Background In the course of the COVID-19 pandemic, the biomedical research community’s attempt to focus the attention on fighting COVID-19, led to several challenges within the field of research ethics. However, we know little about the practical relevance of these challenges for Research Ethics Committees. Methods We conducted a qualitative survey across all 52 German RECs on the challenges and potential solutions with reviewing proposals for COVID-19 studies. We de-identified the answers and applied thematic text analysis for the extraction and (...) synthesis of challenges and potential solutions that we grouped under established principles for clinical research ethics. Results We received an overall response rate of 42%. The 22 responding RECs reported that they had assessed a total of 441 study proposals on COVID-19 until 21 April 2020. For the review of these proposals the RECs indicated a broad spectrum of challenges regarding social value, scientific validity, favourable risk–benefit ratio, informed consent, independent review, fair selection of trial participants, and respect for study participants. Mentioned solutions ranged from improved local/national coordination, over guidance on modified consent procedures, to priority setting across clinical studies. Conclusions RECs are facing a broad spectrum of pressing challenges in reviewing COVID-19 studies. Some challenges for consent procedures are well known from research in intensive care settings but are further aggravated by infection measures. Other challenges such as reviewing several clinical studies at the same time that potentially compete for the recruitment of in-house COVID-19 patients are unique to the current situation. For some of the challenges the proposed solutions in our survey could relatively easy be translated into practice. Others need further conceptual and empirical research. Our findings together with the increasing body of literature on COVID-19 research ethics, and further stakeholder engagement should inform the development of hands-on guidance for researchers, funders, RECs, and further oversight bodies. (shrink)

This article explores emerging ethical questions that result from knowledge development in a complex, technological age. Nursing practice is at a critical ideological and ethical precipice where decision-making is enhanced and burdened by new ways of knowing that include artificial intelligence, algorithms, Big Data, genetics and genomics, neuroscience, and technological innovation. On the positive side is the new understanding provided by large data sets; the quick and efficient reduction of data into useable pieces; the replacement of redundant human tasks by (...) machines, error reduction, pattern recognition, and so forth. However, these innovations require skepticism and critique from a profession whose mission is to care for and protect patients. The promise of technology and the new biological sciences to radically and positively transform healthcare may seem compelling when couched in terms of safety, efficiency, and effectiveness but their role in the provision of ethical nursing care remains uncertain. Given the profound moral and clinical implications of how today’s knowledge is developed and utilized, it is time to reconsider the relationship between ethics and knowledge development in this new uncharted area. (shrink)

Following extensive examination of published and unpublished materials, we provide a history of the use of dexamethasone in pregnant women at risk of carrying a female fetus affected by congenital adrenal hyperplasia (CAH). This intervention has been aimed at preventing development of ambiguous genitalia, the urogenital sinus, tomboyism, and lesbianism. We map out ethical problems in this history, including: misleading promotion to physicians and CAH-affected families; de facto experimentation without the necessary protections of approved research; troubling parallels to the history (...) of prenatal use of diethylstilbestrol (DES); and the use of medicine and public monies to attempt prevention of benign behavioral sex variations. Critical attention is directed at recent investigations by the U.S. Food and Drug Administration (FDA) and Office of Human Research Protections (OHRP); we argue that the weak and unsupported conclusions of these investigations indicate major gaps in the systems meant to protect subjects of high-risk medical research. (shrink)

We live in a society that promotes the universal process of producing knowledge and truth making as fundamental social process. Such promotion of universality seems to subjugate others forms of knowing rendering them invisible, unintelligible, and ineligible and subsequently outside the community of knowing. This has material and symbolic consequences in terms of how research informs policy and subsequent victimization of those who live, and experience subjugation meted by Western truth making universalism. In the words of Foucault, this book is (...) an insurrection of subterranean and clandestine knowledges in ways that provide not just an alternative process of knowledge production but affirms local knowledge as necessary in production of a just society. The book looks at research as a social justice and transformational process that should speak of people's ways of live without necessarily streamlining them into numbers. The book is a critically reflexive project in terms of returning processes of knowledge production to the local space rather than imagining them as entirely centred in the structure. To imagine this book as reflexive exercise is to break boundaries of knowledges in ways that come to imagine how local performs global in very complicated and complex ways. This book is a resurrection of local knowledges steeped in creative and imaginative reflexive methodologies that come to reorient how we come to know what we know, the values and realities that mark what we know and the how of knowledge production. It centres subjugated voices and knowledges as fundamental in production of knowledge. Contributors include: Katie Bannon, Elizabeth Charles, Khulood Agha Khan, Dionisio Nyaga, Fritz Pino, and Rose Ann Torres. (shrink)

L’excellent ouvrage de Pascale Barthélémy constitue un nouveau titre, très bienvenu, dans la floraison d’études dévolues à ce que Gregory Mann a appelé « la relation contrainte particulière » entre la France et l’Afrique. Pascale Barthélémy s’est penchée sur la petite minorité d’Africaines – à peine un millier au total – issues de la fédération d’Afrique Occidentale Française (AOF) et formées par les Français pour devenir sages-femmes, infirmières-visiteuses (jusqu’en 1938) ou encore institut...

The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress (...) phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments. (shrink)

In this paper I attempt to trace some entanglements of an event documented in my PhD research, which contests dominant modes of enquiry. This research takes place with a group of Grade 2 learners in a government school in Cape Town, South Africa. It is experimental research which resists the human subject as the most important aspect of research, the only one with agency or intentionality. In particular, the analysis focuses on the process of the making of the circle, and (...) how integral it is in contributing to building the Community of Enquiry, the pedagogy of Philosophy with Children. A critical posthuman analysis is offered which engages with the material-discursive entanglements of the making of the circle. Also, how this making of a circle can be a democratising practice, by including in the concept of democracy, the more-than-human. The analysis also focuses on the placing of the chairs by the children, as a deliberate pedagogical practice, and how this works to disrupt the adult /child binary. There is a move beyond the linguistic turn by paying attention to not only the discursive in the transcriptions but also the intra-actions in between human and more-than-human, the circle, the chairs and the materiality of place. (shrink)

This article considers two of the methodological steps in a Community of Philosophical Enquiry: developing the questions and voting on the questions. Both of these practices are enacted by the 8-9 year old children who are the participants in a philosophical enquiry, which I facilitated at a government primary school in South Africa. Matthews (1994) reminds us that children as philosophical thinkers/doers have been left out of the dominant narratives about children and childhood. A question that guides this research is (...) where is the place for philosophical questions (developed by children) and the kind of philosophical thinking/drawing/creating/being for child (and adults) in schools? How do we make space for such questioning–so that the richness of these pedagogical encounters can really matter and make a difference to the teaching and learning taking place? Gandorfer in an interview with Barad (2021), suggests that critical thought “is to encounter what is unrecognizable and imperceptible, yet sensible and constructive of sense without separating it from the physical world” (p. 20). I would agree and apply this to the critical thoughts of child. This thinking is not located in the child, in their mind and does not emerge only through the thoughts, child verbalises. A critical posthumanism theory/practice analysis ensures that as researcher, I do not stand outside of the research peering in at a distance. Similarly the children, the questions, the voting and the enquiries are not separate from the world, they are all already entangled with the world. When the children are voting on the questions, this performs as a pedagogy of interruption (Michaud, 2020). As the facilitator, I do not know which question will receive the largest number of votes for the philosophical enquiry. This makes possible an emergent curriculum in its be(com)ing. Toby Rollo’s (2016) formulations about child as political agent and not just moral agent and the implications for more democratic and just schooling are theorised in this paper through the act of the children voting on the questions. I argue that children are not just excluded from participating in decisions about what and even how they are learning at school but from most pedagogical practices in classrooms and schools. I show how the children creating the questions and voting on the questions can be democratic practices with political and moral implications in a community of philosophical enquiry. (shrink)

This study examines the discourse representation of migrant voices in two Spanish broadsheets and two freesheets through the analysis of quoted utterances. Data analyzed were gathered within the framework of a year-long EU research pilot project aimed at developing a cost-effective methodology to comparatively analyze print media content from six EU member states. Within the paradigm of CDA and drawing on Appraisal Theory, we analyzed the writer’s use of different types of reported speech, the corresponding reporting verbs, the endorsement of (...) the reported voices, and the attitudes and emotions that these denote. Results show some significant differences in the way immigrants’ voices are reported in Spanish broadsheets and freesheets. While the stories from the broadsheets depict voices of human suffering, freesheets articles show a different immigrant voice: one which is confident, successful, and well-adapted to the host environment. (shrink)

Building on research demonstrating relationships between well being and perceptions of aspects of life as sacred, this study describes the rationale for and development of a scale measuring perceiving sacredness in life. It then explores associations between perceptions of sacredness in life and these four domains: religious/spiritual, personal, social, and situational. Participants responded to a mailing to a national random sample within the United States, completing 16 scales pertaining to the religious/spiritual, personal, social, and situational domains. While many variables were (...) correlated with perceiving sacredness in life, there were three overall predictors: intrinsic religiosity, mysticism, and community service attitude. (shrink)

One of two commentaries on “Normalizing Atypical Genitalia: How a Heated Debate Went Astray,” by Josephine Johnston, from the November‐December 2012 issue.

Significant advances have recently been made in our understanding of the mechanisms of activation of proteins that require processing. Often this involves endoproteolytic cleavage of precursor forms at basic residues, and is carried out by a group of serine endoproteinases, termed the proprotein convertases. In mammals, seven different convertases have been identified to date. These act in both the regulated secretory pathway for the processing of prohormones and proneuropeptides and in the constitutive secretory pathway, in which a variety of proproteins (...) are activated endoproteolytically. The recently completed sequence of the nematode Caenorhabditis elegans genome affords a unique opportunity to examine the entire proprotein convertase family in a multicellular organism. Here we review the nature of the family, emphasising the structural features, characteristic of the four nematode genes, that supply all of the necessary functions unique to this group of serine endoproteinases. Studies of the C. elegans genes not only provide important information about the evaluation of this gene family but should help to illuminate the roles of these proteins in mammalian systems. BioEssays 22:545–553, 2000. © 2000 John Wiley & Sons, Inc. (shrink)

Research on evaluative conditioning (EC) shows that attitudes can emerge from co-occurrences of stimuli, and accumulating evidence suggests that EC usually depends on memory for these stimulus contingencies. Therefore, processes known to aid memory retention may be relevant for the development of stable attitudes. One such process may be memory consolidation, assumed to be promoted by waking rest and sleep. In two pre-registered experiments, we investigated whether waking rest (vs. cognitive activity, Experiment 1) and sleep (vs. wakefulness, Experiment 2) in (...) between conditioning and measurement of EC, consolidate contingency memory and EC. Contrary to our predictions, waking rest (vs. cognitive activity) promoted neither contingency memory nor EC effects. Sleep (vs. wakefulness) decreased forgetting of contingency memory but crucially, it did not attenuate the impact of counterconditioning on contingency memory. Sleep also did not influence EC effects, nor the reduction of EC by counterconditioning. EC effects in both experiments were predicted by contingency memory. Yet, unexpectedly, EC effects occurred in the absence of contingency memory after waking rest, but neither after sleep nor in the active control conditions. Our findings emphasise a role of contingency memory in EC, but it remains unclear whether this role changes during waking rest. (shrink)

BackgroundThere has been media coverage surrounding the dangers of heavy drinking and benefits of moderation, with TV and radio presenter, Adrian Chiles, documenting his experience of moderating alcohol consumption in an online article for the Guardian. By analysing the comments in response to Chiles’ article, this study aimed to explore posters’ attitudes or beliefs toward moderating alcohol and posters’ experiences of moderating or abstaining from alcohol.MethodA secondary qualitative analysis of online comments in response to an article about moderating alcohol consumption. (...) Main outcome measures: Comments in response to a United Kingdom online news article about moderating alcohol consumption were extracted and inductive thematic analysis was used.ResultsFor aim one, two themes were developed; “general attitudes toward drinking” and “general attitudes toward reducing consumption”. These themes reflect negative perceptions of alcohol and issues around changing attitudes. For aim two, three themes were developed: “moderation vs. abstention”, “reflection on past drinking behaviours”, and “current drinking behaviours”. These themes represent posters’ experiences and implications changing their drinking habits.ConclusionOur analysis provides a novel insight into perceptions and experiences of moderating or abstaining from alcohol. Alcohol is embedded within United Kingdom culture, creating difficulties for those who choose to moderate or abstain from alcohol. Our analysis highlights the need for public health to focus on shifting the current drinking culture, through clearer drinking guidelines and a wider availability of alcohol-free alternatives. (shrink)

In September 2008, 10 years after the untimely death of Pere Alberch (1954–1998), the 20th Altenberg Workshop in Theoretical Biology gathered a group of Pere’s students, col- laborators, and colleagues (Figure 1) to celebrate his contribu- tions to the origins of EvoDevo. Hosted by the Konrad Lorenz Institute for Evolution and Cognition Research (KLI) outside Vienna, the group met for two days of discussion. The meeting was organized in tandem with a congress held in May 2008 at the Cavanilles Institute (...) for Biodiversity and Evolutionary Biology (ICBiBE) in Valencia, Spain. The talks at the KLI were equal parts: nostalgic remembrance, excitement over new ways of thinking about old problems, and an unrepressed vitriol against the resurgence of reductionist thinking in EvoDevo. Here we highlight some of the key aspects of Pere’s life and work that informed and infused the talks. (shrink)

In this paper, we give a flavour of how, against the odds, Reggio-Emilia-inspired pedagogical documentation can work in reconceptualizing environmental education, reconfiguring child subjectivity and provoking an ontological shift from autopoiesis to sympoiesis in teacher education. Working posthuman(e)ly and transdisciplinarily across three foundation phase teacher education courses at a university in South Africa, we situate our teaching within current environmental precarities. We show how we stirred up trouble in and outside our university classroom and provoked our students to “make kin” (...) with children, each other, other animals, and the more-than-human, but also to stay with the trouble, that is, to learn to be truly present in colonized spaces. (shrink)

Chromosome ends have been implicated in the meiotic processes of the nematode Caenorhabditis elegans. Cytological observations have shown that chromosome ends attach to the nuclear membrane and adopt kinetochore functions. In this organism, centromeric activity is highly regulated, switching from multiple spindle attachments all along the chromosome during mitotic division to a single attachment during meiosis. C. elegans chromosomes are functionally monocentric during meiosis. Earlier genetic studies demonstrated that the terminal regions of the chromosomes are not equivalent in their meiotic (...) potentials. There are asymmetries in the abilities of the ends to recombine when duplicated or deleted. In addition, mutations in single genes have been identified that mimic the meiotic effects of a terminal truncation of the X chromosome. The recent cloning and characterization of the C. elegans telomeres has provided a starting point for the study of chromosomal elements mediating the meiotic process. (shrink)

The SARS-CoV-2 (COVID-19) pandemic continues to expose underlying inequities in healthcare for black, indigenous and Latinx communities in the USA. The gaps in equitable care for communities of colour transcend the diagnosis, treatment and vaccinations related to COVID-19. We are experiencing a continued gap across racial and socioeconomic lines for those who suffer prolonged effects of COVID-19, also known as ‘Long COVID-19’. What we know about the treatment for Long COVID-19 so far is that it is complex, requires a multidisciplinary (...) approach and there is still much research needed to fully understand the effects. In this paper, we discuss pragmatic considerations for including affected communities, relevant stakeholders, and leaders from communities of colour in the planning and implementation of Long COVID-19 research. (shrink)

There has been an ongoing appeal in the bioethics literature for a broader understanding and conceptual clarity of the phenomenon of moral distress. Several authors argue that greater conceptual cl...

Introduction: Screen-based and mobile technology has grown at an unprecedented rate. However, little is understood about whether increased screen-use affects executive functioning, the range of mental processes that aid goal attainment and facilitate the selection of appropriate behaviors. To examine this, a systematic review was conducted.Method: This systematic review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A comprehensive literature search was conducted using Web of Science, MEDLINE, PsycINFO and Scopus databases to identify (...) articles published between 2007 and March 2020, examining the use of mobile technologies on aspects of EF in healthy adults aged 18–35 years. In total 6079 articles were screened by title, and 39 screened by full text. Eight eligible papers were identified for inclusion. Our methods were pre-registered on the PROSPERO international prospective register of systematic reviews.Results: A total of 438 participants were included across the eight studies. Five of the eight studies examined more than one EF. Five studies measured inhibition, and four studies measured decision-making. Smartphone use was negatively associated with inhibition and decision-making. Working memory performance was found to be improved by increased time engaging in video games and by refraining from smartphone use prior to bedtime. Quality assessments indicated high risk of methodological biases across the studies and a low quality of evidence for determining the relationship between technology use and executive functioning.Conclusions: This review highlights the scarcity of the literature in this area. It presents a call for rigorous and objective research to further our understanding of the impact of mobile technology on different aspects of executive function. (shrink)

The Covid-19 pandemic creates an unprecedented threatening situation worldwide with an urgent need for critical reflection and new knowledge production, but also a need for imminent action despite prevailing knowledge gaps and multilevel uncertainty. With regard to the role of research ethics in these pandemic times some argue in favor of exceptionalism, others, including the authors of this paper, emphasize the urgent need to remain committed to core ethical principles and fundamental human rights obligations all reflected in research regulations and (...) guidelines carefully crafted over time. In this paper we disentangle some of the arguments put forward in the ongoing debate about Covid-19 human challenge studies (CHIs) and the concomitant role of health-related research ethics in pandemic times. We suggest it might be helpful to think through a lens differentiating between risk, strict uncertainty and ignorance. We provide some examples of lessons learned by harm done in the name of research in the past and discuss the relevance of this legacy in the current situation. (shrink)

BackgroundThere is a growing interest in using cognitive–behavioural therapy (CBT) with people who have Asperger syndrome and comorbid mental health problems.AimsTo examine whether modified group CBT for clinically significant anxiety in an Asperger syndrome population is feasible and likely to be efficacious.MethodUsing a randomised assessor-blind trial, 52 individuals with Asperger syndrome were randomised into a treatment arm or a waiting-list control arm. After 24 weeks, those in the waiting-list control arm received treatment, while those initially randomised to treatment were followed (...) up for 24 weeks.ResultsThe conversion rate for this trial was high (1.6:1), while attrition was 13%. After 24 weeks, there was no significant difference between those randomised to the treatment arm compared with those randomised to the waiting-list control arm on the primary outcome measure, the Hamilton Rating Scale for Anxiety.ConclusionsTrials of psychological therapies with this population are feasible. Larger definitive trials are now needed. (shrink)

Checklists have been used to improve quality in many industries, including healthcare. The use of checklists, however, has not been extensively evaluated in clinical ethics consultation. This article seeks to fill this gap by exploring the efficacy of using a checklist in ethics consultation, as tested by an empirical investigation of the use of the checklist at a large academic medical system (Cleveland Clinic). The specific aims of this project are as follows: (1) to improve the quality of ethics consultations (...) by providing reminders to ethics consultants about process steps that are important for most patient-centered ethics consultations, (2) to create consistency in the ethics consultation process across the medical system, and (3) to establish an effective educational tool for trainers and trainees in clinical ethics consultation. The checklist was developed after a thorough literature review and an iterative process of revising and testing by a group of experienced ethics consultants. To pilot test the checklist, it was distributed to 46 ethics consultants. After a six-month pilot period in which ethics professionals used the checklist during their clinical activities, a survey was distributed to all of those who used the checklist. The 10-item survey examined consultants’ perceptions regarding the three aims listed above. Of the 25 survey respondents, 11 self-reported as experts in ethics consultation, nine perceived themselves to have mid-level expertise, and five self-reported as novices. The majority (68 percent) of all respondents, regardless of expertise, believed that the checklist could be a “helpful” or “very helpful” tool in the consultation process generally. Novices were more likely than experts to believe that the checklist would be useful in conducting consultations. The limitations of this study include: reduced generalizability given that this project was conducted at one medical system, utilized a small sample size, and used self-reported quality outcome measures. Despite these limitations, to the authors’ knowledge this is the first investigatation of the use of a checklist systematically to improve quality in ethics consultation. Importantly, our findings shed light on ways this checklist can be used to improve ethics consultation, including its use as an educational tool. The authors hope to test the checklist with consultants in other healthcare systems to explore its usefulness in different healthcare environments. (shrink)

Project MUSE - Journal of the History of Philosophy - Mary Astell: Theorist of Freedom from Domination Project MUSE Journals Journal of the History of Philosophy Volume 46, Number 2, April 2008 Mary Astell: Theorist of Freedom from Domination Journal of the History of Philosophy Volume 46, Number 2, April 2008 E-ISSN: 1538-4586 Print ISSN: 0022-5053 DOI: 10.1353/hph.0.0014 Reviewed by Alice SowaalSan Francisco State University Patricia Springborg. Mary Astell: Theorist of Freedom from Domination. Cambridge-New York: Cambridge University Press, 2005. (...) Pp. xix + 372. Cloth, $80.00. Scholars have recently begun to expand research in early modern philosophy to include “minor” figures, especially those who contributed to the foundations of the scientific revolution. Simultaneously and separately, other scholars have begun examination of the female figures of the period. Prominent here are Eileen O’Neill’s series of articles, Jacqueline Broad’s Women Philosophers of the Seventeenth Century , and Sarah Hutton’s Anne Conway: A Woman Philosopher . Patricia Springborg, a political scientist, now contributes to this literature with Mary Astell: Theorist of.. (shrink)

The global agricultural sector faces a significant number of challenges for a sustainable future, and one of the tools proposed to address these challenges is the use of automation in agriculture. In particular, robotic systems for agricultural tasks are being designed, tested, and increasingly commercialised in many countries. Much touted as an environmentally beneficial technology with the ability to improve data management and reduce the use of chemical inputs while improving yields and addressing labour shortages, agricultural robotics also presents a (...) number of potential ethical challenges – including rural unemployment, the amplification of economic and digital inequalities, and entrenching unsustainable farming practices. As such, development is not uncontroversial, and there have been calls for a responsible approach to their innovation that integrates more substantive inclusion into development processes. This study investigates current approaches to participation and inclusion amongst United Kingdom (UK) agricultural robotics developers. Through semi-structured interviews with key members of the UK agricultural robotics sector, we analyse the stakeholder engagement currently integrated into development processes. We explore who is included, how inclusion is done, and what the inclusion is done for. We reflect on how these findings align with the current literature on stakeholder inclusion in agricultural technology development, and suggest what they could mean for the development of more substantive responsible innovation in agricultural robotics. (shrink)

Following the introduction of do-not-resuscitate orders in the 1970s, there was widespread misinterpretation of the term among healthcare professionals. In this brief report, we present findings from a survey of healthcare professionals. Our aim was to examine current understanding of the term do-not-attempt-resuscitate, decision-making surrounding DNAR and awareness of current guidelines. The survey was distributed to doctors and nurses in a university teaching hospital and affiliated primary care physicians in Dublin via email and by hard copy at educational meetings from (...) July to December 2014. A total of 519 completed the survey. The response rate in the hospital doctors group was 35.5%, 19.8% in the nurses group but 68.8% in the specialist nurses group and 40% in the primary care physician group.Alarmingly, our results demonstrate that 26.8% of staff nurses and 30% of primary care physicians surveyed believed that a patient with a DNAR order could not receive any/at least one of a list of simple treatments including antibiotics, physiotherapy, intravenous fluids, pain relief, oxygen, nasogastric feeding or airway suctioning, which were higher percentages compared to the other hospital doctors and experienced nurses groups with statistically significant differences. Furthermore, a higher percentage of staff nurses and primary care physicians believed that a patient with a DNAR order could not be referred to hospital from home/a nursing home, when compared with other healthcare groups. Our findings highlight continued misunderstanding and over-interpretation of DNAR orders. Further collaboration and information is required for meaningful Advance Care Plans. (shrink)

Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

Rather than focusing on political and legal debates surrounding attempts to determine if and when genocidal rape has taken place in a particular setting, this essay turns instead to a crucial, yet neglected area of inquiry: the moral significance of genocidal rape, and more specifically, the nature of the harms that constitute the culpable wrongdoing that genocidal rape represents. In contrast to standard philosophical accounts, which tend to employ an individualistic framework, this essay offers a situated understanding of harm that (...) features the importance of interdependence and relationality and that conceptualizes harms as embodied and contextual. The paper ultimately reveals what is distinctive about this particular crime of sexual violence by exploring the logic of genocidal rape: genocidal rape involves the harm of forced self-betrayal unleashed relationally, causing victims as representatives of their group to participate inadvertently in the destruction of that group. (shrink)

The article explores the rich and varied experiences of a collective writing project, unfolding through an anecdote involving Charlie, a young boy who creatively disrupted conventional photography methods. This incident, during an evening promenade by the sea in Ericeira (Portugal), epitomizes the project's embrace of playfulness and exploration of diverse perspectives–materialized through Charlie's playful insistence on experimenting with different angles. The event embodied the group’s approach to writing, leading to a collective inquiry into the interplay of ages, angles, and other (...) themes like waves, threads, shadows, and liminal spaces. The project, driven by the Between Ages Collective, began with informal gatherings in Plymouth, UK, and expanded into a year-long online reading group. Participants, spanning different generations and academic stages, shared various materials, including films, picture books, and scholarly texts, which inspired individual contributions. Influenced by the Collective's collaborative spirit, these contributions explore the concept of 'between ages' – a metaphorical and literal space of transition and fluidity. Contributors were invited to craft pieces that delve into the 'between ages' theme, often exploring serendipitous moments that transform interactions and experiences. The writing tries to capture a sense of openness and curiosity, embracing the uncertainties and ambiguities inherent in the process. The works do not strictly adhere to conventional academic or narrative forms but rather emerge from the collective's shared experiences, including cooking, eating, swimming and walking together. The article suggests that these writings are not meant to be definitive or conclusive but are explorations that invite readers to engage with the mundane and profound textures of everyday life. The stories and themes explored are marked by their diversity in style, rhythm, and imagery, ranging from reflections on the philosophy of shadows to the profound implications of intergenerational and interspecies relationships. The Collective’s work is presented as an ongoing experiment in thinking and writing together, with each piece offering unique insights into the fluid and often blurred boundaries between different states of being. This openness to the in-between spaces brings into question the notion of fixed identities and experiences, inviting a more nuanced understanding of the relational dynamics that shape existence. The article allows the readers to delve into these narratives and engage with the myriad ways they resonate with broader themes of being, storying, and connecting. (shrink)