Transferring critical thinking skills and dispositions from the classroom to our relationships is fraught with peril. The constructive infusion of criticality into interpersonal relationships, however, can greatlyenrich such relationships. An important question is how best to accomplish this enrichment process. In response to that question, we suggest the following strategies to facilitate the process of criticality in a relationship: (1) recognize potential argument frames and explore and negotiate these within the context of our relationships; (2) recognize one’s own and the (...) other’s complex context, especially deep-seatedvalues, attitudes, and commitments; (3) frame caring as including both support and criticality and avoid treating others as “spun glass,” too fragile to partake of critical thinking exchanges; (4) apply active listening skills during critical thinking discussions. These strategies can help transform potentially adversarial interactions into positive growth experiences for all concerned. (shrink)

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 article draws on ethnographic field data collected during an investigation of the informed consent process and AIDS clinical trials. It describes the involvement of care providers (physicians, nurse practitioners, physician assistants) during the enlistment, or recruitment, phase of the informed consent process. It shows that sometimes care providers are involved in the receipt, evaluation and distribution of information on clinical trials through their interactions with research professionals and patients. It suggests that the involvement of care providers has the potential (...) to influence the informed consent process. Some of the ethical and practice considerations of this are discussed. (shrink)

This paper reviews the characteristics of anorexia nervosa described in the DSM-III-R , relates them to normative gender roles and adolescent development, and critiques those roles on feminist grounds. Two apparently contradictory explanations for the irrational pursuit of thinness are considered: a) the anorexic thus attempts to conform to a socially defined feminine ideal; b) the anorexic thus attempts to avoid the appearance and consequences of mature womanhood. I propose that both explanations are applicable, together emplifying the ambiguity that Simone (...) de Beauvoir considers characteristic of female experience. Because both explanations suggest a gender identity disorder, I question the fact that the DSM-III-R fails to indicate this linkage. I argue further that therapeutic considerations require efforts to alter the socialization factors that are implicative in anorexia nervosa. Keywords: anorexia nervosa, diagnoses, feminism, philosophy of biology, psychiatry CiteULike Connotea Del.icio.us What's this? (shrink)

In A Passage to India, E.M. Forster examines the duality of three main characters, Mrs. Moore, Aziz, and Fielding and thereby demonstrates their relative stability in the primordial chaos of India. Unlike Adela who falls apart after her experience in the cave, these characters draw on the power of the imagination in a grappling struggle to remain morally centered when facing the darkness within. Forster suggests that turning to the East (where the Marabar caves represent darkness and destabilization) contrasts with (...) returning to the West (where imaginative form represents order and light). In Mrs. Moore, Aziz, and Fielding, Forster examines the manner in which one might embrace a centered life committed to empathy for others by way of facing one’s own otherness. As these characters immerse themselves in India’s primordial formlessness and acknowledge their shadows, they embrace imaginative form rather than fall apart, and in doing so they serve as models of mythmakers and relative stability. (shrink)

An exploration of the limitations of the language of "mental health" in the light of suicide epidemics at universities, and a sketch of the existentialist understanding of death as alternative.

Teenagers enjoy better physical and mental health when they avoid early sexual debut and reserve the sexual act for marriage. Teens who initiate sexual relations outside of marriage risk contracting sexually transmitted diseases, and those who also use hormonal contraception to avoid pregnancy often suffer unwanted physical and emotional side effects. Teens who have multiple partners may have later attachment or bonding difficulties. The consequences of an unintended pregnancy after a casual sexual relationship are often abortion or single motherhood and (...) an increased likelihood of poverty. Teenagers who save sexual relations for marriage experience freedom from these negative consequences and are more likely, in marriage, to experience the beauty of self-giving love. (shrink)

The prelims comprise: Introduction The Physician and the Provider Organization The Physician and the Payer Organization Dealing with Systems Conclusion Notes References.

Although some types of cognition may not affect early vision, there is ample evidence that other types of cognition do. Evidence indicating that early vision is penetrable by direct manipulation of viewers' perceptual intentions and by knowledge of the structure of familiar objects is reviewed, and related to both the Pylyshyn target article and Fodor (1983).

This paper examines contemporary developments in legal philosophy and in ethics with a view to a possibile reunification of moral philosophy on Kantian principles. With regard to legal philosophy, it notes the difficulty of an empiricist account of natural rights and relates it to the problem of obligation to apply with juridical laws. It then considers Kant's solution to problems regarding the concepts of obligation and of a right encountered by his predecessors in the natural rights tradition, whom he would (...) classify as empiricists. Turning form "The Droctrine of Right" to "The Doctrine of Virtue," it evaluates the assertion that Kant, as distinguished from "virtue ethics," has an "ethics of rules" modelled on law rather than an "ethics of character." Der Beitrag befaßt sich mit gegenwärtigen Entwicklungen im Bereich von Rechtsphilosophie und Ethik mit dem Ziel einer möglichen Wiedervereinigung der Moralphilosophie nach kantischen Prinzipien. In bezug auf die Rechtsphilosophie betont er die Schwierigkeit eines empiristischen Verständnisses von Naturrechten und bezieht diese Schwierigkeit auf das Problem der Verbindlichkeit juridischer Gesetze. Dann wird Kants Lösung der Probleme untersucht, die sich mit den Begriffen "Verbindlichkeit" und "ein Recht" für diejenigen seiner Vorgänger in der Naturrechtstradition ergeben, die Kant als Empiristen bezeichnen würde. Von der "Rechtslehre" zur "Tugendlehre" übergehend wird schließlich die Behauptung geprüft, derzufolge Kant, im Unterschied zur "Tugendethik-Lehre" , eher eine "Ethik der Regeln" vertritt, die sich auf Gesetze stützt, als eine "Ethik des Charakters". (shrink)

Human beings experience themselves through various kinds of collectively experienced time. Medicine that relies upon precarious forms of ancestral or evolutionary explanation generates such collectively experienced forms of time, which are thus essentially politico-medically instituted versions of kin relations. Kin relations structure our ethical relations to each other rather thoroughly, even in Western modernity, especially through legally sanctioned relations. Hence, an ancestral or evolutionary explanation in medicine should be examined for its ethical import via its structuring of etiologically linked kin (...) relations, even if those relations extend beyond the family, people, population or group context back into cosmic and evolutionary origins. (shrink)

Understanding the clinical significance of variants associated with hereditary cancer risk requires access to a pooled data resource or network of resources—a “cancer gene variant commons”—incorporating representative, well-characterized genetic data, metadata, and, for some purposes, pathways to case-level data. Several initiatives have invested significant resources into collecting and sharing cancer gene variant data, but further progress hinges on identifying and addressing unresolved policy issues. This commentary provides insights from a modified policy Delphi process involving experts from a range of stakeholder (...) groups involved in the data-sharing ecosystem. In particular, we describe policy issues and options generated by Delphi participants in five domains critical to the development of an effective cancer gene variant commons: incentives, financial sustainability, privacy and security, equity, and data quality. Our intention is to stimulate wider discussion and lay a foundation for further work evaluating policy options more in-depth and mapping them to those who have the power to bring about change. Addressing issues in these five domains will contribute to a cancer gene variant commons that supports better care for at-risk and affected patients, empowers patient communities, and advances research on hereditary cancers. (shrink)

The goal of this study is to discover and critically examine the major influences on the development of Joseph Fletcher's theological and philosophical ethics. Subsidiary investigation will reveal the influence of particular philosophical points of view , theological positions , and the effects of social context and other determinants on Fletcher's thought. Whether Fletcher's ethics remain dependent on social or temporal contingencies, whether they are historically contingent or of lasting practical value will be analyzed. ;This paper will take the form (...) of an intellectual biography. The first two chapters are purely biographical, sketching the social environment and formative personal relationships of Fletcher's youth and early adulthood. Three subsequent chapters chronologically critique the development of Fletcher's theology of social redemption, the personalistic and rights-based approach to an ethic of medical care espoused in Morals and Medicine, and the amalgam of presuppositions that comprises the moral framework of Situation Ethics. The primary foundations of Fletcher's basic ethical premises; control, choice, and responsibility will be analyzed in terms of their origins and place in the evolution of his ethical thought. (shrink)

This is a book about the journey of a man, Jizi, whose goal was to make contemporary what is authentically Chinese and to do it in a way that speaks to an increasingly global audience. The first ha...