La relación entre generaciones que la educación concreta, articula los roles y expectativas que niños, adultos e instituciones escolares juegan en el entramado social presente y en la línea de transmisión de formas y relaciones necesarias para que el mundo sucumba o resista a las instancias devoradoras de la vida y de los procesos sociales automatizados. Sin embargo, las estrategias políticas de resistencia, que en Arendt se postulan como eminentemente adultas, son los textos de Walter Benjamin atravesados por niños los (...) que van a proporcionarlas. ¿Se puede hablar de un espacio de politización de la infancia, más allá de adoctrinamientos y programas de partido? (shrink)

Las discusiones sobre la intencionalidad en la Filosofía de la mente contemporánea se plantean en un marco un tanto ajeno al de la Fenomenología, bajo la suposición, de modo bastante generalizado, de que hay una separación entre intencionalidad y consciencia . Mi objetivo en este artículo es, en primer lugar, exponer tal supuesto. En segundo lugar, presentar los elementos clave de la teoría de la intencionalidad en las Investigaciones Lógicas de Husserl para presentar una visión que se opone a tal (...) separación. Y, en tercer lugar, finalizar con un tema común a ambos espacios de discusión, el de una experiencia o vivencia propia del pensamiento, que surge como un problema para muchas visiones analíticascontemporáneas y que tiene una explicación que puede derivarse de la concepción de Husserl.In contemporary Philosophy of mind, discussions about intentionality areset up in a quite different framework from the phenomenological one, assuming, in general, a separation between intentionality and consciousness. My aim in this paper is, firstly, to present this assumption. Secondly, I will put forward the key elements of Husserl's theory of intentionality in the Logical Investigations in order to present a view which is opposed to this assumption. And thirdly, I will end up with a common topic for both frameworks, that is, the topic of a specific experience of thinking, which emerges as a problem for many contemporary analytic views and which has an explanation that can be derived from Husserl's conception. (shrink)

In this paper I discuss whether there is a specific experience of thinking or not. I address this question by analysing if it is possible to reduce the phenomenal character of thinking to the phenomenal character of sensory experiences. My purpose is to defend that there is a specific phenomenality for at least some thinking mental states. I present Husserl's theory of intentionality in the Logical Investigations as a way to defend this claim and I consider its assumptions. Then I (...) present the case of understanding as a paradigmatic case for the phenomenal contrast argument and I defend it against two objections. (shrink)

El concepto jurídico de persona se encuentra ampliamente naturalizado como sinónimo de sujeto de derechos y obligaciones, a la par que remite a un antiguo elemento teatral. La carga simbólica de este concepto ha provocado que el campo semántico variara notablemente a lo largo de la historia y que, en la actualidad, existan controversias en torno a su sentido y significado. En este marco, el objetivo de este trabajo es presentar cómo la hermenéutica analógica puede realizar útiles aportes en el (...) desentrañamiento del sentido del término “persona”, pero, sobre todo, resaltar el vínculo entre controvertibilidad y analogía que se manifiesta en su interpretación. (shrink)

Depression is a widespread concern in the United States. Neuromodulation treatments are becoming more common but there is emerging concern for racial disparities in neuromodulation treatment utilization. This study focuses on Transcranial Magnetic Stimulation (TMS), a treatment for depression, and the structural and attitudinal barriers that racialized individuals face in accessing it. In January 2023 participants from the Twin Cities, Minnesota engaged in focus groups, coupled with an educational video intervention. Individuals self identified as non-white who had no previous TMS (...) exposure but had tried at least one treatment for their depression. Results revealed that the intervention did not notably change knowledge or stigma about TMS, but attitudes surrounding traveling for treatment changed. Notably, barriers like affordability, frequency of treatment, and lack of knowledge persist. Participants expressed a desire for more information, personal connection, and a tailored educational approach. The study suggests a need for multifaceted strategies to reduce disparities, focusing on education, community-based resources, and policy interventions. Immediate actions that can be taken include the creation of a TMS education program focused on patient engagement and awareness about TMS. (shrink)

La metáfora del teatro no sólo aparece en el título del _Teatro crítico universal_ (1726–1739) de Benito Jerónimo Feijoo, sino también fue aducida por Pierre Bayle en su _Projet et fragmens d’un dictionaire critique _(1692). Es cierto que, a principios de la Edad Moderna, la metáfora del teatro podía emplearse y se empleaba en multitud de contextos y con fines muy diversos. Sin embargo, la combinación de teatro y error, tal y como se da tanto en Bayle como en Feijoo, (...) merece un examen más detenido. Se muestra cómo el _Theatrum vitae humanae_ (1565) de Theodor Zwinger, que es el texto en el que Bayle afirma basar su _Dictionnaire_, introduce una noción de teatro que no se centra en el escenario sino en el auditorio. Esto es significativo tanto para las estrategias de escritura de Bayle como para las de Feijoo, ya que apunta a la gestión de vastos cuerpos de conocimiento y, en última instancia, a la citacionalidad de ambos proyectos. Al mismo tiempo, sitúa al lector frente a la sabiduría tradicional y prepara así un espacio para el modo emergente de la crítica – por algunos caracterizado como escepticismo – que informa los proyectos de ambos autores. (shrink)

New technologies, such as functional magnetic resonance imaging and transcranial magnetic stimulation, are currently touted as, not only giving us a better picture of the structure of the brain, but also a better understanding of our thinking. As Alan Snyder demonstrates when he claims his aim is to understand the ‘architecture of thought’ by investigating the brain. Against this backdrop, I will argue that new technologies present a worrying extension of mathematical natural science into the domain of human affairs. Extrapolating (...) upon Heidegger, I will put forward that neuroscientific experiments force thinking to conform to the mathematical conception of nature, rather than reveal something about the ‘true’ nature of our thinking. In a time when the expansion of mathematical natural science threatens to reduce every domain to that which is quantifiable, I will conclude by suggesting that the responsibility of the philosopher is to question the presuppositions of modern science and psychology.Nuevas tecnologías como la imagen de resonancia magnética funcional y la estimulación magnética transcranial se consideran presumiblemente capaces de darnos no solo una mejor imagen de nuestro cerebro, sino también una mejor comprensión de nuestro pensamiento, tal como demuestra Alan Snyder cuando afirma que su objetivo es entender la “arquitectura del pensamiento” mediante la investigación del cerebro. Contra este marco general, argumentaré que las nuevas tecnologías nos presentan una preocupante extensión de la ciencia natural matemática al dominio de los asuntos humanos. Extrapolando a partir de Heidegger, propondré que los experimentos neurocientíficos fuerzan al pensamiento a conformarse a la concepción matemática de la naturaleza en vez de revelar algo sobre la verdadera naturaleza de nuestro pensamiento. Nos encontramos en un momento en que o la expansión de la ciencia natural matemática amenaza con reducir todos los dominios a lo que es cuantificable. Concluiré sugiriendo que la responsabilidad del filósofo es cuestionar los presupuestos de la ciencia moderna y de la psicología. (shrink)

Abstract“Psychological essentialism” refers to our tendency to view the natural world as emerging from the result of deep, hidden, and internal forces called “essences.” People tend to believe that genes underlie a person’s identity. People encounter information about genetics on a regular basis, as through media such as a New York Times piece “Infidelity Lurks in Your Genes” or a 23andMe commercial showing people acquiring new ethnic identities as the result of their genotyping. How do people make sense of new (...) scientific findings that are inherently complex if they don’t have years of specialized training and education at their disposal? Given the substantial overlap between a lay understanding of genetics and lay intuitions about essences, we argue that, when most people are thinking about genes, they are not really thinking about genes in the complex ways that good scientists are. Combating people’s essentialist biases can be a formidable challenge. Although we have identified some promising results of trying to reduce people’s genetic essentialist tendencies, there is still much to learn about how these essentialist biases can be countered. It is important to help people understand genetic information so they are able make well‐informed decisions about their lives. (shrink)

Over the past decades, anti-cancer treatments have evolved rapidly from cytotoxic chemotherapies to targeted therapies including oral targeted medications and injectable immunooncology and cell therapies. New anti-cancer medications come to markets at increasingly high prices, and health insurance coverage is crucial for patient access to these therapies. State laws are intended to facilitate insurance coverage of anti-cancer therapies.Using Massachusetts as a case study, we identified five current cancer coverage state laws and interviewed experts on their perceptions of the relevance of (...) the laws and how well they meet the current needs of cancer care given rapid changes in therapies. Interviewees emphasized that cancer therapies, as compared to many other therapeutic areas, are unique because insurance legislation targets their coverage. They identified the oral chemotherapy parity law as contributing to increasing treatment costs in commercial insurance. For commercial insurers, coverage mandates combined with the realities of new cancer medications — including high prices and often limited evidence of efficacy at approval — compound a difficult situation. Respondents recommended policy approaches to address this challenging coverage environment, including the implementation of closed formularies, the use of cost-effectiveness studies to guide coverage decisions, and the application of value-based pricing concepts. Given the evolution of cancer therapeutics, it may be time to evaluate the benefits and challenges of cancer coverage mandates. (shrink)

El estudio buscó evaluar los niveles de dominio de las competencias investigativas en posgraduados de Perú y Ecuador desde un enfoque pedagógico socioformativo. Se desarrolló bajo el método deductivo de alcance descriptivo. El análisis de los resultados ubica a los posgraduados de ambos países en el nivel medio o resolutivo, lo cual indica que existen competencias aceptables y suficientes para investigar, pero no logran expresarse eficientemente ni de manera creativa e innovadora. Asimismo, existen limitaciones en el afrontamiento de distintas competencias (...) inherentes a la investigación científica. (shrink)

El feedback correctivo escrito ha demostrado ser efectivo para el tratamiento de ciertas estructuras gramaticales ; sin embargo, persisten factores que dificultan realizar conclusiones categóricas al respecto. Algunos de estos corresponden al tipo de las formas que se benefician de un tratamiento como este, a los distintos contextos de aprendizaje investigados, a los diversos niveles de competencia lingüística de los participantes, entre otros. La presente investigación estudia dos estrategias de FCE indirecto; a saber, indirecto con indicación y localización e indirecto (...) con indicación, localización y explicación metalingüística, en el tratamiento de la forma comparativa de adjetivos en inglés a nivel escolar. Los objetivos son examinar la efectividad del FCE y robustecer la evidencia empírica en contextos de aprendizaje que han sido insuficientemente indagados. Este primer acercamiento constituye una aproximación inédita que contribuye al fortalecimiento y al aumento de la evidencia empírica existente en el ámbito del FCE. La muestra del estudio correspondió a 24 estudiantes de 8° año de enseñanza primaria con un nivel básico de competencia lingüística en el idioma inglés como lengua extranjera. Los resultados muestran que ambos tipos de feeback promueven el uso preciso de la forma estudiada pero el FCE indirecto con indicación y localización del error es el que consigue mayores logros que se mantienen en el tiempo. Estos antecedentes sugieren una acción facilitadora del FCE en el tratamiento de la forma gramatical apuntada. (shrink)

Este estudio examina la frecuencia de colocaciones gramaticales verbo + preposición en aprendientes anglófonos de Español como Lengua Extranjera de nivel A2 y B1 bajo el modelo de Análisis Contrastivo de la Interlengua. Para ello, se implementa una tipología colocacional sustentada en un criterio de fijación intermedia de estas unidades. Los resultados muestran mayor frecuencia en el nivel B1, pero no en la variedad de unidades, y un mayor número de usos correctos que en A2. Respecto de las diferencias encontradas (...) según el patrón sintáctico-semántico, las variables competencia, complejidad del patrón y temáticas aparecen como factores importantes para explicarlas en el contexto del corpus de aprendientes examinado. Este trabajo aporta al estudio de las ColGram v+p, y de otros tipos en ELE. (shrink)

Resumen: Este estudio examina la frecuencia de colocaciones gramaticales verbo + preposición en aprendientes anglófonos de Español como Lengua Extranjera de nivel A2 y B1 bajo el modelo de Análisis Contrastivo de la Interlengua. Para ello se implementa una tipología colocacional sustentada en un criterio de fijación intermedia de estas unidades. Los resultados muestran mayor frecuencia en el nivel B1, pero no en la variedad de unidades, y un mayor número de usos correctos que en A2. Respecto de las diferencias (...) encontradas según el patrón sintáctico-semántico, las variables competencia, complejidad del patrón y temáticas aparecen como factores importantes para explicarlas en el contexto del corpus de aprendientes examinado. Este trabajo aporta al estudio de las ColGram v+p, y de otros tipos en ELE.: This study examines the frequency of grammatical collocations verb + preposition in L1-English learners of Spanish as a Foreign Language of levels A2 and B1 under the model of Interlanguage Contrastive Analysis. To this end, a collocational typology based on a criterion of intermediate fixedness was implemented. The results show higher frequency in level B1, but not in the variety of the units, and a greater number of correct uses than in A2. Regarding found differences according to syntactic and semantic pattern, the variables of competence, pattern complexity and theme appear to play an important role in their explanation in the context of the learners’ corpus examined. This work contributes to the study of GramCol v+p and other types in SFL. (shrink)

Diversos estudios internacionales indican que los pescadores sufren diferentes problemas de salud, entre los cuales son frecuentes las enfermedades cardiovasculares, accidentes laborales, heridas, ahogamientos, estrés laboral y problemas de salud mental. Objetivo: Con el estudio se pretendió identificar el nivel de bienestar sicológico y sedentarismo de pescadores artesanales de la Región de Los Lagos, Chile. Método: Se realizó un estudio cuantitativo que consistió en la aplicación de la escala de bienestar sicológico de Ryff y la versión breve del cuestionario de (...) actividad física IPAQ a 41 pescadores artesanales con una media de edad de 53,22 años. Resultados: Los resultados indican que un 68,3 % de pescadores son sedentarios, mientras que en las dimensiones del bienestar sicológico un 22 % muestra un alto nivel de crecimiento personal, seguido de un 14,7 % que presenta un alto nivel de dominio del entorno. No obstante, un alto porcentaje de los pescadores, 34,1 %, se encuentra en un nivel bajo de crecimiento personal, seguido de un 31,7 % con bajo nivel de autonomía y un 26,8 % con bajo nivel de relaciones positivas. Conclusiones: Los datos indican la necesidad de generar acciones preventivas de promoción y tratamiento oportuno de las patologías de salud mental para evitar que se conviertan en causas directas o indirectas de fallecimiento de los trabajadores. Diverse international studies show that artisanal fishermen suffer from different health issues, among which cardiovascular diseases, occupational accidents, injuries, drowning, work-related stress and mental health problems are the most frequent. Objective: the aim of the study was to identify the psychological well-being and sedentary lifestyle levels in artisanal fishermen from Los Lagos Region, Chile. Method: this was quantitative study consisting in applying Ryff's Psychological Well-being Scale and the short form of the International Physical Activity Questionnaire to 41 artisanal fishermen, whose mean age was 53.22 years. Results: the results reveal that 68.3 % of the fishermen have a sedentary lifestyle, while in the psychological well-being dimensions 22 % of them show a high level of personal development, followed by 14.7 % who have a high level of the control of the environment. Nevertheless, there is a considerable percentage of fishermen, 34.1 %, who have a low level od personal development, followed by 31.7 % with a low level of autonomy and 26.8 % with a low level of positive relationships. Conclusions: the data reveals a need to generate preventive healthcare measures and its promotion, and ensure an opportune treatment of mental pathologies in order to avoid that those become a direct or indirect cause for the demise of workers. (shrink)

Esta reseña aborda comentarios críticos y descriptivos del libro La conjetura de Anita, una obra literaria de cuentos, del contexto latinoamericano y sus transculturaciones, del autor chileno Miguel Baraona Cockerell, publicado por la Editorial de la Universidad Nacional (EUNA) en el año 2024. La obra está compuesta de ocho relatos y ha sido divulgada con el ISBN 978-9977-65-856-8.

Ten of the twelve essays in this fine collection treat subjects that are relevant to any reasonably comprehensive understanding of the nature of the history of science. The first four essays are either completely or largely historiographical. Each explores the extent to which the natural sciences have been, or should be, seen as central to the Scottish Enlightenment. As all four provide extended descriptive historiographies, there is extensive repetition here, but as the four also offer radically different answers, they are (...) worth reading.In the first essay Paul Wood argues that Dugald Stewart created an imaginary picture of the Scottish Enlightenment that has influenced almost all subsequent interpretations of the movement. These interpretations have promoted the idea that there was a coherent “Scottish school” of philosophy of which David Hume and Francis Hutcheson were the cofounders; that the Scottish school emphasized moral philosophy and social theory; and that it included figures from Glasgow, Edinburgh, and Aberdeen. Wood claims that Stewart downplayed the relationship between natural knowledge and social theory, except for some minor methodological commonalities, for several reasons. In part, he desperately wanted to maintain the mind‐body dualism that characterized the Scottish school. In addition, his main statement on the Scottish Enlightenment appeared as an essay on the history of the progress of metaphysics and morals that was paired with John Leslie's essay on the progress of the natural sciences in the supplement to the fourth edition of the Encyclopaedia Britannica, and he was simply responding to the limits of his assignment. Regardless of his motives, one major consequence of Stewart's approach has been the exclusion of the natural sciences from a central role in most subsequent interpretations of the Scottish Enlightenment not written by historians of science—an exclusion Wood laments.The second essay, by John Robertson, seems, on one level, almost designed to prove Wood's main point, for it explicitly denies natural science a significant role. For Robertson, moral philosophy, history, and, above all, political economy are at the core of Scottish concerns. He departs from Stewart, however, by insisting on a fundamental opposition between Hume and Hutcheson and by arguing that the Scottish Enlightenment would be better understood as part of a broader European Enlightenment, with less patriotic fervor about Scots exceptionalism.Richard Sher's essay on what book history can tell us about science and medicine in the Scottish Enlightenment is remarkably insightful and illuminating; it left me waiting with great anticipation for his book‐length study on the subject. Although Sher rejects Roger Emerson's claims that the natural sciences were the driving force for the Enlightenment in Scotland, he insists that science and medicine were important. He then goes on to suggest a series of fascinating ways in which characteristics of the book trade both shaped and can illuminate the place of science.Among the other essays likely to interest historians of science are those by Anita Guerrini, John Wright, and Fiona MacDonald. These authors explore aspects of medical theory and medical care in very different but very illuminating ways. One other related set of essays consists of pieces by James Moore, Christopher Berry, and Alexander Broadie, all of which focus on aspects of the theorized relationship between science and religion. Here, the major theme is the difference in emphases between those who followed the ancient materialists in seeing fear as the primary motive in the origins of religion and those who emphasized some version of the design argument.This volume provides a good introduction to the current state of interpretations of the Scottish Enlightenment, and its special emphasis on the place of science among eighteenth‐century Scottish intellectuals should make it attractive to many readers of Isis. (shrink)

Der Kern der Denkleistung Schellings kann als der fortgesetzte Versuch umschrieben werden, einen absoluten Anfang, den Ursprung, zu denken. Nach Schellings eigener Meinung ist die Losung dieser Aufgabe in seinen Weltalter-Texten erstmals formuliert. Hier liegt der Schlussel zum Verstandnis des spaten Schelling, vielleicht der ganzen Philosophie Schellings.

Den einen gilt Nietzsche als Verfasser blendender Aphorismen, in denen zu fast allen Themen kritische bis zynische Pointen zu finden sind, andere schatzen und ehren in ihm den systematischen Denker, dessen Relevanz fur die Geistesgeschichte des 20. Jahrhunderts kaum zu uberschatzen ist. Die vorliegende Studie zeigt, dass aphoristische wie systematische Aspekte Ausdruck eines Forschungsprogramms sind, welches Nietzsche als historische Philosophie bzw. historisches Philosophieren bezeichnet und praktiziert hat. Die im Werk verstreuten und bislang nicht systematisch ausgewerteten richtungweisenden Formulierungen werden umfassend aufgearbeitet.

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...) of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted. (shrink)

Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic (...) injustice has received limited treatment in bioethics. In this paper, we examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. We critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. We also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration. We argue that providers ought to avoid epistemic injustice in pain management by striving toward epistemic humility. Epistemic humility, as a form of epistemic justice, may be the kind disposition required to correct the harmful prejudices that may arise through testimonial exchange in chronic pain management. (shrink)

In this paper we introduce two issues relevantly related to the cognitive phenomenology debate, which, to our minds, have not been yet properly addressed: the relation between access and phenomenal consciousness in cognition and the relation between conscious thought and inner speech. In the first case, we ask for an explanation of how we have access to thought contents, and in the second case, an explanation of why is inner speech so pervasive in our conscious thinking. We discuss the prospects (...) of explanation for both sides of the debate and argue that cognitive phenomenology defenders are in an overall advantageous position. We also propose an account of inner speech that differs from other influential explanations in some interesting respects. (shrink)

According to Husserl’s phenomenology, the intentional horizon is a general structure of experience. However, its characterisation beyond perceptual experience has not been explored yet. This paper aims, first, to fill this gap by arguing that there is a viable notion of cognitive horizon that presents features that are analogous to features of the perceptual horizon. Secondly, it proposes to characterise a specific structure of the cognitive horizon—that which presents possibilities for action—as a cognitive affordance. Cognitive affordances present cognitive elements as (...) opportunities for mental action (i.e., a problem affording trying to solve it, a thought affording calculating, an idea affording reflection). Thirdly, it argues that postulating cognitive affordances helps to unfold a rational dimension of thinking by conceiving of them as motivating reasons for action, something that in turn provides an argument for the experienced character of cognitive affordances. (shrink)

Background: After over 4 years since medical assistance in dying legalization in Canada, there is still much uncertainty about how this ruling has affected Canadian society. Objective: To describe the positive aspects of medical assistance in dying legalization from the perspectives of hospice palliative care providers engaging in medical assistance in dying. Design: In this qualitative descriptive study, we conducted an inductive thematic analysis of semi-structured interviews with hospice palliative care providers. Participants and setting: Multi-disciplinary hospice palliative care providers in (...) acute, community, residential, and hospice care in Vancouver and Toronto, Canada, who have engaged in end-of-life care planning with patients who have inquired about and/or requested medical assistance in dying. Ethical considerations: The research proposal was approved by University of British Columbia Research Ethics Board in Vancouver and University Health Network in Toronto. Participants were informed regarding the research goals, signed a written consent, and were assigned pseudonyms. Results: The 48 participants included hospice palliative care physicians (n = 22), nurses (n = 15), social workers (n = 7), and allied health providers (n = 4). The average interview length was 50 min. Positive aspects of medical assistance in dying legalization were identified at (1) the individual level: (a) a new end-of-life option, (b) patients’ last chance to express control over their lives, (c) patient and family comfort and relief, and (d) a unique learning experience for hospice palliative care providers; (2) the team level: (a) supportive collegial relationships, (b) broadened discussions about end-of-life and palliative care, and (c) team debriefs provide opportunities for education and support; and (3) the institutional level: (a) improved processes to facilitate the implementation logistics. Conclusion: While being involved in the medical assistance in dying process is complex and challenging, this study sheds light on the positive aspects of medical assistance in dying legalization from the hospice palliative care provider’s perspectives. Medical Assistance in Dying legalization has resulted in improved end-of-life conversations between hospice palliative care providers, patients, and their families. Improved communication leads to a better understanding of patients’ end-of-life care plans and bridges some of the existing gaps between hospice palliative care and medical assistance in dying. (shrink)

This article presents two ways of contributing to the debate on cognitive phenomenology. First, it is argued that cognitive attitudes have a specific phenomenal character or attitudinal cognitive phenomenology and, second, an element in cognitive experiences is described, i.e., the horizon of possibilities, which arguably gives us more evidence for cognitive phenomenology views.

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

To the woman, God said, “I will greatly multiply your pain in child bearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you.”Genesis 3:16There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country. There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed and treated for their (...) pain.One particularly troublesome study indicated that women are more likely to be given sedatives for their pain and men to be given pain medication. Speculation as to why this difference might exist has included the following: Women complain more than men; women are not accurate reporters of their pain; men are more stoic so that when they do complain of pain, “it's real”; and women are better able to tolerate pain or have better coping skills than men. (shrink)

This introduction presents a state of the art of philosophical research on cognitive phenomenology and its relation to the nature of conscious thinking more generally. We firstly introduce the question of cognitive phenomenology, the motivation for the debate, and situate the discussion within the fields of philosophy, cognitive psychology and consciousness studies. Secondly, we review the main research on the question, which we argue has so far situated the cognitive phenomenology debate around the following topics and arguments: phenomenal contrast, epistemic (...) arguments and challenges, introspection, ontology and temporal character, intentionality, inner speech, agency, holistic perspective, categorical perception, value, and phenomenological description. Thirdly, we suggest future developments by pointing to four questions that can be explored in relation to the cognitive phenomenology discussion: the self and self-awareness, attention, emotions and general the... (shrink)

Prescription opioid abuse (POA) is an escalating clinical and public health problem. Physician worries about iatrogenic addiction and whether patients are ‘drug seeking’, ‘abusing’ and ‘diverting’ prescription opioids exist against a backdrop of professional and legal consequences of prescribing that have created a climate of distrust in chronic pain management. One attempt to circumvent these worries is the use of opioid contracts that outline conditions patients must agree to in order to receive opioids. Opioid contracts have received some scholarly attention, (...) with trust and trustworthiness identified as key values and virtues. However, few articles have provided a critical account of trust and trustworthiness in this context, particularly when there exists disagreement about their role in terms of enhancing or detracting from the patient–physician relationship. This paper argues that opioid contracts represent a misleading appeal to patient–physician trust. Assuming the patient is untrustworthy may wrongfully undermine the credibility of the patient's testimony, which may exacerbate certain vulnerabilities of the person in pain. However, misplaced trust in certain patients may render the physician vulnerable to the potential harms of POA. If patients distrust their physician, or feel distrusted by them, this may destabilise the therapeutic relationship and compromise care. A process of epistemic humility may help cultivate mutual patient–physician trust. Epistemic humility is a collaborative effort between physicians and patients that recognises the role of patients’ subjective knowledge in enhancing physicians’ self-understanding of their theoretical and practice frameworks, values and assumptions about the motivations of certain patients who report chronic pain. (shrink)

Whereas intersectionality presents a fruitful framework for theoretical and empirical research, some of its fundamental features present great confusion. The term ‘intersectionality’ and its metaphor of the crossroads seem to reproduce what it aims to avoid: conceiving categories as separate. Despite the attempts for developing new metaphors that illustrate the mutual constitution relation among categories, gender, race or class keep being imagined as discrete units that intersect, mix or combine. Here we identify two main problems in metaphors: the lack of (...) differentiation between positions and effects and the problem of reification. We then present a new metaphor that overcomes these two problems: a basket of apples. We argue that considering social positions as the diverse properties of different apples avoids reification by considering categories as properties and not as objects themselves, and at the same time it allows us to think about the effects dimension from a plural and contextual approach. With this shift, we propose a reframing of the discussion in debates on intersectionality theory on the relation among categories, their in/separability and fragmentation. (shrink)

Phenomenal contrast arguments (PCAs) are normally employed as arguments showing that a certain mental feature contributes to (the phenomenal character of) experience, that certain contents are represented in experience and that kinds of sui generis phenomenologies such as cognitive phenomenology exist. In this paper we examine a neglected aspect of such arguments, i.e., the kind of mental episodes involved in them, and argue that this happens to be a crucial feature of the arguments. We use linguistic tools to determine the (...) lexical aspect of verbs and verb phrases – the tests for a/telicity and for duration. We then suggest that all PCAs can show is the presence of a generic achievement-like phenomenology, especially in the cognitive domain, which contrasts with the role that PCAs are given in the literature. (shrink)

Although euthanasia has been a pressing ethical and public issue, empirical data are lacking in Japan. We aimed to explore Japanese nurses’ attitudes to patients’ requests for euthanasia and to estimate the proportion of nurses who have taken active steps to hasten death. A postal survey was conducted between October and December 1999 among all nurse members of the Japanese Association of Palliative Medicine, using a self-administered questionnaire based on the one used in a previous survey with Australian nurses in (...) 1991. The response rate was 68%. A total of 53% of the respondents had been asked by patients to hasten their death, but none had taken active steps to bring about death. Only 23% regarded voluntary active euthanasia as something ethically right and 14% would practice it if it were legal. A comparison with empirical data from the previous Australian study suggests a significantly more conservative attitude among Japanese nurses. (shrink)

This paper explores the relation of thought and the stream of consciousness in the light of an ontological argument raised against cognitive phenomenology views. I argue that the ontological argument relies on a notion of ‘processive character’ that does not stand up to scrutiny and therefore it is insufficient for the argument to go through. I then analyse two more views on what ‘processive character’ means and argue that the process-part account best captures the intuition behind the argument. Following this (...) view, I reconstruct the ontological argument and argue that it succeeds in establishing that some mental episodes like judging, understanding and occurrent states of thought do not enter into the stream but fails to exclude episodes like entertaining. Contrary to what it might seem, this conclusion fits well with cognitive phenomenology views, given that, as I show, there is a way for non-processive mental episodes to be fundamentally related to processive ones, such that they cannot be excl.. (shrink)

In this paper we report on an investigation into the principles underlying the choice of a particular referential expression to refer to an object located in a domain to which both participants in the dialogue have visual as well as physical access. Our approach is based on the assumption that participants try to use as little effort as possible when referring to objects. This assumption is operational-ized in two factors, namely the focus of attention and a particular choice of features (...) to be included in a referential expression. We claim that both factors help in reducing the effort needed to, on the one hand, refer to an object and, on the other hand, to identify it. As a result of the focus of attention the number of potential target objects is reduced. The choice of a specific type of feature determines the number of objects that have to be identified in order to be able to understand the referential expression. An empirical study was conducted in which pairs of participants cooperatively carried out a simple block-building task, and the results provided empirical evidence that supported the aforementioned claims. Especially the focus of attention turned out to play an important role in reducing the total effort. Additionally, focus acted as a strong coherence-establishing device in the studied domain. (shrink)