In clinical ethics consultations, clinical ethicists bring moral reasoning to bear on concrete and complex clinical ethical problems by undertaking ethical deliberation in collaboration with others. The reasoning process involves identifying and clarifying ethical values which are at stake or contested, and guiding clinicians, and sometimes patients and families, to think through ethically justifiable and available courses of action in clinical situations. There is, however, ongoing discussion about the various methods ethicists use to do this ethical deliberation work. In this (...) paper, we make visible and accessible seven steps of facilitation used in the critical dialogue method of ethics consultation.We describe how the facilitation techniques serve two overall purposes. First, to identify ethically justified responses to ethical questions. Second, to assist participants to gain greater moral clarity, understanding and confidence to respond to ethical challenges as independent moral agents.By describing in detail facilitation steps for clinical ethics consultation, we aim to advance the scholarship of ‘clinical ethics facilitation methods’ and to demystify the ethical deliberation work undertaken by clinical ethicists. (shrink)

Background Nurses play an integral role in the care of children hospitalised with a serious illness. Although information about diagnostics, treatments, and prognosis are generally conveyed to parents and caregivers of seriously ill children by physicians, nurses spend a significant amount of time at the child’s bedside and have an acknowledged role in helping patients and families understand the information that they have been given by a doctor. Hence, the ethical role of the nurse in truth disclosure to children is (...) worth exploring. Methods A systematic academic database and grey literature search strategy was conducted using CINAHL, Medline Psych Info, and Google Scholar. Keywords used included truth, children, nurse, disclosure, serious illness, and communication. A total of 17 publications of varying types were included in the final data set. Ethical Considerations As this was a review of the literature, there were no direct human participants. Empirical studies included in the review had received ethics approval. Results Of the 17 articles included in the review, only one directly reported on the experiences of nurses asked to withhold the truth from patients. Empirical studies were limited to HIV-positive children and children diagnosed with cancer and the dying child. Conclusion A paucity of literature exploring the experiences, attitudes, and beliefs of nurses with regard to truth-telling to seriously ill children is evident. Little consideration has been given to the role nurses play in communicating medical information to children in a hospital setting. The 17 articles included in the review focused on cancer, and HIV, diagnosis, and end-of-life care. Further research should be undertaken to explore the experiences and attitudes of nurses to clinical information sharing to children hospitalised with a wide range of serious illnesses and in diverse clinical scenarios. (shrink)

A leading international expert on environmental issues, Shrader-Frechette brings a new standard of rigor to philosophical discussions of environmental justice in her latest work. Observing that environmental activists often value environmental concerns over basic human rights, she points out the importance of recognising that minority groups and the poor in general are frequently the biggest victims of environmental degradation, a phenomenon with serious social and political implications that the environmental movement has failed to adequately address. She argues for their equal (...) rights to 'environmental justice' and maintains that they should not have to bear most of the weight of the burdens of pollution and resource depletion. Advocating a greater awareness on the part of professionals in a position to help these victims, Shrader-Frechette proposes a more equitable distribution of environmental resources and, in doing so, makes an important contribution to the fields of environmental ethics and applied philosophy. (shrink)

Published in 1797, the Doctrine of Right is Kant's most significant contribution to legal and political philosophy. As the first part of the Metaphysics of Morals, it deals with the legal rights which persons have or can acquire, and aims at providing the grounding for lasting international peace through the idea of the juridical state. This commentary analyzes Kant's system of individual rights, starting from the original innate right to external freedom, and ending with the right to own property and (...) to have contractual and family claims. Clear and to the point, it guides readers through the most difficult passages of the Doctrine, explaining Kant's terminology, method and ideas in the light of his intellectual environment. One of the very few commentaries on the Doctrine of Right available in English, this book will be essential for anyone with a strong interest in Kant's moral and political philosophy. (shrink)

Informed consent is an essential step in helping patients be aware of consequences of their treatment decisions. With surgery, it is vitally important for patients to understand the risks and benefits of the procedure and decide accordingly. We explored whether a written IC form was provided to patients; whether they read and signed it; whether they communicated orally with the physician; whether these communications influenced patient decisions. Adult postsurgical patients in nine general hospitals of Italy’s Campania Region were interviewed via (...) a structured questionnaire between the second and seventh day after the surgery at the end of the first surgical follow up visit. Physicians who were independent from the surgical team administered the questionnaire. The written IC form was given to 84.5% of those interviewed. All recipients of the form signed it, either personally or through a delegate; however, 13.9% did not know/remember having done so; 51.8% said that they read it thoroughly. Of those who reported to have read it, 90.9% judged it to be clear. Of those receiving the written consent form, 52.0% had gotten it the day before the surgery at the earliest 41.1% received it some hours or immediately before the procedure. The written IC form was explained to 65.6% of the patients, and 93.9% of them received further oral information that deemed understandable. Most attention was given to the diagnosis and the type of surgical procedure, which was communicated respectively to 92.8 and 88.2% of the patients. Almost one in two patients believed that the information provided some emotional relief, while 23.2% experienced increased anxiety. Younger patients and patients with higher levels of education were more likely to read the written IC form. The written IC form is not sufficient in assuring patients and making them fully aware of choices they made for their health; pre-operative information that was delivered orally better served the patients’ needs. To improve the quality of communication we suggest enhancing physicians’ communication skills and for them to use structured conversation to ensure that individuals are completely informed before undergoing their procedures. (shrink)

Demonstrates the systematic connection between Kant's ethics and his philosophy of history.

Growing nursing workforce maldistributions impede rural healthcare access globally. In‐depth exploration of underlying philosophical ideas about rural health in nursing curricular could support recruitment and retention of nurses who are well positioned to support and advocated for health care and services relevant to their communities. Through a lens of positionality, the purpose of this paper is to explore rural health and nursing within the United States and Australia from the perspective of undergraduate students. Recognizing that both countries have ‘first world’ (...) health services, issues of access to services associated with systemic and structural biases were significant features identified by participants. Their perceptions were supported by discussion with attendees of the 26th International Nursing Philosophy Conference from several countries, during a presentation titled ‘What is different about rural health nursing: A philosophical exploration.’ This international consistency suggests that systemic and structural biases are global phenomena. While exposure to rural health and rural nursing may be beneficial for recruitment, preparing nurses for rural practice requires more than educating students to complete clinical tasks. Uncovering collaboration, advocacy and policy development opportunities for nurses in rural communities could move the dial from recruiting rural nurses to fulfill immediate needs to retention of well‐educated and highly skilled nurses. Building a stronger philosophical base for rural healthcare inclusive of all people, honouring their distinguishing characteristics such as age, gender, ethnicity, is long overdue. Positionality can inform how nurses across the globe relate to other countries' governments, cultures, norms, values, expectations, etc., which can influence the advancement of the profession and address social inequities among rural populations. (shrink)

The Routledge Handbook of Feminist Philosophy of Science is a comprehensive resource for feminist thinking about and in the sciences. Its 33 chapters were written exclusively for this Handbook by a group of leading international philosophers as well as scholars in gender studies, women’s studies, psychology, economics, and political science. The chapters of the Handbook are organized into four main parts: I. Hidden Figures and Historical Critique II. Theoretical Frameworks III. Key Concepts and Issues IV. Feminist Philosophy of Science in (...) Practice. The chapters in this extensive, fourth part examine the relevance of feminist philosophical thought for a range of scientific and professional disciplines, including biology and biomedical sciences; psychology, cognitive science, and neuroscience; the social sciences; physics; and public policy. The Handbook gives a snapshot of the current state of feminist philosophy of science, allowing students and other newcomers to get up to speed quickly in the subfield and providing a handy reference for many different kinds of researchers. (shrink)

In this book Shrader-Frechette reveals how politicians, campaign contributors, and lobbyists--and their power over media, advertising, and public relations--have conspired to cover up environmental disease and death.

Strike action in healthcare has been a common global phenomenon. As such action is designed to be disruptive, it creates substantial ethical tension, the most cited of which relates to patient harm, that is, a strike may not only disrupt an employer, but it could also have serious implications for the delivery of care. This article systematically reviewed the literature on strike action in healthcare with the aim of providing an overview of the major justifications for strike action, identifying relative (...) strengths and shortcomings of this literature and providing direction for future discussions, and theoretical and empirical research. Three major themes emerged related to (1) the relationship between healthcare workers, patients and society; (2) the consequences of strike action; and (3) the conduct of strike action. Those who argue against strike action generally cite the harms of such action, particularly as it relates to patients. Many also argue that healthcare workers, because of their skills and position in society, have a special obligation to their patients and society more generally. Those who see this action as not only permissible but also, in some cases, necessary have advanced several points in response, arguing that healthcare workers do not necessarily have any special obligation to their patients or society, and even if so, this obligation is not absolute. Overwhelmingly, when talking about the potential risks of strike action, authors have focused on patient welfare and the impact that a strike could have. Several directions for future work are identified, including greater explorations into how structural and systemic issues impact strike action, the need for greater consideration about the contextual factors that influence the risks and characteristics of strike action and finally the need to tie this literature to existing empirical evidence. (shrink)

The main goal of our paper ‘The Critical Dialogue method of Ethics Consultation’ was to make a particular method of clinical ethics facilitation visible and therefore accessible to others. We believe that our method is a good one, but the idea behind exposing and explaining a method of ‘doing’ clinical ethics was not to claim that our model was the ideal model for clinical ethics facilitation or the most effective in achieving ethical resolution. Instead, we wanted to enable readers to (...) ‘see’ a set of specific goals of ethics facilitation and to ‘see’ the facilitation steps used to achieve them. By uncovering and demystifying the ethics facilitation processes and goals, our objective was to advance the scholarship of clinical ethics work. To advance scholarship in fields of education and research, the work or practice must be public, available for peer review and critique according to accepted standards and able to be reproduced and built on by other scholars.1 The five responses to the ‘Critical Dialogue’ (CD) method paper suggest that we have achieved our objective of advancing scholarship in clinical ethics work. In the responses, we see ethicists engaging with our method, reflecting on their own methods and goals, and thinking critically about the nature of clinical ethics work and how to do it well. In this brief response, we discuss three key issues raised in the responses to the ‘critical dialogue’ paper and then identify how they could be used to further refine and broaden specific steps of our method (table 1). View this table: Table 1 Refinements to the critical dialogue method of ethics facilitation Both Knox et al 2 and Boretti3 discuss some challenges of having consensus as a key goal of the CD method of clinical ethics consultation. Boretti explains that reliance on consensus building may not address …. (shrink)

Within the psy- disciplines, Foucauldian discourse analysis has shown that those who exercise power in defining psychological experiences seek to maintain existing power hierarchies through this labeling. In that way, it is a fitting method to examine how the use of specific language constructs reality for individuals and society as a whole. Currently, the use of the word "triggered" has proliferated beyond the common mental health usage to refer to posttraumatic stress disorder or a re-experiencing symptom of a trauma. In (...) this qualitative investigation, we analyze "triggered" experiences written about in participants' vignettes to explore how using the word "triggered" does something in terms of power, hierarchy, and expression of vulnerability for individuals, and how this is impacted by the way they position themselves and others in speaking about their experiences. We understand the experience of being "triggered" to be constructed differently depending on the source of the trigger. The difference is particularly salient for those who use "triggered" to refer to a microaggression as opposed to those who are referring to a sexual assault. We discuss the tension between supporting a psychiatric status quo regarding trauma and the subversion of this status quo via the expanded use of the word "triggered.". (shrink)

Policy decisions regarding immunization during a pandemic are informed by the ethical understandings of policy makers. With the possibility that a vaccine might soon be available to mitigate the deadly COVID-19 pandemic, policy makers can consider learnings from past pandemic immunization campaigns. This critical analysis of three policy decisions made in Alberta, Canada, during the 2009 H1N1 influenza pandemic demonstrates the predominance of distributive justice principles and the problems that this created for vulnerable groups. Vulnerable groups identified in Alberta include (...) rural and First Nations populations. We propose a social justice approach as a viable alternative to inform pandemic immunization policy and invite debate. (shrink)

The Sickness unto Death is commonly regarded as one of Kierkegaard's most important works – but also as one of his most difficult texts to understand. It is a meditation on Christian existentialist themes including sin, despair, religious faith and its redemptive power, and the relation and difference between physical and spiritual death. This volume of new essays guides readers through the philosophical and theological significance of the work, while clarifying the complicated ideas that Kierkegaard develops. Some of the essays (...) focus closely on particular themes, others attempt to elucidate the text as a whole, and yet others examine it in relation to other philosophical views. Bringing together these diverse approaches, the volume offers a comprehensive understanding of this pivotal work. It will be of interest to those studying Kierkegaard as well as existentialism, religious philosophy, and moral psychology. (shrink)

In April 2020, in the midst of its first pandemic lockdown, the Dutch government announced plans to develop a contact tracing app to help contain the spread of the coronavirus – the _Coronamelder._ Originally intended to address the problem of the overburdening of manual contract tracers, by the time the app was released six months later, the problem it sought to solve had drastically changed, without the solution undergoing any modification, making it a prime example of technosolutionism. While numerous critics (...) have mobilised the concept of technosolutionism, the questions of how technosolutionism works in practice and which specific harms it can provoke have been understudied. In this paper we advance a thick conception of technosolutionism which, drawing on Evgeny Morozov, distinguishes it from the notion of technological fix, and, drawing on constructivism, emphasizes its constructivist dimension. Using this concept, we closely follow the problem that the Coronamelder aimed to solve and how it shifted over time to fit the Coronamelder solution, rather than the other way around. We argue that, although problems are always constructed, technosolutionist problems are _badly_ constructed, insofar as the careful and cautious deliberation which should accompany problem construction in public policy is absent in the case of technosolutionism. This can lead to three harms: a subversion of democratic decision-making; the presence of powerful new actors in the public policy context – here Big Tech; and the creation of “orphan problems”, whereby the initial problems that triggered the need to develop a (techno)solution are left behind. We question whether the most popular form of technology ethics today, which focuses predominantly on the _design_ of technology, is well-equipped to address these technosolutionist harms, insofar as such a focus may preclude critical thinking about whether or not technology should be the solution in the first place. (shrink)

Two distinct and perhaps mutually exclusive understandings of utilitarianism have emerged in the ethics literature. Utilitarianism is typically regarded as an approach to determine ethicality by focusing on whether or not actions produce the greater good, but has also been conceptualized as a set of traits to which individuals might be predisposed. This paper is designed to clarify the meaning and implications of such utilitarian traits as “results-oriented,” “innovative,” and “a winner.” Although the Janus-headed model of ethical theory from which (...) these traits emerged had been acknowledged by its developer as possibly misrepresenting typical views of utilitarianism, much research using these traits appears to have been conducted without clear recognition of this. If the conceptual foundation underpinning hypothesis development is disconnected from the measure used to test them, then little support for relevant predictions should emerge. A review of the literature which featured utilitarian traits generally confirmed this. This paper also explored the origins and emergence of these traits and suggested that existing evidence that these measure utilitarian ethical predispositions is not especially persuasive. Understanding what utilitarian traits do not assess is critical in order for knowledge about this potentially useful measure to advance. (shrink)

This book examines the nuanced and situated experiences of self-study researchers. It explores the ways in which ethics are dynamic, idiosyncratic and require an ongoing ethical reflexivity. In addition, the book identifies, documents and collates the collective experiences of self-study researchers and sheds new light on the role and impact of ethics, ethical dilemmas and ensuing decisions for education researchers. The book considers the ethical dilemmas that self-study researchers in teacher education face, their careful ethical considerations while conducting research, and (...) how they form their professional judgment and understanding of what it means to be an ethical self-study researcher. For self-study researchers, there are a number of ethical dilemmas and challenges that cannot be neatly captured by the frameworks and guidelines of an ethics board. For many, this requires researchers to be ever-present and re-engaged with the ethics of their own projects, from the development, through to the dissemination of their work. Readers will gain a deeper understanding of ethics, ethical perspectives and practices in the field of self-study research. (shrink)

Climate science denial results from ignorance and perpetuates ignorance about scientific facts and methods of inquiry. In this paper, I explore climate science denial as a type of active ignorance...

Unit I. Fundamental characteristics of the common law. The source of law -- The jury -- The adversary system of trial -- Retroactivity: a return to stare decisis -- Unit II. The courts and their jurisdiction. Court systems in the United States -- Court system in England -- Unit III. Constitutional law. Judicial review -- Equal protection -- Freedom of speech -- Appendix I. Constitution of the United States -- Appendix II. Table of Supreme Court cases -- Appendix III. Common (...) case citations. (shrink)

Why has right-wing activism in Japan, despite its persistence throughout the postwar era, only gained significant traction recently? Focusing on the Zaitokukai, an anti-Korean movement in Japan, this article demonstrates how the new Far Right were able to popularize formerly stigmatized right-wing ideas. The Zaitokukai represents a political group distinct from the traditional right and reflective of new Far Right movements spreading worldwide. In Japan, concerns about the growing influence of South Korea and China in the 1980s as well as (...) the decline of left-wing norms opened up a discursive opportunity for the new Far Right. By framing Korean postcolonial minorities as undeserving recipients of social welfare benefits, the Zaitokukai mobilized perceptions of threat that has continued to powerfully influence public perceptions of Koreans even following the group’s organizational decline. While past research has focused on the new Far Right’s political influence, this article stresses their roles as ideological entrepreneurs. (shrink)

This paper examines whether adults can adapt to novel accents of their native language that contain unfamiliar context-dependent phonological alternations. In two experiments, French participants listen to short stories read in accented speech. Their knowledge of the accents is then tested in a forced-choice identification task. In Experiment 1, two groups of listeners are exposed to newly created French accents in which certain vowels harmonize or disharmonize, respectively, to the rounding of the preceding vowel. Despite the cross-linguistic predominance of vowel (...) harmony over disharmony, the two groups adapt equally well to both accents, suggesting that this typological difference is not reflected in perceptual learning. Experiment 2 further explores the mechanism underlying this type of phonological learning. Participants are exposed to an accent in which some vowels harmonize and others disharmonize, yielding an increased featural complexity. They adapt less well to this regularity, showing that adaptation to novel accents involves feature-based inferences. (shrink)

Human nature and its implications for moral philosophy has been a recurrent topic of philosophical inquiry. Thinkers from Plato to Arendt, struggling with the testimony of human experience, have attempted to explain the relation between reason and wickedness. Some have stressed the intrinsic rationality and goodness of human beings, relegating evil to the influence of factors alien to reason. Others have viewed humans as intrinsically evil, their capacity for reason a weak and inconsequential force.

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

The American Educational Research Association and American Psychological Association published standards for reporting on research. The transparency of reporting measures and data collection is paramount for interpretability and replicability of research. We analyzed 57 articles that assessed alphabet knowledge using researcher-developed measures. The quality of reporting on different elements of AK measures and data collection was not related to the journal type nor to the impact factor or rank of the journal but rather seemed to depend on the individual author, (...) reviewers, and journal editor. We propose various topics related to effective reporting of measures and data collection methods that we encourage the early childhood and literacy communities to discuss. (shrink)

The objective in this article is to apply a Daoist model of an ethic derived from the _Laozi_ on writings of the Huang Lao tradition to offer a unique Daoist cosmically derived ethic _in its own terms_. Having our point of departure in the _Laozi_ we refer to its paradoxical language as a _living riddle_ that is inherent in the tradition, and as such it suggests a "model of modeling." We find this model in _Laozi_ 25, according to which self-so (...) (_ziran_ 自然) serves as foundation for an ethic that is neither dichotomizing nor resting on human moral conventions, but serves rather as a guiding philosophy of living. On this basis we explore the question of an ethic in the Huang Lao tradition. (shrink)

This collection showcases the work of 18 analytical feminists from a variety of traditional areas of philosophy. It highlights successful uses of concepts and approaches from traditional philosophy, and illustrates the contributions that feminist approaches have made and could make to the analysis of issues in key areas of traditional philosophy, while also demonstrating that traditional philosophy ignores feminist insights and feminist critiques of traditional philosophy at its own peril.

We argue that psychological research can enhance the identification of reasoning errors and the development of an appropriate pedagogy to instruct people in how to avoid these errors. In this paper we identify some of the findings of psychologists that help explain some common fallacies, give examples of fallacies identified in the research that have not been typically identified in philosophy, and explore ways in which this research can enhance critical thinking instruction.

How much responsibility ought a professional engineer to have with regard to supporting basic principles of sustainable development? While within the United States, professional engineering societies, as reflected in their codes of ethics, differ in their responses to this question, none of these professional societies has yet to put the engineer’s responsibility toward sustainability on a par with commitments to public safety, health, and welfare. In this paper, we aim to suggest that sustainability should be included in the paramountcy clause (...) because it is a necessary condition to ensure the safety, health, and welfare of the public. Part of our justification rests on the fact that to engineer sustainably means among many things to consider social justice, understood as the fair and equitable distribution of social goods, as a design constraint similar to technical, economic, and environmental constraints. This element of social justice is not explicit in the current paramountcy clause. Our argument rests on demonstrating that social justice in terms of both inter- and intra-generational equity is an important dimension of sustainability (and engineering). We also propose that embracing sustainability in the codes while recognizing the role that social justice plays may elevate the status of the engineer as public intellectual and agent of social good. This shift will then need to be incorporated in how we teach undergraduate engineering students about engineering ethics. (shrink)

Issues of race have traditionally been addressed in medical school curricula in a didactic manner. However, medical school curricula often lack adequate opportunity for the application of learning material relating to race and culture. When confronted with acts of racism in clinical settings, students are left unprepared to respond appropriately and effectively. Forum Theatre offers a dynamic platform by which participants are empowered to actively engage with and become part of the performance. When used in an educational context, Forum Theatre (...) can be a powerful tool for students to interact with a wide variety of social issues. This paper describes the process by which one medical school designed a workshop in the Forum Theatre style to equip students to respond to racism observed in clinical settings. Based on real student experiences, the Responding to Racism in the Clinical Setting workshop was designed to give students an opportunity to combine cultural humility, communication theory and conflict resolution skills in order to prepare for interactions in clinical stages of medical education. As a result of workshop evaluations, surveys, and written reflections, the authors propose that Forum Theatre is a novel teaching modality for incorporating issues of race and culture into medical curriculum. (shrink)