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)

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)

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.

Modern medicine emphasizes treatment of the sick. It is often said that the widespread genetic testing soon to follow the completion of the Human Genome Project will usher in a new era of preventive medicine. Such changes require new ways of thinking, however. For example, there may be nothing clinically wrong with a healthy patient who requests genetic testing, even if the tests reveal disease genes. Since all individuals have genetic skeletons in their closets, it is important to be careful (...) not to confuse having disease genes with having the diseases that they cause. Unfortunately, many in the public have adopted a kind of genetic determinism that sees genes as destiny: for example, having the gene associated with colon cancer means they will develop colon cancer. Physicians tend to be more careful, yet even they are not immune to subtle versions of genetic determinism. One example of this is the uncritical categorization of certain diseases as “genetic”. In fact, an adequate concept of genetic disease is extremely difficult to come by. The simplest notion would require a 1:1 correspondence between a disease and its genes, but this is the exception rather than the rule. For example, cystic fibrosis (CF) is often put forward as a good example of a genetic disease, since it seems to result from mutations in a single gene, CFTR. Even in this case, however, the exact relationship between CFTR mutations and disease is not clear, as virtually every possible combination of sweat chloride test results, genetic test results, and symptoms has been observed.[1] If a patient presents with the classic symptoms of CF and is found to have a mutation in the CFTR gene, the physician might understandably infer that the mutation caused the disease. But if an asymptomatic patient is tested and it is discovered that he or she has a CFTR mutation, it is unclear what this means. The doctor might tell the patient the gene is abnormal and that he or she is likely to develop pulmonary problems, etc., but it’s not really known whether even this qualified prognosis is true.. (shrink)

Prolonged survival after the declaration of death by neurologic criteria creates ambiguity regarding the validity of this methodology. This ambiguity has perpetuated the debate among secular and nondissenting Catholic authors who question whether the neurologic standards are sufficient for the declaration of death of organ donors. Cardiopulmonary criteria are being increasingly used for organ donors who do not meet brain death standards. However, cardiopulmonary criteria are plagued by conflict of interest issues, arbitrary standards for candidacy, and the lack of standardized (...) protocols for organ procurement. Combining the neurological and cardiopulmonary standards into a single protocol would mitigate the weaknesses of both and provide greater biologic and moral certainty that a donor of unpaired vital organs is indeed dead. (shrink)

Technoscientific research, a kind of scientific research conducted within the decontextualized approach (DA), uses advanced technology to produce instruments, experimental objects, and new objects and structures, that enable us to gain knowledge of states of affairs of novel domains, especially knowledge about new possibilities of what we can do and make, with the horizons of practical, industrial, medical or military innovation, and economic growth and competition, never far removed from view. The legitimacy of technoscientific innovations can be appraised only in (...) the course of considering fully what sorts of objects technoscientific objects are: objects that embody scientific knowledge confirmed within DA; physical/chemical/biological objects, realizations of possibilities discovered in research conducted within DA, brought to realization by means of technical/experimental/instrumental interventions; and components of social/ecological systems, objects that embody the values of technological progress and (most of them) values of capital and the market. What technoscientific objects are - their powers, tendencies, sources of their being, effects on human beings and social/economic systems, how they differ from non technoscientific objects - cannot be grasped from technoscientific inquiry alone; scientific inquiry that is not reducible to that conducted within DA is also needed. The knowledge that underlies and explains the efficacy of technoscientific objects is never sufficient to grasp what sorts of object they are and could become. Science cannot be reduced to technoscience. (shrink)

A boy from Stagira -- In the shadow of Socrates and Plato -- The student becomes the teacher -- New ideas in science, logic, and politics -- The rise and fall of Aristotle's legacy.

While much has been written on Latour’s politics and use of militaristic language, by attending to some of Latour’s lesser known or read writings, his political location within the traditional Left-Right spectrum becomes more discernable, as does the reason for his frequent resort to the language of war. This article does not seek to defend Latour’s politics or rhetoric, but to provide a corrective by incorporating, rather than taking distance from, his use of militaristic language. Doing so reveals an understanding (...) of Latour’s project as having always been—if not traditionally Left—charting a different Leftist approach. (shrink)

In this manuscript, the author demonstrates how a new idea of the future came into being in eighteenth-century France with the development of modern biological, economic, and social engineering. With the emergence of these practices, the future transformed from something that was largely believed to be predetermined and beyond significant human intervention into something that could be significantly affected through actions in the present. Focusing on the second-half of the century, The author argues that specific mechanisms for constructing the future (...) first arose through the development of practices and instruments aimed at countering degeneration. In their attempts to regenerate a healthy natural state, Enlightenment philosophes created the means to exceed previously recognized limits and create a future that was not merely a recuperation of the past, but was fundamentally different from it. The new active orientation to the future that emerged from these practices was not something that was explicitly articulated during the Enlightenment. Instead this practical orientation must be seen as an implicit understanding of historical temporality. Historical actors often had a tacit knowledge of time--one that they worked with--without necessarily being fully aware of it or articulating it explicitly in their writing. The full articulation of the new idea of the future did not occur until the French Revolution, but the practical understanding of it that developed during the Enlightenment played an important role in making possible the French revolutionaries' unprecedented attempts to remake the world completely anew. (shrink)

From a religious studies perspective, Atran & Norenzayan (A&N) succeed in arguing for the influence of evolved cognitive functions in religious phenomena. To develop their argument further, four suggestions are offered: (1) Look beyond the ordinary to the extraordinary; (2) culture matters more than ever; (3) theists need not despair, atheists ought not celebrate; and (4) dreaming is a primal wellspring of religion.

This 1945 “Preface” is intended to answer the question “What is phenomenology?” and to justify it as the methodology of the long work of philosophical psychology to follow. Merleau-Ponty approaches this task by first setting out the apparent paradoxes and contradictory claims that have been advanced by phenomenology, in a long and eloquent survey section that is built on a series of “X, but also Y” rhetorical devices. He then surveys four prominent themes of phenomenology. Just as he does in (...) the introductory section of the essay “The Philosopher and His Shadow,” Merleau-Ponty here presents himself as the chief interpreter and champion of Husserl's later philosophy. The first major theme considered is that phenomenology is a matter of describing the field of perception. This sets it in contrast to the prevalent explanatory methodologies of a) scientific empiricism and b) metaphysical idealism. Empirical science (such as mathematical physics) begins with observation, but then abstracts entirely from lived experience to consider idealized schematic cases (such as motion across a frictionless surface) that may reveal universal laws. Such a methodology is obviously fruitful in important respects, but is nonetheless naïve and dishonest in its renunciation of the specifics of observed events. The metaphysical idealism of Kant or Descartes likewise abstracts from the experienced particularity of perception to posit an “inner man” that constitutes the world according to 2 internal, transcendental principles. Merleau-Ponty's criticism is the same, whether these principles are “reason” of Rationalism, “the categories of understanding” of Critical Rationalism, or the rules governing the “association of ideas” posited by Empiricism. Phenomenology indicates that perception is not an act but a fact; the world is not an object but rather the unified setting of perception; and the inner man is a myth, along with his allegedly privileged access to univocal truth. The second theme is the technique of “phenomenological reduction,” the suspension of belief in the assemblage of everyday assumptions known as the “natural attitude.” Husserl's understanding of the reduction long led him to an idealist position: that all particular consciousnesses are united in a transcendental ego.. (shrink)

La aplicación del principio de relatividad, una vez que se ha formulado la posibilidad de una instancia de referencia central, determina una libre opción (autónoma) por medio de la cual se prescinde de la posibilidad de existir en el relativismo, dado que si bien no se descubre una "realidad" , ..

During the last third of the 20C, public discourse in the United States has become increasingly acerbic. Parallel to this development there has been an increasing enrollment in College level logic courses, courses that focus on arguments and their appraisal. Could there be a connection? A number of majorphilosophers do not just see arguments as either 100% correct or 100% incorrect. Notable in this regard are Plato, Aquinas and Hume. Their approach to “logic” and that of others is offered as (...) a palliative to the types of logic that we now teach. (shrink)

Kant behauptet, daß wir nur indirekte Pflichten haben können, von Grausamkeiten und Gewalt gegen Tiere abzusehen. Pflichten dieser Art seien direkte Pflichten gegen uns selbst, um unseren moralischen Charakter nicht zu verderben, aber könnten nicht direkte Pflichten gegenüber den Tieren sein, weil Tiere keine rationalen Wesen sind. Diese Sichtweise erscheint unbefriedigend, da die Tiere die Opfer einer solchen Mißhandlung sind, wenn sie stattfindet, und die Vorstellung, daß wir keine direkten Pflichten ihnen gegenüber haben sollen, erscheint merkwürdig. Ich plädiere dafür, daß (...) Kant, durchaus in Übereinstimmung mit seiner allgemeinen Moralphilosophie, hätte ein Konzept von direkten Pflichten gegenüber Tieren entwickeln können. Ein solches Konzept wäre weitaus plausibler und hätte Kant geholfen, mit allfälligen Problemen umzugehen, die sich im Hinblick auf die Behandlung von zurechnungsunfähigen Personen ergeben, die ebenfalls keine rationalen Wesen sind, sondern allenfalls potentiell. Zwar kann Kant durchaus plausibel machen, daß es die von ihm behaupteten indirekten Pflichten im Hinblick auf Tiere gibt, aber nicht, daß unsere Pflichten gegenüber Tieren auf derartige indirekte Pflichten beschränkt sind. Kant claimed that we could only have indirect duties to abstain from cruelty and violence to animals; such duties were directly duties to ourselves not to degrade our moral character, but could not be direct duties to animals because animals are not rational beings. This view seems unsatisfactory because animals are the victims of such mistreatment when it occurs, and the idea that we have no direct obligations to them seems odd. I urge that Kant, consistent with his general moral philosophy, could have developed a view of DIRECT duties to animals. Such a view would have been more plausible and would also have helped him deal with lurking problems concerning the treatment of incompetent humans, some of whom are also not rational beings, even potentially. Kant can plausibly claim that there are such indirect duties to animals, but not that our duties to them are limited to such indirect duties. (shrink)

Should I break my promise? -- Should I tell people his secret? -- Can I cancel my plans with my friend? -- Why won't he trust me with his toy? -- Why didn't they believe me? -- Is it okay if I keep Maddie's shirt? -- Is it honest to stuff everything under Mary's bed? -- Should I tell my teacher the truth? -- Should I look at his paper and copy him? -- Activity.

The primary intention of this book is to elucidate the relations between sensory perception and art as a form of knowledge. This enables us to understand how different kinds of art are given their meaning not only from observation, resemblance and reason but also from an artist’s sensitivity to the inner form of sensory experience as it is realized in perception, reflection, memory and imagination. By assuming a number of different points of view, Part 1 shows how the physical object (...) and the act of sensory perception are logically interdependent, and I give my elaboration of this argument two kinds of emphasis. In the first place, it opposes all arguments that support a merging of the mental and physical, as in idealism, materialism, neutral monism and panpsychism. A conceptual distinction is observed because sensory perception gives the physical object its identity. This idea also implies that the physical object is only realized by sentient life - self-aware inner life and a world become possible simultaneously. The second emphasis concerns the mind-body problem, and towards the end of Part 1 I offer an argument which places this problem in a certain light by representing the brain not as a physical counterpart to inner experience but as essentially instrumental to perception and self-awareness, and related experience. The argument in Part 2 is distinguished by a sense of continuity between the nature of sensory perception and the formal resources of artists in both physical and literary media. Hence, in a discussion of Titian’s Assumption of the Virgin, I indicate ways in which the painter conveys the inner experience and character of the figures in the painting by means of compositional design, light and colour, and thereby uses these and other sensuous resources to portray human life and experience. This is followed by a discussion of two sonnets by Shakespeare, in which the same general aim is pursued by using the literary resources of figurative language. Finally, a discussion of Hamlet shows how, in this work, the augmentation of figurative language by dramatic form strengthens the view that art can provide a form of knowledge that is based as completely upon intuition about our sensory experience as it is upon reason and observation. Just as my (true) perception of a cup as a vessel for drinking tea or coffee arises immediately from past experience, so the dramatist can see immediately from his or her past experience how a character might perceive things and behave. -/- . (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)

Law and medicine can be caught in a tight embrace. They both play a central role in the politics of harm, making decisions regarding what counts as injury and what might be the most suitable forms of redress or remedy. But where do law and medicine converge and diverge in their responses to and understandings of harm and suffering? Using empirical case studies from Europe, the Americas and Africa, The Clinic and the Court brings together leading medical and legal anthropologists (...) to explore this question. (shrink)