Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (shrink)

A high percent of oxidative energy metabolism is needed to support brain growth during infancy. Unhealthy diets and limited nutrition, as well as other environmental insults, can compromise these essential developmental processes. In particular, iron deficiency anemia has been found to undermine both normal brain growth and neurobehavioral development. Even moderate ID may affect neural maturation because when iron is limited, it is prioritized first to red blood cells over the brain. A primate model was used to investigate the neural (...) effects of a transient ID and if deficits would persist after iron treatment. The large size and postnatal growth of the monkey brain makes the findings relevant to the metabolic and iron needs of human infants, and initiating treatment upon diagnosis of anemia reflects clinical practice. Specifically, this analysis determined whether brain maturation would still be compromised at 1 year of age if an anemic infant was treated promptly once diagnosed. The hematology and iron status of 41 infant rhesus monkeys was screened at 2-month intervals. Fifteen became ID; 12 met clinical criteria for anemia and were administered iron dextran and B vitamins for 1–2 months. MRI scans were acquired at 1 year. The volumetric and diffusion tensor imaging measures from the ID infants were compared with monkeys who remained continuously iron sufficient. A prior history of ID was associated with smaller total brain volumes, driven primarily by significantly less total gray matter and smaller GM volumes in several cortical regions. At the macrostructual level, the effect on white matter volumes was not as overt. However, DTI analyses of WM microstructure indicated two later-maturating anterior tracts were negatively affected. The findings reaffirm the importance of iron for normal brain development. Given that brain differences were still evident even after iron treatment and following recovery of iron-dependent hematological indices, the results highlight the importance of early detection and preemptive supplementation to limit the neural consequences of ID. (shrink)

Introduction: the Study of Argumentation Although our overall organization of the readings suggests one way of dividing our selected literature, ...

The Drosophila salivary gland has emerged as an outstanding model system for the process of organ formation. Many of the component steps, from initial regional specification through cell specialization and morphogenesis, are known and many of the genes required for these different processes have been identified. The salivary gland is a relatively simple organ; the entire gland comprises of only two major cell types, which derive from a single contiguous primordium. Salivary cells cease dividing once they are specified, and organ (...) growth is achieved simply by an increase in size of individual cells, thus eliminating concerns about the potential unequal distribution of determinants during mitosis. Drosophila salivary glands form by the same cellular mechanisms as organs in higher organisms, including regulated cell shape changes, cell intercalation and directed cell migration. Thus, learning how these events are coordinated for tissue morphogenesis in an organism for which the genetic and molecular tools are unsurpassed should provide excellent paradigms for dissecting related processes in the more intricate organs of more complicated species. BioEssays 23:901–911, 2001. © 2001 John Wiley & Sons, Inc. (shrink)

In 2018-2019, at the Keck School of Medicine of the University of Southern California, we developed and piloted a narrative-based health systems science intervention for patients living with HIV and medical students in which medical students co-wrote patients’ life narratives for inclusion in the electronic health record. The pilot study aimed to assess the acceptability of the “life narrative protocol” from multiple stakeholder positions and characterize participants’ experiences of the clinical and pedagogical implications of the LNP. Students were recruited from (...) KSOM. Patients and staff were recruited from the Maternal, Child, and Adolescent/Adult Center for Infectious Disease and Virology at Los Angeles County+USC Medical Center. Ten patients, seventeen students, and ten MCA staff participated in the pilot study. Qualitative methods were used to gather data from students’, patients’, and staff’s perspectives. Three themes emerged from the thematic analysis: patients’ life narratives conveyed their unique life experiences and voices; the protocol could result in wide-ranging effects on HIV care; the LNP enabled students to contribute value to patients’ healthcare. Across groups, participants considered the LNP an acceptable intervention. The LNP, its limitations, and implications for HIV care, narrative medicine, and health information technology are presented. (shrink)

This book examines influential conceptions of sport and then analyses the interplay of challenging borderline cases with the standard definitions of sport. It is meant to inspire more thought and debate on just what sport is, how it relates to other activities and human endeavors, and what we can learn about ourselves by studying sport.

We defend the view of some feminist writers that the notion of silencing has to be taken seriously in discussions of free speech. We assume that what ought to be meant by ‘speech’, in the context ‘free speech’, is whatever it is that a correct justification of the right to free speech justifies one in protecting. And we argue that what one ought to mean includes illocution, in the sense of J.L. Austin.

"Remarkable how well Bouwsma understood Wittgenstein's approach to philosophical problems and how intelligently he was able to recount Wittgenstein's discussions. The bits about sensation are especially good. And the asides about the other philosophers--e.g. Dewey, Russell, Anscombe--are, while not frivolous, gossipy and titillating." --Riley Wallihan, Western Oregon University.

Motivated by an old construction due to J. Kalman that relates distributive lattices and centered Kleene algebras we define the functor K • relating integral residuated lattices with 0 with certain involutive residuated lattices. Our work is also based on the results obtained by Cignoli about an adjunction between Heyting and Nelson algebras, which is an enrichment of the basic adjunction between lattices and Kleene algebras. The lifting of the functor to the category of residuated lattices leads us to study (...) other adjunctions and equivalences. For example, we treat the functor C whose domain is cuRL, the category of involutive residuated lattices M whose unit is fixed by the involution and has a Boolean complement c. If we restrict to the full subcategory NRL of cuRL of those objects that have a nilpotent c, then C is an equivalence. In fact, C M is isomorphic to C e M, and C e is adjoint to, where assigns to an object A of IRL0 the product A × A 0 which is an object of NRL. (shrink)

Offered here is Part 2 of a two-part critical survey of recent work in philosophy on divine hiddenness. Part 1 surveyed recent development of the discussion initiated by my 1993 book on the subject. Here, I examine some related work that expands the scope of the hiddenness discussion. Some of the enlargements take further the discussion of Stephen Maitzen's work on the demographics of theism. Others introduce new hiddenness problems and ways of dealing with them. A third category of new (...) work urges theological constraints, of one sort or another, on hiddenness reasoning, thus raising new methodological issues. (shrink)

Si le christianisme a survécu en Grande Syrie, c'est en raison de facteurs spécifiques: l'intégrité de la communauté chrétienne arabe indigène dans la région; l'intégration sociale des chrétiens arabes syriens dans la société musulmane; l'échec des musulmans dans le prosélytisme agressif auprès des chrétiens; l'identification ethnique de la population indigène avec les nouvelles arrivées du VIIe siècle. L'arabisation ne signifiait pas systématiquement l'islamisation. Elle encourageait même le contraire dans certaines régions comme la Palestine, coeur d'une Eglise chrétienne arabophone viable.

Prof. Alberto Urquidez, in an important recent article that appears in different form in his book, Redefining Racism, offers an informed, sustained, careful, multi-pronged, and sometimes original critique of the volitional analysis of racism, which I have proposed in a series of articles over the past two dozen years. Here I expand and improve VAR’s analysis of paternalistic racists and their beliefs, clarify its ‘infection’-model’s explanation of racism’s spread and variety, and lay out what it is for something to be (...) ‘characteristically’ racist, an understanding that I then use to offer a unified account of the way in which both certain physical objects and certain abstract objects can properly be called racist. Identifying and engaging some presuppositions behind Urquidez’s social, political, and moral criticisms of VAR, I respond to complaints from him and others, showing that VAR’s content is neither politically conservative nor dependent on religious doctrine, and point out that race theory would in fact profit from taking more seriously and internalizing the Christian morality of most African-Americans. (shrink)

The definition of acedia presents unique conceptual problems among the eight Evagrian logismoi. Its descriptions are so complex and varied as to render the concept seemingly incoherent. This article argues that the conceptual unity of acedia has been obscured by the translation of Evagrian logismoi into the ‘deadly sins’ tradition, resulting in a category error. Acedia is more properly understood, not as a psychological state or a sin, but rather as an array of demonic temptations with the unifying end-goal of (...) interrupting the anchoritic ideal of sustained contemplation. (shrink)

‘Agathon and Eudaimonia in the Ethics of Aristotle’ is a response to an article on the meaning of Agathon in the Ethics of Aristotle, published by H. A. Pritchard in 1935. In this paper, Pritchard argued that Aristotle regarded Agathon to mean ‘conducive to our happiness’ and, consequently, that he maintained that every deliberate action stems, ultimately, from the desire to become happy. Austin finds fault with this view: first, Agathon in Aristotle does not have a single meaning, and a (...) fortiori not the one Pritchard suggested; secondly, if one had to summarise the meaning of ‘being agathon’ in one phrase, then ‘being desired’ cannot fulfil this function, for there are other objects of desire besides τό άγαθόν. (shrink)

This is an invited response to Peter Forrest’s review of my trilogy on the philosophy of religion, which appeared in a previous issue of this journal.

In this paper we construct the ortholattices arising in quantum logic starting from the phenomenologically plausible idea of a collection of ensembles subject to passing or failing various “tests.” A collection of ensembles forms a certain kind of preordered set with extra structure called anorthospace; we show that complete ortholattices arise as canonical completions of orthospaces in much the same way as arbitrary complete lattices arise as canonical completions of partially ordered sets. We also show that the canonical completion of (...) an orthospace of ensembles is naturally identifiable as the complete lattice of properties of the ensembles, thereby revealing exactlywhy ortholattices arise in the analysis of “tests” or experimental propositions. Finally, we axiomatize the hitherto implicit concept of “test” and show how they may be correlated with properties of ensembles. (shrink)