The claim that nurses should be patient advocates is a questionable one, especially when it is mixed in with the professional issue of nurses' freedom to practice. A less combative, more cooperative model of the profession would serve nurses better.

Hysterectomy (or hysterectomy with oophorectomy) is the most frequently performed major surgery in the United States, affecting approximately 700,000 women each year (Easterday, 1983). There has long been interest in the psychological effects of these surgeries. However, apart from the concern that some hysterectomies may be unnecessary (Pearse, 1976), there has been little attention to bioethical issues relating to hysterectomy. Physicians and nurses are ethically obligated to respect the woman who may have a hysterectomy by treating her as an autonomous (...) agent. Informed consent within the context of a decision for hysterectomy should include balanced information and supportive exploration of the woman's values, goals, and life plan. Care of the patient should assist her adjustment, thereby also promoting her autonomy. Physician attitudes toward hysterectomy and the hysterectomy patient can have a major influence on patient self-determination. (shrink)

Wojtasiewicz (2006) raises an intriguing and concerning possibility: that end-of-life conflict resolution processes—“futility” policies—may compound discrimination against African Americans, who ha...

Advance directives are useful ways to express one's wishes about end of life care, but even now most people have not completed one of the documents. David Doukas and William Reichel strongly encourage planning for end of life care. Although Planning for Uncertainty is at times fairly abstract for the general reader, it does provide useful background and practical steps.

Many new genetic tests are used in clinical practice, and the number of available tests is growing. Two important health policy questions arise as these genetic tests become available. The first question, whether a new test should be made available, has been the focus of much recent discussion. The second question concerns defining the appropriate standards surrounding the use of these tests, including patient selection, education, informed consent, test interpretation and counseling.Genetic tests currently move from the research arena, where strategies (...) are put in place to minimize risks,into the clinical context where the practice of medicine is more variable and the risks to patients less understood. In the research setting, risks can be minimized through safeguards including education, consent, and counseling. The frequency and magnitude of psychosocial and clinical risks canbe assessed. In the clinical setting, however, these safeguards may not be used consistently, creating unknown risksfor patients. (shrink)

Many new genetic tests are used in clinical practice, and the number of available tests is growing. Two important health policy questions arise as these genetic tests become available. The first question, whether a new test should be made available, has been the focus of much recent discussion. The second question concerns defining the appropriate standards surrounding the use of these tests, including patient selection, education, informed consent, test interpretation and counseling.Genetic tests currently move from the research arena, where strategies (...) are put in place to minimize risks,into the clinical context where the practice of medicine is more variable and the risks to patients less understood. In the research setting, risks can be minimized through safeguards including education, consent, and counseling. The frequency and magnitude of psychosocial and clinical risks canbe assessed. In the clinical setting, however, these safeguards may not be used consistently, creating unknown risksfor patients. (shrink)

Advance directives are useful ways to express one's wishes about end of life care, but even now most people have not completed one of the documents. David Doukas and William Reichel strongly encourage planning for end of life care. Although Planning for Uncertainty is at times fairly abstract for the general reader, it does provide useful background and practical steps.

Volume 20, Issue 7, July 2020, Page W15-W16.

The authors surveyed hospitals across the country on their policies regarding overlapping surgery, and found large variation between hospitals in how this practice is regulated. Specifically, institutions chose to define “critical portions” in a variety of ways, ultimately affecting not only surgical efficiency but also the autonomy of surgical trainees and patient experiences at these different hospitals.

Although many studies have revealed the importance of study skills for students' first?year performance and college retention, the extent of the impact of study skills preparation on students' academic achievement is less clear. This paper explores the impact of pre?university study skills preparation on students' first?year study experiences, academic achievement and persistence. The setting for this study is a large law school in the Netherlands which attracts students from more than 100 schools for secondary education. The results show that the (...) perceived study skills preparation concerning time management and learning skills does have a positive impact on college students' first?year study behaviour and academic achievement. However, the study also shows that the impact of perceived college preparation is far less important for college retention than other factors such as satisfaction about the chosen degree programme and tutorial attendance. (shrink)

Metaphors abound in descriptions of the COVID-19 pandemic: it is described, among other things, as a war, a flood, and a marathon. However, not all metaphors may resonate equally well with members...

This paper investigates how deans and directors at the top 50 global MBA programs (as rated by the "Financial Times" in their 2006 Global MBA rankings) respond to questions about the inclusion and coverage of the topics of ethics, corporate social responsibility, and sustainability at their respective institutions. This work purposely investigates each of the three topics separately. Our findings reveal that: (1) a majority of the schools require that one or more of these topics be covered in their MBA (...) curriculum and one-third of the schools require coverage of all three topics as part of the MBA curriculum, (2) there is a trend toward the inclusion of sustainability-related courses, (3) there is a higher percentage of student interest in these topics (as measured by the presence of a Net Impact club) in the top 10 schools, and (4) several schools are teaching these topics using experiential learning and immersion techniques. We note a fivefold increase in the number of stand-alone ethics courses since a 1988 investigation on ethics, and we include other findings about institutional support of centers or special programs; as well as a discussion of integration, teaching techniques, and notable practices in relation to all three topics. (shrink)

The combination of breeding for increased production and the intensification of housing conditions have resulted in increased occurrence of behavioral, physiological, and immunological disorders. These disorders affect health and welfare of production animals negatively. For future livestock systems, it is important to consider how to manage and breed production animals. In this paper, we will focus on selective breeding of laying hens. Selective breeding should not only be defined in terms of production, but should also include traits related to animal (...) health and welfare. For this we like to introduce the concept of robustness. The concept of robustness includes individual traits of an animal that are relevant for health and welfare. Improving robustness by selective breeding will increase (or restore) the ability of animals to interact successfully with the environment and thereby to make them more able to adapt to an appropriate husbandry system. Application of robustness into a breeding goal will result in animals with improved health and welfare without affecting their integrity. Therefore, in order to be ethically acceptable, selective breeding in animal production should accept robustness as a breeding goal. (shrink)

The thought of contemporary North American theologian and ethicist Wendy Farley is an unflinching clarion call to justice and compassion. Farley invites us to discover ways of embodying the deep compassion capable of resisting pernicious distortions and traumatizing injustices that harm and dehumanize us all. This volume of essays embodies her invitation to awaken as beloved community. And when we are overwhelmed by the magnitude of struggle and despair, Farley reminds us that the powerful longing of hope, at times against (...) all evidence, refuses to give up on seeking justice and wholeness. Compassionate justice, radical hospitality, creative liberation, and deep listening emerge as more than ethical values for Farley; they are expressions of erotic faith, a praxis of faithfulness born of divine desire. These writings explore transformative perspectives and practices that have the capacity to help us recover and author our identity as the "god-bearers" we are. Erotic faith embodies the love-seeking persistence of divine faithfulness necessary to transform us from within; it meets the truth of human harm, vulnerability, and suffering by offering a complex, struggling, unscripted creativity capable of remaking us, and our world, until the beloved community is whole. (shrink)

As interest in working memory is increasing at a rapid pace, an open discussion of the central issues involved is both useful and timely. This new volume compares and contrasts conceptions of working memory, with contributions from proponents of different views.

We conducted focus groups with 47 potential jurors who were presented with diferent scenarios in a hypothetical malpractice case involving failure to order a PSA test. Better documentation that a patient made an informed decision to decline a PSA test appeared to provide more medical-legal protection for physicians, especially with the use of a decision aid.

Screening for prostate cancer with the prostate-specific antigen blood test is controversial, as evidence to date has not demonstrated such screening does more good than harm. While the potential benefit of PSA screening on reducing prostate cancer mortality has not been documented in randomized trials, many risks of PSA screening have been well documented. These risks include a substantially higher risk of a prostate cancer diagnosis over a screenee’s lifetime, false-positive and false-negative test results, possible complications from biopsies done in (...) response to suspicious test results, and substantial risks of side effects from subsequent prostate cancer treatments. Nevertheless, PSA screening is widespread in the United States, and many physicians in a national survey reported supporting routine PSA screening as well as getting PSA tests themselves, despite the lack of evidence. (shrink)

Buddhisms and Deconstructions considers the connection between Buddhism and Derridean deconstruction, focusing on the work of Robert Magliola. Fourteen distinguished contributors discuss deconstruction and various Buddhisms—Indian, Tibetan, and Chinese —followed by an afterword in which Magliola responds directly to his critics.

This study explores the relationship between moral intensity and the use of different sensemaking strategies in military critical incidents. First, narratives of military personnel were used to select prototypical high/low moral intensity critical incidents. In a follow-up, a scenario study was conducted with active duty military personnel to examine the relationship between moral intensity and the use of sensemaking tactics. This study offers three main conclusions. First, the use of sensemaking tactics is strongly tied to the level of moral intensity (...) in the situation. In high-intense situations, the servicemen draw on previous experiences, prediction of consequences, and help of others to recognize and interpret the situation. Less attention goes out to higher level critical thinking. Thus, it seems that in these critical incidents, the servicemen react without giving room for thorough consideration and deliberation. Second, the number of deployments a serviceman experienced influences the perceived seriousness and harmfulness of the situation negatively in low-intense situations. Finally, and in line with earlier studies, the results indicate that the concept of moral intensity is formed out of three rather than the six dimensions originally proposed by Jones. The implications of these findings are discussed. (shrink)

Wisdom is a multi-component trait that is important for mental health and well-being. In this study, we sought to understand gender differences in relative strengths in wisdom. A total of 659 individuals aged 27–103 years completed surveys including the 3-Dimensional Wisdom Scale and the San Diego Wisdom Scale. Analyses assessed gender differences in wisdom and gender’s moderating effect on the relationship between wisdom and associated constructs including depression, loneliness, well-being, optimism, and resilience. Women scored higher on average on the 3D-WS (...) but not on the SD-WISE. Women scored higher on compassion-related domains and on SD-WISE Self-Reflection. Men scored higher on cognitive-related domains and on SD-WISE Emotion Regulation. There was no impact of gender on the relationships between wisdom and associated constructs. Women and men have different relative strengths in wisdom, likely driven by sociocultural and biological factors. Tailoring wisdom interventions to individuals based on their profiles is an important next step. (shrink)

Excerpt from The Fundamental Principle of Fichte's Philosophy The purpose of this monograph is to make a careful study of Fichte's conception of the ultimate principle. In his various writings the principle appears under many different names. 'The Ego, ' 'the Idea of the Ego, ' 'the moral world-order, ' 'God, ' 'the Absolute, ' 'Being, ' 'the Light, ' are some of the phrases by which it is most commonly designated. It is not the main purpose of this study (...) to examine tile much discussed question of the relation between the two periods of Fichte's philosophy. But the question is so intimately connected with the problem which I have undertaken that some discussion of it is inevitable. I have tried, however, to keep well within the limits of my theme, and instead of considering the relation between the two periods in all its aspects, have sought merely to determine how far the conception of the fundamental principle which we find in Fichte's later writings differs from that which appears in the earlier ones. The references to Fichte's writings are to the Sammtliche Werke (Berlin, 1845-1846, 8 vols.) and to the Nachgelassene Werke (Bonn, 1834-1835, 3 vols.). References to the Sammtliche Werke are indicated by the letters S. W.; to the Nachgelassene Werke, by the letters N. W. References to the Kritik der remen Vernunft arc indicated by the letters A (for the First Edition) and B (for the Second). All other references to Kant's writings are made to Hartenstein's second edition of the Sammtliche Werke (Leipzig, 1867-1868, 8 vols.) and are indicated by the letter H. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.". (shrink)

Wright maintains that tradition (including language) plays a fundamental role in the origins and shaping of the monastic world that made a unique Chan mind possible. Through a creative application of the Buddhist idea of dependent origination, Wright has broadened the hermeneutic concept of historicity in that it is more than a linear and causal relationship of contextuality (that is, the person is always a person-in-community, and the text is always a text-in-context). Instead, contextuality refers to a (w)holistic network of (...) associations and re-associations. The word tradition thus becomes an open tradition that is constantly shaped and reshaped, formed and transformed. The meaning of tradition as such is always a trace of that other which is forever absent. In this sense, Wright is quite Derridean. Like Derrida’s deconstruction, Wright’s interpretative endeavor, as part of the tradition of linguistic turn, seems to become separated from the real world of flux and takes on an independent status, that is, the realm of reading, explaining, and understanding (perhaps mis-understanding, sometimes). Wright’s project fits the need of those who have a passion for doing things with words, and those who prefer meditative reading to meditative practice (in a Buddhist sense). Though Wright keeps reminding us that the effort to play language in relation to Chan experience does not imply that Chan enlightenment/mind is in any sense reducible to language; it still remains a question whether his critical philosophical meditations are fully out of the spell of conceptuality of the hermeneutical circle. Wright might say that there is no need to be out of the circle, or there is no such circle in the first place. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 38.4 (2004) 113-120 [Access article in PDF] Wonders, Witches, Wolves, and Wisdom Ellen Handler Spitz Honors College Professor of Visual Arts University of Maryland The Annotated Classic Fairy Tales, ed. Maria Tatar, New York: W.W. Norton, 2002, Paperback: 394 pp., $16.95. We persist in hearkening to fairy tales. Along with ancient myths, the parables of scripture, the secular legends and sacred texts of (...) many lands, a stable canon of these magical tales still provides, even in the twenty-first century, an ongoing source of inspiration to artists, composers, choreographers, filmmakers, poets, and, above all, to the writers and illustrators and readers of children's books. They are of abiding interest as well to all of us who, in our various ways, concern ourselves with the aesthetic education of children. Why is this so? One preeminent authority in the field is Maria Tatar, John L. Loeb Professor of Germanic Languages and Literatures at Harvard University, an author who, with wisdom, tenderness, and erudition, has traced and researched these tales. Having devoted two decades to the phenomenon, Tatar's works include The Hard Facts of the Grimms' Fairy Tales, Off with their Heads! Fairy Tales and the Culture of Childhood, and The Classic Fairy Tales: A Norton Critical Edition.1 She has recently come out with a new book, an edited collection of twenty-six tales all illustrated, marginally annotated, and a number of them retranslated for the occasion, the result being The Annotated Classic Fairy Tales, a painstakingly produced, lavishly decorated volume that would grace any library.In addition to commenting, in the volume's elegantly wide margins, on each of the included tales, Tatar has arranged to have this new compilation ornamented with small colored reproductions of both rare and famous images associated with the tales by distinguished illustrators of the nineteenth and early twentieth centuries — artists such as Gustave Doré, Edmund Dulac, Walter Crane, Maxfield Parrish, and Arthur Rackham. While small in size and often not quite as clear as one might ideally wish (I found myself longing for some sorcery that would blow them up to full size so as to be able to feast my eyes on their wealth of detail and imaginative splendor), these images grace the text and greatly enhance its pleasures. Their presence, in fact, is one of the factors that makes this book unique. I know of no other extant work where a comparable effort has been made to join the fairy tales with a multiplicity of their most celebrated illustrations. The effect is astonishing. Readers are either transported directly back into their own early childhoods or newly acquainted with a brilliant visual canon parallel to that of the fairy [End Page 113] tales themselves. I predict it will be a rare reader who, after seeing this book, will not be desirous of learning more about the artists whose works are reproduced here. To further that end and to begin to satisfy the desire she must have known she would create, Tatar has supplied her readers with a section of mini-biographies and bibliographies not only of the authors and collectors of the fairy tales themselves (most notably, Charles Perrault, the brothers Wilhelm and Jacob Grimm, and Hans Christian Andersen) but of the illustrators. For this felicitous marriage — of word and image, of story and picture — her endeavor deserves our gratitude.Rather than take this tasteful treasure trove as a culmination of Tatar's pre-existing work, which, in a certain sense, it is, I prefer to see it as a lure that entices readers to revisit her earlier volumes which, while of recognized scholarly import and interpretive richness, all tackle questions pertinent not only to folklorists and to historians of literature but to all of us who, in the wake of recent history, have come to wonder ever more anxiously what sort of tales we ought to be telling children and ourselves and how and why. This question, incidentally, returns us to Book II of Plato's Republic, where Socrates poses this question directly to... (shrink)