Background/purpose:Research from other disciplines demonstrates that ethical position, idealism, or relativism predicts ethical decision-making. Individuals from diverse cultures ascribe to various religious beliefs and studies have found that religiosity and culture affect ethical decision-making. Moreover, little literature exists regarding undergraduate nursing students’ ethical position; no studies have been conducted in the United States on students’ ethical position, their self-identified culture, and intrinsic religiosity despite an increase in the diversity of nursing students across the United States.Participants and Research Context Objectives:The study’s (...) two aims were to determine the relationship of self-identified culture, religiosity, and ethics position of undergraduate nursing student and whether students’ level of education and past ethics courses taken related to idealism. Two hundred and twelve volunteer undergraduate students participated.Research design:A descriptive cross-sectional study was designed for participants who completed the Ethical Position Questionnaire, The intrinsic subscale of the Religious Orientation Scale, and a Demographic, Cultural, Ethnicity Form. To test the five hypotheses, analyses included t-tests, correlations, and ANOVA.Ethical Considerations:The study was approved by the Institutional Review Board at Adelphi University.Results:Idealism and intrinsic religiosity were significantly related. Differences were observed for intrinsic religiosity and idealism for cultural identity and cultural dimensions such as parents’ place of birth, and if participants were US born. Students’ level of education or participation in past courses on ethics did not influence idealism.Conclusions:The study’s findings were similar to most of the research from other disciplines on culture, ethics position, and religiosity. Generic courses on ethics taken prior to clinical work may not assist nursing students in integrating principles into complex ethical dilemmas. Self-identified culture, religion, and intrinsic religiosity related to ethics position; completing ethics courses and level of education, juniors compared with seniors, did not influence idealism. Faculty should consider integrating students’ culture, religious orientation, and ethics position into teaching ethics for all levels of nursing education. (shrink)

BackgroundCervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status. Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like ‘equity’. Equity is a poorly defined and understood concept. We aimed to explain experts’ perspectives on how cervical screening programs might justifiably respond to ‘the underscreened’.MethodsThis paper reports (...) on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing.ResultsMost experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines.ConclusionsExperts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to ‘improving equity’ taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage. (shrink)

Background The world is threatened by future pandemics. Vaccines can play a key role in preventing harm, but there will inevitably be shortages because there is no possibility of advance stockpiling. We therefore need some method of prioritising access. Main text This paper reports a critical interpretative review of the published literature that discusses ethical arguments used to justify how we could prioritise vaccine during an influenza pandemic. We found that the focus of the literature was often on proposing different (...) groups as priorities. Different reasons were often suggested as a means of justifying such priority groupings. We suggest that much of the literature, wrongly, assumes that we are able to plan priority groups prior to the time of a particular pandemic and development of a particular vaccine. We also point out the surprising absence of various issues from the literature. Conclusions The literature proposes a wide range of ways to prioritise vaccines, focusing on different groups and ‘principles’. Any plan to use pandemic vaccine must provide justifications for its prioritisation. The focus of this review was influenza pandemic vaccines, but lessons can be learnt for future allocations of coronavirus vaccine, if one becomes available. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Pragmatist Philosophy of History by Marnie BinderPiers H. G. StephensA Pragmatist Philosophy of History Marnie Binder. Lexington Books, 2023.Looking at current scholarship and opinion in American philosophy, one can easily conclude that there has been much more work done on studying the history of pragmatist philosophy than there has been on what pragmatist philosophy can give to the study of history. Ever since the resurrection of interest (...) in pragmatism in the late twentieth century, we have seen a range of publications offering new interpretations for the ideas of the classical pragmatists, as well as important new applications for philosophical pragmatism and the moving to center stage of historically sidelined individuals and groups. What we have seen relatively little of, however, aside from a 2016 symposium in the European Journal of Pragmatism and American Philosophy, is sustained engagement with the question of what a classically pragmatist approach to historical inquiry might contribute, entail, or imply. It is this important niche in the ecosystem of American philosophy that Marnie Binder's A Pragmatist Philosophy of History seeks to partially fill in.Binder, who is perhaps best known for her past writings on José Ortega y Gasset, is at pains from the start to indicate both the humility and the utility of her project. As befits the tradition, there are no grandiose philosophical pretensions here, with the "goal in presenting a pragmatist philosophy of [End Page 112] history" merely being "to add another apparatus to the toolkits of the philosopher and the historian," an extra perspective that is "meant to complement other methodologies" (xi; emphasis in original), as she explains in her introduction. At the same time, pragmatism can offer something distinctive, firstly through asking the pragmatic question of what difference is meant by the accepting of particular presumed facts as being true, and secondly, being able to better understand why certain historical details have relevance, value, and meaning for us as a result of answering the first question. A pragmatist philosophy of history is helpful then, Binder maintains, as it "is in a unique position to bridge the speculative analytic divide" (xiii), and her approach to doing this is to draw upon the resources found in the works of a succession of the familiar classical pragmatists, building toward a synthesis and a cashing out of insights in her concluding reflections.Structurally the work consists of an explanatory introduction followed by six chapters, each dedicated to a particular pragmatist and their insights, leading finally to an extended concluding section drawing the component parts together and answering possible objections to the project. Pragmatism, as Binder recognizes, is seldom thought of as a historically orientated philosophy, but she argues that for each of these thinkers—William James, John Dewey, F. C. S. Schiller, Charles Sanders Peirce, George Herbert Mead, and Jane Addams—there is at least the germ of a philosophy of history that can be unearthed and developed, eventually helping to inform understanding of what is needed to bring a pragmatist ethics into practical reality, the last of which is manifested primarily by Addams. Thus, the treatment of William James in chapter 1 homes in on James's psychological insights into the way that experienced reality forms a temporal continuum; our consciousness necessarily selects from the experiences of the past, ascribing interpretations and assuming levels of facticity and relevance, since no individual can know all the facts or select among them with perfect impartiality. The continuum will be one that speaks to the inquirer's concerns with accuracy, practicality, meaningfulness, and coherence, as all knowledge comes about through temporal processes, and since past events are continuously added to and can be continuously reinterpreted, it can have no real or ultimate beginning or end. Accordingly, for a Jamesian pragmatist account, the "continuum of history is the way in which we construct a meaning for history of the connected past experiences with the present and in view of the future—this is what we call 'history'" (7; emphasis in original), and Binder draws upon José Medina's recent work to further illuminate how such history can and will be continuously critically reconstructed. In addition, she observes, such reconstruction [End Page... (shrink)

In the absence of a well articulated conceptual framework for nursing ethics, this article argues for a theory of applied ethics - casuistics - used within a clinical reasoning model, to analyse the complicated issues presented in three cases involving adolescents receiving treatment for abuse through a rural alternative learning centre. The clinical nurse specialist, as an independent practitioner within the community, is presented with many ethical challenges arising from cultural diversity. The inherent independent nature of such practice environments combined (...) with the pluralism which exists in today's multicultural society demands that professional nurses working in these circumstances develop and utilize an ethical framework for the analysis of patient care in situations that involve moral conflict. (shrink)

For several decades historians of science have interrogated the relationship between empire and science, largely focusing on European imperial powers. At the same time, scholars have sought alternatives to an early diffusionist model of the spread of modern science, seeking to capture the multi-directional and dialogic development of science and its institutions in most parts of the globe. The papers in this special issue illuminate these questions with added attention to particular claims about the exceptionalism – or not – of (...) Islamic societies’ approach to science, modernity and politics. Each contribution centres individuals and groups who engaged with science theoretically or practically, taking seriously their analytical categories and how they understood and grappled with the social, economic and intellectual transformations happening around them. Collectively, these studies make the case for Middle Eastern and Ottoman history as useful sites for furthering our field's understanding of processes of the globalization of science and how authority, politics and science have been and continue to be interconnected. (shrink)

In 1958, economist A. W. Phillips published an article describing what he observed to be the inverse relationship between inflation and unemployment; subsequently, the "Phillips curve" became a central concept in macroeconomic analysis and policymaking. But today's Phillips curve is not the same as the original one from fifty years ago; the economy, our understanding of price setting behavior, the determinants of inflation, and the role of monetary policy have evolved significantly since then. In this book, some of the top (...) economists working today reexamine the theoretical and empirical validity of the Phillips curve in its more recent specifications. The contributors consider such questions as what economists have learned about price and wage setting and inflation expectations that would improve the way we use and formulate the Phillips curve, what the Phillips curve approach can teach us about inflation dynamics, and how these lessons can be applied to improving the conduct of monetary policy. ContributorsLawrence Ball, Ben Bernanke, Oliver Blanchard, V. V. Chari, William T. Dickens, Stanley Fischer, Jeff Fuhrer, Jordi Gali, Michael T. Kiley, Robert G. King, Donald L. Kohn, Yolanda K. Kodrzycki, Jane Sneddon Little, Bartisz Mackowiak, N. Gregory Mankiw, Virgiliu Midrigan, Giovanni P. Olivei, Athanasios Orphanides, Adrian R. Pagan, Christopher A. Pissarides, Lucrezia Reichlin, Paul A. Samuelson, Christopher A. Sims, Frank R. Smets, Robert M. Solow, Jürgen Stark, James H. Stock, Lars E. O. Svensson, John B. Taylor, Mark W. Watson. (shrink)

Annotation. Informed by recent developments in literary criticism and social theory, this book addresses the presumption that nature exists independent of culture and, in particular, of language.

At the beginning of the sixteenth century, in the lands that are now the United States (the forty-eight contiguous states, Alaska and Hawaii), there must have been many hundreds of distinct languages. Fewer than two hundred remain, and the future of these is decidedly insecure, even where the remoteness of the location (in the case of Inuit in Northern Alaska) or the large size of the speech community (in the case of Navajo in the Southwest) might seem to protect the (...) community from language loss. Yet even this vastly reduced reservoir of linguistic diversity constitutes one of the great treasures of humanity, an enormous storehouse of expressive power and profound understandings of the universe. The loss of the hundreds of languages that have already passed into history is an intellectual catastrophe in every way comparable in magnitude to the ecological catastrophe we face today as the earth's tropical forests are swept by fire. Each language still spoken is fundamental to the personal, social and - a key term in the discourse of indigenous peoples - spiritual identity of its speakers. They know that without these languages they would be less than they are, and they are engaged in the most urgent struggles to protect their linguistic heritage. The goal of this paper is to review the contexts and practices of this struggle, in the hope that people everywhere will support it. (shrink)

Epistasis plays an important role in the genetic architecture of common human diseases and can be viewed from two perspectives, biological and statistical, each derived from and leading to different assumptions and research strategies. Biological epistasis is the result of physical interactions among biomolecules within gene regulatory networks and biochemical pathways in an individual such that the effect of a gene on a phenotype is dependent on one or more other genes. In contrast, statistical epistasis is defined as deviation from (...) additivity in a mathematical model summarizing the relationship between multilocus genotypes and phenotypic variation in a population. The goal of this essay is to review definitions and examples of biological and statistical epistasis and to explore the relationship between the two. Specifically, we present and discuss the following two questions in the context of human health and disease. First, when does statistical evidence of epistasis in human populations imply underlying biomolecular interactions in the etiology of disease? Second, when do biomolecular interactions produce patterns of statistical epistasis in human populations?Answers to these two reciprocal questions will provide an important framework for using genetic information to improve our ability to diagnose, prevent and treat common human diseases. We propose that systems biology will provide the necessary information for addressing these questions and that model systems such as bacteria, yeast and digital organisms will be a useful place to start. BioEssays 27:637–646, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

With aims to both increase organ supply and better reflect individual donation preferences, many nations worldwide have shifted from ‘opt‐in’ to ‘opt‐out’ systems for post‐mortem organ donation (PMOD). In such countries, while a prospective donor's willingness to donate their organs/tissues for PMOD was previously ascertained—at least partially—by their having recorded positive donation preferences on an official register prior to death, this willingness is now presumed or inferred—at least partially—from their not having recorded an objection to PMOD—on an official organ donation (...) register. Using evidence regarding the presence and prevalence of selective donation preferences, and via exploration of how appeals to donation preferences are used to both motivate and legitimate shifts to opt‐out frameworks, this paper draws attention to a set of previously unexplored problems for opt‐out organ donation arising in contexts where: (a) individuals demonstrate selective post‐mortem organ/tissue donation preferences, (b) legislation provides prospective donors with the opportunity to selectively permit/refuse the donation of certain organs/tissues in line with these preferences. While selective preferences pose few problems for opt‐in systems where a selective occasion is built into the process of signing the donor register, this is not the case for opt‐out systems. The loss of this selective occasion can cause significant problems where appeals to preferences motivate/legitimate shifts to opt‐out but evidence regarding variable preferences does not feed into determinations regarding organ/tissue exclusions. The nature of these problems depends on how the authorization aspect of ‘opt‐out’ systems is framed (e.g. as presumed consent, deemed consent or, given the role of familial consent in many jurisdictions as consent in name only). (shrink)

This book explains and defends a central ideas in the theory of history put forward by R. G. Collingwood, perhaps the foremost philosopher of history in the 20th century. Professor Dray analyses critically the idea of re-enactment, explores the limits of its applicability, and determines its relationship to other key Collingwoodian ideas, such as the role of imagination in historical thinking, and the indispensability of a point of view.

This collection of 30 essays covers living a moral and ethical life as a lawyer and Christian, following the example of J. Reuben Clark, Jr. The mission and history of the BYU Law School is also adressed.

In the past decade, numerous ethical frameworks have been developed to support public health decision‐making in challenging areas. Before the COVID‐19 pandemic began, members of the authorship team were involved in research programmes, in which the development of ethical frameworks was planned, to guide (a) the use of new technologies for emerging infectious disease surveillance; and (b) the allocation of scarce supplies of pandemic influenza vaccine. However, as the pandemic evolved, significant practical challenges emerged that led to our questioning the (...) value of these frameworks. We now believe that a normative instrument, such as a framework, cannot adequately or reliably provide the ethical guidance that needs to be incorporated into public health decision‐making during natural disasters or infectious disease emergencies. Recently it has been suggested that there are potentially more dynamic, flexible, and effective ways to navigate decisions involving complex considerations entailed in policies and practices during a public health emergency. In this paper, we first outline the key functions of a public health ethics framework, before describing why we believe it would not be fit for purpose during a crisis. We end by considering whether proposed alternative methods to promote ethical public health decision‐making goals have the potential to meet these objectives. (shrink)

Traditionally, empathy is conceived of as a cognitive function that governs how people think during social interactions, and is considered as largely impervious to change. However, developments in psychology and neuroscience show that empathy is grounded in neural substrates of emotionally communicative behaviour and so is learned through imitation and other forms of cultural learning. This also means that abnormal patterns of empathic function can develop through adverse life experiences, or that empathy may fail to develop in young people with (...) neurodevelopmental disorders. Nevertheless, by focussing on empathy as a quality of social interaction and affective expression in the here and now, and by appreciating that it is as a special form of sensorimotor skill, pathways to training and fostering better development of empathy can be identified. (shrink)

We have investigated the emotional profile of dreams and the relationship between dream emotion and cognition using a form that specifically asked subjects to identify emotions within their dreams. Two hundred dream reports were collected from 20 subjects, each of whom produced 10 reports. Compared to previous studies, our method yielded a 10-fold increase in the amount of emotion reported. Anxiety/fear was reported most frequently, followed, in order, by joy/elation, anger, sadness, shame/guilt, and, least frequently, affection/eroticism. Unexpectedly, there was no (...) significant difference in the profiles of emotion reported by men and women. When the reports were scored for bizarreness, a significant correlation was found between the occurrence of bizarreness and major shifts in emotion. These results support the conclusion that dreaming is a mental state whose general emotional features are widely shared across individuals and strongly linked to cognitive features within individual dreams. (shrink)

We discuss a case where clinical genomic investigation of muscle weakness unexpectedly found a genetic variant that might (or might not) predispose to kidney cancer. We argue that despite its off-target and uncertain nature, this variant should be discussed with the man who had the test, not because it is medical information, but because this discussion would allow the further clinical evaluation that might lead it to becoming so. We argue that while prominent ethical debates around genomics often take ‘results’ (...) as a starting point and ask questions as to whether to look for and how to react to them, the construction of genomic results is fraught with ethical complexity, although often couched as a primarily technical problem. We highlight the need for greater focus on, and appreciation of, the ethical work undertaken daily by scientists and clinicians working in genomic medicine and discuss how public conversations around genomics need to adapt to prepare future patients for potentially uncertain and unexpected outcomes from clinical genomic tests. (shrink)