Lying to Insurance Companies: The Desire to Deceive among Physicians and the Public

This study examines the public's and physicians' willingness to support deception of insurance companies in order to obtain necessary healthcare services and how this support varies based on perceptions of physicians' time pressures. Based on surveys of 700 prospective jurors and 1617 physicians, the public was more than twice as likely as physicians to sanction deception (26% versus 11%) and half as likely to believe that physicians have adequate time to appeal coverage decisions (22% versus 59%). The odds of public support for deception compared to that of physicians rose from 2.48 to 4.64 after controlling for differences in time perception. These findings highlight the ethical challenge facing physicians and patients in balancing patient advocacy with honesty in the setting of limited societal resources.     

An “Opting In” Paradigm for Kidney Transplantation

Almost 60,000 people in the United States with end stage renal disease are waiting for a kidney transplant. Because of the scarcity of organs from deceased donors live kidney donors have become a critical source of organs; in 2001, for the first time in recent decades, the number of live kidney donors exceeded the number of deceased donors. The paradigm used to justify putting live kidney donors at risk includes the low risk to the donor, the favorable risk-benefit ratio, the psychological benefits to the donor, altruism, and autonomy coupled with informed consent; because each of these arguments is flawed we need to lessen our dependence on live kidney donors and increase the number of organs retrieved from deceased donors.

An “opting in” paradigm would reward people who agree to donate their kidneys after they die with allocation preference should they need a kidney while they are alive. An “opting in” program should increase the number of kidneys available for transplantation and eliminate the morally troubling problem of “organ takers” who would accept a kidney if they needed one but have made no provision to be an organ donor themselves. People who “opt in” would preferentially get an organ should they need one at the minimal cost of donating their kidneys when they have no use for them; it is a form of organ insurance a rational person should find extremely attractive.

An “opting in” paradigm would simulate the reciprocal altruism observed in nature that sociobiologists believe enhances group survival. Although the allocation of organs based on factors other than need might be morally troubling, an “opting in” paradigm compares favorably with other methods of obtaining more organs and accepting the status quo of extreme organ scarcity. Although an “opting in” policy would be based on enlightened self-interest, by demonstrating the utilitarian value of mutual assistance, it would promote the attitude that self-interest sometimes requires the perception that we are all part of a common humanity.     

Peer Leadership Programs in Schools

Abstract

This paper presents an outline for implementing a peer leadership program in the schools. It provides a brief overview of the historical roots of peer leadership. This paper also addresses issues relevant to implementing a peer leadership program such as selecting peer leaders, the roles peer leaders play in education, the role of educators in this process and how educators can be involved in peer leadership programs to create a more effective learning environment in the school. Peer leadership is discussed in the context of the public schools with a focus on future directions that peer leadership may pursue.     

Confucian Ethical Practice as a Method of Creating and Sustaining Whiteheadian Beauty

I argue that Confucian ethical practice can be considered as a feasible method of creating and sustaining Whiteheadian beauty. I first investigate Whitehead’s understanding of value, beauty and morality. Next, I show the affinity between Confucius and Whitehead in their understanding of value, beauty, and morality through an analysis of the Analects (Lunyu 论语), focusing on the aesthetic aspects of Confucian ethics understood as role ethics. Finally, I argue that Confucian ways of moral self-cultivation can be viewed as methods that foster our disposition to create and sustain the beauty of experience.     

An Eco-Ethical Interpretation of Confucian Tianren Heyi

Opposed to a commonly held interpretation that Confucian discourse regarding tianren heyi (天人合一) is simply a human-centred philosophical fusion of humanity and nature, this article argues that the Confucian discourse is in fact composed of two contradictory orientations, one ren-centred (roughly equivalent to “anthropocentric”) and the other tian-centred (“nature-centric” in a specific sense), which generally correspond to the two major camps of environmental philosophy in the West in the twentieth century. It will be further argued that the two orientations of the Confucian view have different yet related functions with regard to environmental protection and conservation: the tian-centred understanding establishes a metaphysical and religious framework for Confucian eco-ethical norms, in which ecological prohibitions and policies are built into the political and religious infrastructure, while the ren-centred orientation adds practical values and meanings to the ontological care of the human relation to the environment. In modern times, the two orientations of Confucian eco-ethics are under further development, moving away from being dualistic philosophies and converging on the eco-ethical way of life. Contemporary Confucians are investigating how the two traditional “orientations” can be unified as one holistic perspective which could provide theoretical and practical guidance for our understanding of the human position in the universe, the harmony between humans and nature, and the value of environmental protection and conservation.     

默认网络的神经机制、功能假设及临床应用

认知神经科学的迅速发展使得研究者对大脑的功能有了深刻的认识。近些年来, 研究者对大脑在进行外在注意任务时产生的负激活有了更多的了解, 默认网络(Default Mode Network)的概念被提出, 并引起了很多神经科学家的关注, 关于默认网络的相关理论也已提出。当前综述对默认网络的研究历史, 概念理论, 个体和种系发展, 及其与疾病的关系以及临床应用等方面进行了概括总结。未来研究可从默认网络的个体发展, 种系差异, 与其他大脑网络(如注意网络, 视觉网络, 执行控制网络)的关系以及与具体疾病的关系等角度入手进行研究, 共同来探讨默认网络的神经机制。     

Exploring the ethics of agency through the lens of Bildung

Experiencing something of a renaissance, the German pedagogical idea ‘Bildung’ has recently been reconsidered for contemporary education. Historically proposed by von Humboldt, Bildung’s interplay represents a relational movement between a learner and the world that aims for personal freedom and growth. It is also identified as a means by which learners might become aware of their personal capacity to develop responses to daily experiences. Thus, it attends to agency and has resonance with children’s spirituality. Whilst such a notion of learning might be promoted as an alternative to a functionalistic educational paradigm, this paper highlights ethical concerns regarding pedagogical freedom. It highlights philosophically the illusion of freedom and considers critically the place of power in learner-led methods. Finally, the paper proposes how a nuanced, Kierkegaardian application of Bildung might address the ethical concerns raised and proposes how a re-considered understanding of the notion might be valuable for education today.     

Inviting perspective transformation: Sexual history awareness for professional formation

How do we deal with our own sexuality as teachers and as learners in the classroom? As a seminary professor in a mainline Christian context, I find that discussing sexuality increases student discomfort levels by threatening to raise questions about the connections between morality, behavior, and bodies of those in the room – questions we have been culturally trained to avoid. In order to decrease discomfort, many instructors approach sexuality only as content‐based subject matter. Particularly for ministry students, this approach can be a disservice to their discernment process and preparation for future ministry contexts, especially for those in turmoil regarding sexuality‐related issues. By explicitly engaging how personal experience and cultural contexts shape our sexuality, pedagogical models can promote critical self‐reflection and seek perspective transformation, not values change, as a resource for professional sexual ethics training in ministry.     

Civic learning and teaching as a resource for sexual justice: An undergraduate religious studies course module

Civic learning and teaching, a form of critical and democratically engaged pedagogy, is utilized in an upper‐level undergraduate sexual ethics course to leverage public problem solving around the sexual violence on a mid‐size Catholic collegiate campus. Through the course, students, faculty, staff, and community members work together to deepen understanding of the causes and consequences of sexual violence within society and the local community in order to evaluate and design programming for bystander intervention, education, and sexual violence prevention advocacy. After a discussion of the application of civic teaching and learning to sexual violence, the course module describes the learning outcomes and assignments used to assess them. See as well Donna Freitas's response to this essay, “The Risk and Reward of Teaching about Sexual Assault for the Theologian on a Catholic Campus,” published in this issue of the journal.