To address the growing costs associated with chronic illness care, many countries, both developed and developing, identify increased patient self‐management or self‐care as a focus of healthcare reform. Health coaching, an implementation strategy to support the shift to self‐management, encourages patients to make lifestyle changes to improve the management of chronic illness. This practice differs from traditional models of health education because of the interactional dynamics between nurse and patient, and an orientation to care that ostensibly centres and empowers patients. (...) The theoretical underpinnings of coaching reflect these differences, however in its application, the practices arranged around health coaching for chronic illness self‐management reveal the social regulation and professional management of everyday life. This becomes especially problematic in contexts defined by economic constraint and government withdrawal from activities related to the ‘care’ of citizens. In this paper, we trace the development of health coaching as part of nursing practice and consider the implications of this practice as an emerging element of chronic illness self‐management. Our purpose is to highlight health coaching as an approach intended to support patients with chronic illness and at the same time, problematize the tensions contained in (and by) this practice. (shrink)

Confronting any science studies or learning sciences researcher in the 21st century is the reality of interdisciplinary science. New hybrid fields1 collaboratively build new concepts, combine models from two or more disciplines and forge inter-reliant relationships among specialists with different skill sets to solve new problems. This paper emerges from our recognition that inescapable psychological factors, including identity dynamics, must be described and analyzed in order to better understand the social and cognitive practices specific to interdisciplinary science. In analysis of (...) the foundations and opportunities for an... (shrink)

For over 100 years, the field of contemporary public health has existed to improve the health of communities and populations. As public health practitioners conduct their work – be it focused on preventing transmission of infectious diseases, or prevention of injury, or prevention of and cures for chronic conditions – ethical dimensions arise. Borrowing heavily from the ethical tools developed for research ethics and bioethics, the nascent field of public health ethics soon began to feel the limits of the clinical (...) model and began creating different frameworks to guide its ethical challenges. Several public health ethics frameworks have been introduced since the late 1990s, ranging from extensions of principle-based models to human rights and social justice perspectives to those based on political philosophy. None has coalesced as the framework of choice in the discipline of public health. This paper examines several of the most-known frameworks of public health ethics for their common theoretical underpinnings and values, and suggests next steps toward the formulation of a single framework. (shrink)

Teaching competency in bioethics has been a concern of the field since its start. In 1976, The Hastings Center published the first report on the teaching of contemporary bioethics. Graduate programs culminating in an MA or PhD were not needed at the time, concluded the report. “In the future, however,” the report speculated, “the development and/or changing social priorities may at some point allow, or even require, the creation of new academic structures for graduate education in bioethics.” Although that future (...) might be upon us, the creation of a terminal degree in bioethics has its detractors. Scholars have debated whether bioethics is a discipline with its own methods and theoretical grounding, a multidisciplinary field bringing various professional perspectives to bear on particular types of problems, a set of problem-solving skills to resolve moral disagreements, or something else entirely. Whether or not efforts to develop the methods and theory of bioethics have matured to the point that it is now a discipline in the strictest sense, new bioethics training programs have appeared at all postsecondary levels. In this essay, we examine the number and types of U.S. programs and degrees in this growing field. (shrink)

The attempt to critique the profession of clinical ethics consultation by establishing the impossibility of ethics expertise has been a red herring. Decisions made in clinical ethics cases are almost never based purely on moral judgments. Instead, they are all-things-considered judgments that involve determining how to balance other values as well. A standard of justified decision-making in this context would enable us to identify experts who could achieve these standards more often than others, and thus provide a basis for expertise (...) in clinical ethics consultation. This expertise relies in part on what Richard Zaner calls the “expert knowledge of ethical phenomena”. (shrink)

Abram Brummett and Christopher Ostertag offer critiques of my argument that clinical ethics consultants have expertise but are not “ethics experts”. My argument begins within our less-than-ideal world and asks what a justification of a clinical ethics consultation recommendation might look like under those conditions. It is a challenge to what could be called an “inflationary” position on ethics expertise that requires agreement on or rational proof of metaethical facts about the values at stake in clinical ethics consultation. Brummett and (...) Ostertag critique three distinct steps in the argument. Two of those I have a brief answer for, and an assessment of the third demonstrates that Brummett and Ostertag do not consider the premise upon which I based my account. Instead, they assert a counter-premise without argument, which at best results in a stalemate between our two accounts. However, the reasons supporting my premise still seem to me to be stronger, so I am in the end unconvinced by their critiques. (shrink)

This paper presents an analysis of emotional and affectively toned discourse in biomedical engineering researchers’ accounts of their problem solving practices. Drawing from our interviews with scientists in two laboratories, we examine three classes of expression: explicit, figurative and metaphorical, and attributions of emotion to objects and artifacts important to laboratory practice. We consider the overall function of expressions in the particular problem solving contexts described. We argue that affective processes are engaged in problem solving, not as simply tacked onto (...) reasoning but as integral to it. The examples we present illustrate the close relation of emotion to problem solving and experimentation; they also implicate social and cultural dimensions of emotion expression. The analysis underscores a need to consider emotional expression to be intimately and importantly tied to the cognitive achievements and social negotiations of laboratory practices. (shrink)

The question of whether clinical ethics consultants may engage in patient advocacy in the course of consultation has not been addressed, but it highlights for the field that consultants? allegiances, and the boundaries of appropriate professional practice, must be better understood. I consider arguments for and against patient advocacy in clinical ethics consultation, which demonstrate that patient advocacy is permissible, but not central to the practice of consultation. I then offer four recommendations for consultants who engage in patient advocacy, and (...) consider the implications of this issue for the field.1. (shrink)

A major obstacle to broad support of clinical ethics consultation is suspicion regarding the nature of the moral expertise it claims to offer. The suspicion seems to be confirmed when the field fails to make its moral expertise explicit. In this vacuum, critics suggest the following:Clinical ethics consultation's legitimacy depends on its ability to offer an expertise in moral matters.Expertise in moral matters is knowledge of a singular moral truth which applies to everyone.The claim that a clinical ethics consultant can (...) offer knowledge of a singular moral truth in virtue of her professional training is absurd, false, or gravely immoral.Therefore,The field is illegitimate. (shrink)

We historically and conceptually situate distributed cognition by drawing attention to important similarities in assumptions and methods with those of American ?functional psychology? as it emerged in contrast and complement to controlled laboratory study of the structural components and primitive ?elements? of consciousness. Functional psychology foregrounded the adaptive features of cognitive processes in environments, and adopted as a unit of analysis the overall situation of organism and environment. A methodological implication of this emphasis was, to the extent possible, the study (...) of cognitive and other processes in the natural (real world) contexts in which they occur. We therefore emphasize commonalities and differences between functional psychology and D-Cog. One purpose of the comparison is to consider the extent to which criticisms directed at functional psychology are relevant to D-Cog. We also examine the relation between functional psychology and philosophical pragmatism and conclude that D-Cog's conceptual framework would be strengthened through more explicit adoption of philosophical pragmatism, consistent with the eventual trajectory of functional psychology. (shrink)

For the first time, the revised Common Rule specifies that public health surveillance activities are not research. This article reviews the historical development of the public health surveillance exclusion and implications for other foundational public health practices.

Despite increased interest in “intuition” within cognitive psychology, the conceptual framework of this notion remains problematic. This paper argues that conceptual shortcomings stem from a tendency to ignore the philosophical heritage of intuition or to dismiss the relevance of this heritage to contemporary theory. The paper outlines major understandings of intuition within psychology and prominent philosophical traditions, highlighting important points of inconsistency in these and examining consequences of the inconsistency. It also considers psychological conceptions of intuition that more readily overlap (...) with philosophical accounts and offers some suggestions toward a more philosophically informed notion of intuition relevant to contemporary psychological theory. (shrink)

In this Article I argue that the emerging public/private nexus of surveillance involves the augmentation of state power and calls for new models of constitutional constraint. The key phenomenon is the role played by communications intermediaries in collecting the information that the state subsequently accesses. These intermediaries are not just powerful companies engaged in collecting and analyzing the information of users and the information they hold are not just business records. The key feature of these companies is that, through their (...) information practices and architecture, they mediate other relationships. I argue that this mediating function, and its underlying technological form, interacts with legal and social norms in ways that can lead to the erosion of constraints on state power. This Article maps two stories of erosion, rooted in two kinds of community displacement. The first involves the displacement of community participation in law enforcement and the emergence of “technological tattletales” where intermediaries cooperate with the state. Unlike citizen cooperation, this practice augments state power and undermines more traditional informal modes of constraint on state power. The second involves the displacement of national legal and political community. Communications intermediaries are often large multinational companies that operate in multiple jurisdictions and move their data to various datacenters across the world even as the individual data subject remains in one geographical location. Laws that treat nonresident aliens differently from residents and citizens can create “constitutional black holes” where the communications data of an individual is not protected by any constitutional constraints. (shrink)

The ethical (and philosophical) issues arising in citizen science are fascinating, challenging, and potentially pathbreaking in that they force us to reconsider the conceptual and regulatory catego...

The American Journal of Bioethics, Volume 12, Issue 8, Page W1-W3, August 2012.

The cognitive revolution in the 1950s and 1960s led researchers to view the human mind--like a computer--as an information-processing system that encodes, represents, and stores information and is constrained by limits on hardware and software. The emergence of new behavioral, computational, and neuroscience methodologies, has deeply expanded psychologists' understanding of the workings of the infant, child, and adult mind. One result is that research has focused on mechanisms of change, over developmental time, in the information-processing mind.In this book, Lisa (...) Oakes, Cara Cashon, Marianella Casasola, and David Rakison bring together the recent findings and theories about the origins and early development of the information-processing mind, and provide insight into the future directions in the study of infant perception and cognition. The contributors represent a wide-range of research areas in the study of infant perception and cognition, who emphasize the use of diverse methodological techniques to address key questions about development. Their chapters demonstrate how the combination of historical perspectives on the information-processing approach to cognition and recent advances in behavioral, computational, and neuroscience approaches to cognition has contributed to our understanding of how abilities ranging from visual attention to face processing to object categorization have developed during infancy. Across this broad range of topics, it is clear that much of our modern understanding of infant perceptual and cognitive development emerges from the foundation of classic information-processing models of development, such as that of Leslie B. Cohen. The recent advances illustrated in this book show how researchers have built on this foundation to uncover the mechanisms that drive developmental change. (shrink)

Rational Intuition explores the concept of intuition as it relates to rationality through mediums of history, philosophy, cognitive science, and psychology.

The rule of law is widely perceived to be a public law doctrine, concerned with the way governmental authority conforms to dictates of law. This book explores the idea that the rule of law instead concerns the conditions under which any relationship - that among citizens as well as that between citizens and the state - becomes subject to law.

The development of physical theory is one of our greatest intellectual achievements. Its products--the currently prevailing theories of physics, astronomy, and cosmology--have proved themselves to possess intrinsic beauty and to have enormous explanatory and predictive power. This anthology of primary readings chronicles the birth and maturation of five such theories (the heliocentric theory, the electromagnetic field theory, special and general relativity, quantum theory, and the big bang theory) in the words of the scientists who brought them to life. It is (...) the first historical account that captures the rich substance of these theories, each of which represents a fascinating story of the interplay of evidence and insight--and of dialogue among great minds. Readers sit in with Copernicus, Kepler, and Galileo as they overturn the geocentric universe; observe the genius of Faraday and Maxwell as they "discover" the electromagnetic field; look over Einstein's shoulder as he works out the details of relativity; listen in as Einstein and Bohr argue for the soul of quantum mechanics in the Completeness Debate; and watch as Hubble and others reveal the history of the universe. The editors' approach highlights the moments of discovery that rise from scientific creativity, and the presentation humanizes the scientific process, revealing the extent to which great scientists were the first to consider the philosophical implications of their work. But, most significantly, the editors offer this as their central thesis: although each was ushered in by a revolution, and each contains counterintuitive elements that delayed its acceptance, these five theories exhibit a continuous rational development that has led them to a permanent place in the worldview of science. Accessible to the general reader yet sufficiently substantive that working scientists will find value in it, The Tests of Time offers an intimate look into how physical theory has been developed, by the brilliant people who have developed it. (shrink)

Journal of Philosophy of Education, EarlyView.

Women working in the sciences face obstacles at virtually every step along their career paths. From subtle slights to blatant biases, deep systemic problems block women from advancing or push them out of science and technology entirely. Women in Science Now examines solutions to this persistent gender gap, offering new perspectives on how to make science more equitable and inclusive for all. This book shares stories and insights of women from a range of backgrounds working in various disciplines, illustrating the (...) journeys that brought them to the sciences, the challenges they faced along the way, and the important contributions they have made to their fields. Lisa M. P. Munoz combines these narratives with a wealth of data to illuminate the size and scope of the challenges women scientists face, while highlighting research-based solutions to help overcome these obstacles. She presents groundbreaking studies in social psychology and organizational behavior that are informing novel approaches for combating historic and ongoing inequities. Through a combined focus on personal experiences and social-science research, this timely book provides both a path toward greater gender equity and an inspiring vision of science and scientists. (shrink)

Ethical considerations from both the clinical and public health perspectives have been used to examine whether it is ethically permissible to mandate the seasonal influenza vaccine for healthcare workers (HCWs). Both frameworks have resulted in arguments for and against the requirement. Neither perspective resolves the question fully. By adding components of justice to the argument, I seek to provide a more fulsome ethical defence for requiring seasonal influenza immunisation for HCWs. Two critical components of a just society support requiring vaccination: (...) fairness of opportunity and the obligation to follow democratically formulated rules. The fairness of opportunity is informed by Rawls’ two principles of justice. The obligation to follow democratically formulated rules allows us to focus simultaneously on freedom, plurality and solidarity. Justice requires equitable participation in and benefit from cooperative schemes to gain or profit socially as individuals and as a community. And to be just, HCW immunisation exemptions should be limited to medical contraindications only. In addition to the HCWs fiduciary duty to do what is best for the patient and the public health duty to protect the community with effective and minimally intrusive interventions, HCWs are members of a just society in which all members have an obligation to participate equitably in order to partake in the benefits of membership. (shrink)

From accessible and affordable health care to old or new reproductive technologies, human or animal research, and beyond, the justice and well‐being of our society depends on the ability of key groups—such as scientists and health care providers—along with members of the public to identify the key issues, articulate their values and concerns, deliberate openly and respectfully, and together find the most defensible ways forward.The Presidential Commission for the Study of Bioethical Issues and The Hastings Center are committed to improving (...) the ethical literacy of the American public in the domain of bioethics. But what are the best educational practices to spur and support these sorts of societal conversations? And where are the greatest gaps in our collective knowledge of how best to inspire and increase moral understanding, analytical thinking in the moral domain, and professional integrity? (shrink)

There are no national recommendations for routine screening for sickle cell trait, nor is there guidance on whether or how to notify donors that they might be tested or identified as having sickle cell trait. As a result, the organizations that collect blood have implemented variable policies about whether and how to inform prospective donors of the possible screening and discovery of this noncommunicable condition. The question of what they should do is related to the broader question of how to (...) handle incidental and secondary findings. In a recent report, the Presidential Commission for the Study of Bioethical Issues outline a framework for handling such findings in the clinical, research, and direct‐to‐consumer contexts. While the commission's report did not directly address incidental and secondary findings in the public health context of blood donation, it made several overarching recommendations that apply in all contexts where such findings might arise. This essay outlines the special issues raised by discovering sickle cell trait in blood donation and considers the implications of the commission's framework for that problem. (shrink)

Volume 19, Issue 9, September 2019, Page 44-45.

Volume 19, Issue 11, November 2019, Page 65-66.

Contemporary biomedical ethics and environmental ethics share a common ancestry in Aldo Leopold's and Van Rensselaer Potter's initial broad visions of a connected biosphere. Over the past five decades, the two fields have become strangers. Public health ethics, a new subfield of bioethics, emerged from the belly of contemporary biomedical ethics and has evolved over the past 25 years. It has moved from its traditional concern with the tension between individual autonomy and community health to a wider focus on social (...) justice and solidarity. Public health has a broad focus that includes individual, community, and environmental health. Public health ethics attends to these broad commitments reflected in the increasing concern with the connectedness of health of individuals to the health of populations, to the health of animals, to the health of the environment; it is well situated to reconnect all three “fields” of ethics to promote a healthier planet. (shrink)

We describe our efforts to address theoretical opportunities and methodological challenges that arose in the context of our ethnographic investigation of research labs in four different fields of bioengineering science. The multiyear study compared the common and specific features of four sites of interdisciplinary practice and aimed to analyze personal and collective goals, problem formulations, methods, technologies, and social organization within each lab. In the second phase of the study we sought to inform curriculum development for biomedical engineering from the (...) ethnographic study, with the broader goal of positioning students to engage in the kind of thinking scientists actually do. Evaluating thinking in action posed considerable challenges, and required us to develop an approach to assessing the extent to which students enrolled in the new course were “thinking like a biomedical engineer.” Our principal point of emphasis for this chapter is that honest confrontation of the challenges of ethnographic study of science practice must lead to caution, yet that ethnographic study of science enables innovative adaptations of methods and can yield vital insights into psychological dimensions of science, including interdisciplinary science. (shrink)

Validation of a biomarker-based medical product development tool or clinical test is an evidentiary process that must be tailored to the proposed use. Appropriate data and analyses are needed to demonstrate that the biomarker meets analytical and clinical performance criteria consistent with favorable benefit: risk balance.