Objectivity has fruitfully been explored in last two decades, manifested by the many studies on ‘objectivity’ in various scientific disciplines. Due to the variety of contexts studied, the focus on...

Background: Family members are often required to act as substitute decision-makers when health care or research participation decisions must be made for an incapacitated relative. Yet most families are unable to accurately predict older adult preferences regarding future health care and willingness to engage in research studies. Discussion and documentation of preferences could improve proxies' abilities to decide for their loved ones. This trial assesses the efficacy of an advance planning intervention in improving the accuracy of substitute decision-making and increasing (...) the frequency of documented preferences for health care and research. It also investigates the financial impact on the healthcare system of improving substitute decision-making. Methods/DesignDyads (n = 240) comprising an older adult and his/her self-selected proxy are randomly allocated to the experimental or control group, after stratification for type of designated proxy and self-report of prior documentation of healthcare preferences. At baseline, clinical and research vignettes are used to elicit older adult preferences and assess the ability of their proxy to predict those preferences. Responses are elicited under four health states, ranging from the subject's current health state to severe dementia. For each state, we estimated the public costs of the healthcare services that would typically be provided to a patient under these scenarios. Experimental dyads are visited at home, twice, by a specially trained facilitator who communicates the dyad-specific results of the concordance assessment, helps older adults convey their wishes to their proxies, and offers assistance in completing a guide entitled My Preferences that we designed specifically for that purpose. In between these meetings, experimental dyads attend a group information session about My Preferences. Control dyads attend three monthly workshops aimed at promoting healthy behaviors. Concordance assessments are repeated at the end of the intervention and 6 months later to assess improvement in predictive accuracy and cost savings, if any. Copies of completed guides are made at the time of these assessments. DiscussionThis study will determine whether the tested intervention guides proxies in making decisions that concur with those of older adults, motivates the latter to record their wishes in writing, and yields savings for the healthcare system. Trial RegistrationISRCTN89993391. (shrink)

This powerful study is based on the premise that literary theory is important because literature is important. Bugliani explores the intersection of tragedy with philosophy and psychoanalysis. A threefold purpose is evident: to examine the tension between philosophy and literature, to discuss the teaching of tragedy and finally to discuss that teaching in the works of Lacan, Marcel and, above all, Paul Claudel.

The aim of this workshop was to ask potential end-users of the citizens’ information pack on legal and ethical issues around ICTs the following questions: What is your knowledge of the EU’s General Data Protection Regulation, and what actions have you taken in response to these regulations? What challenges are you experiencing in ensuring the protection and security of your project data, and compliance with the GDPR, within existing data management processes/systems? What information/tools/resources do you need to overcome these challenges? (...) What are the best formats/channels for receiving, sharing and acting upon this information? What is the most appropriate structure/format for the citizens’ information pack? (shrink)

ICTs, personal data, digital rights, the GDPR, data privacy, online security… these terms, and the concepts behind them, are increasingly common in our lives. Some of us may be familiar with them, but others are less aware of the growing role of ICTs and data in our lives - and the potential risks this creates. These risks are even more pronounced for vulnerable groups in society. People can be vulnerable in different, often overlapping, ways, which place them at a disadvantage (...) to the majority of citizens; Table 3 in this guide presents some of the many forms and causes of vulnerability. As a result, vulnerable people need greater support to navigate the digital world, and to ensure that they are able to exercise their rights. This guide explains where such support can be found, and also answers the following questions: - What are the main ethical and legal issues around ICTs for vulnerable citizens? - Who is vulnerable in Europe? - How do issues around ICTs affect vulnerable people in particular? This guide is a resource for members of vulnerable groups, people who work with vulnerable groups, and citizens more broadly. It is also useful for data controllers1 who collect data about vulnerable citizens. While focused on citizens in Europe, it may be of interest to people in other parts of the world. It forms part of the Citizens’ Information Pack produced by the PANELFIT project, and is available in English, French, German, Italian and Spanish. You are welcome to translate this guide into other languages. Please send us a link to online versions in other languages, so that we can add them to the project website. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 503 Possibility, Necessity, and Existence: Abbagnarw and His Predecessors. By NINO LANGIULLI. Philadelphia: Temple University Press, 1992. Pp. xv + 205. $44.95 (cloth). Although Nicola Abbagnano would agree in some sense with the currently fashionable claim that metaphysics is dead, Nino Langiulli's treatment of Abbagnano's thought constitutes a challenge to that claim. The aim, of Possibility, Necessity, and Existence is "to expound and elucidate historically and analytically (...) the concepts of possibility, necessity, and existence as they are refracted through the thought of the twentieth-century Italian philosopher Nicola Abbagnano." Langiulli characterizes Abbagnano as a bold and original thinker whose defense of "possibility" as the fundamental sense of being is understood by Abbagnano himself as an anti-metaphysical position. In his critical reflections, however, especially in the last chapter, Langiulli shows that Abbagnano is indeed engaged in an inquiry that can only be called metaphysical. Parts I and II are preparatory to the third part in which the concept of possibility and its relation to existence are most directly addressed. Part I provides a historical overview of four phases of the movement of Abbagnano's thought "from a positive existentialism to a radical empiricism." Abbagnano's version of existentialism is "positive" in that it sees in human finitude the very possibility of man's relationship with being. Here Abbagnano is distinguished from other existentialists such as Heidegger, Jaspers, Marcel, and Sartre. His criticisms of these positions are among the most important and interesting parts of the book. Heidegger and Jaspers both begin by apprehending human existence as a structure of possibilities but then reduce human existence to a structure of impossibilities. Christian existentialists such as Marcel really treat possibilities as potentialities to be inevitably realized. For Sartre all possibilities are equivalent, but for Abbagnano "the complete arbitrariness of choice among human possibilities does not imply freedom at all, but the impossibility of choice" (18). Here also Langiulli's comparison of Abbagnano with Quine, Sellars, and Rorty is pertinent and illuminating: Abbagnano would share Rorty's criticism of Quine and Sellars for holding on to vestiges of the old empiricism, but Abbagnano would not accept Rorty's "emptying" of philosophy itself. The influence of Abbagnano on his student Umberto Eco and on Gianni Vattimo and the differences between Abbagnano and Derrida's views of possibility are spelled out by Langiulli. In a section entitled "Dumping Philosophy and the Madness of It That Is Also Folly," Langiulli locates Abbagnano clearly and precisely within the debate over the legitimacy of reason. Abbagnano finds the basis of philosophical madness in the persistent tendency to take one aspect of human life as an absolute determinant, thus marginalizing or ignoring all others. "This privileged status has even been attributed to reason, but only when it 504 BOOK REVIEWS is absolutized or divinized as a superhuman force regulating the whole of nature, humanity included, according to necessary and necessitating laws" (39). So, for example, the order of mathematics or the techniques of verification and control employed in physics are transferred to the human world. But Abbagnano's rejection of absolutized reason is not a rejection of reason as such. He sees the current favoring of the nonrational and irrational aspects of life as a kind of folly and madness, "the vertigo of absurdity." The deliberate and crass ignorance of history and the search for novelty are also forms of madness. Part II consists of four chapters that trace the sources for Abbagnano's concept of possibility. The first of these sources is Plato's treatment of existence and possibility in the Sophist, where Abbagnano finds what he takes to be the antecedent for his own thought and for existentialism in general: the idea that possibility is both the structure and the ground of existing things. The two persistent themes of Greek metaphysics that Abbagnano is concerned to overcome are found most explicitly in Aristotle: the priority of actuality over possibility and the primacy of necessity over possibility. Kant is credited with opening the path for contemporary thought with his concept of real possibility (as distinguished from merely logical possibility). Finally, Abbagnano is indebted to Kierkegaard's criticisms of Aristotle and Hegel in the Philosophical... (shrink)

Sur la couverture des albums parus aux éditions Delcourt, on peut lire « Marcel Proust, À la recherchedu temps perdu, adaptation et illustrations de Stéphane Heuet ». En affichant ainsi son rôle avec modestie,l’adaptateur-illustrateur réussit à faire endosser à Proust la paternité littéraire d’une BD , ce qui n’est pas rien. Comble d’ironie ou de provocation, la Recherche illustrée par Heuet,c’est Tintin au pays des Guermantes. Dans les cases rectangulaires d’un strip standard au graphisme résolument« ligne claire », ceux (...) qui aiment la phrase proustienne en ses méandres, avec sa lecture au lentcours, découvrent une ligne TGV : Un amour de Swann en deux albums de 517 dessins, au lieu des200 pages en Pléiade. Cette alliance contre-nature est dénoncée par certains défenseurs de la littératurequi y voient une dénaturation de l’oeuvre et par des amoureux de la BD d’auteur qui déplorent une BDsans audace graphique. L’objet de cet article est de répondre à ces deux objections.On the cover of an album series published by Delcourt is written “Marcel Proust, À la recherche du tempsperdu, adaptation and illustrations by Stéphane Heuet”. With such an unassuming announcement of his role,the adaptor-illustrator manages to ascribe the literary paternity of a comic strip to Proust himself, which is no mean feat. And as a final irony or provocation, the “Recherche du temps perdu” illustrated by Heuet becomes “Tintin in the Land of the Guermantes”. As they peruse the rectangularframes of a classic comic strip with their “clear line” graphic style, those who enjoy a leisurely ramblethrough Proust’s meandering paragraphs may well find themselves aboard a high-speed train at full throttle:“Un amour de Swann” in two albums and 517 drawings, instead of 200 pages from the publisher Pléiade. Thisunnatural alliance has been denounced by advocates of literature as a travesty of Proust’s work, and bydevotees of authored comic strips as a work devoid of graphic boldness. This article sets out to answer both ofthese objections. (shrink)

An ideal vision model accounts for behavior and neurophysiology in both naturalistic conditions and designed lab experiments. Unlike psychological theories, artificial neural networks (ANNs) actually perform visual tasks and generate testable predictions for arbitrary inputs. These advantages enable ANNs to engage the entire spectrum of the evidence. Failures of particular models drive progress in a vibrant ANN research program of human vision.

In the study of organ and tissue transplantation, the focus tends to be on donation. But where there is “giving,” there is also “getting:” receiving help. Altruism, helping behavior, and the exchange of benefits have received extensive attention from social psychological researchers. The gift exchange described by anthropologist Marcel Mauss provides a framework for reviewing this social psychological research on altruism and exchange and applying it to transplantation. An overall conclusion is that altruistic donation is not so ethically or (...) clinically problematic, while receiving help has a complex psychosocial context that needs to be acknowledged and given more attention. (shrink)

This paper interprets the British legislative process that initiated the first comprehensive national regulation of embryo research and fertility services and examines subsequent efforts to restrain the assisted reproduction industry. After describing and evaluating British regulatory measures, I consider successive failures to control the assisted reproduction industry in the US. I discuss disparities between UK and US regulatory initiatives and their bearing on regulation in other countries. Then I turn to the political and social structures in which the assisted reproduction (...) industry is embedded. I argue that regulatory bodies are seldom neutral arbiters. They tend to respond most readily to special interests and neglect strategies that could more effectively meet the health needs of the people they represent. Neither national nor international bodies have aggressively pursued policies to harness the industry, reduce infertility rates, or meet the needs of people whose fertility is threatened by substandard healthcare and environmental neglect. In conclusion, I consider recent initiatives by activist groups to mount an alternative response to the industry's current practices and build a transnational reproductive justice movement. (shrink)

Griffiths et al. have proposed a quantitative measure of causal specificity and used it to assess various attempts to single out genetic causes as being causally more specific than other cellular mechanisms, for example, alternative splicing. Focusing in particular on developmental processes, they have identified a number of important challenges for this project. In this discussion note, I would like to show how these challenges can be met.

The current pandemic period has triggered a series of changes in society, at both individual and collective behavioral levels. These changes were perceived as either positive or negative by the impacted bodies, leading to both social change and positive interactions in a tense context. In this paper, the authors will deal with Pandemica Panotpica, subjugation infiltrating all levels of society, and the approach adopted by several countries in trying to find countermeasures to combat the virus' proliferation. Our research scope began (...) at the onset of the pandemic and ended on early January 2021. (shrink)

This piece seeks to elucidate how and why Latin America is neither anecdotal nor peripheral to pandemic preoccupations—nor to larger health and disease narratives—past and present. First, it examines the world's proportionately most destructive pandemic as coterminous with the rise of imperialism. Next, it traces how the impetus for international health cooperation based on regional crises predated and informed efforts elsewhere. Finally, it explores two under-charted narratives: the creative harnessing of data produced under adversity, and alternative health solidarities that bypass (...) reigning hierarchies of “humanitarian” aid. Together, these glimpses underscore a fundamental need for incorporating histories of and from Latin America to overcome the “history-telling injustice” created by the centuries-long Western dismissal of knowledge, practices, experiences, and existential meaning generated in the Global South. In short, these accounts provide a more complex and possibility-filled restructuring of dominant narratives around the diverse trajectories and consequences, as well as varieties of resistance, that shape understandings of pandemics. (shrink)

In a recent paper titled “Content Preservation”, Tyler Burge argues that certain psychological processes play a purely preservative role, and not a justificatory role. Burge’s claim is that the justificatory force of the beliefs sustained by these processes is independent of features of these processes, such as their reliability. The function of these psychological processes is merely to preserve the beliefs in order to “assure the proper working of other cognitive capacities over time”. In particular, Burge claims that the memory (...) processes underlying deductive reasoning and the psychological processes underlying verbal communication are purely preservative. (shrink)

Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO (Population, Intervention, Comparison, and (...) Outcome) worksheet. A total of 40 articles were included. The review is conducted according to the Vancouver Protocol. The main findings from the systematic literature review show that ethical challenges experienced by healthcare and social care providers in home-based care are related to autonomy and balancing ethical principles, decisions regarding intensity of care, challenges related to priority settings, truth-telling, and balancing the professional role. Findings regarding ethical challenges within home-based care are in line with findings from institutional healthcare and social care settings. However, some significant differences from the institutional context are also highlighted. (shrink)

This study aimed to explore the conditions for nurses' daily patient education work by focusing on managers' way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could ‘see’ neither their (...) role as a supporter of the patient education provided by nurses, nor their role in the development of nurses' pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses' provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost‐effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses' patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice. (shrink)

Many philosophers have defended the view that we are subject to the following evidential ought: “One ought to believe in accordance with one's evidence.” Although they agree on this, a more fundamental question keeps dividing them: from where does the evidential ought derive its normative force? The instrinsicalist answer to this question is sometimes described as the claim that "there is a brute epistemic value in believing in accordance with one's evidence" (Cowie, 2014, 4005). But what does this really mean? (...) Intrinsicalists' negative claim is that the normative source of the evidential ought has nothing to do with the fulfilment of our epistemic purposes. But what is their positive claim exactly? This paper aims at improving our understanding of intrinsicalism. Its conclusion is that there is only one possible way of being an intrinsicalist. Intrinsicalists need to be constitutivists. (shrink)

The general typology for the dialogue between religion and science is built on the assumption that there is an objective world, one reality that can be described. In this paper, I present an alternative epistemological framework for the dialogue that understands all descriptions of reality as symbolic. Therefore, this understanding creates a new possibility for mutual enrichment between the two dialogue partners. I demonstrate the usefulness of this framework by applying it to the dialogue between artificial intelligence (AI) and theology. (...) I discuss an advanced AI project: Cog, a humanoid robot. After briefly describing this project, its assumptions, and the emotions it creates (mainly hope and fear), I show how the project can be enriched by theological insight. The concept ofimago Dei—the understanding of humans created in the image of God—can be applied to the Cog project especially when it is presented in a way that takes the metaphorical character of both theological and scientific theories seriously. (shrink)

Everett’s main claim is that language is a “cultural tool”, created by hominids for communication and social cohesion. I examine the meaning of the expression “cultural tool” in terms of the influence of language on culture or of the influence of culture on language. I show that these hypotheses are not well-supported by evidence and that language and languages, rather than being “cultural tools” as wholes are rather collections of tools used in different language games, some cultural or social, some (...) cognitive. I conclude that the coincidence between language and culture is due to the fact that both originate from human nature. (shrink)

Research has established that the burdens of externalities associated with industrial production are disproportionately borne by socially and politically vulnerable groups, and this is particularly true for farmworkers who are at high risk for environmental exposures and illnesses. The impacts of these risks are often compounded by farmworker communities’ social vulnerability. Yet, less is known about how the intersection of race, class, and gender can position some farmworkers to be at higher risk for particular types of oppressions. We extend the (...) literature by analyzing the case of Black women farmworkers in Apopka, Florida, which was historically home to a large agricultural community. Drawing on the concept of critical environmental justice, we investigate the lived experiences of these women in the context of racialized, gendered, and economic oppressions during their time working on the farms. We use the case of Apopka to ask: how the policies and socio-historical context of the agricultural industry in the American South contributed to injustices experienced by Black women farmworkers in Apopka, Florida; and how race, gender, and class intersected and intersect to create and legitimize environmental injustices in the workplace for these farmworkers. Our data include semi-structured in-depth interviews, newspaper and media coverage, and archival materials. Our analysis advances work on critical environmental justice and intersectionality by mapping the relationship between structural and environmental intersectional oppressions for Black women farmworkers. (shrink)

Nudging is a concept in behavioural science, political theory and economics that proposes indirect suggestions to try to achieve non-forced compliance and to influence the decision making and behaviour of groups and individuals. Researchers in medical ethics are currently discussing whether nudging is ethically permissible in healthcare. In this article, we examine current knowledge about how different decisions (rational and pre-rational decisions, major and minor decisions) are made and how this decision-making process pertains to patients. We view this knowledge in (...) light of the nursing project and the ongoing debate regarding the ethical legitimacy of nudging in healthcare. We argue that it is insufficient to discuss nudging in nursing and healthcare in light of free will and patient autonomy alone. Sometimes, nurses must take charge and exhibit leadership in the nurse–patient relationship. From the perspective of nursing as leadership, nudging becomes a useful tool for directing and guiding patients towards the shared goals of health, recovery and independence and away from suffering. The use of nudging in nursing to influence patients’ decisions and actions must be in alignment with the nursing project and in accordance with patients’ own values and goals. (shrink)

In recent years, an increasing number of medical books and papers attempting to analyse the concepts of health and disease from the perspective of evolutionary biology have been published.This paper introduces the evolutionary approach to health and disease in an attempt to illuminate the premisses and the framework of Darwinian medicine. My primary aim is to analyse to what extent evolutionary theory provides for a biological definition of the concept of disease. This analysis reveals some important differences between functional explanations (...) in the field of evolutionary biology and functional explanations in the field of medicine. Moreover, I shall argue that the biological functions relevant to the health of an organism cannot be determined on the basis of evolutionary theory. Accordingly, it seems that Darwinian medicine does not provide for the definition of a biological concept of disease. Still,Darwinian medicine may suggest why we are susceptible to certain diseases; it might also prove a suggestive heuristic on the basis of which new hypotheses concerning relevant treatments of various diseases might be advanced. (shrink)