Organizational ethics—defined as the alignment of an institution’s practices with its mission, vision, and values—is a growing field in health care not well characterized in empirical literature. To capture the scope and context of organizational ethics work in United States healthcare institutions, we conducted a nationwide convenience survey of ethicists regarding the scope of organizational ethics work, common challenges faced, and the organizational context in which this work is done. In this article, we report substantial variability in the structure of (...) organizational ethics programs and the settings in which it is conducted. Notable findings included disagreement about the activities that comprise organizational ethics and a lack of common metrics used to assess organizational ethics activities. A frequently cited barrier to full engagement in these activities was poor institution-wide understanding about the role and function of organizational ethics resources. These data suggest a tension in the trajectory of organizational ethics’ professionalization: while some variability is appropriate to the field’s relative youth, inadequate attention to definitions of organizational ethics practice and metrics for success can impede discussions about appropriate institutional support, leadership context, and training for practitioners. (shrink)

Telling Our Lives explores how three working-class women-from Jewish, African-American, and Irish-American backgrounds connect across their differences through storytelling and conversation.

In September 2010 at the Johns Hopkins Hospital, one of the nation's elite academic hospitals located in East Baltimore, Maryland, Paul Warren Pardus entered the facility to visit his mother, a patient. During a discussion with her doctor in a hospital hallway, Pardus became “overwhelmed” about the care and condition of his mother, pulled a handgun from his waistband, and shot the doctor in the chest. Pardus then locked himself and his mother in her room, shot and killed her, and (...) committed suicide.Dr. Gabe Kelen, a national expert on emergency preparedness and director of the Johns Hopkins emergency department, admitted several years later that this tragic event “really got us thinking in a very serious way.” Together with colleagues at the Johns Hopkins Office of Critical Event Preparedness and Response, Kelen conducted research on the threat and impact of “active shooters” in health care settings. (shrink)

Obesity is the definitive epidemic of the modern era in the United States. Its well-documented public health impacts, especially related to children and adolescents, are horrific. Nearly one-third of American minors are overweight; over 50% of them are obese. Already, these kids suffer from multiple adverse physical and mental health conditions. Sadly, absent serious communal and individual interventions, their lives may be cut short compared to their own parents’ life expectancy. While recent surveillance suggests childhood obesity may be trending down (...) slightly in some populations, public health experts remain concerned about the threat obesity poses to the health of America's youth.The concurrent travesty underlying childhood obesity is the relative societal failure to slow and reverse its spread. (shrink)

Nelson Goodman argues against those who, like Carnap, claim extensional identity is the criterion for correct constructional definition. Goodman argues that internal logical difficulties sink such a criterion, thus he proposes his own criterion of extensional isomorphism. We argue that Goodman's criterion itself falls prey to his own arguments or else extensional identity is not shown faulty.

To better understand the available publications addressing ethical issues in rural health care we sought to identify the ethics literature that specifically focuses on rural America. We wanted to determine the extent to which the rural ethics literature was distributed between general commentaries, descriptive summaries of research, and original research publications. We identified 55 publications that specifically and substantively addressed rural health care ethics, published between 1966 and 2004. Only 7 (13%) of these publications were original research articles while (12) (...) 22% were descriptive summaries of research and 36 (65%) were general commentaries. The majority of publications examined (55%) were clinically focused while 27% addressed organizational ethics and 18% addressed ethical ramifications of rural health care policy at a national or community level. Our findings indicate that there are a limited number of publications focusing on rural health care ethics, suggesting a need for scholars and researchers to more rigorously address rural ethics issues. (shrink)

Independently of whether an object of experience becomes a candidate for being a part of the self or a part of the external world, it is always given to us as just an object of experience. The observer-observed relation can be seen as a type of relation with many instances, both between the self and different objects of experience and between any given object of experience and different selves. The self is situated in a spatial grid, where the latter can (...) be characterised as an array of relations, of which the relata include both observers and observed. The world, understood as independent existence, including the self, is empty. However, Paolo Bozzi’s method for identifying the self and delimiting its independent existence from the external world has taught us just the opposite lesson. Bozzi’s project is to teach us how to use them, and to recognise that they allow a self to be situated in a world of objects. (shrink)

Critically engaging the work of Immanuel Kant, Hannah Arendt, Martin Heidegger, and Jacques Derrida together with her own observations on contemporary politics, environmental degradation, and the pursuit of a just and sustainable world, Kelly Oliver lays the groundwork for a politics and ethics that embraces otherness without exploiting difference. Rooted firmly in human beings' relationship to the planet and to each other, Oliver shows peace is possible only if we maintain our ties to earth and world. Oliver begins with (...) Immanuel Kant and his vision of politics grounded on earth as a finite surface shared by humans. She then incorporates Hannah Arendt's belief in plural worlds constituted through human relationships; Martin Heidegger's warning that alienation from the Earth endangers not only politics but also the very essence of being human; and Jacques Derrida's meditations on the singular worlds individuals, human and otherwise, create and how they inform the reality we inhabit. Each of these theorists, Oliver argues, resists the easy idealism of world citizenship and globalism, yet they all think about the earth against the globe to advance a grounded ethics. They contribute to a philosophy that avoids globalization's totalizing and homogenizing impulses and instead help build a framework for living within and among the world's rich biodiversity. (shrink)

Many philosophers have wrongly assumed that there is an asymmetry between the problem of induction and the logocentric predicament (the justification of deductive inferences). This paper will show that the demand for justification, for the very inferences that are required for justification, is deeply problematic. Using a Wittgensteinian approach, I will argue that justification has an internal relation with deductive and inductive inferences. For Wittgenstein, two concepts are internally related if my understanding of one is predicated on my understanding of (...) the other. Separating the two concepts so that one can be applied to the other is then a misunderstanding of role that these concepts play. (shrink)

Physicalists about the mind are committed to claims about property identities. Following Kripke's well-known discussion, modal arguments have emerged as major threats to such claims. This paper argues that modal arguments can be resisted by adopting a counterpart theoretic account of modal claims, and in particular modal claims involving properties. Thus physicalists have a powerful motive to adopt non-Kripkean accounts of the metaphysics of modality and the semantics of modal expressions.

© 2019 The Author. Background: The phenomenon of being 'with woman' is fundamental to midwifery as it underpins its philosophy, relationships and practices. There is an identified gap in knowledge around the 'with woman' phenomenon from the perspective of midwives providing care in a variety of contexts. As such, the aim of this study was to explore the experiences of being 'with woman' during labour and birth from the perspective of midwives' working in a model where care is provided by (...) a known midwife. Methods: A descriptive phenomenological design was employed with ten midwives working in a 'known midwife' model who described their experiences of being 'with woman' during labour and birth. The method was informed by Husserlian philosophy which seeks to explore the same phenomenon through rich descriptions by individuals revealing commonalities of the experience. Results: Five themes emerged 1) Building relationships; 2) Woman centred care; 3) Impact on the midwife; 4) Impact on the woman; and 5) Challenges in the Known Midwife model. Midwives emphasised the importance of trusting relationships while being 'with woman', confirming that this relationship extends beyond the woman - midwife relationship to include the woman's support people and family. Being 'with woman' during labour and birth in the context of the relationship facilitates woman-centred care. Being 'with woman' influences midwives, and, it is noted, the women that midwives are working with. Finally, challenges that impact being 'with woman' in the known midwife model are shared by midwives. Conclusions: Findings offer valuable insight into midwives' experiences of being 'with woman' in the context of models that provide care by a known midwife. In this model, the trusting relationship is the conduit for being 'with woman' which influences the midwife, the profession of midwifery, as well as women and their families. Descriptions of challenges to being 'with woman' provide opportunities for professional development and service review. Rich descriptions from the unique voice of midwives, provided insight into the applied practices of being 'with woman' in a known midwife model which adds important knowledge concerning a phenomenon so deeply embedded in the philosophy and practices of the profession of midwifery. (shrink)

Belief revision theory aims to describe how one should change one’s beliefs when they are contradicted by newly input information. The guiding principle of belief revision theory is to change one’s prior beliefs as little as possible in order to maintain consistency with the new information. Learning theory focuses, instead, on learning power: the ability to arrive at true beliefs in a wide range of possible environments. The goal of this paper is to bridge the two approaches by providing a (...) learning theoretic analysis of the learning power of belief revision methods proposed by Spohn, Boutilier, Darwiche and Pearl, and others. The results indicate that learning power depends sharply on details of the methods. Hence, learning power can provide a well-motivated constraint on the design and implementation of concrete belief revision methods. (shrink)

This book brings together a team of leading theorists to address the question 'What is the right measure of justice?' Some contributors, following Amartya Sen and Martha Nussbaum, argue that we should focus on capabilities, or what people are able to do and to be. Others, following John Rawls, argue for focussing on social primary goods, the goods which society produces and which people can use. Still others see both views as incomplete and complementary to one another. Their essays evaluate (...) the two approaches in the light of particular issues of social justice - education, health policy, disability, children, gender justice - and the volume concludes with an essay by Amartya Sen, who originated the capabilities approach. (shrink)

This study focuses on a set of dreams related to the September 11, 2001 terrorist attacks and their aftermath, using content analysis and cognitive psychology to explore the interweaving of external public catastrophe and internal psychological processes. The study tests several recent claims in contemporary dream research, including the central image theory of Hartmann [Hartmann, E., & Basile, R. . Dream imagery becomes more intense after 9/11/01. Dreaming, 13, 61–66; Hartmann, E., & Brezler, T. . A systematic change in dreams (...) after 9/11/01. Sleep, 31, 213–218], the media exposure factor postulated by Propper [Propper, R. E., Stickgold, R., Keeley, R., & Christman, S. D. . Is television traumatic? Dreams, stress, and media exposure in the aftermath of September 11, 2001. Psychological Science, 18, 334–340], the continuity hypothesis of Domhoff [Domhoff, W. G. . Finding meaning in dreams: A quantitative approach. New York: Plenum], the cognitive and metacognitive approach of Kahan [Kahan, T. L. . Consciousness in dreaming: A metacognitive approach. In K. Bulkeley , Dreams: A reader on the religious, cultural, and psychological dimensions of dreaming . New York: Palgrave], and the threat simulation theory of Revonsuo [Revonsuo, A. . The reinterpretation of dreams: An evolutionary hypothesis of the function of dreaming. Behavioral and Brain Sciences, 23, 877–901]. Our findings suggest the terrorist attacks had a tangible impact on the content of many people’s dreams, but did not fundamentally alter the cognitive processing features of their dreaming. The 9/11 attacks affected what they dreamed about, but not the way they dreamed. (shrink)

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep (...) this “essential industry” producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry’s implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities. (shrink)

This article claims that Asha Bhandary’s theory of justice in Freedom to Care: Liberalism, Dependency Care, and Culture is right to stress the interdependency of justice and care in addressing structural oppressions, but wrong in upholding liberalism’s capacity for doing so. Against her procedural mechanism of education for caregiving skills in particular, I point to the critical and generative methods of social reproduction feminism and Transformative Justice as models of radical praxis in the collective work of politically centering and radically (...) transforming cultures of care. (shrink)

Josiah Royce (1855-1916) was the leading American proponent of absolute idealism, the metaphysical view (also maintained by G. W. F. Hegel and F. H. Bradley) that all aspects of reality, including those we experience as disconnected or contradictory, are ultimately unified in the thought of a single all-encompassing consciousness. Royce also made original contributions in ethics, philosophy of community, philosophy of religion and logic. His major works include The Religious Aspect of Philosophy (1885), The World and the Individual (1899-1901), The (...) Philosophy of Loyalty (1908), and The Problem of Christianity (1913). Royce's friendly but longstanding dispute with William James, known as "The Battle of the Absolute," deeply influenced both philosophers' thought. In his later works, Royce reconceived his metaphysics as an "absolute pragmatism" grounded in semiotics. This view dispenses with the Absolute Mind of previous idealism and instead characterizes reality as a universe of ideas or signs which occur in a process of being interpreted by an infinite community of minds. These minds, and the community they constitute, may themselves be understood as signs. Royce's ethics, philosophy of community, philosophy of religion, and logic reflect this metaphysical position. (shrink)

Chemistry is a highly technical field that relies heavily on a range of symbolic and imagic formalisms. These formalisms conceptualize specific chemical knowledge into semiotic resources that are rarely used elsewhere in most other academic fields or contexts. To develop an understanding of semiosis in highly technical fields such as chemistry, key questions include what this range of formalisms do and why they occur. These are key questions not only for our understanding of semiosis, but also if we wish to (...) develop integrated literacy programs that can support students to marshal the multimodal discourse of chemistry. This paper explores these questions by examining how three key chemical formalisms organize their meaning: symbolic formalisms known as chemical formulas and chemical equations, and an imagic formalism known as structural formulas. Drawing on Systemic Functional Linguistics and using a corpus of formalisms from secondary school chemistry, these formalisms are explored in terms of their overarching grammatical organization and the content meanings they realize through the concept of “field.” This is used to compare and contrast each formalism in terms of a semiotic typology so as to understand how they work and what meanings they realize. By exploring chemical formalisms in this way, this paper establishes a means of seeing the similarities and differences in meaning-making across formalisms and explaining why different formalisms occur. This then begins to provide a base upon which applied programs can interpret the literacy needs of chemistry. (shrink)