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Communicative Understandings of Women's Leadership Development: From Ceilings of Glass to Labyrinth Paths, edited by Elesha L. Ruminski and Annette M. Holba, weaves the disciplines of communication studies, leadership studies, and women's studies to offer theoretical and practical reflection about women's leadership development in academic, organizational, and political contexts. This work claims a space for women's leadership studies and acknowledges the paradigmatic shift from discussing women's leadership using the glass ceiling to what Eagly and Carli identify as the labyrinth of (...) leadership. (shrink)

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This interview with media anthropologist,Rebecca L. Stein, conducted by Noa Levin and Andrew Fisher in Spring 2023, takes her recent book Screenshots: State Violence on Camera in Israel and Palestine (2021) as its starting point in order to explore issues of state violence and the militarization of social media in Israel/Palestine. This book marks the culmination of a decade-long research project into the camera dreams introduced by digital imaging technologies and the fraught histories of their disillusionment. Stein discusses (...) the way her research has critically conceptualized the recent history of hopes invested in the digital image in this geopolitical context, by the occupier as much as the occupied, and charts the failures and mistakes, obstructions and appropriations that characterize the conflicted visual cultures of Israel/Palestine. (shrink)

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Rebecca Farinas takes seven major figures from the American philosophical canon and examines their relationship with an artistic or scientific interlocutor. In so doing, she provides a unique insight into the origins of American philosophy and, through case studies such as the friendship between Alain Locke and the biologist E.E. Just and the collaboration between Jane Addams and George Herbert Mead, sheds new light on these thinkers' ideas.

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Research-oriented universities are known for prolific research activity that is often supported by students in faculty-guided research. To maintain ethical standards, universities require on-going training of both faculty and students to ensure Responsible Conduct of Research (RCR). However, previous research has indicated RCR-based training is insufficient to address the ethical dilemmas that are prevalent within academic settings: navigating issues of authorship, modeling relationships between faculty and students, minimization of risk, and adequate informed consent. U.S. universities must explore ways to identify (...) and improve RCR concerns for current (faculty) and future researchers (students). This article reports the findings of a self-study (_N_ = 50) of research stakeholders (students and faculty) at a top tier research institution. First, we report on their perceived importance of applying RCR principles. Second, we explore relationships between stakeholder backgrounds (e.g., prior training, field, and position) and how they ranked the degree of ethical concerns in fictitious vignettes that presented different unethical issues university students could encounter when conducting research. Vignette rankings suggested concerns of inappropriate relationships, predatory authorship and IRB violations which were judged as most unethical, which was dissimilar to what sampled researchers reported in practice as the most important RCR elements to understand and adhere to for successful research. Regression models indicated there was no significant relationship between individuals’ vignette ethics scores and backgrounds, affirming previous literature suggesting that training can be ineffectual in shifting researcher judgments of ethical dilemmas. Recommendations for training are discussed. (shrink)

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In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

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Phase 1 healthy volunteer clinical trials—which financially compensate subjects in tests of drug toxicity levels and side effects—appear to place pressure on each joint of the moral framework justifying research. In this article, we review concerns about phase 1 trials as they have been framed in the bioethics literature, including undue inducement and coercion, unjust exploitation, and worries about compromised data validity. We then revisit these concerns in light of the lived experiences of serial participants who are income-dependent on phase (...) 1 trials. We show how participant experiences shift attention from discrete exchanges, behaviors, and events in the research enterprise to the ongoing and dynamic patterns of serial participation in which individual decision-making is embedded in collective social and economic conditions and shaped by institutional policies. We argue in particular for the ethical significance of structurally diminished voluntariness, routine powerlessness in setting the terms of exchange, and incentive structures that may promote pharmaceutical interests but encourage phase 1 healthy volunteers to skirt important rules. (shrink)

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Drawing on theoretical work on humans’ adaptive capacity, we propose that supervisors’ perception of top management’s high bottom-line mentality (BLM) has a dysfunctional effect on their ethical leadership practices. Specifically, we suggest that these perceptions hinder supervisors’ empathy, which eventuates in less ethical leadership practices. We also investigate, in a first-stage moderated mediation model, how supervisors high in trait mindfulness are resistant to the ill effects of perceptions of top management’s high BLM. Supervisors high (versus low) in this trait are (...) less likely to respond to perceptions of top management’s high BLM with reduced empathy that then hinders ethical leadership. Results from a multi-wave, multi-source sample of working adults from the Chinese high technology industry provide general support for our theoretical model. Theoretical and practical implications are discussed. (shrink)

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Despite some improvements in access to evidence-based medications for opioid use disorder, treatment rates remain low at under a quarter of those with need. High costs for brand name products in these medication markets have limited the volume of drugs purchased, particularly through public health insurance and grant programs. Brand firm anti-competitive practices around the leading buprenorphine product Suboxone — including product hops, citizen petitions and Risk Evaluation and Mitigation Strategy abuses — helped to maintain high prices by extending brand (...) exclusivity periods and hindering generic drug entry. Remedies to address costly anti-competitive activities include adoption of the proposed CREATES Act and modernization of the Hatch-Waxman Act by the Congress, and implementation of substantive modifications to the Food and Drug Administration citizen petition filing procedures. Given the persistence of these abuses, prescriptive changes are favorable to the procedural and clarifying steps thus far favored by the federal government. Extrapolating from the 37% price declines attributable to generic entry for buprenorphine tablets in 2011, our calculations suggest that implementing these remedies to facilitate generic competition with Suboxone film would have resulted in savings of approximately $703 million overall and $203 million to Medicaid in 2017. (shrink)

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Realist ideology critique (RIC) is a strand of political realism recently developed in response to concerns that realism is biased toward the status quo. RIC aims to debunk an individual's belief that a social institution is legitimate by revealing that the belief is caused by that very same institution. Despite its growing prominence, RIC has received little critical attention. In this article, I buck this trend. First, I improve on contemporary accounts of RIC by clarifying its status and the role (...) of motivated reasoning. Second, I show that realist ideology critics face a dilemma: either their account makes deeply implausible epistemological assumptions, or they temper its epistemology at the expense of rendering it toothless. I argue for each horn in turn before revealing the dilemma to be a false one by making a novel distinction between varying strengths of RIC based on their underlying epistemological assumptions. I propose Moderate RIC as a solution: upon discovering that one reason for your belief that a social institution is legitimate is likely malignantly epistemically circular, the belief should undergo further epistemic testing. I respond to three potential objections and suggest that Moderate RIC would make a fruitful addition to political theorists' methodological toolkit. (shrink)

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Mr. C is a twenty‐two‐year‐old who was flown to a level‐1 trauma center after diving headfirst into shallow water. Prior to this accident, he was in excellent health. At the scene, he had been conscious but was paralyzed and had no sensation below his neck. The emergency medical services team immobilized Mr. C's neck with a cervical collar and intubated him for airway protection before transport. As Mr. C's medical care proceeds, he expresses a desire for extubation, although it was (...) not clear that he had the capacity to make this (or any other) decision. It also was unclear whether this desire reflected his authentic wishes to be allowed to die or stemmed from feelings of discomfort and agitation. Over a period of several days, Mr. C's sedation was lightened, and the psychiatry service conducted a formal decision‐making capacity assessment. Mr. C continues to express a desire to withdraw life‐sustaining medical treatment. However, the psychiatry service is concerned that Mr. C seems to lack adequate insight into what it would mean to die.What does it mean to respect Mr. C's autonomy? (shrink)

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Ongoing evaluation of a clinical ethics consultation service (ECS) allows for continuous quality improvement, a process-based, data-driven approach for improving the quality of a service. Evaluations by stakeholders involved in a consultation can provide realtime feedback about what is working well and what might need to be improved. Although numerous authors have previously presented data from research studies on the effectiveness of clinical ethics consultation, few ECSs routinely send evaluations as an ongoing component of their everyday clinical activities. The primary (...) purpose of this article is to equip and encourage others to engage in ongoing evaluation of their own ECS. Toward that end, the following resources are shared: (1) the survey tool used to gather the evaluation data, (2) the procedure used to elicit and collate responses, and (3) how the resulting data are used to support continuous quality improvement and justify the continued financial support of the ECS to hospital administration. (shrink)

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Adoption of technology in agriculture can significantly reorganize production and relationships amongst humans, animals, technology, and the natural environment. However, the adoption of agricultural technology is not homogenous, and diversity in integration leads to a diversity of outcomes and impacts. In this study, we examine the adoption of automated milking systems in small and midsize dairy farms in the US Midwest, the Netherlands, and Denmark. In contrast to technological determinism, we find significant variation amongst adopters in the implementation of AMS (...) and corresponding variation in outcomes. Adopters have significant discretion in determining the use of AMS, which leads to a diversity of possible outcomes for family and non-family labor, human–cow relationships, animal welfare, the environment, and financial resiliency. Adoption and implementation are shaped by both structural factors, such as debt load and labor market variation, and by farmers’ individual personality traits and values, such as a willingness to release control to technology. Rather than uniform adoption and impacts of technology, we highlight the importance of context, the co-constitution of technology and users, and the diversity of technology adoption and its associated impacts. (shrink)

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The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than (...) usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy. (shrink)

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Human beings with diminished decision-making capacities are usually thought to require greater protections from the potential harms of research than fully autonomous persons. Animal subjects of research receive lesser protections than any human beings regardless of decision-making capacity. Paradoxically, however, it is precisely animals’ lack of some characteristic human capacities that is commonly invoked to justify using them for human purposes. In other words, for humans lesser capacities correspond to greater protections but for animals the opposite is true. Without explicit (...) justification, it is not clear why or whether this should be the case. Ethics regulations guiding human subject research include principles such as respect for persons—and related duties—that are required as a matter of justice while regulations guiding animal subject research attend only to highly circumscribed considerations of welfare. Further, the regulations guiding research on animals discount any consideration of animal welfare relative to comparable human welfare. This paper explores two of the most promising justifications for these differences␣between the two sets of regulations. The first potential justification points to lesser moral status for animals on the basis of their lesser capacities. The second potential justification relies on a claim about the permissibility of moral partiality as␣found in common morality. While neither potential justification is sufficient to justify the regulatory difference as it stands, there is possible common ground between supporters of some regulatory difference and those rejecting the current difference. (shrink)

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Most hospitals and nursing homes have individuals who engage in ethics consultation, and most do so with very little, if any, training. The goal of this article is not to advance the scholarly literature on training clinical ethics consultants, but instead to provide a road map for individuals doing ethics consultation who would like more training. In this way, I hope to advance the field in some small way, by educating, empowering, and encouraging small- to medium-sized hospitals to train the (...) members of their ethics committee who engage in ethics consultation. (shrink)

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Opioid litigation continues a growing public health litigation trend in which governments seek to hold companies responsible for population harms related to their products. The litigation can serve to address gaps in regulatory and legislative policymaking and in market self-regulation pervasive in the prescription opioid domain. Moreover, prior opioid settlements have satisfied civil tort litigation objectives of obtaining compensation for injured parties, deterring harmful behavior, and holding certain opioid manufacturers, distributors and pharmacies accountable for their actions. In this way, opioid (...) litigation represents progress over prior public health litigation campaigns involving tobacco, lead paint, and asbestos, which had more limited tort litigation effects. Although opioid litigation is not a comprehensive solution to the opioid crisis, it can complement other strategies and infuse much needed money, behavior changes, and public accountability for prescription opioid and related harms. (shrink)

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This essay explores three issues in respect for autonomy that pose unfinished business for the concept. By this, I mean that the dialogue over them is ongoing and essentially unresolved. These are: whether we ought to respect persons or their autonomous choices; the role of relational autonomy; and whether nonhuman animals can be autonomous. In attending to this particular set of unfinished business, I highlight some critical moral work left aside by the concept of respect for autonomy as understood in (...) Beauchamp and Childress’ Principles of Biomedical Ethics. Specifically, while significant pragmatic traction is gained by the authors’ focus on autonomous choice, carving such a focus out from the broader questions of moral respect and the autonomy of the person leaves aside a number of questions that we might have thought a view about respect for autonomy in biomedicine ought to answer. These include: How should physicians respond when autonomous patients make decisions that appear nonautonomous? What is the impact of the view that autonomy is “relational” for cross-cultural differences in how autonomy is respected? If chimpanzees can be autonomous, what does that mean for how they should be treated? (shrink)

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. This paper follows the journey of two small fluid units throughout the nineteenth century in Anglo-American medicine and pharmacy, explaining how the non-uniform “drop” survived while the standardized minim became obsolete. I emphasize two roles these units needed to fulfill: that of a physical measuring device, and that of a rhetorical communication device. First, I discuss the challenges unique to measuring small amounts of fluid, outlining how the modern medicine dropper developed out of an effort to resolve problems with (...) the “minimometer,” which measured minims. Second, I explain how drops, utilized in “the open drop method” of administering general anesthesia, effectively communicated a gradual process and epistemically valuable heuristic to the audience of practitioners, whose attention to individual medical outcomes was important for verifying the proper dosage. The standardized minim was never able to achieve success as the drop’s intended replacement; the non-uniform drop better served the relevant epistemic goals within the practical contexts for which these units were designed. The surprising historical trajectory of drops should cause us to question the common equivocation of “standardization” with “progress” in the history and philosophy of measurement. This study also exemplifies how examining non-standard measurement practices can be instructive for better understanding the role and function of standardization within epistemology of measurement. (shrink)

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In lieu of an abstract, here is a brief excerpt of the content:“Please Help Me”Rebecca L. VolpeTwo–year–old Jay was born prematurely at 26 weeks gestation, addicted to opiates. After several months in the Neonatal ICU, he was sent home, ventilator–dependent but with a high likelihood of survival and a low chance of severe, lasting disability. When Jay was 1½, he had a cardiopulmonary arrest at home. The parents of children who are on ventilators at home receive extensive education and (...) training about how to respond to something like an arrest. They are taught that a quick response is often critical to their child’s long–term prognosis. And yet, Jay’s parents took such a long time to respond to his code that Jay now has severe hypoxic ischemic encephalopathy: his brain was deprived of oxygen for so long that he has no higher cortical function, and will never think, speak, walk, or play.Currently, Jay is ventilator–dependent and has a very poor prognosis. Jay goes back and forth between a nursing home and the hospital. During one of his many hospitalizations, the ICU team decided to call an ethics consultation, because they felt that continued aggressive intervention was no longer in Jay’s best interests. I was the person on the other end of the line when the medical team called. After having a brief conversation with the attending physician, I left my office and walked to the Pediatric ICU to visit Jay. I arrived at the bedside—really just a large crib—and saw a baby with dark hair lying flat on his back. His tongue was swollen and protruding from his mouth, his eyes were puffy and closed, and his limbs were limp. On his belly was a piece of paper with the words, “BECKY PLEASE HELP ME” typed in huge, bold font. I looked up, into the eyes of the attending physician and said, “Did you type that?” The physician nodded yes. Much could be said about this physician’s behavior. But the bottom line—from a clinical perspective, at least—is that this ICU team was desperate, and that they had significant expectations that I would be able to help them.I began the work of the consultation. I reviewed the medical record, spoke with members of the treating team, and set up a time to talk to the family. During the family meeting, I learned that Jay’s parents wanted to continue to treat aggressively, and that they believed it was not their place to decide when it was their son’s time to die. That was [End Page 122] God’s decision. They could not fathom removing interventions that were maintaining their son’s life. They acknowledged that his quality of life was not high, but, still, it was life.The preferences of the treating team were in stark contrast to the parents’ preferences. The neurologists believed Jay did not have the capacity to experience physical pain, but the ICU team believed that continuing to treat Jay was cruel. Although the ICU team acknowledged that Jay was probably not suffering, they noted that we could not know for sure, and that sometimes Jay grimaced and withdrew—signs that are often interpreted as suffering. The ICU team also argued that given all the sick children in the world, and the scarcity of healthcare resources, it didn’t make sense to invest hundreds of thousands of dollars into prolonging Jay’s life. Additionally, they discovered that Jay had osteopenia (weak, brittle bones)—which was causing multiple bone fractures. The ICU team anguished over the thought of Jay’s small, soft bones continuing to break despite their best efforts.The bioethicist in me knows that, as long as the patient isn’t suffering and the parents aren’t demanding futile interventions (they weren’t), our role as providers was not to judge the parents’ value system. I told the ICU team over and over that different people place different value on Jay’s type of life, and that it wasn’t for us to tell them that their value structure was wrong. I talked with other members of the clinical ethics consultation service. Then I brought the case to the entire institutional... (shrink)

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Should monkeys be used in painful and often deadly infectious disease research that may save many human lives? This is the challenging question that Anne Barnhill, Steven Joffe, and Franklin G. Miller take on in their carefully argued and compelling article “The Ethics of Infection Challenges in Primates.” The authors offer a nuanced and even-handed position that takes philosophical worries about nonhuman primate moral status seriously and still appreciates the very real value of such research for human welfare. Overall, they (...) argue for an extension and revision of the recommendations regarding chimpanzee research offered by the Institute of Medicine in 2011; the practical upshot of their argument would allow for infection challenge research for promising interventions for Ebola and Marburg virus diseases but not for smallpox or the common cold. The IOM recommendations regarding chimpanzee research put in motion an exceptionalist policy for this great ape population. Barnhill and colleagues’ proposal would enlarge the scope of that exceptionalism to embrace NHPs other than great apes. But is such exceptionalism warranted? It is not obvious to me either that the more sophisticated capacities of a species as a whole give it greater ethical protections or that less intellectually or socially sophisticated animals ought to therefore receive less protection when it comes to painful experimental interventions. (shrink)

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Craig Hanks and Aili Bresnahan are contributing editors only -- not main editors.

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Research uses of human bodies maintained by mechanical ventilation after being declared dead by neurological criteria, were first published in the early 1980s with a renewed interest in research on the newly or nearly dead occurring in about last decade. While this type of research may take many different forms, recent technologic advances in genomic sequencing along with high hopes for genomic medicine, have inspired interest in genomic research with the newly dead. For example, the Genotype-Tissue Expression program through the (...) National Institutes of Health aims to collect large numbers of diverse human tissues with the eventual goal of elucidating the genetic bases of common diseases through a better understanding of the relationship between genetic variation and gene expression. (shrink)

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Drawing on social comparison theory, we investigate employees’ ethical and performance comparisons relative to a similar coworker and subsequent emotional and behavioral responses. We test our theoretically driven hypotheses across two studies. Study 1, a cross-sectional field study, reveals that employees who perceive they are more ethical than their coworkers experience negative emotions toward the comparison coworkers and those feelings are even stronger when the employees perceive they are lower performers than their coworkers. Results also reveal that negative emotions mediate (...) the indirect relationship between being more ethical than a coworker, but also being a lower performer than that coworker onto social undermining and ostracism. Study 2, a 2 × 2 between-subjects experimental design, provides further support for our moderated mediation model. Results reveal that participants experience negative emotions when they receive information that they are more ethical than a comparison participant. Negative emotions are amplified if the participant is told they were a lower performer than the comparison participant. Those participants indicate their desire to mistreat and ignore the comparison participant if given the opportunity. Thus, we find support for our hypotheses using a multi-method design. (shrink)

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While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample (...) of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries. (shrink)

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A volume in Transforming Education for the Future Spirituality and spiritual experiences have been the bedrock of every civilization and together form one of the highest mechanisms for making sense of the world for billions of people. Current research paradigms, due to their limitation to empirical, sensory, psychologically, or culturally constructed realities, fail to provide a framework for exploring this essential area of human experience. The development of a spiritual research paradigm will provide researchers from the social sciences and education (...) the tools and abilities to systematically explore fundamental questions regarding human spiritual experiences and spiritual growth. A spiritual research paradigm requires an ontology that considers all reality to be multidimensional, interconnected, and interdependent. It requires an epistemology that integrates knowing from outer sources as well as inner contemplation, acknowledging our integration of soul and spirit with the body and mind. Three additional aspects are useful to a spiritual research paradigm: axiology, methodology, and teleology. An axiology concerns what is valued, good, and ethical. A methodology is the appropriate approach to systematic inquiry. A fifth and less frequently mentioned aspect is teleology, an explanation of the goal or end (telos) to which new knowledge is applied, such as gaining wisdom and truth, touching the divine, increasing inner peace, exploring hidden dimensions, or improving society. This book takes the first step to develop such a research paradigm. We draw from world spiritual traditions as well as scholarship that has arisen from contemplative practices. We also attempt to build a bridge between science and spirituality. Spiritual research is not necessarily opposed to scientific research; in fact, each can shed light on the other. (shrink)

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Mr. Galanas, an eighty‐six‐year‐old man, intentionally shot himself in the chest and abdomen. Surprisingly, the bullet damaged only his distal pancreas and part of his colon, requiring a diverting colostomy to prevent leakage of bowel fluids into his abdomen. After being admitted, he lies intubated in the intensive care unit awaiting surgery to repair his colon. He is responsive but does not demonstrate clear decision‐making capacity. He grudgingly accepts pain medications but refuses antibiotics and antidepressants. He has a living will (...) that gives his wife durable power of attorney and also explicitly states a desire to refuse all medical interventions if he is permanently unconscious or in an end‐stage condition. Mrs. Galanas reports frequent conversations in which her husband said he would not want to be sustained on life support. She also says that he often mentioned he would not want an ostomy bag—a likely, albeit temporary, outcome of the proposed surgery. His physicians are nervous about withholding medical interventions when Mr. Galanas's injury is the result of a suicide attempt and his prognosis is good. Should the care team surgically repair his injured colon, regardless of the patient's capacity, his advance directive, and his wife's statement that he would not want surgery or other life‐sustaining treatment? (shrink)

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: Offering an introduction to both John Dewey's philosophy of education and the 4-H Youth Development Program, this paper draws clear connections between these two topics. Concepts explored include Dewey's principles of continuity and interaction, and contagion with respect to learning. Roles of educational leaders (including teachers) are investigated in the context of a discussion about the structuring of opportunities for students to develop habits of meaningful and life-long learning. Specific examples are described in depth to demonstrate, from a Deweyan (...) perspective, the educational process and value of 4-H participation. Brief comments are made about the place of 4-H in the U.S. system of public education. (shrink)

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Biodefense and emerging infectious disease animal research aims to avoid or ameliorate human disease, suffering, and death arising, or potentially arising, from natural outbreaks or intentional deployment of some of the world’s most dreaded pathogens. Top priority research goals include finding vaccines to prevent, diagnostic tools to detect, and medicines for smallpox, plague, ebola, anthrax, tularemia, and viral hemorrhagic fevers, among many other pathogens (National Institute of Allergy and Infectious Diseases [NIAID] priority pathogens). To this end, increased funding for conducting (...) research, developing research facilities, and purchasing (stockpiling) developed vaccines, diagnostic tools, and therapeutics .. (shrink)

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From the late 1950s through the early 1970s, Harry F. Harlow's primate laboratory at the University of Wisconsin–Madison undertook a series of studies on infant rhesus macaque monkeys that gained the attention of both animal welfare advocates and the scientific community.1 Establishing one of the first primate research laboratories in 1932, Harlow began his career as a primate researcher by studying primate learning capabilities and shredding previous assumptions within psychology that primates were restricted to the conditioned learning of a rat. (...) As his need for subjects in particular age ranges and easily susceptible to study grew in the 1950s, he again broke research ground by establishing a captive breeding... (shrink)

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The country of Botswana currently has one of the highest HIV infection rates in the world. Government and international aid agencies have undertaken initiatives to address the rapidly growing epidemic, but few measures address the current crisis of care as a key element in that process. In this article, the author uses case study data to highlight how women in Northern Botswana are affected by the increasing burden of caregiving to children who are orphaned as a result of the HIV/aids (...) epidemic. In particular, she describes how the role of women as caregivers in communities has been transformed as a result of the HIV/aids crisis. She suggests that the intersecting cultural patterns of migration and reproduction are central to understanding the spread of the disease in the current emerging crisis of care. (shrink)

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The American Journal of Bioethics, Volume 11, Issue 12, Page 69-70, December 2011.

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Informed consent is the practical application of the principle of autonomy, and two of the five core features of informed consent are related to information. Researchers have reported on patients’ expressed needs for information, such as their stated desires for the quantity of and the source of information. A separate body of research has examined patients’ unexpressed needs for information from the perspective of cognitive psychology, such as the emotional tone and order of information. This article suggests that the autonomy (...) of patients is best served by meeting their expressed and unexpressed information needs in tandem. (shrink)

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Background: Prior research has explored reasons why health care providers may or may not choose to seek an ethics consultation. Although low-quality communication is evident in many ethics consultations, it is unknown whether poor communication in clinical settings is related to health care providers' requests for ethics involvement. Objective: To assess the relationship between self-reported ratings of health care providers' inter- and intraprofessional communication and ethics consultation requests. Method: This cross-sectional survey was conducted using a self-administered questionnaire of physicians and (...) nurses in six intensive care units at one academic medical center in the United States. The questionnaire assessed perceptions about requesting ethics consultations and how health care providers perceive communication. Results: Two hundred sixty-two participants (228 nurses and 34 physicians) responded to the survey (response rate 55%; 59% for nurses and 41% for physicians). Requests for an ethics consult were positively associated with perceived quality of interprofessional communication (r =.13, p<.05), but perceptions of the number of ethical dilemmas that occur on participants' units each month were negatively associated with the perceived quality of intra-professional communication (r = −.17, p<.01). Conclusion: The relationship that was hypothesized between perceived poor communication and increased number of ethics consultations was not borne out by these data. Indeed, we found the opposite; these finding suggests that good inter- and intraprofessional communication may promote the use of outside resources, such as ethics, when they are needed. (shrink)

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