Wszalek offers a detailed examination of the challenges involved in assisting people with language and communication impairments in the comprehension of legal language and concepts (LLC). If we settle for a minimum threshold of LLC comprehension, we are likely to observe that some people will not meet this threshold due to personal choices, such as not having practiced reading sufficiently or having avoided intellectually stimulating social interactions.

Name der Zeitschrift: Studies in Logic, Grammar and Rhetoric Jahrgang: 45 Heft: 1 Seiten: 69-86.

This book adds impetus to the nexus between human rights, human rights education and material reality. The dissonance between these aspects is of growing concern for most human rights educators in various social contexts. The first part of the book opens up new discourses and presents new ontologies and epistemologies from scholars in human rights, human rights education and human rights literacies to critique and/or justify the understandings of human rights' complex applications. Today's rapidly changing social contexts and new languages (...) attempting to understand ongoing dehumanization and violations, put enormous pressure on higher education, educators, individuals working in social sciences, policy makers and scholars engaged in curricula making. The second part demonstrates how global interactions between citizens from different countries with diverse understandings of human rights (from developed and developing democracies) question the link between human rights and it's in(ex)clusive Western philosophies. Continuing inhumane actions around the globe reflect the failure of human rights law and human rights education in schools, higher education and society at large. The book shows that human rights education is no longer a blueprint for understanding human rights and its universal or contextual values presented for multicomplexial societies. The final chapters argue for new ontologies and epistemologies of human rights, human rights education and human rights literacies to open-up difficult conversations and to give space to dissonant and disruptive discourses. The many opportunities for human rights education and literacies lies in these conversations. (shrink)

One clear indication of the increasing use of the written word in western Europe from the twelfth century onwards was the compilation of an unprecedentedly diverse and numerous body of legal texts. In part, the growing textualization of law built on earlier foundations. This was particularly true of Roman law, whose rediscovery in Italy in the late eleventh century led to a revival in the study of law. At the same time, the expansion of papal power from the second (...) half of the eleventh century accelerated the production of new collections of canon law, whose compilers sought to impose order upon a mass of written law going back to the earliest councils of the church and also to integrate contemporary additions to that law resulting from conciliar and papal legislation. Yet the diversification of legal writing also owed much to the compilation of texts of secular customary law, in both Latin and the vernacular. In some societies, such as Iceland and Scandinavia, these texts marked the beginning of written law; in others, including England, France, Germany, and, above all, Italy, where law and legislation had been written earlier in the Middle Ages, the custom of particular kingdoms or provinces was committed to writing in new forms with the compilation of coutumiers. Although their relationship to earlier Welsh legal writing is unclear, the lawbooks of medieval Wales provide a further instance of this textualization of secular custom. (shrink)

The aim of the study was to evaluate the effectiveness of a media literacy intervention targeting, for the first time, the specific topic of Performance and Appearance Enhancing Substances use in high-school students. Overall, 389 students aged between 13 and 19 years participated to a media literacy intervention while 103 students aged between 14 and 19 year were considered as the control group. In two separate occasions over the course of six consecutive months, students in both groups filled (...) out a set of questionnaires which included measures of social-cognitive beliefs and a self-reported measure of retrospective use of doping and supplements. Compared to students in the control group = 1.96; SD= 0.85; and Mean= 2.09; SD= 0.94), intervention students on average expressed relatively stronger attitudes against doping use over time = 2.2; SD= 0.85; and Mean= 2.05; SD= 0.82). Students in the latter group also showed a statistically significant decrease in self-reported supplement use = 6.7%; Use= 3.8%;p= 0.05, McNemar Test). Interestingly, albeit marginally significant, students in the control group showed a relative increment in the self-reported use of supplements over time = 4.9%; Use= 8.7%;p= 0.22, McNemar Test). Overall, the media literacy intervention investigated in the present study was effective in decreasing adolescent student’s positive attitudes toward doping use and in reducing the use of legal PAES. These findings supported the generalizability and the usefulness of a media literacy approach in the specific field of PAES. (shrink)

Medical informed consent stands as an ethical and legal requisite preceding any medical intervention. Hospitalized patients face functional health literacy (FHL) challenges when dealing with informed consent forms (ICFs). The legitimacy of ICFs and informed consent procedures in China remains substantially undisclosed. The study’s aim was to investigate if Chinese patients have adequate FHL to be truly informed before providing medical consent. In this cross-sectional, structured interview-based study, FHL was assessed within the context of the informed consent scenarios (...) in two teaching hospitals (a 1500-bed general tertiary hospital and a 700-bed cancer hospital) affiliated with Shantou University Medical College. Twenty-seven patients admitted across clinical departments, along with their relatives (n = 59), were enrolled in the study after obtaining informed consent. The participants underwent a three-step assessment with two selected ICFs —teach-back skills, perceived understanding (perception), and informed knowledge (cognizance), with each component carrying a maximum score of 10. Data were analyzed with SPSS (version 22.0) for descriptive and inferential statistics, with consideration of significant P values as < 0.05. The median age (IQR and range) of participants was 35.5 (28 – 49 and 13 – 74) years. Most participants had only high school education (24.4%, 21/86) or below high school education (47.7%, 41/86). The median score (IQR) of FHL assessments—teach-back, perception, and cognizance—was 4.0 (2.5, 5.8), 8.0 (6.8, 8.8), and 6.5 (5.5, 8.0) out of 10, respectively. A moderate correlation was observed between the scores of cognizance and teach-back (r = 0.359, P = 0.002) or perception (r = 0.437, P < 0.001). Multivariate linear regression analysis predicted being a patient and having lower education levels as independent risk factors of inadequate FHL (Ps = 0.001). Lack of patient-centeredness in ICFs, time constraints, and poor clinical communication were identified as barriers impeding informed consent. This study demonstrates inadequacy in personal FHL and impaired organizational HL, resulting in compromised informed consent in Chinese teaching hospitals. As a remedy, we propose improving the quality of ICFs and institutionally mandated outcome-focused training on informed consent for all concerned clinicians to enhance medical ethics, ensure quality health care, address patient values, and mitigate potential medical conflicts. (shrink)

Introduction. The development of legal culture and a culture of human rights in the modern world through media technologies, is acquiring special significance in connection with the processes of globalization and the spread of media in recent decades. The purpose of the article is to study the prospects for the use of media education in the formation of the legal social culture and a culture of human rights. Materials and methods. Based on a study of domestic and foreign (...) sources, issues of media education, media literacy, spiritual and moral education, the legal culture of society, the phenomenon of post-truth and ways of forming critical, creative thinking are considered. The use of general scientific, philosophical, and socio-pedagogical methods has made it possible to study media education as a dialogue of learning, stimulating the development of rational, critical thinking, focused on the search for the value foundations of intellectual and social activity. Results. The development of the field of information and communication technologies determines the principles for the formation of the content and orientation of modern education. Media education is interlinked with the development of democracy and human rights. It influences the formation of a culture of citizen participation, their active social position, civic and political culture. Media education plays a significant role in shaping the legal culture of society since critical media research and information research focuses on the analysis of power structures and structures of dominance in the media. A study of the interpretations of the concepts of "media education" and "media literacy" made it possible to show that media education focuses a person on a critical approach to media content. One of the main issues of media education is teaching a person the skills to critically study media and media technologies, which involves addressing the technological, cultural and historical specifics of specific media used at a specific time and place. Information and communication technologies have changed the way of life, work, communication, and ways of selfpresentation, the formation of values, participation in socially significant events. Therefore, a critical approach to mass media should be based on knowledge of socio-philosophical theories, ethics and research in the field of mass media. Discussion. Mass media are constructing a history of human rights, which updates the topic of the media policy of human rights, combining socio-legal, cultural and media theories. Education in the field of acquiring information perception skills, the ability to correctly understand the importance of audiovisual images, to competently handle and navigate information flows are necessary for the life of a modern person in society. (shrink)

Christian Piska, one of the leading Austrian authorities in constitutional and administrative law, published a seventh revised edition of his Casebook—Introduction to Legal Studies in 2019. The work is intended to assist first-year law students in dealing with the challenging of the Written Module Examination Introduction to Legal Studies (“Schriftliche Modulprüfung ‘Einführung in die Rechtswissenschaften’” (University of Vienna, Faculty of Law. 2024). This reflective essay focuses not only on the question what is taught and exemplified as the foundations (...) of legal skills and knowledge first-year law students are expected to acquire, but also how and to which degree Piska’s Casebook is likely to achieve the goal it sets, i.e. to provide strategic guidance in preparing for one of the most challenging entrance examinations at the University of Vienna. We find that Piska’s Casebook constitutes a useful resource for students seeking to prepare for the Module Entrance Examination at the University of Vienna but also for legal educators and legal language teachers in legal literacy programmes. We find that the work lives up to its purpose of providing strategic guidance in preparing for the entrance examinations at the University of Vienna. We recommend integrating the growing body of research in applied legal linguistics, legal semiotics and in legal language teaching in future editions of the work which would likely enhance its educational value for students of law and those interested in advancing legal language teaching, legal language learning and legal language assessment. (shrink)

Artificial Intelligence (AI) is set to bring changes to legal systems. These technologies may have positive practical implications when it comes to access, efficiency, and accuracy in Justice. However, there are still many uncertainties and challenges associated with the implementation of AI in the legal space. In this research, we surveyed Judges on critical challenges related to the Judging Profession in the AI paradigm; Automated Adjudication; and Legal Principles. Our results suggest that (i) Judges are hesitant about (...) changes in their profession. They signal the need for adequate training that fosters legal literacy in AI, but are less open to changes in legal writing or their social and institutional role; (ii) Judges believe higher levels of automation only lead to fair outcomes if used in earlier phases of adjudication; (iii) Judges believe and are concerned about AI leading to Techno-Legal Positivism; and (iv) Judges consider that Legal AI technologies may have a positive impact in some legal principles, as long as everyone has equal access to those technologies and cybersecurity and judge on the loop safeguards are in place; and (v) Judges are strongly concerned about the de-humanization of Justice. They consider that assessing evidence, analyzing arguments, and deciding on a legal case should be inherently human. By surveying these practitioners, we aim to foster a responsible, inclusive, and transparent innovation in Justice. (shrink)

In 2017, Barth and Barber released the third edition of their textbook “Hospitality Law: Managing Legal Issues in the Hospitality Industry.” This review focuses on the scope and depth of the legal areas it covers. It examines whether the book strikes the right balance between practicality, feasibility, and conventions within the hotel industry. The authors aim to provide guidance to hospitality students and hospitality managers in developing legal literacy for their professional lives. The review finds that (...) Barth and Barber have successfully compiled a comprehensive and relevant compilation of legal issues within the hospitality industry. They support and illustrate their explanations with authentic case law and relevant examples, demonstrating the practicality of the work. While there may be some criticism regarding the depth of legal argumentation, it should be pointed out that this criticism should be viewed in light of the book's intended purpose. The primary goal was not to create an exhaustive analysis of the multi-faceted nuances in legal discourse within hospitality law. Instead, it aimed to sensitise and assist hospitality students and professional hospitality managers in the United States with their everyday decision-making processes. We suggest that the textbook could further benefit from integrating recent insights from applied (legal) linguistics and legal semiotics. It is concluded that the book remains a valuable resource for teaching hospitality law to non-legal professionals but also for researchers interested in the intersection of language and law in the hospitality industry. (shrink)

This paper examines the use of language in the legal processes established by Law 4921/2022 through a social lens, focusing on the digital transformation of the Greek Public Employment Service (DYPA) and the enactment of rigorous active labor market policies (ALMPs). By analyzing relevant documents, the study reveals a neoliberal orientation that prioritizes individual responsibility over traditional state welfare activities. While the advantages of digitalization—such as improved efficiency in job placement and streamlined administrative processes—are acknowledged, the paper also raises (...) significant concerns about the implications of digital literacy disparities, data privacy issues, and the ethical considerations surrounding the profiling of job seekers. Ultimately, the paper provides a detailed analysis of these legislative changes, situating them within the broader socio-economic context of Greece, and highlights the insufficient protection of the unemployed. It further demonstrates that active labor market policies are inextricably linked to the integration of technology, with this relationship anticipated to intensify in the future, particularly given the rapid expansion of Artificial Intelligence (AI). (shrink)

This article is about time. It is about time, or more precisely, about the absence of time in law’s digital future. It is also about time travelling and the seemingly ever-popular BBC science fiction television series Doctor Who. Further, it is about law’s timefullness; about law’s pictorial past and the ‘visual baroque’ of its chronological fused future. Ultimately, it is about a time paradox of seeing time run to a time when time runs ‘No More!’ This ‘timey-wimey’ article is in (...) three parts. The first part looks to a hazy remembered past of the legal emblem tradition as presented in Peter Goodrich’s Legal Emblems and the Art of Law to learn visual literacy and also to glimpse the essential elements of modern legality with authority, decision and violence. The second part maps how these images and icons of modern legality are manifest in the Doctor Who fiftieth year anniversary special ‘The Day of the Doctor.’ The third stage looks beyond these first order meanings to understand the chronological chaos of ‘The Day of the Doctor.’ The technicity of the image as a portal through time and space that the narrative revolves around charts the implications for the digital end of time for law. (shrink)

Resumen: Los documentos jurídicos y administrativos son difíciles de entender. ¿Hay forma de corregirlos? Una de las técnicas principales en aras de la claridad es la de hacer preguntas. La fundamentación de nuestra tesis la encontramos en las teorías más relevantes de la pragmalingüística, en algunos textos clásicos y en bibliografía reciente sobre lenguaje claro y literacidad en español. Es posible y necesario fundamentar las propuestas del lenguaje claro en función de los efectos cognitivos que producen en el receptor del (...) mensaje. Aquí, pues, dotamos de bases científicas al movimiento y contribuimos a atacar el escepticismo con el que se recibe. Abstract: Legal and administrative documents are difficult to understand; Is there a proper way to correct them? One of the main techniques for the sake of clarity is to ask questions. The basis of our thesis is found in the most relevant theories of the pragmatics, in some classic texts and in recent bibliography about plain language and literacy. It is possible to defend the use of plain language in terms of the cognitive effects. We will endow the scientific bases of plain language and, therefore, we will contribute to attack the scepticism with which it is received. (shrink)

The article discusses the legal and regulatory aspects of enlightenment activities within the context of the socio-cultural objectives of contemporary Russian educational policy. The author examines social and education-policy factors that underscore the need for extensive enlightenment efforts in the country. One of these factors is the increasing pragmatization of attitudes towards knowledge, leading to a decline in the cultural literacy of the population. Among the manifestations of this issue is the undervaluation of the importance of fostering a (...) well-rounded cultural identity, giving precedence to a “competency-based approach.” Educational standards are geared towards skill and ability development while minimizing the significance of general education subjects. The author also highlights the challenges associated with the growing impact of information technology on the intellectual development of society. These factors necessitate the development of federal legislation to support enlightenment in Russia. However, the existing legal and regulatory framework for enlightenment activities contradicts the values of Russian society and the traditions of domestic enlightenment, effectively turning government bureaucrats into the primary enlighteners. The author analyzes specific legislative clauses that establish cumbersome bureaucratic procedures, which essentially make free enlightenment impossible. Government agencies are burdened with overwhelming responsibilities to monitor enlightenment activities. The dangers of involving citizens in oversight of enlightenment efforts are emphasized, as this poses risks of reviving a culture of denunciation. Enlightenment in Russia requires state support, not artificial constraints. The author substantiates the thesis that enlightenment activities should focus on personal development, not merely on training specific competencies. (shrink)

Kohl and Nimmerfall, two legal scholars from the Faculty of Law at the University of Vienna, have put forth an edited volume dealing with ‘law and language in practice’. In this article, I present a critical evaluation of the work, taking into consideration its structure and organisation, the range and depth of the work, and the construction of and perspectivation on legal language in use and the legal language user. I do so from the interdisciplinary view of (...) legal linguistics and social semiotics, two areas of critical intellectual inquiry that are doubtlessly underrepresented in this volume. While legal linguists in Austria have anticipated the work as a hopeful bridge-builder across the domains of law and language, Kohl and Nimmerfall display a lack of awareness towards ongoing controversies in legal linguistics on the national and international level that seriously jeopardise the aim of the work. Currently the volume is being used in a course held by the authors entitled “Legal Literacy: Contract drafting, legislation and other areas of law”. Despite the work’s breadth of legal contexts touched upon and its undisputed worth for the community of practice, the work gives a sometimes disconcerting impression of authority in the field. While the authors’ openness to embracing language issues in legal contexts ought to be welcomed, the nearly complete lack of references made to the ever-growing body of research in legal linguistics, not only in Austria but around the globe, is surprising and concerning. (shrink)

This research focuses on the issue of human rights violations, particularly those affecting Muslim women in Indonesian diaspora marriages in Russia. Despite the regulations set by the Family Code of the Russian Federation, there have been reports of abuse, expulsion, withholding of documents and unilateral divorce. The purpose of this qualitative research using Smith’s phenomenological approach is to analyse the root causes of these violations and provide solutions. Data were collected through in-depth interviews, observation and documentation analysis. The results showed (...) that domestic violence was caused by a lack of self-concern and lack of cultural, legal and legal administration literacy. This lack of literation contributes to the violation of the rights of married diaspora women in Russia. Self-protection can be enhanced by increasing faith-based marriage literacy and cultural and legal literacy. Contribution: This research provides insight into the factors contributing to human rights violations in Indonesian diaspora marriages in Russia and proposes solutions to prevent such violations. The findings of this study can also serve as a basis for future research in the field of human rights and diaspora. (shrink)

Definition of the problem Digital health technologies have gained significant importance in recent years. These technologies include symptom checker apps which use algorithms or artificial intelligence to provide users with analyses and recommendations based on their symptom input. Despite their widespread recognition, research shows mixed results regarding the accuracy of these apps, thus, limiting their current utility. The interdisciplinary CHECK.APP project examined the ethical, legal, and social aspects associated with symptom checker apps. Arguments The resulting recommendations presented here are (...) directed towards various stakeholders, including users, physicians, developers, and public institutions. It is crucial to adopt a critical stance towards the use of symptom checker apps, promote health literacy and eHealth literacy, and ensure transparency regarding the data basis and user experiences. Moreover, there is a need for reliable and independent information sources that allow users and physicians to stay informed about current developments in the digitalization of healthcare. At the same time, developers are encouraged to follow clear guidelines on transparency, quality assurance, and accessibility. Additionally, policymakers are recommended to ensure the voluntary use of symptom checker apps and to create conditions that strengthen the health literacy of the population. Conclusion The recommendations presented here outline how symptom checker apps can be used responsibly to maximize potential benefits and minimize risks. (shrink)

The focus of this paper are the ethical, legal and social challenges for ensuring the responsible use of “big brain data”—the recording, collection and analysis of individuals’ brain data on a large scale with clinical and consumer-directed neurotechnological devices. First, I highlight the benefits of big data and machine learning analytics in neuroscience for basic and translational research. Then, I describe some of the technological, social and psychological barriers for securing brain data from unwarranted access. In this context, I (...) then examine ways in which safeguards at the hardware and software level, as well as increasing “data literacy” in society, may enhance the security of neurotechnological devices and protect the privacy of personal brain data. Regarding ethical and legal ramifications of big brain data, I first discuss effects on the autonomy, the sense of agency and authenticity, as well as the self that may result from the interaction between users and intelligent, particularly closed-loop, neurotechnological devices. I then discuss the impact of the “datafication” in basic and clinical neuroscience research on the just distribution of resources and access to these transformative technologies. In the legal realm, I examine possible legal consequences that arises from the increasing abilities to decode brain states and their corresponding subjective phenomenological experiences on the hitherto inaccessible privacy of these information. Finally, I discuss the implications of big brain data for national and international regulatory policies and models of good data governance. (shrink)

Patient-centered pharmacy practice involves increased pharmacist engagement in patient care. This increased involvement can sometimes require diverse decision-making when handling various situations, ranging from simple matters to major ethical dilemmas. There is literature about pharmacy ethics in developed Western countries. However, little is known about pharmacists’ practices in many developing countries. For example, there is a paucity of research conducted in the area of pharmacy ethics in Jordan. This study aimed to explore the manner in which ethical dilemmas were handled (...) by Jordanian pharmacists, the resources used and their attitudes towards them. Semi-structured, face to face interviews were carried out with 30 Jordanian registered pharmacists. The transcribed interviews were thematically analysed for emerging themes. Four major themes were identified: legal practice; familiarity with the code of ethics; personal judgement, cultural and religious values; and Experience. Findings showed that ethical decision-making in pharmacy practice in Jordan was decisively influenced by pharmacists’ personal moral values, legal requirements and managed by exercising common sense and experience. This pointed to gaps in Jordanian pharmacists’ understanding and application of basic principles of pharmacy ethics and highlighted the need for professional ethics training, incorporating pharmacy ethics courses in pharmacy undergraduate curricula, as well as professional development courses. This study highlighted that paternalism, personal values and legal obligations were major drivers influencing decision-making processes of Jordanian pharmacists. Findings also highlighted an inclination towards lack of respect for patient autonomy. This illuminated the need for increasing pharmacists’ literacy in professional ethics. (shrink)

BackgroundInformed consent is an ethical and legal requirement for research involving human participants. However, few studies have evaluated the process, particularly in Africa.Participants in a case control study designed to identify correlates of immune protection against tuberculosis (TB) in South Africa. This study was in turn nested in a large TB vaccine efficacy trial.The aim of the study was to evaluate the quality of consent in the case control study, and to identify factors that may influence the quality of (...) consent.Cross-sectional study conducted over a 4 month period.MethodsConsent was obtained from parents of trial participants. These parents were asked to complete a questionnaire that contained questions about the key elements of informed consent (voluntary participation, confidentiality, the main risks and benefits, etc.). The recall (success in selecting the correct answers) and understanding (correctness of interpretation of statements presented) were measured.ResultsThe majority of the 192 subjects interviewed obtained scores greater than 75% for both the recall and understanding sections. The median score for recall was 66%; interquartile range (IQR) = 55%–77% and for understanding 75% (IQR = 50%–87%). Most (79%) were aware of the risks and 64% knew that they participated voluntarily. Participants who had completed Grade 7 at school and higher were more likely (OR = 4.94; 95% CI = 1.57 – 15.55) to obtain scores greater than 75% for recall than those who did not. Participants who were consented by professional nurses who had worked for more than two years in research were also more likely (OR = 2.62; 95% CI = 1.35–5.07) to obtain such scores for recall than those who were not.ConclusionNotwithstanding the constraints in a developing country, in a population with low levels of literacy and education, the quality of informed consent found in this study could be considered as building blocks for establishing acceptable standards for public health research. Education level of respondents and experience of research staff taking the consent were associated with good quality informed consent. (shrink)

This comprehensive analysis dives deep into the intricate interplay between artificial intelligence (AI) and human agency, examining the remarkable capabilities and inherent limitations of large language models (LLMs) such as GPT-3 and ChatGPT. The paper traces the complex trajectory of AI's evolution, highlighting its operation based on statistical pattern recognition, devoid of self-consciousness or innate comprehension. As AI permeates multiple spheres of human life, it raises substantial ethical, legal, and societal concerns that demand immediate attention and deliberation. The metaphorical (...) illustration of humans as “shepherds” of AI, coupled with a thought-provoking examination of “agency without intelligence,” engenders deep reflections on the future of human-AI interplay and the associated philosophical, ethical, and practical ramifications. The paper further elucidates critical challenges associated with AI, such as ethical dilemmas, “agency without intelligence,” the role of human oversight, and the environmental impact of AI technologies. In the pursuit of solutions, the paper maps prospective directions, emphasizing the need for robust AI policies, improved AI literacy, sustainable AI practices, and a continued dialogue on the multifaceted issues surrounding AI. Through a holistic exploration of AI, this paper underlines the necessity for a multidisciplinary, collaborative approach to chart an ethical, beneficial, and sustainable AI future, enabling society to harness the potential of AI responsibly while mitigating the associated risks. (shrink)

Although "objectivity" is a term used widely in many areas of public discourse, from discussions concerning the media and politics to debates over political correctness and cultural literacy, the question "What is objectivity?" is often ignored, as if the answer were obvious. In this volume, Allan Megill has gathered essays from fourteen leading scholars in a variety of fields--history, anthropology, philosophy, psychology, history of science, sociology of science, feminist studies, literary studies, and accounting--to gain critical understanding of the idea (...) of objectivity as it functions in today's world. In diverse essays the authors provide fascinating studies of objectivity in such areas as anthropological research, corporate and governmental bureaucracies, legal discourse, photography, and the study and practice of the natural sciences. Taken together, Megill argues, this volume calls for developing a notion of "objectivities." The absolute sense of objectivity--that is, objectivity as a "God's eye view"--must be supplemented, and in part supplanted, by disciplinary, procedural, and dialectical senses of objectivity. This book will be of great interest to a broad range of scholars as it presents current thinking on a topic of fundamental concern across the disciplines in the humanities and social sciences. Contributors. Barry Barnes, Dagmar Barnouw, Lorraine Code, Lorraine Daston, Johannes Fabian, Kenneth J. Gergen, Mary E. Hawkesworth, Barbara Herrnstein Smith, Evelyn Fox Keller, George Levine, Allan Megill, Peter Miller, Andy Pickering, Theodore M. Porter. (shrink)

Continuing advances in human ability to manipulate matter at the atomic and molecular levels (i.e. nanoscale science and engineering) offer many previously unimagined possibilities for scientific discovery and technological development. Paralleling these advances in the various science and engineering subdisciplines is the increasing realization that a number of associated social, ethical, environmental, economic and legal dimensions also need to be explored. An important component of such exploration entails the identification and analysis of the ways in which current and prospective (...) researchers in these fields conceptualize these dimensions of their work. Within the context of a National Science Foundation funded Research Experiences for Undergraduates (REU) program in nanomaterials processing and characterization at the University of Central Florida (2002–2004), here I present for discussion (i) details of a “nanotechnology ethics” seminar series developed specifically for students participating in the program, and (ii) an analysis of students’ and participating research faculty’s perspectives concerning social and ethical issues associated with nanotechnology research. I conclude with a brief discussion of implications presented by these issues for general scientific literacy and public science education policy. (shrink)

In her article, Barbara M. Staff ord argues for the conception of literacy that would encompass visual skills besides the traditional emphasis on verbal competence. Image itself is important, not merely the information it may convey. Moreover, a more extens ive notion of education is necessitated by the process of radical perceptual and conceptual changes that have been occurring since the Enlightenment and are all-pervasive in Postmodernism. The new-found power and ubiquity of images needs to be recogn ized in (...) order to surpass the limitative, yet enduring Platonic distrust in visual culture. Medical, environmental, physical, legal, and other practices have nonetheless profoundly benefited from the technologies of visualization. Examples from the 18th century visual endeavors such as preserving fragmented cultures, exhibit ion of diversity, and the externalization of somatic experience show, how images challenge the restrictions of human compreh ension. With the advent of visual and electronically generated culture, the time is ripe to edify images from their low status. Visual cognition as the crucial element of knowledge should be reflected in a hybrid art-science, public policy, as well as pedagogy. (shrink)

In medical research, the ethical principle of respect for persons is operationalized into the process of informed consent. The consent tools should be contextualized and adapted to the different socio-cultural environment, especially when research crosses the traditional boundaries and reaches poor communities. We look at the challenges experienced in the malaria Quinact trial, conducted in the Democratic Republic of Congo, and describe some lessons learned, related to the definition of acceptable representative, the role of independent witness and the impact of (...) socio-economic vulnerability. To ensure children's protection, consent is required by the parents or, in their absence, by a legally mandated representative. In our setting, children's responsibility is often entrusted permanently or temporarily to relatives or friends without a tribunal mandate. Hence, a notion of ‘culturally acceptable representative’ under supervision of the local Ethics Committee may be more suitable. To ensure protection of illiterate subjects, an independent witness is required to confirm that the consent was freely given. However, in low-literacy contexts, potential witnesses often don't have any previous relationship with patient and there may be power-unbalance in their relationship, rather than genuine dialogue. In poor communities, trial participation may be seen as an opportunity to secure access to healthcare. Poverty may also lead to ‘competition’ to access the research-related benefits, with a risk of disturbance at societal or household level. Adjusting consent procedures to sociocultural and socioeconomic realities is essential for fulfilling the underlying ethical principles. This requires a collaborative dialogue between researchers, regulators and ethics committees. (shrink)

Advance care planning allows patients to articulate preferences for their medical treatment, lifestyle, and surrogate decision-makers in order to anticipate and mitigate their potential loss of decision-making capacity. Written advance directives are often emphasized in this regard. While these directives contain important information, there are several barriers to consider: veracity and accuracy of surrogate decision-makers in making choices consistent with the substituted judgement standard, state-to-state variability in regulations, literacy issues, lack of access to legal resources, lack of understanding (...) of medical options, and cultural disparities. Given these issues, it is vital to increase the use of patient and healthcare provider conversations as an advance care planning tool and to increase integration of such discourse into advance care planning policy as adjuncts and complements to written advance directives. This paper reviews current legislation about written advance directives and dissects how documentation of spoken interactions might be integrated and considered. We discuss specific institutional policy changes required to facilitate implementation. Finally, we explore the ethical issues surrounding the increased usage and recognition of clinician–patient conversations in advance care planning. (shrink)

BackgroundObtaining consent has become a standard way of respecting the patient’s rights and autonomy in clinical research. Ethical guidelines recommend that the child’s parent/s or authorised legal guardian provides informed consent for their child’s participation. However, obtaining informed consent in paediatric research is challenging. Parents become vulnerable because of stress related to their child’s illness. Understanding the views held by guardians and researchers about the consent process in Malawi, where there are limitations in health care access and research (...) class='Hi'>literacy will assist in developing appropriate consent guidelines.MethodsWe conducted 20 in-depth interviews with guardians of children and research staff who had participated in paediatric clinical trial and observational studies in acute and non-acute settings in the Southern Region of Malawi. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. Interviews were compared across studies and settings to identify differences and similarities in participants’ views about informed consent processes. Data analysis was facilitated by NVIVO 11 software.ResultsAll participants across study types and settings reported that they associated participating in research with therapeutic benefits. Substantial differences were noted in the decision-making process across study settings. Guardians from acute studies felt that the role of their spouses was neglected during consenting, while staff reported that they had problems obtaining consent from guardians when their partners were not present. Across all study types and settings, research staff reported that they emphasised the benefits more than the risks of the study to participants, due to pressure to recruit. Participants from non-acute settings were more likely to recall information shared during the consent process than participants in the acute setting.ConclusionThe health care context, culture and research process influenced participants’ understanding of study information across study types and settings. We advise research managers or principal investigators to define minimum requirements that would not compromise the consent process and conduct study specific training for staff. The use of one size fits all consent process may not be ideal. More guidance is needed on how these differences can be incorporated during the consent process to improve understanding and delivery of consent.Trial registration Not applicable. (shrink)

Discrimination and inequalities in healthcare can be experienced by many patients due to many characteristics ranging from the obviously visible to the more subtly noticeable, such as race and ethnicity, legal status, social class, linguistic fluency, health literacy, age, gender and weight. Discrimination can take a number of forms including overt racist statement, stereotyping or explicit and implicit attitudes and biases. This paper presents the case study of a complex transcultural clinical encounter between the mother of a young (...) infant in a highly vulnerable social situation and a hospital healthcare team. In this clinical setting, both parties experienced difficulties, generating explicit and implicit negative attitudes that heightened into reciprocal mistrust, conflict and distress. The different factors influencing their conscious and unconscious biases will be analysed and discussed to offer understanding of the complicated nature of human interactions when faced with vulnerability in clinical practice. This case vignette also illustrates how, even in institutions with long-standing experience and many internal resources to address diversity and vulnerability, cultural competence remains a constant challenge. (shrink)

Utilising empirical ethics analysis, we evaluate the merits of systems proposed to increase deceased organ donation in South Africa. We conclude that SA should maintain its soft opt-in policy, and enhance it with ‘required transplant referral’ in order to maximise donor numbers within an ethically and legally acceptable framework. In SA, as is the case worldwide, the demand for donor organs far exceeds the supply thereof. Currently utilising a soft opt-in system, SA faces the challenge of how to increase donor (...) numbers in a context which is imbued with inequalities in access to healthcare, multiplicitous personal beliefs and practices, distrust of organ transplant and varying levels of education and health literacy. We argue that a hard opt-in, opt-out or mandated consent system would be problematic, and we present empirical data from Gauteng Province illustrating barriers to ethically sound practice in soft consent systems. Ultimately, we argue that in spite of some limitations, a soft opt-in system is most realistic for SA because its implementation does not require extensive public education campaigns at national level, and it does not threaten to further erode trust at a clinical level. However, to circumvent some of the clinical-level barriers identified in our empirical study, we propose a contextually sensitive option for “enabling” soft opt-in through “required transplant referral”. We argue that this system is legally defensible, enhances ethical practice and could also increase donor numbers as it has in many other countries. (shrink)

Background: Informed consent (IC) is an ethical and legal obligation protected by constitutional rights to bodily integrity, well-being, and privacy in South Africa. The National Health Act 2003 codified IC regulations, requiring that all healthcare professionals inform patients about diagnosis, risks, benefits, options, and refusal rights while factoring in patients’ language and literacy levels. Objectives: This study’s primary aim was to determine the extent of South African professional/staff nurses’ compliance with current IC regulations and ascertain socio-cultural impediments impacting (...) proper IC practice. Methods: A cross-sectional survey using semi-structured questionnaires was used to evaluate knowledge and practice of IC among nurses in KwaZulu-Natal province. Data were analyzed using SPSS, v.21. Descriptive statistics, chi-squared tests, and content analysis were used to compare nursing domains. Results: Three hundred fifty-five (355) nurses, 92% females, with 1 to 41 years of professional experience, completed this study. Information disclosed by nurses to patients included diagnosis (77%), treatment benefits (71%), risks (69%), recommendations (65%), risks of refusal (80%), and right of refusal (67%). Nurses (80%) felt information disclosure was adequate, while 85% reported that patients understood disclosed information. Conclusions: Nurses practicing in local public hospitals had moderate knowledge of IC regulations. Practical implementation appeared deficient. Barriers to IC included language, workload, time constraints, lack of interpreters, and skewed gender norms in the nursing profession. Nurses require continuing professional education in healthcare law and ethics, a “corps of trained interpreters”, and gender transformation in the nursing profession to improve IC practice and overall quality of healthcare service delivery in South Africa. (shrink)

Background: Artificial intelligence (AI) is the simulation of human intelligence processes by machines, such as learning, reasoning, and problem-solving. AI has the potential to transform the field of public health, which is concerned with promoting and protecting the health of populations and preventing diseases. AI can help public health organizations perform their essential functions more efficiently, effectively, and equitably; AI can transform the public health field, but it also poses some challenges and risks that must be addressed carefully and responsibly. (...) Objectives: This paper reviews the current and potential applications of AI in public health, discusses the opportunities and challenges of AI for public health, and provides recommendations for the ethical and responsible use of AI in public health. Results: AI can improve the speed and accuracy of diagnosis, screening, and treatment of various diseases and support disease surveillance, outbreak response, and health systems management. However, AI poses significant challenges and risks, such as ethical, legal, and social implications, data quality and security, algorithmic bias and fairness, and environmental impact. Conclusion: AI has the potential to revolutionize public health, but it comes with risks that must be addressed. Promoting digital literacy, establishing modern data governance frameworks, and investing in advanced data infrastructure and procedures are essential. Public health organizations must also train their workforce to collaborate with AI. By doing so, they can improve health outcomes, reduce health disparities, and advance public health science and practice. (shrink)

Allowing persons to make an informed choice about their participation in research is a pre-eminent ethical and legal requirement. Almost universally, this requirement has been addressed through the provision of written patient information sheets and consent forms. Researchers and others have raised concerns about the extent to which such forms—particularly given their frequent lengthiness and complexity—provide participants with the tools and knowledge necessary for autonomous decision-making. Concerns are especially pronounced for certain participant groups, such as persons with low (...) class='Hi'>literacy and Indigenous persons. Multimedia strategies have the potential to usefully supplement current consent practices in Australia; however, information is needed about the need for supplementary consent practices, along with drivers for and barriers against adoption. This study initiates the required evidence base through an audit of informed consent practices for medical research in the Australian state of Tasmania to assess the need for, and current uptake of, supplementary consent strategies. Drivers for and barriers against adoption of multimedia consent practices were explored in detail through interviews with key stakeholders, including researchers, HREC chairs and members, and research participants, including Indigenous participants. (shrink)

If a transformation in medicine occurs in the wake of the Human Genome Project, its likely focus will be prevention, a logical extension of the lessons of variation and individuality inherent in molecular genetics. The transformation of medicine will require a transformation in genetics education as well, focusing on the development of genetic literacy that allows patient and provider to collaborate as partners in health promotion and disease prevention. The components of genetic literacy include new views of genetics (...) and of disease, and attention to the nature of science, the principles of technology, and ethical, legal, and social implications of genetic medicine. (shrink)

This paper considers Canada’s young offenders in the context from which they enter the youth criminal courtroom. To determine how youth criminal justice courts violate the Canadian Youth Criminal Justice Act, this analysis relates said context to several phenomena, including legal linguistics, oral language competency, literacy, communicative competency, non-verbal communication, the physical structure of youth courtrooms, and legal translation. As a result of the standards of procedural communication upheld by the Canadian criminal justice system, young people’s rights, (...) including the right to be respected regardless of cultural, ethnic, or linguistic differences, the right to be heard and to participate in proceedings, the right to be sentenced meaningfully, the right to privacy, and the right to be tried in a timely manner are abused in the youth criminal courtroom. Although insufficient structures of procedural communication cause these issues and are beyond the control of counsel, defense counsel are often blamed for their effects. Legal professionals must make important adjustments such as altering the formal speech required in youth criminal courtrooms, employing legal professionals with the role of translating legal jargon to young people in the courtroom, and closing youth courtrooms off from the public to reduce the YCJA violations occurring in youth criminal justice court. These adjustments are ultimately the responsibility of the Canadian criminal justice system. (shrink)

In the tradition of the Cracow Academy, Mikołaj Sienicki tried to establish a practical link between critical humanism and religious Reform by leading his compatriots from orality to literacy, from the culture of the spoken language to the culture of the written language. In his speeches he combined new conceptual maps with pragmatic objectives and demonstrated how these were referred to in the existing texts, both legal and religious. As a speaker he was able to satisfy the emotional (...) needs of his multicultural, partly pagan audiences by a skilful use of the spoken discourse and, at the same time to inspire them with a critical and rational approach to new European realities; to reconcile Sarmatism with the rule of law. (shrink)

Definition of the problem Digital health technologies have gained significant importance in recent years. These technologies include symptom checker apps which use algorithms or artificial intelligence to provide users with analyses and recommendations based on their symptom input. Despite their widespread recognition, research shows mixed results regarding the accuracy of these apps, thus, limiting their current utility. The interdisciplinary CHECK.APP project examined the ethical, legal, and social aspects associated with symptom checker apps. Arguments The resulting recommendations presented here are (...) directed towards various stakeholders, including users, physicians, developers, and public institutions. It is crucial to adopt a critical stance towards the use of symptom checker apps, promote health literacy and eHealth literacy, and ensure transparency regarding the data basis and user experiences. Moreover, there is a need for reliable and independent information sources that allow users and physicians to stay informed about current developments in the digitalization of healthcare. At the same time, developers are encouraged to follow clear guidelines on transparency, quality assurance, and accessibility. Additionally, policymakers are recommended to ensure the voluntary use of symptom checker apps and to create conditions that strengthen the health literacy of the population. Conclusion The recommendations presented here outline how symptom checker apps can be used responsibly to maximize potential benefits and minimize risks. (shrink)

The notion that a false positive (false conviction) is worse than a false negative (false acquittal) is a deep-seated commitment in the theory of criminal law. Its most illustrious formulation, the so-called Blackstone’s ratio, affirms that “it is better that ten guilty persons escape than that one innocent suffer”. Are people’s evaluations of criminal statutes consitent with this tenet of the Western legal tradition? To answer this question, we conducted three experiments (total _N_ = 2492) investigating how people reason (...) about a particular class of offenses—proxy crimes—known to vary in their specificity and sensitivity in predicting actual crime. By manipulating the extent to which proxy crimes convict the innocent and acquit those guilty of a target offense, we uncovered evidence that attitudes toward proxy criminalization depend primarily on its propensity toward false positives, with false negatives exerting a substantially weaker effect. This tendency arose across multiple experimental conditions—whether we matched the rates of false positives and false negatives or their frequencies, whether information was presented visually or numerically, and whether decisions were made under time pressure or after a forced delay—and was unrelated to participants’ probability literacy or their professed views on the purpose of criminal punishment. Despite the observed inattentiveness to false negatives, when asked to justify their decisions, participants retrospectively supported their judgments by highlighting the proxy crime’s efficacy (or inefficacy) in combating crime. These results reveal a striking inconsistency: people favor criminal policies that protect the rights of the innocent, but report comparable concern for their expediency in fighting crime. (shrink)

Philanthropy is a contentious and often polarising topic within egalitarian social movements. There are good reasons for this. Philanthropy is reliant on the inequalities inherent in the capitalist system, is fundamentally at odds with democratic relationships, and can moderate or control the activities of recipients. This article therefore starts from the premise that philanthropy violates egalitarian ideals in very significant ways. However, it goes on to suggest that, absent a ruptural change that would drastically weaken the bases of philanthropic wealth, (...) there is a strategic and contingent case for its selective use so long as it pushes existing configurations of power in more egalitarian directions. In making this case, the article draws primarily on the work of Wright ( 2010 ) but also on recent developments in the political theory of philanthropy. It calls for a critical literacy around philanthropy that combines an openness to experimentation with a clear-eyed sense of its significant risks. In this respect, it outlines specific conditions and strategies that movements should adopt if they pursue or accept philanthropic funding. Firstly, movements must deliberately articulate and actively defend their transformative vision, clarifying in the process the tactical place of philanthropy within this. Secondly, they must resist funder conditionalities, and preserve egalitarian modes of organising in the face of practices which undermine participatory ideals and threaten relations of care and solidarity. The article’s chief contribution is to integrate normative insights with lessons from the sociological literature on movement-philanthropy relations, for the sake of systematically untangling a live and troublesome issue within the praxis of radical movements. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Eighteenth-Century Hermeneutics: Philosophy of Interpretation in England from Locke to BurkePaul J. KorshinEighteenth-Century Hermeneutics: Philosophy of Interpretation in England from Locke to Burke, by Joel Weinsheimer; xiii & 275 pp. New Haven: Yale University Press, 1993, $30.00.Hermeneutics has until the present study had little application to eighteenth-century England. The omission is curious for, although there were few advances in biblical scholarship during the Restoration and eighteenth century, modern (...) literary criticism begins in this century with Dryden and Johnson, modern aesthetics with Shaftesbury and the Scottish school of taste, and modern theories of art with Reynolds and writers on the picturesque. Joel Weinsheimer’s treatment of this topic, then, instantly possesses originality, not only from a lack of serious competition but because of its approach to [End Page 365] hermeneutics. He “does not offer a historical narrative” of what happened in hermeneutics in eighteenth-century England (p. xi). Rather, Weinsheimer prefers to see hermeneutics as a series of snapshots of how various writers, of whom only a few are conventional exegetes, deal with matters of interpreting texts. In all, the book treats eight major figures (Swift, Locke, Toland, Bolingbroke, Hume, Reid, Blackstone, and Burke), devoting a chapter to each.The method in each one is approximately the same: Weinsheimer produces a reading not of a single work alone but of all, or almost all that an author writes about interpretation. In the case of Swift, for instance, his principal contribution on exegesis, A Tale of a Tub, is a satire on styles of exegesis Swift considered ridiculous. This chapter adds little to what we know of Swift but, in relation to Weinsheimer’s analysis of Sir William Blackstone, we can see that there is a legal background to parts of the debate among the three brothers on the meaning of Scripture. Locke (pp. 23–45) also dealt with the Bible extensively, but his tendency to prefer the doctrine of “sola scriptura” limits what an author can say about his hermeneutics. John Toland (pp. 46–71), in his Christianity Not Mysterious, proposes radical notions of biblical exegesis, and Weinsheimer gives us a lucid reading of the first English skeptical exegete. All the other figures he studies, however, had little interest in traditional literary exegesis. Weinsheimer sees Bolingbroke (pp. 72–102) as a philosopher of history who tried to generate a theory of decoding the past, but he does not clearly distinguish Bolingbroke’s rules for writing history. Hume (pp. 103–34) wrote extensively on exegetical topics without actually being an exegete; although this is one of Weinsheimer’s more opaque chapters, it does succeed in showing the diversity of Hume and his inability to reason conclusively on matters of interpretation. Hume basically did not think that there is any problem in understanding others, so his theories of exegesis are not coherent. So, too, Thomas Reid (pp. 135–65) considered language, properly used, as lacking in opacity; hence elaborate theories of interpretation have little use for him.However, with Blackstone and Edmund Burke, Weinsheimer contributes his two most interesting chapters. The law, as Blackstone conceived of it, is extremely difficult to understand, so his Commentaries on the Laws of England is an attempt to read legal texts “in the context of general literacy” (p. 168); Bentham would later imitate him. Burke, Weinsheimer argues, started as an aesthetician and ended applying principles of good and bad taste to political behavior, always one of the weaknesses of reactionary politics.In a brief epilogue (pp. 226–33), Weinsheimer speculates on the effort of eighteenth-century hermeneutics to understand historical reason, but he does not comment on the failure of the period to produce a single important hermeneuticist. His own choice to avoid major exegetes such as Samuel Johnson and Joshua Reynolds abridges his results dramatically, but a study based on scholarly snapshots always courts this risk. Hermeneutics is a [End Page 366] recondite concept, yet Weinsheimer renders his topic more difficult than it need be by frequent shifts in its definition and a complex, often unclear, style. Eighteenth-Century Hermeneutics provides a start, if not a definitive treatment, for later students of exegesis in the English Enlightenment.Paul... (shrink)

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the (...) least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. (shrink)

The traditional blackface character Black Pete has been at the center of an intense controversy in the Netherlands, with most black citizens denouncing the tradition as racist and most white citizens endorsing it as harmless fun. I analyze the controversy as an utter failure, on the part of white citizens, of what Alison Jaggar has called multicultural literacy. This article aims to identify both the causes of this failure of multicultural literacy and the conditions required for multicultural (...) class='Hi'>literacy to be possible. I argue that this failure of multicultural literacy is due to hermeneutical injustice and to white ignorance. I close by considering possible avenues for fostering multicultural literacy. (shrink)

This paper opens with a presentation of the philosophical underpinning and rationale of the concept of physical literacy. This is followed by an articulation of the concept of physical literacy. Three subsequent sections then consider aspects of the concept in a little more detail. The first investigates the relationship of the physical literacy to the development of a sense of self and to establishing interaction with others. Here the philosophical approach is informed by writings on cognitive development (...) and recent neurological insights. The second considers the universality of the concept and looks briefly at the views of existentialists and of contemporary sociologists. The third section addresses the place of propositional knowledge in being physically literate. The implications of objectifying the body in descriptive language are weighed against the fact that verbally expressed understanding and knowledge are an integral part of Western culture. The debate presented is one of a series that has, over the last five years, mapped the author's work on developing the concept of physical literacy. The aspects chosen to be discussed here are three that have generated considerable interest and debate. In conclusion, there is a short reflection on the implications of the views discussed for education and physical education. (shrink)

Environmental literacy is not encouraged by discipline-based education. Discipline-based education is damaging not only because it breaks the link between experience and theory but also because it encourages learners to believe that complex practical problems can be solved using the resources of just one or two specialist disciplines or frameworks of thought. It is argued that discipline-based education has been extremely successful, and its very success is a factor which explains some of our poor thinking about environmental problems. These (...) problems are highly complex, and it is important for learners to discover the limitations of particular frameworks of thought and disciplinary approaches. This is particularly important in the case of economics. An education which emphasises the limitations of specialist approaches to complex problems can also be used to help overcome the depersonalising effect of bureaucracies. (shrink)

Emerging evidence has shown a positive association between the home literacy environment and monolingual children’s language and literacy development. Yet, far fewer studies have examined the impact of the HLE on second language development. This study examined relations between the HLE and children’s development of English as a second language in Hong Kong. Participants were 149 ethnic Chinese children and one of their caregivers. Caregivers completed questionnaires about their family backgrounds and HLE and children were assessed on their (...) English language and literacy skills. Findings revealed considerable variability in the types of literacy activities that caregivers were engaged in at home with their children. A series of multilevel regressions demonstrated that the HLE was differentially associated with English vocabulary, letter knowledge, phonological awareness, and word reading skills after controlling for child and family characteristics. Results highlight the importance of a literacy-rich home environment for children’s development of English as a second language and the need to support caregivers in providing a range of home literacy activities to facilitate different language and literacy skills. (shrink)

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the (...) least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. (shrink)