Background International electives are often considered a valuable learning opportunity for medical students. Yet, as travelling to lower and middle income countries (LMICs) becomes more common, ethical considerations of such practices emerge. We conducted a scoping review to assess the extent to which five ethical themes were addressed in existing literature about electives, with the aim of investigating the ethical impacts of medical student electives on local resources, patients and clinicians in LMICs. Methods We systematically searched PubMed, Global (...) Health and Embase databases using the search terms “(ethics) AND (medical electives)”. Thematic content analysis was undertaken using a combination of deductive and inductive themes. The deductive themes included: exceeding clinical competence, use of limited local resources, respect for patients and local culture, collaboration with local community/colleagues, and one-sided benefits in partnership. In addition, we also allowed for emerging themes within the data, and conducted a narrative synthesis of the results. Results A total of 37 papers discussed ethical issues relating to medical student international electives to LMICs. More publications were written from the medical student perspective (n = 14), than by the host-institution (n = 5), with nearly half written from third-party perspectives (n = 18). Negative impacts on local host students and impact upon patient care were identified as additional ethical considerations. Conclusions Our review demonstrated that while there is a degree of awareness in the existing literature of the potential negative impacts of medical electives to local LMIC students’ access to medical education and patient care, continued work is needed to ensure equitable partnerships. We recommend that these ethical themes should be further explored in pre-departure elective teaching courses and post-elective debriefs to increase medical students’ awareness of the impact of their presence on host communities. (shrink)

ObjectsHealth Behaviours in School-aged Children is an international survey programme aiming to investigate adolescents’ health behaviours, subjective perception of health status, wellbeing, and the related contextual information. Our scoping review aimed to synthesise the evidence from HBSC about the relationship between family environmental contributors and adolescents’ health-related outcomes.MethodsWe searched previous studies from six electronic databases. Two researchers identified the qualified publications independently by abstract and full-text screening with the assistance of an NLP-based AI instrument, ASReview. Publications were included (...) if they were based on HBSC data and investigated the effects of family environment on adolescents’ health outcomes. Researches addressed family-related factors as mediators or moderators were also included.ResultsA total of 241 articles were included. Family environmental contributors could be mapped into six categories: Demographic backgrounds ; General family’s psycho-socio functions ; Parenting behaviours ; Parental health behaviours ; Family activities ; and Siblings. Except for 75 papers that assessed family variables as moderators and mediators, the others suggested family environment was an independent variable. Only five studies employed the data-driven approach.ConclusionOur results suggest most research studies focussed on the influences of family demographic backgrounds on adolescents’ health. The researches related to parental health behaviours and siblings are most inadequate. Besides, we recommend further research studies to focus on the mediator/moderator roles of the family, for exploring the deep mechanism of the family’s impacts. Also, it would be valuable to consider data-driven analysis more in the future, as HBSC has mass variables and data. (shrink)

While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) (...) the predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis. A total of 34 studies met inclusion criteria. Support for strike action was largely context‐dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction. (shrink)

As the size of the published scientific literature has increased exponentially over the past 30 years, review articles play an increasingly important role in helping researchers to make sense of original research results. Literature reviews can be broadly classified as either “systematic” or “narrative”. Narrative reviews may be broader in scope than systematic reviews, but have been criticised for lacking synthesis and rigour. The submission of more scientific manuscripts requires more researchers acting as peer reviewers, which requires (...) adding greater numbers of new reviewers to the reviewing population over time. However, whereas there are many easily accessible guides for reviewers of primary research manuscripts, there are few similar resources to assist reviewers of narrative reviews. Here, I summarise why literature reviews are valued by their diverse readership and how peer reviewers with different levels of content expertise can improve the reliability and accessibility of narrative review articles. I then provide a number of recommendations for peer reviewers of narrative literature reviews, to improve the integrity of the scientific literature, while also ensuring that narrative review articles meet the needs of both expert and non-expert readers. (shrink)

Background Second victim is the name given to the healthcare personnel—most often a nursing professional—involved with the error that led to the adverse event to a patient and who, as a result, have experienced negative psychological effects. Research with second victims has increased over the years, however concerns exist with regards to the ethical risks imposed upon these individuals. Aim To explore the extent to which research with second victims of adverse events in healthcare settings adhere to ethical requirements. Methods (...) A scoping review was conducted following Arksey and O’Malley’s methodological framework and using the following databases: PUBMED, Web of Science, and SCOPUS. Original research of any study design focused on second victims and published in English, Spanish, or Portuguese in 2014–2023 were included. A critical narrative approach was used to discuss the findings. Ethical considerations The review followed ethical guidelines emphasizing accurate authorship attribution and truthful data reporting. Results Fifteen studies using qualitative ( n = 2), quantitative ( n = 10), and mixed-method ( n = 3) designs were included. Over half were not assessed by a research ethics committee, with questionable reasons given by the authors. One-third did not refer to having used an informed consent. In two studies, participants were recruited by their workplace superiors, which could potentially right to autonomy and voluntary participation. Conclusion Over half of the included studies with second victims did not comply with fundamental ethical aspects, with risk to inflict respect for individual autonomy, confidentiality, and of not causing any harm to participants. Implications for nursing research Healthcare personnel involved in adverse events are most often nursing professionals; therefore, any breach of ethics in research with this population is likely to directly affect their rights as research participants. We provide recommendations to promote better research practices with second victims towards safeguarding their rights as research participants. (shrink)

BackgroundThe significant increase of digital collaboration, driven by the current COVID-19 pandemic, is resulting in changes in working conditions and associated changes in the stress-strain perception of employees. Due to the evident leadership influence on employees' health and well-being in traditional work settings, there is a need to investigate leadership in virtual remote work contexts as well. The objective of this scoping review was to assess the extent and type of evidence concerning virtual leadership in relation to employees' (...) mental health, job satisfaction and perceptions of isolation.MethodA search was undertaken in five databases, PubMed, Cochrane Library, PsycINFO, PSYNDEX and Web of Science, as well as reference lists of included articles on 9th February 2021 and an update on 28th September 2021. The search strategy was limited to English, German and French language, peer reviewed journal articles published from January 2000 onwards. This scoping review was conducted in accordance with the JBI methodology for scoping reviews. The methodological quality of the included studies was assessed using the JBI critical appraisal tools. A narrative synthesis was conducted.ResultsNineteen studies met the eligibility criteria for this review. Overarching review findings suggested a positive link between virtual leadership and well-being, job satisfaction, and a negative link to psychological strain, stress and perceptions of isolation of digitally collaborating employees.ConclusionsBy mapping the available evidence on virtual leadership in relation to health and work-related employee outcomes, the review identified many research gaps in terms of content and methodology. Due to limited data, causal relationships were not derived. Future research is needed to examine the complex cause-and-effect relationships of virtual leadership in more detail. (shrink)

Organizational climate and culture may influence different work-related outcomes, including responsible conduct of research and research misconduct in academic or research organizations. In this scoping review we collected evidence on outcomes of interventions to change organizational climate or culture in academic or research settings. Out of 32,093 documents retrieved by the search, we analysed 207 documents in full text, out of which 7 met the eligibility criteria and were included in the final analysis. The included studies measured organizational (...) climate, organizational culture, or both at biomedical faculties or non-academic university departments. Four studies had post-test, and three before-and-after study designs. The majority of interventions were face-to-face activities, and two were based on organizational change. Six studies reported positive changes in organizational climate/culture after the intervention. These positive changes were measured as improvements in score on different questionnaire survey or were described through authors’ or external evaluator’s narrative reports. However, the methodological quality of the studies was low, both for qualitative and quantitative study designs. Replicable studies, using rigorous methods and clearly defined outcomes are urgently needed if organizations want to achieve a real change in organizational climate or culture for responsible research. The protocol for this scoping review was registered at https://osf.io/7zjqb. (shrink)

This narrative scoping review examines ethical practice in educational and school psychology from a bioecological systems’ perspective. A search of four databases yielded 34 articles in the final narrative synthesis. Informed by Bronfenbrenner and Morris’ bioecological systems theory, the ethical experiences of educational and school psychologists were analyzed using the concepts of Process, Person, Context and Time. The complexity, intensity and frequency of ethical dilemmas are reviewed in Process. The demand, resource, and force characteristics impacting on (...) psychologists as Person are reviewed. Within Context, studies identified dilemmas that arose for psychologists across systems. In Time, issues including implications of the Fourth Industrial Revolution on psychologists’ ethical practice with the emergence of Artificial Intelligence are examined. This paper demonstrates the synergies and the interrelated influences on psychologists’ ethical practices arising from a systematic review of their experiences and their professional training needs. (shrink)

Background The significance of medical implants goes beyond technical functioning and reaches into everyday life, with consequences for individuals as well as society. Ethical aspects associated with the everyday use of implants are relevant for individuals’ lifeworlds and need to be considered in implant care and in the course of technical developments. Methods This scoping review aimed to provide a synthesis of the existing evidence regarding ethically relevant psychosocial and cultural aspects in cochlear, glaucoma and cardiovascular implants in (...) patient-centered empirical research. Systematic literature searches were conducted in EBSCOhost, Philpapers, PsycNET, Pubmed, Web of Science and BELIT databases. Eligible studies were articles in German or English language published since 2000 dealing with ethically relevant aspects of cochlear, glaucoma and passive cardiovascular implants based on empirical findings from the perspective of (prospective) implant-wearers and their significant others. Following a descriptive-analytical approach, a data extraction form was developed and relevant data were extracted accordingly. We combined a basic numerical analysis of study characteristics with a thematically organized narrative synthesis of the data. Results Sixty-nine studies were included in the present analysis. Fifty were in the field of cochlear implants, sixteen in the field of passive cardiovascular implants and three in the field of glaucoma implants. Implant-related aspects were mainly found in connection with autonomy, freedom, identity, participation and justice, whereas little to no data was found with regards to ethical principles of privacy, safety or sustainability. Conclusions Empirical research on ethical aspects of implant use in everyday life is highly relevant, but marked by ambiguity and unclarity in the operationalization of ethical terms and contextualization. A transparent orientation framework for the exploration and acknowledgment of ethical aspects in “lived experiences” may contribute to the improvement of individual care, healthcare programs and research quality in this area. Ethics-sensitive care requires creating awareness for cultural and identity-related issues, promoting health literacy to strengthen patient autonomy as well as adjusting healthcare programs accordingly. More consideration needs to be given to sustainability issues in implant development and care according to an approach of ethics-by-design. (shrink)

Background: Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care. Ethical considerations: No formal ethical approval was required. Aim: To synthesize the literature and identify gaps about approaches to the provision of ethical and culturally competent care to transgender populations. Design: A Scoping Review Literature Search: Literature was searched within CINAHL, Science Direct, PubMed, Google Scholar, EMBASE, and Scopus (...) databases using indexed keywords such as “transgender,” “gender non-conforming,” “ethically sensitive care,” and “culturally sensitive care.” In total, 30 articles, which included transgender patients and their families and nurses, doctors, and health professionals who provided care to transgender patients, were selected for review. Data were extracted and synthesized using tabular and narrative summaries and thematic synthesis. Findings: Of 30 articles, 23 were discussion papers, 5 research articles, and 1 each case study and an integrative review. This indicates an apparent dearth of literature about ethical and culturally sensitive care of transgender individuals. The review identified that healthcare professionals should educate themselves about sensitive issues, become more self-aware, put transgender individual in charge during care interactions, and adhere to the principles of advocacy, confidentiality, autonomy, respect, and disclosure. Conclusions: The review identified broad approaches for the provision of ethical and culturally competent care. The identified approaches could be used as the baseline, and further research is warranted to develop and assess organizational and individual-level approaches. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:(P)rescription Narratives: Feminist Medical Fiction and the Failure of American Censorship. by Stephanie Peebles TaveraEtta M. MaddenStephanie Peebles Tavera. (P)rescription Narratives: Feminist Medical Fiction and the Failure of American Censorship. Edinburgh: Edinburgh University Press, 2022. Hardback, xii + 220 pp. ISBN 978-1-4744-9319-2.Utopian Studies readers first saw Stephanie Peebles Tavera’s work in print in her 2018 essay on reproductive health in Charlotte Perkins Gilman’s Herland. More recently, in (P)rescription (...) Narratives, she gives readers a view of the much broader historical scope of her scholarship in literary and cultural studies. Tavera’s analysis of what she labels “feminist medical fiction” considers not only novels and short stories but also literary reviews, dramas, and documentary films, many of which will be unfamiliar to readers of utopian and dystopian literature. Yet the book contextualizes the ways in which these works capture the “utopian possibilities” of women writers who pushed for breaking the boundaries of the dystopian strictures of embodied life. The literary works “rescript” what had been prescribed by others as “normalized behavior,” from the latter-nineteenth century through the Progressive Era (5, 37). As Tavera illustrates through her detailed analysis, these women’s narratives provide “interventions that... interrupt the dissemination of false [End Page 612] narratives of the female body” and “alter the course of cultural development toward greater inclusivity” (5).To establish the temporal boundaries for the project, Tavera emphasizes the Comstock Law, established in 1873, and the death of its author Anthony Comstock in 1915. While Comstock’s work often has been understood as restricting pornography, she explains the Comstock Law as more than merely that. Comstock sought to control what he and others saw as sexual deviation, which included birth control in any form. Tavera also bookends the project with lawsuits associated with Victoria Woodhull and Margaret Sanger, both women who advocated for abortion and birth control as means of allowing women to avoid the strictures over their bodies. Additionally, she explains, Comstock’s racism caused him to completely overlook Black women, ironically allowing a space in which Black women’s feminist medical fiction especially rescripts “normalized behavior” (37)—a topic she pursues in two parts of the book.The book follows a roughly chronological path as it examines four topics related to women’s health, brilliantly organized into “(p)rescriptions,” indicated by Rx, rather than chapters with numbers. Rx1, “Crip Medicine,” illustrates how authors such as Charlotte Perkins Gilman pointed to the socially constructed status of “hysteria” in a patriarchal culture that saw women as deviant by nature. Instead, these authors advocated for a more holistic examination of women’s health, impacted by the environments in which they lived. Drawing from Lyman Tower Sargent’s widely accepted view of utopianism as dreaming of a place “considerably better than the society in which the author lived,” she underscores “the utopian impulse underlies much of the work of feminist medical fiction” (39). In particular, writers of feminist medical fiction were “driven by failure.”Perhaps most familiar to illustrate this point is Gilman’s work, such as “The Yellow Wallpaper,” which illustrated how the culture failed certain characters. The narrator of that story suffers postpartum depression and is made worse by Dr. S. Weir Mitchell’s rest cure. Consequently, Gilman proceeded to write other works, such as Moving the Mountain (1911) and then Herland (1915), which push readers to envision “alternative societies” without such destructive patriarchal medical practices (39). But Tavera also explains how Louisa May Alcott’s Eight Cousins, or the Aunt-Hill (1875) critiques contemporary culture by providing a “domestic utopia” in the female domain of Aunt-Hill, wherein the male Dr. Alec Campbell demonstrates “a better way... of caring for the female body” (55). And another key example is Rebecca Harding [End Page 613] Davis’s Kitty’s Choice: A Story of Berrytown (1875). Berrytown is described as “the Utopia in actual laths, orchards, and bushel-measures of the advance guard of the reform party in the United States” (qtd. in Tavera 55). Through its two physicians, Dr. Muller and Dr. McCall, who represent homeopathic and allopathic practitioners, readers see that the society... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Narrative Ontology by Axel HutterFrank SchalowHUTTER, Axel. Narrative Ontology. Translated by Aaron Shoichet. Cambridge: Polity Press, 2022. xiii + 296 pp. Cloth $69.95; paper, $26.95Where postmodernism has dominated the language of contemporary philosophy, there is a need to develop an alternative discourse to address perennial philosophical issues. In Narrative Ontology, Axel Hutter proceeds along this path by introducing narration or a form of storytelling to (...) reinscribe "the three ideas that have belonged since time immemorial to the heart of philosophical reflection: freedom, God and immortality." Hutter's defense of his thesis is twofold. First, he distinguishes narration as a temporal enactment embodied in telling a story, the scope of which is sufficiently universal as to found a new understanding of history, its alpha and omega. Second, he appeals to the biblical account of the tribulations of Jacob and Joseph as retold in the narrative style of Thomas Mann's novel Joseph and His Brothers. "The first reason a philosophical enquiry seeks to connect with Thomas Mann is that he himself accommodates a reciprocal illumination of philosophy and literature by situating his own way of thinking and working in explicit proximity to philosophy." "The second reason this philosophical enquiry seeks to connect with Thomas Mann is that he accommodates a narrative ontology of meaning, by contemplating, in his way, the same fundamental question."Along with an introduction, Hutter divides his book into three parts. In Part One ("The Stories of Jacob"), Hutter undertakes a precise explication of Mann's novel, in order to illustrate how ontology can be reconstituted as a narrative event that redefines "being" as a foundational act of history. "Jacob's sentences give expression to the hope that God can preserved the possibility of the future even if it seems to be destroyed in the fire of death." Form (that is, the narrative style) and content (that is, the interwoven meanings of the biblical text of Jacob as told and retold) are united. "This characterizes how Thomas Mann reads the original text.... The manner of his reading is articulated, in fact, in the Joseph novel itself.... Thus, a complex intertwining of narrative levels of meanings emerges: the inner meaning of the original story consists in a narrative ontology in which being is understood—in a sense that is still in need of elucidation—narratively and historically: as (hi)story. For an adequate understanding, this original story is re-narrated by Thomas Mann himself with the explicit intention of raising the original meaning of the story, its narrative ontology, clearly into consciousness."In Part Two ("Time and Meaning"), Hutter explores the thematic and methodological implications of narration as an attempt to infuse meaning into history and, conversely, through its own self-illustration, to chart the course of what is historical, that is, the transmission of future [End Page 143] understanding through the recovery of the past. Thus, storytelling renders history concrete, and, reciprocally, history challenges the narrator to plumb the depths of its greatest mysteries. According to Hutter, the Joseph novel embodies Mann's effort to meet this challenge. Storytelling is a way of preserving the past, but only under the condition of welcoming the promise of the future. "Yet the story that the Joseph novel narrates concretely is the story of Abraham and his blessing that is handed down to his descendants. In the peculiarly timeless omnipresence of this story, the tradition of the figure of Abraham is joined with the prophecy of the blessing that is not only promised to Abraham but to all his heirs."In Part Three ("The Stories of Joseph"), Hutter examines the dynamic of conversion or the transformative movement from self-love to compassion. He appeals to these spiritual elements to check the nihilistic tendency to exalt the individual both as the center of freedom and as the ground of social relations. Another kind of bond is necessary to overcome the abyss of meaninglessness, which is prefigured in ancient times and becomes most evident today in postmetaphysical forms of nihilism. "The 'whole theology' of the Joseph novel revolves around the Abrahamic covenant between God and human being—a covenant that, as already stated, implies a theory of... (shrink)

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services. Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic (...) class='Hi'>review was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. (shrink)

This book is intended as a contribution to the philosophy of history. The scope of this contribution--uncovering the awareness of the historical past as a part of human experience--is laid out in an extensive introduction drawing upon both contemporary analytic and phenomenological thought. In chapter 1, Carr presents an account of the temporal structure of experience based primarily on Husserl and, relevant themes in analytic philosophy. Chapter 2 describes the concept of narration and relates this concept to the account of (...) experience and action offered in chapter 1. In chapter 3, Carr draws upon Dilthey and the early Heidegger's use of Dilthey to develop the restricted descriptions of the first chapter into an account of the self as a unity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Descartes’s Dualism by Marleen RozemondSteven J. WagnerMarleen Rozemond. Descartes’s Dualism. Cambridge: Harvard University Press, 1998. Pp. xx + 279. Cloth, $24.00.Rozemond gives particular attention to questions of mind-body distinctness vs. union and to the status of sensory ideas. Her historical emphasis, backed by impressive scholarship, is Descartes’s relation to the late scholastics. Rozemond is clear, alert to detail, and fair-minded. While the text is too long (esp. in (...) chapters 4–5), this study is indeed rich, its scope and architecture justified.Any good reading of a philosopher is defined—both enhanced and limited—by certain decisions. I have mentioned one of Rozemond’s: her account of Descartes’s dialogue with such predecessors as Suárez and Fonseca sheds important light. It makes one ask, further, whether standard histories are not just as wrong to ignore scholastic concerns in, say, Hobbes, Spinoza, and Locke. Yet Rozemond is less helpful with issues that make more sense when we read forward from the 1640s, not back. An historian also sets a level of philosophical engagement. One chooses between presenting a meaningful narrative, and struggling with the endless problems of detail that can both doom [End Page 678] a philosophical position and give it life. Rozemond inclines toward narrative, often stopping just short of hard questions. Yet she shows curiosity and intelligence throughout. As in the first case, another decision would not have been better or worse but simply yielded a different kind of history.Fundamental is a third choice. A philosopher’s thought may appear as an orderly structure; or as a mix of fixed points and shifting, inconsistent tendencies. Most of us are trained to the former style of representation (although we let philosophers “develop” over time). Rozemond’s Descartes, too, turns out this way. He occupies definite positions. Within each position he knows whether Ρ is a premise for Q, vice versa, or neither. This way of presenting a body of thought, i.e., as a determinate structure admitting logical assessment, is an indispensable tool for historians. Its value in any particular case is, however, a matter of judgment. Rozemond attacks textual problems with skill, often improving decisively on the competition, but the going looks smoother than it is. Sometimes she carries the privilege of selective reading too far. At other times, she overlooks the poor mutual fit of separately smooth solutions, or rests with an outcome that could not have satisfied Descartes. Some examples:1. There is an old question how far Descartes goes towards proving dualism in the Second Meditation, how much is left for the Sixth. Rozemond basically champions the Second Meditation. Although some texts favor this, she ignores important contrary passages. Her reconstruction of the “argument from separability” also fails completely to carry over to Descartes’s alternate proof (AT VII, 85–6) from the indivisibility of mind.2. Rozemond identifies (“pure”) intellection with thought or mind (56). This leaves a problem how sensation could be a mode of thought, given that for her sensations differ from pure thoughts in being ‘modes of the mind as united to the body’ (201, emphasis mine). She remarks that sensations are not ‘straightforward modes of the mind’; yet her earlier chapters have no place for obscure modal hybrids and indeed require the tidy metaphysical scheme that is now denied.3. Although Rozemond handles Descartes’s anti-empiricism well, the discussion of empty space (95–7) no sooner suggests than it drops a crucial question. Descartes traces belief in the void to a childhood prejudice according to which all bodies are perceptible; rejecting the prejudice is supposed to remove support for the hypothesis of the void. But can Descartes really pick up the doctrine of childhood prejudice, an anti-Aristotelian weapon, and turn it against the radically different atomist framework? Rozemond passes on the attendant philosophical and textual problems (cf. 133–7).4. Rozemond’s extensive treatment of sensory perceptions and qualities rewards study (particularly on the importance, for dualism, of problems about body). But she misses the chance for more. Her Descartes firmly “places sensory qualities in the mind.” The real one struggled repeatedly over whether sensory ideas can or must... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Women and Philosophy in Eighteenth-Century Germany ed. by Corey W. DyckJulia BorcherdingCorey W. Dyck, editor. Women and Philosophy in Eighteenth-Century Germany. Oxford: Oxford University Press, 2021. Pp. 272. Hardback, $85.00.In more ways than one, this volume constitutes an important contribution to ongoing efforts to reconfigure and enrich our existing philosophical canon and to question the narratives that have led to its current shape. To start, while there is (...) a growing amount of research dedicated to recovering the contributions of women to early modern philosophy, much of this work focuses on the seventeenth century, and geographically centers on England, France, and Italy. By turning the spotlight on eighteenth-century Germany, this volume broadens the scope of these efforts in an important way. Further, with the historiography of this period still shaped by a long-standing dismissive treatment of post-Leibnizian German philosophy and by the long shadow cast by the success of Kant's Critical philosophy, which eclipsed many of the thinkers opposed to it, challenges to its traditional narratives seem especially important. The editor's earlier collection (coedited with Falk Wunderlich) on Kant and his German contemporaries already succeeded in mounting such a challenge by showing that German philosophy throughout the eighteenth century in fact presents us with an extraordinarily rich tableau of intellectual life (Kant and His German Contemporaries. Vol. 1: Logic, Mind, Epistemology, Science and Ethics [Cambridge: Cambridge University Press, 2018]).The present volume stands as a further valuable contribution to relativizing the still dominant narrative of German philosophy as the story of a select few brilliant minds. It successfully dispenses not only with the idea that those minds were few, but also with the equally persistent one that they were exclusively male. Already in the nineteenth century, we find historians such as Karl Joël explicitly casting the new age of German philosophy inaugurated by Kant as its "masculine epoch"—an image undoubtedly furthered by its main protagonist, who cast philosophical acumen in decidedly male terms when he observed that "[a] woman who has a head full of Greek, like Madame Dacier, or one who engages in debate about the intricacies of mechanics, like the Marquise du Châtelet, might just as well have a beard; for that expresses in a more recognizable form the profundity for which she strives" (Karl Joël, Die Frauen in der Philosophie [Hamburg, 1896], 48; Immanuel Kant, Beobachtungen über das Gefühl des Schönen und Erhabenen [Königsberg, 1764], translation in Londa Schiebinger, The Mind Has No Sex? Women in the Origins of Modern Science [Cambridge, MA: Harvard University Press, 1989], 146; both cited in Eileen O'Neill, "Disappearing Ink: Early Modern Women Philosophers and Their Fate in History," in Philosophy in a Feminist [End Page 154] Voice: Critiques and Reconstructions, ed. Janet A. Kourany [Princeton, NJ: Princeton University Press, 1997], 17–62). Yet as the contributions to this volume forcefully illustrate, women in the period did—in spite of the numerous severe social, religious, and political obstacles they faced—in fact manage to gain access to its intellectual sphere, and actively shaped its philosophical landscape.While the papers collected here are of high quality throughout, they do vary in their approach. Many chapters, especially in the earlier parts of the volume, investigate female figures as philosophers in their own right, and carve out their self-standing contributions to prominent philosophical movements and debates. Focusing on Sophie of Hanover's correspondence with Leibniz, Christian Leduc's chapter begins by examining her metaphysical views and argues, against standing interpretations, that her main aim is to defend a version of the doctrine of physical influence as an account of mind-body interaction while rejecting metaphysical commitments regarding the nature of the soul in favor of a more agnostic, Lockean empiricist approach. In chapter 3, Stefanie Buchenau shows how women engaging with Wolffian Schulphilosophie began to view themselves as more than teachers and translators and started to claim the title of philosophers. Using the example of Johanna Charlotte Unzer, Buchenau convincingly argues that despite the "feminine," aesthetic garb of her thought, Unzer in fact offers a serious critique and revision of the Wolffian model of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 126.1 (2005) 135-138 [Access article in PDF] Jenny Strauss Clay. Hesiod's Cosmos. Cambridge: Cambridge University Press, 2003. xii + 202 pp. Cloth, $65. This book, following on The Wrath of Athena (1983), The Politics of Olympus (1989), and a number of articles, continues Clay's distinctive work on "early Greek theology" (1), that is, the nature of gods and their relations with human beings as treated (...) in archaic epic poetry. For Clay, the works of early Greek epos can be seen as a coherent and interconnected whole, in which the combined subject matter of the Homeric Hymns, Iliad, and Odyssey is book-ended, as it were, by the two major Hesiodic poems: Theogony tells the story from the beginning of things to the accession of Zeus, whereas Works and Days describes life in the post-heroic Iron Age. Hesiod's Cosmos argues for a closely interrelated and complementary relationship between these two works, in which one poem looks at the world from a divine standpoint, paying little attention to human life, while the other focuses on the here-and-now exigencies of human existence, considering the gods mainly as they intersect with those realities. Together they make up a view of the world that transcends any single perspective, displaying the superior skill, intelligence, and inspiration of their poet. As a pragmatic explanation for this thoroughly intertextual relationship, Clay proposes that Hesiod may have been at work simultaneously on both compositions.Dealing succinctly with the Hesiodic Question about authorship and authorial persona, Clay locates the composition of Theogony and Works and Days in a middle ground, somewhere between the work of a historical poet, whose biography is reflected in the poems, and the product of a didactic tradition in which "Hesiod" is the persona that a performer of this poetry adopts (a view developed especially by Gregory Nagy). A historical Hesiod seems likely to Clay, but even so, "the voice we hear is constructed within the text for its own ends" (3). Although she maintains that this question is not central to her analysis of the Hesiodic poems, the nuanced and subtle cross-references that she postulates between the two works prompt her to write as if there were an individual, thoughtful author behind the texts—one working with ideas that will be taken up later by acknowledged "philosophical" writers. Further, and central to her methodology, Clay maintains (9) that it is both possible and desirable, if hardly simple, to seek authorial intentions in the works under discussion. The admittedly provocative goal of Hesiod's Cosmos, then, is to "demonstrate a coherent plan that unites the poems into a consistent vision that is both thoughtful and subtle" and thereby "to recover the reputation the Hesiodic poems long enjoyed in antiquity" (2: a discussion of Hesiod's ancient reputation would have been welcome here). [End Page 135]The book is well organized to achieve that end. It begins with a general chapter on Theogony and another on Works and Days, summarizing each work while emphasizing its structural peculiarities and teasing out the meanings suggested thereby. The five chapters that follow compare salient aspects of the two poems: their divergent proems, what they say about the origins of humankind, their two versions of the Prometheus story, the presentation of gods in Works and Days and men in Theogony, and finally each poem's treatment of what Clay terms "hybrids" (monsters and heroes, both being of mixed birth) in a chapter that includes substantial discussion of the Hesiodic Catalogues. A brief conclusion, focusing on the ancient theme of a contest between Hesiod and Homer, argues that Hesiodic poetry makes a claim to broader knowledge and scope than Homeric.A conspicuous and valuable characteristic of Clay's approach is her insistence on treating both texts in their entirety. Each poem is reviewed in linear sequence in the two introductory chapters, with an eye to its "intratextual" content—especially the relation of digressions to the structural backbone. The Theogony's basic structure is obviously genealogical, but its narrative digressions come at unpredictable junctures, some of them (such... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Man and Animal in Severan Rome: The Literary Imagination of Claudius Aelianus by Steven D. SmithFabio TutroneSteven D. Smith. Man and Animal in Severan Rome: The Literary Imagination of Claudius Aelianus. Greek Culture in the Roman World. Cambridge: Cambridge University Press, 2014. 308pp. $99.When Otto Keller published his meticulous work Die Antike Tierwelt (1909–13), classical scholars still conceived of ancient zoological knowledge as an astonishingly labyrinthine corpus of (...) tales. One felt the need to separate objective truths and fabulous accounts on the basis of a modern-oriented comparatist approach which was especially suspicious of Aelian’s De Natura Animalium and the so-called paradoxographic tradition. At that time, classicists were also keen to [End Page 532] see Severan literature as a scarcely original (and relatively uninteresting) digest of earlier writings—a faithful mirror of the beginning of the end.Steven Smith’s book on Aelian’s “literary imagination” and its culturally embedded use of animal figures is paradigmatic of the notable progress of scholarship in both such fields of research—the role of animals as revealing symbolic constructs and the intellectual life of Severan Rome. Throughout his well-structured survey, Smith offers new insights into Aelian’s worldview as a profoundly Hellenized Roman writer creatively combining biological notions and literary mirabilia, socio-political patterns, and sophistic aesthetics. On the one hand, the book clearly situates itself in the flourishing area of cultural and animal studies, making the most of both well-known and newly emerging theoretical frameworks (from Michel Foucault to Donna Haraway, from Derrida and Deleuze to Giorgio Agamben). Of course, the purpose of Smith as well as of other contemporary scholars interested in the ancient representation of animals is no longer to identify reliable “scientific” data as distinct from ancient folklore. Rather, it is the intersection of rhetorical, historical, and anthropological factors which seems to characterize most properly the Graeco-Roman discourse on animal life. On the other hand, however, Smith engages in an ambitious reconfiguration of Aelian’s (admittedly enigmatic) profile as an exponent of the Second Sophistic, at the same time indebted and alien to the milieu of the third century c.e. The multifaceted textual construction of Aelian’s animal narratives is shown to entail a critical (and at times ambiguous) reflection on such different issues as gender, religion, ethnicity, natural philosophy, and kingship.The book is composed of ten chapters, each one investigating a specific aspect of Aelian’s Weltanschauung on the basis of thematically connected passages. While the main focus is on De Natura Animalium (and thus on animal-related topics), two chapters (2 and 10, respectively) extend the scope of the inquiry to Aelian’s Rustic Letters and Varia Historia (VH). The monograph as a whole is framed by an introductory overview (starting with a fictional first-person speech by Aelian) and a conclusive note which sums up Smith’s most relevant theses. In addition, a more “philological” appendix discusses seventeen short fragments possibly pertaining to Aelian’s lost Katēgoria tou gunnidos (“The Indictment of the Little Woman”), a bitter invective against Elagabalus prudently written after the emperor’s death (cf. Philostr. Vit. Soph. 625).The question of Aelian’s elusive literary persona figures prominently in the general introduction and is the core subject of chapter 1. By qualifying the author of the De Natura Animalium (NA) as “independent” and “countercultural,” Smith does not mean to remove him from his social and political context. On the contrary, the evidence drawn from the NA itself (especially from the impressionistic self-portrait of the preface and the epilogue), together with the biographical sketches in Philostratus’ Lives of the Sophists and in the Byzantine Souda lexicon, is used to demonstrate that, though “inextricably bound up with and perhaps even unwittingly celebratory of urban Roman culture of the early third century c.e., Aelian nevertheless also fashions a literary persona that is critical of that same [End Page 533] cultural milieu” (16). In Smith’s view, such a fascinatingly ambivalent effect is made possible by the overwhelming stylistic variety (poikilia) of the NA, which appears as an “open” work (in Umberto Eco’s terms) intentionally lacking any large-scale... (shrink)

This article introduces a comprehensive definition of life projects. It begins with a broad conception of a project as a process comprising the formation, enactment, and maintenance of intentional structures and actions. This definition represents the integration of two theoretical traditions that considered a project either as a process prior to action or a set of actions aimed at the same goals. Next, we differentiate life projects from other types of projects. Then based on a broad conceptual framework, we define (...) a life project as an ongoing, evolving process to form, enact, and maintain intentional structures and actions that, altogether, comprise a long-term, meaningful, and prospective narrative capable of guiding decisions and behavior in daily life. This comprehensive definition integrates six different dimensions of life projects reported across 93 journal articles analyzed in a previous scoping review. We end by contrasting our definition to related concepts and discussing practical implications in career counseling. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ovid’s Causes: Cosmogony and Aetiology in the MetamorphosesMargaret Worsham MusgroveK. Sara Myers. Ovid’s Causes: Cosmogony and Aetiology in the Metamorphoses. Ann Arbor: University of Michigan Press, 1994. xvi + 206 pp. Cloth, $32.50.This book takes seriously Ovid’s claim in the proem of the Metamorphoses that his work will encompass the entire universe. Ovid’s primaque ab origine mundi (1.3) must be read as a statement of thematic, not merely (...) chronological scope. “The origin of the world” will continue as a central concern throughout the poem. Myers reads the cosmogony of Book 1 as a continuation of the programmatic statement of the proem: Ovid is allying himself with the tradition of natural-philosophical poetry, as originated by Hesiod and adapted to Hellenistic standards by Apollonius and Vergil. The theme of cosmogony does not merely “frame” the poem, and does not surface only in the explicit creation stories of Book 1 and the didactic discourse of Pythagoras in 15, but instead pervades the entire work. Aetiological stories, as explanations of where individual phenomena come from, continue the scientific theme displayed in the opening cosmogony. The whole Metamorphoses can thus be read as an exploration of the type of poetry which investigates origins of everything, from the universe to natural features to cultural institutions. We should credit Myers with elucidating this cosmogony-aetiology link, which breaks us free of narrow, literal categories, and allows us to see the similar poetic aims of these two literary devices. Her introductory chapter, exploring “The Generic Question” of the Metamorphoses and of post-Callimachean literature in general, points out how recent Latin scholarship has already begun to blur some of those long-unquestioned black-and-white distinctions between genres.At the same time, Myers acknowledges the clash between science (or natural philosophy) and myth. Ovid uses “scientific” language, often in the form of Lucretian allusions, to recount fantastic mythological tales of creatures whose very existence would be questioned by the philosophers. Chapter 1 examines metamorphosis stories which involve natural phenomena, such as the cosmos itself, various animals, etc. Metamorphosis is seen and narrated as a kind of scientific process; hence Ovid’s detailed descriptions of the moment of transformation. [End Page 338] But by calling attention to the incongruity of his subject and his language, Ovid questions the authority of cosmogony to validate myth and of myth to convey the truth.The remainder of Myers’ book focuses on the way in which Ovid unmasks the devices used in aetiological poetry’s claim to a voice of authority. Chapter 2 examines the Alexandrian affiliations of aetiological stories explaining the origins of cultural or religious institutions. This chapter follows something of the approach of P. Knox in the studious attempt to look at the elegiac, unepic features of Ovid’s narrative. Myers investigates the language used to mark a story as an aetion: words such as causa, origo, novus, and unde. Partially through comparison with Ovid’s technique in Fasti (a consistently aetiological, didactic poem) and through examination of the fragments of Callimachus, she also points out certain narrative techniques as characteristic of aetiology. The embedded narrative, related by a supposedly authoritative informant, is revealed as part of the modus operandi of didactic and aetiological poetry.This chapter is perhaps Myers’ most valuable contribution, because it gives us a rationale for some of the seemingly odd features of Ovid’s narrative. One example: why, at Met. 4.772–89, are Perseus’ most famous adventures reported only in indirect statement? Variatio for its own sake is not an adequate answer. Genre would seem to be part of the explanation: battles with monsters belong in epic, a genre which Ovid eschews, at least for the moment. But beyond that negative explanation, Myers suggests a positive one. After the indirect report, someone asks Perseus for an aetiological story: why Medusa had snakes in her hair. His answer in direct speech displays several of the linguistic features which Myers has identified as characteristic of aetia. Thus, Ovid depicts Perseus not so much at a Homeric banquet, with stories of battles and conquests, but at a Callimachean one, with learned exchanges of aetiological myths (cf... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Home Is Somewhere Else: Autobiography in Two VoicesPatrick HenryHome Is Somewhere Else: Autobiography in Two Voices, by Desider Furst and Lilian R. Furst; xv & 235 pp. Albany: SUNY Press, 1994, $14.95 paper.Published in the “Margins of Literature” series, Home Is Somewhere Else follows a family of three who, on the margins of the Holocaust, live for nine months in Nazi occupied Vienna before escaping illegally in early (...) 1939 into Brussels and then legally to England. The narration goes on to relate both the life of that family in England until the mother’s death in 1969 ended “the symbiotic threesome” (p. 203) and the subsequent emigration of the father and daughter to the United States where, with her retired father, the daughter pursues her career as professor of comparative literature. The final chapter, “As My Father Used to Say,” records the wisdom and witticisms of her father who died in 1985 leaving her alone, in mourning and still deracinated, having become “more [herself] and thereby more other” (p. 217). “My geographical roots are shallow; only those created by the brand mark of the red ‘J’ [meaning “Jew” and stamped on the family passport in Vienna in 1938] run deep into my being” (p. 217).The technical interest of the book resides in its dual autobiographies. Desider, the father, wrote his (entitled A Superfluous Man) in the early 1970s after his retirement and emigration to the United States. Lilian, the daughter, read it in 1983 and found it organized into chapters around places where they had lived. Without rereading it, she began her autobiography in 1991, deciding to write alternative chapters that would be centered on the same places her father had written about: Vienna, Cologne, Brussels, London, Bedford, and Manchester. In addition, he writes a chapter on the Isle of Man where he was interned for four months in 1941 and she on Chertsey where she spent a year alone. She also writes a chapter about her mother’s life and one on her life with her father in America. [End Page 156]Although both autobiographies are completely retrospective accounts composed, without diaries or notes of any kind, decades after the initial events they narrate, each reflects the preoccupations of the narrator at the time of the events being narrated. Thus Lilian’s, composed as “a tribute of [her parents] for bringing [her] through to safety” (p. xiv), contains the child’s impressions of family, friends, home, relatives, and nanny as well as her fear and terror as she experiences the Nazi entry into Vienna in 1938, Crystal Night, the train ride to Cologne, and the flight to Brussels. From Desider’s, on the other hand, emanates the broader vision of the responsible adult, parent and husband, conscious of the historical scope within which his particular drama unravels. He paints in vivid colors the happy decade in Vienna (1928–38), the descent into the hell of Nazism, the struggle to escape “this gigantic prison” (p. 47), and his appreciation and admiration for the British. He underscores the complexity of the situation by populating his account with scores of individuals—unfortunate Jews, sadistic Nazis, good Austrians, profiteers of all kinds—and by frequent conflicting references to Providence, destiny, luck, and the totally gratuitous nature of survival. Written as a memorial to his wife by a man who claims never to have wanted anything more than a normal life for himself and his family, his narration fittingly ends with her death in Manchester in 1969.The power of the book, however, springs as much from what unites the narratives, as from what divides them. I am not speaking of the similarity of events but rather of the deeply held human values (responsibility, courage, sacrifice, family union, interdependence, and love) that resonate powerfully throughout both accounts. Indeed, the intertwining of the two voices is poetically and umbilically linked to the hands of father and daughter that grip each other throughout the narrative. We find a father who risks everything to keep his family together, a mother who gives up her medical career for the same reason, and a daughter, full of gratitude, love, and an intense sense... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Wandering in Ancient Greek CultureVanda ZajkoSilvia Montiglio. Wandering in Ancient Greek Culture. Chicago: University of Chicago Press, 2005. xii + 290 pp. Cloth, $50.Beginning at the beginning with Odysseus's poignant statement to Eumaeus at Odyssey 15.343 that "for mortals, nothing is worse than wandering," Silvia Montiglio seeks to present an overview of the conception of wandering from the archaic to the early Roman age. The introduction states clearly (...) that its approach is both synchronic and diachronic, and the way the chapters are organized reinforces this approach, as they focus on particular themes ("Wandering, Lying and Poetry," "The Meaning of 'Home' in One's Journey: From Apollonius' Argonautica to the Novel") while simultaneously pursuing an historical trajectory. The epilogue, entitled "What Greek Wanderers Did Not Do," expands the time fame and provides insights into the differences between pagan and Christian ideas about wandering, contrasting Neoplatonist and Cynic ascetics who describe wandering primarily as a figurative manifestation of the human condition with the peregrinatio of those Christian sages for whom "to wander means to renounce this world and one's earthly self in the expectation of the Kingdom of God" (264).Throughout, there is a preoccupation both with the semantic fields of the words used for wandering, such as, for example, in the second chapter, where the middle-passive voice of the words used for wandering are adduced to emphasize the fundamental passivity of the wanderer within Greek thought, and with the wider symbolic significance of wandering within mythological, geographical, and political landscapes as it is manifested in a variety of genres and historical periods. [End Page 129] This extensive concentration means that the potential readership of the book is a diverse one and includes both those with and without Greek and those interested in particular texts as well as in the ancient world as it is most broadly conceived. There are some places in the discussion where the material is openly and heavily dependent on other works, such as the discussion of liminality that occupies pages 16–23, which to a large extent reviews the insights of Ken Dowden, Death and the Maiden: Girls' Initiation Rites in Greek Mythology (1989), and 37–41, which revisit some of the points made by Ruth Padel, Whom Gods Destroy (1995); but in a work of such scope and eclecticism, this avowed indebtedness testifies to the thoroughness of the scholarship rather than the unoriginality of the thought involved in its production.One of the great strengths of the book is the forging of connections among different kinds of texts. In the chapter entitled "Wandering in Space and Time," Plato's theory of the wandering cause in the Timaeus is read alongside other narratives of beginnings so that the progress of the cosmos from wandering to stability is associated with that of the individual body: Herodotus contrasts the "much-wandering" of the ancestors of the Dorians with the autochthony of the Athenians who are by far the most developed of the Greeks; his successor Thucydides argues that migrations characterized the patterns of habitation of the earliest times; Democritus describes the mother's navel as an anchor that restrains the wandering womb, and he also considers the earth to have wandered before it thickened and became fixed in one position; pursued by Hera, the pregnant Leto searches far and wide for a place to deliver Apollo until she finds refuge on Delos, the island that, according to Callimachus (Hymn to Delos 191–92), also wandered until the birth of the god enabled it to put down roots. Montiglio describes the thematic and conceptual links among these different discourses in a typically fertile passage:Associating wandering within the amorphous beginnings of the cosmos is not idiosyncratic to the philosopher who disparagingly relegates wandering to the world of matter. The materialistic Democritus shares a similar notion, and so do myth and historiography. Wandering, the liminal condition, is systematically removed by growth and progress. Whether it be in biology, history, or geology, progress equals sedentariness, agglomeration, and fixity; whereas wandering defines the physical or social organism when still in the making and/or disjointed. Wandering marks cultural, biological, and geological protohistory.(12)The book... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A History of Scottish PhilosophyManfred KuehnAlexander Broadie. A History of Scottish Philosophy. Edinburgh: Edinburgh University Press, 2009. Pp. viii + 392. Cloth, $140.00.Alexander Broadie is well known to those who have an interest in Scottish Philosophy. His 1990 book, The Tradition of Scottish Philosophy: A New Perspective on the Enlightenment (Barnes & Noble), attempted to show that there were two great periods in the history of Scottish culture, (...) the "circle of John Mair" around 1500 and the so-called "Scottish Enlightenment" of the last half of the eighteenth century. Broadie argued that one could "trace a line of philosophical influence from Mair's circle to the philosophers of the Scottish enlightenment."The present book has a much wider scope. It is an attempt to tell the entire story of Scottish philosophy from its beginnings to the 1960s. The book has twelve chapters, including a short Introduction (1–6) and an even shorter Conclusion (365–69). The first philosopher discussed is John Duns Scotus. The next five chapters are called "The Fifteenth Century," "The Circle of John Mair," "Humanism and After," and "Scotland Moves into the Age of Enlightenment," which deals with Gershom Carmichael, George Turnbull, and Francis Hutcheson. Chapters 6, 7, 8, and 9, which constitute the bulk of the book, deal with David Hume, Adam Smith, and The Scottish Philosophy of Common Sense. The nineteenth and twentieth centuries are treated relatively briefly under the titles "The Nineteenth Century: Ferrier to Seth" and "Realism and Idealism: Some Twentieth-century Narratives." The book has a fairly extensive bibliography and a very useful index.The summaries of the different philosophical positions are lucid, balanced, and fair. They provide very useful introductions to the thought of the philosophers discussed in the book. Someone interested in the background of Hume and Reid and looking for a first orientation could do a lot worse than consulting this book.I do have a problem with the way Broadie places the accents in his history. The two chapters on the nineteenth and twentieth centuries take up only about one sixth of the book, yet they are among the most interesting—at least for me. They would have deserved a more detailed treatment. The discussion of the Middle Ages and Humanism is rather long. The same holds for the eighteenth century. The discussion of Hume in particular, whose philosophy has received much attention of late, could have been significantly shortened. Thomas Brown, Dugald Stewart's successor, who is not as well known, but was a brilliant philosophical mind, would have deserved a section of his own—or so I believe. Since he did discuss Mair and his circle extensively in his earlier publication, this part of the book could also have been abbreviated. Whether Duns Scotus belongs in a "history of Scottish philosophy" I do not know. In any case, it appears that the concerns of his earlier book on The Tradition of Scottish Philosophy exercise an undue influence on the new book.I would have liked to hear a little more about what makes a certain philosopher a Scottish philosopher and what makes Scottish philosophy Scottish. It may well be impossible to write a national history of philosophy in the strictest sense of the word. Philosophy, perhaps still more than Literature and Literary Criticism, knows no national boundaries. As Lewis White Beck once pointed out, any national history of philosophy encounters the problem of figures whose importance transcends the limits of the philosophical discussion in any one nation or language: "No history of English or German philosophy can be understood [End Page 124] without Descartes," Locke or Hume, for that matter. A national history of philosophy may therefore "appear at best episodic, at worst arbitrary. Why not write a history of philosophy mentioning only men whose names begin with the letter 'p'?"Broadie believes that these philosophers "responded to each other partly because they were close by and partly because they were so interested in each other's thinking" (5). This context justifies us or "makes it appropriate to speak of Scottish philosophy, parallel to the way in which writers speak of German philosophy" (6). This point goes both too far and not... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Transformations of the Confucian Way, and: Histoire de la pensáe chinoiseMichael NylanTransformations of the Confucian Way. By John H. Berthrong. Boulder, Colorado: Westview Press, 1998. Pp. xiv + 250.Histoire de la pensáe chinoise. By Anne Cheng. Paris: Editions du Seuil, 1997. Pp. 650.Reviewing bad books, W. H. Auden once observed, is bad for the character. On the assumption that the reverse must also be true, I am delighted (...) to review not one, but two good books: John H. Berthrong's Transformations of the Confucian Way and Anne Cheng's Histoire de la pensáe chinoise. Each contributes significantly—though differently—to our appreciation of the long history of classical learning in China. [End Page 632]Berthrong, in seven chapters and 250 pages, neatly summarizes the main developments of what he calls the "Confucian Way." As a teaching tool for undergraduates and nonspecialists, the book's strong appeal is based on three factors: (1) the coherence of its narrative (no mean feat for a book covering over 2,500 years of the Way); (2) the respectful approach that it brings to intellectual traditions and the controversies they have engendered over time; and (3) the case that it urges for the relevance of the Confucian Way today to life outside the classroom and outside China. To achieve such coherence, Berthrong divides his story into seven manageable units spanned by "six paradigmatic historical transformations of the Confucian Tradition" (p. 6): (1) the rise of the Confucian tradition in Zhou China; (2) the canonization of the Confucian Classics in Han times; (3) "the defense of the [Confucian] faith" during the third through the tenth centuries; (4) the Neo-Confucian Revival in the Song; (5) reactions to Song Neo-Confucianism in "the turn toward the mind," epitomized by Wang Yangming (1472-1529); (6) the late empires of Qing China, Tokugawa Japan, and Yi/Chosŏn Korea; and (7) Confucianism in the modern world.Berthrong has chosen a sensible approach to his sprawling history, whose scope would leave most scholars cowering. He judiciously draws upon the best scholarship available on each of the transformations (giving full credit where it is due), with the result that even beginning students can quickly gain a sense not only of the important debates in the long history of classical learning but also of prominent scholars working in the field today. As a master of the declarative sentence, Berthrong has no trouble writing the bridging paragraphs required to situate his thinkers neatly within the broader historical trends that Confucian morality has shaped, reflected, or been changed by. His afterword devoted to "Further Readings and Contentious Issues" then leads readers responsibly outside the book to larger worlds, broaching difficult topics with sensibility and grace. Without hesitation, then, I would recommend that this book be assigned in all manner of undergraduate courses, in "rice paddies" as well as in courses on comparative thought and Chinese history— though I would have my own students think of it as an intellectual history of East Asia, not as a history of the Confucian Way (a point to which I return below).To communicate his respect, Berthrong seeks to illustrate "the complexity of the vision, life, conduct, meditation, conflict, compromise, and creativity that is hidden by the generalization of the word 'Confucianism'" (p. 7). To Berthrong's way of thinking, the death of "scriptural Confucianism" (Mark Elvin's phrase) notwithstanding, a tradition so protean in its transformations and so compelling in its advocacy of full humanity (ren) should find a way to renew itself in the near future—especially when his set of thinkers have at least as much light to shed on the philosophical problems encountered by humans as their counterparts among the philosophical masters of Europe and America. Berthrong is therefore at his very best when discussing xing (human nature), li (principle), and xin (heart/mind), comparing and contrasting the epistemology of Shao Yong (1011-1077), the cosmological speculations of Zhou Dunyi (1017-1073), the Cheng brothers on mind and principle (li), or the ruminations on sagehood by Wang Yangming (1472-1529).While such discussions richly convey to even the beginning student of Chinese [End Page 633] thought... (shrink)

This well-written volume is an introduction, not to world history, but to the special genre of "Big History," as the subtitle indicates. Christian and his fellow big historians, reacting against popular scepticism toward "master narratives," seek to create a new class of grand works that incorporate not only the history of human society, but also of the Earth, its life, and the universe as a whole. Specialists in any of the fields covered by the volume may find rough spots in (...) the treatment of topics they know well, but given the scope of the effort I think it is fair to regard this as something like the first edition of a continuing work. Later editions would be strengthened—as would the Big History movement as a whole—by explicitly incorporating some discussion of teleological reasoning in science, and by deploying clear distinctions between processes that are teleomatic (such as star formation), teleonomic (such as organismal development), and classically teleological (such as intentional behaviour on the part of humans). In "Maps of Time," David Christian has given us a book full of interesting facts, and with ideas to argue for and against in every chapter. It should provoke lively discussion across a whole range of academic disciplines. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 124.1 (2003) 150-153 [Access article in PDF] Lisa Kallet. Money and the Corrosion of Power in Thucydides: The Sicilian Expedition and Its Aftermath. Berkeley and Los Angeles: University of California Press, 2001. xiv + 347 pp. Cloth, $55. Jonathan J. Price. Thucydides and Internal War. Cambridge: Cambridge University Press, 2001. xii + 410 pp. Cloth, $70. These two new contributions to Thucydidean studies are similar (...) in scope and execution. Each pursues a thesis so well defined that dust jacket summaries do them justice. Kallet argues that "the second half of Thucydides' history contains a damning critique of Athens and its leaders for becoming corrupted by money and for failing to appropriately use their financial strength to support military power." Price contends that "Thucydides consciously viewed and presented the Peloponnesian War in terms of a condition of civil strife—or stasis, in Greek." Many, if not most students of Thucydides would find each of these propositions reasonable, and some might argue that book-length narratives are not needed to establish these basic theses one way or another.Nevertheless, Thucydides requires careful study, and each of these books contains strong analyses of many key sections and themes from the History. Both studies shed a great deal of light on Thucydidean historiography beyond their immediate topics. Thucydides, however, enjoys the mixed blessing of popularity among more learned policy makers who trot him out from to time as a founder of realist thinking. In such contexts, tendentious remarks from the Melian dialogue or similarly complex contexts appear as aphorisms, and Thucydides is reduced to a sound bite. Those who are students of Greek culture, political philosophy, international relations, or some related field can easily skim these books for their core arguments but would benefit from closer readings of the particular discussions within them, many of which exhibit considerable insight and originality.Kallet's book builds on the foundations of her earlier research on Money, Expense and Naval Power in Thucydides 1-5.24 (California, 1993). Kallet begins her new work with the Melian dialogue but largely skips over the remainder of Book 5 and concentrates here on Books 6-8. The introductory chapter on the Melian dialogue introduces a core theme, which the Sicilian narrative will extend: where proper strategy uses imperialism as an investment to acquire more tangible revenue or to maintain existing sources of income, the conquest of Melos as a display of power cannot possibly yield enough revenue to justify the initial expense. The Athenians pursue this adventure not because it will improve their financial base but because they wish to demonstrate their power for third parties to observe. The radical realism of the Melian dialogue thus becomes an exercise in traditional (and by Thucydides' standards, wasteful) display of wealth and power. Thus, even as Thucydides' Athenians see themselves as progressive thinkers untrammeled by illusion, they let their illusion of sophistication blind them to the regressive policy that they are actually pursuing. [End Page 150]The following four chapters comprise a fairly discrete monograph on the Sicilian expedition. The analyses of the speeches and major actions in this section of Thucydides constitute a significant contribution to our understanding of Thucydidean narrative. Kallet's discussion of the debate between Nikias and Alkibiades at the opening of Book 6 (31-48) traces issues of public/private, community/individual, and archaic/contemporary in a clear fashion that would make it a useful reading in an introductory class on Thucydides. She traces the language of display and seduction, articulating the means whereby the Athenians succumb to problematic strategic judgments.I particularly enjoyed chapter 2, which explores the relationship between the Ionian revolt in Herodotus and the Sicilian Expedition in Thucydides. I remain uncertain in my own mind as to how much Thucydides has Herodotus in particular in mind and the degree to which Herodotus and Thucydides shared cognitive models that were almost invisible elements of Greek ideology. Given the limited sample of Greek source materials, we may never achieve any certainty, but even... (shrink)

Patient-centered care is now recognized as a clinical method and ideal model for patient – health professional relationships, and many definitions have influenced its evolution. Overall the patient-centered care literature has provided relatively little to define patient-centered care at the level of the patient-professional relationship. Additionally, patient-centered care lacks grounding in ethical theory. This thesis asserts that theoretical concepts from the ethics of care can provide a stronger conceptual basis for patient-centered care.This thesis begins with a critical interpretive review (...) of the patient-centered care literature, yielding 12 articles that previously introduced new theoretical and definitional work on patient-centered care and patient-centered communication. Six common themes and ideas were discovered, and include Engaging the Patient as a Whole Person, Recognizing and Responding to Emotions, Fostering a Therapeutic Alliance, Promoting an Exchange of Information, Sharing Decision Making, and Enabling Self-Management and Patient Navigation. These elements were then compared to key elements of the ethics of care. This thesis argues that feminists have good reason to consider care as a type of moral duty, and it describes how this duty functions. This thesis also argues that a duty to care is triggered when caregivers are presented with particular substantive forms of vulnerability. Specifically, this thesis argues that vulnerable subjects whose constitutive needs are at risk require particular moral obligations. The links between the ethics of care and patient-centered care are discussed, including how an ethics of care response ought to function in the health care context. Finally, the cases of J.J. and Makayla Sault, two aboriginal girls who refused chemotherapy in favour of traditional aboriginal healing practices, are analyzed. This thesis offers a short scoping review of the bioethics discourse surrounding these cases. A review of this discourse revealed several common themes, which included the peripheral importance of culture and history, the equating of best interests with survival, the supremacy of science-based medicine, and the impartial application of ethical principles. This thesis recommends that health care professionals apply an ethics of care approach to similar ethical dilemmas in the future, which involves shifting one's ethical focus to the central relationships of the case, understanding the unique perspective of the patient's narrative, and promoting a care-based rather than a justice-based approach to problem-solving. (shrink)

BackgroundThe areas of Research Ethics (RE) and Research Integrity (RI) are rapidly evolving. Cases of research misconduct, other transgressions related to RE and RI, and forms of ethically questionable behaviors have been frequently published. The objective of this scoping review was to collect RE and RI cases, analyze their main characteristics, and discuss how these cases are represented in the scientific literature.MethodsThe search included cases involving a violation of, or misbehavior, poor judgment, or detrimental research practice in relation (...) to a normative framework. A search was conducted in PubMed, Web of Science, SCOPUS, JSTOR, Ovid, and Science Direct in March 2018, without language or date restriction. Data relating to the articles and the cases were extracted from case descriptions.ResultsA total of 14,719 records were identified, and 388 items were included in the qualitative synthesis. The papers contained 500 case descriptions. After applying the eligibility criteria, 238 cases were included in the analysis. In the case analysis, fabrication and falsification were the most frequently tagged violations (44.9%). The non-adherence to pertinent laws and regulations, such as lack of informed consent and REC approval, was the second most frequently tagged violation (15.7%), followed by patient safety issues (11.1%) and plagiarism (6.9%). 80.8% of cases were from the Medical and Health Sciences, 11.5% from the Natural Sciences, 4.3% from Social Sciences, 2.1% from Engineering and Technology, and 1.3% from Humanities. Paper retraction was the most prevalent sanction (45.4%), followed by exclusion from funding applications (35.5%).ConclusionsCase descriptions found in academic journals are dominated by discussions regarding prominent cases and are mainly published in the news section of journals. Our results show that there is an overrepresentation of biomedical research cases over other scientific fields compared to its proportion in scientific publications. The cases mostly involve fabrication, falsification, and patient safety issues. This finding could have a significant impact on the academic representation of misbehaviors. The predominance of fabrication and falsification cases might diverge the attention of the academic community from relevant but less visible violations, and from recently emerging forms of misbehaviors. (shrink)

Healthcare organisations are hierarchical; almost all are organised around the ranking of individuals by authority or status, whether this be based on profession, expertise, gender or ethnicity. Hierarchy is important for several reasons; it shapes the delivery of care, what is prioritised and who receives care. It also has an impact on healthcare workers and how they work and communicate together in organisations. The purpose of this scoping review is to explore the qualitative evidence related to hierarchy in (...) healthcare organisations defined broadly, to address gaps in macro‐level healthcare organisational research, specifically focusing on the (1) impact of hierarchy for healthcare workers and (2) how hierarchy is negotiated, sustained and challenged in healthcare organisations. After a search and screening, 32 papers were included in this review. The findings of this review detail the wide‐reaching impacts that hierarchy has on healthcare delivery and health workers. The majority of studies spoke to hierarchy's impact on speaking up, that is, how it shaped communication between staff with differential status: not only what was said, but how it had an impact on what was acceptable to say, by whom and at what time. Hierarchy was also noted to have substantial personal costs, impacting on the well‐being of those in less powerful positions. These findings also provide insight into the complex ways in which hierarchy was negotiated, challenged and reproduced. Studies not only detailed the way in which hierarchy was navigated day to day but also spoke to the reasons as to why hierarchy is often entrenched and difficult to shift. A number of studies spoke to the impact that hierarchy had in sustaining gender and ethnic inequalities, maintaining historically discriminatory practices. Importantly, hierarchy should not be reduced to differences between or within the professions in localised contexts but should be considered at a broad organisational level. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:A Greek Countryside: The Southern Argolid from Prehistory to the Present Day, with a Register of Sites by Curtis N. Runnels and Mark H. MunnDonald C. HaggisMichael H. Jameson, Curtis N. Runnels and Tjeed H. Van Andel. A Greek Countryside: The Southern Argolid from Prehistory to the Present Day, with a Register of Sites by Curtis N. Runnels and Mark H. Munn. Stanford: Stanford University Press, 1994. xx (...) + 658 pp. 224 figs. 36 tables. 8 back-pocket maps. Cloth, $125.The methodological divide between Greek history and archaeology is bridged in areas of epigraphy, topography, and political geography, or in instances where the data (sites, inscriptions, or destruction levels) manifestly complement or corroborate the text. This "handmaiden" role of archaeology has been challenged in the past two decades, and links between history and archaeology have been strengthened by changes in both disciplines, especially in the range of data utilized if not in method and approach. The archaeologist's reconstruction of long-term history is only enriched by textual documentation; and the historian has found in new approaches to ancient landscapes a wider scope of data, a realm of problems, and a multi-dimensional context for writing history.A new vision of documenting the Greek past is as yet nowhere more effectively illustrated than in A Greek Countrysidey. This book, which is the final publication of the Argolid Exploration Project (and Stanford University Archaeological and Environmental Survey), was conceived in an era of vastly changing approaches to the past and inspired by the first regional and diachronic survey in Greece, the Minnesota Messenia Expedition. The exploration of the southern Argolid also emerged in the context of two vastly different yet complementary excavations at the Paleolithic-Neolithic Franchthi Cave and Classical Halieis. The chronological, methodological, and environmental scope and problem orientation of these projects were important in setting the stage for the examination of human history in the broader region, emphasizing human-environment interaction as important to understanding culture change through time.A Greek Countryside presents the results of the survey (conducted in 1972 and 1979-1983) in the southern Argolid (225 km2) that recovered some 328 sites from an intensive sample of 44 km2. The first three chapters, "Topography," "History," and "Land and Sea in the Southern Argolid," provide an introduction to the study area. They present the synchronous dimensions of observable terrain, environment, and communication routes, and the diachronic perspectives of history (1000 B.C.-modern times), geomorphology, and environmental studies. Chapter 4, "The Archaeological Survey," describes the process and methods of fieldwork, the basis for the identification and functional designations of sites, and the classificatory nomenclature of the observable settlement patterns. Chapter [End Page 333] 5, "Using the Resources of the Land and Sea," is a discussion of agricultural, pastoral, and maritime activities derived from archaeological evidence from Franchthi Cave, Halieis, and wider afield, and from ethnography, studies of ancient and modern agriculture, and Medieval and Venetian records and travelers' accounts. This chapter injects the human element into the natural environment, setting the stage for the patterns of interaction between cultural and natural landscapes. The authors' synthesis and conclusions are presented in the final chapter 6, unambiguously titled, "Fifty Thousand Years of Coevolution of Landscape and Human Settlement."This concluding chapter is wonderfully detailed, referring back to the data presented in previous chapters and forward to the numerous appendices. The appendices are focused treatments of the sites recovered (A); population estimates (B); pseudo-Scylax's periplus (C); Pausanias' account of the south Argolid (D); the town of Hermion (E); the border dispute between Hermion and Epidauros in the first half of the second century B.C. (F); and an account of the Turkish traveler, Evliya Chelebi, in 1669 (G). Chapter 6 is somewhat of an achievement in itself, providing a lucid and fascinating chronological and historical narrative, un-encumbered by tendentious footnotes or cross-references, while making the reader constantly aware of both the data and the interpretive basis for conclusions. Although the diachronic survey maps, showing settlement patterns, are presented earlier in chapter 4, more detailed maps illustrate chapter 6 and are essential and effective complements to the text.The effects of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Age and Ageing in Contemporary Speculative and Science Fiction by Sarah Falcus and Maricel Oró-PiquerasMariana Batista da CruzSarah Falcus and Maricel Oró-Piqueras, eds. Age and Ageing in Contemporary Speculative and Science Fiction. London: Bloomsbury, 2023. 248 pp., hardcover, $115.00. ISBN 9781350230668.The pervasiveness of questions of temporality, futurity, and immortality in science and speculative fiction opens new perspectives on aging and generationality. However, despite the potential of these genres (...) to illuminate alternative ways of thinking about the human being in time, there has been a clear tendency within the field of aging studies to favor the analysis of realist narratives. To be sure, Age and Ageing in Contemporary Speculative and Science Fiction does not venture into completely uncharted territory. Teresa Mangum's study of "rejuvenation narratives," Andreu Domingo's conceptualization of "demodystopias," and Sarah Falcus's analysis of generational anachronism in dystopian novels have attempted to fill related gaps in aging studies.1 Yet Sarah Falcus and Maricel Oró-Piqueras's edited collection of essays is the first extensive study of speculative and science fiction (SF) as cultural productions that encode prevalent concerns about age and aging societies.Focusing on texts from Europe, North America, and South Asia, with particular emphasis on the anglophone world, the scope of the collection is limited but its contributions are rich in the range of themes that they address. This broad variety, touching on questions of genre, immortality, bio-power, demographic change, temporalities, and transhumanism, renders the book relevant not only to those working within the field of aging studies, in [End Page 266] particular scholars of SF and those more generally interested in representations of futurities.The collection is divided into two parts: The first part consists of six essays, each of which analyzes a range of SF narratives and identifies "genre-based trends in the representation of age and ageing" (4); the second part presents five detailed case studies that consider specific SF texts. This structure suits the book's goal of mapping the intersections between studies of SF and aging studies. The first part illuminates recurrent patterns in the representation of aging in works of SF, while the cases analyzed in the second part demonstrate the range of creative and aesthetic possibilities that SF affords to reimagine human temporality. The two parts contain chapters on literary as well as audiovisual texts, including essays on film, TV, and a play. The latter are a valuable addition to the collection, not only, as the editors point out, due to "the importance of the visual medium to SF/speculative writing" (4), but also given the popularity and reach of these textual modes, which establish SF as particularly influential forms of cultural representation.The chapters in the first half of the book center around the topic of longevity, exploring narratives that capture hopes and anxieties connected to the possibility of prolonging human life. Teresa Botelho's essay on the opportunities that science fiction provides to reimagine humanity's "biological destiny" (10) opens the collection well, as it introduces topics that are further developed in subsequent chapters. Focusing on texts that construct transhumanist scenarios where enhancement technologies have made rejuvenation, immortality, or life extension tangible realities, this chapter considers how SF narratives have questioned the desirability and political implications of these changes to the human life span. Peter Goggin and Ulla Kriebernegg study age regression and progression as narrative devices to show how popular SF films and TV series have assigned meanings to old age and given expression to dominant concerns regarding aging. The narratives that they analyze have done little to subvert dominant cultural assumptions about old age, and older women in particular continue to be underrepresented in SF.Generationalism is the focus of Falcus and Oró-Piqueras's discussion of anglophone longevity narratives, one of the highlights of the first part of the book. This chapter examines literary and audiovisual texts that project future worlds where the aging process has been successfully halted or delayed: the novels Super Sad True Love Story by Gary Shteyngart (2010), The Postmortal by Drew Magary (2011), and Everything Belongs to the Future by Laurie Penny (2016), as well as the film... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Buddhist Literature as Philosophy and Buddhist Philosophy as Literature ed. by Rafael K. StepienVesna A. Wallace (bio)Buddhist Literature as Philosophy and Buddhist Philosophy as Literature. Edited by Rafael K. Stepien. Albany, NY: State University of New York Press, 2020. Pp. xi + 381. Paperback $26.95, isbn 978-1-4383-8070-1.The editor of the Buddhist Literature as Philosophy and Buddhist Philosophy as Literature should be commended for bringing together an excellent collection (...) of essays and producing the first comprehensive volume that offers a coherent study of the relationship between Buddhist literature and philosophy. This book is an ambitious and praiseworthy project, which covers a wide range of Buddhist literary genres produced in India, Tibet, and East Asia over two millennia. As a whole, the volume invites the reader to reexamine a centuries-long binary division between the categories of literature and philosophy, which have been often approached in academic studies as mutually exclusive. It does so by demonstrating that in the context of Buddhism, philosophy and literature continuously converge, diminishing the overarching binary and broadening their scopes. Most contributions to this volume demonstrate that Buddhist philosophy as presented and enacted in Buddhist literature is not limited to what some would consider a "pure philosophy." The volume is divided into the two, mutually mirroring sections, with each section containing six chapters. Chapters forming the section one, "Buddhist Literature as Philosophy," aim at broadening our perspective about literary forms, such as tales, novels, hymns, and court poetry, which have not been usually explored as the means of articulating Buddhist philosophical views. Chapters grouped in the section "Buddhist Philosophy as Literature" focus on Buddhist literary theories as philosophy of language and introduce the Buddhist biographical and autobiographical genres characterized by practical philosophy to further challenge our preconceptions of what it is that constitutes literature and philosophy. While some contributors endeavor to demonstrate the presence of rational, analytical reasoning in unexpected literary forms, other contributors problematize a strict distinction between literature and philosophy as inapplicable to Buddhism, which is undeniably cross-disciplinary.The first two chapters in section one, authored by Amber Carpenter and Sarah Shaw respectively, draw examples from jātaka stories to show us how Buddhist ethical lessons work in the narrative tales of the Buddha's former births. These two chapters also draw our attention to an accessible and engaging, [End Page 1] narrative manner that presents the Bodhisattva's philosophical exercises to the audience, a manner that stands in contrast to the a priori reasoning characteristic of philosophical treatises. In the first chapter, titled "Transformative Vision: Coming to See the Buddha's Reality," Carpenter analyzes two jātaka stories--"Bodhi the Wandering Ascetic" and "The Man Without an Heir"--taken from Āryaśūra's Jātakamālā. In the first story, a renunciant Bodhi, while repudiating the king's ministers who are intent on disqualifying him as a king's advisor on morality, makes metaphysical claims regarding the nature of reality, causation, and the universe, and provides the reasons and arguments. According to Shaw, by offering an insight into the Buddhist worldview and morality, jātaka tales have a transformative power not only with regard to ethics but also in transforming the reader's vision of reality. In the chapter "Jātakas and the Abhidhamma: Practical Compassion and Kusala Citta," Shaw suggests that a reason why jātaka stories are rarely discussed seriously in the way that they were intended is their literary format based in narrative and mundane situations. Analyzing the concepts of momentariness and kusala citta ("virtuous consciousness") in these stories, Shaw shows that by communicating the technical and insight-based Buddhist doctrinal elements, jātaka tales significantly contribute to Buddhist practical ethics. The Pāli Javanahaṃsa-jātaka, a tale about the friendship between a goose and a king, introduces the reader to some of the most complex Buddhist ideas such as impermanence, momentariness, and mental states, expounded in the Abhidhamma in extraction. Through her analysis of the Kurudhamma-jātaka and Mahosaddha-jātaka, Shaw further shows the integration of narrative literature and Buddhist philosophical tenets, of Buddhist tales and the Abhidhamma, of the relationship between the intention and consciousness... (shrink)

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, (...) to inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders. (shrink)

We conducted a scoping review to ascertain the landscape of ethics regulations for AD/ADRD research in Africa using Arksey and O'Malley's framework. We sourced regulations from the International Compilation of Human Research Standards. We included regulations from 14 countries published between 1997 and 2020. Provisions in the regulations applicable to research in AD/ADRD were part of broader sub-provisions for research such as with persons under legal disability. Regulations mostly required the appointment of Legally Authorised Representatives, as a major (...) protection for persons with AD/ADRD. Provisions supporting capacity assessment and advance directives were only provided in regulations from five and two countries respectively. No regulation cited the Convention on the Rights of Persons with Disabilities as a foundational instrument for its provisions. In conclusion, regulations specifically applicable to research among AD/ADRD or other cognitively impaired persons in Africa are scarce and provisions in existing regulations mostly lack specificity for practical implementation. (shrink)

Background “Crisis military deployment” was defined as a situation in which military personnel are suddenly ordered to duty to support an operation away from their home station and in a potentially dangerous environment. As a result of complex changes in the global political and economic landscape, military nurses are assuming an increasing number of crisis military deployment tasks. Moral distress has been widely studied among civilian nurses. However, little is known about the moral distress military nurses experience during military deployments (...) in crisis. Aim This review discussed the current state of research on the phenomenon, unique factors, specific sources, and measurement tools. Methods The scope of the study was defined using a framework developed by Arksey and O’Malley. Following English databases were searched: PubMed, CINAHL, Cochrane Library, Web of Science, and Embase, using MeSH terms and free word combinations; furthermore, Chinese databases: CNKI and CBMDisc, were explored using thematic terms from inception until January 20, 2023. Data were selected and defined by the inclusion and exclusion criteria and independently screened by two researchers. Ethical considerations The scoping review adhered to sound scientific practice and respected authorship and reference sources. Results Finally, 21 articles were included in the review. The moral distress of military nurses in crisis military deployments had unique and specific sources and reported positive aspects. The deployment environment and nature of the mission, responsibilities and obligations of military nurses, and the limited rights of patients were unique factors. Specific sources included third-party intervention, military triage, resource allocation, futile care, care of the enemy, and return to the battlefield. Military nurses in deployment reported positive aspects. They grow in their inner strength, build deep friendships and gain a greater sense of professional value. Conclusion It is important to understand the unique factors and specific sources of moral distress faced by military nurses in crisis military deployments and to identify the positive aspects. This research will help prepare military nurses for future deployments in advance by providing useful information to mitigate and eliminate moral distress. (shrink)

Substance use disorders (SUDs) constitute a growing global health crisis, yet many limitations and challenges exist in SUD treatment research, including the lack of objective brain-based markers for tracking treatment outcomes. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity, and although much is known about EEG activity in acute and chronic substance use, knowledge regarding EEG in relation to abstinence and treatment outcomes is sparse. We performed a scoping review of longitudinal and pre-post treatment EEG studies (...) that explored putative changes in brain function associated with abstinence and/or treatment in individuals with SUD. Following PRISMA guidelines, we identified studies published between January 2000 and March 2022 from online databases. Search keywords included EEG, addictive substances (e.g., alcohol, cocaine, methamphetamine), and treatment related terms (e.g., abstinence, relapse). Selected studies used EEG at least at one time point as a predictor of abstinence or other treatment-related outcomes; or examined pre- vs. post-SUD intervention (brain stimulation, pharmacological, behavioral) EEG effects. Studies were also rated on the risk of bias and quality using validated instruments. Forty-four studies met the inclusion criteria. More consistent findings included lower oddball P3 and higher resting beta at baseline predicting negative outcomes, and abstinence-mediated longitudinal decrease in cue-elicited P3 amplitude and resting beta power. Other findings included abstinence or treatment-related changes in late positive potential (LPP) and N2 amplitudes, as well as in delta and theta power. Existing studies were heterogeneous and limited in terms of specific substances of interest, brief times for follow-ups, and inconsistent or sparse results. Encouragingly, in this limited but maturing literature, many studies demonstrated partial associations of EEG markers with abstinence, treatment outcomes, or pre-post treatment-effects. Studies were generally of good quality in terms of risk of bias. More EEG studies are warranted to better understand abstinence- or treatment-mediated neural changes or to predict SUD treatment outcomes. Future research can benefit from prospective large-sample cohorts and the use of standardized methods such as task batteries. EEG markers elucidating the temporal dynamics of changes in brain function related to abstinence and/or treatment may enable evidence-based planning for more effective and targeted treatments, potentially pre-empting relapse or minimizing negative lifespan effects of SUD. (shrink)

Flow is a gratifying state of deep involvement and absorption that individuals report when facing a challenging activity and they perceive adequate abilities to cope with it. The flow concept was introduced by Csikszentmihalyi in 1975, and interest in flow research is growing. However, to our best knowledge, no scoping review exists that takes a systematic look at studies on flow which were published between the years 2000 and 2016. Overall, 252 studies have been included in this (...) class='Hi'>review. Our review provides a framework to cluster flow research, gives a systematic overview about existing studies and their findings, and provides an overview about implications for future research. The provided framework consists of three levels of flow research. In the first “Individual” level are the categories for personality, motivation, physiology, emotion, cognition, and behavior. The second “Contextual” level contains the categories for contextual and interindividual factors and the third “Cultural” level contains cultural factors that relate to flow. Using our framework, we systematically present the findings for each category. While flow research has made progress in understanding flow, in the future, more experimental and longitudinal studies are needed to gain deeper insights into the causal structure of flow and its antecedents and consequences. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 126.3 (2005) 461-463 [Access article in PDF] Graham Zanker. Modes of Viewing in Hellenistic Poetry and Art. Wisconsin Studies in Classics. Madison: The University of Wisconsin Press, 2004. xiv + 223 pp. 34 black-and-white ills. Cloth, $39.95. The underlying contention here is that if a Hellenistic poetic description of a person, an animal, the weather, a scene, or an objet d'art adopts a particular way (...) of viewing, we have independent evidence for the habits of viewing that Hellenistic people would have brought to their contemplation of representational art. (4) So Graham Zanker summarizes the thesis of his new book, the most extensive and detailed account of Hellenistic visuality yet published. This is a carefully worded sentence. Zanker's enumeration of poetic descriptions of "a person, an animal, the weather, a scene or an objet d'art" deliberately exemplifies what he takes to be the scope of ekphrasis and hence reproves those who have taken ekphrasis more narrowly as the description of works of art (cf. 6–10). The target of this disapproval turns out to be especially Simon Goldhill, whom he attacks at 82–83 and in a long endnote (184–85, n. 26). Yet the care to be precise in matters of literary definition goes with such large, even lax, social and cultural generalizations as "Hellenistic people" and "representational art." What Zanker must mean by those whose contemplation of art can be evoked through poetic descriptions is a highly literate and educated social elite—perhaps the court itself—that may have played (Marie-Antoinette-like) at shepherds and fishermen (as in the cup of Theocritus' first Idyll) but surely did so from a much narrower social perspective than the totalizing generalism of "Hellenistic people." The weapon of precision is a dangerous one to use, when it may be turned back on the user.There are, moreover, numerous problems with both the notion of "independent evidence" and that of "habits of viewing." While the literary evidence of ekphrasis (not only in poetry) certainly encompasses viewing, its specially wrought and often spectacular cleverness may signal the exceptional, even the perverse, as much as (or more than) the habitual. Does a revolutionary statue like the Aphrodite of Cnidos (not actually Hellenistic, but nonetheless rightly incorporated at some length in Zanker's book) reflect or elicit the habitual gaze? In what sense? And, if so, when? Was the gaze it enticed at its moment of creation "habitual," or did that gaze only become "habitual" in its numerous—within our surviving material archive of examples, mainly Roman-period—versions and replications? More difficult still is "independent evidence." I am not really sure what that could be in a topic created from critical and interpretative explications of complex images and texts that do not themselves draw explicit or simple conclusions about viewing (or anything) beyond what readers may impute to them. How they may collectively constitute evidence about viewing can only come about as the result of argument. I think a compelling argument based on the critical interpretation of images and texts may be taken as evidence, but is that "independent evidence?" What does this mean? And such a complex argument is a very different kind of evidence from what Zanker seems to mean by any particular viewpoint we may find expressed in an ekphrasis. [End Page 461]Again, I do not think it follows that the evidence for viewing we may entice from a poetic description of a person, an animal, or the weather need necessarily be related to the contemplation of a work of art. Indeed, Zanker's use of the term contemplation (with its Kantian overtones) appears to indicate a specifically aesthetic zone of response. Certainly the Hellenistic period explicitly elevated creativity in the visual arts to a new canonical status with its creation of art-historical narratives and histories devolving on the rise of naturalism and on the genius of particular hallowed artists who are preserved for us by the likes of Quintilian and Pliny. That special aestheticism, marked in the choice of works of... (shrink)

Behavioural variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia characterized by changes in personality, social behaviour, and cognition. Although neural abnormalities cause bvFTD patients to struggle with inhibiting problematic behaviour, they are generally considered fully autonomous individuals. Subsequently, bvFTD patients demonstrate understanding of right and wrong but are unable to act in accordance with moral norms. To investigate the ethical, legal, and social issues associated with bvFTD, we conducted a scoping review of academic literature with inclusion (...) & exclusion criteria and codes derived from our prior work. Among our final sample of fifty-six articles, four mentioned bvFTD patient-offenders as unfit to stand trial by insanity, and sixteen mentioned the use of dementia evidence in a court of law to better understand the autonomy of bvFTD patients. Additional emergent issues that were discovered include: training police officers to handle situations involving bvFTD patients and educating healthcare providers on how to help caregivers navigate bvFTD. The current literature highlights the inadequacy of traditional applications of medico-legal categories such as autonomy, capacity and competence, in informing cognitive capacity assessments in clinical and legal settings and deserves consideration by neuroethicists. (shrink)

BackgroundSocio-cultural perceptions surrounding death have profoundly changed since the 1950s with development of modern intensive care and progress in solid organ transplantation. Despite broad support for organ transplantation, many fundamental concepts and practices including brain death, organ donation after circulatory death, and some antemortem interventions to prepare for transplantation continue to be challenged. Attitudes toward the ethical issues surrounding death and organ donation may influence support for and participation in organ donation but differences between and among diverse populations have not (...) been studied.ObjectivesIn order to clarify attitudes toward brain death, organ donation after circulatory death and antemortem interventions in the context of organ donation, we conducted a scoping review of international English-language quantitative surveys in various populations.Study appraisalA search of literature up to October 2020 was performed, using multiple databases. After screening, 45 studies were found to meet pre-specified inclusion criteria.Results32 studies examined attitudes to brain death, predominantly in healthcare professionals. In most, around 75% of respondents accepted brain death as equivalent to death of the person. Less common perspectives included equating death with irreversible coma and willingness to undertake organ donation even if it caused death. 14 studies examined attitudes to organ donation following circulatory death. Around half of respondents in most studies accepted that death could be confidently diagnosed after only 5 min of cardiorespiratory arrest. The predominant reason was lack of confidence in doctors or diagnostic procedures. Only 6 studies examined attitudes towards antemortem interventions in prospective organ donors. Most respondents supported minimally invasive procedures and only where specific consent was obtained.ConclusionsOur review suggests a considerable proportion of people, including healthcare professionals, have doubts about the medical and ethical validity of modern determinations of death. The prognosis of brain injury was a more common concern in the context of organ donation decision-making than certainty of death. (shrink)

The purpose of the study. This study aims to identify the prevalence of participants in physical activities, the motivation needed by the students to engage in the activity, challenges encountered by the implementors, health benefits, and recommendations and suggestions needed for the improvement of the implementation. -/- Materials and methods. A systematic analysis of the data from different articles was conducted using Arksey and O’Malley’s (2005) scoping review framework. -/- Results. It was found that the implementation of active (...) recreational activities offers different health benefits to the youth, physical literacy and orientation and motivation played a vital role in the implementation of the recreational activities. -/- Conclusions. Therefore, the implementation of active recreational activities must be strengthened in schools not just for the sake of participation but because they are motivated to. And engagement in these activities must not only be limited to school grounds but also engaged at home and in the community. (shrink)

Background The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs). Methods We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes (...) during public health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach. Results Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically. Conclusions There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics. (shrink)

The aim was to synthesize the findings of empirical research about the unmet nursing care needs of older people, mainly from their point of view, from all settings, focusing on (1) methodological approaches, (2) relevant concepts and terminology and (3) type, nature and ethical issues raised in the investigations. A scoping review after Arksey and O’Malley. Two electronic databases, MEDLINE/PubMed and CINAHL (from earliest to December 2019) were used. Systematic search protocol was developed using several terms for unmet (...) care needs and missed care. Using a three-step retrieval process, peer-reviewed, empirical studies concerning the unmet care needs of older people in care settings, published in English were included. An inductive content analysis was used to analyse the results of the included studies (n = 53). The most frequently used investigation method was the questionnaire survey seeking the opinions of older people, informal caregivers or healthcare professionals. The unmet care needs identified using the World Health Organization classification were categorized as physical, psychosocial and spiritual, and mostly described individuals’ experiences, though some discussed unmet care needs at an organizational level. The ethical issues raised related to the clinical prioritization of tasks associated with failing to carry out nursing care activities needed. The unmet care needs highlighted in this review are related to poor patient outcomes. The needs of institutionalized older patients remain under-diagnosed and thus, untreated. Negative care outcomes generate a range of serious practical issues for older people in care institutions, which, in turn, raises ethical issues that need to be addressed. Unmet care needs may lead to marginalization, discrimination and inequality in care and service delivery. Further studies are required about patients’ expectations when they are admitted to hospital settings, or training of nurses in terms of understanding the complex needs of older persons. (shrink)

Duty of care is the core ethical responsibility of healthcare workers. Getting the workforce vaccinated will provide safety to the public, protect the vulnerable population and provide a safe working environment. While most agree that healthcare workers should be prioritised in the vaccination programme, mandatory vaccination remains a complicated and contentious issue with political, legal and ethical dimensions. This study aims to determine the ethical considerations associated with mandatory vaccinations among healthcare workers. A total of 152 abstracts were identified of (...) which, 142 were excluded based on abstracts because they did not meet the inclusion criteria. The remaining ten articles were further evaluated with three articles that fit the inclusion criteria specifically discussing mandatory vaccination among healthcare workers and the ethical issues. Benefits, risks, effectiveness, equity and justice, autonomy, reciprocity and trust were used as a framework to discuss the ethical considerations which resonated both directly from the included papers, as well as more generally from the other literature associated with this search. There is limited literature on the topic of ethical considerations associated with COVID-19 mandatory vaccination of healthcare workers, as a systematic review identified only 3 papers. Benefits, risks, effectiveness, equity and justice, autonomy, reciprocity and trust were among the seven ethical considerations identified and discussed. (shrink)

Ethical research conduct is a cornerstone of research practice particularly when research participants include vulnerable populations. This study mapped the extent of reporting ethical research practices in studies conducted among refugees and war-affected populations in the Arab World, and assessed variations by time, country of study, and study characteristics. An electronic search of eight databases resulted in 5668 unique records published between 2000 and 2013. Scoping review yielded 164 eligible articles for analyses. Ethical research practices, including obtaining institutional (...) approval, access to the community/research site, and informed consent/assent from the research participants, were reported in 48.2, 54.9, and 53.7% of the publications, respectively. Institutional approval was significantly more likely to be reported when the research was biomedical in nature compared to public health and social, when the study employed quantitative compared to qualitative or mixed methodologies, and when the journal required a statement on ethical declarations. Institutional approval was least likely to be reported in papers that were sole-authored, when these did not mention a funding source, or when published in national journals. Similar results were obtained for access to the community site and for seeking informed consent/assent from study participants. The responsibility of inadequacies in adherence to ethical research conduct in crisis settings is born by a multitude of stakeholders including funding agencies, institutional research boards, researchers and international relief organizations involved in research, as well as journal editors, all of whom need to play a more proactive role for enhancing the practice of ethical research conduct in conflict settings. (shrink)

BackgroundDespite the rapid global growth of biobanking over the last few decades, and their potential for the advancement of health research, considerations specific to the sharing of benefits that accrue from biobanks have received little attention. Questions such as the types and range of benefits that can arise in biobanking, who should be entitled to those benefits, when they should be provided, by whom and in what form remain mostly unanswered. We conducted a scoping review to describe benefit (...) sharing considerations and practices in biobanking in order to inform current and future policy and practice. MethodsDrawing on the Arksey and O’Malley framework, we conducted a scoping review of the literature in three online databases (PubMed, Cochrane library, and Google Scholar). We extracted and charted data to capture general characteristics, definitions and examples of benefits and benefit sharing, justification for benefit sharing, challenges in benefit sharing, governance mechanisms as well as proposed benefit sharing mechanisms.Results29 articles published between 1999 and 2020 met the inclusion criteria for the study. The articles included 5 empirical and 24 non-empirical studies. Only 12 articles discussed benefit sharing as a stand-alone subject, while the remaining 17 integrated a discussion of benefits as one issue amongst others. Major benefit sharing challenges in biobanking were found to be those associated with uncertainties around the future use of samples and in resultant benefits.ConclusionMost of the benefit sharing definitions and approaches currently in use for biobanking are similar to those used in health research. These approaches may not recognise the distinct features of biobanking, specifically relating to uncertainties associated with the sharing and re-use of samples. We therefore support approaches that allow decisions about benefit sharing to be made progressively once it is apparent who samples are to be shared with, the intended purpose and expected benefits. We also highlight gaps in key areas informing benefit sharing in biobanking and draw attention to the need for further empirical research. (shrink)

Dyadic coping (DC), how couples cope together to deal with a stressor like chronic illness, has received increased attention over the last three decades. The aim of the current study was to summarize the current state of research on DC in couples. We conducted a scoping review of qualitative, quantitative, and mixed-methods studies published between 1990 and 2020, assessing DC in couples during three decades. 5,705 studies were identified in three electronic databases and hand searches. We included 643 (...) sources in this review (with a total ofN= 112,923 study participants). Most studies were based in the global North, particularly in the US and Europe. Publication numbers increased constantly over time. A third of study designs were cross-sectional studies followed by qualitative and longitudinal studies. The most prolific DC research areas were related to DC and minor stressors and DC and major physical health stressors. Overall, DC has been established internationally as a highly relevant construct in many disciplines (clinical, social, developmental, personality psychology, social work, nursing etc.). To conclude, the review reveals that future studies should focus on predictors, trajectories, and the importance of very specific DC behaviors for personal and dyadic functioning. (shrink)

Digital Pills are an innovative drug-device technology that permits to combine traditional medications with a monitoring system that automatically records data about medication adherence as well as patients’ physiological data. Although DP are a promising innovation in the field of digital medicine, their use has also raised a number of ethical concerns. These ethical concerns, however, have been expressed principally from a theoretical perspective, whereas an ethical analysis with a more empirically oriented approach is lacking. There is also a lack (...) of clarity about the empirical evidence available concerning the application of this innovative digital medicine. To map the studies where DP have been tested on patients and discuss the ethically relevant issues evident therein, we performed a scoping review of the empirical literature concerning DP. Our search allowed us to identify 18 papers reporting on studies where DP were tested on patients. These included studies with different designs and involving patients with a variety of conditions. In the empirical literature, a number of issues with ethical relevance were evident. At the patient level, the ethical issues include users’ interaction with DP, personal sphere, health-related risks and patients’ benefits. At the provider level, ethically relevant issues touch upon the doctor-patient relationship and the question of data access. At the societal level, they concern the benefits to society, the quality of evidence and the dichotomy device-medicine. We conclude that evidence concerning DP is not robust and that more research should be performed and study results made available to evaluate this digital medicine. Moreover, our analysis of the ethically relevant aspects within empirical literature underscores that there are concrete and specific open questions that should be tackled in the ethical discussion about this new technological solution. (shrink)