Background: Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives (to implement research protocols and advance science), setting (research facilities), and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether (...) research nurses experience unique ethical challenges distinct from those experienced by nurses in traditional patient-care settings. Research objectives: The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice. Research design: The study utilized a qualitative descriptive design with individual interviews. Participants and research context: Participating nurses (N = 12) self-identified as having experienced ethical challenges during screening. The majority were Caucasian (90%), female (83%), and worked in outpatient settings (67%). Approximately 50% had > 10 years of research experience. Ethical considerations: The human subjects review board approved the study. Written informed consent was obtained. Findings: Predominant themes were revealed: (1) the inability to provide a probable good, or/do no harm, and (2) dual obligations (identity as a nurse vs a research nurse). The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship. Discussion: Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science. Conclusion: Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

This study highlights an innovative educational project entitled ‘Dynamic Teaching through Communication Skills’ as well as forming part of joint initiative for Erasmus + Communities and Students Together (CaST) 2019-1-UK01-KA203-061463. The pilot study shows that there are many ways to approach teaching across the disciplines with Engaged Learning. The proposal includes discussions on the practical methodologyof integrated content and language in higher education. While bringing real worldproblem solving into the Health Engineering degree, the chapter underscores aspects of persuasion and pitch (...) development within the paradigm of English as a LinguaFranca. (shrink)

Digital communication between a patient and their clinician offers the potential for improved patient care, particularly for young people with long term conditions who are at risk of service disengagement. However, its use raises a number of ethical questions which have not been explored in empirical studies. The objective of this study was to examine, from the patient and clinician perspective, the ethical implications of the use of digital clinical communication in the context of young people living with long-term conditions. (...) A total of 129 semi-structured interviews, 59 with young people and 70 with healthcare professionals, from 20 United Kingdom -based specialist clinics were conducted as part of the LYNC study. Transcripts from five sites were read by a core team to identify explicit and implicit ethical issues and develop descriptive ethical codes. Our subsequent thematic analysis was developed iteratively with reference to professional and ethical norms. Clinician participants saw digital clinical communication as potentially increasing patient empowerment and autonomy; improving trust between patient and healthcare professional; and reducing harm because of rapid access to clinical advice. However, they also described ethical challenges, including: difficulty with defining and maintaining boundaries of confidentiality; uncertainty regarding the level of consent required; and blurring of the limits of a clinician’s duty of care when unlimited access is possible. Paradoxically, the use of digital clinical communication can create dependence rather than promote autonomy in some patients. Patient participants varied in their understanding of, and concern about, confidentiality in the context of digital communication. An overarching theme emerging from the data was a shifting of the boundaries of the patient-clinician relationship and the professional duty of care in the context of use of clinical digital communication. The ethical implications of clinical digital communication are complex and go beyond concerns about confidentiality and consent. Any development of this form of communication should consider its impact on the patient-clinician-relationship, and include appropriate safeguards to ensure that professional ethical obligations are adhered to. (shrink)

This anthology of articles provides contemporary international feminist perspectives on issues of identity, agency, and difference as they pertain to both feminist politics in particular, and contemporary western politics more generally.

Since the 1980s, there has been an increasing acknowledgement of the importance of recognising the ethical dimension of clinical decision-making. Medical professional regulatory authorities in some countries now include ethical knowledge and practice in their required competencies for undergraduate and post graduate medical training. Educational interventions and clinical ethics support services have been developed to support and improve ethical decision making in clinical practice, but research evaluating the effectiveness of these interventions has been limited. We undertook a systematic review of (...) the published literature on measures or models of evaluation used to assess the impact of interventions to improve ethical decision making in clinical care. We identified a range of measures to evaluate educational interventions, and one tool used to evaluate a clinical ethics support intervention. Most measures did not evaluate the key impact of interest, that is the quality of ethical decision making in real-world clinical practice. We describe the results of our review and reflect on the challenges of assessing ethical decision making in clinical practice that face both developers of educational and support interventions and the regulatory organisations that set and assess competency standards. (shrink)

In the UK, the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is a widely used process, designed to facilitate shared decision-making between a clinician and a patient or, if the patient lacks capacity to participate in the conversation, a person close to the patient. A key outcome of the ReSPECT process is a set of recommendations, recorded on the patient-held ReSPECT form, that reflect the conversation. In an emergency, these recommendations are intended to inform clinical decision-making, and thereby (...) enable the attending clinician—usually a general practitioner (GP) or paramedic—to act in the patient’s best interests. This study is the first to explore the extent to which ReSPECT recommendations realise their goal of informing best interests decision-making in community contexts. Using a modified framework analysis approach, we triangulate interviews with patients and their relatives, GPs and nurses and care home staff. Our findings show that inconsistent practices around recording patient wishes, diverging interpretations of the meaning and authority of recommendations and different situational contexts may affect the interpretation and enactment of ReSPECT recommendations. Enacting ReSPECT recommendations in an emergency can be fraught with complexity, particularly when attending clinicians need to interpret recommendations that did not anticipate the current emergency. This may lead to decision-making that compromises the patient’s best interests. We suggest that recording patients’ values and preferences in greater detail on ReSPECT forms may help overcome this challenge, in providing attending clinicians with richer contextual information through which to interpret treatment recommendations. (shrink)

ABSTRACT:This article outlines the policy context for teachers’ learning and continuing professional development in Scotland and considers this in relation to the perspectives of key informants gained through interview. The analysis draws on a triple-lens conceptual framework and points to some interesting contradictions between the policy text and the expressed aspirations of the interviewees. Current policy and the associated structural arrangements are viewed as broadly positive, but interviewees express concerns that an unintended emphasis on contractual arrangements might inhibit the more (...) transformative elements of professional learning. (shrink)

The aim of this paper is to bring recent work on metaphysical grounding to bear on the phenomenon of social construction. It is argued that grounding can be used to analyze social construction and that the grounding framework is helpful for articulating various claims and commitments of social constructionists, especially about social identities, e.g., gender and race. The paper also responds to a number of objections that have been leveled against the application of grounding to social construction from Elizabeth Barnes, (...) Mari Mikkola, and Jessica Wilson. (shrink)

This is a review of Marie-Eve Morin's translation of Jean-Luc Nancy's "Ego Sum.".

R. Marie Griffith and Sarah Coakley suggest that feminist ecumenism across the evangelical-liberal spectrum is valuable for feminist studies of religion and theologies. In this context, I trace the conversation that has arisen around the idea of adopting ‘submission’ vis-à-vis the Christian notion of kenosis, and turn it in a new direction. I argue that Coakley’s apophatically cruciform understanding of submission in contemplative prayer contrasts with womanist approaches like that of Delores Williams. Drawing on Williams’ considerations of atonement and Friedrich (...) Schleiermacher’s understanding of prayer, I offer ‘incarnational submission’ as a way to acknowledge the value of prayerful submission while avoiding its potentially oppressive features. (shrink)

Developing and implementing artificial intelligence (AI) systems in an ethical manner faces several challenges specific to the kind of technology at hand, including ensuring that decision-making systems making use of machine learning are just, fair, and intelligible, and are aligned with our human values. Given that values vary across cultures, an additional ethical challenge is to ensure that these AI systems are not developed according to some unquestioned but questionable assumption of universal norms but are in fact compatible with the (...) societies in which they operate. This is particularly pertinent for AI research and implementation across Africa, a ground where AI systems are and will be used but also a place with a history of imposition of outside values. In this paper, we thus critically examine one proposal for ensuring that decision-making systems are just, fair, and intelligible—that we adopt a principle of explicability to generate specific recommendations—to assess whether the principle should be adopted in an African research context. We argue that a principle of explicability not only can contribute to responsible and thoughtful development of AI that is sensitive to African interests and values, but can also advance tackling some of the computational challenges in machine learning research. In this way, the motivation for ensuring that a machine learning-based system is just, fair, and intelligible is not only to meet ethical requirements, but also to make effective progress in the field itself. (shrink)

Mary Kalantzis was from 2006 to 2016 Dean of the College of Education at the University of Illinois, Urbana-Champaign. Bill Cope is a Professor in the College of Education at the University of Illinois, Urbana-Champaign. They are co-authors of multiple books including Making Sense: Reference, Agency, and Structure in a Grammar of Multimodal Meaning (Cambridge, forthcoming), New Learning: Elements of a Science of Education (Cambridge, 2008, 2012), Literacies (Cambridge 2012, 2016) and e-Learning Ecologies (2017).

Here is Lukcs among his friends, lovers, and peers in those important years before 1918, when he converted to Communism and Marxism at the age of thirty-nine.

_Jung and the Human Psyche: An Understandable Introduction_ presents a comprehensive introduction to Jungian theory, taking the reader through the major themes of Jung's work in a clear way, relating such concepts to individual experience. Drawing on her extensive experience in practicing and teaching Jungian psychology, Mary Ann Mattoon succeeds in making the fundamental insights of Jung's work accessible. The major topics of Jungian psychology are presented in a manner that is clear, emotionally engaging, well illustrated and non-dogmatic. Areas (...) covered include: The visible psyche: ego, persona, typology. The hidden psyche: self, shadow, unconscious, archetypes, instincts. Becoming who we are: early development, gender. Obstacles and helps to growth: complexes, projection, psychopathology. Helps from the psyche: psychic energy, self-regulation/compensation, symbol, synchronicity, creativity. _Jung and the Human Psyche_ provides an original and imaginative introduction to Jung's work, and will appeal to students of Jungian psychology, those considering training in Jungian analysis, and anyone interested in Jungian psychology. (shrink)

This book provides a comprehensive insight into the ways in which psychoanalysts think and work. Mary Brownescombe Heller and Sheena Pollet bring together internationally known contributors trained at the Institute of Psychoanalysis to explore the broad range of clinical work, thinking, and teaching undertaken with children, families, adults and staff by psychoanalysts in the UK public health sector. Divided into four sections, _The Work of Psychoanalysts in the Public Health Sector_ covers: clinical work with parents and young children clinical (...) work with adults and their families analytic thinking in health service practice analytic support for health service staff. Experienced psychoanalysts discuss work with various client groups including parents with babies, children, adolescents who self harm, and adults with serious mental health conditions and psychosis. The book also explores how psychoanalytically-informed work can be used alongside other treatment methods, and how health service staff can best be trained and supported. _The Work of Psychoanalysts in the Public Health Sector_ offers the reader a broad perspective and a clear understanding of the various analytical concepts used in clinical practice. It will be invaluable reading for anyone interested in, or already using psychoanalytic ideas and techniques in the health sector, as well as students in training. (shrink)

When I first became acquainted with the thought of the American philoso pher Josiah Royce, two factors particularly intrigued me. The first was Royce's claim that the notion of community was his main metaphysical tenet; the second was his close association with the two American pragmatists, Charles Sanders Peirce and William James. Regarding the first factor, I was struck by the fact that a philosopher who died in 1916 should emphasize a topic of such contemporary significance not only in philosophy (...) but in so many other vital fields as well (sociology, psychology, politics, theology - to name only a few). Regarding the second, I was curious as to whether the pragmatism of Peirce and James might have influenced Royce during the course of their professional and personal contacts. Similarly, I wondered whether the idealism of Royce might have affected the thought of Peirce and James. To have appeased my curiosity in regard to all three thinkers, however, would have required (at least) three books. As a start I have now appeased it in regard to one. In researching the writings of Royce I found my way to the Houghton Library and to the Archives of Harvard University at Cambridge, Massa chusetts, where the unpublished manuscripts of Royce are preserved. (No editing job has yet been done on this bulk of material, though such would certainly be a welcome contribution to American philosophy. (shrink)

Retaliation against whistleblowers is a well-recognized problem, yet there is little explanation for why uninvolved peers choose to retaliate through ostracism. We conduct two experiments in which participants take the role of a peer third-party observer of theft and subsequent whistleblowing. We manipulate injunctive norms and descriptive norms. Both experiments support the core of our theoretical model, based on social intuitionist theory, such that moral judgments of the acts of wrongdoing and whistleblowing influence the perceived likeability of each actor and (...) ultimately influence intention to ostracize each actor and indicate more willingness to ostracize the whistleblower than the wrongdoer. When we vary norms for the wrongdoing in Experiment 1, we find that descriptive and injunctive norms indirectly influence intentions to ostracize both the wrongdoer and whistleblower. These relationships are serially mediated by the observers’ moral judgments of the act and likeability of the actor. When we vary norms for whistleblowing in Experiment 2, the injunctive norm manipulation affected moral judgment of the action of whistleblowing, and we do not observe any other significant effects of the norm manipulations on moral judgments of the actions of wrongdoing or whistleblowing. (shrink)

M. M. McCabe presents a selection of her essays which explore the Platonic method of conversation: how it may inform our understanding both of Plato and of his predecessors and successors, and how its centrality accounts for the connections between argument, knowledge, and virtue in the texts McCabe examines.

Several decision rules, including the minimax regret rule, have been posited to suggest optimizing strategies for an individual when neither objective nor subjective probabilities can be associated to the various states of the world. These all share the shortcoming of focusing only on extreme outcomes. This paper suggests an alternative approach of ‘tempered regrets’ which may more closely replicate the decision process of individuals in those situations in which avoiding the worst outcome tempers the loss from not achieving the best (...) outcome. The assumption of total ignorance of the probabilities associated with the various states is maintained. Applications and illustrations from standard neoclassical theory are discussed. (shrink)

This set reprints a wide range of key articles exploring the role of feminists in the development of post-Enlightenment thought. Including groundbreaking work from the 1970s, 1980s and 1990s, with pieces by Sandra Harding, Julia Kristeva, Gayatri Chakravorty Spivak, Elizabeth Spelman, and other internationally-esteemed scholars, the collection features an original introduction and comprehensive index, making this an invaluable resource for women's studies students in a wide range of subject areas. For a full listing of contents, visit www.routledge-ny.com and type the (...) isbn into the search engine. (shrink)

Paper edition (0768-3), $14.95. Annotation copyrighted by Book News, Inc., Portland, OR.

In the Philippines, all transplant centers are mandated by the Department of Health (DOH) to have a Hospital Transplant Ethics Committee (HTEC) to ensure that donations are altruistic, voluntary and free of coercion/commercial transactions. This study was undertaken primarily to describe the organizational and functional profile of existing HTECs and identify areas for improvement. This is a descriptive cross‐sectional study. There was variation in their logistical arrangements (support from hospital, filing systems, office spaces), operations (length and frequency of meetings, number (...) of referrals) and membership (composition, qualifications, occupation, training). The approval rate for donor‐recipient pairs is high with the majority of cases made by living non‐related donors. Appropriate reasons were cited for rejection. The perception of HTECs is that they are competent and confident in their decision‐making. However, there is a need to standardize HTEC composition, provide operating procedures and additional training which can be done by the DOH. (shrink)

ch. 1. Conscience--the subjective norm of morality -- ch. 2. Conscience and law -- ch. 3. Relationship between conscience and law -- ch. 4. Holy Scipture on the nature of conscience -- ch. 5. Freedom and commitment of conscience -- ch. 6. The African and conscience with particular reference to the Igbos of Nigeria -- ch. 7. Igbo moral conscience in the light of cross-cultural education: Western civilisation and christianity.