This study examined Canadian Research Ethics Board practices concerning continuing ethics review of approved studies. A mail-out questionnaire was used to elicit information from Canadian REB representatives about whether their board engaged in continuing ethics review, and, if so, what their methods were. The study found that a majority of REBs conduct continuing ethics review. REBs conduct continuing ethics review of clinical trial research significantly more often than of academic research. The study also found little difference in the frequency of (...) continuing ethics review between academic and other types of REBs. The most commonly reported method for conducting continuing ethics review was a review of ongoing research reports. (shrink)

Introduction -- Australia : 1788-2001 -- Kelsen : authorised constitutional change -- Application of Kelsen's account -- Raz : continuity of social form -- Application of Raz's account.

In order to maximize human performance, defence forces continue to explore, develop, and apply human performance enhancement (HPE) methods, ranging from pharmaceuticals to (bio)technological enhancement. This raises ethical, legal, and societal concerns and requires organizing a careful reflection and deliberation process, with relevant stakeholders. We discuss a range of ethical, legal, and societal aspects (ELSA), which people involved in the development and deployment of HPE can use for such reflection and deliberation. A realistic military scenario with proposed HPE application can (...) serve as a starting point for such an iterative and participatory process. Stakeholders can discuss this application, modify its features, and design appropriate processes around it – for instance, procedures for informed consent. We propose that organizing aspects into these three categories – ethical, legal, and societal – can help involve appropriate interlocutors at different moments: legal aspects with people in strategy or management roles, from the start of a project; ethical aspects with people in operations and medical roles, during development; and societal aspects with people in communication and personnel roles, during deployment. Notably, we developed and discussed this framework and the three aspects in close collaboration with personnel from the military. (shrink)

This short article discusses the nature of research and art practice and makes a case for the necessary intermingling of these activities. It does not attempt to define a space for art to operate as research, quite the opposite: research is an operating structure for the process and production of, among other things, art. It is regarded as integral to the processes of thinking, making, and reflecting, and it is important to note that curiosity, creative enquiry, and critical reflection (...) underpin much that is considered research in various fields. The author asserts that these processes are not necessarily discipline-specific although particular disciplines have specific procedures and goals. It is argued that "provisionality" is central to what art can offer other disciplines; it can make a virtue of incompleteness. The author suggests that art open itself up to quizzical scrutiny and help others to recognise that research has long been, and will continue to be, a driving force within its makeup. The article posits an expanded notion of the artwork that is essentially provisional and reliant on spectatorial involvement. (shrink)

Historical continuities and constraints in the professionalization of nursingThe support of medicine and the state may be crucial to nursing's current professional aspirations for legitimation and implementation of nursing reforms and for new roles for nurses in health care. As such, medicine and the state are in the invidious position of influencing nursing's occupational future. This situation is not new. An historical analysis of the establishment of nursing at Prince Alfred Hospital, Sydney, Australia, at the end of the nineteenth century (...) reveals that the State Government of NSW and the medical profession supported nursing's occupational development, yet set the framework within which this could occur. For instance, the state provided patronage to nursing through recommendations of the 1873 Royal Commission and because it financially backed Prince Alfred Hospital, while the medical profession defined nursing knowledge and practice through its control of the nursing curriculum. Membership of the hospital board provided both medicine and the state with powerful positions over hospital policies that affected nursing. While nursing became established as a distinct occupation for women with the aid of State and medical support, its subordinate position in health care was, and continues to be, constrained by these traditional supporters. This relationship between nursing, medicine and the state has implications for nursing's current professionalization strategies and aspirations. (shrink)

It has become easy to make a case for the relevance, richness, and importance of philosophical thinking for information research and practice. [Introduction to a special issue].

The tradition of planting and maintaining home gardens is an expression of culture and represents an intense interaction between humans and plants. Forty-nine home gardens in northeastern Thailand were surveyed and found to be quite rich and diverse. The gardens contained domesticated plants, species that are not native to the area, and local non-domesticates. We focused on women's gardening practices as behaviors that create an intensive interaction with the physical and social environment and found that women are increasing their management (...) and manipulation of non-domesticated resources. Home gardens, maintained primarily by women, are part of a continuum of resource areas that are constructed and utilized. The maintenance of specific plants in the gardens provide a source of stability in the rapidly changing cultural, social, and economic environment. (shrink)

Dress serves as a discursive daily practice of gender, and this article explains the dress practices of Bosnian Muslim refugee women living in Vermont. These dress practices tend toward elaborate, carefully cultivated styles for hair, makeup, and dress. Based on participant observation, in-depth interviews, and secondary historical sources, the authors seek to explain the meanings and practice of these dress practices. They argue that gendered dress practices reflect agentic processes that are situated within the flow of time and (...) are rooted in relational processes that occur at the macrostructural level of history and nation and at the micro world of social interaction and lived experience. (shrink)

The ArgumentThe overall portrayal of early modern experimentation as a new method of securing assent within a philosophical discourse sketched in many of the recent studies on the historical origin of experimentation is questioned by the analysis of the experimental practice of chemistry at the Paris Academy. Chemical experimentation at the Paris Academy in the late seventeenth and early eighteenth century originated in a different tradition than the philosophical. It continued and developed the material culture of the chemical work (...) shops of the sixteenth and seventeenth centuries, and explored epistemic objects which had rather loose connections to philosophy. On the other hand, I argue against the classical dichotomy between the work of the mind that of the hand, and for an epistemology of experimentation that acknowledges that experimental manipulation goes hand in hand with reflexion. In particuler, I argue against the view that chemists at the Paris Academy were “pragmatists” who merely gathered experimental facts and classified substances and operations without perplexing themselves over general conceptions. I claim that the chemists at the Paris Academy constructed a general conception framework which shaped the significance of their experiments. This conception that I call conception of the chemical combination, compound and reaction was rather quickly reified into an experimental fact. Despite its generality it was a genuine chemical conception rather independent of philosophy. (shrink)

Continuous deep sedation (CDS) has the effect of making the patient unconscious until death, and that it has this effect is clearly an undesirable aspect of CDS. However, some authors have recently maintained that many physicians do not intend this effect when practicing CDS. According to these authors, CDS is differentiated into two types; in what is called “gradual” CDS (or CDS as a result of proportionate palliative sedation), physicians start with low doses of sedatives and increase them only (...) gradually, whereas in “rapid” CDS (or palliative sedation to unconsciousness), physicians rapidly administer a heavy dose that clearly induces unconsciousness from the beginning. The claim is that the physicians intend permanent unconsciousness only if they rapidly administer a heavy dose, but they do not intend it when the unconsciousness is the result of a gradual increase of sedatives. This paper attempts to refute these claims based on a close examination of the protocol of gradual CDS. If my argument is valid, the doctrine of double effect would not be useful in justifying most, if not all, cases of CDS. (shrink)

Learning to work as a relational caring professional in healthcare and social welfare, is foremost a process of transformative learning, of Building, of professional subjectification. In this article we contribute to the design of such a process of formation by presenting a structured map of five domains of formational goals. It is mainly informed by many years of care-ethical research and training of professionals in healthcare and social work. The five formational domains are:Relational Caring Approach,Perception,Knowledge,Interpretation, andPractical Wisdom. The formation process, (...) described as the recurring detour of a continuing practice, requires ‘exposure’, in-depth learning and learning communities. Relational caring—care consequently resulting from and structured by relational thinking, exploring, and steering—requires ‘inquiry’ as a continuous learning process in practice. The process is ultimately aimed at fostering mature, competent, and practically wise professional caregivers who are able to relationally connect with and attune to care receivers, and adequately navigate existential, moral, and political-institutional tensions in relational caring in complex organizations in Late-Modern society. (shrink)

The practice of corporate social responsibility has often been described as a balance of profitability and social or societal responsibility by scholars as well as practitioners. It is assumed that regulations and guidelines of CSR practices link competitiveness and responsibility together. While recognising that formal CSR statements represent a goal-oriented managerial approach to CSR, we argue based on the description of a qualitative case study that the relationship between profitability and social or societal responsibility is not as clear and (...) simple as it is often described. Instead, CSR should be considered as a continuously negotiated process between companies and stakeholders. Hence, the creation of a constructive link between profitability and social or societal responsibility is dependent on the amount of effort that has been put into exploring the concerns of the stakeholders, vis-a-vis the company, while simultaneously accepting changes when they are necessary. (shrink)

Lifelong learning is becoming part of the philosophy of professional education. Continuing medical education is the responsibility of all personnel who are responsible for the delivery of components of the healthcare delivery system. Continuing education is becoming increasingly obvious for medical universities, hospitals, and health care providers. Pharmacists who practice in a community pharmacy and hospital, and who are participating in residency recognize that the traditional role of the pharmacist is changing. Over the last decades, a host of new (...) services have been identified as a function of the pharmacist [1]. A review of these services revealed a personal commitment to continuing education. It is the absolute need to develop a level of competence that will improve patient care. In Libya, pharmacists working in the community practice setting are pharmacists with a diploma of pharmacy or with a Bachelor of Pharmaceutical Science, Master of Science, and Doctor of Pharmacy (Pharm D). The main objective is that the graduates possess the knowledge and skills needed to optimally mange the pharmaceutical services [1, 2]. Patient's expectations from pharmacists are that the medicine should be effective, safe and affordable. (shrink)

The relatively new practice of continuous sedation at the end of life (CS) is increasingly being debated in the clinical and ethical literature. This practice received much attention when a U.S. Supreme Court ruling noted that the availability of CS made legalization of physician-assisted suicide (PAS) unnecessary, as CS could alleviate even the most severe suffering. This view has been widely adopted. In this article, we perform an in-depth analysis of four versions of this ?argument of preferable (...) alternative.? Our goal is to determine the extent to which CS can be considered to be an alternative to PAS and to identify the grounds, if any, on which CS may be ethically preferable to PAS. (shrink)

When it comes to the question of what kind of moral claim an intelligent or autonomous machine might have, one way to answer this is by way of comparison with humans: Is there a fundamental difference between humans and other entities? If so, on what basis, and what are the implications for science and ethics? This question is inherently imprecise, however, because it presupposes that we can readily determine what it means for two types of entities to be sufficiently different—what (...) I will refer to as being “discontinuous”. In this paper, I will sketch a formal characterization of what it means for types of entities to be unique with regard to each other. This expands upon Bruce Mazlish’s initial formulation of what he terms a continuity between humans and machines, Alan Turing’s epistemological approach to the question of machine intelligence, and Sigmund Freud’s notion of scientific revolutions dealing blows to the self-esteem of mankind. I will discuss on what basis we should regard entities as (dis-)continuous, the corresponding moral and scientific implications, as well as an important difference between what I term downgrading and upgrading continuities—a dramatic difference in how two previously discontinuous types of entities might become continuous. All of this will be phrased in terms of which scientific levels of explanation we need to presuppose, in principle or in practice, when we seek to explain a given type of entity. The ultimate purpose is to provide a framework that defines which questions we need to ask if we argue that two types of entities ought (not) to be explained (hence treated) in the same manner, as well as what it takes to reconsider scientific and ethical hierarchies imposed on the natural and artificial world. (shrink)

Continuous sedation until death is an increasingly common practice in end-of-life care. However, it raises numerous medical, ethical, emotional and legal concerns, such as the reducing or removing of consciousness, the withholding of artificial nutrition and hydration, the proportionality of the sedation to the symptoms, its adequacy in actually relieving symptoms rather than simply giving onlookers the impression that the patient is undergoing a painless 'natural' death, and the perception that it may be functionally equivalent to euthanasia. This (...) book brings together contributions from clinicians, ethicists, lawyers and social scientists, and discusses guidelines as well as clinical, emotional and legal aspects of the practice. The chapters shine a critical spotlight on areas of concern and on the validity of the justifications given for the practice, including in particular the doctrine of double effect. (shrink)

This study examines inter-firm buyer–supplier relationships through an ethical lens. Drawing on the concept of reciprocity in social exchange theory as well as resource dependence theory, we examine the effect of customers’ unethical practices on their suppliers’ intention to continue their business relationships with their customers. Specifically, we distinguish two types of unethical practices: unfair business practices, which directly target suppliers and socially irresponsible practices, which have an impact on wider society. Integrating social exchange theory and resource dependence theory, we (...) investigate the effects of two moderating factors: suppliers’ dependence on their customers and the benefits derived from the supplier–customer relationship. Using data obtained from 506 managers from small-to-medium-sized firms, our findings show that both customers’ unfair business practices and socially irresponsible practices have negative relationships with their suppliers’ intention to continue the relationships. These effects are moderated by supplier dependence and benefits derived from their customers. Overall, our study shows that intention to continue in these relationships, in response to unethical practices by customers, is bounded by supplier self-interest and resource dependence. Our study is one of the few to examine suppliers’ responses to unethical practices and our findings are consistent with the notion of weak reciprocity, rather than strong reciprocity that predominates in the literature. (shrink)

This article presents an argument for the use of interpretative hermeneutic phenomenology as an insightful and innovative methodology for research in early childhood education. In providing guidance for the use of this methodology, this article will focus on a doctoral study investigating preschool teachers’ experiences of engagement with a continuing professional development (CPD) programme aimed to inform their pedagogical practice. The CPD programme focused on promoting and supporting inclusive pedagogy, practice and culture in the early education setting. The (...) research study considered the phenomenon of engagement with the programme on participants’ perceptions and practices of inclusion with the emphasis on their “lived experience” working in practice with young children. Findings from the research, validated by the philosophical principles of Heidegger, illustrate the importance of consideration of participants’ individual contextual realities when addressing teacher education through acknowledgment of other perspectives that influence the effectiveness of the learning experience. The professional identity of the early years’ educator and societal perception of this role is presented as having a direct influence on participants’ engagement with the CPD programme. Interpretive phenomenology and the hermeneutic principles underpinning this approach are presented here as central to understanding the professional role and the subsequent development of effective teacher education in the early years. (shrink)

Surveys in different countries (e.g. the UK, Belgium and The Netherlands) show a marked recent increase in the incidence of continuous deep sedation at the end of life (CDS). Several hypotheses can be formulated to explain the increasing performance of this practice. In this paper we focus on what we call the ‘natural death’ hypothesis, i.e. the hypothesis that acceptance of CDS has spread rapidly because death after CDS can be perceived as a ‘natural’ death by medical practitioners, (...) patients' relatives and patients.We attempt to show that the label ‘natural’ cannot be unproblematically applied to the nature of this end-of-life practice. We argue that the labeling of death following CDS as ‘natural’ death is related to a complex set of mechanisms which facilitate the use of this practice. However, our criticism does not preclude the view that CDS may be clinically and ethically justified in many cases. (shrink)

We study the complexity of isomorphism of classes of metric structures using methods from infinitary continuous logic. For Borel classes of locally compact structures, we prove that if the equivalence relation of isomorphism is potentially $\mathbf {\Sigma }^0_2$, then it is essentially countable. We also provide an equivalent model-theoretic condition that is easy to check in practice. This theorem is a common generalization of a result of Hjorth about pseudo-connected metric spaces and a result of Hjorth–Kechris about discrete (...) structures. As a different application, we also give a new proof of Kechris’s theorem that orbit equivalence relations of actions of Polish locally compact groups are essentially countable. (shrink)

Getting a graduate education is one of the most important parts of a professional in a field. It allows them to climb higher in the professional rankings or even get higher pay for their academic work. All graduate students are adults and self-directed due to their past experiences in work or practice. However, when the pandemic hit the world, these self-directed learners were not spared from shutting of schools. In the Philippines, most graduate schools deliver their lessons through the (...) traditional mode or face-to-face until the pandemic that they shifted in the emerging online learning modality. Using the mixed method of quantitative and qualitative type of study the researchers were able to gather 419 graduate students from various regions of the archipelago to take part in the study. The researchers found out that upon experiencing the benefits of online learning, graduate students want to continue this modality even in the future. More than a third of the respondents also claimed that they want the blended or hybrid type of graduate studies as opposed to going back to the more traditional face-to-face classes. The reasons for these can vary on each learner’s situation. (shrink)

Theory of mind explanations of how we know other minds are limited in several ways. First, they construe intersubjective relations too narrowly in terms of the specialized cognitive abilities of explaining and predicting another person's mental states and behaviors. Second, they sometimes draw conclusions about secondperson interaction from experiments designed to test third-person observation of another's behavior. As a result, the larger claims that are sometimes made for theory of mind, namely, that theory of mind is our primary and pervasive (...) means for understanding other persons, go beyond both the phenomenological and the scientific evidence. I argue that the interpretation of "primary intersubjectivity" as merely precursory to theory of mind is inadequate. Rather, primary intersubjectivity, understood as a set of embodied practices and capabilities, is not only primary in a developmental sense, but is the primary way we continue to understand others in second-person interactions. (shrink)

A distinction is commonly drawn between continuous sedation until death and physician-assisted suicide/euthanasia. Only the latter is found to involve killing, whereas the former eludes such characterization. I argue that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia in that both involve killing. This is established by first defining and clarifying palliative sedation therapies in general and continuous sedation until death in particular. A case study analysis and a look at current practices are provided. This is (...) followed by a defense of arguments in favor of definitions of death centering on higher brain (neocortical) functioning rather than on whole brain or cardiopulmonary functioning. It is then shown that continuous sedation until death simulates higher brain definitions of death by eliminating consciousness. Appeals to reversibility and double effect fail to establish any distinguishing characteristics between the simulation of death that occurs in continuous sedation until death and the death that occurs as a result of physician-assisted suicide/euthanasia. Concluding remarks clarify the moral ramifications of these findings. (shrink)

Abstract Six apparent features of Kant's conception of autonomy appear to differentiate it sharply from anything that we can find in an Aristotelian conception of will and practical reason. (1) Autonomy requires a role for practical reason independent of its instrumental role in relation to non-rational desires. (2) This role belongs to the rational will. (3) This role consists in the rational will's being guided by its own law. (4) This guidance by the law of the will itself requires acts (...) of legislation?the making of laws?for oneself. (5) These acts of legislation constitute the law as one's own law, as moral constructivists hold. (6) Kant marks this character of the rational will by using ?autonomy? and cognates. These six apparent features, however, do not mark any discontinuity between Kant and an Aristotelian conception. The first three apparent features are genuinely Kantian, but are not aspects of discontinuity, whereas the last three mark aspects of discontinuity, but are not genuinely Kantian. (shrink)

Context: Under the title “Ask von Glasersfeld,” for 13 years the Oikos web site offered the opportunity to questioners to pose any type of query directly to Ernst von Glasersfeld. Purpose: Based on the collected questions and answers gathered on the web site, this series of four articles re-presents and highlights key aspects of von Glasersfeld’s life’s work constructing his model of radical constructivism. Method: The question-answer pairs are grouped into eight categories. Because the selected contents are so extensive, these (...) eight categories are presented in a series of four articles, of which this is the second and which deals with with von Glasersfeld’s views on human experience. The material is divided into two main themes: the first deals with his views on “experiential reality” and the second deals with the issue of “learning.” Results: One of von Glasersfeld’s main objectives was to define clearly that which we can rationally claim to know. As part of this task, in the first section of this article he deals with the question of how we go about constructing our personal experiential reality. The second part deals with his views on how to apply practically the tenets of radical constructivism in a variety of fields. He is especially interested in redefining what “learning” means and in creating novel approaches to teaching and training students. Implications: This re-presentation of von Glasersfeld’s ideas offers an easily accessible resource for people of all levels of understanding who are seeking to deepen their appreciation of his work. One can come to appreciate not only the lucidity of his writings but also glean “insights” into the person himself, who can be glimpsed between the lines of these various interactions. (shrink)

Continuous sedation is increasingly used as a way to relieve symptoms at the end of life. Current research indicates that some physicians, nurses, and relatives involved in this practice experience emotional and/or moral distress. This study aims to provide insight into what may influence how professional and/or family carers cope with such distress.

This article attempts to show the continuing practical relevance of hermeneutics through the example of legal interpretation. The article begins with the very concrete nature of legal hermeneutics that forms everyday legal practice – the interrelation of meaning and application – and expands at a more theoretical to show how legal hermeneutics, and hermeneutics more generally, offers what Ricoeur calls an interpretive “choice in favor of meaning.” The choice in favour of meaning underscores the restorative character of hermeneutics that (...) legal hermeneutics can epitomize. The article concludes with some of the challenges facing contemporary legal hermeneutics. (shrink)

In this paper, the elaboration of the concept of practical realist philosophy of science which began in the author's previous papers is continued. It is argued that practical realism is opposed to standard scientific realism, on the one hand, and antirealism, on the other. Standard scientific realism is challengeable due to its abstract character, as being isolated from practice. It is based on a metaphysical-ontological presupposition which raises the problem of the God's Eye point of view (as it was (...) called by Hilary Putnam). Joseph Rouse's conception of science as practice, Sami Pihlström's pragmatic realism, and even Ilkka Niiniluoto's critical scientific realism are interpreted as practical realist conceptions. Pihlström suggests that the contemporary scientific realist should be prepared to accept the pragmatically naturalized Kantian transcendental perspective on realism. It is argued, however, that this realistically naturalized Kantianism can be nothing more than practical realism, as originated by Karl Marx. (shrink)

In the first section, the author relates how laboratory schools and communities of practice are no longer limited to a single geographic location and how boundaries for professional development are disappearing because of information and computer technology, such as the Internet, the World Wide Web, and globalization. The second section provides a narrative account of the professional development workshop experiences that occurred during EdTech Summit Africa 2017. In the third section, the author reflects on the conditions that she encountered (...) in South Africa while leading professional development workshops on project-based learning and technology integration. This narrative underscores the importance of teacher... (shrink)

Practice Then and Now"Practice theory" has a long history in philosophy, under various names, but current practice theory is a response to failures of projects of modernity or enlightenment which attempt to reduce science or politics to formulae. Heidegger, Oakeshott, and MacIntyre are each examples of philosophers who turned to practice conceptions. Foucault and Bourdieu made similar turns. Practice accounts come in different forms: some emphasize skill-like individual accomplishments, others emphasize the social character or presupposition-like (...) character of the tacit conditions of activities. The Social Theory of Practices problematized the idea of sameness, the idea that participants in an activity had the same tacit possessions, which undermined the idea that practices were collective objects in which individuals participated. Later critics, such as Schatzki and Rouse, emphasized the normative coherence and character of practice, which has a collective aspect. Pickering and others suggested a notion of practices that was de-mentalized and focused on the objects that were part of the practical activity, which provided for the continuity and sociality of practice without collectivizing its mental content. The discovery of mirror neurons suggested a non-collective mode of transmission of practices. The implications of these developments can be seen in connection with ethics, where the conflict between the ethical and the practical can be understood in terms of the intrinsic conflict between the need to behave successfully and our learned ethical intuitions. (shrink)

We test the hypothesis that demographic continuity was a necessary condition of performable token post-communist social restorations. Demographic continuity means sufficient overlapping between populations of original and restored systems. Token social restoration refers to restorations where original and restored systems are identical. It is opposed to type restoration where original and restored systems are numerically different instances of the same type. The identity of original and restored systems in token restorations is achieved by performing various practices in the restored system (...) to establish institutional continuity with the original system. The restitution of property rights is the most important of them in the post-communist restorations. So our hypothesis claims that these practices cannot be performed without sufficient demographic continuity. We abstract the demographic continuity thresholds by measuring shares of survivors from the precommunist times in the population of Baltic countries by 1990. Our data confirm the hypothesis as in none of post-communist countries with demographic continuity below these thresholds there was property rights restitution. (shrink)

In our time of increasing reliance on digital media the history of the book has a special role to play in studying the codex form and the persistence of old media alongside the growth of new ones. As a contribution to recent work on the continued use of manuscript in the handpress era, I focus on some examples of manuscripts copied from printed books in the Rylands Library and discuss the motivations for making them. Some of these manuscripts were luxury (...) items signalling wealth and prestige, others were made for practical reasons – to own a copy of a book that was hard to buy, or a copy that could be customized in the process of copying. The act of copying itself was also considered to have devotional and/or pedagogical value. (shrink)

The interocular suppression technique termed continuous flash suppression (CFS) has become an immensely popular tool for investigating visual processing outside of awareness. The emerging picture from studies using CFS is that extensive processing of a visual stimulus, including its semantic and affective content, occurs despite suppression from awareness of that stimulus by CFS. However, the current implementation of CFS in many studies examining processing outside of awareness has several drawbacks that may be improved upon for future studies using CFS. (...) In this paper, we address some of those shortcomings, particularly ones that affect the assessment of unawareness during CFS, and ones to do with the use of ‘visible’ conditions that are often included as a comparison to a CFS condition. We also discuss potential biases in stimulus processing as a result of spatial attention and feature-selective suppression. We suggest practical guidelines that minimize the effects of those limitations in using CFS to study visual processing outside of awareness. (shrink)

Debates on morally acceptable and lawful end-of-life practices in pediatrics were reignited by the recent amendment in Belgian law to allow euthanasia for minors of any age who meet the criteria for capacity. Euthanasia and its legalization in pediatrics are often opposed based on the availability of aggressive palliative sedation. For terminally ill patients, this type of sedation is often identified as continuous and deep sedation until death. We demonstrate that this reasoning is based on flawed assumptions: CDS is (...) a morally preferable alternative to euthanasia; CDS can meet the same patient needs as euthanasia; children lack the capacity and experience to make EOL decisions; unlike euthanasia, CDS does not raise capacity issues. Our aim is not to reject CDS as a valid option at the EOL, nor to offer a clear-cut defense of euthanasia for minors, but to emphasize the ethical issues with both practices. (shrink)

ObjectiveThis study aims to investigate the lived experience in patients with obstructive sleep apnea syndrome and comorbid obesity following after continuous positive airway pressure therapy made with the disease the device, and to identify barriers and facilitators to the use of CPAP to improve rehabilitation provision and aid in disease self-management.MethodsQualitative research was conducted using three focus groups with a representative sample of 32 inpatients undergoing a 1-month pulmonary rehabilitation program at the IRCSS Istituto Auxologico Italiano San Giuseppe Hospital, (...) Verbania, Italy. The focus groups were recorded on tape, and contemporaneous notes were made. The tapes were transcribed verbatim, and Interpretative Phenomenological Analysis was used to develop themes.ResultsSix main themes were extracted: Living the diagnosis as a shock; You should not sleep on it: the importance of prevention; The adjustment to CPAP; Barriers and facilitators to the use of CPAP; Three in a bed; and The relationship with the healthcare system.ConclusionResults of this study suggest potential avenues for interventions to increase adherence to CPAP, including the provision of information and continued support. Individual counseling providing strategies aimed at helping the person to cope with the emotional problem and relational difficulties associated with the use of CPAP, and at strengthening self-efficacy and self-management skills are also encouraged for optimal care during the rehabilitation program. (shrink)

The dichotomy between the conceptual and the empirical is part of common sense, yet its organizing force also extends to intellectual life more generally, including the disciplinary life of science and technology studies. This article problematizes this dichotomy as it operates in contemporary STS discussions, arguing instead that the conceptual and the empirical form unstable hybrids. Beginning with a discussion of the “discontents” with which the dominant theory methods packages in STS are viewed, it is suggested that STS has entered (...) a phase resembling Kuhnian normal science. Based on a discussion of the making of cognitive dissonance theory, it is then argued conceptual–empirical mixtures are unavoidable in actual research practice. This situation can be taken as an encouragement for more sustained exploration of conceptual–empirical relations and their inventive potentials. Invoking Deleuze and Guattari’s notion of “continuous variation,” the article concludes that STS as a discipline is well served by promoting an ethos of empirical and conceptual experimentation. (shrink)