Effective documentation is considered a core competency for clinical ethics consultation. Ethics consultants within the Cleveland Clinic in Cleveland, Ohio, observed variation in the formatting of ethics chart notes across consultants and realized that this formatting was based on their own views of effectiveness. To minimize variation and optimize the readability and understandability of ethics chart notes for end users, a team undertook a quality improvement project to assess the formatting preferences of healthcare professionals who rely on ethics (...) consultation notes. The team developed three sample templates and conducted interviews with stakeholders to understand their preferences. A single standardized template was developed based on the preferences that emerged, which all consultants on the ethics consultation service then utilized. In the first five months of implementation, the percentage of end user respondents marking the highest Likert scale option on a post-consultation survey regarding whether the ethics consultation service provided helpful documentation increased from 60 percent to 72 percent compared to the same five-month period in the year prior. (shrink)

Background: Despite procedural innovations and increasing numbers of uterus transplant attempts worldwide, the perspectives of uterus transplant (UTx) trial participants are lacking. Methods: We conducted a mixed-methods study with women with absolute uterine factor infertility (AUFI). Participants included women who had previously contacted the Cleveland Clinic regarding the Uterine Transplant Trial and met the initial eligibility criteria for participation. In-depth interviews were conducted in conjunction with FertiQoL, a validated and widely used tool to measure the impact of infertility on (...) the quality of life of infertility patients. Results: All (n = 19) rated their overall health as good; some experienced grief and social isolation. AUFI is a life-framing experience that influences acceptance by family, partners, peers, and one’s self. UTx is a means to gain control of reproductive autonomy. UTx allows family-building and the ability to play an active role in prenatal health and well-being. Establishing and maintaining a supportive relationship is a key issue of AUFI and when considering UTx. Risks of UTx are perceived relative to risks to self/child/family posed by adoption/surrogacy. Participants had no overall preference regarding living or deceased donor. Conclusions: The ways in which women with AUFI conceptualize this condition in their lives and choices around UTx and participating in a study of the procedure are multifaceted and textured. These perspectives are critical to understanding its ethical, legal, and social implications. (shrink)

In its treatment of the role of emotion in ethics the argument of the book outlines a new way of packing motivational force into moral meaning that allows for a ...

Despite the fact that a number of economists and philosophers of late defend insider trading both as a viable and useful practice in a free market and as not immoral, I shall question the value of insider trading both from a moral and an economic point of view. I shall argue that insider trading both in its present illegal form and as a legalized market mechanism undermines the efficient and proper functioning of a free market, thereby bringing into question its (...) own raison d'etre. It does so and is economically inefficient for the very reason that it is immoral. Thus this practice cannot be justified either from an economic or a moral point of view. Insider trading is the reverse of speculation. It is reward without risk, wealth generated — and injury done to others — by an unfair advantage in information ... [T]he core principle is clear: no one should profit from exploitation of important information not available to the public. (shrink)

There is a well-known scene from The Adventures of Tom Sawyer that illustrates what might be considered benign manipulation: Tom has the job of whitewashing a fence but would rather spend the time with friends. By feigning enthusiasm for the job he manages to get his friends to hang around and do it for him. They even pay to do it - with various little items that he later trades for..

The purpose of this article is to start a dialogue between the so-called autopoietic enactivism and the semiotic pragmatism of C. S. Peirce, in order to re-examine both action and representation under a Peircean light. The focus lays on autopoietic enactivism because this approach offers a wider theoretical scope to cognition based on the continuity of life and mind, embodiment, dynamic and non-linear interaction between a system and its environment which are compatible ideas with Peirce’s semiotic pragmatism. The term ‘pragmatic’ (...) has been introduced in cognitive science to reinforce the idea that cognition is a form of practice and to help action-oriented viewpoints to escape representationalism. In this paper, I shall try to demonstrate that Peirce’s semiotic pragmatism can be a meaningful methodological path to guide a reconciliation between not only anti-Cartesianism and representation but also representation and action. In order to accomplish this purpose, Peirce’s account to action, habit, thought and mind will be addressed through some of the guiding principles of his semiotic—sign and sign action. What follows is the re-examining of the problem of representation—as refuted by autopoietic enactivism—under the light of Peirce’s semiotic pragmatism. (shrink)

With the demise of Marxism and socialism, the United States is becoming a model not merely for free enterprise, but also for employment practices worldwide. I believe that free enterprise is the least worst economic system, given the alternatives, a position I shall assume, but not defend, here. However, I shall argue, a successful free enterprise political economy does not entail mimicking US employment practices. I find even today in 1998, as I shall outline in more detail, these practices, when (...) consistently carried out, by and large erode trust in the workplace, they are, on balance unfair to workers and managers, and, if Jeffrey Pfeffer is correct, they do not maximize long-term corporate earnings or growth. Getting clear on US employment practices and their weaknesses may help to shape other models for employment that neither contravene free enterprise nor are degrading to workers. (shrink)

What value does genomics hold for industry? Ten years after the White House Press conference where the human genome sequence was first presented, we ask in which ways and to what extent the developments in genomics have been integrated into industry. This enables us to assess whether this integration has been as successful as expected, but also which unexpected developments in genomics advances have triggered additional benefits for industry. Genomics has contributed to the beginning of a global transition to a (...) bio-based economy, but there have been and there still are hurdles to be cleared. The hurdles are not merely of a technological nature, since the objectives are a complex between economic progress, environmental and global climate concerns, and energy security. Therefore, they are at the same time technological, societal and environmental in nature. These categorisations fall short of articulating the many issues that arise, such as economic development (for emerging economies), public opinion formation and scientific and technological progress. We argue that to make this transition happen, industrialists, policy makers and the wider public have to be prepared to be more actively involved in the debate, weighing the pros and cons and taking responsibility in creating the desired sustainable world.This paper will examine the advances of genomics in the industrial context, the role of these advances in current attempts to find sustainable solutions to a variety of problems, the enthusiasm with which they have been picked up, the implications for industrial innovation and the accompanying discussion about possible consequential social and ethical issues. It will also sketch out the nature of this ongoing establishment of a bio-based economy, the parties that are currently at the negotiation table, and whether the current situation has an impact on the way societal debates emerge. (shrink)

Three studies using the Dreyfus model of skill acquisition were conducted over a period of 21 years. Nurses with a range of experience and reported skill-fulness were interviewed. Each study used nurses’ narrative accounts of actual clinical situations. A subsample of participants were observed and interviewed at work. These studies extend the understanding of the Dreyfus model to complex, underdetermined, and fast-paced practices. The skill of involvement and the development of moral agency are linked with the development of expertise, and (...) change as the practitioner becomes more skillful. Nurses who had some difficulty with understanding the ends of practice and difficulty with their skills of interpersonal and problem engagement did not progress to the level of expertise. Taken together, these studies demonstrate the usefulness of the Dreyfus model for understanding the learning needs and styles of learning at different levels of skill acquisition. (shrink)

A set of six publications have introduced, commented, criticized and defended Amir Alexander’s book on infinitesimals published in 2014. The aim of the following article is to bring the various arguments together.

Separate reviews would ordinarily be required of disparate works. Here reviewed together are works as different as the new scholarly thesis of Prakken and a historically directed anthology of papers for students of rhetoric. Their joint consideration, however, is an occasion for serious comment on how the best work in AI and Law should be placed in longstanding traditions. It is an occasion for commenting on the directions of rhetoric in the past few decades.

Innate emotional bases of ethics have been proposed by authors in evolutionary psychology, following Darwin and his sources in eighteenth-century moral philosophy. Philosophers often tend to view such theories as irrelevant to, or even as tending to undermine, the project of moral philosophy. But the importance of emotions to early moral learning gives them a role to play in determining the content of morality. I argue, first, that research on neural circuits indicates that the basic elements or components of emotions (...) need not be limited to what psychologists think of as basic emotions. But in that case, innate mechanisms of social transfer of emotion, such as infants’ tendency to facial imitation, gaze-following, and emotional contagion or empathy, provide a source of plasticity in developing the basic elements that lets emotions incorporate cultural influence from early on. This leaves room later for cognitive components of adult human emotions and hence for the further role of language in conveying cultural influence. We can thus see how moral judgment might depend on innate emotional capacities that are both modifiable by culture and capable of registering objective values. I use Rawls’s treatment of the development of moral sentiments to illustrate the kind of supportive role that emotions can play in a principle-based account – though my own account involves modifications I go on to indicate. (shrink)

On an expressivist view, ethical claims are understood as expressions of our attitudes, desires, and feelings. A famous puzzle for this view concerns the use of logic in ethical reasoning, and two standard treatments try to solve the puzzle by explaining logical inconsistency in terms of conflicting attitudes. I argue, however, that this general strategy fails: because we can reason effectively even in the presence of conflicting moral attitudes – in cases of moral dilemmas – avoiding these conflicts cannot be (...) a ground for correct moral reasoning. The result is a dilemma for expressivists: if they take all kinds of attitudes to be under consideration, then conflict cannot play the required role, since attitudes can fail to be compatible in cases of moral conflict. If they restrict attention to ‘all-in attitudes’ or to intentions or plans, then there is an important notion of obligation, used in standard arguments – one for which conflicts are allowed – that they fail to capture. I explain why expressivists should be especially tolerant of conflicting attitudes, and I conclude that they should pursue a different strategy for grounding logical normativity. (shrink)

This article focuses on the aesthetics of the psychedelic experience. Aldous Huxley’s Doors of Perception remains one of the few studies that investigates the aesthetic dimension of the psychedelic experience as profoundly meaningful as such, because it gives direct attention to the nonhuman otherness of the universe that is hard to describe in words, but that can be felt and sensed. Similarly, Deleuze and Guattari have investigated psychedelics as a perceptual, aesthetic, phenomenon. They argue that psychedelic aesthetics offers an experience (...) at the limits of perception to the point of ultimate abstraction of geometric figures and grains. Drawing upon the works of two experimental filmmakers from two different generations and backgrounds, Philippe Garrel’s enigmatic Le Révélateur ( The Revealer, 1968 ) and Morgan Quaintance’s thought-provoking Surviving You, Always (2021), the borders of the perceptual field by cinematographic means will be investigated. These works are exemplary of how the nonhuman perception of the camera, its ‘bodies without organs’, and its affective intensity evoke a psychedelic, mind-revealing, experience and an ethics of – in Deleuze’s words – ‘becoming not unworthy of the event’. (shrink)

The aim of this paper is discussion of a new middle‐range theory of patient safety goal priming via safety culture communication. Bedside nurses are key to safe care, but there is little theory about how organizations can influence nursing behavior through safety culture to improve patient safety outcomes. We theorize patient safety goal priming via safety culture communication may support organizations in this endeavor. According to this theory, hospital safety culture communication activates a previously held patient safety goal and increases (...) the perceived value of actions nurses can take to achieve that goal. Nurses subsequently prioritize and are motivated to perform tasks and risk assessment related to achieving patient safety. These efforts continue until nurses mitigate or ameliorate identified risks and hazards during the patient care encounter. Critically, this process requires nurses to have a previously held safety goal associated with a repertoire of appropriate actions. This theory suggests undergraduate educators should foster an outcomes focus emphasizing the connections between nursing interventions and safety outcomes, hospitals should strategically structure patient safety primes into communicative activities, and organizations should support professional development including new skills and the latest evidence supporting nursing practice for patient safety. (shrink)

The skin is always and already a serietl of planes which signify race, gender, age and such. Tattooing creates a new surface of potential significance upon the body. Tattooing can call into question concepts of volition in reference to the power to inscribe and define one's subjectivity through one's own skin, and the social defining of the subject. Skin is the involution or event between subject and object, will and cultural inscription, the social and the self. Feminists, particularly corporeal feminists, (...) have attempted to think ways in which the female flesh may be recognized and self-defined without risking essentialism through reification of the meaning of ‘woman's body’. Thinking a tattooed female body thus resonates with some of the risks and benefits feminism has found in theorizing a marginalized body. Using Deleuze, Guattari, Lyotard and other major influences on corporeal feminists, this article explores ways in which significance is sought in skin, and possible configurations of skin and world, which challenge the desire to read the flesh as a legible incarnation of subjectivity. (shrink)