L. Johnson

A survey was administered during fall 2013 to 163 self-identified adult ethical vegans and/or ethical vegetarians in the United States to determine whether the respondents+ beliefs meet the definition of religion according to U.S. federal law. The data demonstrate that a majority of the surveyed group possesses beliefs concordant with the definition of "religion" according to federal statutes, federal judicial tests, and regulatory law. Since religion is a protected characteristic in U.S. law, and ethical veganism meets various definitions for religion, then ethical veganism should be recognized as a religion and a protected characteristic under U.S. law.

Future generations do not exist, and are not determinate in their make-up. The moral significance of future generations cannot be accounted for on the basis of a purely individualistic ethic. Yet future generations are morally significant. The Person-Affecting Principle, that (roughly) only acts which are likely to affect particular individuals are morally significant, must be augmented in such a way as to take into account the moral significance of Homo sapiens, a holistic entity which certainly does exist. Recent contributions to Environmental Values by Alan Carter and Ernest Partridge are criticised (but not entirely rejected)

There is little information about the content of ethics consultations in pediatrics. We sought to describe the reasons for consultation and ethical principles addressed during EC in pediatrics through retrospective review and directed content analysis of EC records at St. Jude Children's Research Hospital. Patient-based EC were highly complex and often involved evaluation of parental decision making, particularly consideration of the risks and benefits of a proposed medical intervention, and the physician's fiduciary responsibility to the patient. Nonpatient consultations provided guidance in the development of institutional policies that would broadly affect patients and families. This is one of the few existing reviews of the content of pediatric EC and indicates that the distribution of ethical issues and reasons for moral distress are different than with adults. Pediatric EC often facilitates complex decision making among multiple stakeholders, and further prospective research is need..

This volume provides an easily understood presentation of Roy's Adaptation Model of nursing theory which views the person as a biopsychosocial being in constant interaction with the changing environment. Roy believes nursing is needed when unusual stressors or weakened coping mechanisms make the person's usual attempts to cope ineffective. The goal of nursing is thus to promote the adaptation of the patient, leading to a higher level of wellness. Roy's model has been a guiding influence on numerous critical care research studies.

This research calls for attention to complexity theory and the integration of complexity methodologies in policy research. A complexity approach in research practice requires a systems worldview and recognition of non-linearity, networks, self-organization, emergence, and feedback in policy. Simply, if a phenomenon is complex and can be explored from varied contexts and scales, the conceptual frame, and the methodical approach should be able to address the complexity. Complexity science has the capacity to account for complexity in varied contexts, on varied scales, and with an interrelated and interdependent environment. Further, if policy systems are at times simple, complicated, complex, and chaotic, then complexity mythologies combined with traditional qualitative and quantitative methods can bring to light the workings of the elusive black box. Complexity allows for triangulation of both linear and non-linear methodologies integrating qualitative, quantitative, network analysis, and agent-based models, as well as other methodologies. Complexity science is not the panacea to solve all policy problems with perfection. But if you do not acknowledge the complexity you will be missing out on the opportunity to shape patterns of sustainability, to effectively manage complex policy problems to someday solve them.

Disorders of Consciousness (DoCs) raise difficult and complex questions about the value of life for persons with impaired consciousness, the rights of persons unable to make medical decisions, and our social, medical, and ethical obligations to patients whose personhood has frequently been challenged and neglected. Recent neuroscientific discoveries have led to enhanced understanding of the heterogeneity of these disorders, and focused renewed attention on the medical and ethical problem of misdiagnosis. This book examines the entanglement of epistemic and ethical uncertainty in DoCs and other medical contexts, and how they interact to create both epistemic and ethical risks. Philosopher and bioethicist L. Syd M Johnson pulls together multiple threads in this work: the ontological mysteries of consciousness, medical uncertainty about unconsciousness, ableist bias, withdrawal of treatment in neurointensive care, and the rarely questioned view that consciousness is essential to personhood and moral status. Johnson challenges longstanding bioethical dogmas about DoC patients, and argues for an ethics of uncertainty for contexts where there is a need for decisive action in the presence of unavoidable uncertainty. The ethics of uncertainty refocuses ethical inquiry concerning persons with DoCs, placing less emphasis on their contested personhood, and more on inductive risk and uncertainty, on respect for autonomy, and especially on epistemic justice. With applications to various decisional contexts where uncertainty and ethical risk interact, this ethical approach enables surrogate decision makers facing fraught and risky choices to fulfill their obligations as moral and epistemic agents.

The authors of this article are previous or current members of the Clinical Ethics Consultation Affairs (CECA) Committee, a standing committee of the American Society for Bioethics and Humanities (ASBH). The committee is composed of seasoned healthcare ethics consultants (HCECs), and it is charged with developing and disseminating education materials for HCECs and ethics committees. The purpose of this article is to describe the educational research and development processes behind our teaching materials, which culminated in a case studies book called A Case-Based Study Guide for Addressing Patient-Centered Ethical Issues in Health Care (hereafter, the Study Guide). In this article, we also enumerate how the Study Guide could be used in teaching and learning, and we identify areas that are ripe for future work.

For many immigrants to the United States, between 1892 and 1924, admission was contingent upon a medical inspection at an immigration centre, such as the one located at Ellis Island in the harbour of New York City. Much like passing through customs or security at airports today, these medical inspections were dreaded by immigrant travellers, and United States Government and Public Health Service publications show that these medical inspections were escalating in intensity and emphasis during the early twentieth-century. The purpose of the PHS inspections becomes especially evident when looking at the gender considerations, or lack thereof, which arose during medical inspections at Ellis Island. A gender analysis of the PHS medical inspections, examined through the use of oral histories and photographs, provides a window into understanding the primary concern of the United States Public Health Service.