Michael D Dahnke - Academia.edu (original) (raw)

Papers by Michael D Dahnke

Research paper thumbnail of Ethics and the image of the healthcare administrator in popular culture

International journal of healthcare management, Aug 1, 2013

ABSTRACT

Research paper thumbnail of Philosophy of Science for Nursing Practice: Concepts and Application

Tailored for both DNP and PhD doctoral nursing programmes, this text is the first to focus on phi... more Tailored for both DNP and PhD doctoral nursing programmes, this text is the first to focus on philosophy of science applications to the discipline of nursing. The authors, a philosopher and a nurse-scholar who co-teach the course upon which this volume is based, address a growing need for increased philosophy of science content in evolving DNP programs, as well as practice-oriented research considerations for this discipline. The volume presents a creative use of the social, political, and historical content in which nursing has evolved. As a whole, this extremely important text reassures the student of the fluid and palpable connections between philosophy of science and nursing science and practice. Key Features: Explores the concept of nursing as a practice profession and assesses how much philosophy of science is needed for doctoral nursing students. Examines the practical application of the philosophy of science to both DNP and PhD students. Addresses the basic principles and concepts of the philosophy of science and their practical application for contemporary practice inquiry. Provides an overview of the century-long path to the development of nursing science that is an essential "bridge" to the philosophy of science content and serves as a "next step" towards building a nursing epistemology Reinforces important connections between the philosophy of science to nursing science and nursing practice.

Research paper thumbnail of The Role of the American Nurses Association Code in Ethical Decision Making

Holistic Nursing Practice, Mar 1, 2009

Ethical decision making is complex and difficult. For this reason, many professions compose ethic... more Ethical decision making is complex and difficult. For this reason, many professions compose ethical codes to aid their practitioners, to aid those in the profession in dealing with perplexing situations that inevitably arise. The American Nurses Association (ANA) Code of Ethics is of course one such code. It outlines the important general values, duties, and responsibilities that flow from the specific role of being a nurse. The relationship of the individual practitioner to the code, however, is an aspect of professional moral life that requires interpretation and may not always be well understood. A historical and theoretical analysis of the ANA Code can provide for an understanding as to how it is to be used not as a substitute for moral thinking but as an aid to moral thinking.

Research paper thumbnail of Clarification and Mitigation of Ethical Problems Surrounding Withdrawal of Extracorporeal Membrane Oxygenation

Critical Care Nurse, Oct 1, 2016

Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides tim... more Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice. In particular, these issues are considered in relation to how they affect and can be addressed by staff nurses and advanced practice nurses in the intensive care unit. Advanced practice nurses in particular can represent the voice of nurses to promote a healthier workplace in situations of moral distress related to stopping ECMO life-support technology and in developing clear and consistent guidelines for ceasing ECMO treatment, all leading toward clarification and mitigation of the ethical problems surrounding the withdrawal of this critical technology.

Research paper thumbnail of Ethics as First Philosophy

Auslegung: a Journal of Philosophy, Jun 1, 2001

The phrase "ethics as first philosophy" is most identified with Emmanuel Levinas. It is the idea,... more The phrase "ethics as first philosophy" is most identified with Emmanuel Levinas. It is the idea, put simply, that what has been traditionally looked to as first philosophy, usually epistemology or metaphysics, is not first in any sense at all. Rather, all such positions are dependent on a precedent ethics. Thus, ethics becomes first philosophy. In my investigation of the concept here, I intend to place it in a broader context of Continental philosophy, identifying the threads of Continental thought that inform the concept, both within and outside the limits of the phenomenological, and primarily through the lens of the influential predecessors Nietzsche and Heidegger. In this way I hope to provide a deeper understanding of the concept and possibly a broader defense of its validity.

Research paper thumbnail of Philosophy of Science for Nursing Practice

Research paper thumbnail of Nursing Ethics and Disaster Triage: Applying Utilitarian Ethical Theory

Journal of Emergency Nursing, Jul 1, 2015

demonstrate the connection between nursing paradigms and nursing theory, and and ethical ways of ... more demonstrate the connection between nursing paradigms and nursing theory, and and ethical ways of knowing, which are integral parts of nursing knowledge. ABSTRACT Quality clinical decisionmaking in nursing is the essence of quality nursing care delivery. ABSTRAK Gehalte kliniese besluitneming in verpleging. Nursing Ethics and Disaster Triage: Applying Utilitarian Ethical Theory ED triage nurses traditionally practice using 4 ethical principles of autonomy, beneficence, nonmaleficence, and justice, along with the attendant moral PDF (142 KB).

Research paper thumbnail of The Challenge of Personhood

Oxford University Press eBooks, Jun 9, 2011

Research paper thumbnail of Film, Art, and Filmart: An Introduction to Aesthetics Through Film

Research paper thumbnail of Emmanuel Levinas and the face of Terri Schiavo: bioethical and phenomenological reflections on a private tragedy and public spectacle

Theoretical Medicine and Bioethics, Sep 15, 2012

The controversial case of Terri Schiavo came to a close on March 31, 2005, with her death followi... more The controversial case of Terri Schiavo came to a close on March 31, 2005, with her death following the removal of a percutaneous endoscopic gastrostomy tube. This event followed years of controversy and social upheaval. Voices from across the entire political and cultural spectrums filled the airwaves and op-ed pages of major newspapers. Protests ensued outside of Ms. Schiavo's care facility. Ms. Schiavo's parents published videos of their daughter on the internet in an effort to prove that she was not in a vegetative state and could potentially recover. There is a certain mystery to the entire controversy given the fact that, legally, it was largely a matter of settled law. Precedent cases and legal statutes clearly set out the proper procedures and decisions to be followed in this case. Nonetheless, powerful challenges and virulent opposition to these standards arose. Through an investigation of this case as well as a comparative study of the case of Dax Cowart (in particular, the documentary depictions of Dax Cowart's case) and of a photograph by Joel-Peter Witkin, I plan to investigate the source of these social upheavals and hypothesize that they were largely the result of a phenomenological reaction to the human face.

Research paper thumbnail of The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

Critical Care Nurse, Dec 1, 2016

The issue of medical futility requires a well-defi ned process in which both sides of the dispute... more The issue of medical futility requires a well-defi ned process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is fi rst determined by medicine, in order for the determination to meet legal criteria, it must be subject to review. The hope is that through a review process that meets legal criteria, the issue can be resolved without the need for court proceedings. If resolution cannot be obtained through this process, surrogates still have the right to seek court intervention. This issue is of relevance and importance in critical care nursing because of the role and position of critical care nurses, who have direct contact with patients and patients' families, the potential for moral distress in cases of possibly futile treatment, and the expanding roles of nurses, including critical care nurses and advanced practice nurses, in management and policy development. (Critical Care Nurse. 2016;36[6]:13-23) M rs J, an 88-year-old woman with an admitting diagnosis of change in mental status, originally on a nonmonitored medical surgical unit, was a full code. During her stay in the hospital, she had pneumonia develop. Mrs J underwent cardiopulmonary resuscitation (CPR) several times and was transferred to the intensive care unit, back to the medical surgical unit, then to an intermediate care unit, and back to the intensive care unit. During the last CPR attempt, Mrs J was intubated and became ventilator dependent.

Research paper thumbnail of Utilizing codes of ethics in health professions education

Advances in Health Sciences Education, Jan 22, 2014

Codes of ethics abound in health care, the aims and purposes of which are multiple and varied, fr... more Codes of ethics abound in health care, the aims and purposes of which are multiple and varied, from operating as a decision making tool to acting as a standard of practice that can be operational in a legal context to providing a sense of elevated seriousness and professionalism within a field of practice. There is some doubt and controversy, however, regarding the value and use of these codes both in professional practice and in the education of healthcare professionals. I intend to review and analyze the various aims and purposes of ethics codes particularly within the study and practice of healthcare in light of various criticisms of codes of ethics. After weighing the strength and import of these criticisms, I plan to explore effective means for utilizing such codes as part of the ethics education of healthcare professionals. While noting significant limitations of this tool, both in practice and in education, I plan to demonstrate its potential usefulness as well, in both generating critical thinking within the study of ethics and as a guide for practice for the professional.

Research paper thumbnail of Devotion, Diversity, and Reasoning: Religion and Medical Ethics

Journal of Bioethical Inquiry, Sep 1, 2015

Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethic... more Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively.

Research paper thumbnail of Philosophy of Science for Nursing Practice

Research paper thumbnail of The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

Critical care nurse, 2016

The issue of medical futility requires a well-defined process in which both sides of the dispute ... more The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is first determined by medicine, in order for the determination to meet legal criteria, it must be subject to review. The hope is that through a review process that meets legal criteria, the issue can be resolved without the need for court proceedings. If resolution cannot be obtained through this process, surrogates still have the right to seek court intervention. This issue is of relevance and importance in critical care nursing because of the role and position of critical care nurses, who have direct contact with patients and patients&...

Research paper thumbnail of What we Learn (and don’t learn) from the Terri Schiavo autopsy

Research paper thumbnail of Devotion, Diversity, and Reasoning: Religion and Medical Ethics

Journal of Bioethical Inquiry, 2015

Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethic... more Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively.

Research paper thumbnail of Clarification and Mitigation of Ethical Problems Surrounding Withdrawal of Extracorporeal Membrane Oxygenation

Critical care nurse, 2016

Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides tim... more Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice. In particular, these issues are considered in relation to how they affect and can be addressed by staff nurses and advanced practice nurses in the intensive care unit. Advanced practice nurses in particular can represent the voice of nurses to promote a healthier w...

Research paper thumbnail of The Ethical Use of Social Media in Nursing Practice

Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses, 2015

Research paper thumbnail of Legal and Ethical Issues in Nursing Education

Research paper thumbnail of Ethics and the image of the healthcare administrator in popular culture

International journal of healthcare management, Aug 1, 2013

ABSTRACT

Research paper thumbnail of Philosophy of Science for Nursing Practice: Concepts and Application

Tailored for both DNP and PhD doctoral nursing programmes, this text is the first to focus on phi... more Tailored for both DNP and PhD doctoral nursing programmes, this text is the first to focus on philosophy of science applications to the discipline of nursing. The authors, a philosopher and a nurse-scholar who co-teach the course upon which this volume is based, address a growing need for increased philosophy of science content in evolving DNP programs, as well as practice-oriented research considerations for this discipline. The volume presents a creative use of the social, political, and historical content in which nursing has evolved. As a whole, this extremely important text reassures the student of the fluid and palpable connections between philosophy of science and nursing science and practice. Key Features: Explores the concept of nursing as a practice profession and assesses how much philosophy of science is needed for doctoral nursing students. Examines the practical application of the philosophy of science to both DNP and PhD students. Addresses the basic principles and concepts of the philosophy of science and their practical application for contemporary practice inquiry. Provides an overview of the century-long path to the development of nursing science that is an essential "bridge" to the philosophy of science content and serves as a "next step" towards building a nursing epistemology Reinforces important connections between the philosophy of science to nursing science and nursing practice.

Research paper thumbnail of The Role of the American Nurses Association Code in Ethical Decision Making

Holistic Nursing Practice, Mar 1, 2009

Ethical decision making is complex and difficult. For this reason, many professions compose ethic... more Ethical decision making is complex and difficult. For this reason, many professions compose ethical codes to aid their practitioners, to aid those in the profession in dealing with perplexing situations that inevitably arise. The American Nurses Association (ANA) Code of Ethics is of course one such code. It outlines the important general values, duties, and responsibilities that flow from the specific role of being a nurse. The relationship of the individual practitioner to the code, however, is an aspect of professional moral life that requires interpretation and may not always be well understood. A historical and theoretical analysis of the ANA Code can provide for an understanding as to how it is to be used not as a substitute for moral thinking but as an aid to moral thinking.

Research paper thumbnail of Clarification and Mitigation of Ethical Problems Surrounding Withdrawal of Extracorporeal Membrane Oxygenation

Critical Care Nurse, Oct 1, 2016

Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides tim... more Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice. In particular, these issues are considered in relation to how they affect and can be addressed by staff nurses and advanced practice nurses in the intensive care unit. Advanced practice nurses in particular can represent the voice of nurses to promote a healthier workplace in situations of moral distress related to stopping ECMO life-support technology and in developing clear and consistent guidelines for ceasing ECMO treatment, all leading toward clarification and mitigation of the ethical problems surrounding the withdrawal of this critical technology.

Research paper thumbnail of Ethics as First Philosophy

Auslegung: a Journal of Philosophy, Jun 1, 2001

The phrase "ethics as first philosophy" is most identified with Emmanuel Levinas. It is the idea,... more The phrase "ethics as first philosophy" is most identified with Emmanuel Levinas. It is the idea, put simply, that what has been traditionally looked to as first philosophy, usually epistemology or metaphysics, is not first in any sense at all. Rather, all such positions are dependent on a precedent ethics. Thus, ethics becomes first philosophy. In my investigation of the concept here, I intend to place it in a broader context of Continental philosophy, identifying the threads of Continental thought that inform the concept, both within and outside the limits of the phenomenological, and primarily through the lens of the influential predecessors Nietzsche and Heidegger. In this way I hope to provide a deeper understanding of the concept and possibly a broader defense of its validity.

Research paper thumbnail of Philosophy of Science for Nursing Practice

Research paper thumbnail of Nursing Ethics and Disaster Triage: Applying Utilitarian Ethical Theory

Journal of Emergency Nursing, Jul 1, 2015

demonstrate the connection between nursing paradigms and nursing theory, and and ethical ways of ... more demonstrate the connection between nursing paradigms and nursing theory, and and ethical ways of knowing, which are integral parts of nursing knowledge. ABSTRACT Quality clinical decisionmaking in nursing is the essence of quality nursing care delivery. ABSTRAK Gehalte kliniese besluitneming in verpleging. Nursing Ethics and Disaster Triage: Applying Utilitarian Ethical Theory ED triage nurses traditionally practice using 4 ethical principles of autonomy, beneficence, nonmaleficence, and justice, along with the attendant moral PDF (142 KB).

Research paper thumbnail of The Challenge of Personhood

Oxford University Press eBooks, Jun 9, 2011

Research paper thumbnail of Film, Art, and Filmart: An Introduction to Aesthetics Through Film

Research paper thumbnail of Emmanuel Levinas and the face of Terri Schiavo: bioethical and phenomenological reflections on a private tragedy and public spectacle

Theoretical Medicine and Bioethics, Sep 15, 2012

The controversial case of Terri Schiavo came to a close on March 31, 2005, with her death followi... more The controversial case of Terri Schiavo came to a close on March 31, 2005, with her death following the removal of a percutaneous endoscopic gastrostomy tube. This event followed years of controversy and social upheaval. Voices from across the entire political and cultural spectrums filled the airwaves and op-ed pages of major newspapers. Protests ensued outside of Ms. Schiavo's care facility. Ms. Schiavo's parents published videos of their daughter on the internet in an effort to prove that she was not in a vegetative state and could potentially recover. There is a certain mystery to the entire controversy given the fact that, legally, it was largely a matter of settled law. Precedent cases and legal statutes clearly set out the proper procedures and decisions to be followed in this case. Nonetheless, powerful challenges and virulent opposition to these standards arose. Through an investigation of this case as well as a comparative study of the case of Dax Cowart (in particular, the documentary depictions of Dax Cowart's case) and of a photograph by Joel-Peter Witkin, I plan to investigate the source of these social upheavals and hypothesize that they were largely the result of a phenomenological reaction to the human face.

Research paper thumbnail of The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

Critical Care Nurse, Dec 1, 2016

The issue of medical futility requires a well-defi ned process in which both sides of the dispute... more The issue of medical futility requires a well-defi ned process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is fi rst determined by medicine, in order for the determination to meet legal criteria, it must be subject to review. The hope is that through a review process that meets legal criteria, the issue can be resolved without the need for court proceedings. If resolution cannot be obtained through this process, surrogates still have the right to seek court intervention. This issue is of relevance and importance in critical care nursing because of the role and position of critical care nurses, who have direct contact with patients and patients' families, the potential for moral distress in cases of possibly futile treatment, and the expanding roles of nurses, including critical care nurses and advanced practice nurses, in management and policy development. (Critical Care Nurse. 2016;36[6]:13-23) M rs J, an 88-year-old woman with an admitting diagnosis of change in mental status, originally on a nonmonitored medical surgical unit, was a full code. During her stay in the hospital, she had pneumonia develop. Mrs J underwent cardiopulmonary resuscitation (CPR) several times and was transferred to the intensive care unit, back to the medical surgical unit, then to an intermediate care unit, and back to the intensive care unit. During the last CPR attempt, Mrs J was intubated and became ventilator dependent.

Research paper thumbnail of Utilizing codes of ethics in health professions education

Advances in Health Sciences Education, Jan 22, 2014

Codes of ethics abound in health care, the aims and purposes of which are multiple and varied, fr... more Codes of ethics abound in health care, the aims and purposes of which are multiple and varied, from operating as a decision making tool to acting as a standard of practice that can be operational in a legal context to providing a sense of elevated seriousness and professionalism within a field of practice. There is some doubt and controversy, however, regarding the value and use of these codes both in professional practice and in the education of healthcare professionals. I intend to review and analyze the various aims and purposes of ethics codes particularly within the study and practice of healthcare in light of various criticisms of codes of ethics. After weighing the strength and import of these criticisms, I plan to explore effective means for utilizing such codes as part of the ethics education of healthcare professionals. While noting significant limitations of this tool, both in practice and in education, I plan to demonstrate its potential usefulness as well, in both generating critical thinking within the study of ethics and as a guide for practice for the professional.

Research paper thumbnail of Devotion, Diversity, and Reasoning: Religion and Medical Ethics

Journal of Bioethical Inquiry, Sep 1, 2015

Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethic... more Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively.

Research paper thumbnail of Philosophy of Science for Nursing Practice

Research paper thumbnail of The Need for an Effective Process to Resolve Conflicts Over Medical Futility: A Case Study and Analysis

Critical care nurse, 2016

The issue of medical futility requires a well-defined process in which both sides of the dispute ... more The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is first determined by medicine, in order for the determination to meet legal criteria, it must be subject to review. The hope is that through a review process that meets legal criteria, the issue can be resolved without the need for court proceedings. If resolution cannot be obtained through this process, surrogates still have the right to seek court intervention. This issue is of relevance and importance in critical care nursing because of the role and position of critical care nurses, who have direct contact with patients and patients&...

Research paper thumbnail of What we Learn (and don’t learn) from the Terri Schiavo autopsy

Research paper thumbnail of Devotion, Diversity, and Reasoning: Religion and Medical Ethics

Journal of Bioethical Inquiry, 2015

Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethic... more Most modern ethicists and ethics textbooks assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion, of course, implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics-especially professional ethics-than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life-and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas-personal morality, interpersonal morality, and rational morality-each of which I explore in terms of its relationship to religion, normatively characterized by the qualities of devotion, diversity, and reasoning, respectively.

Research paper thumbnail of Clarification and Mitigation of Ethical Problems Surrounding Withdrawal of Extracorporeal Membrane Oxygenation

Critical care nurse, 2016

Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides tim... more Extracorporeal membrane oxygenation (ECMO) is temporary life-support technology that provides time to rest the cardiac and respiratory system of critically ill people with acute, reversible medical conditions. Health care providers face emotional and challenging situations, where death may result, when withdrawing ECMO. A deepening of understanding of the ethical issues involved can aid clinicians in handling such difficult situations, leading to a possible mitigation of the moral problems. Toward this end, the ethical issues raised in the consideration of ECMO withdrawal are analyzed with respect to the ethical principles and concepts of autonomy, nonmaleficence/beneficence, medical futility, moral distress, and justice. In particular, these issues are considered in relation to how they affect and can be addressed by staff nurses and advanced practice nurses in the intensive care unit. Advanced practice nurses in particular can represent the voice of nurses to promote a healthier w...

Research paper thumbnail of The Ethical Use of Social Media in Nursing Practice

Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses, 2015

Research paper thumbnail of Legal and Ethical Issues in Nursing Education

Research paper thumbnail of Philosophy of Science for Nursing Practice: Concepts and App;ication

Tailored for both DNP and PhD doctoral nursing programs, this text is the first to focus on philo... more Tailored for both DNP and PhD doctoral nursing programs, this text is the first to focus on philosophy of science applications to the discipline of nursing. The authors, a philosopher and a nurse-scholar who co-teach the course upon which this volume is based, address a growing need for increased philosophy of science content in evolving DNP programs, as well as practice-oriented research considerations for this discipline.

Research paper thumbnail of Film, Art, and Filmart: An Introduction to Arsthetics throgh Film

This work is a basic introduction to aesthetics and covers the major theories of art, while refer... more This work is a basic introduction to aesthetics and covers the major theories of art, while referring to various filmic examples to illustrate the complex ideas related to the philosophy of art. In addition, it addresses film itself as an art form, analyzes film studies, and discusses film's ambiguous cultural/artistic position.

Research paper thumbnail of What We Learn (And Don’t Learn) from the Terri Schiavo Autopsy

The case of Terri Schiavo engendered bilious debate and controversy to a degree perhaps never see... more The case of Terri Schiavo engendered bilious debate and controversy to a degree perhaps never seen before regarding an end-of-life case. With the autopsy of Terri Schiavo in hand (or on the internet) we have at least the possibility of clearing up some of the more difficult—factual and moral—questions regarding this case. With an eye to the most important controversies of this case and a desire not to over or under interpret a complex and technical document, I attempt in this paper to determine just what we can reach a clearer view on and what we cannot, maintaining stringent standards to reach conclusions both factual and moral. Despite the hysteria, over-hyped controversy and wealth of misinformation that surrounded this case, cases like these should never be easy. They should always challenge us both epistemically and ethically.

VI International Symposium on Brain Death and Disorders of Consciousness. Havana, Cuba, December 3-6, 2013.

Research paper thumbnail of Devotion, Diversity, and Reasoning: Religion and Medical Ethics

Most modern ethicists and ethics textbooks will assert that religion holds little or no place in ... more Most modern ethicists and ethics textbooks will assert that religion holds little or no place in ethics, including fields of professional ethics like medical ethics. This assertion of course implicitly refers to ethical reasoning, but there is much more to the ethical life and the practice of ethics—especially professional ethics—than reasoning. It is no surprise that teachers of practical ethics, myself included, often focus on reasoning to the exclusion of other aspects of the ethical life. Especially for those with a philosophical background, reasoning is the most patent and pedagogically controllable aspect of the ethical life—and the most easily testable. And whereas there may be powerful reasons for the limitation of religion in this aspect of ethics, there are other aspects of the ethical life in which recognition of religious belief may arguably be more relevant and possibly even necessary. I divide the ethical life into three areas—personal morality, interpersonal morality and rational morality—which I then explore individually as to the relationship of religion to each, normatively characterized by the qualities of devotion, diversity and reasoning, respectively.

24th Annual Canadian Bioethics Society Conference. Banff, AB, Canada, May 29-June 1, 2013.

Research paper thumbnail of Ethics and the Image of the Healthcare Administrator in Popular Culture

In hospital culture physicians and healthcare administrators often occupy the highest leadership ... more In hospital culture physicians and healthcare administrators often occupy the highest leadership positions. When hospital culture is represented in movies and TV, however, there is a clear, general distinction between how these two roles are portrayed. The image of physicians in popular culture has largely remained positive. This image may have tarnished some since the sparkling clean, idealized days of Drs. Marcus Welby and Ben Casey, but in movies and television programs the physician is still generally portrayed heroically, as the epitome of ethics, dedication, knowledge and wisdom. The healthcare administrator generally has not fared as well. Cast often as the ‘bad guy’, his character traits typically include avarice, hard-heartedness and pride. Yet of course in real life health care administrators are actual persons, as complex and subject to virtue and vice as any physician—and with ethical challenges as unique to their own profession as those of the physician. With this incongruity between image and reality in mind I plan first to outline the basic ethical obligations and challenges of healthcare administrators. Then, I will analyze three representative images of healthcare administrators from popular culture: the Hospital Administrator (Michael Palin) from Monty Python’s The Meaning of Life (Terry Jones, 1983), Hospital Director Rebecca Payne (Anne Heche) from John Q (Nick Cassavetes, 2002), and Dean of Medicine Dr. Lisa Cuddy (Lisa Edelstein) from the television drama House M. D. These images will help to show the importance of ethics education for healthcare administrators. For administrators and students of healthcare administration, it is important to recognize their distance from these images in order to develop their own ethical life while meeting their ethical obligations and recognizing their profession’s unique ethical challenges. For others it is important for administrators to grow beyond these images to demonstrate the ethical potential of all, including those in administrative positions.

American Society for Bioethics and Humanities 14th Annual Meeting: Representing Bioethics. Washington, DC, October 18-21, 2012

Research paper thumbnail of Utilizing Codes of Ethics in Health Professions Education

Codes of ethics abound in health care: the AMA’s Code of Medical Ethics, the ANA’s Code of Ethics... more Codes of ethics abound in health care: the AMA’s Code of Medical Ethics, the ANA’s Code of Ethics for Nurses, The American College of Healthcare Executives Code of Ethics, The American Academy of Physician Assistants’ AAPA Code of Ethics, etc. Certainly codes of ethics have a long and deep history in medicine and healthcare, beginning of course with the Hippocratic Oath, but modern medicine and health care has seen an explosion of apparent concern with ethics. One symptom of this interest is the proliferation of codes of ethics in the healthcare professions in the modern era. Beginning with the AMA’s Code of Medical Ethics in 1847 to the contemporary era in which not only does each profession in healthcare have its own code of ethics but many specialties within specific professions have developed their own unique codes of ethics.
The aims and purposes of these codes are multiple and varied, from operating as a decision making tool to acting as a standard of practice that can be operational in a civil legal context to providing a sense of elevated seriousness and professionalism within a field of practice. There is some doubt and controversy, however, regarding the value and use of these codes both in professional practice and in the education of healthcare professionals. Among the many criticisms of ethics codes are charges that they tend to be too vague, that they are intended and utilized merely to burnish a profession’s image and that they are viewed by professionals in a legalistic manner as merely a set of minimal requirements. Some of these criticisms are well-founded and present serious limitations, while others are more superficial and more easily overcome.
I intend to review and analyze the various aims and purposes of ethics codes particularly within the study and practice of healthcare in light of various criticisms of codes of ethics. After weighing the strength and import of these criticisms, I plan to explore effective means for utilizing such codes as part of the ethics education of healthcare professionals. While noting significant limitations of this tool, both in practice and in education, I plan to demonstrate its potential usefulness as well, in both generating critical thinking within the study of ethics and as a guide for practice for the professional.

Inaugural International Conference on Education in Ethics. Duquesne University, Pittsburgh, PA, May 1-3, 2012

Research paper thumbnail of Teaching Philosophy of Science to Doctor of Nursing Practice Students

The Doctor of Nursing Practice Degree (DNP/DrNP) is a relatively new degree in the U.S., but alre... more The Doctor of Nursing Practice Degree (DNP/DrNP) is a relatively new degree in the U.S., but already there are more DNP programs and graduates than the PhD which has been around since 1933. As opposed to an academic degree like the nursing PhD the focus of which is research, the nursing practice doctorate is intended to be an advanced degree focusing on the practice of nursing. Being a new degree, introduced in 2001 but not becoming a significant force in nursing education until 2005, the doctor of nursing practice is still in a process of development and evolution. Its essence, its purpose and its proper curriculum is as yet a matter of negotiation working itself out. Being a practice-oriented rather than an entirely research-oriented degree, the amount and depth of theoretical knowledge necessary is one of those points still under discussion. Within this realm of theoretical knowledge is the possible inclusion of the teaching of the philosophy of science. Nursing’s status as science itself is of an uncertain nature (or is it better described as an applied science?), making the relevance of philosophy of science on the one hand uncertain but on the other hand possibly especially intriguing in potentially facing a form of the demarcation question. Philosophy of science courses are very common if not universal in nursing PhD curricula, as scientific and theoretical research is the prime focus of these programs. In the doctor of nursing practice curricula such courses are far less common and more controversial. Their relevance depends not only on the natures of nursing and of science but the nature of this particular degree and the roles to be filled by graduates of these programs. Part of this nature and these roles include questions of the role of knowledge for advanced practice nurses. Are they to be merely implementers and at most interpreters of knowledge or generators of knowledge (as PhD nurses are conceived to be) in their own right or perhaps generators of practice knowledge? We would contend the deeper their commitment to producing practice knowledge for the nursing discipline, the deeper the justification seems to be for including the philosophy of science in their academic study.

In our DrNP program at Drexel University we have included a course in the philosophy of science since its inception in 2005. We believe the inclusion of this course reflects our commitment to our understanding of what nursing is, what this particular degree is, and the roles these graduates are expected to fill, as well as a commitment to rigor in advanced nursing education. This constitutes our affirmation of the place of philosophy of science in a practice discipline. In this presentation we plan to defend this view with an overview of our course and our experience teaching it and with an exploration of the nature of nursing, the nature of this degree, and the relevance of philosophy of science to the relationship advanced practice nurses will have toward knowledge and practice knowledge development.

Third Bienniel Society for the Philosophy of Science in Practice Conference. Exeter, UK, June 22-24, 2011.

Research paper thumbnail of How Much Philosophy of Science Belongs in a Doctor of Nursing Practice Curriculum?

When we first set out to design a doctor of nursing practice degree, we held one requirement to b... more When we first set out to design a doctor of nursing practice degree, we held one requirement to be a philosophy of science course. A course such as this is not common in Doctor of Nursing Practice curricula but is one that comprises, in the words of the AACN, one of “the foundational competencies that are core to all advanced nursing practice roles” (American Association of Colleges of Nursing [AACN], 2006, p. 8). Our faculty recognized a formal philosophy of science course as beneficial, even necessary, for advanced nursing education. Among advanced practice nurses, we have found lack of understanding regarding the fundamentals of scientific research. Students often have a lack of understanding of the logic underpinning scientific conclusions: the distinction of deductive and inductive logic, the use of abductive logic in hypothesis construction. The distinction between natural and social sciences is often not well understood. And the distinction between quantitative and qualitative research is often not clear. Given the nature and purpose of doctoral study as “the terminal academic preparation for nursing practice,” students should study not only the basic and advanced practices, theories and ideas of their discipline but the fundamental and metatheoretical bases of the discipline as well (AACN, 2006, p. 8). Particularly as most students in a doctor of nursing practice program (and all in our program) will be conducting a project including scientific research, an understanding of the philosophical foundation of science—which would include the philosophical problems facing scientific claims and investigation and a critical understanding of the scope and limitations of science—would provide a deeper, more complete understanding of their own discipline and practices.

Doctor of Nursing Practice Conference: The Dialogue Continues… Hilton Head, South Carolina, March 24-27, 2009.

Research paper thumbnail of The Role of the ANA Code in Ethical Decision Making

Ethical decision making is complex and difficult. For this reason many professions compose ethic... more Ethical decision making is complex and difficult. For this reason many professions compose ethical codes to aid their practitioners. Other motivations for such codes are to document and establish the core moral values of the profession and to maintain a level of moral professionalism. However, the most direct purpose is to aid those in the profession, those in the clinical setting, in dealing with perplexing situations that inevitably arise. The ANA Code of Ethics is of course one such code. It outlines the important general values, duties and responsibilities that flow from the specific role of being a nurse. The relationship of the individual practitioner to the code, however, is an aspect of moral life that requires interpretation. The code itself cannot define this relationship, as this is a second order consideration (or meta-consideration) regarding the code. The danger is in the individual nurse applying the code in an unthinking manner as simply a set of pre-existing rules, in which one merely has to define the situation and pick out the appropriate rule. Rather, of course, any such code should be viewed as an aid in ethical decision making. Otherwise, subjectivity and autonomy are compromised on the nurse’s part, little is learned from difficult experience, and the situation in question is never fully understood by the moral agent (the nurse) him/herself. What is needed is both a historical and theoretical analysis of the code that would allow for an understanding as to how it is to be used not as a substitute for moral thinking but as an aid to moral thinking.

Nursing Ethics and Health Care Policy—Bridging Local, National and International Perspectives: the International Centre for Nursing Ethics Conference, Yale University School of Nursing, July 17-19, 2008.

Research paper thumbnail of Screening Health: Teaching Concepts of Health and Illness Through Film

Why study health and illness through film? Studing health and illness in textbooks and through s... more Why study health and illness through film? Studing health and illness in textbooks and through scientific studies provides objective, scientific knowledge. What can film provide that is superior to or different from this? Not just film but narrative and fictional forms specifically can expand knowledge in ways that cold, scientific reports cannot. Philosopher Martha Nussbaum makes this claim regarding literature when she writes, "Good literature is disturbing in a way that history and social science writing frequently are not. Because it summons powerful emotions, it disconcerts and puzzles. It inspires distrust of conventional pieties and exacts frequently painful confrontation with one's own thoughts and intentions...Literary works that promote identification and emotional reaction cut through...self-protective strategems, requiring us to see and to respond to many things that may be difficult to confront--and they make this process palatable by giving us pleasure in the very act of confrontation" (Nussbaum, 1995, pp. 5-6). Much the same might be said about film. Good films, like good literature, can force us to confront our own beliefs and presuppositions, can help us to come to a deeper understanding of deeply ingrained ideas--and they may even make this possibly difficult and painful process enjoyable. Also, film can place us into the perspective and experience of others different from ourselves. In so doing, they can instill an understanding and sympathy that merely reading about the facts regarding these others cannot. Regarding health and illness, being put into the experience of one who is suffering can give us a deeper understanding of the position and experience of those who suffer than merely reading a list of symptoms, blood levels and test results can. This understanding can lead to a sympathy that will make for a more caring attitude among health care workers.
In this presentation I plan to demonstrate with a few key examples the manner in which film can be used to augment and broaden the education of health care students in the manners suggested above.
Nussbaum, M. (1995). Poetic justice: The literary imagination and public life. Boston, MA: Beacon Press.

Third International Conference on the Arts in Society, Birmingham Institute of Art and Design, Birmingham, England, United Kingdom, July 28-31, 2008.

Research paper thumbnail of Teaching Ethics to APRN Students Online: Strategies and Outcomes

There are numerous reasons that knowledge of ethics is crucial in today’s healthcare environment.... more There are numerous reasons that knowledge of ethics is crucial in today’s healthcare environment. Three of the documented concerns are unreported patient safety issues, lack of critical thinking in new graduates, and technological advances exceeding pace of ethical considerations. This session will focus on “lessons learned” after 1.5 years of an online course entitled “Advanced Ethical Decision Making in Health Care.” The course has been taught by PhD nurse with masters in bioethics and PhD philosophers.

The focus of the workshop will be on the following questions. What are the key components we believe are necessary to change nursing practice? Is there a difference in focus and in course evaluations based on the discipline? What do these evaluations tell us and how have we changed the course? These and other evaluation questions will be the focus of this presentation by two of the course professors.

We will also present the course syllabus, discuss assignments and student performance on these requirements, as well as provide examples from the online discussion that we believe are examples of stimulating critical thinking. We will as well discuss the importance of including the Code of Ethics for Nurses in the curriculum. Participants will leave this workshop with a diverse perspective on the importance of ethics education for APRN nurses.

Drexel University Nursing Education Institute, June 27-29, 2008, Atlantic City, N.J.

Research paper thumbnail of Visceral and Other Pleasures: Foucault, Butler and Film

Meeting of the Eastern Division of the American Society for Aesthetics, Philadelphia, Pennsylvani... more Meeting of the Eastern Division of the American Society for Aesthetics, Philadelphia, Pennsylvania, April 2001

Research paper thumbnail of Don Roos’ The Opposite of Sex: A Sexual Ontology of Unnatural Kinds

Popular Culture Association and the American Culture Association Annual Conference, San Diego, Ca... more Popular Culture Association and the American Culture Association Annual Conference, San Diego, California, April 1999.

Research paper thumbnail of Fruits of a New Vision: Aesthetics and Technoculture

Eastern Division of the American Society of Aesthetics, Towson State University, Towson, Maryland... more Eastern Division of the American Society of Aesthetics, Towson State University, Towson, Maryland, March 1999.

Research paper thumbnail of For Love or Duty.pptx

When a family member becomes ill, seriously ill, the sick person is not typically the only one af... more When a family member becomes ill, seriously ill, the sick person is not typically the only one affected. A chronic, debilitating, or fatal illness inevitably affects other family members, none more so than those who end up providing basic, daily care for the ill family member. These individuals take on the common, personal, non-professional role of family caregiver. Although with little documentation, family caregivers have a long history, far predating modern medicine and likely predating any system of formal medicine and care. The tasks, abilities, and motivations of family caregivers vary greatly, leaving the role radically heterogeneous and open. Much research has been written about the experience of family caregivers. However, in addition to this knowledge, an ethical understanding of the role is needed. I intend to construct an ethical model for understanding this role. I begin with an ideal concept of the family caregiver, epitomized by the character of Michaela Odone (Susan Sarandon) in the 1992 film Lorenzo’s Oil, and then explore the heterogeneity and openness of the role to fit a variety of other moral models. I will focus on a virtue approach that will allow for a view of the role as a quasi-cohesive practice and for an analysis of the heterogeneous range of family caregivers. In addition, a virtue-based analysis will allow for a variety of morally praiseworthy models in recognition of the uniqueness of individuals’ personalities and the uniqueness of the situation of any individual caregiver.