Despite the frequency of stillbirths, the subsequent implications are overlooked and underappreciated. We present findings from comprehensive, systematic literature reviews, and new analyses of published and unpublished data, to establish the effect of stillbirth on parents, families, health-care providers, and societies worldwide. Data for direct costs of this event are sparse but suggest that a stillbirth needs more resources than a livebirth, both in the perinatal period and in additional surveillance during subsequent pregnancies. Indirect and intangible costs of stillbirth are (...) extensive and are usually met by families alone. This issue is particularly onerous for those with few resources. Negative effects, particularly on parental mental health, might be moderated by empathic attitudes of care providers and tailored interventions. The value of the baby, as well as the associated costs for parents, families, care providers, communities, and society, should be considered to prevent stillbirths and reduce associated morbidity. (shrink)

The conventional paradigm for developing new treatments for disease mainly involves either the discovery of new drug targets, or finding new, improved drugs for old targets. However, an ion channel found only in invertebrates offers the potential of a completely new paradigm in which an established drug target can be re‐engineered to serve as a new candidate therapeutic agent. The L‐glutamate‐gated chloride channels (GluCls) of invertebrates are absent from vertebrate genomes, offering the opportunity to introduce this exogenous, inhibitory, L‐glutamate receptor (...) into vertebrate neuronal circuits either as a tool with which to study neural networks, or a candidate therapy. Epileptic seizures can involve L‐glutamate‐induced hyper‐excitation and toxicity. Variant GluCls, with their inhibitory responses to L‐glutamate, when engineered into human neurons, might counter the excitotoxic effects of excess L‐glutamate. In reviewing recent studies on model organisms, it appears that this approach might offer a new paradigm for the development of candidate therapeutics for epilepsy. (shrink)

The Hebrew Psalter is a repertoire of paired phenomena. From parallelisms to twin Psalms, biblical scholars have paid attention to these structural and poetical features as keys to unlocking and interpreting the meaning and theology of these psalms. Unfortunately, the otherwise admirable results of these exegetical works remain abstract and largely removed from the interests of the African reader. An alternative way of engaging these texts is to realise that paired phenomena are not exclusive to the Hebrew Psalter. African indigenous (...) sacred texts such as the Adinkra of the Akan people equally contain similar phenomena though relatively little attention has been paid to them. This article, using a dialogical approach of African Biblical Hermeneutics, studies the twin Psalms 111 and 112 as an example of a paired phenomenon in the Psalter. It brings this text into dialogue with the Adinkra denkyemfunefu to illustrate how focussing on similar structural phenomena in either text uncovers the same theme of the common good in either text and facilitates the reception of the biblical discourse in contemporary African contexts.Contribution: It is argued that common literary features in biblical and African indigenous sacred texts could be harnessed as vehicles for facilitating the reception of biblical discourse in contemporary Africa. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

ObjectiveParenting sensitivity and mutual parent-child attunement are key features of environments that support children’s learning and development. To-date, observational measures of these constructs have focused on children aged 2–6 years and are less relevant to the more sophisticated developmental skills of children aged 7–8 years, despite parenting being equally important at these ages. We undertook a rigorous process to adapt an existing observational measure for 7–8-year-old children and their parents. This paper aimed to: describe a protocol for adapting an existing (...) framework for rating parent-child interactions, determine variations in parents’ sensitive responding and parent-child mutual attunement by family demographics, and evaluate the psychometric properties of the newly developed measure.MethodParent-child dyads completed one home visit, including a free-play observation and parent questionnaire. Dyads were provided with three toy sets: LEGO® Classic Box, Classic Jenga®, and animal cards. The Coding of Attachment-Related Parenting was adapted for use with 7–8-year-old children, and rating procedures were streamlined for reliable use by non-clinician/student raters, producing the SCARP:7–8 Years. Trained staff rated video-recorded observations on 11 behaviors across two domains.ResultsData were available for 596 dyads. Consistently strong inter-rater agreement on the 11 observed behaviors was achieved across the 10-week rating period. Average ICCs were 0.77 for sensitive responding and 0.84 for positive mutuality. These domains were found to be related but distinct constructs. For both domains, average ratings were strongly associated with the main toy used during the observation. Adjusted multivariate linear regression models revealed that less sensitive responding was associated with younger parent, male parent, non-English speaking background, and greater neighborhood disadvantage. Construct validity was demonstrated using six parent-reported psychosocial and parenting measures.ConclusionThe SCARP: 7–8 Years shows promise as a reliable and valid measure of parent-child interaction in the early school years. Toy selection for direct observation should be considered carefully in research and practice settings. (shrink)

The House of Lords majority decision in Matthews v. Kent and Medway Towns Fire Authority overturns the narrow interpretation given to key aspects of the Part-Time Workers (Protection of Less Favourable Treatment) Regulations’ core comparator mechanism in the lower tribunals and the Court of Appeal. It is a contextually astute judgment, which recognises the reductionist implications of an overly narrow approach to establishing comparability for the purposes of a less favourable treatment claim on the grounds of part-time work. The positive (...) aspect of this decision remains overshadowed, however, by the fact that this interpretation provides little consolation to the large majority of part-time women workers whose disadvantage and inequality remains outside the scope of the Regulations’ protection. (shrink)

As several commentators and researchers have noted since late spring 2020, COVID-19 has laid bare the connections between entrenched structurally generated inequalities on one hand, and on the other hand relatively high degrees of susceptibility to contracting COVID-19 on the part of economically marginalized population segments. Far from running along the tracks of race neutrality, studies have demonstrated that the pandemic is affecting Black people more than Whites in the U.S.A. and U.K., where reliable racially-disaggregated data are available. While the (...) situation in Canada seems to follow the same pattern, race-specific data on COVID-19 are hard to come by. At present, there is no federal mandate to collect race-based data on COVID-19, though, in Ontario, at the municipal level, the City of Toronto has been releasing such data. This paper examines the entanglements of race, immigration status and the COVID-19 pandemic in Canada with particular emphasis on Black immigrants and non-immigrants in Toronto, using multiple forms of data pertaining to income, housing, immigration, employment and COVID-19 infections and deaths. Our findings show that the pandemic has had a disproportionate negative impact on Black people and other racialized people in Toronto and, indeed, Canada. (shrink)

Passionate readers both, Olivia Langdon and Mark Twain courted through books, spelling out their expectations through literary references as they corresponded during their frequent separations. Surprisingly, in the process Olivia Langdon reveals herself not as a hypochondriacal hysteric, as many twentieth-century critics have portrayed her, but as a thoughtful intellectual, widely read in literature, history and modern science. Not so surprisingly, Samuel Clemens reveals himself as a critic and a sceptic, lampooning Langdon's physics lessons and her literary heroines. (...) He also shows himself as an astute strategist, carefully manipulating Langdon and her parents. At the same time, Clemens's letters exhibit his own conservatism about women's nature and women's roles, while Langdon's show her carefully choosing from her culture's array of possible role models. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

The study of rare diseases has long been an area of challenge for medical researchers, with agonizingly slow movement towards improved understanding of pathophysiology and treatments compared with more common illnesses. The push towards evidence-based medicine (EBM), which prioritizes certain types of evidence over others, poses a particular issue when mapped onto rare diseases, which may not be feasibly investigated using the methodologies endorsed by EBM, due to a number of constraints. While other trial designs have been suggested to overcome (...) these limitations (with varying success), perhaps the most recent and enthusiastically adopted is the application of artificial intelligence to rare disease data. This paper critically examines the pitfalls of EBM (and its trial design offshoots) as it pertains to rare diseases, exploring the current landscape of AI as a potential solution to these challenges. This discussion is also taken a step further, providing philosophical commentary on the weaknesses and dangers of AI algorithms applied to rare disease research. While not proposing a singular solution, this article does provide a thoughtful reminder that no ‘one-size-fits-all’ approach exists in the complex world of rare diseases. We must balance cautious optimism with critical evaluation of new research paradigms and technology, while at the same time not neglecting the ever-important aspect of patient values and preferences, which may be challenging to incorporate into computer-driven models. (shrink)

This paper examines the meaningfulness of pointing in great apes. We appeal to Hannah Ginsborg’s conception of primitive normativity, which provides an adequate criterion for establishing whether a response is meaningful, and we attempt to make room for a conception according to which there is no fundamental difference between the responses of human infants and those of other great apes to pointing gestures. This conception is an alternative to Tomasello’s view that pointing gestures and reactions to them reveal a fundamental (...) difference between humans and other apes. (shrink)

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others’ emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need to be (...) humanely understood. Because we respond to others’ very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. (shrink)

Promoting Farmer Managed Natural Regeneration (FMNR) aims to increase the productive capacities of farmer households. Under FMNR, farmers select and manage natural regeneration on farmlands and keep them under production. While FMNR contributes to the wealth of farming communities, its contribution to household food security has rarely been researched. We, therefore, used a mixed-methods approach to address the research gap by measuring FMNR’s contribution to food security among farmer households in the Talensi district of Ghana. We adopted the Household Dietary (...) Diversity Score (HDDS) and Food Consumption Score (FCS) to estimate food security status among 243 FMNR farmer households and 243 non-FMNR farmer households. Also, we performed a Chi-square test of independence to compare the frequency of each food group (present vs not present) between FMNR adopters and non-FMNR adopters to establish the relationship between adopting FMNR and consuming the FCS and HDDS food groups. Our results reveal that FMNR farmer households are more food secure than non-FMNR farmer households. The HHDS of the FMNR farmer households was 9.6, which is higher than the target value of 9.1. Conversely, the HHDS of the non-FMNR farmer households was 4.3, which is lower than the target value of 9.1. Up to 86% and 37% of the FMNR farmer households and non-FMNR farmer households fell within acceptable FCS; 15% and 17% of FMNR farmer households and non-FMNR farmer households fell within borderline FCS. While none of the FMNR farmer households fell within poor FCS, 46% of non-FMNR farmer households fell within poor FCS. Adopting FMNR is significantly related to consuming all food groups promoted and benefiting from FMNR practices. The paper recommends enabling farmers in semi-arid environments to practice and invest in FMNR for long-term returns to food security. (shrink)

Several studies have illuminated how processing manual action verbs (MaVs) affects the programming or execution of concurrent hand movements. Here, to circumvent key confounds in extant designs, we conducted the first assessment of motor–language integration during handwriting—a task in which linguistic and motoric processes are co‐substantiated. Participants copied MaVs, non‐manual action verbs, and non‐action verbs as we collected measures of motor programming and motor execution. Programming latencies were similar across conditions, but execution was faster for MaVs than for the other (...) categories, regardless of whether word meanings were accessed implicitly or explicitly. In line with the Hand‐Action‐Network Dynamic Language Embodiment (HANDLE) model, such findings suggest that effector‐congruent verbs can prime manual movements even during highly automatized tasks in which motoric and verbal processes are naturally intertwined. Our paradigm opens new avenues for fine‐grained explorations of embodied language processes. (shrink)

A timely and penetrating investigation, this book seeks to transform moral philosophy. In the face of continuing disagreement about which general moral principles are correct, there has been a resurgence of interest in the idea that correct moral judgements can be only about particular cases. This view--moral particularism --forecasts a revolution in ordinary moral practice that has until now consisted largely of appeals to general moral principles. Moral particularism also opposes the primary aim of most contemporary normative moral theory that (...) attempts to show that either one general principle, or a set of general principles, is superior to all its rivals. (shrink)

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...) in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)

Bernard Spodek, one of the most important figures in contemporary early childhood education, has been a seminal figure in early childhood education for approximately six decades. He has also been a creative contributor to contemporary thinking on the integration of theory, research, and practice on the development and education of young children. He is the author of numerous theoretical, research, and practical articles that continue to be published in scholarly journals and the author of textbooks that span the fields of (...) early childhood education and child development. This book, Bernard Spodek: Early Childhood Education Scholar, Researcher, and Teacher, offers an understanding of an eminent scholar who has made significant contributions to the field of early childhood education. It has a richly detailed and intimate picture of the construction of a knowledge base for the development and education of young children. All of the chapters show how Bernard Spodek assumes various roles to promote the field of early childhood education as he functions as a mentor, scholar, researcher, and master teacher. Bernard Spodek: Early Childhood Education Scholar, Researcher, and Teacher is a text for students who are interested in acquiring the basic knowledge about early childhood education, about the work that practitioners do with young children, and about the ideas that underlie that work. It is an appropriate text for graduate students in four-year colleges and universities. (shrink)

Blockchain’s language and terminology is confusing, contested, and rapidly changing. As a hype-driven technology, Blockchain is critical to an increasing number of projects that exist in a space of regulatory uncertainty. As communities of blockchain develop and evolve, the language they use to describe these functions changes. This causes concerns when attempting to have global regulatory certainty and clarity. Regulators and communities have different approaches to blockchain language, and this causes problems because of the translation between practical use in a (...) community, and the legal effects created by regulators. Of particular concern is the lack of clear expression amongst the broader community regarding the concept of blockchain-related assets as these ‘tokens’, ‘coins’, and ‘assets’ form a key part of financial regulation. This project uses semiotics to study the diverse language associated with blockchain. This analyzes a series of self-proclaimed ‘dictionaries of blockchain’ to assess key definitions, themes, perceptions, and misconceptions present in these communities. The study involved a case analysis of the terminology used in Australia’s proposed response to blockchain in comparison with that of wider communities. When comparing this to regulatory definitions and approaches, it becomes clear that this is an area that requires further attention. This project highlights the need for regulators to understand and use common terms in blockchain regulation. It is argued that this approach facilitates a better understanding of poorly understood concepts and clearly connects the law with those it intends to target. (shrink)

In Wittgenstein on Rules and Private Language, Saul Kripke articulates a form of scepticism about meaning. Even though there is considerable disagreement among critics about the reasoning in which the sceptic engages, there is little doubt that he seeks to offer constraints for an adequate account of the facts that constitute the meaningfulness of expressions. Many of the sceptic's remarks concern the nature of the guidance involved in a speaker's meaningful uses of expressions. I propose that we understand those remarks (...) as seeking to give shape to the idea that to use an expression under the guidance of one's understanding is to have a reason for that use, which one's understanding allows one to discern and act on. Any philosophical elucidation of meaning must adequately capture the rational nature of our linguistic acts. (shrink)

We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Researchers want to offer carrots to incentivise participation. We (...) are proposing that research participation be viewed as a job with the full suite of financial entitlements of fairly remunerated work, including payment for risk and labour law protections. This would be a significant shift from current practice and standards. Ambuehl, Ockenfels and Roth have grasped this basic point and have beautifully elaborated how a fair price could be arrived at using economic theory. They build on our proposal helpfully and suggest ‘ salary for time involvement that is adjusted to account for the amount of discomfort experienced during participation, insurance against ex post adverse outcomes and ex ante compensation for risks that cannot be compensated ex post.’3 This effectively addresses Fernandez Lynch and Largent’s2 concern that compensation for risk is inappropriate for harms which do not eventuate. However, because death cannot be compensated for, there must be payment for risk of death, as Ambuehl, Ockenfels and Roth convincingly argue.3 Indeed, the three-part model suggested by Ambuehl, Ockenfels and Roth makes us realise that job model would be a better title for our model than a payment for risk model. The alternative to a properly remunerated job model is the original altruistic model. However, this …. (shrink)

Streaming in secondary schools is not beneficial for improving student outcomes of education with vast amounts of educational research indicating that it does not improve academic results and increases inequity. Yet teachers often prefer working in streamed classes, and research shows that teachers mediate the effects of streaming on students. This study sought to add to the understanding of teachers’ role in student learning by investigating how teachers conceptualise the students in streamed classes. A qualitative case study approach was used, (...) where 18 teachers were interviewed in-depth to create narrative examples, three of which are presented here. These narratives summarise the research findings that teachers saw students in high and low streams as having homogenous characteristics according to five dichotomous categories: approach to learning, attitude to learning, learning style, autonomy and background. Students in mixed-ability classes were viewed along these same continua, but as more heterogeneous groups. Furthermore, these views of students had direct implications for how teachers planned for learning and the expectations that they held of their students. The discussion links streaming research with teacher expectation research, suggesting that teachers of streamed classes in this secondary school hold specific whole-class ideas that affect student learning. The article concludes with recommendations for further inquiry that links these two important fields of educational research. (shrink)

Research into early Chinese olfactory culture is only just beginning. This paper argues that before the arrival of Buddhism, elite scent culture had already begun to be transformed by the importation of foreign aromatics, though these substances arrived shorn of their original cultural context. Prior to the importing of intense foreign perfumes, the aromatics available were mostly local, and traditional Chinese practice stressed the use of individual scents in religious contexts, a concept which also had a profound influence on secular (...) usage. The same is true of early osmographies, which link particular kinds of smells—including many that might be considered unpleasant—to the changing seasons. When foreign spices and aromatics arrived in China for the first time, a phenomenon later literature specifically associates with the reign of Han Wudi, this resulted in the development of new complex and powerful perfumes. This in turn may have had a significant impact upon the material culture of Han China, with the spread of personal scenting devices and incense burners. (shrink)

According to the sceptic Saul Kripke envisages in his celebrated book on Wittgenstein on rules and private language, there are no facts about an individual that determine what she means by any given expression. If there are no such facts, the question then is, what justifies the claim that she does use expressions meaningfully? Kripke’s answer, in a nutshell, is that she by and large uses her expressions in conformity with the linguistic standards of the community she belongs to. While (...) Kripke’s sceptical problem has gripped philosophers for over three decades, few, if any, have been satisfied by his proposed solution, and many have struggled to come up with one of their own. The purpose of this paper is to show that a more satisfactory answer to Kripke’s challenge can be developed on the basis of Donald Davidson’s writings on triangulation, the idea of two individuals interacting simultaneously with each other and the world they share. It follows from the triangulation argument that the facts that can be regarded as determining meaning are irreducible. Yet, contra Kripke, they are not mysterious, for the argument does spell out what is needed for an individual’s expressions to be meaningful. (shrink)

This paper examines Hannah Ginsborg's attempt to address the challenge raised by Saul Kripke's meaning sceptic. I start by identifying the two constraints that the sceptic claims must be met by a satisfactory answer. Then I try to show that Ginsborg's proposal faces a dilemma. In the first instance, I argue that it is able to meet the second constraint, but not the first. I then amend the proposal in order to make room for the first constraint. I go on (...) to argue that, under this new interpretation, it cannot meet the second constraint. (shrink)

In this article, it will be concluded that the major automotive racing league, Formula 1, is failing in its efforts to be a truly unisex sport. In the current Formula 1 series, there are no female drivers. Although women have never been officially prohibited from competing in Formula 1, there have been fewer than 10 female drivers since its inception. This inquiry focuses on why women drivers have been prevented from securing professional driving positions in Formula 1 and racing on (...) equal terms with men. I argue that there are five major barriers which perpetuate women’s exclusion from this league: historical and current attitudes, assumed physical and mental inferiority, sexualisation, money, and representation and visibility. In this cultural examination, I demonstrate that the situation for women in Formula 1 appears to be bleaker than in other sports that are making progress in their quest for gender equality. However, I also suggest that, despite ethical issues, W Series – a new, women-only, single-seater car racing championship – could potentially motivates positive change for women’s car racing by promoting gender equity through a new league which enables women to improve themselves in a protected category. This article also considers the impact of sex in Formula 1, which is pertinent to the discussion surrounding alleged biological differences. The discussion employs Simone de Beauvoir’s conceptualisation of ‘Otherness’, as well as Helmut Pflugfelder’s account of female embodiment in motorsport. The overall findings are that more focused research is required for gender issues in Formula 1 to be accurately addressed. (shrink)

The ethics of technology has primarily focused on what values are and how they can be embedded in technologies through design. In this context, some work has been done to show the efficacy of a number of design approaches. However, existing studies have not clearly pointed out the ways in which design-for-values approaches can be used by design team managers to properly organize and use technologies in practice. This chapter attempts to fill this gap by discussing the value sensitive design (...) (VSD) approach as a useful means of co-designing technologies as a toolkit for existing workflow management, in this case, Agile. It will be demonstrated that VSD shows promise as a way of democratically designing technologies as well as fostering democratic technology policy innovation. (shrink)

Although undergraduate engineering ethics courses often include the development of moral sensitivity as a learning objective and the use of active learning techniques, teaching centers on the transmission of cognitive knowledge. This article describes a complementary assignment asking students to perform an ethics “experiment” on themselves that has a potential to enhance affective learning and moral imagination. The article argues that the focus on cognitive learning may not promote, and may even impair, our efforts to foster moral sensitivity. In contrast, (...) the active learning assignments and exercises, like the ethics “experiment” discussed, offer great potential to expand the scope of instruction in engineering ethics to include ethical behavior as well as knowledge. Engineering ethics education needs to extend beyond the narrow range of human action associated with the technical work of the engineer and explore ways to draw on broader lifeworld experiences to enrich professional practice and identity. (shrink)

Background:Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous.Objective:This article is an analysis of the concept (...) of moral courage in nursing.Design:Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis.Data sources:The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis.Ethical considerations:This study was conducted according to good scientific guidelines.Results:Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment.Discussion and conclusion:This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)

Are there limits to what it is morally okay to imagine? More particularly, is imaginatively inhabiting morally suspect perspectives something that is off-limits for truly virtuous people? In this paper, I investigate the surprisingly fraught relation between virtue and a familiar form of imaginative perspective taking I call empathy. I draw out a puzzle about the relation between empathy and virtuousness. First, I present an argument to the effect that empathy with vicious attitudes is not, in fact, something that the (...) fully virtuous person can indulge in. At least one prominent way of thinking about the psychology of the virtuous person excludes the possibility that the virtuous could emotionally apprehend the world in a less than virtuous way, and empathizing with vicious outlooks does seem to run afoul of that restriction. Then, I develop an argument that runs in the contrary direction: virtue in fact requires empathy with vicious outlooks, at least in some situations. There is reason to think that a crucial part of being virtuous is ministering effectively to others’ needs, and there is also reason to think that other people may need to be empathized with, even if their emotional outlooks are at least minorly vicious. Finally, I outline two different solutions to this puzzle. Both solutions hold some promise, but they also bring new challenges in their train. (shrink)

The reality-virtuality continuum encompasses a multitude of objects, events and environments ranging from real-world multisensory inputs to interactive multisensory virtual simulators, in which sensory integration can involve very different combinations of both physical and digital inputs. These different ways of stimulating the senses can affect the consumer’s consciousness, potentially altering their judgements and behaviours. In this perspective paper, we explore how technologies such as Augmented Reality and Virtual Reality can, by generating and modifying the human sensorium, act on consumer consciousness. (...) We discuss the potential impact of this altered consciousness for consumer behaviour while, at the same time, considering how it may pave the way for further research. (shrink)

Background:Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage.Objectives:The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors.Research design:In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ Moral Courage Scale and analysed (...) statistically.Participants and research context:The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses.Ethical considerations:The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital.Findings:Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity.Discussion and conclusion:Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)

A sensibility is, on a rough first pass, an emotional orientation to the world. It shapes how things appear to us, evaluatively speaking. By transfiguring things’ evaluative appearances, a change in sensibility can profoundly alter one’s overall experience of the world. I argue that some forms of sensibility change entail (1) risking one’s knowledge of what experiences imbued with one’s prior sensibility were like, and (2) surrendering one’s grasp on the intelligibility of one’s prior emotional apprehensions. These costs have consequences (...) for Laurie Paul’s ‘problem of transformative experience.’ Paul has argued that when we are poised to become someone new, our inexperience generates problems for authentic choice about our own futures. By reckoning with the epistemic losses involved in sensibility change, I show that this problem must not be confined to novel transformations. Prior experience does not guarantee the knowledge or understanding necessary for choosing authentically (in Paul’s sense). If the problem Paul highlights is indeed a problem _at all,_ then, it is a still more pervasive and intractable one than it has been taken to be. (shrink)

Our collective enthusiasm for empathy reflects a sense that it is deeply valuable. I show that empathy bears a complex and surprisingly problematic relation to another social epistemic phenomenon that we have reason to value, namely testimonial trust. My discussion focuses on empathy with and trust in people who are members of one or more oppressed groups. Empathy for oppressed people can be a powerful tool for engendering a certain form of testimonial trust, because there is a tight connection between (...) empathy and a approval of another's outlook. I then argue that the qualities of empathy that make it such a powerful tool for bridging differences and building trust also have a problematic upshot: they make it the case that reliance on empathy will sometimes have a distorting effect upon the ways we extend testimonial trust. (shrink)