Adherence to professional ethics in nursing is fundamental for high-quality ethical care. However, analysis of the use and impact of nurses’ codes of ethics as a part of professional ethics is limited. To fill this gap in knowledge, the aim of our review was to describe the use and impact of the Code of Ethics for Nurses with Interpretive Statements published by the American Nurses Association as an example of one of the earliest and most extensive codes of ethics for (...) nurses with their interpretative statements and constituting a strong basis for the International Council of Nurses’ Code of Ethics for Nurses. We based our review on previous literature using a scoping review method. We included both non-scientific and scientific publications to provide an analysis of codes of ethics which can be utilized in development and revision of other nurses’ codes of ethics. In the searches, we used CINAHL and PubMed databases limiting publications to texts with a connection to the Code of Ethics for Nurses published from January 2001 to November 2022 and written in English. Searches yielded 1739 references, from which 785 non-scientific and 71 scientific publications were included for analysis of the data. Although non-scientific and scientific publications addressed different number of categories, the results indicated that in the both groups the use and impact focused on professional ethics, nursing practice, and work environment and less on education, research, or social health issues. Nurses’ ethical standards were not addressed in non-scientific publications, and clinical issues and leadership were not in focus in scientific publications. To increase evidence-based knowledge of the impact of codes of ethics additional research is needed. Good scientific conduct was followed. (shrink)

Aim: Explore nurses’ values and perceptions regarding the practice of medical aid in dying. Background: Medical aid in dying is becoming increasing legal in the United States. The laws and American Nurses Association documents limit nursing involvement in this practice. Nurses’ values regarding this controversial topic are poorly understood. Methodology: Cross-sectional electronic survey design sent to nurse members of the American Nurses Association. Inductive thematic content analysis was applied to open-ended comments. Ethical Considerations: Approved by the institutional review board (#191046). (...) Participants: 1213 nurses provided 3639 open-ended comments. More than 80% of participants self-identified as white 58% held a graduate degree; and half were of Christian faith. Results: Values ranged on a continuum expressed through four themes: “Honoring Patient Autonomy without Judgment,” “Honoring with Limitations,” “Not until...,” and “Adamantly against.” Some felt it was a duty to honor the patients’ wishes, set aside own beliefs, and respect patients’ choices often with a spiritual connotation. Nurses held concerns about the process, policy, potential psychological harm, legal risk, and the need to learn more about MAID. Nurse who were adamantly against MAID associated the practice with murder/suicide and against religious beliefs. Disparate values were expressed about changing the MAID legislation to allow patient support with taking MAID medications and allowing MAID via advance directive. Conclusions: Nurses desire more education on MAID. There is not one universally held position on the nurse’s role during MAID. Healthcare policy/standards need to accommodate the wide variation in nurses’ values. Implications: Nurses desire education regarding their role in MAID. Nurses are encouraged to participate in policy discussions as the practice becomes increasingly legal. Managers need to expect that nurses, patients, and families will need psychological support to participate in MAID. Careful construction of policy/standards is needed to minimize conflict, moral distress, and psychological harm amongst nurses. Further research is needed. (shrink)

Does the idea of human enhancement presuppose a goal or an ideal to direct technological modifications? In the absence of such an agreed ideal in today’s culture, can Christian theology help clarify the goal or the meaning of “perfection” when applied to human beings? A theological perspective rooted in scripture and in the writings of theologians such as Irenaeus, Athanasius, and Gregory of Nyssa suggests that theology instead of offering its own definition of the human ideal, theology rejects the possibility (...) of any defined human goal. An analysis of the biblical word teleios (“mature” or “perfect”), along with Gregory’s view of infinite ascent, leads to the conclusion that the human goal is found in relationship to the triune God and not in any anthropologically-definable status. (shrink)

Relativism is central to the social sciences for the simple reason that customs and morals are diverse, and explaining this diversity is one of its major tasks. The explanations have relativistic implications, but they vary according to the type of explanation. In the nineteenth century evolutionary explanations dominated: differences were relative to stages. The social determination of ideas followed from these accounts, but could be logically separated from them. In the twentieth century, accounts based on the culture concept, understood loosely (...) in neo-Kantian terms as a matter of different shared presuppositions, dominated. This conception informed a relativistic methodological approach to history and disciplinary differences, exemplified in the methodological writings of Max Weber, where they were related to values. This was more radical, in the sense that there was no further explanation of the presuppositions. They simply differed. As this conception was expanded into the epistemic realm, it became even more radical, by being applied to science itself. The “Strong Programme in the sociology of science” observed a principle of symmetry, which held that true and false scientific beliefs needed to be explained using the same explanatory tools. In each of these cases problems of reflexivity and self-undermining played a role. (shrink)

The generalizability crisis is compounded, or even partially caused, by a lack of specificity in psychological theories. Expanding the use of mechanistic models among psychologists is therefore important, but faces numerous hurdles. A cultural evolutionary approach can help guide and evaluate interventions to improve modeling efforts in psychology, such as developing standards and implementing them at the institutional level.

Lately there has been a wave of criticism of the concept of living fossils. First, recent research has challenged the status of paradigmatic living fossil taxa, such as coelacanths, cycads, and tuataras. Critics have also complained that the living fossil concept is vague and/or ambiguous, and that it is responsible for misconceptions about evolution. This paper defends a particular phylogenetic conception of living fossils, or taxa that exhibit deep prehistoric morphological stability; contain few extant species; and make a high contribution (...) to phylogenetic diversity. The paper shows how this conception of living fossils can make sense of recent research on contested cases. The phylogenetic living fossil concept has both theoretical and practical importance: theoretical, because it picks out an important explanatory target for evolutionary theory; and practical, because it picks out taxa that we might wish to prioritize for conservation. The best way to defend the concept of living fossils is to get clearer about the reasons for defending living fossil taxa. (shrink)

Verstehen, understanding another human being through some form of empathy, is a natural process with the involvement, probably in a complex way, of the brain. There is a temptation to describe Vers...

Personal narratives in which medical students and clinicians reflect on their education and practice, or recipients of health care reflect on their journey though the system can provide valuable insights which can usefully be shared. In this paper, a medical student describes the effect of a humanities-based student-selected component on her understanding of anatomy and dissection, and a junior doctor in Iraq learns some painful lessons about medicine and society during a night shift in the casualty department.

Surgical expertise does not have a clear definition and is often culturally associated with power, authority, prestige, and case number rather than more objective proxies of excellence. Multiple models of expertise progression have been proposed including the Dreyfus model, however, they all currently require subjective evaluation of skill. Recently, efforts have been made to improve the ways in which surgical excellence is measured and expertise is defined using artificial intelligence, video recordings, and accelerometers. However, these aforementioned methods of assessment are (...) still subjective or indirect proxies of expertise, thus uncovering the neural mechanisms that differentiate expert surgeons from trainees may enhance the objectivity of surgical expertise validation. In fact, some researchers have already suggested that their neural imaging-based expertise classification methods outperform currently used methods of surgical skill certification such as the Fundamentals of Laparoscopic Surgery scores. Such imaging biomarkers would not only help better identify the highest performing surgeons, but could also improve residency programs by providing more objective, evidence-based feedback and developmental milestones for those in training and perhaps act as a marker of surgical potential in medical students. Despite the potential advantages of using neural imaging in the assessment of surgical expertise, this field of research remains in its infancy. This systematic review identifies studies that have applied neuromonitoring in assessing surgical skill across levels of expertise. The goals of this review are to identify the strongest neural indicators of surgical expertise, the limitations of the current literature on this subject, the most sensible future directions for further study. We found substantial evidence that surgical expertise can be delineated by differential activation and connectivity in the prefrontal cortex across multiple task and neuroimaging modalities. Specifically, novices tend to have greater PFC activation than experts under standard conditions in bimanual and decision-making tasks. However, under high temporal demand tasks, experts had increased PFC activation whereas novices had decreased PFC activation. Common limitations uncovered in this review were that task difficulty was often insufficient to delineate between residents and attending. Moreover, attending level involvement was also low in multiple studies which may also have contributed to this issue. Most studies did not analyze the ability of their neuromonitoring findings to accurately classify subjects by level of expertise. Finally, the predominance of fNIRS as the neuromonitoring modality limits our ability to uncover the neural correlates of surgical expertise in non-cortical brain regions. Future studies should first strive to address these limitations. In the longer term, longitudinal within-subjects design over the course of a residency or even a career will also advance the field. Although logistically arduous, such studies would likely be most beneficial in demonstrating effects of increasing surgical expertise on regional brain activation and inter-region connectivity. (shrink)

This paper offers a novel argument against the phenomenal intentionality thesis (or PIT for short). The argument, which I'll call the extended mind argument against phenomenal intentionality, is centered around two claims: the first asserts that some source intentional states extend into the environment, while the second maintains that no conscious states extend into the environment. If these two claims are correct, then PIT is false, for PIT implies that the extension of source intentionality is predicated upon the extension of (...) phenomenal consciousness. The argument is important because it undermines an increasingly prominent account of the nature of intentionality. PIT has entered the philosophical mainstream and is now a serious contender to naturalistic views of intentionality like the tracking theory and the functional role theory (Loar 1987, 2003; Searle 1990; Strawson 1994; Horgan and Tienson 2002; Pitt 2004; Farkas 2008; Kriegel 2013; Montague 2016; Bordini 2017; Forrest 2017; Mendelovici 2018). The extended mind argument against PIT challenges the popular sentiment that consciousness grounds intentionality. (shrink)

Many in the Christian tradition affirm two things: (1) that Jesus Christ descended to Hades/Limbus Patrum on Holy Saturday and (2) that the human nature of Jesus is a hylemorphic compound, the unity of a human soul and prime matter. I argue that (1) and (2) are incompatible; for the name ‘Jesus’, ‘Christ’, and ‘Jesus Christ’ rigidly designates a human being. But, given a certain view of hylemorphism, the human being, Jesus, ceased to exist in the time between his death (...) and resurrection. So, Jesus did not descend to Hades/Limbus Patrum, even if God the Son did. (shrink)

Conventional accounts of liberal democracy tend to obscure a basic fact: the phenomenon of administration. The American reception of the administrative state was self-consciously imitative of Continental models of state bureaucracy, as a remedy for the ills of democratic politics, but construed as a means of saving democracy from itself, and from lawyers and legalism, in the name of efficiency. The means was discretionary power, unaccountable to the courts and to voters. Reconciling this to democracy proved a challenge, and continues (...) to be one. (shrink)

Freud was a major cultural and intellectual influence in the twentieth century, whose significance waned. Kaye’s exposition argues that part of the reason is that his presentation of himself as a medical scientist obscured his true interest in society and thus the social theory that informed his commentary on culture. In support of this argument he reconstructs the social theory. The reconstruction exhibits some familiar problems: the question of how deep motivations relating to the parricide hypothesis are transmitted over millennia, (...) the plausibility of the family drama itself, the question of the cultural origins of Freud’s own perspective, and the plausibility and historical specificity of his cultural diagnosis. The paper comments on some of the prehistory of these problems to contextualize Freud, and to discuss the problem of resonance: the dependence of acceptance of his arguments on seeing the mechanisms in oneself. (shrink)

The phenomenon of sacrifice was a major problem in nineteenth-century social thought about religion for a variety of reasons. These surfaced in a spectacular way in a German trial in which the most prominent Jewish philosopher of the century, the neo-Kantian Hermann Cohen, was asked to be an expert witness. The text he produced on the nature of Judaism was widely circulated and influential. It presents what can be taken as the neo-Kantian approach to understanding ritual. But it also reveals (...) the ways in which neo-Kantianism avoided becoming relativistic social science. In this case, it came to the edge and stopped. Cohen's account is compared to the similar, but ‘empirical’, account of the same material in Marcel Mauss and Henri Hubert, which completed the transition. (shrink)

Cognition, and mental processes, played an important role in early social theory, especially in the thought of Comte and Spencer, but a gradually reduced role in the “classics,” and a minimal role in what became the “Standard Social Science Model.” This is now changing, so this history has become quite relevant. Comte is known for his interest in phrenology, but this interest took the form of a critique of phrenology as well as of the faculty psychology of the time. This (...) critique pointed toward a modern view of cognition. Herbert Spencer, whose reputation in cognitive science is deservedly high, provided a fully developed account of basic cognition that pointed to key issues of societal explanation that preserved individualism, supporting a view of society as a spontaneous order, and also qualified his view of the social organism. Despite his great influence, this development was largely cut off when social scientists absorbed and transformed neo-Kantianism and combined it with Völkerpsychologie into a model of culture that transferred cognitive issues to the collective level. The later social psychological use of “attitude” as a surrogate for cognitive processes also blocked a cognitively based account of society, as proposed by sociologists like Charles Ellwood. (shrink)

A number of thinkers suggest that, given certain conditions, it’s possible that any concrete human nature could have been united hypostatically to the second Person of the Trinity. Oliver Crisp argues that a potency to have been possibly hypostatically united to the Logos is an important part of what it means for a human person to be made in the image of God. Against this line of reasoning, and building on an argument in print by Andrew Jaeger, I argue two (...) things: first, that many metaphysics of human persons on offer fail to allow the Logos possibly to unite hypostatically to just any concrete human nature. And this is because, given the necessity of identity, every metaphysics that deploys an identity relation between a human person and her human nature or some essential component of her human nature fails to allow concrete human natures to be identical to any other person than they in fact are or else to lack some essential component that is identical to any other person than it in fact is. And, in the Incarnation, the Logos does not unite with a person. Second, supposing the preceding line of reasoning goes through, I argue that Oliver Crisp’s thesis about the imago Dei is mistaken, provided that it relies on a metaphysics of human persons that deploys an identity relation between a person and her concrete human nature or else some essential component of her concrete human nature. (shrink)

DOES A STANDARD OF DESERT BELONG IN CHRISTIAN CONCEPTIONS OF distributive justice? This essay places John Calvin and John Rawls, two of desert's most incisive critics, in conversation to examine the theological and philosophical issues raised by this question. Calvin and Rawls make similar arguments against deservingness as a moral principle, but Calvin emerges as the more adamant detractor, noting that God's grace and humanity's corrupt nature make the validity of positive human desert claims virtually unthinkable. Still, the moral force (...) of desert invites a reevaluation of both Calvin's and Rawls's objections and the fittingness of this principle to theological conceptions of distributive justice. (shrink)

Philosopher Jean-Paul Sartre counted among his friends and associates some of the most esteemed intellectuals, writers, and artists of the twentieth century. In _Portraits_, Sartre collected his impressions and accounts of many of his notable acquaintances, in addition to some of his most important writings on art and literature during the early 1950s. _Portraits_ includes Sartre’s preface to Nathalie Sarraute’s _Portrait of a Man Unknown_ and his homages to André Gide, Albert Camus, and Maurice Merleau-Ponty. The essay on Merleau-Ponty casts (...) considerable light on the recent history of French philosophy, particularly with regard to dominant post-war political conceptions. Featured as well are lengthy studies of Sartre’s close friend Paul Nizan and of the young André Gorz that are no less revealing, as well as Sartre’s “Reply to Albert Camus,” which sealed the ideological and personal break between the two writers on its publication in 1952. Alongside these major writings are fascinating articles on Tintoretto and a number of contemporary artists, including Giacometti and Masson. Finally, _Portraits _concludes with two travelogue-style accounts of Sartre’s time in Italy. This new translation by Chris Turner presents these essays in their complete form as originally intended by Sartre when he first published _Situations IV_ in France and is thus essential reading for anyone interested in the artistic and intellectual history of the time. (shrink)

The N‐terminal domain of histone H4 has been implicated in various nuclear functions, including gene silencing and activation and replication‐linked chromatin assembly. Many of these have been identified by using H4 mutants in the yeast S. cerevisiae. In a recent paper, Megee et al.(1) use this approach to show that mutants in which all four N‐terminal H4 lysines are substituted with glutamines accumulate increased levels of DNA damage. A single lysine, but not an arginine, anywhere in the N‐terminal domain suppresses (...) this phenotype. It is suggested that histone H4 plays a role in maintaining genome integrity through the cell cycle, possibly by a mechanism involving lysine acetylation. (shrink)

The Lacanian concept of fantasy is an essential locus for the conception of subjectivity and reality in the work of Slavoj Žižek, particularly in his initial English texts from 1989–2002. Whilst looked at creatively in its various guises and extended beyond clinical applications in his vast oeuvre – e.g. toward the exploration of the social, in terms of ideological fantasy foremost, to fuller elaborations in The Plague of Fantasies and beyond – the conceptual heritage is in need of fleshing out (...) within contemporary scholarship. To this end, and as part of a larger project currently underway, in the following we will trace the somewhat staggered development of the concept of fantasy in Lacan's initial meetings held at le Centre hospitalier Sainte-Anne between 1953 and 1961 where 'fantasy' as subjective component was truly born. Ultimately, the understanding of this trajectory and the changing significations involved in conceptual evolution can broaden our insight into Lacan's theoretical methodology as well as their insistence on retaining the category of subject in the philosophical tradition. (shrink)

In his “Plantinga on Exclusivisim,” Richard Feldman argues that Alvin Plantinga, in an earlier paper, has not sufficiently addressed a particular problem for the religious exclusivist. The particular problem that Feldman thinks Plantinga has failed sufficiently to address is the problem of epistemic peer disagreement—that is, disagreement between two (or more) equally competent thinkers who share equally good reasons for, and are in equally good epistemic situations regarding, their contradictory beliefs—in matters of religious belief. To demonstrate that Plantinga has so (...) failed, Feldman introduces a principle, “B”, that purports to show that exclusivism (religious or not) tends to lead to unjustified beliefs. But I think that Feldman has failed successfully to show that B demonstrates exclusivism’s tendency to lead to unjustified beliefs; so, in the paper, I defend Plantinga, and the exclusivist more generally, from Feldman’s criticisms. (shrink)

Daniel Steel addresses one of the most serious objections against the precautionary principle. According to the dilemma objection, strong versions of the PP are incoherent or self-defeating, w...

Philosophical Perspectives: Philosophy of Language brings together state of the art essays to address the key issues at the heart of the philosophy of language, written by some of the top minds in the field.