End Page 337] optimistic eschatologies, especially those associated with Dionysus and Orpheus. The second topic is treated in chapters 3 (on death, mourning, and last rites) and 4 (on markers, epitaphs, and tomb and hero cult). Chapter 5 is devoted to the third topic, with particular attention to the development of the polis and Athens’ patrios nomos and funerary legislation. R. Garland’s widely used survey (The Greek Way of Death [Ithaca 1985], 2d ed. 2001) covers much the same ground, though that book’s feel is quite different. Garland provides a richness of source and scholarly citations that Mirto eschews; for example, Garland devotes twenty-three pages (chap. 7 and its dense endnotes) to visits to the grave, while Mirto barely touches on the matter.At the level of specifics, Mirto’s comprehensiveness is uneven. Reflecting her expertise in archaic and classical poetry, as well as her engagement with the history of mentalities, discussions of literature and some sub-literary textual material are excellent, while she is less full but still useful on iconography (especially that of white-ground lekythoi and sculpture) and polis regulations. Perceptions of comprehensiveness, of course, will vary among readers. Because of gaps in my knowledge, I learned most from Mirto’s presentation of Dionysian and “Orphic” material: the gold lamellae, the Olbia bones, the Derveni papyrus (chap. 2, with the... (shrink)

Herbert Morris argues in his influential retributivist paper, "Persons and Punishment," that criminals deserve punishment because their actions represent an unfair distribution of benefits and burdens in society. The proper distribution of benefits and burdens is important, in part, to restore law abiding citizens’ confidence that others will follow the law. In this paper I show that Morris's argument for why criminals deserve punishment morally requires us to set up an institution of rehabilitation in addition to the institution (...) of punishment. Such an institution is morally required because neither pure punishment systems nor punishment systems that incorporate quasi-rehabilitative aspects have ever worked to uphold the necessary confidence that Morris tells us law abiding citizens must have in order to protect the social order. Moreover, we cannot abandon Morris's appeal to the duty to maintain social order without also abandoning a plausibly Morrisian framework. (shrink)

Protein structure is dynamic: the intrinsic flexibility of polypeptides facilitates a range of conformational fluctuations, and individual protein chains can assemble into complexes. Proteins are also dynamic in evolution: significant variations in secondary, tertiary and quaternary structure can be observed among divergent members of a protein family. Recent work has highlighted intriguing similarities between these structural and evolutionary dynamics occurring at various levels. Here we review evidence showing how evolutionary changes in protein sequence and structure are often closely related to (...) local protein flexibility and disorder, large‐scale motions and quaternary structure assembly. We suggest that these correspondences can be largely explained by neutral evolution, while deviations between structural and evolutionary dynamics can provide valuable functional insights. Finally, we address future prospects for the field and practical applications that arise from a deeper understanding of the intimate relationship between protein structure, dynamics, function and evolution. (shrink)

It was easier to make a revolution than to write 600 to 800 laws to create a market economy.Jiri Dienstbier, Foreign Minister of Czechoslovakia (1990)[I]t would be as absurd to argue that the distribution of property must never be modified by law as it would be to argue that the distribution of political power must never bechanged.Morris Cohen (1927)The takings clause of the United States Constitution requires government to pay compensation when private property is taken for public use. When (...) government regulates, but does not physically seize, property, the Supreme Court of the United States has had trouble defining when individuals have been deprived of property rights so as to give them a right to compensation. The takings clause serves “to bar Government from forcing some people alone to bear public burdens that, in all fairness and justice, should be borne by the public as a whole.” To determine when a regulation amounts to a “taking” of property requiring compensation, the Court has rightly stated that the ultimate question is whether the burden of regulation has been unfairly placed on a small class of individuals rather than the public at large. To answer this question, the Court has identified a variety of factors to consider, including the character of the governmental action, (whether the regulation effects a permanent physical invasion, destroys a core property right, or is intended to prevent public harm), whether the regulation interferes with reasonable investment-backed expectations, and the extent of the diminution in value of the property (particularly whether the regulation deprives the owner of any economically viable use of the property). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:‘Reading’ Greek Death: To the End of the Classical PeriodJoseph W. Day and Leslie Preston DayChristiane Sourvinou-Inwood. ‘Reading’ Greek Death: To the End of the Classical Period. Oxford: Clarendon Press, 1995. xiv + 489 pp. 11 pls. Cloth, $79.This important book contributes much to the growing, though divided, scholarship on Greek mortuary practice as a system of behavior that reflected and constructed eschatological, religious, and socio-political attitudes and (...) ideologies. Distancing herself strongly from I. Morris’ historical analysis of mortuary data (Burial in Ancient Society [1987]; Death-Ritual and Social Structure in Classical Antiquity [1992]), with its rejection of what he sees as limiting text- and object-based approaches, S-I derives cultural attitudes from texts like Homer and artifacts like the archaic grave monument. Her approach to this conventional material is hardly conventional, however, nor are its results.Chapter 1, which most classicists could read with benefit, explains S-I’s reader-oriented method; but methodology is foregrounded throughout, especially the semiological principle that no element of a text or artifact, independent of its context, has a fixed meaning for readers. S-I recreates ancient readings of grave monuments, epitaphs, literary texts, and other artifacts accordingly, by reconstructing the cultural lenses through which contemporaries would have interpreted such an artifact (that is, their attitudes to death, expectations about relevant genres, and other aspects of their cultural repertoire). To alleviate the dangers of circularity inherent in such approaches, S-I constructs, and criticizes others for failing to construct, several independent arguments to support each point. Though “very idiosyncratic post-structuralist” (113), S-I’s method can be compared to recent semiological, cultural, and functional approaches to literary and artistic “texts” (e.g., C. Dougherty and L. Kurke, Cultural Poetics in Archaic Greece [1993]) and inscriptions (e.g., D. T. Steiner, The Tyrant’s Writ [1994]).Chapter 2 deals with views of the afterlife in the Homeric poems and with beliefs about the dead from the Late Bronze Age to the seventh century. For S-I, Homer represents the culture of eighth-century Ionia, and she uses the poems to show later eighth-century attitudes toward death. This is too facile a solution to complex Homeric problems, and while her analysis of the beliefs reflected in the poems is excellent, she does not apply archaeological evidence to demonstrate that this analysis is relevant to eighth-century Greece. She sees two attitudes in the poems: the predominant belief that “everyone must die,” a simple statement of the inevitability of death without any idea of reward and punishment, and the nascent idea that a few individuals can achieve happiness and even immortality after death. She debunks the theory that this latter concept of Elysion comes from Minoan Crete. What she does not do is use archaeological evidence to support her hypotheses. As she rightly points out, reconstructing “belief systems on the basis of archaeological data is a complex and problematic enterprise” (90); [End Page 645] but given the hundreds of burials excavated all over the Greek world from this period, it seems amazing that she refers to them so little. S-I is not unfamiliar with archaeological evidence and uses it to good account in discussing Minoan and Mycenaean burial practices, and she makes excellent use of sculpture and vase painting in chapters 3 and 5; but she chooses not to use actual burial data for Homeric beliefs, perhaps partly in response to Morris. Chapter 2 supplies a useful background for the study of archaic grave markers, but the unwary classicist should know that a methodologically rigorous archaeologist, in particular, will have trouble with it, as with Morris, although for different reasons.Morris and his methodology come under heavy attack in the lengthy Appendix. While some find Morris’ model-building methodology problematic, it is widely accepted by anthropologists looking for an objective method akin to scientific hypothesis testing. S-I opposes this methodology because of its a priori assumptions, yet no methodology is free of cultural bias. We need a variety of approaches, and archaeology must be allowed to give its evidence without either being forced into Morris’ a priori models or S-I’s (and the traditional... (shrink)

Volume 19 of _The Annual of Psychoanalysis_ turns to the ever-intriguing relationship between "Psychoanalysis and Art." This introductory section begins with Donald Kuspit's scholarly reflections on the role of analysis in visual art and art criticism, and then proceeds to a series of topical studies on Freud and art introduced by Harry Trosman. Egyptologist Lorelei Corcoran explores the Egypt of Freud's imagination, thereby illuminating our understanding of the archaeological metaphor. Marion Tolpin offers new insights into Freud's analysis of the American (...) writer Hilda Doolittle by focusing on the meaning of the Goddess Athene - whose statue rested on Freud's desk - to both analyst and analysand. Stephen Toulmin examines Freud's artistic sensibility - and places the historical significance of Freud's art collection in bold relief - by looking at the many contemporary art objects Freud chose _not_ to collect. Danielle Knafo identifies key events in the early life of Austrian Expressionist Egon Schiele that were "primary determinants" of the content and form of his self-portraits. And Barbara Almond examines the spontaneous healing process depicted in Margaret Drabble's novel _The Needle's Eye _as an analogue to the kind of growth and development mobilized by the psychoanalytic process. Section II, "Psychoanalysis and Development," begins with Barbara Fajardo's appreciation of the contribution of biology to analyzability; she reviews findings from both infant research and biogenetic research that tend toward an understanding of "constitution" as resilience in development and, subsequently, in treatment. Benjamin Garber adds to the psychoanalytic understanding of childhood learning disabilities by presenting the three-and-a-half-year analysis of a learning-disabled child. In a fascinating two-part contribution, "Bridging the Chasm Between Developmental Theory and Clinical Theory," Joseph Palombo sheds light on some of the knottiest problems in contemporary analysis, including the relationship between childhood events and the reconstruction of those events in treatment. In Section III, "Psychoanalysis and Empathy," Mary Newsome presents case material in support of her claim that the analyst's empathic understanding catalyzes the coalescence of the patient's affect and aim, that is, the patient's capacity to believe in and then realize his ambitions. The acquisition of the capacity, she contends, not only betokens a specific kind of structure formation, but is the bedrock of emerging self-cohesion. Her challenging paper is thoughtfully discussed by David Terman and Jerome Winer. Section IV of _The Annual_ offers Jerome Kavka's appreciation of the work of N. Lionel Blitzsten. Blitzsten, the first Chicago psychoanalyst and one of America's most gifted clinicians and teachers, anticipated modern concepts of narcissism in identifying "narcissistic neuroses" with special treatment requirements. Morris Sklansky furthers our understanding of Blitzsten in his discussion of Kavka's essay. Ranging across the analytic canvas with presentations as edifying as they are provocative, volume 19 of _The Annual of Psychoanalysis_ challenges readers to wrestle with issues at the cutting edge of the discipline. It takes a well-deserved place in the preeminent continuing series in the field. (shrink)

Disability activists have sometimes claimed their disability has actually increased their well-being. Some even say they would reject a cure to keep these gains. Yet, these same activists often simultaneously propose improvements to the quality and accessibility of assistive technology. However, for any argument favoring assistive over curative technology to work, there must be a coherent distinction between the two. This line is already vague and will become even less clear with the emergence of novel technologies. This paper asks and (...) tries to answer the question: what is it about the paradigmatic examples of curative and assistive technologies that make them paradigmatic and how can these defining features help us clarify the hard cases? This analysis will begin with an argument that, while the common views of this distinction adequately explain the paradigmatic cases, they fail to accurately pick out the relevant features of those technologies that make them paradigmatic and to provide adequate guidance for parsing the hard cases. Instead, it will be claimed that these categories of curative or assistive technologies are defined by the role the technologies play in establishing a person’s relational narrative identity as a member of one of two social groups: disabled people or non-disabled people. (shrink)

The author identifies the major micro-, meso-, and macro-level financial risk shifting factors that contributed to the Great Global Recession and how the absence of a compelling moral vision of responsible financial risk management perpetuated the economic crisis and undermined the recovery by blind reliance upon insufficiently accountable bailouts. The author offers a new theoretical model of Sustainable Stakeholder Capitalism by exercising moral imagination which inclusively and moderately balances four multi-level factors: types of capitalism, moral theories, human nature drives, and (...) credit risk profiles. Finally, the author recommends micro-, meso-, and macro-level practical reforms to prevent a recurrence of the current economic freefall, to re-create systemic global financial institution integrity, and to promote responsible risk management for sustainable global prosperity for current and future generations. (shrink)

We investigate the causal effects of religious service attendance on prosocial behaviours using longitudinal data from a nationally representative sample of 33,198 New Zealanders collected between 2018 and 2021. Our study innovates in three ways: (1) we use longitudinal rather than cross-sectional data; (2) we incorporate measures of help received alongside self-reported giving; and (3) our statistical models are designed to address causal questions, rather than simply to describe change over time. We model causal contrasts for three hypothetical interventions – (...) increasing, decreasing, or maintaining religious service attendance – and assess their effects on eight distinct prosocial domains. Study 1 focuses on self-reported charitable donations and volunteering. Studies 2 and 3 examine receiving help – both personal and financial – from family, friends, and the wider community. Across all analyses, we find that the causal effects of religious service attendance are notably smaller than cross-sectional correlations suggest. However, even modest increases in regular attendance would result in charitable donations equivalent to approximately 4% of the New Zealand Government’s annual spending – a considerable public benefit. By applying robust methods for causal inference to national-scale panel data, our study provides insights that can inform public policy about the social functions of religious participation and advances a methodological framework for investigating the social consequences of cultural practices. (shrink)

The author argues that, while logical rigor requires Whiteheadians to emphasize the ontological priority of the notion of actual entity as a self-constituting subject of experience for the proper understanding of physical reality. Whitehead's understanding of the key category of society in his metaphysics, especially the way that societies and their constituent actual entities reciprocally "constrain " one another's existence and activity and the way that societies are hierarchically ordered to one another within the evolutionary process will presumably have more (...) empirical resonance with natural scientists in their own efforts to understand the emergence of life from non-life, the progressive growth of self-awareness among higher-order animal species, etc. So, in dialogue with natural scientists, why not start with what is psychologically more interesting to the listener? (shrink)

This chapter argues that, sometimes, disabled bioethicists actually have a duty to do public philosophy. It contends that this duty can be justified with ethical, epistemic, and prudential reasons. Any triage protocol will discriminate against disabled people if one uses a broadly inclusive definition of disability that subsumes diseases or chronic illnesses that can be disabling in their effects, like cancer or kidney failure. The most obvious reasons justifying a duty to do public philosophy as a disabled bioethicist are ethical. (...) One example of this testimonial injustice vis à vis disability and well‐being occurred during the early days of the COVID‐19 pandemic when medical triage protocols were being developed to ration critical care resources. Discriminatory triage protocols also diminish a disabled person's autonomy. The COVID‐19 pandemic amplified these costs in many ways but also created an opportunity for philosophical reflection that demonstrates the importance of more public‐facing work. (shrink)

The authors identify the challenge of holding contemporary business leaders accountable for enhancing the intangible strategic asset of integrity capacity in organizations. After defining integrity capacity and framing it as part of a strategic resource model of sustainable global competitive advantage, the stakeholder costs of integrity capacity neglect are delineated. To address this neglect issue, the authors focus on the cultivation of judgment integrity to handle behavioral, moral and hypothesized economic complexities as key dimensions of integrity capacity. Finally, the authors (...) recommend two leadership practices to build competence in business leaders to enhance integrity capacity as an organizational strategic asset. (shrink)

Volume 20, Issue 3, March 2020, Page 44-46.

Law enforcement organizations invest in ongoing education of employees on various topics concerning diversity, equity and accountability. Such education is designed to ensure the highest levels of performance and to earn the trust of the public. Traditional approaches to education, however, have proved challenging. The effectiveness of what passes as “training” is unregulated, and negative attitudes and beliefs about mandatory educational programs themselves may sabotage any possible benefits for policing. Utilizing a 2-wave, pre-/post-education panel design (N = 263), we demonstrate (...) significant, even dramatic attitude and belief change among members of a police department concerning the value and importance of implicit bias education. That the program succeeded in promoting positive attitudes and beliefs offers a possible path forward given that law enforcement desires a rational, science-based approach to improving professional conduct and police-community relations, and given increased demands for implicit bias education as a component of police reform. Self-reported attitude change is most emphatically not an indication of reduction in bias in the trenches of policing. Nevertheless, positive shifts in attitudes and beliefs about bias education is a notable step forward as it likely reduces resistance to procedures and policies for individual and institutional reform that might otherwise remain elusive. (shrink)

During the Middle Ages, philosophers and theologians argued over the extramental reality of universal forms or essences. In the early modern period, the relation between subjectivity and objectivity, the individual self and knowledge of the outside world, was a rich subject of debate. Today, there is considerable argument about the relation between spontaneity and determinism within the evolutionary process, whether a principle of spontaneous self-organization as well as natural selection is at work in the aggregation of molecules into cells and (...) the development of primitive forms of life into complex organisms. In _Subjectivity, Objectivity and Intersubjectivity_, Joseph A. Bracken proposes that what is ultimately at stake here is the age-old problem of the relationship between the One and the Many, universality and particularity on different levels of existence and activity within nature. Bracken rejects traditional models of this relationship, wherein either the One or the Many is presupposed to have priority over the other. He instead suggests that a new social ontology—one that is grounded in a theory of universal intersubjectivity—protects both the concrete particularity of individual entities in their specific relations to one another and their enduring corporate reality as a stable community or environment within Nature. What emerges is a bold reimagining of the sometimes strained relationship between religion and science. Bracken's clear writing, sophisticated philosophical analysis, and exemplary scholarship will lend this new work an enthusiastic appreciation by readers with deep interests in philosophy and philosophical theology. (shrink)

An a l y s e s of more than 300 textbooksfound that the development of lessons on ethics in news reporting and writing textbooks clearly mirrored the development of scholarship in media ethics. Substantial discussion of ethics did not appear in textbooks until the 1920s and 1930s, and after a 40-year absence, returned in the 1970s, 1980s, and 1990s. However, the author argues, the potentialforfurther advancement of ethics lessons among news reporting and writing textbooks remains n question mark. Text (...) discussions of ethics are still not prominent, and important moral and intellectual questions in journalism are overlooked. (shrink)

Bracken synthesizes Polanyi’s notion of morphogentic field and Whitehead’s notion of societies of actual occasions. These comments emphasize the implications of the metaphors involved in these notions. The rnetaphor of plants growing in afield lies beyond the concept of a morphogenetic field, and the metaphor of a society of interacting persons lies behind the concept of a society of actual occasions. I suggest that one of the implications of this metaphor is that there is not, as Bracken argues, a problem (...) of continuity in Whitehead’s metaphysics of events. (shrink)

Reductionism and holism, that is, antireductionism, are two of the prevailing paradigms within the philosophy of biology. Reductionists strive to understand biological phenomena by reducing them to a series of levels of complexity with each lower level forming the foundation for the subsequent level, by mapping such biological phenomena inasmuch as possible to the principal phenomena within the fundamental sciences of chemistry and physics. In this way, complex phenomena can be reduced to assemblages of more elementary explananda. Holism, in counterpart, (...) claims that there independently exist phenomena arising from ordered levels of complexity that have intrinsic causal power and cannot be reduced in this way. When dealing with the nature of biology and its unique foundations of essentialism, determinism and ethics, the pedagogical lens through which these foundations are conveyed to learners could provide a limited perspective if only the reductive approach is followed as it would not sensitise learners to the true complexity of the phenomenon of life and the study thereof, and it is the purpose of this article to frame the reductionist–antireductionist debate in order to illustrate this.Contribution: This article contributes new knowledge to the field of the philosophy of science; more specifically, the philosophy of biology by critically evaluating the pervasive dialectic between the theoretical frameworks of reductionism and antireductionism and alluding to the pedagogical consequences thereof. (shrink)

Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.