The argument of the paper is that, for cases of self-deception that involve grave consequences for others, judging moral accountability need not involve the claim that the person knows he is deceiving himself. ignorance can be genuine and yet be culpable. in disagreement with fingarette, i conclude further that self-deceptive disavowal does not entirely subvert moral authority over what is disavowed.

Current work on hooking up—or casual sexual activity on college campuses—takes an individualistic, “battle of the sexes” approach and underestimates the importance of college as a classed location. The authors employ an interactional, intersectional approach using longitudinal ethnographic and interview data on a group of college women’s sexual and romantic careers. They find that heterosexual college women contend with public gender beliefs about women’s sexuality that reinforce male dominance across both hookups and committed relationships. The four-year university, however, also reflects (...) a privileged path to adulthood. The authors show that it is characterized by a classed self-development imperative that discourages relationships but makes hooking up appealing. Experiences of this structural conflict vary. More privileged women struggle to meet gender and class guidelines for sexual behavior, placing them in double binds. Less privileged women find the class beliefs of the university foreign and hostile to their sexual and romantic logics. (shrink)

This chapter contains sections titled: Allotment Associations The Allotment Site New Relationships: Councillors and Gardeners Conclusions Notes.

Involuntary civil commitment to treatment for opioid use disorder prevents imminent overdose, but also restricts autonomy and raises other ethical concerns. Using the Kass Public Health Ethics Framework, we identified ICC benefits and harms. Benefits include: protection of vulnerable, underserved patients; reduced legal consequences; resources for families; and “on-demand” treatment access. Harms include: stigmatizing and punitive experiences; heightened family conflict and social isolation; eroded patient self-determination; limited or no provision of OUD medications; and long-term overdose risk. To use ICC (...) ethically, it should be recognized as comprising vulnerable patients worthy of added protections; be a last resort option; utilize consensual, humanizing processes; provide medications and other evidence-based-treatment; integrate with existing healthcare systems; and demonstrate effective outcomes before diffusion. ICC to OUD treatment carries significant potential harms that, if unaddressed, may outweigh its benefits. Findings can inform innovations for ensuring that ICC is used in an ethically responsible way. (shrink)

A revisiting and distillation of themes, questions, and results of the book’s chapters, with a description of possible alternative pathways through the volume. Open problems and suggestions for further research are also offered, laying out a vision of the field as a whole, and calling for future research, especially into topics relating to qualitative vs. quantitative uses of big data, the concept of “media”, issues in the history of philosophy and digital humanities, normative questions concerning social justice, race, gender, and (...) disability, religion, human transformation, virtual and non-virtual reality, collective and individual experience, self-consciousness, personal identity, human enhancement through digital means, privacy, speech-act theory, documentality, history, and the intersection of research into psychological and social cognition. (shrink)

This paper is a critical examination of Lonergan’s notion of moral conversion. Conversion in general is described as a mode of self-transcendence and distinguished from development. Then moral conversion is contrasted with the two other basic forms of conversion, intellectual and religious. Next, I propose that there are two distinct moments of moral conversion: a negative moment of rational compunction, which is more Kantian in nature, and a positive moment of passionate transcendence, which is consonant with Scheler’s value ethics. (...) I draw on philosophical accounts of the initial awakening of moral consciousness, and argue that it is possible to make this first movement yet fail to make the second movement. (shrink)

Mata and von Helversen's integrative review of adult age differences in search performance makes a good case that cognitive control may impact certain aspects of self-regulation of search. However, information foraging as a framework also offers an avenue to consider how adults of different ages adapt to age-related changes in cognition, such as in cognitive control.

In the fifth–sixth century CE the rulers of the Kadamba dynasty claimed the town of Halsi in modern Karnataka as the northern capital of their expanding polity. Their investments in this locale are recorded in a corpus of copper-plate inscriptions spanning four generation of kings. The plates record the growth of a thriving Jain community at Palāśikā and are revelatory of their relationships with the Kadamba rulers and their agents. This study of the donative and political processes converging in Palāśikā (...) shows that the use of Sanskrit inscriptions as media for royal representation and public self-fashioning was highly developed in the Kadamba polity, where idioms and trends developed independent of the Gupta royal model. Moreover, the evidence from Halsi is indicative of the centrality of Jain religious communities, ideologies, and institutions in the administration of the Kadamba polity and the expression of a lineage identity. (shrink)

We propose that middle managers’ perceived organizational support enhances their performance through the sequential mediation of their behavioral integrity and follower organizational citizenship behaviors. We test our model with data collected from middle managers, their direct subordinates, and their direct superiors at 18 hotel properties in China. The current study’s findings contribute to the existing literature on perceived organizational support and behavioral integrity. They also add a practical self-interest argument for middle managers’ efforts to maintain their word-action alignment by (...) demonstrating that middle manager behavioral integrity positively affects middle managers’ own task performance ratings, both directly and via its positive effect on subordinates’ organizational citizenship behaviors. (shrink)

Fundamental problems of environmental sustainability, including climate change and fisheries management, require collective action on a scale that transcends the political and cultural boundaries of the nation-state. Rational, self-interested neoclassical economic theories of human behavior predict tragedy in the absence of third party enforcement of agreements and practical difficulties that prevent privatization. Evolutionary biology offers a theory of cooperation, but more often than not in a context of discrimination against other groups. That is, in-group boundaries are necessarily defined by (...) those excluded as members of out-groups. However, in some settings human’s exhibit behavior that is inconsistent with both rational economic and group driven cooperation of evolutionary biological theory. This paper reports the results of a non-cooperative game-theoretic exercise that models a tragedy of the commons problem in which groups of players may advance their own positions only at the expense of other groups. Students enrolled from multiple universities and assigned to different multi-university identity groups participated in experiments that repeatedly resulted in cooperative outcomes despite intergroup conflicts and expressions of group identity. We offer three possible explanations: students were cooperative because they were in an academic setting; students may have viewed their instructors as the out-group; or the emergence of a small number of influential, ethical leaders is sufficient to ensure cooperation amongst the larger groups. From our data and analysis, we draw out lessons that may help to inform approaches for institutional design and policy negotiations, particularly in climate change management. (shrink)

All lives contain negative events, but how we think about these events differs across individuals; negative events often include positive details that can be remembered alongside the negative, and the ability to maintain both representations may be beneficial. In a survey examining emotional responses to the 2013 Boston Marathon bombings, the current study investigated how this ability shifts as a function of age and individual differences in initial experience of the event. Specifically, this study examined how emotional importance, involvement, and (...) self-reported surprise upon hearing about the event related to the tendency to report focusing on the negative and positive aspects of the bombings. Structural equation models revealed that while greater emotional importance and surprise were associated with a greater focus on negative elements, involvement and age were associated with increased consideration of positive aspects. Further, emotional importance was more strongly related to an increased focus on negative aspects for young adults and an increased focus on positive aspects for older adults, highlighting a tendency for older adults to enhance positive features of an otherwise highly negative event. (shrink)

Background: Clinical genomic implementation studies pose challenges for informed consent. Consent forms often include complex language and concepts, which can be a barrier to diverse enrollment, and these studies often blur traditional research-clinical boundaries. There is a move toward self-directed, web-based research enrollment, but more evidence is needed about how these enrollment approaches work in practice. In this study, we developed and evaluated a literacy-focused, web-based consent approach to support enrollment of diverse participants in an ongoing clinical genomic implementation (...) study. Methods: As part of the Cancer Health Assessments Reaching Many (CHARM) study, we developed a web-based consent approach that featured plain language, multimedia, and separate descriptions of clinical care and research activities. CHARM offered clinical exome sequencing to individuals at high risk of hereditary cancer. We interviewed CHARM participants about their reactions to the consent approach. We audio recorded, transcribed, and coded interviews using a deductively and inductively derived codebook. We reviewed coded excerpts as a team to identify overarching themes. Results: We conducted 32 interviews, including 12 (38%) in Spanish. Most (69%) enrolled without assistance from study staff, usually on a mobile phone. Those who completed enrollment in one day spent an average of 12 minutes on the consent portion. Interviewees found the information simple to read but comprehensive, were neutral to positive about the multimedia support, and identified increased access to testing in the study as the key difference from clinical care. Conclusions: This study showed that interviewees found our literacy-focused, web-based consent approach acceptable; did not distinguish the consent materials from other online study processes; and valued getting access to testing in the study. Overall, conducting empirical bioethics research in an ongoing clinical trial was useful to demonstrate the acceptability of our novel consent approach but posed practical challenges. (shrink)

This paper defends the avowal view of self-deception, according to which the self-deceived agent has been led by the evidence to believe that ¬p and yet is sincere in asserting that p. I argue that the agent qualifies as sincere in asserting the contrary of what they in the most basic sense believe in virtue of asserting what they are committed to believing. It is only by recognizing such commitments and distinguishing them from the more basic beliefs whose (...) rational regulation is automatic that the tension between the self-deceived agent’s actions and assertions can be explained in a core subset of cases of self-deception. (shrink)

This paper raises three concerns regarding self-ownership rhetoric to describe autonomy within healthcare in general and reproductive justice in specific. First, private property and the notion of “ownership” embedded in “self-ownership,” rely on and replicate historical injustices related to the initial acquisition of property. Second, not all individuals are recognized as selves with equal access to self-ownership. Third, self-ownership only justifies negative liberties. To fully protect healthcare access and reproductive care in specific, we must also be (...) able to make claims on others to respect, protect, and fulfill our positive rights. As much as nondomination remains an urgent demand for reproductive rights, it does not go far enough to ensure reproductive justice. (shrink)

"The location of the author’s investigations, the body itself rather than the sphere of subjective representations of self and of function in cultures, is wholly new.... I believe this work will be a landmark in future feminist thinking." —Alphonso Lingis "This is a text of rare erudition and intellectual force. It will not only introduce feminists to an enriching set of theoretical perspectives but sets a high critical standard for feminist dialogues on the status of the body." —Judith Butler (...) Volatile Bodies demonstrates that the sexually specific body is socially constructed: biology or nature is not opposed to or in conflict with culture. Human biology is inherently social and has no pure or natural "origin" outside of culture. Being the raw material of social and cultural organization, it is "incomplete" and thus subject to the endless rewriting and social inscription that constitute all sign systems. Examining the theories of Freud, Lacan, Merleau-Ponty, Foucault, Deleuze, Derrida, etc. on the subject of the body, Elizabeth Grosz concludes that the body they theorize is male. These thinkers are not providing an account of "human" corporeality but of male corporeality. Grosz then turns to corporeal experiences unique to women—menstruation, pregnancy, childbirth, lactation, menopause. Her examination of female experience lays the groundwork for developing theories of sexed corporeality rather than merely rectifying flawed models of male theorists. (shrink)

The self-disorder model provides a phenomenological framework for understanding how the core symptoms of Schizophrenia Spectrum Disorders (SSDs) are rooted in an instability of minimal selfhood. This instability involves a range of “anomalous experiences”: transformations in an individual’s perceptual field and sense of being an agent of action. The explanatory value of this theoretical model can be summarized in two claims about the role of anomalous experiences in self-disorders: (1) anomalous experiences express a common trait-like disturbance that is (...) characteristic of SSDs, and (2) anomalous experiences contribute to explanations regarding how self-disorders progress into SSDs. While hypotheses consistent with the first claim have been substantiated in several studies, hypotheses consistent with the second claim remain underexamined. We argue that attending to this gap in the literature requires considering which methodological strategies are best suited for investigating if and how anomalous experiences contribute to the development of self-disorders into SSDs and psychotic states. Network modeling is discussed as one such strategy suitable for examining the role of anomalies of lived-world in the maintenance of paranoid delusions in SSDs. (shrink)

Counterfactual verbal irony, an evaluative form of figurative language wherein a speaker’s intended meaning is opposite to the literal meaning of his or her words, is used to serve many social goals. Despite recent calls for theoretical accounts to include the factors that influence irony interpretation, few studies have examined the individual differences that may impact verbal irony interpretation. The present study examined whether adults with elevated shyness would generate more negative interpretations of ironic statements. University students with varying degrees (...) of shyness listened to stories wherein one character made literal or ironic criticisms or compliments to another character. Participants then appraised each speaker’s belief and attitude. Self-reported shyness did not predict comprehension of the counterfactual nature of ironic statements. However, shyer adults rated speakers who made ironic compliments as being meaner than did adults low in shyness. Thus, while understanding that ironic speakers intended to communicate their true beliefs, shyer individuals construed the social meaning of irony more negatively. Such interpretive biases may lead shy individuals to more frequently take offense at ironic compliments and experience more negativity in social interactions. (shrink)

This collection is the first comprehensive history of Fichte's reception in America, highlighting the existence of a long and strong tradition of Fichtean studies throughout the continent and demonstrating the centrality of Fichtean ideas in contemporary discussions of issues such as feminism, social criticism, and decolonial thought. Read and reinterpreted in the highly diverse circumstances across the American continent, Fichte's ideas are presented in a radically new light, uncovering the Fichtean spirit of self-activity and autonomous thought in an American (...) context. (shrink)

Climate Change and the Moral Agent examines the moral foundations of climate change and makes a case for collective action on climate change by appealing to moralized collective self-interest, collective ability to aid, and an expanded understanding of collective responsibility for harm.

What counts as an individual in the living world? What does it mean for a living thing to remain the same through time, while constantly changing? Immunology answers these questions with its theory of "self" and "nonself" which has dominated the field since the 1940s. Thomas Pradeu argues that this theory is inadequate, because immune responses to self constituents and immune tolerance of foreign entities are the rule, not the exception.

Unethical pro-organisational behaviour is an ongoing concern, prompting the need for more nuanced understanding of the workplace environment most likely to inhibit it. This study considers the role of risk climate, sometimes referred to as risk culture, as well as ethical climate, for reducing UPB. The study investigates whether four risk climate factors can, by focusing on the long-term consequences of UPB to the organisation, and providing guidance on behavioural norms, reduce UPB misconduct. Surveying employees in three financial institutions we (...) found that only one of the risk climate factors, avoidance, is consistently associated with UPB. On the other hand, a self-interested, ethical climate significantly increases UPB in all samples. In multi-climate analysis, we found that risk climate factors interacted with ethical climate to predict UPB. That is, when employees perceive that the workplace ethos is not self-interested, three factors of risk climate—avoidance, proactive and manager—significantly predict UPB. UPB is least likely when self-interest is low, avoidance risk climate is low, proactive risk climate is high and manager risk climate is high. Implications for leaders are discussed. (shrink)

Traditionally, phenomenological theories of schizophrenia have emphasized disturbances in self-experience, with relatively little acknowledgement of the surrounding world. However, epidemiological research consistently demonstrates a strong relationship between traumatic and stressful life events and the development of schizophrenia, suggesting that encounters in the world are highly relevant for many people diagnosed with this disorder. This paper reviews foundational texts in phenomenology and phenomenological psychopathology on the nature of subjectivity and its disturbances, finding support for broadening contemporary phenomenological models of schizophrenia (...) to incorporate world events and their subjective meaning as essential aspects of this disorder. This contextual approach to phenomenology emphasizes the relationship between self and world, one that is especially unstable, unclear, and untrustworthy in schizophrenia. Both epidemiological and phenomenological research can benefit from this approach: in epidemiology, researchers might consider the ways that various risk factors are experienced by persons vulnerable to schizophrenia, while phenomenologists are encouraged to inquire about the environmental and social context in which altered experiences occur and incorporate these considerations into their explanatory models. (shrink)

Background:Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives, setting, and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced (...) by nurses in traditional patient-care settings.Research objectives:The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice.Research design:The study utilized a qualitative descriptive design with individual interviews.Participants and research context:Participating nurses self-identified as having experienced ethical challenges during screening. The majority were Caucasian, female, and worked in outpatient settings. Approximately 50% had > 10 years of research experience.Ethical considerations:The human subjects review board approved the study. Written informed consent was obtained.Findings:Predominant themes were revealed: the inability to provide a probable good, or/do no harm, and dual obligations. The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship.Discussion:Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science.Conclusion:Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

A popular objection to theistic commitment involves the idea that faith is irrational. Specifically, some seem to put forth something like the following argument: (P1) Everyone (or almost everyone) who has faith is epistemically irrational, (P2) All theistic believers have faith, thus (C) All (or most) theistic believers are epistemically irrational. In this paper, I argue that this line of reasoning fails. I do so by considering a number of candidates for what faith might be. I argue that, for each (...) candidate, either (P1) is false or (P2) is false. Then, I make two positive suggestions for how faith can be epistemically rational but nonetheless have a unique relationship to evidence: one, that Jamesian self-justifying attitudes describe a distinctive kind of faith in oneself and others, and two, that faith is not solely based on empirical evidence. (shrink)

According to rationalists about moral knowledge, some moral truths are knowable a priori. Rationalists often defend their position by claiming that some moral propositions are self-evidently true. Copp 2007 has recently challenged this rationalist strategy. Copp argues that even if some moral propositions are self-evident, this is not enough to secure rationalism about moral knowledge, since it turns out that such self-evident propositions are only knowable a posteriori. This paper considers the merits of Copp’s challenge. After clarifying (...) the rationalists’ appeal to self-evidence, I show why this rationalist strategy survives Copp’s challenges to it. (shrink)

The current assessment of behaviors in the inventories to diagnose autism spectrum disorders (ASD) focus on observation and discrete categorizations. Behaviors require movements, yet measurements of physical movements are seldom included. Their inclusion however, could provide an objective characterization of behavior to help unveil interactions between the peripheral and the central nervous systems. Such interactions are critical for the development and maintenance of spontaneous autonomy, self-regulation and voluntary control. At present, current approaches cannot deal with the heterogeneous, dynamic and (...) stochastic nature of development. Accordingly, they leave no avenues for real-time or longitudinal assessments of change in a coping system continuously adapting and developing compensatory mechanisms. We offer a new unifying statistical framework to reveal re-afferent kinesthetic features of the individual with ASD. The new methodology is based on the non-stationary stochastic patterns of minute fluctuations (micro-movements) inherent to our natural actions. Such patterns of behavioral variability provide re-entrant sensory feedback contributing to the autonomous regulation and coordination of the motor output. From an early age, this feedback supports centrally driven volitional control and fluid, flexible transitions between intentional and spontaneous behaviors. We show that in ASD there is a disruption in the maturation of this form of proprioception. Despite this disturbance, each individual has unique adaptive compensatory capabilities that we can unveil and exploit to evoke faster and more accurate decisions. Measuring the kinesthetic re-afference in tandem with stimuli variations we can detect changes in their micro-movements indicative of a more predictive and reliable kinesthetic percept. Our methods address the heterogeneity of ASD with a personalized approach grounded in the inherent sensory-motor abilities that the individual has already developed. (shrink)

Background: Caregivers and administrators in long-term facilities have fragile moral work in caring for residents with dementia. Residents are susceptible to barriers and vulnerabilities associated with the most intimate aspects of their lives, including how they express themselves sexually. The conditions for sexual agency are directly affected by caregivers’ perceptions and attitudes, as well as facility policies. Objective: This article aims to clarify how to approach capacity determinations as it relates to sexual activity, propose how to theorize about patient autonomy (...) in this context, and suggest some considerations for finding an ethically responsible and practically feasible way to respect the sexual rights of this population. Research Design: The focus is on residents with early to moderate dementia in states of daily dependency on professional caregivers. The article critically examines existing empirical research on sexuality among persons with dementia, caregivers’ attitudes, and institutional roadblocks to enabling residents’ sexuality. A relational lens and insights from disability studies are used in the philosophical analysis. Participants and Research Context: No research participants were part of this analysis. Ethical Considerations: This article offers a conceptual analysis and normative framework only. Findings: The analysis highlights the delicate balance that capacity assessments for sexual activity have to strike; while caregivers should protect those who cannot give adequate consent, the denial of sexuality among residents can cause deep, long-ranging harms. Sexual agency features into an ongoing sense of self for many individuals with dementia, and the imposition of inappropriate standards and expectations for sexual autonomy can lead to unwarranted obstacles to sexual activity. Discussion: Recommendations include developing clear and inclusive institutional policies and practices of care, providing education for caregivers on how to discuss and document residents’ sexual preferences over time, and taking advantage of ethics consultation services. Conclusion: This analysis establishes the need for more research and discussion on this sensitive topic. Future research should investigate the specific responsibilities of caregivers in furthering the sexual interests of residents, how exactly to modify existing capacity instruments, and how best to support historically marginalized patients in their sexual identities. (shrink)

What exactly does it mean to “trust your gut”? What use are gut-level insights when a person is attempting to consciously and deliberately navigate life altering decisions, such as those surrounding marriage, divorce, job changes, home buying, etc.? This essay provides a partial answer to those questions by leveraging the account of “emotional bodily feelings” offered in Tom Cochrane’s The Emotional Mind: A Control Theory of Affective States. This essay shows why “trusting your gut” is a reasonably good path to (...) emotional self-awareness in decision-making. The first half of the essay offers an analysis of what many people mean by the colloquial advice to “trust your gut,” at least when they deploy that advice in context of an ongoing dialogue about a friend or family member’s major life-decision. In the second half, this article briefly summarizes Cochrane’s account of emotions and emotional bodily feelings, and spells out how these concepts might be deployed to understand the advice to “trust your gut” as nearly tantamount to saying “pursue emotional self-awareness.”. (shrink)

I argue that same-sex divorce presents a different kind of potential constraint to the agency of persons pursuing the dissolution of their marriage; a constraint upon one’s counterstory and the reconstitution of one’s personal identity. The dialectic within the paper mirrors the movements that I have had to make as I have sought to constitute and reconstitute myself throughout my divorce process. Beginning from a juridical perspective, I examine how the constraints on same-sex divorce present constraints on one’s agency that (...) are antithetical to the spirit of a liberal democratic conception of freedom of movement. I then explore the role of narrative in my self-(re)constitution, as well as the limits of the narrative and counterstories, when the institutional framework of the State fails to acknowledge the change in my State-sanctioned personal relationship. I end by arguing that this view from the law ignores the ways in which we relationally constitute ourselves, and in so doing covers over the harms done to persons that find themselves in a married-yet-not state of limbo. (shrink)

I argue for a conception of moral community as “ethical home,” in which home is a hybrid public and private concept, cohered through members’ complicit participation in the formation and endorsement of the community’s values and practices. In this essay I present and defend three premises that comprise my argument for this conception of moral community as an ethical home. First, I make a case for why “home” is an apt conception of moral community, defining the features of home relevant (...) to my claim, and clarifying which connotations of home I am abandoning by modifying home to be an “ethical” home. Second, I illustrate how when the concept of moral community is conceptualized as an ethical home, it is formed and defined by a community’s practices of moral self-definition, that occur within the ethical home-making process. Third, I claim that the process of ethical home-making, through moral self-definition around cohering values and practices, renders members of an ethical home as both rights holders within the ethical home, and as having shared responsibility for their fellow ethical home members. (shrink)

Smoking consequences are seen disproportionately among low-SES smokers. We examine the self-regulatory strategy of mental contrasting with implementation intentions as a smoking reduction tool and whether its effectiveness depends on subjective-SES. This pre-registered online experiment comprised a pre-screening, baseline survey, and follow-up. Participants reported past-week smoking, subjective-SES, perceived stress, and were randomized to an active control or MCII condition. Data were collected via MTurk, during the U.S.’ initial wave of COVID-19. Participants were moderate-to-heavy smokers open to reducing or quitting. (...) The primary outcome was self-reported smoking reduction, computed as the difference between recent smoking at baseline and follow-up. The secondary outcome was cessation, operationalized as self-reported 7-day point-prevalence abstinence at follow-up. Among those low—but not high—in subjective-SES, MCII improved smoking reduction by an average of 1.09 fewer cigarettes smoked per day, though this effect was not conclusive. Similarly, quitting was descriptively more likely for those in the MCII than control condition, but the effect was non-significant. Per an exploratory analysis, we observed that stress significantly moderated the condition effect, such that MCII facilitated reduction among those experiencing high, but not low stress. Consistent with prior findings that MCII works best in vulnerable populations, MCII may be more effective for smoking reduction among high-stress than low-stress individuals. These findings contribute to growing research on income-related health disparities and smoking behavior change tools. (shrink)

On Hume's account, when we lack virtues that would typically prompt moral action, we can instead be motivated by the "sense of duty." Surprisingly, Hume seems to maintain that, in such cases, we are motivated by a desire to avoid the unpleasantness of "self-hatred" evoked in us when we realize we lack certain traits others possess. This account has led commentators to argue that Hume is not a moral internalist, since motivation by duty is motivation by a self-interested (...) desire. This paper concludes that Hume is indeed a moral internalist and that the motive of duty can be understood as a form of motivation by moral disapprobation in a way supported by Hume's general motivational psychology. (shrink)

In this paper I elaborate a notion of nurses’ professional self as one who is attracted towards intrinsic value. My previous work in 2003 has shown how nurses, who see intrinsic value in their work, experience self‐affirmation when they believe that they have made a difference to that which they see to have value. The aim of this work is to reveal a further aspect of nurses’ professional self. I argue that nurses’ desire towards that which they (...) see to have intrinsic value, is a necessary and self‐transcending aspect of a nurses’ professional self. I argue further that nurses’ desire towards intrinsic value inevitably involves their vulnerability. Nurses who see intrinsic value are shown to be vulnerable to self‐sacrifice in their inclination to work for the good of their patients, at the expense of themselves. Yet an ability to transcend their self in this way remains a necessary aspect of a nurse's professional self, which requires nurture and support through nurse education. (shrink)

Various forms of anomalous self-experience can be seen as central to schizophrenia and other psychiatric disorders. We examined similarities and differences between anomalous self-experiences common in schizophrenia-spectrum disorders, as listed in the EASE , and those described in published accounts of severe depersonalization. Our aims were to consider anomalous self-experience in schizophrenia in a comparative context, to refine and enlarge upon existing descriptions of experiential disturbances in depersonalization, and to explore hypotheses concerning a possible core process in (...) schizophrenia . Numerous affinities between depersonalization and schizophrenia-spectrum experience were found: these demonstrate that rather pure forms of diminished self-affection can involve many experiences that resemble those of schizophrenia. Important discrepancies also emerged, suggesting that more automatic or deficiency-like factors—probably involving self/world or self/other confusion and erosion of first-person perspective—are more distinctive of schizophrenia-spectrum disorders. (shrink)

In the last decades, interest in the study of the negative consequences of bullying for the victims has increased. Victims are often known to show emotional adjustment issues, such as negative self-concept and low life satisfaction. Moreover, some studies have observed important associations between self-concept and life satisfaction, in which a positive self-concept is related to high levels of life satisfaction. Other studies have pointed out the importance of emotional intelligence, as a regulatory and protective factor against (...) the negative impact of victimization on adjustment in adolescents. The main objective of this work was to analyze the mediating effect of self-concept on life satisfaction and the moderated mediation effect of EI on self-concept and life satisfaction in the context of peer victimization. The participants in the study were 1,318 Spanish students of both sexes and aged between 11 and 18 years, from four compulsory secondary education centers. The results indicated that, on the one hand, self-concept mediated the relationship between victimization and life satisfaction. On the other hand, EI was not only positively associated with self-concept, but it also significantly moderated the negative influence of victimization on self-concept. EI may also indirectly moderate the relationship between victimization and life satisfaction through the self-concept. These data show the importance of EI as a possible protective and moderating factor of the negative effect of bullying on emotional adjustment, which is interesting for the design of future prevention and intervention programs in school contexts. (shrink)

According to moral intuitionism, moral properties are objective, but our cognitions of them are not always based on premises. In this paper, I develop a novel version of moral intuitionism and argue that this new intuitionism is worthy of closer attention. The intuitionistic theory I propose, while inspired by the early twentieth-century intuitionism of W. D. Ross, avoids the alleged errors of his view. Furthermore, unlike Robert Audi's contemporary formulation of intuitionism, my theory has the resources to account for the (...) noninferential character of particular, as opposed to merely general, moral beliefs. I achieve this result by avoiding the appeal to self-evidence to explain the possibility of noninferential moral knowledge. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Patient Self-Determination ActElizabeth Leibold McCloskey (bio)What are the ethics of extending the length of life? We know that we cannot artificially end life (Thou Shalt not Kill), but how about artificially extending life? Is that always good, sometimes good?... In ethics, is keeping people alive the highest good? Should our priority be to keep people breathing?... What does basic religious ethics say about this?(John C. Danforth, letter (...) to the author, 19 August 1989)The Patient Self-Determination Act, signed into law as part of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90) last November, marks the first time that Congress has passed legislation concerning the ethics of life-sustaining medical treatment. The bill was spearheaded by Senator John C. Danforth (RMO), who has a special interest in this area. An Episcopal priest, Danforth was formerly an assistant chaplain at New York's Memorial Sloan-Kettering Cancer Center and now sits as a senior member of the Senate Finance Committee, which oversees Medicare and Medicaid. Although Senator Danforth's legislative initiative was not a result of the Cruzan case, it was in his state of Missouri that the U.S. Supreme Court case involving removal of Nancy Cruzan's feeding tube arose (Cruzan v. Director of Missouri Department of Health, U.S. Supreme Court, 58 LW 4916, 26 June 1990). From his unique vantage point, he felt it was time to craft a legislative response to some of the difficult issues surrounding prolongation of life.The short answer to Senator Danforth's questions about when to artificially extend life is simple enough: people must be free to determine that for themselves. Common law and common sense dictate such a conclusion; living will and health care proxy statutes, enacted in almost every state, codify that right. The Catholic moral tradition teaches that one is not morally obligated to use extraordinary means to prolong life, a tradition shared both by the mainline Protestant and the reform and conservative Jewish community. Yet most people are unaware of their fundamental legal right to make such decisions, and as court cases from Quinlan (In re Quinlin, 137 N.J. Super. 227, 1975) to Cruzan demonstrate, few know [End Page 163] how to make arrangements for this right to be exercised if they become incapacitated.Meanwhile, health care practices are often driven by a denial of death. When Senator Danforth and Senator Daniel Patrick Moynihan (D-NY) introduced the bill on October 17, 1989, Senator Danforth said:More and more it is arguable that we play God by subjecting people to unwanted and sometimes unnecessary treatment, treatment that unnaturally prolongs the dying process. Our health care system has become obsessed with extending life, at times neglecting the caring component of medicine and trampling on the rights of patients.(Congressional Record 1989, 135:5.13566)The American Hospital Association estimates that 70 percent of deaths now occur after a determination to withhold or withdraw medical treatment. Many of those decisions are made without the benefit of an incapacitated patient's views, yet a Harvard study revealed that 95 percent of the population would like to prepare in advance for such decisions. Only 4 percent of hospitals have a systematic method of asking patients if they have an advance directive. Family members confront painful choices in the face of uncertainty about their loved one's wishes and it can be even more painful when a family knows the patient's desires but providers and the courts act otherwise because clear evidence is lacking.The Patient Self-Determination Act is rooted in the belief that people should be given information that enables them to specify the extent of medical treatment they wish to receive should they become incapacitated. The public should be educated about applicable state laws that protect the individual's right to make such choices through the use of an advance directive.The Act moves toward that goal by promoting knowledge of state laws. It requires every hospital, nursing home, home health agency, hospice, and health maintenance organization that participates in Medicaid or Medicare to routinely give all adult patients information about advance directives. Patients will also be given information on the... (shrink)

The power of compulsory heterosexuality regulates the sexuality of adolescent lesbians as strongly as it does their heterosexual peers. Marked with a sexual(ized) identity, young Southern lesbians in this life history study made claim to moral high ground by consistently identifying with the hegemonic good girl construct and by participating in the naming of women whose sexual behavior demonstrated a disregard for the ?rules.? The good girl/bad girl, the virgin/slut binaries, played significant roles in their identity claims, in their relationships, (...) and in their choices of friendships. Personal self-control (?just kissing?) is seen by these young women as admirable and sluts are seen as dangerous women who harm others and themselves. This article explores the marking of sluts and too experienced women in the life stories of White Southern adolescent lesbians and the continued social controls imposed on adolescent female sexuality through the devaluing of women's sexual agency. (shrink)

The Healer's Art curriculum is one of the best-known educational strategies to support medical student professional identity formation. HART has been widely used as an elective curriculum. We evaluated students’ experience with HART when the curriculum was required. All one hundred eleven members of the class of 2019 University of New Mexico School of Medicine students were required to enroll in HART. We surveyed the students before and after the course to assess its self-reported impact on key elements of (...) professional identity formation such as empathy towards patients and peers, commitment to service, and burnout. A majority of students reported positive effects of the course on their empathy towards other students. This finding was significantly associated with self-reported willingness to have elected the course had it not been required. One-half of respondents reported positive effects on their empathy towards future patients. At least one-quarter to one-third of respondents reported positive influences on commitment to service, conceptions about being a physician, and self-perceived burnout. Students report benefits on their professional identity formation after participating in a required course on humanism. Empathy-building among peers is one valuable outcome of such curricula. (shrink)

: The natural philosopher Michael Faraday and the psychologist Jean Piaget experimented directly with natural phenomena and children. While Faraday originated evidence for spatial fields mediating force interactions, Piaget studied children's cognitive development. This paper treats their experimental processes in parallel, taking as examples Faraday's 1831 investigations of water patterns produced under vibration and Piaget's interactions with his infants as they sought something he hid. I redid parts of Faraday's vibrating fluid activities and Piaget's hiding games. Like theirs, my experiences (...) showed that incomplete observations and confusions accompanied—and facilitated —experimental developments. While working with things in their hands, these experimenters' minds were also engaged, inferring new, more coherent understandings of the behaviors under study. Transitory ripples disclosed distinct patterns; infants devised more productive search methods. From the ripples, Faraday discerned an oscillatory condition that informed his subsequent speculations about light. From the infant search, Piaget identified experimenting as a child's means of developing self and world, later envisioning its infusion into education. Taken together, these two stories demonstrate that cognitive capacities emerge in the actual process of experimenting. This finding eclipses the historical context in its implications for education today. When learners pursue their own experiments, their minds develop. (shrink)

Moral distress is a phenomenon increasingly recognized in healthcare that occurs when a clinician is unable to act in a manner consistent with his or her moral requirements due to external constraints. We contend that some experiences of moral distress are self-inflicted due to one’s under-assertion of professional authority, and these are potentially avoidable. In this article we outline causes of self-inflicted moral distress and offer recommendations for mitigation.