Artykuł przedstawia analizę historii zakończeń dwóch wierszy Anny Kamieńskiej – „Kiedy odchodzą wielcy” oraz „Jesteś mi ciepły młody”. Znane nam dokumenty literackie pozwalają znaleźć wspólny element tych dwóch procesów, z których jeden polegał na nieoczekiwanym dopisaniem puenty do ostatniej znanej nam wersji rękopiśmiennej wiersza, a drugi puentą uczynił w ostatnim etapie prac nad utworem zapis ze środka wcześniejszego brulionu. Tą częścią wspólną jest medytacyjny, nieretoryczny charakter warsztatu pisarskiego dojrzałej poetki. Jeśli pominąć oczywiste różnicy między obiema wierszami i procesami, z których (...) się wyłoniły, pozostanie silne podobieństwo, prawdopodobnie cecha charakterystyczna dla sposobu, w jaki pisała Anna Kamieńska przynajmniej od lat sześćdziesiątych minionego wieku, gdy proces twórczy był dla niej nie tyle okazją do znalezienia formy myśli, ale sam był myślorodny. (shrink)

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

A recent article in this journal described practical and conceptual difficulties faced by public health researchers studying scabies outbreaks in British residential care facilities. Their study population was elderly, decisionally incapacitated residents, many of whom lacked a legally appropriate decision-maker for healthcare decisions. The researchers reported difficulties securing Research Ethics Committee approval. As practicing healthcare ethicists working in a large Canadian research hospital, we are familiar with this challenge and welcomed the authors’ invitation to join the discussion of the ‘outstanding (...) ambiguities and further questions’ that their experience uncovered. We propose a Power of Attorney for Research as one substantive solution to help address the problems they identified. Although we acknowledge the familiar shortcomings associated with Advance Directives in the clinical context, we believe that Powers of Attorney for Research Participation, accompanied by Advance Research Directives, may increase the likelihood of gaining deeper understandings of potential participant’s values and priorities and how they might apply to foreseeable research opportunities. (shrink)

The Institute of Medicine has called on health care leaders to transform their health systems into “learning health care systems,” capable of studying and continuously improving their practices. Learning health care systems commit to carrying out numerous kinds of investigations, ranging from clinical effectiveness studies to quality improvement research and implementation science. There has been progress in realizing the IOM's vision, but also many challenges. One of these challenges has been lingering uncertainty about whether the data collection and monitoring central (...) to learning health care systems is actually research and if so, what kind of ethical oversight it should have. This is not a new question. Yet so far, there has been no foundational analysis of the fit between the existing human subjects protection framework in use in the United States and the new kinds of data collection activities that are being, and increasingly will be, undertaken by learning health care systems. Two companion feature articles in this volume, by a team at Johns Hopkins, fill this void. (shrink)

Introduction US data reveal a Caesarean rate discrepancy between insured and uninsured patients, with the C-section rate highest among the privately insured. The data have prompted concern that financial incentives associated with insurance status might influence American physicians' decisions to perform Caesarean deliveries. Objective To determine whether differences in medical risk factors account for the apparent Caesarean rate discrepancy between Medicaid and privately insured patients in Michigan, USA. Method A retrospective review was performed of 617 269 live birth deliveries in (...) Michigan hospitals during 2004–8. All live birth records that were able to be linked to their mothers' hospital discharge records were utilised. Diagnosis-related group codes from the hospitalisation records were used to identify Caesarean deliveries. Regression models determined Caesarean probability for the time period under study, adjusted for insurance type, maternal age, race, maternal medical conditions, multiple births, prematurity and birth weight. Results From 2004 to 2008, Caesarean rates were 33% for privately insured patients and 29% for Medicaid patients. The probability of Caesarean delivery was significantly greater for privately insured than Medicaid patients on univariate analysis (OR 1.2, 95% CI 1.19 to 1.22) but not on multivariate analysis (adjusted OR 1.01, 95% CI 0.99 to 1.02). Conclusion No significant disparity was found in the odds of Caesarean delivery between privately insured and Medicaid patients in Michigan after adjusting for other Caesarean risk factors. A positive disparity would have provided de facto evidence that financial incentives play a role in physician decision-making regarding Caesarean delivery. (shrink)

Access to investigational drugs is a concern to patients and regulatory agencies. In order to determine potential trial participants’ views on access to investigational drugs, we surveyed one hundred people who had been referred to a phase I clinical trial. Most respondents indicated that patients had a right to investigational drugs, that the drugs should be offered only in the context of research, that getting access to these drugs is too hard, and that knowing the right people and being persistent (...) increased the likelihood of gaining access. Respondents did not think that investigational drugs should be given to anyone who wanted them, or that physicians were aware of the latest investigational agents. They most frequently recommended two allocation criteria: offering investigational drugs to those who would benefit most or were most needy; and allocating them to maximize scientific advancement. Respondents who understood the purpose of the trial were more likely to choose the second criterion. (shrink)

In attempting to explain or deal with negative workplace behaviours such as workplace bullying, the notion of ‘workplace psychopaths’ has recently received much attention. Focusing on individual aspects of negative workplace behaviour is at odds with more systemic approaches that recognise the contribution of individual, organisational and societal influences, without seeking to blame a person(s) for their behaviour or personality disorder. Regarding a coworker as a psychopath is highly stigmatising, and given the relatively low prevalence of psychopathy in the community, (...) is likely to be incorrect. Sources promoting the notion of workplace psychopathy provide lists of diagnostic criteria and appear to encourage the perception that it is common. This research examines how lay persons use behavioural criteria consistent with psychopathy and the label ‘psychopath’ in relation to a coworker. 307 Australian workers completed an online survey concerning their experience of workplace bullying, which also asked them to rate a coworker’s behaviour on a range of scales to assess perceptions of psychopathy. Rates of psychopathy, when using labels and behavioural criteria, were found to be much higher than scientific estimates of prevalence, for both participants who had been bullied and those who had not. A higher proportion of non-bullied participants classified a coworker as a psychopath when using the label ‘psychopath’, compared to when using behavioural criteria. The notion that there are psychopaths in every workplace should be treated with caution to ensure that the potential for ‘misdiagnosis’ and stigmatisation do not cause further harm in situations of unacceptable workplace behaviours. (shrink)

This study aims to investigate the relationship between job burnout and employee performance in the feed industry during the ASF outbreak. Further, the researchers employed a descriptive-correlational research design in order to analyze the acquired data and produce pertinent findings. Thus, the researchers gathered data from one hundred two (102) feed industry employees. The Maslach Burnout Inventory (MBI) and Individual Work Performance Questionnaire (IWPQ) were employed to ascertain the extent of job burnout experienced by the respondents and evaluate employee performance, (...) respectively. Based on the statistical analysis, there is a significant relationship between job burnout and employee performance. Moreover, the study's findings were thoroughly analyzed and discussed. (shrink)

This book's importance is derived from three sources: careful conceptualization of teacher induction from historical, methodological, and international perspectives; systematic reviews of research literature relevant to various aspects of teacher induction including its social, cultural, and political contexts, program components and forms, and the range of its effects; substantial empirical studies on the important issues of teacher induction with different kinds of methodologies that exemplify future directions and approaches to the research in teacher induction.

Each contributor to this book has used personal experience as the basis from which to frame his individual sociological perspectives. Because they have personalized their work, their accounts are real, and recognizable as having come from 'real' persons, about 'real' experiences. There are no objectively-distanced disembodied third person entities in these accounts. These writers are actual people whose stories will make you laugh, cry, think, and want to know more.

A la fin du XIXe siècle, l'image de la femme criminelle est devenue une obsession nationale en France. Partout on vendait des pamphlets et des gravures relatant ces crimes en détail. Même les journaux en parlaient à loisir. Tout en analysant la criminalité féminine de fin-de-siècle à Paris, Ann-Louise Shapiro raconte des histoires remplies de détails fascinants sur la vie quotidienne, le système judiciaire et la place des femmes dans la société. L'auteur explore plusieurs perspectives ..

Beata Halicka's masterly narrated biography is the story of an extraordinary man and leading intellectual in the Polish-American community. Z. Anthony Kruszewski was first a Polish scout fighting in World War II against the Nazi occupiers, then Prisoner of War/Displaced Person in Western Europe. He stranded as a penniless immigrant in post-war America and eventually became a world-renowned academic. Kruszewski's almost incredible life stands out from his entire generation. His story is a microcosm of the 20th-century history, covering (...) various theatres and incorporating key events and individuals. Kruszewski walks a stage very few people have even stood on, both as an eye-witness at the centre of the Second World War, and later as vice-president of the Polish American Congress, and a professor and political scientist at world-class universities in the USA. Not only did he become a pioneer and a leading figure in Borderland Studies, but he is a borderlander in every sense of the word. (shrink)

Avec le retour en force de l'histoire littéraire dans l'Université, un nouvel intérêt se fait jour pour les périodes quelque peu négligées par la critique. Comme d'autres tournants de siècles, la Belle Époque est de celles-là : outre leur fonction obligée de transition, les deux ou trois décennies qui précèdent la Grande Guerre souffrent sans doute de leur foisonnement intellectuel même, dont ne se dégagent pas vraiment ces grandes figures, ou ces écoles littéraires dûment définies qui..

Neue Formen der Telekommunikation lassen die Sorge um Privatheit wieder aufkeimen. Zu diesen zählen E-Mails im Internet. Wie können Privatheitsrechte bezüglich E-Mails ethisch begründet werden? Eine differenzierte Formulierung der relevanten Privatheitsrechte ermöglicht die analytische Rechtstheorie von Stig Kanger. Für die Begründung dieser Rechte in unterschiedlichen Beziehungen (z.B. gegenüber Systembetreuer/inne/n, dem Staat oder Arbeitgeber/inne/n) spielen Personsein, persönliche und intime Beziehungen, aber auch politische und soziale Freiheiten eine wesentliche Rolle. Wann verzichten Menschen jedoch auf diese Rechte und von welchen Überlegungen werden sie (...) zurückgedrängt? Die Autorin behandelt nicht nur diese Ethischen Fragen, sondern gibt ebenso eine Reihe aktueller Informationen über technische, positiv-rechtliche und politische Entwicklungen. (shrink)

Although the E-Z Reader model accounts well for eye-tracking data, it will be judged by new predictions and consistency with evidence from brain imaging methodologies. The stage architecture proposed for lexical access seems somewhat arbitrary and calculated timings are conservatively slow. There are certain effects in the literature that seem incompatible with the model.

Typescripts, essays, and an authoritative edition of _Knowing and the Known, _Dewey’s collaborative work with Arthur F. Bentley. In an illuminating Introduction T. Z. Lavine defines the collaboration's three goals—the "construction of a new language for behavioral inquiry," "a critique of formal logicians, in defense of Dewey’s _Logic,_"_ _and "a critique of logical positivism." In Dewey’s words: "Largely due to Bentley, I’ve finally got the nerve inside of me to do what I should have done years ago." "What Is It (...) to Be a Linguistic Sign or Name?" and "Values, Valuations, and Social Facts,’ both written in 1945, are published here for the first time._ _. (shrink)

This study examines the relationship between social background factors and educational achievements. It draws on unique data from London LEAs. The paper illustrates detail analysis on levels of disadvantage in schools and the complexities of judging school performance including discussion on the potential of z-score indicators to measure the levels of deprivation in urban area schools. Overall, the findings from the empirical evidence suggests that there is a strong relationship between disadvantage and examination success, with LEAs located in non-deprived areas (...) tending to obtain higher percentages 5 + A*-C good GCSE passes. Further analysis of the relationship between pupils background and school achievement also confirmed, by and large, that schools with a higher number of disadvantaged families do less well than schools where, a small proportion of their pupils come from disadvantaged families. The paper concluded that uncontextualised performance table is fundamentally flawed and argued for the need to compare like with like and move beyond league table approaches of comparing schools. Policy implications are highlighted as well as practical suggestions. (shrink)

In vertebrates, single cell analyses of replication timing patterns brought to light a very well controlled program suggesting a tight regulation on initiation sites. Mapping of replication origins with different methods has revealed discrete preferential sites, enriched in promoters and potential G‐quadruplex motifs, which can aggregate into initiation zones spanning several tens of kilobases (kb). Another characteristic of replication origins is a nucleosome‐free region (NFR). A modified yeast strain containing a humanized origin recognition complex (ORC) fires new origins at NFRs (...) revealing their regulatory role. In cooperation with NFRs, the histone variant H2A.Z facilitates ORC loading through di‐methylation of lysine 20 of histone H4. Recent studies using genome editing methods show that efficient initiation sites associated with transcriptional activity can synergize over several tens of kb by establishing physical contacts and lead to the formation of early domains of DNA replication demonstrating a co‐regulation between replication initiation and transcription. (shrink)

Marc-Wogau, K. Mina filosofiska fördomar.--Gustafsson, L. Om klassifikation.--Kanger, S. Några synpunkter på begreppet inflytande.--Torstendahl, R. Minikrav, optimumnormer och paradigm i historisk vetenskap.--Lagerberg, D. Punktkommentarer till dialektiken.--Nordenfeldt, L. Om olika former av interaktion.--Puterman, Z. An indeterminist interpretation of Marx's historical determinism.--Carls, R. Kunskap och frihet.--Andersson, J. S. Some notions of pragmatic implication.--Tönisson, I. A preliminary study of interpreting K[subscript x]ø¹.--Bergström, L. Vilken handlingsutilitarism är den riktiga?--Alfredsson, T. Kärlekskoefficienter.--Segerberg, K. The assignment problem as a problem of social choice.--Åqvist, L. En tidslogisk variant (...) av Morgenstjärneparadoxen. (shrink)

Sosyal bilimler alanında, ortak zaman diliminde yaşamanın getirisi olarak benzer özelliklere sahip bireylerin oluşturduğu gruplar “kuşak” kavramı ile tanımlanmaktadır. Günümüzde, kuşaklar ortak bir kabul olarak; Gelenekselciler, Bebek Patlaması, X, Y ve Z Kuşağı olarak literatürde yer almaktadır. Ortak zaman diliminde yaşayan insanların algıları, beklentileri, hayata bakış açıları, alışkanlıkları ve gündelik yaşam pratikleri kendilerinden önceki ve sonraki zamanlarda yaşayanlara göre farklılık göstermektedir. Gündelik yaşamın pratiklerinde yaşanılan değişimin en yoğun hissedildiği alan toplumlarda genel olarak aile kurumu üzerindedir. Günümüzde, Y Kuşağı temsilcilerinin çoğu (...) aileleriyle bir arada yaşayan ve kendinden farklı bir kuşağın temsilcisi olan anne babalarıyla zor iletişim kuran bireyler olarak toplumda yer almaktadır. Toplumu oluşturan en küçük birim olarak tanımlanan aile, eğitim, sağlık ve güvenlik gibi bazı işlevlerini başka kurumlara aktarmış olsa da ulusların ve kültürlerin gelişimi için temel birim olmaya devam etmektedir. Toplumun temel yapısını oluşturan aile kurumu, bireylerin ve toplumun gösterdiği değişime paralel bir şekilde değişmektedir. Ailenin yapısında görülen değişimlere rağmen aile, özünde toplumun en küçük birimi olarak kalmaya ve hem bireyler için hem de toplum için işlevini sürdürmeye devam etmektedir. Bu çalışmada, önceki araştırmalar ve Y kuşağının temel özellikleri dikkate alınarak bu kuşak temsilcileri için ailenin değişen anlam ve önemine ve toplumsal yaşamda nasıl bir belirleyiciliği olduğuna değinilmektedir. (shrink)

Według tradycyjnych standardów, nauka powinna być wolna od wartościowań i perswazji, a w swej formie dążyć do beznamiętnego, obiektywnego opisu. Takich kryteriów nie da się jednak utrzymać szczególnie w naukach humanistycznych czy społecznych, operujących językami naturalnymi. Języki te obfitują bowiem w wyrażenia nacechowane emocjonalnie i oceniające, co sprawia, że nie mogą być wolne od perswazji. Perswazyjność języka należy do specyfiki nauk humanistycznych i nie jest zjawiskiem negatywnym. Jednakże świadome przedstawianie argumentacji i definicji perswazyjnych jako czystego opisu stanowi, z punktu widzenia (...) reguł metodologicznych, praktykę zasługująca na ocenę negatywną. Szczegółowa analiza i interpretacja popularnonaukowej książki pt. Płeć Mózgu, których dokonuję w niniejszym tekście, ujawniają zastosowane w niej liczne zabiegi perswazyjne. Autorzy świadomie posługują się nimi w celu przekonania odbiorcy do określonego światopoglądu, zaś powołanie się na autorytet nauki (tj. przyrodoznawstwa) ma uwiarygodnić ich stanowisko. Ten kontrowersyjny zabieg posiada nie tylko wymiar metodologiczny (wyznaczenie standardów literatury popularnonaukowej), ale także moralny, związany jest bowiem z odpowiedzialnością popularyzatorów nauki, którzy mogą wprowadzić czytelnika w błąd. (shrink)

Apart from the names of Jan Baudouin de Courtenay (1845-1929), Mikołaj Kruszewski (1851-1887), and, later, Jerzy Kuryłowicz (1895-1978), Polish linguists and Polish linguistics generally have been little known in the West. The first two were mentioned with approval by Saussure in an unpublished paper, and this reference was picked up by Roman Jakobson and others many years later. Kuryłowicz, for his part, made himself well known in the West through his important work as Indo-Europeanist, even Semiticist, and as a (...) general linguist. The present volume is a first attempt to broaden the perspectives on the Polish contribution to linguistics both inside and outside of Poland during the past centuries. Specialists in their respective fields contributed chapters on the origins and development of general linguistics (Z. Wąsik), applied linguistics (F. Grucza), lexicology (T. Piotrowski), dialectology (St. Gogolewski), and onomastics (S. Gala), followed by five chapters presenting the theories of the arguably most remarkable Polish linguistic thinkers, from Baudouin de Courtenay (A. Adamska-Sałaciak), Kruszewski (F. M. Berezin), and Kuryłowicz (W. Smoczyński) to Mikołaj Rudnicki (1881-1978) and Ludwik Zabrocki (1907-1977) (both written by J. Bańczerowski). Detailed individual bibliographies, a full index of names (with life dates of Polish linguists from the Renaissance to the present day), and a thorough index of subjects and terms make this volume an important reference tool for anyone wishing to acquaint himself with the rich heritage of Polish linguistic thought. (shrink)

'The church in danger' : latitudinarians, Socinians, and Hobbists -- Animal spirits and living fibres -- Mortalists and materialists -- Journalism, exile, and clandestinity -- Mid-eighteenth-century materialism -- Epilogue : some consequences.

Table of Contents: Illustrations Acknowledgments Conventions Introduction 3 Ch. 1 Kinds of Natural Philosophy 14 Ch. 2 Methods of Bookishness 49 Ch. 3 Modes of Argument 82 Ch. 4 Bodin’s Philosophy of Nature 116 Ch. 5 Theatrical Metaphors 153 Ch. 6 The Reception of the Theatrum 180 Epilogue: The Legacies of the Theatrum 225 Notes 233 Bibliography 331 Index 369.

Examines how violence has been conceptually and rhetorically put to use in continental social theory.

Philosophical discussion about the reality of sensory perceptions has been hijacked by two tendencies. First, talk about perception has been largely centered on vision. Second, the realism question is traditionally approached by attaching objects or material structures to matching contents of sensory perceptions. These tendencies have resulted in an argumentative impasse between realists and anti-realists, discussing the reliability of means by which the supposed causal information transfer from object to perceiver takes place. Concerning the nature of sensory experiences and their (...) capacity to provide access to reality, this article challenges the standard categories through which most arguments in this debate have been framed to date. Drawing on the underexplored case of olfaction, I first show how the details of the perception process determine the modalities of sensory experiences. I specifically examine the role of measurement and analyze its influence on the characterization of perceptions in olfaction. My aim is to argue for an understanding of perception through a process view, rather than one pertaining to objects and properties of objects. (shrink)

Detecting contract cheating in written submissions can be difficult beyond direct plagiarism detectable via technology. Successfully identifying potential cases of contract cheating in written work such as essays and reports is largely dependent on the experience of assessors and knowledge of student. It is further dependent on their familiarity with the patterns and clues evident in sections of body text and reference materials to identify irregularities. Consequently, some knowledge of what the patterns and clues look like is required. This paper (...) documents how to identify some of the patterns and clues observed in essay and report submissions. Effective assessment design with specific contextual requirements make irregularities easier to detect and interpret. The irregularities identified were confirmed as instances of contract cheating through conversations held with postgraduate students. An essential element of the conversations was the evidence presented for discussion. Irregularities were noted on a pro-forma specifically developed for this purpose. Patterns identified include misrepresented bibliographic data, inappropriate references, irrelevant material and generalised text that did not address the assessment question or grading criteria. The validated patterns formed the basis of identifying potential instances of contract cheating in later submissions. Timely conversations with students before the end of semester are essential to determining whether the patterns and clues link to poor knowledge of academic writing conventions or classified as contract cheating necessitating the application of appropriate penalties under institutional policies and procedures. (shrink)

Is the sense of smell a source of aesthetic perception? Traditional philosophical aesthetics has centered on vision and audition but eliminated smell for its subjective and inherently affective character. This article dismantles the myth that olfaction is an unsophisticated sense. It makes a case for olfactory aesthetics by integrating recent insights in neuroscience with traditional expertise about flavor and fragrance assessment in perfumery and wine tasting. My analysis concerns the importance of observational refinement in aesthetic experience. I argue that the (...) active engagement with stimulus features in perceptual processing shapes the phenomenological content, so much so that the perceptual structure of trained smelling varies significantly from naive smelling. In a second step, I interpret the processes that determine such perceptual refinement in the context of neural decision-making processes, and I end with a positive outlook on how research in neuroscience can be used to benefit philosophical aesthetics. (shrink)

The causal theory of properties is standardly combined with a realist's ontology of universals or tropes. In this paper, I consider an uncharted alternative – a nominalist causal theory of properties. I discuss advantages and disadvantages of the resulting theory of properties, and explore the Rylean understanding of causal powers that emerges.

In this article I will revisit the question of what I term the continuum of heteronormative sexual interactions, that is, the idea that purportedly ethically acceptable heterosexual interactions are conceptually, ethically, and politically associated with instances of sexual violence. Spurred by recent work by psychologist Nicola , I conclude that some of my earlier critiques of Catharine MacKinnon's theoretical linkages between sexual violence and normative heterosex are wanting. In addition, neither MacKinnon's theory nor my critique of it seem up to (...) the task of providing an ethical account of the examples of “unjust sex” that Gavey has described. I come to the conclusion that an ethical analysis of sexual interactions requires a focus on sexual desire, but that desire cannot take on the by now heavily criticized role of consent. Rather than looking for the presence or absence of sexual desire prior to sexual encounters as a kind of ethical certification of them, we ought instead to focus on the efficacy of that sexual desire, that is, its ability (or lack thereof) to shape an encounter in substantial and meaningful ways. (shrink)

Theories of perception have traditionally dismissed the sense of smell as a notoriously variable and highly subjective sense, mainly because it does not easily fit into accounts of perception based on visual experience. So far, philosophical questions about the objects of olfactory perception have started by considering the nature of olfactory experience. However, there is no philosophically neutral or agreed conception of olfactory experience: it all depends on what one thinks odors are. We examine the existing philosophical methodology for addressing (...) our sense of smell: on the one hand appeals to phenomenology that focus on the experiential dimensions of odor perception and on the other approaches that look at odor sources and their material dimensions. We show that neither strategy provides enough information to account for the human sense of smell and argue that the inclusion of the missing dimension of biology, with its concern for the function (or functions) of olfaction, provides the means to develop a satisfactory and empirically informed philosophy of smell. (shrink)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

Relatively few articles discuss the ethical issues that accompany healthcare in rural areas. This article presents and discusses the key findings obtained from multi-method research studies conducted over a 9-year period of time in a multi-state rural area. It challenges the efficacy of current models for bioethics, shows what kinds of ethical issues develop in rural communities, and offers a framework for envisioning resources and approaches that may be more appropriate.

The notion of virtue in general, and courage in particular, has had a hard time integrating itself into the everyday lexicon of bioethics. Following the lead of enlightenment moral philosophy, which concentrates on the theory of right action as opposed to the ancient Greeks' emphasis on the development of good character, bioethics, with some notable exceptions, has tended to relegate consideration of the virtues to the sidelines of moral argument. Recently, however, there have been calls for the necessity of “moral (...) courage” in the context of clinical ethics. As nurses, physicians, and other health care professionals confront a variety of moral contexts in which the virtue of courage is invoked to "do the right thing," stand up for patients' rights, and uphold the ethical standards of their professions, they are increasingly reminded of their moral duty to exhibit courage in the face of institutional obstacles to the proper care of their patients. For example, a nurse's hesitation to approach a physician to request increased sedation for an agitated patient out of fear of retaliation is represented in one article as a lack of courage.In this paper we offer a critical assessment of such invocations of courage. While we find courage to be an indispensable virtue in some challenging contexts, in other settings we find invocations of courage to be both an unfortunate endorsement of an oppressive status quo that can divert attention from the real problems and an undesirable and potentially destructive strategy within health care institutions whose goal is medically excellent and morally good clinical practice. As we shall argue, a call to virtuousness is not always virtuous. (shrink)

What if depression, in the Americas at least, could be traced to histories of colonialism, genocide, slavery, exclusion, and everyday segregation and isolation that haunt all of our lives, rather than to biochemical imbalances? This article seeks alternatives to the medical model found in most depression memoirs by considering how the epistemological and methodological struggles faced by a scholar of the African diaspora confronted by the absent archive of slavery are relevant to discussions of political depression. Combining scholarly investigation and (...) personal memoir, Saidiya Hartman’s Lose Your Mother exemplifies feminism’s affective turn not only by bringing personal narrative into scholarship, but by seeking reparation for the past in the affective dynamics of cultural memory rather than in legal reform or state recognition. Stubbornly refusing to find solace in an African past before slavery, though, Hartman provides a model of emotional reparation in which feelings of loss and alienation persist. Her work suggests the relevance of political depression to both the ordinary life of racism and to what gets called clinical depression. (shrink)