The history of the Institute of Medical Ethics has been well recorded. Accounts of its origins in the London Medical Group were published in an academic paper of 2003,1 in the transcript of a Wellcome Witnesses to Twentieth Century Medicine Seminar in 20072 and in a chapter of the 2009 Cambridge World History of Medical Ethics.3 In 2013, 50 years since the inauguration of its first series of lectures and symposia, the LMG as an organisation (...) no longer exists, but its aspirations and achievements are alive and well, both in the Journal of Medical Ethics and in the IME, now exploring a new phase as a membership organisation. Other papers in this issue will discuss the history and prospects of the Journal and Institute. But the LMG, similar medical groups in all other British medical schools and the Society for the Study of Medical Ethics from which the IME derived also have a significant continuing life in the thinking and practice of many medical and healthcare professionals who participated in their activities, and then in turn on those influenced by their thinking and practice. The LMG, it could be said, is ‘no more’ an organisation ‘Now but a whole climate of opinion’.4A bottom-up evolutionThe first medical students to be involved in the LMG may not have foreseen its influence on their future careers, but many were aware of being part of something new and exciting. One of those with whom the first lecture series was planned was Margaret Lloyd . "The beginning of the LMG in 1963 was an exciting time for medical students in London. As a mature student entering St Mary's Hospital Medical School … ". (shrink)

Although many conferences stimulate a great deal of discussion and practical interest at the time, not so many are followed up to try and estimate what, if any, practical results followed the meeting. This the authors of this study have done. (In Britain the 'medical groups' are voluntary groupings of students at medical schools who meet to discuss ethical problems related to their profession). Sixty-five participants (not all of them students) in the conference on iatrogenic disease replied (...) to the questionnaire, and from the answers it was clear that not only the attitudes of those responding had in some cases been changed but in some positive action had resulted, for example, in the matter of prescribing. This analysis may provide an answer to those who criticize conferences as being a waste of time and money, because much more than could be evaluated from the responses to this survey must have affected all the participants. (shrink)

London Medical Group was founded in 1963. It was student-led, spawned Medical Groups in almost every UK medical school and met a need for non-partisan debate and dialogue in medical ethics. It became a victim of its own success as the Institute of Medical Ethics published the Pond Report in 1987, which recommended that medical ethics be incorporated into the undergraduate curriculum. Medical schools began to teach medical ethics and (...) the General Medical Council demanded this in 1993's Tomorrow's Doctors. The Institute of Medical Ethics had grown out of the LMG. After running a number of successful conferences for medical ethics teachers, the Institute of Medical Ethics is recapturing the natural innovative tendencies of students and junior doctors that the LMG and related Medical Groups had fostered. It is now launching itself as a membership organisation: the recommendations of the Francis report and responses to it have emphasised the need to support individuals with the ability, freedom and confidence to question the status quo from a reasoned ethical basis. The Institute of Medical Ethics aims to develop a robust medical ethics community ready to face the challenges of 21st Century healthcare. (shrink)

Background: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students’ experiences (...) during the first semester of an undergraduate problem-based learning medical program at an African medical school. Method: We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Results: Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Conclusions: Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem based learning process. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.2 (2004) 165-173 [Access article in PDF] Professional Judgment, Critical Realism, Real People, and, Yes, Two Wrongs Can Make a Right! K.W.M. Fulford Anthony Colombo Keywords values, values-based practice, models of disorder, concept of mental illness, user-centred practice, patient-centred practice, multidisciplinary teamwork We are grateful to our four commentators for putting much-needed conceptual air and space around the models project. Published originally as an empirical (...) study of the different implicit models of disorder, held by users of services, carers, nurses, psychiatrists, and social workers (Colombo et al. 2003), our paper outlined the philosophical roots of the models project in linguistic analytic philosophy of the "Oxford school" (Fulford and Colombo 2004). Our four commentators provide extra dimensions of understanding, respectively from professional education (Williams 2004), sociology (Bendelow 2004), Heideggerian phenomenology (Heginbotham 2004), and mental health policy and practice (Williamson 2004).Since the original study, the models project has been taken forward as a key contribution to a range of philosophy-into-practice initiatives called, collectively, Values-Based Practice. In this brief response, we outline the key features of Values-Based Practice and indicate how these connect with some of the many thoughtful points about models made by our commentators. Values-Based Practice Values-Based Practice, then, is the theory and skills-base for effective health care decision making where different, and hence potentially conflicting, values are in play (Fulford 2004). Premised on the democratic meta-value of equal respect for all voices, Values-Based Practice relies, much as a political democracy relies, on good process rather than preset outcomes for its practical effectiveness. The ten pointers to good process in Values-Based Practice are summarized in Figure 1. We return to the implications of these for the work on models below.Relying on good process may be thought to be a recipe more for relativism and indecision in clinical decision making than for practical effectiveness. To the contrary, however, the 'values democracy' of Values-Based Practice, again like a political democracy, carries a number of clear and coherent implications for policy and practice in health care. [End Page 165] Click for larger viewFigure 1 10 Pointers to Good Process in VBP [End Page 166]Examples of the implications of Values-Based Practice for policy and practice are given in the Values Framework shown in Figure 2. This is a policy framework for the development of Values-Based Practice in mental health produced by a project group in the National Institute for Mental Health in England (NIMHE), the section of the UK's National Health Service (NHS) responsible for implementing government policy on mental health as embodied in the National Service Framework for Mental Health (Department of Health 1999) and subsequent policies. The framework gives three key principles of Values-Based Practice (the three Rs of recognition, raising awareness, and respect) and then summarizes some of the specific implications of the approach. Racism, for example, is incompatible with Values-Based Practice because racism is by definition intolerant of diversity. Again, we indicate some of the policy implications of Values-Based Practice for the points about models made by our commentators below.Training for mental health practitioners in Values-Based Practice will be rolled out from April 2005, through both voluntary and statutory bodies, in each of the eight regions of the National Health Service of England and Wales. This roll out will be supported by training methods developed and piloted in a unique joint venture between Warwick University's Department of Philosophy and Medical School, and an in-service training provider, the Sainsbury Centre for Mental Health (Fulford, Williamson, and Woodbridge 2002; Woodbridge and Fulford 2003). These training methods are the basis of a detailed workbook for Values-Based Practice (Woodbridge and Fulford 2004). The workbook will be launched in July 2004 at a conference in London by the Minister of State with responsibility for mental health, Rosie Winterton. Professional Training and Professional Judgment The models project has been central to the development of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Lives Saved, With a Little Help from FriendsPrasanta TripathyIn November 2000, Jharkhand was carved out of Bihar, a state in eastern India, to be a separate state to fulfill the aspirations of its people and [End Page 109] allay their feeling of alienation. It was a good time for me to reflect on how best I could contribute. In 2002 Ekjut, a registered development organization, was set up (...) by myself and other like-minded colleagues. Ekjut, which means "togetherness," was the outcome of a longstanding desire to do something on our own, something that was close to my heart—doing something for and with the people I had grown up with. An invisible cord kept me attached to this region of India and after stints with a few development organizations within and outside the state, my wife, Nirmala, and I decided to relocate to a village near my hometown, Chakradharpur.Chakradharpur is a small railway township in South Bihar where I spent all my childhood and days of schooling. Beyond the periphery of this township and its satellite market place, live indigenous people, the Adivasi, in villages and hamlets. Even as children we could appreciate the government policy that protected them in the sense that their ancestral lands could not be acquired by Dikus, the non-tribal people living in the towns and cities. The un-spoilt bounties of nature protected and preserved by the original inhabitants of the land—the Adivasi people—was there for all of us to see and enjoy.A rumor that a doctor couple was building a nursing home led to a regular flow of men, women and children to our unfinished home with all kinds of ailments, including medical emergencies. It was becoming increasingly difficult to cope with the workload of constructing the house and at the same time—overwhelming to see children dying in our home, which was never meant to be the hospital that the villagers thought it to be. They were reluctant to visit the government hospitals, which were primarily meant to serve poor people and their attitude could be summarized in just one word—fatalism. We wanted this to change—they somehow needed to understand their rights and entitlements. The public health care system had to be strengthened and Nitmala and I wondered how our work could make this happen.The Adivasi people were soon to become partnering communities with Ekjut. It did not take us long to realize how unprotected they were. We had a vague idea that we wanted to build healthier communities. Providing full-time curative care was not an option; it was also beyond our means. Knowing that strengthening the health system would take time, we hoped that our community-based work would strengthen the demand side, since even the minimum services that were available were grossly under-utilized.India is home to about 10 million tribal people. We had seen and also knew that their health status was poor and that tribal people have the disproportionate burden of child mortality, malnutrition, malaria and death in childbirth. But we could not find a reliable existing data base that could guide our work. The health status of women and children soon became Ekjut's main concern.We wanted our work to generate knowledge that would be relevant in a wider context. Adivasis are not a monolithic entity and our evidence needed to grow from working with several different tribal groups. We needed to build our research capabilities and willingness to work with several different indigenous groups, as well as, the poor people living alongside them in different districts. A collaboration with University College of London was soon to follow. Professor Anthony Costello who was my teacher more than a decade back, invited me to partner with his department and jointly bid for a grant. This grant was likely to come at the confluence of several interesting developments. First, the self-help group movement in India had made a substantial jump and such groups existed in almost every village. Second, a grassroots organization called PRADAN was working with women's groups to strengthen their livelihoods in several states of India including our district. PRADAN shared with... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 15.2 (2007) 177-179MuseSearchJournalsThis JournalContents[Access article in PDF]Reviewed byLise Vaugeois University of TorontoHildegard C. Froehlich, Sociology for Music Teachers:Perspectives for Practice (Upper Saddle River, NJ: Pearson Prentice Hall, 2007)Hildegard Froehlich's book, Sociology for Music Teachers, provides an important and much needed resource for undergraduate and advanced music education programs. Music students tend to see their interests and goals within a narrow (...) framework, one that is reinforced by the intensely personal nature of music-making as well as the material and psychological separation that inheres from our location in physically detached faculties of music. Froehlich's book provides a resource that directly addresses this tendency towards narrowness by inviting students to engage with sociological questions as they affect us personally, professionally, and in the context of questions much larger than ourselves.The book is organized into eight chapters, each of which explores a particular set of questions and introduces related studies and resources. She recommends that students actively engage with the material and provides suggestions for group discussion throughout the book. Each chapter introduces a comprehensive survey of related questions and the body of literature that investigates these questions. Thus, it can be used as the basis to structure an undergraduate course as well as a literature guide for graduate students.Undergraduate students are often resistant to exploring ideas beyond their [End Page 177] immediate conceptions of themselves as musicians and Froehlich addresses this resistance by discussing concepts about identity formation in the first chapter. Students are thus asked to consider a series of questions they can easily recognize as relevant to their own lives. She begins with the personal and the familiar and then brings in ideas that broaden the range of inquiry, gradually introducing concepts that challenge many of our assumptions about the meaning of music in different people's lives; the range of meanings possible within sounds and musical practices; the role of public education and various ways that music education functions within this larger system, and important questions about how we might conceive of ourselves as transmitters of extant cultural values or transformers of values and social relations.The chapter headings give an indication of the range of material introduced in her text: "The Performer and Teacher in You: A Matter of Identity"; "Teaching as Work: What Educational Sociologists Tell Us"; "Music Learning and Teaching as Socially Situated Acts"; "Music and Social Context: Macro, Micro, and Interactive Perspectives in Selected Texts on the Sociology of Music"; "Musical Meaning and Social Context: Thoughts by Selected Ethnomusicologists and Cultural Theorists"; "Sociology of Education: Major Theories and Their Connection to School Practice"; "Application of Sociological Constructs in Education to Music Schooling"; "Conclusion: You and the Big Picture." Each chapter gives a historical survey of the literature pertaining to the area of inquiry plus an introduction to contemporary writing. Competing discourses are introduced throughout.Froehlich's survey of disciplines that intersect with sociology is quite comprehensive. Amongst other disciplines, she includes foundational literature from musicology, philosophy of music education, sociology of education, and social psychology. The book is thus valuable as a resource for its bibliography alone. She also includes a glossary of terms, another feature that makes the book particularly helpful to undergraduate students. One writer I was surprised not to see included is Jacques Attali. His theoretical arguments on the relations of musical culture to economy provide a significant lens for considering the influence of music on social development and would have been an appropriate addition to the chapter on "Music and Social Context." I also missed work by musicologists and human geographers who have explored the role of race in music and music education.Related to these missing discourses, I have a major concern that is less a critique of Froehlich than an acknowledgement that this position has not yet been given sufficient consideration in our field, and to which Deborah Bradley refers as the "normative centering of whiteness."1 Froehlich bases her work on the assumption that her audience consists of a... (shrink)

Born in Vienna in 1864, Bernard Hollander was a London-based psychiatrist. He is best known for being one of the main proponents of phrenology. This title, originally published in 1916, deals with "the nervous defects of children, and the various forms and degrees of mental and moral deficiency that may occur from infancy up to the age of twenty-one." Very much of its time, it looks at both what it calls the "subnormal" and the "supernormal" child, the causes (...) of abnormality, and suggests ways of educating children in order to minimise their defects and maximise their abilities. This is an opportunity to enjoy a historical look at child psychology from the early twentieth century. (shrink)

The teaching of ethics in UK medical schools has recently been reviewed, from the perspective of the teachers themselves. A questionnaire survey of medical undergraduates at King’s College London School of Medicine provides useful insight into the students’ perception of ethics education, what they consider to be the value of learning ethics and law, and how engaged they feel with the subject.

Concern is growing as research continues to find evidence of academic misconduct among medical students. There is, however, paucity of information on this issue among medical students and medical graduates in Africa. We determined the perceptions and attitude of house officers on academic misconduct within Nigerian medical schools. We conducted 7 focus group discussions among pre-registration house-officers working in a Nigerian Teaching hospital between October and November 2013. A FGD guide containing 7 broad questions (...) related to their perception and attitude on academic misconduct was employed. Ethnographic content analysis and manual coding were adopted in identifying themes, issues and representative quotations. A total of 58 participants out of an eligible pool of 76 PRHOs were recruited. All the groups associated academic misconduct chiefly with cheating in examinations, and perceived it as a commonplace problem. “It is a part of school life”, admitted one PRHO. Copying during exam appeared to be the commonest form of cheating. Another respondent opined that “The lecturers should be more concerned with helping students understand better. They should not make passing an exam a do-or-die affair.” The perception and attitudes towards academic misconduct may be a reflection of the prevailing moral decline in the contemporary Nigerian society. Underlying the reasons adduced by the participants for getting involved in academic misconduct is the fear of failure in examinations. Apart from consolidating formal and informal medical ethics education, the medical schools should ensure that the opportunities and pressures to indulge in academic misconduct are minimized. (shrink)

The study examined the influence of the Pond Report on the teaching of medical ethics in the London medical schools. A questionnaire was given to both medical students and college officers. All medical colleges reported that ethics was included in the curriculum. However, from students' replies, it seems that attendance of optional courses is low and that not all current final year medical students have had any formal teaching in medical ethics. (...) Stronger guidelines are necessary to ensure appropriate ethical training in London medical schools. (shrink)

BackgroundBurnout is a syndrome that results from stressors in the work environment that have not been successfully managed. The prevalence of burnout among schoolteachers was always controversial. COVID-19 pandemic added more stressors to teachers since they had to change their working styles in response to the pandemic lockdowns or curfews. In Saudi Arabia, the prevalence and determinants of burnout among school teachers were not measured by any other group during the COVID-19 pandemic stressors.MethodsA cross-sectional survey was (...) conducted among 879 teachers in the Jazan region, Saudi Arabia, using the Maslach Burnout Inventory, during April 2021. Multistage cluster random sampling was used.ResultsThe mean age of the participants was 41.4 years. Male teachers represented 52.6% of the participants while females represented 47.4%. Most teachers showed burnout symptoms. Consequences of burnout were observed, such as using psychotropic medications, absenteeism, lack of job satisfaction, and changing schools. Using the MBI scale, most teachers showed medium or high emotional exhaustion, low depersonalization, and low personal accomplishment.ConclusionMost teachers showed symptoms of burnout during the COVID-19 pandemic. Being an expert and ability to adapt to technology during the COVID-19 pandemic proved to effectively reduce burnout symptoms. Increasing incentives, early detection, and improving the work environment is recommended to diminish burnout consequences. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education (...) might be causing them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 23 (2003) 39-41 [Access article in PDF] Wishing I Were Here:Postcards from My Religious Journey Grace G. Burford Prescott College Summer 1966, Bowling Green, Kentucky An energetic ten-year-old, sitting on a red-cushioned wooden pew in a Presbyterian church leans over to her mother to whisper, "Which is it? Are we supposed to be like little children, or leave behind our childish ways?" After church, her mother (...) does a reasonably good job at answering the question.Later, perhaps even later that day, this little girl has gleefully exchanged her dress and going-to-church shoes for a cotton shirt and shorts and blue Keds, and has escaped to her favorite spot in the woods behind her house. There she swings on vines in imitation of Tarzan and plays contentedly on her own for hours, feeling utterly at home.In this scene, we see that the little girl has discovered that she can best deal with a certain type of recurring physical pain by focusing her entire attention on her breath, as she silently repeats "breathing in, breathing out." Fall 1971, Bryn Mawr, Pennsylvania A group of eight or so teenagers attend their English literature class at an elite college-preparatory school for girls. Our hero, recently arrived, southern accent still quite in evidence, revels in real education; this a delightfully stark contrast to what she got from Kentucky public schools, then forty-ninth in the nation according to some poll or other—only Mississippi's were worse. In this particular class she finds herself defending Presbyterians against what she considers simply inaccurate descriptions of them by James Joyce. At the same time, she is waking up to the realization that she does not believe—and the suspicion that she never really has believed—the Christian doctrines she has been raised on. Indeed, she feels quite foolish for never having properly examined what exactly she had bought into when she participated in all those church activities. She can't recall ever actually believing in "God the Father, Almighty, Maker of Heaven and Earth," much less in "Jesus Christ, His only Son, Our Lord," and all the rest of it. [End Page 39] Spring 1975, Swarthmore, Pennsylvania Having thoroughly rejected religion—for she knows none other than the one she grew up with—our hero pursues study of astronomy, math, language, and music, quite intent on becoming a college professor of some subject or another. Somewhat annoyed that she must take two courses in the curricular area that includes religion, philosophy, anthropology, and sociology, but encouraged by her friends' assertions that religion courses are "not too bad," she signs up for religion and science, figuring that at least half of it will be rational. At the same time, she takes a course on Asian religions. Sometime in the middle of a clear spring night we find her engaged in her part-time job, seated at the eyepiece end of a twenty-meter-long, twenty-four-inch refracting telescope, patiently keeping a star placed just so on the cross-hairs in the siting scope, making fine adjustments to the telescope's precise tracking while the light of stars collects on glass plates coated with very fast photographic emulsion. Between clicks of the shutter she ponders the curiously attractive ideas she is encountering in her religion courses this term. Spring 1983, Evanston, Illinois Our hero earns a Ph.D. in the history and literature of religions, with a focus on Buddhism and Hinduism, and heads for Washington, D.C., to become what she had always aspired to be—a college professor. Summer 1997, Interstate 40 Having experienced a denial of tenure, the challenges of part-time college teaching, training and freelance work in the field of copyediting, life as a wildlife-wielding teacher of auditoria full of elementary school children, an administrative job as second-in-command to a self-described megalomaniac, and the vagaries of teaching two hundred students a term—this lifelong seeker eagerly moves across the country to start a job teaching at an alternative, experiential learning-based... (shrink)

Rationale, aims and objectives: Bioethics and professionalism are standard subjects in medical training programmes, and these curricula reflect particular representations of meaning and practice. It is important that these curricula cohere with the actual concerns of practicing clinicians so that students are prepared for real-world practice. We aimed to identify ethical and professional concerns that do not appear to be adequately addressed in standard curricula by comparing ethics curricula with themes that emerged from a qualitative study of (...) class='Hi'>medical practitioners. Method: Curriculum analysis: Thirty-two prominent ethics and professionalism curricula were identified through a database search and were analysed thematically. Qualitative study: In-depth, semi-structured interviews were conducted with 20 medical practitioners. Participants were invited to reflect upon their perceptions of the ways in which values matter in their practices and their educational experiences. The themes emerging from the two studies were compared and contrasted. Results: While representations of meaning and value in ethics and professionalism curricula overlap with the preoccupations of practicing clinicians, there are significant aspects of ‘real-world’ clinical practice that are largely ignored. These fell into two broad domains: ‘sociological’ concerns about enculturation, bureaucracy, intra-professional relationships, and public perceptions of medicine; and epistemic concerns about making good decisions, balancing different kinds of knowledge, and practising within the bounds of professional protocols. Conclusions: Our findings support the view that philosophy and sociology should be included in medical school and specialty training curricula. Curricula should be reframed to introduce students to habits of thought that recognize the need for critical reflection on the social processes in which they are embedded, and on the philosophical assumptions that underpin their practice. (shrink)

Previous studies show that medical students in clinical training face ethical problems that are not often discussed in the literature. In order to make teaching timely and relevant for them, it is important to understand what medical students perceive as ethical problems, as various factors may influence their perception, including cultural differences and working environment. The purpose of this qualitative study was to explore students’ perceptions of what an ethical problem is, during their clinical training in the hospital, (...) and compare the results from two different countries. We observed a total of eighteen ethics group discussions and interviewed fifteen medical students at two medical schools, in Indonesia and the Netherlands. Data were interpreted and analyzed using content analysis. We found that students in both settings encounter problems which are closer to their daily work and responsibilities as medical students and perceive these problems as ethical problems. Indonesian students perceived substandard care and inequity in healthcare as ethical problems, while Dutch students perceived that cases which are not matters of life and death are less worthy to discuss. Our study suggests that there might be a gap between ethical problems that are discussed in class with teachers, and problems that students actually encounter in practice. Teachers should be aware of the everyday situations in clinical training which may be perceived by students as ethically problematic and should acknowledge and discuss these ethical problems with students as part of the learning processes in ethics education. (shrink)

Ted Shotter's founding of the London Medical Group 50 years ago in 1963 had several far reaching implications for medical ethics, as other papers in this issue indicate. Most significant for the joint authors of this short paper was his founding of the quarterly Journal of Medical Ethics in 1975, with Alastair Campbell as its first editor-in-chief. In 1980 Raanan Gillon began his 20-year editorship . Gillon was succeeded in 2001 by Julian Savulescu, followed by (...) John Harris and Soren Holm in 2004, with Julian Savulescu starting his second and current term in 2011. In 2000 an additional special edition of the JME, Medical Humanities , was published, under the founding joint editorship of Martyn Evans and David Greaves. In 2003 Jane Macnaughton succeeded David Greaves as joint editor. Deborah Kirklin, under whose auspices MH became an independent journal, took over in 2008, and she was succeeded in 2013 by Sue Eckstein. This short paper offers reminiscences and reflections from the two journals’ various editors.From the start the JME was committed to clearly expressed reasoned discussion of ethical issues arising from or related to medical practice and research. In particular, both Edward Shotter and Alastair Campbell, each a cleric , were at pains to make clear that the JME was not a religious journal and that it had no sort of partisan axe to grind.Campbell's appointment as founding editor was something of a surprise, as the original intention had been to appoint a medical doctor, who could be expected to know medical practice from the inside. However, in 1972 Campbell, a Joint Secretary of the Edinburgh Medical Group, had published Moral dilemmas in medicine. …. (shrink)

Evidence‐based medicine has become both the mantra of clinical practice and the dominant contemporary approach to patient care. Gordon Guyatt et al. first proposed applying the concept to medical education in the early 1990s, arguing for training that “de‐emphasizes intuition, unsystematic clinical experience, and pathophysiologic rationale” in favor of “examination of evidence from clinical research”; over the following twenty‐five years, nearly every medical school and residency program in the United States incorporated these methods into its training. During (...) this same period, admissions requirements and protocols have continued to rely on subjective, non‐evidence‐based ideals largely developed a century earlier. In light of the continued underrepresentation of certain demographic groups among matriculants, as well as the national controversy surrounding admissions standards at undergraduate institutions—most notably embodied in the lawsuit by Students for Fair Admissions against Harvard University—the moment may be ripe for a radical reexamination of those requirements. (shrink)

Western society today is less unified by a set of core values than ever before. Undoubtedly, the concept of moral consensus is a difficult one in a liberal, democratic and pluralistic society. But it is imperative to avoid a rigid majoritarianism where sensitive personal values are at stake, as in bioethics. Bioethics has become an influential part of public and professional discussions of health care. It has helped frame issues of moral values and medicine as part of a more general (...) effort to find consensus about some of the most perplexing questions of our time. But why is it thought that a moral consensus is important or that it deserves respect? How does moral consensus acquire legitimacy in a society that includes diverse value systems? How is moral consensus possible and how do small groups help create or distort consensus processes? Written by a medical school professor trained in philosophy, this timely work tackles these questions from philosophical, historical, and social scientific standpoints. It begins by describing the traditional ambivalence about consensus in Western culture as well as the uncertain relationship in modernity between consensus and expertise. After outlining the current bioethical consensus, the book gives philosophical and political analyses of the idea of consensus, then assesses the role of consensus in national ethics commissions and in the ethics committee movement. Moreno constructs an original, naturalistic philosophy of moral consensus, referred to as "bioethical naturalism", and then applies sociology and social psychology to actual consensus processes. The book concludes with an account of bioethics as a consensus-oriented social reform movement. This insightful volume will be essential reading for bioethicists, philosophers, physicians, members of ethics committees, and all those concerned with ethical and social issues in health care. (shrink)

School bullying also referred to as peer victimization is considered extremely harmful for all parties involved. It has been recognised as an important issue in Polish schools. This article presents the first stage of a project financed by the National Centre of Research and Development and includes the results of qualitative research conducted in groups of middle-school students, middle-school teachers and psychologists. The results highlight several factors leading to the exclusion from the dominant peer group. The (...) results also indicate that although students are aware of the consequences of bullying and excluding behaviours, they do not implement this knowledge when explaining their own excluding actions. All results are discussed in terms of designing and implementing a data-based programme which would effectively mitigate excluding behaviours during middle-school transition. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Lenore Davidoff 1923–2014 Lenore Davidoff, a pioneering historian of British women, died October 19, 2014, from Hodgkins’ lymphoma. We have lost a generous and influential leader in gender studies and an early supporter of Feminist Studies. Born in the United States, Davidoff left in 1953 to study sociology at the London School of Economics. Her first book, The Best Circles: Society, Etiquette and the Season (1973), (...) led her to a subject she made her own: the paid and unpaid work of women, not only of wives and mothers, but also of servants. In 1979 she published an article in Feminist Studies on the secret cross-class love between a master and servant, “Class and Gender in Victorian England: The Diaries of Arthur J. Munby and Hannah Cullwick.” It remains one of Feminist Studies’s most frequently cited publications. Davidoff went on to publish numerous books and articles, including the influential Family Fortunes: Men and Women of the English Middle Class, 1780-1850 (1987), co-authored with Catherine Hall, which argued that the formation of separate spheres—men for business, women for home—was an integral part of the early capitalist enterprise. Davidoff played a key role in building a community of fellow scholars in the 1970s and 1980s. She was instrumental in starting the Feminist History Group in London and the Women ’s Research and Resources Centre, now the Feminist Library. She served as the founding editor of the international journal Gender and History from 1987 until 1994 and remained active on its board till her death. Davidoff inspired countless feminists with her writings, mentorship, and friendship. She was invariably encouraging with younger scholars, offering incisive suggestions that could turn an early, inchoate idea into an exciting project. She will be sorely missed. —Martha Vicinus I n M e m o r y o f... (shrink)

SETTING: Previous health policies in South Africa neglected the teaching of ethics and human rights to health professionals. In April 1995, a pilot course was run at the University of Cape Town in which the ethical dimensions of human rights issues in South Africa were explored. OBJECTIVES: To compare knowledge and attitudes of participating students with a group of control students. DESIGN: Retrospective cohort study. SUBJECTS: Seventeen fourth-year medical students who participated in the course and 13 control students (...) from the same class, matched for gender. INTERVENTIONS: Students participated in a one-week module on ethics and human rights. Five months after the course had been run, students completed a semi-structured questionnaire exploring their knowledge and attitudes with regards to ethics and human rights issues. MAIN OUTCOME MEASURES: Knowledge scores, attitude scores and various individual indicators of attitude. RESULTS: Clear benefits for overall knowledge score, for four out of five individual knowledge questions and for one of the attitude questions, were demonstrated. Participating students also appeared to be more convinced of the need for teaching on the ethical dimensions of human rights at postgraduate level and that such teaching should also be integrated in the curriculum. The low response rate amongst controls may have selected students who were more socially conscious, thereby leading to an underestimate of the true impact of the course. CONCLUSION: The evaluation indicates clear benefits of the course for undergraduate students, and supports arguments for the inclusion of such courses in the training of health professionals. This is particularly important given the challenges posed by the Truth and Reconciliation Commission to the health professions to address past complicity in human rights abuses through reorientation of medical training in South Africa. (shrink)

In England, education reforms in 2014 and 2019 place more emphasis on inclusive policies and practices. How are school teachers meeting this new requirement for better inclusion of pupils with special educational needs and disability (SEND)? Do collaborative practices have a part to play? These questions are addressed within the research project Empowering Teachers for Inclusion in Schools (ETIS), which examines teachers’ views of inclusion and in-school practices across six countries. This article reports on field research (...) carried out in England in 2022, and the views of 16 educators working in mainstream or SEND schools in London and Sussex. Teachers’ voices are heard describing the challenges and successes of working collaboratively to better include diverse pupils in both mainstream and SEND settings. Findings point to the importance of knowledge-sharing within and between schools in the mainstream sector, where new responsibilities to include have been defined by the recent education reforms. Equally, capacity-building in mainstream schools could be developed in conversation with the SEND sector, wherein lies considerable expertise about adaptive pedagogies. (shrink)

Teachers have a very important role in determining the quality of the teaching-learning process and the students’ learning outcomes. Learning outcomes will optimally be achieved if it is supported by qualified teachers. One way to enhance the teachers’ performance is through instructional supervision which can be divided into two techniques, namely group and individual supervision techniques. Therefore, this study aims to find out the influence of instructional supervision techniques on the work motivation and performance of elementary (...) school teachers. This study was conducted in East Java, Indonesia, and an explanatory research design was used. The sample was taken from 80 elementary school teachers in Malang and Blitar using a multi-stage random sampling technique. Data were collected through the use of questionnaires and documentation, and then they were analyzed by using the structural equation modeling technique. The result of this study showed that group supervision has a significant effect on teachers’ performance, whereas individual supervision influenced teachers’ work motivation and it affected their performance. (shrink)

Dick Welbourn, who was Professor of Surgery at the Royal Postgraduate Medical School at Hammersmith Hospital from 1963 until 1979, was one of the early advisers of the London Medical Group .He served on its Consultative Council, whose function was to identify clinicians and others to address topics selected by students for inclusion in the London Medical ….

OBJECTIVES: To study the resources available and resources needed for ethics teaching to medical students in UK medical schools as required by the new GMC core curriculum. DESIGN: A structured questionnaire was piloted and then circulated to deans of medical schools. SETTING: All UK medical schools. RESULTS: Eighteen out of 28 schools completed the questionnaire, the remainder either indicating that their arrangements were "under review" (4) or not responding (6). Among those responding: (...) 1) library resources, including video and information technology were found to be fairly well developed; 2) many schools had a good supply of handouts and sample cases for teaching; 3) most had a written syllabus, and 4) two-thirds examined in the subject. However, many schools indicated that there was an urgent need for: 1) full-time teachers (most ethics teaching is still by part-time and voluntary staff); funding for books and journals, and 3) additional teaching materials (including further case vignettes, handouts and sample exam questions). CONCLUSIONS: There has been a considerable overall improvement in resources for medical ethics teaching since the time of the last national survey (The Pond Report). However, provision varies widely from medical school to medical school. The particular needs identified were for full-time teachers, library resources and teaching materials. Wider use of existing organisations concerned with medical ethics could help to meet these needs. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law (...) and medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developing by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an African Working Group addressed key challenges for the relevance (...) and cogency of an ethical code in occupational health for an African context through an iterative consultative process. (shrink)

During the twentieth century, bibliographic classification theory underwent a structural revolution. The first modern bibliographic classifications were top-down systems that started at the universe of knowledge and subdivided that universe downward to minute subclasses. After the invention of faceted classification by S.R. Ranganathan, the ideal was to build bottom-up classifications that started with the universe of concepts and built upward to larger and larger faceted classes. This ideal has not been achieved, and the two kinds of classification systems are not (...) mutually exclusive. This paper examines the process by which this structural revolution was accomplished by looking at the spread of facet theory after 1924 when Ranganathan attended the School of Librarianship, London, through selected classification textbooks that were published after that date. To this end, the paper examines the role of W.C.B. Sayers as a teacher and author of three editions of The Manual of Classification for Librarians and Bibliographers. Sayers influenced both Ranganathan and the various members of the Classification Research Group (CRG) who were his students. Further, the paper contrasts the methods of evaluating classification systems that arose between Sayers’s Canons of Classification in 1915–1916 and J. Mills’s A Modern Outline of Library Classification in 1960 in order to demonstrate the speed with which one kind of classificatory structure was overtaken by another. (shrink)

The article presents results of a research of student – teacher relationship styles in the school environment, measured by the stroke economy. The sample includes 339 students between the ages of 13 to 15, of whom 198 are from vulnerable and 141 are from invulnerable groups, and 229 teachers between the ages of 24 to 65. The results present significant differences in the styles used by the three groups. Students from vulnerable groups declare preferences for the (...) styles “Don't accept” and “Don't give yourself”, which is expressed in a tendency to devalue their own achievements and successes. Students from invulnerable groups and teachers express preferences for the styles “Don't accept” and “Don't ask”, which suggests manifestations of characteristics such as confidence and a tendency to reject compliments. The obtained results can be used as an approach to increase the efficiency of the student-teacher relationship and improve the social climate in the classroom. (shrink)

Background: International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the (...) relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion: Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand that actions for occupational health extend beyond just the workplace. Summary: A stronger articulation of occupational health practice with advocacy for prevention should be an ethical norm. Ethical codes should ideally harmonize and balance individual and community needs so as to provide stronger moral authority guidelines. There is a need to consider an African Charter on Bioethics as complementary and strengthening of existing codes for the region. (shrink)

Photo by Thought Catalog on Unsplash INTRODUCTION The coronavirus pandemic is a challenge to educators, policy makers, and ordinary people. In facing the threat from COVID-19, school systems and global institutions need “to address the essential matter of each human being and how they are interacting with, and affected by, a much wider set of biological and technical conditions.”[1] Educators must grapple with the societal issues that come with the intent of ensuring the safety of the public. To some, (...) “these are actually as important as the biological concerns of people.”[2] The current global crisis shows that “scientifically, socially, and politically the economy and technosphere are not just related, they are integral to a comprehensive response to major challenges.”[3] In developing these responses, scientists, government leaders, and policy makers need to consider the vulnerabilities of people, especially those in “thrown away” groups.[4] Jerome Ravetz explains that “microscopic viral predators cull our populations, as ever, but with a selection that is not natural but social and political.”[5] Educators must address the underlying vulnerabilities and evaluate the virus as a threat to academic experiences and access to a fair education. ANALYSIS • Critical Pedagogy By definition, the critical approach to teaching is about the problem-posing method of education developed by Paolo Freire. In his Pedagogy of the Oppressed, he proposed a paradigm shift away from the banking method of learning wherein teachers deposit knowledge into the minds of students. Critical pedagogy is an educational approach that challenges students to develop the ability to recognize and criticize dominating theories and evaluate them in their social context. Teachers press students to recognize oppression and try to remedy oppression in their culture.[6] Despite the lack of in-person interaction between the teacher and the students, the effort to use innovative teaching techniques like critical pedagogy should continue. Online learning is not just about the use of technology, although the internet is crucial in the delivery of content. Since human beings are creators of value, they determine the meaning and purpose of technology. In this way, the set of values people have will influence online learning. Teachers cannot be more concerned about outcomes than about the process itself. The process is crucial since the ability of the student to think critically is developed in the exchange between the student and the teacher. The teacher cannot simply dump loads of information (deposit knowledge) but must pose problems to test the analytical and critical skills of students.[7] Education is about how people humanize the world. Policy makers miss the point when they focus on the delivery but do not pay attention to the substantive aspect of learning, which is human empowerment. Education is meant to expand the freedom of people. Education should be seen as an integrative activity. Learning is a formative process that aims to develop the human person. Without the face-to-face encounter between teacher and students, the challenge is finding ways to make learning an effective means to mold the values of young people. • Online Critical Pedagogy & the Role of Technology Physical distance appears to be an impediment in realizing the ideals of learning. The lack of contact between the teacher and the students may prevent a more meaningful interaction since online instruction is impersonal. It can be argued that there is no alternative to some classroom activities, especially laboratory experiments in science courses. The total classroom environment naturally influences the behavior of students when it comes to academic work: the look in the eyes of the professor, the caring ways of a teacher, or the pressure while taking exams contribute to an experience that only a classroom setting can provide. If implemented properly, technology can facilitate the personal relationships between teachers and students while providing meaningful experiences. With the current need for online learning during the COVID-19 pandemic, gadgets are indispensable. Some would even consider gadgets an extension of the human body. A mobile phone is not just any instrument; it has evolved into a novel way of being in the world. Our gadgets are a means of seeing how the outside world unfolds. Modern technological tools allow the interface of people in many fields of experience in a globalized environment. Computers and other digital devices extend the meaning and value of human freedom. For example, a laptop provided to a poor child can redefine the meaning of and what the future might hold for that child. The device is crucial to the whole learning process. Modern tools are critical to self-discovery and greater freedom. The values that people embrace will matter in the new normal. The internet has provided a new democratic space that empowers groups and individuals to express themselves and to understand the world.[8] In an online class, students and teachers alike need to analyze big picture questions and layers of information. For example, the student in an ethics or philosophy class can reflect on the realities of life. With the proper guidance, online education should help define the meaning of moral commitment and human responsibility. CONCLUSION Before the pandemic, policy makers had been pursuing the goals of a globalized economy. They had been fashioning and promoting programs that cater to the interests of a consumer-driven world that has deprived the poor of opportunity. When the pandemic struck, globalization suddenly came to a halt and people realized the things that truly matter in life – family, love, and life itself. The new normal must now emphasize the role of education as a source of inner strength that can empower the person to live well reinforcing values based on a social consciousness. Critical pedagogy is possible under the new normal. The distance between the teacher and student does not make the educational process less real and in the absence of a vaccine, online learning is the safest strategy. Governments cannot freeze an entire school year since education is the only way out from poverty for millions. The COVID-19 pandemic provides a reason to re-imagine teaching using technology to encourage all students to question systems of oppression or greed, as the persistent pursuit of the truth is what education is all about. [1] Hartsell, Layne, Krabbe, Alexander, & Pastreich, Emmanuel. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene.” Social Ethics Society Journal of Applied Philosophy 6, no. 2 (2020), 3. [2] Ravetz, Jerome. “Science for a Proper Recovery: Post-Normal, not New Normal.” Issues in Science and Technology [Internet] July 15, 2020. https://issues.org/post-normal-science-for-pandemic-recovery/ [3] Hartsell, et al. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene,” 6. [4] Ravetz, “Science for a Proper Recovery: Post-Normal, not New Normal.” [5] Ibid. [6] Freire, Paolo. Pedagogy of the Oppressed. (New York: Continuum Books, 1993). [7] Freire writes that in such a situation “instead of communicating, the teacher issues communiqués and makes deposits which the students patiently receive, memorize, and repeat.” See his Pedagogy of the Oppressed. [8] Bakardjieva, Maria. Internet Society. (London: Sage Publications, 2005). (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Jewish Thought and Scientific Discovery in Early Modern EuropeNoah J. EfronAlmost a quarter-century ago Benjamin Nelson published his famous plea for what he called a “differential” and “comparative historical sociology of ‘science’ in civilizational perspective.” 1 Like Max Weber, Robert Merton, and Joseph Needham, Nelson believed that the growth of western science could be better understood when compared to the ways “science” fared in other cultures with other (...) intellectual and institutional and economic sensibilities and structures. A particularly propitious case study for such a differential and comparative historical study of science, as Hillel Levine observed in his 1983 essay about Jewish reactions to heliocentrism, are the Jews of early modern Europe, who constituted “a society geographically and culturally contiguous with those who framed and advanced occidental ‘science.’” 2Since about the time of Nelson’s plea, David B. Ruderman has been writing the history of Jewish attitudes towards, and engagements with, science during the period in which modern western science was constituting itself. It is no exaggeration to say that he established this as a field of study, producing a steady stream of historical studies, initially of Italian Jews who read and wrote about nature and its study, but continually expanding his compass. 3 The field [End Page 719] Ruderman established and the studies he produced have been “repercussive” (to borrow his own adjective) in many directions—shedding light on Jewish-Christian relations, on early-modern Jewish intellectual history, on the deployments of Kabbalah and magic in early modern times, and so on. One of Ruderman’s achievements—perhaps not the most important in his view (for he considers himself a historian of Jewish thought and culture and not a historian of science) but of great importance nonetheless—has been to begin to lay the groundwork for a comparative history of Jewish and Christian attitudes towards and participation in the “new sciences.”Ruderman’s newest book is a big step towards Nelson’s desideratum, using Jewish attitudes as the comparative case. It is a collection of twelve linked essays (five of which have appeared elsewhere in one form or another) framed by a synthetic introduction and epilogue. The essays are individual or group portraits of Jews who evinced interest in natural philosophy or medicine, in a variety of settings and for a variety of reasons, between the sixteenth and eighteenth centuries. Ruderman describes his subject as “three distinct but interrelated groups among early modern Jews”: (1) “converso physicians and other university-trained intellectuals who fled Spain and Portugal in the seventeenth century and settled in Holland, Italy, Germany, England, and even eastern Europe, serving as doctors and purveyors of scientific learning throughout the Jewish communities of Europe, while yielding considerable political and economic power,” (2) “certain circles of Jewish scholars in central and eastern Europe [who] pursued scientific learning, especially astronomy, in more informal settings as a desirable supplement to rabbinic study,” and (3) “the hundreds of Jews who attended Italian medical schools, primarily the University of Padua, from the late sixteenth through the eighteenth centuries.” 4In fact Ruderman covers even more ground than this. As background, he includes a brief essay on the attitudes of tenth- to fifteenth-century Jews towards nature and its study, surely the best survey of the sort available. Of the thirty or so early modern Jews that he describes in the remainder of the book, about twenty fit in at least one of the three camps upon which he focuses. 5 Nine [End Page 720] emerged from different circumstances (though these too were often highly influenced by one or more of the focus populations). This fact does nothing to impugn Ruderman’s typology—the groups he described were, in fact, of particular importance, and his identification of them as the principle populations contemplating and promulgating natural philosophy among Jews is in itself an advance of some moment. But the fact that a third of the cases Ruderman described do not fit into his own typology is testimony both to the complexity of his subject, and to his agility in addressing it.By anthologizing a dozen depictions of different thinkers in different milieus, Ruderman affords what might be called a “hawk... (shrink)

It is common practice within primary classrooms for teachers to spilt children into different ability groups so that children of similar level are taught together. Whilst this practice is used across the globe, research is mixed on the benefits of such grouping strategy. This paper presents data collected from mixed methods research which investigated teachers use of grouping strategies and social comparison, the act of comparing oneself with others. It focuses on when, why and with whom children (...) from different ability groups compare themselves and the impact this has on their self-perceptions. Drawing upon data from children aged between 10 and 11 years from 12 primary schools, social comparison was found to play a significant role in daily classroom life for some children. The study identified different strands of the social comparison process including acknowledgment, topic, target, and direction, and it revealed positive and negative effects of social comparison. A difference by ability group was identified. Children within the low ability group were particularly vulnerable to the negative effects of social comparison and found to engage in more frequent and intentional social comparisons which were heavily relied upon for self-evaluation and performance evaluation. The paper discusses the educational implications of social comparison regarding pupil ability grouping strategies, motivation, engagement, and academic performance. Implications for teacher education and professional development is discussed. (shrink)

IntroductionExperimental research on animals has been guided by principles of the three Rs: reduction, refinement and replacement.1 Recently the fourth R—rehabilitation—has also been incorporated to enhance the welfare of animals that are used in research. With growing scientific curiosity and increasing research, animal use has anything but reduced despite the fact that modern technology has brought to fore many alternatives to animal use.2 ,3 There are many arguments for and against animal use. In India, there has been a proposal to (...) ban the use of animals for training and academic purposes, as reported in two major daily newspapers. This has evoked mixed reactions from the scientific community. We conducted this study to assess the awareness, attitudes and practices regarding the use of animals and their alternatives, in medical training and research amongst medical teachers and students.Study designA …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine by Laurence B. McCullough, John Gregory’s Writings on Medical Ethics and Philosophy of Medicine ed. by Laurence B. McCullough, Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush by Lisbeth HaakonssenHeiner F. KlemmeLaurence B. McCullough. John Gregory and the Invention of Professional Medical Ethics and the Profession (...) of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xv + 347. Cloth, $140.00.Laurence B. McCullough, editor. John Gregory’s Writings on Medical Ethics and Philosophy of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xi + 254. Cloth, $105.00.Lisbeth Haakonssen. Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush. Amsterdam, Atlanta: Rodopi, 1997. Pp. x + 247. Paper, $20.50.The Scottish Enlightenment is widely appreciated for its contributions to philosophy, economics, sociology, law, chemistry, and medicine. The ideas and theories advanced by Hume, Smith, Millar, and Ferguson are still widely debated. John Gregory (1724–1773), important in his own time, is not as well known as some of his friends and colleagues. He was professor of medicine at the University of Edinburgh from 1766 to 1773, where he taught introductory lectures on the theory and practice of medicine. A set of extensive student notes from these lectures, entitled Observations on the Duties and Offices of a Physician, appeared anonymously in 1770. Two years later, Gregory himself published a revised version of his lectures under the title Lectures on the Duties and Qualifications of a Physician. These two books are said to mark the beginnings of professional medical ethics in the English-speaking world. They are also sometimes characterized as having anticipated bioethics.McCullough’s comprehensive John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine is the first modern intellectual biography of Gregory. Based on extensive research into eighteenth-century institutional context and the study of hitherto unknown manuscripts, he gives a full account of Gregory’s education at Edinburgh and Leiden, and his practice and teaching of medicine at Aberdeen, London, and Edinburgh. He stresses the importance of Gregory’s membership in the Aberdeen Philosophical Society and his close contact with Mrs. Montagu and her Circle for the understanding of his medical ethics. McCullough also shows that Bacon’s experimental method had a decisive influence on Gregory. Gregory took over Bacon’s three offices or ends of medicine: preservation of health, prolonging of life, and curing of diseases. In 1772, perhaps anticipating his premature death from hereditary gout, he added a fourth office, namely easing the pain of dying. Gregory referred mainly to Bacon (and Reid) in his Lectures to make clear how we can enlarge our medical knowledge by the method of experience and observation, pointing out that the progress of medicine had been seriously retarded by the way in which it was taught since Hippocrates. He also thought it was handicapped by the view that only professionals [End Page 535] should practice it, and claimed that even quacks have their advantages because their interest and reputation seldom suffer from the failure of the experiments necessary for the improvement of the medical profession.Gregory also argued that we should regard medicine not as a trade but as an art. In this context the principle of sympathy (or humanity) became important for him. Sympathy was the basis of the central duties in his Lectures. In a time of extreme instability of manners, when medicine was regarded more as a trade than an art, there was no physician-patient relationship based on the epistemological and moral authority of the physician. According to McCullough, it was Gregory who created “the physician-patient relationship as fiduciary. The virtues of the physician as fiduciary—openness to conviction, tenderness, and steadiness—provided for him the moral causes that would gather physicians together into a group worthy of the name, ‘profession,’ in its intellectual and moral senses” (265). The physician should no longer view his patients as moral strangers.McCullough claims that Gregory’s medical ethics is not just of historical interest, providing bioethics with its own history. It is also of... (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (...) (52%) respondents were course directors; 26 (43%) were deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

Medical ethics and law (MEL) have a well-established place in medical curricula within the UK, but appropriately assessing MEL in a medical school context can be extremely challenging. The Institute of Medical Ethics convened a working group focused on assessment in 2021, and in this article, we present a summary of the work undertaken by this group. We start by explaining the challenges presented by the assessment of MEL, highlighting the potentially demanding requirements set (...) out by the General Medical Council in the UK. We then explore how MEL is currently assessed in UK medical schools. We go on to consider a number of different forms of assessment and their suitability for assessing ethics and law. Finally, we report the key recommendations from the working group and conclude that we are unconvinced that current approaches to assessing MEL are sufficient to robustly assess the General Medical Council’s learning outcomes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Past, Present—and Future Perfect?Taking Psychiatry Beyond Its Single Message MythologiesK. W. M. Fulford (bio)I am grateful to John Sadler and his colleagues for their generous invitation to contribute to this collection marking Philosophy, Psychiatry, & Psychology (PPP)'s thirtieth birthday. True to our editorial tradition of "no nonsense" publishing, the "ask" was a reflection on PPP's past, present and future, limited to 500 words. In fact, one word does it (...) for me—collegiality.Collegiality was our watch word from the start. I still treasure a group photo taken at an early pre-meeting of the Association for the Advancement of Philosophy and Psychiatry (AAPP) convened by Michael Schwartz at his home in 1992, when, among other initiatives, PPP was conceived through transferring our then-nascent journal proposal from a small British publishing house to its current international publisher, the Johns Hopkins University Press. Michael and I had met earlier by phone when he had called the Royal College of Psychiatrists in London to enquire about its recently launched Philosophy Group and (by mere chance) I happened to be standing next to the person who took the call! PPP, with John and myself its founder editors, was subsequently born as, and has remained, a joint venture between our two groups: and Peter Zachar's recent initiative in building closer links with the International Network for Philosophy and Psychiatry (INPP) has taken us an important step towards the vision shared by Michael, John and myself that PPP should grow to reflect and represent a global open society of philosophy and mental health.As a pointer to the future, this global open society was no mere utopian vision but a joint commitment to what we conceived as a necessary ambition. Contemporary disenchantment with the repeated failures of translation of current narrowly empirical models of psychiatry, points to the truth of our German colleague, Paul Hoff's, characterization of the history of psychiatry as a history of serial collapses into single message mythologies. This disenchantment might seem to offer an opportunity for colonial expansion of philosophy into psychiatry (a re-assertion, perhaps, of phenomenology?). But PPP was born out of the "decade of the brain" and has remained throughout an ally of, not competitor to, the neurosciences. [End Page 3] So, while it is true that, with Peter's initiative, and with editorial and other innovations introduced by John, PPP is actively extending its reach (to new areas of philosophy, and to new voices, informed notably by experience as well as by training), this expansion remains a collegial not colonial enlargement of the field. I need hardly point to the challenges presented by the inclusive ambitions of such enlargement (not least to maintaining the highest standards of editorial and peer review). But PPP's collegiality provides the foundation for the work needed to deliver on these challenges. Even if imperfectly realized, this collegiality will help to take us beyond the single message mythologies by which our discipline has too long been hobbled. [End Page 4]K. W. M. Fulford K.W.M. (Bill) Fulford is a Fellow of St Catherine's College and Member of the Philosophy Faculty, University of Oxford; Emeritus Professor of Philosophy and Mental Health, University of Warwick Medical School; and Founder Director of the Collaborating Centre for Values-based Practice, St Catherine's College, Oxford (valuesbasedpractice.org).Copyright © 2023 Johns Hopkins University Press... (shrink)

Our study adopted a person-based approach with the aim to identify socio-behavioral profiles of primary school students based on peer group perception. The study involved 109 classes and their teachers, from the first three grades of elementary school. The final student sample consisted of 424 children, aged 6–9 years ( M = 94.9 months; SD = 9.7), of whom 58.3% were male. We used peer-group nomination to investigate the aspects that are linked to peer group (...) acceptance and perception of classroom behaviors, with reference to academic and relational criteria. We identified and defined six clusters. We validated these clusters by taking into consideration the children’s academic performances and the teacher’s perceptions of their relationship with the single students. The identified clusters were related to both of these aspects, and they show predictive value when referring to children’s behaviors as evaluated by their teachers. Implications for theory and educational policies are discussed. (shrink)

It is time for the noon conference. Your job is to impart a career-changing experience in ethics to a group of students and interns gathered from four different schools with varying curriculums in ethics. They have just finished 1½ h of didactic sessions and lunch. One third of them were on call last night. Your first job is to keep them awake. The authors argue that this “tragic case” approach to ethics education is of limited value because (...) it limits understanding of moral problems to dilemmas; negates the moral agency of the student; encourages solutions that are merely intellectual; and suggests that ethical encounters are a matter for experts. The authors propose an alternative that focuses on three issues: the provider-patient relationship, the relationships between providers in the everyday world of health work and, the social position of healthcare providers in society. In this approach, teachers are not experts but more like guides on a journey who help students to learn that much of ethical practice comprises living through difficult situations of caring for vulnerable others and who help students to navigate some of these difficulties. (shrink)

The South African government’s COVID-19 pandemic risk mitigation strategies significantly limited social contact, which necessitated a novel approach to existing face-to-face career guidance practices. The Grade 9 Career Guidance Project, originally developed as a group-based career development intervention, required radical adaptation into a self-directed, manualized format to offer career guidance to Grade 9 learners from low-income communities amid a global pandemic. The adaptation and continuation of the project was deemed essential as secondary school learners in low-income communities have (...) limited career guidance support. Furthermore, a close collaboration with the teachers at eight resource-constrained South African secondary schools was vital for successful implementation. To assess the success of the adaptation to a self-directed format, a mixed-methods design was employed, and Life Orientation teachers’ evaluative feedback was solicited. Favorable quantitative results were obtained; majority of teachers agreed that learners enjoyed the booklet and that it was deemed an adequate substitute to the previous contact-based format of the Career Guidance Project. This was also confirmed by the qualitative findings revealing teachers’ satisfaction with the booklet’s content, specifically that the booklet is complementary to the Life Orientation curriculum. Qualitative findings identified specific contextual barriers that contributed to some learners struggling to use the booklet optimally. The results suggest that it is feasible and acceptable to implement a self-directed career guidance intervention among secondary school learners amid a global pandemic. Teachers recommended ways to integrate the booklet, resources, and contact sessions as a preferred way forward. These findings have important implications for similar resource-constrained settings that may not have readily access to in-person career guidance and counseling human development. (shrink)

ObjectiveThis study investigated the effects of a school-based skill-training intervention in attention control and executive functions for pupils with hyperactivity-impulsivity and cognitive control deficits. The main aim was to examine whether the intervention differently influenced H-I and CC, and whether cognitive abilities or conduct problems moderated response to the intervention.MethodElementary school pupils from 41 schools participated the study and were divided into an intervention group and a waitlist control group. Intervention outcomes were assessed with an inventory (...) assessing executive function difficulties completed by classroom teachers.ResultsSignificant intervention effects and positive changes were detected in CC but not in H-I. Significant intervention effects were found mainly among pupils with low levels of conduct problems.ConclusionsThe results suggest that a skill-training intervention has specific positive effects on CC, but conduct problems may diminish response to intervention. (shrink)

We examined developmental changes in British children’s (8- to 10-year-olds) and adolescents’ (13- to 15-year-olds,N = 340; FemaleN = 171, 50.3%) indirect bystander reactions (i.e., judgments about whether to get help and from whom when witnessing social exclusion) and their social-moral reasoning regarding their reactions to social exclusion. We also explored, for the first time, how the group membership of the excluder and victim affect participants’ reactions. Participants read a hypothetical scenario in which they witnessed a peer being (...) excluded from a school club by another peer. We manipulated the group membership of the victim (either British or an immigrant) and the group membership of the excluder (either British or an immigrant). Participants’ likelihood of indirect bystander reactions decreased from childhood into adolescence. Children were more likely to get help from a teacher or an adult than getting help from a friend, whereas adolescents were more likely to get help from a friend than getting help from a teacher or an adult. For both indirect bystander reactions, children justified their likelihood of responding by referring to their trust in their teachers and friends. Adolescents were more likely to refer to group loyalty and dynamics, and psychological reasons. The findings support and extend the Social Reasoning Developmental (SRD) approach by showing the importance of group processes with age in shaping children’s judgments about how to respond indirectly by asking for help from others, when they are bystanders in a situation that involves exclusion. The findings have practical implications for combating social exclusion and promoting prosocial bystander behavior in schools. (shrink)

This timely, well‐written book illuminates an aspect of Brazilian science that has long been neglected, for two major reasons. The first is that it is only in the past two decades that the scientific past of Latin America, including Brazil, seemed to merit systematic academic investigation, and only with this change have scholars discovered, or rediscovered, several important, but forgotten, developments, such as the one Julyan Peard analyzes in this study. The second reason is that, although there is a substantial (...) literature on late nineteenth‐ to early twentieth‐century colonial science and medicine—which is considered almost synonymous with tropical medicine—none of it treats Brazil or any of the other Latin American countries because, even though they fall within the tropical zone, they were formally independent nations from the early 1800s onward.Peard rejects this adherence to the old criterion for defining “tropical.” Drawing on a respectable collection of both primary and secondary sources, she tells the story of the Escola Tropicalista Bahiana , which was founded before the revolution in bacteriological knowledge and the great European colonial expansion. The idea for the school originated, Peard says, with “a group of nineteenth‐century doctors in Brazil who, in attempting to adapt Western medicine to more fully engage with the problems of their tropical country, sought novel answers to the age‐old question of whether diseases of warm climates were distinct from those of temperate Europe. In their search, they used the tools of Western medicine to confront European ideas about the fatalism of the tropics and its people, and to argue in favor of Brazilian expertise.”The text is organized into five chapters, whose titles clearly describe both the structure of the narrative and Peard's main points, as well as part of her conclusions: “The Escola Tropicalista Bahiana: A Creative Response in Adversity”; “The Politics of Disease”; “Race, Climate, Medicine: Framing Tropical Disorders”; “Physicians and Women in Bahia”; and “Moving into Mainstream.” In her introduction Peard presents a useful discussion of the earlier literature on her topic, pointing out her contribution to several relevant fields. Throughout, the text is structured to highlight the tension between the Tropicalistas and European science: “although they [the Tropicalistas] resisted aspects of European cultural authority that harped on Brazilian, and Latin American, inferiority, they wanted to gain the mantle of legitimacy that they believed only European science, as the leader in universal science, could bestow on them.” Peard shows, chapter by chapter, the Tropicalistas' sometimes conscious, sometimes intuitive strategies to build up an innovative scientific field, a project that entailed issues of national identity and the regional response to the centralized imperial authority of Rio de Janeiro. Almost half the volume is devoted to supplementary material: three useful appendixes, notes to all the chapters, a list of primary sources, the bibliography, and a well‐elaborated index—all of which testify to the quality of both Peard's research and her book as a whole.It is important to stress here that Peard relies on what one could call the “new” Brazilian history and sociology of science, particularly in the fields of medicine and public health. Despite its vigorous growth, both quantitatively and qualitatively, this historiography still remains more or less confined to Latin America, its wider dissemination impeded by language barriers. In using and commenting on the bibliography of this new historiography, Peard respects the local intellectual production while helping to enrich the traditional set of references. Nevertheless, and although I warmly recommend the book, I regret that she did not fully incorporate the conclusions reached by this recent historiography, preferring instead to present essentially the same picture drawn in previous works, a picture based on the view that “in the few instances of research work being carried out in Brazil before 1900 such work was sporadic, isolated … or incapable of being self‐sustaining.”. (shrink)

Each year a national day of commemoration of the war dead is celebrated on 11th November in the United Kingdom. Despite public controversy about the nature and purpose of remembrance, there has been no significant discussion of the role schools should play in this event. In this centenary year of the outbreak of the First World War, with the government planning to send groups from every secondary school in Britain to tour the battlefields of the western front over (...) the next four years, the question of how war should be remembered in schools is more pressing than ever. In this bold and rigorous pamphlet, David Aldridge takes a hard look at the reasons usually advanced for involving children and young people in commemorating the war dead, and finds many of them wanting. He critically examines the high profile in schools of charities, like the Royal British Legion, with vested interests in certain kinds of commemoration. And he argues forcefully for a justification of remembrance in schools that requires a major rethink of established rituals and practices. This is a compelling treatment of a topic high on the agenda of teachers and education policy-makers and will be an invaluable resource for anyone involved in planning centenary commemorative events for children and young people. (shrink)

Based on the broaden-and-build theory of positive emotions, this study explored the mediating effect of spiritual intelligence between awe and life satisfaction among Chinese primary school teachers and whether this effect was moderated by ethnicity. Participants comprised 569 teachers from 24 primary schools in southwestern China, where many of the ethnic minority groups of China reside. Awe and spiritual intelligence were found to positively predict life satisfaction among primary school teachers, while awe also indirectly influenced (...) life satisfaction through the partial mediation of spiritual intelligence. Ethnicity was also found to moderate the relation between awe and life satisfaction, i.e., when compared with the Han teachers, there is a more significant and positive relation between awe and life satisfaction in ethnic minority teachers. These findings not only indicate the critical role of awe in promoting life satisfaction of primary school teachers but also especially show that awe embodied in the traditional cultural activities makes it easier to breed life satisfaction in ethnic minority teachers. (shrink)

This study assessed the mediating role of cognitive rigidity between temperament and social adjustment in teachers of schools and religious madaris of Pakistan while controlling for the influence of teaching experience. A purposive sample of 300 teachers (150 from public schools and 150 from religious madaris with equal representation of both the genders) was recruited from Sargodha and Lahore. Teachers of schools and madaris were matched in terms of their gender, age, (...) and educational qualification. Urdu translated versions of the Approach–Avoidance Temperament Questionnaire (ATQ), Cognitive Flexibility Scale (CFS), and Social Adjustment Scale were used to operationalize the focal constructs of this study. Path analysis revealed that approach temperament negatively and avoidance temperament positively predicted cognitive rigidity, which in turn led to lowered levels of social adjustment. Approach temperament positively and avoidance temperament negatively predicted social adjustment. The negative association between approach temperament and cognitive rigidity was stronger in the group of school teachers, whereas the positive association between avoidance temperament and cognitive rigidity was stronger among teachers of religious madaris. The positive indirect effect of approach temperament on social adjustment through rigidity was stronger for school teachers. Significant differences were observed in the mean scores of teachers of madaris and schools on avoidance temperament, social adjustment, and cognitive rigidity. Implications of the study and suggestions for future research have been reflected upon. (shrink)

__Demoralized: Why Teachers Leave the Profession They Love and How They Can Stay_ offers a timely analysis of professional dissatisfaction that challenges the common explanation of burnout. _Featuring the voices of educators, the book offers concrete lessons for practitioners, school leaders, and policy makers on how to think more strategically to retain experienced teachers and make a difference in the lives of students. Based on ten years of research and interviews with practitioners across the United States, the book (...) theorizes the existence of a “moral center” that can be pivotal in guiding teacher actions and expectations on the job. Education philosopher Doris Santoro argues that demoralization offers a more precise diagnosis that is born out of ongoing value conflicts with pedagogical policies, reform mandates, and school practices. _Demoralized_ reveals that this condition is reversible when educators are able to tap into authentic professional communities and shows that individuals can help themselves. Detailed stories from veteran educators are included to illustrate the variety of contexts in which demoralization can occur. Based on these insights, Santoro offers an array of recommendations and promising strategies for how school leaders, union leaders, teacher groups, and individual practitioners can enact and support “re-moralization” by working to change the conditions leading to demoralization. (shrink)

There is a need for empirically based research on social and ethical challenges related to informed consent processes, particularly in studies focusing on adolescent sexual and reproductive health. In a pilot study of a school-based pregnancy prevention intervention in rural Zambia, the majority of the guardians who were asked to consent to their daughters’ participation, refused. In this paper we explore the reasons behind the low participation in the pilot with particular attention to challenges related to the community engagement and (...) informed consent process. The pilot was implemented in two schools and examined the acceptability of a package of interventions including economic support to families to keep their girls in school, pocket money for girls, youth club meetings on reproductive health, and community meetings to sensitize the community. Focus group discussions were conducted with girls who participated in the pilot, boys in their class and with parents. Individual semi-structured interviews were conducted with teachers, peer educators and community health workers involved in the coordination of the intervention as well as with religious and traditional leaders. Data were analyzed through thematic analysis. The findings indicate that inadequate use of recognized community communication channels during the community engagement process and dissemination of information about the pilot resulted in limited understanding of the pilot concept by the community. This surfaced through uncertainty and fear that the intervention may result in loss of control over daughters, worries about why money was provided unconditionally to girls, and suspicion of links to satanism. The sense of insecurity appeared to be exacerbated by low literacy levels, poverty, fear of loss of bride wealth, perceived disregard for local perceptions of social status, and scanty trust in the actors implementing the pilot. Inadequate use of locally appropriate channels in the dissemination of information created room for interpretation and facilitated development of mistrust, undermining the conditions for community engagement and actual informed consent. A key lesson learnt is the importance of taking seriously the complexity of local values and structures that may impact people’s capability to consent or not consent to a study in an informed manner. (shrink)