BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Since the publication of the first volume in 1993, the Routledge History of Western Philosophy has established itself as the most comprehensive chronological survey of the history of western philosophy available. The final volume is being published in March 1999, completing the history from its beginnings in the sixth century B.C. to the present. Key features of the series: * Includes in-depth discussion of all major philosophical developments and philosophers * Is compiled by prestigious editors leading an international team of (...) over 100 specialists giving wide-ranging, balanced coverage * Each volume contains an index, a detailed bibliography, a glossary of technical terms and a chronological table to set the philosophical developments in context * Each chapter is written by an acknowledged authority in the field * Provides an essential resource for students, teachers and researchers in philosophy. The Routledge History of Philosophy is available either as separate volumes or as a complete 10 volume set. For more details on the Routledge History of Philosophy please contact us at our London address. (shrink)

The Routledge History of Philosophy series provides a chronological survey of the history of Western Philosophy fro its beginnings in the sixth century BC to the present time. It discusses all the major philosophical developments in depth, and covers all those regarded as great philosophers and many lesser figures of philosophypast and present. We are pleased to announce all 10 volumes are now available in paperback for the first time.

Canada’s Medical Assistance in Dying (MAID) legislation changed in 2021; persons without a reasonably foreseeable natural death (RFND) could now be eligible for MAID and would have to wait at least 90 days before their intervention. This legislative change caused a new ethically complex question to arise, which we explore in this commentary, namely: Where should individuals without a RFND wait (for 90 days) in a publicly funded health system?

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the United Kingdom (UK) from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from the ethical and legal stream of the study, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and information (...) governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were coded using qualitative thematic analysis. Participants told us that a significant aspect of Big Data research in public health is varying drivers of mistrust—of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish greater confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach to research in this area can help assure (1) that meaningful community and participant engagement is taking place and that extant challenges are addressed, and (2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied, including those who are often marginalised in research. (shrink)

R K Elliott; Aestheticism, Imagination and Schooling: a reply to Ruby Meager, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 33–42.

R K Elliott; Aestheticism, Imagination and Schooling: a reply to Ruby Meager, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 33–42.

Clinical and Care Bioethics Committees at Public and Private Healthcare Institutions of Medium and High Complexity Levels in Cities of the Atlantic Coast of Colombia Comitês de Bioética clínico-assistencial nas instituições de saúde públicas e privadas dos níveis de média e alta complexidade das cidades da Costa Atlântica da Colômbia Care bioethics committees are interdisciplinary groups engaged in providing education to members of said committees, all the staff in the hospital —including professors and students in their internship—, and members of (...) the community. The objective of this study is to determine the situation of clinical and care bioethics committees at healthcare institutions in the Atlantic Coast of Colombia between 2010-2016. The study is cross-sectional, descriptive, and retro-prospective. Twenty-six health institutions that met the inclusion criteria were selected and administered a semi-structured survey. The statistical software SPSS version 22 was used to analyze the information. This study adhered to ethical research guidelines. The name most commonly given to committees is Hospital Ethics Committee. Only half have staff trained in ethics or bioethics and the most outstanding function is education in ethics; however, in the same percentage there are committees whose opinion is divided as their operation is unclear. Committees should follow existing ethical and bioethical models, and bills should be brought forward to help committees at healthcare institutions become more effective as regards their structure and operation. Para citar este artículo / To reference this article / Para citar este artigo Carrillo González S, Lorduy-Gómez J, Muñoz-Baldiris R. Comités de Bioética Clínico-Asistencial en las instituciones de salud públicas y privadas de los niveles de mediana y alta complejidad de las ciudades de la Costa Atlántica de Colombia. Pers Bioet. 2019; 23: 122-136. DOI: https://doi.org/10.5294/pebi.2019.23.1.8 Recibido: 23/08/2018 Aceptado: 25/02/2019. (shrink)

The target article is an attempt to make some progress on the problem of color realism. Are objects colored? And what is the nature of the color properties? We defend the view that physical objects (for instance, tomatoes, radishes, and rubies) are colored, and that colors are physical properties, specifically types of reflectance. This is probably a minority opinion, at least among color scientists. Textbooks frequently claim that physical objects are not colored, and that the colors are "subjective" or "in (...) the mind." The article has two other purposes: first, to introduce an interdisciplinary audience to some distinctively philosophical tools that are useful in tackling the problem of color realism and, second, to clarify the various positions and central arguments in the debate. (shrink)

A critique of LaPorte's views on chemical kinds, like jade and ruby, is presented. More positively, a new slant is provided on the question of whether elements are natural kinds. This is carried out by appeal to the dual nature of elements, a topic that has been debated in the philosophy of chemistry but not in the natural kinds literature. It is claimed that the abstract notion of elements, as opposed to their being simple substances, is relevant to the (...) Kripke–Putnam approach to natural kinds and to some criticisms that have been raised against it, although I do not support the K–P account. The proposed view avoids the traditional microstructuralist approach to natural kinds. The article also addresses the question of whether natural kinds concern metaphysical or epistemological considerations. Recent attempts by chemists to modify the periodic table are brought to bear on the question of classification and consequently on whether the identification of elements is interest dependent. (shrink)

There are good arguments for examining great ape communicative achievements for what they contribute to our understanding of great ape cognition and its evolution (Russon & Begun, in press a). Our concern is whether Shanker & King's (S&K's) thesis advances communication studies from a broader cognitive and evolutionary perspective.

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.4 (2001) 391-400 [Access article in PDF] Bioethics Inside the Beltway A Shooting on Capitol Hill: "The Ruby Satellite System," Mental Illness, and Failure of the American Legal System Peter J. Cohen On 24 July 1998, Russell Eugene Weston, Jr., stormed the United States Capitol, forced his way through a security checkpoint, bypassed a metal detector, and entered the office complex of Representative (...) Tom DeLay (R-TX), the House Majority Whip (Weil 1998). During this period of terror, he shot and killed two officers of the Capitol Police and seriously wounded another as they attempted to end his foray. 1 Weston was severely wounded by several Capital police officers and taken into custody. After being treated for his injuries, he was incarcerated in the District of Columbia. 2On 5 May 1999, Weston was transferred to the Federal Correctional Institute in Butner, North Carolina (United States v. Weston, 69 F. Supp. 2d 99 (D.D.C. 1999), 103), where he remains to this day. He has neither been brought to trial nor received appropriate psychiatric therapy, but continues to be warehoused "in solitary confinement under constant observation... in a psychotic state (United States v. Weston, 255 F.3d 873; LEXIS 16851 (U.S. App. 2001b), 3-4 [LEXIS]). I will briefly detail the legal events responsible for this mad situation and suggest alternative actions that should have been taken at the very onset of the case. Early Chronology Although overtly the crime appeared to be senseless and without any conceivable motivation, Weston believed that his acts were justified and necessary. The story he told to the court-appointed forensic psychiatrist, Sally C. Johnson, M.D., 3 was that while working for NASA in the early 1980s, he had developed a "Ruby Satellite System," a powerful machine that could reverse time. With access to this system, nothing was permanent--the user could simply reverse time and exit from the current scene. However, the "System" was now controlled by cannibals who were developing and spreading "Black Heva," the deadliest disease known to [End Page 391] humankind, similar to HIV or the plague. It resulted from human corpses rotting and turning black. Time was running out, and Weston believed he had to return to override the "Ruby Satellite System" in the Capitol so that he could stem the spread of "Black Heva" and prevent world calamity. He believed that if he were tried, convicted, and even executed, he could simply time reverse himself, place himself in a safe within the Capitol, and subsequently resume his life at whatever point he chose (United States v. Weston, 206 F.3d 9 (D.C. Cir. 2000), 19-20).On 22 April 1999, the district court accepted Dr. Johnson's diagnosis that Weston suffered from paranoid schizophrenia, the symptoms of which were so severe that he would be incapable of understanding the proceedings against him and of assisting in his own defense. On this basis, the court had no difficulty in finding him incompetent to stand trial (U.S. v. Weston 1999, 102).At Weston's initial hearing, Dr. Johnson had testified that medication would be efficacious in treating Weston's delusions: [T]he standard of care in someone suffering from this type of symptom picture would be to treat them with medication.... [T]here is a good likelihood that he'll have a positive response, positive in the sense that his symptoms will diminish in response to treatment.... The potential benefits to treating the defendant far outweigh the risks.... (U.S. v. Weston 1999, 108) The defense presented no expert testimony refuting Dr. Johnson's presentation. The district court then ordered that Weston begin receiving medication in order to render him nondangerous and competent for trial (U.S. v. Weston 1999, 108-9). The Problem Weston refused to be medicated! 4 He has continued to claim that the administration of antipsychotic drugs against his will would violate his Fifth Amendment due process liberty interest in avoiding unwanted bodily intrusion and implicated... (shrink)

Business and Society Review, Volume 127, Issue S1, Page 193-222, Spring 2022.

The #1bestseller that presents a funny, honest, and engaging look at the craziness of modern life, explaining why we're all just a little bit out of our minds. In Sane New World, Ruby Wax - comedian, writer and mental health advocate - shows us just how our minds can send us mad as our internal critics play on a permanent loop tape. 'Don't do that.. why you... you didn't... should have... but you didn't...'. Ruby knows those voices well. (...) She has been on a tough but ultimately enlightening journey that has taken her from battling depression to achieving a Masters Degree from Oxford University in Mindfulness-based Cognitive Therapy. In Sane New World, Ruby helps us all understand why we sabotage our sanity, how our brains work and how we can rewire our thinking - often through simple mindfulness techniques - to find calm in a frenetic world. (shrink)

This book attempts to bridge the gulf that still exists between 'literary' and 'philosophical' interpreters of Plato by looking at his use of characterization. Characterization is intrinsic to dramatic form and a concern with human character in an ethical sense pervades the dialogues on the discursive level. Form and content are further reciprocally related through Plato's discursive preoccupation with literary characterization. Two opening chapters examine the methodological issues involved in reading Plato 'as drama' and a set of questions surrounding Greek (...) 'character' words, including ancient Greek views about the influence of dramatic character on an audience. The figure of Sokrates qua Platonic 'hero' also receives preliminary discussion. The remaining chapters offer close readings of select dialogues, chosen to show the wide range of ways in which Plato uses his characters, with special emphasis on the kaleidoscopic figure of Sokrates and on Plato's own relationship to his 'dramatic' hero. (shrink)

Human uterus transplantation is currently under investigation as a treatment for uterine infertility. Without a uterus transplant, the options available to women with uterine infertility are adoption or surrogacy; only the latter has the potential for a genetically related child. UTx will offer recipients the chance of having their own pregnancy. This procedure occurs at the intersection of two ethically contentious areas: assisted reproductive technologies and organ transplantation. In relation to organ transplantation, UTx lies with composite tissue transplants such as (...) face and limb grafts, and shares some of the ethical concerns raised by these non-life saving procedures. In relation to ART, UTx represents one more avenue by which a woman may seek to meet her reproductive goals, and as with other ART procedures, raises questions about the limits of reproductive autonomy. This paper explores the ethical issues raised by UTx with a focus on the potential gap between women's desires and aspirations about pregnancy and the likely functional outcomes of successful UTx. (shrink)

Scholars are beginning to use the concept medicalization of poverty to theorize how the United States spends large amounts of money on illnesses related to poverty but invests much less in preventing these illnesses and the conditions that create them. This study examines the connection between poverty, disease burden and health-related costs through the in-depth interviews of 86 Black mothers living in neighborhoods with high levels of violence on the South Side of Chicago. The rippling costs of poverty and violence (...) include 56 percent of the mothers reporting post-traumatic stress disorder symptoms and 48 percent reporting mild to severe depressive symptoms. Mothers also report poor housing quality such as “toxic mold.” The physical costs include reports of back pains, stomach aches, hair falling out, panic attacks, hands shaking, insomnia, fainting from exhaustion and lack of sexual desire, and children with asthma and osteomyelitis reportedly from the exposure to mold. Transformative solutions are explored that build upon the cultural resources of Black mothers and engage policy levers. (shrink)

Using historical documents and evidence gathered in the field, Rubie Watson provides a social history of the 600-year-old Chinese lineage village of Ha Tsuen in the New Territories of Hong Kong, and demonstrates the crucial role that the lineage played in the evolution of the community from a few scattered households in the fourteenth century into a regional power from the 1700s onwards. Despite a patrilineal ideology that extols the virtues of brotherhood and equality, Dr Watson shows that the lineage (...) has in fact played a central role in the formation, development and maintenance of an élite class of landlords and merchants, who, even though their economic importance has now declined, continue to exert political control. Dr Watson examines the dynamics of interclass relations within a single lineage and shows how these relations have been transformed as a consequence of the growth of wage labour. (shrink)

Early Christian writers defined idolatry around the monotheistic distinction between proper worship of the creator and vain worship of the creature, which they had inherited from Hellenistic Judaism. Despite the remarkable consensus about the validity of this theological analysis, the medieval synthesis was under severe strain throughout the early modern period, mainly because of the concept's extended range of application in the new contexts of religious controversy. In all these cases, deciding what practices constituted idolatry was open to debate. By (...) the eighteenth century, libertine writers could retain the concept of superstition at the expense of that of idolatry, which Voltaire (himself an anti-Christian deist) denounced as meaningless. (shrink)

As the number of consumer transgressions continues to increase, so do their financial repercussions for companies. Though academic and managerial interest in addressing this issue is growing, research on how to dissuade consumers from committing transgressions remains scarce. Drawing on the mental imagery literature and normative moral theory, the present research examines a novel way of reducing consumers’ appraisals of their own transgressions. Whereas an actor-imagery perspective fosters a teleological, egoistic view of morality and, in turn, induces moral leniency, having (...) consumers adopt an observer-imagery perspective fosters a deontological view of morality and, in turn, induces moral stringency. The effects are robust across various types of consumer transgressions, including the purchase of counterfeit products and return fraud in the form of wardrobing. Study 2 also rules out vividness as an alternative explanation for these effects. Theoretical and managerial implications are discussed. (shrink)

The AI world was rocked with controversy when Blake Lemoine, an AI researcher at Google claimed that their new LaMDA model was sentient. This Curmudgeon’s Corner article explores his claims critically by contrasting them to the original LaMDA paper released by the team of researchers at Google. The piece explores the human tendency for anthropomorphization via historical chatbots such as Eliza and potential reasons why we developed this propensity. It addresses the potential causes for the model’s choice of words. Subsequently, (...) using the scoring criteria of the language model, I provide an explanation for the model’s behavior in the conversation with Lemoine. Finally, I explore some of Lemoine’s assertions and break down the logical gaps they hold. I conclude on a potential reorientation of the debate in view of our unfortunate tendency. (shrink)

This book is the first detailed study of the plays of Sophocles through examination of a single ethical principle--the traditional Greek popular moral code of "helping friends and harming enemies." Five of the extant plays are discussed in detail from both a dramatic and an ethical standpoint, and the author concludes that ethical themes are not only integral to each drama, but are subjected to an implicit critique through the tragic consequences to which they give rise. Greek scholars and students (...) of Greek drama and Greek thought will welcome this book, which is presented in such a way as to be accessible to specialists and nonspecialists alike. No knowledge of Greek is required. (shrink)

The world flipped its sign from open to closed. I'm 6,714 miles from home in a place that tastes familiar. At night, I dream about my mother. It goes like this: I, blindfolded, frantic. My mother, always out of reach.When the sun rises, I bake bread and find I have fallen in...

In contemporary political theory, democracy embodies the ideals of the Aristotelian state, the one that is most able to realize the ideal life of the political community. Nevertheless, fledgling democracies are confronted with economic and political problems which Paul Ricœur thinks are due to the essential dissymmetry between the governing authority and the governed, culminating in the violence of the powerful agent. The enjoyment of the good life in a democracy presupposes what Ricœur calls an ethics of politics, which consists (...) in nothing other than the creation of spaces of freedom which confer on the governed a structure that enables its members to pursue the aim of enduring indefinitely in the future. When the governing authority buries into oblivion the desire of the historical community to live well with and for others in just institutions, the governed are expected to act in concert in order to ascertain their enjoyment of the good life because they feel particularly responsible for the horizontal bond that is constitutive of their will to live together. Thus, Paul Ricœur explains that the balancing of power in common and domination is an endless task of democracy that seeks to place domination under the control of power-in-common. (shrink)

This article analyzes ‘commemorative’ images of Diana Spencer for how they invoke tropes of charity and sympathy to produce racialized mediations of history, memory, motherhood and US national identity. Drawing from cultural theory that establishes technologies of memory and forgetting as material forces, this discussion illumines how images of Diana appearing in such popular US magazines as People and Life incorporate visual scripts of race and sentiment that have historically demarcated the relative social value(s) of maternity and reproduction. Understanding visual (...) culture as a force that is both structured by and structuring of hierarchies of power enables us to see how the posthumous circulation of images of ‘Our Princess’ are indeed not ideologically innocent memorializations. Rather, these images are the physical, embodied material of a national monument that provides faithful ‘visitors’ an affective connection to historically idealized notions of whiteness, motherhood, and the family. (shrink)

Ruby Meager; The Dangers of Aestheticism in Schooling, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 23–30, https://doi.org/10.1111.

Ruby Meager; The Dangers of Aestheticism in Schooling, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 23–30, https://doi.org/10.1111.

Reason and Value collects 15 new papers by leading contemporary philosophers on themes from the work of Joseph Raz. Raz has made major contributions in a wide range of areas, including jurisprudence, political philosophy, and the theory of practical reason; but all of his work displays a deep engagement with central themes in moral philosophy. The subtlety and power of Raz's reflections on ethical topics make his writings a fertile source for anyone working in this area. Especially significant are his (...) explorations of the connections between practical reason and the theory of value, which constitute a sustained and penetrating treatment of a set of issues at the very center of moral philosophy as it is practiced today. The contributors to the volume acknowledge the importance of Raz's contributions by engaging critically with his positions and offering independent perspectives on the topics that he has addressed. The volume aims both to honour Raz's accomplishments in the area of ethical theorizing, and to contribute to an enhanced appreciation of the significance of his work for the subject. (shrink)