The concept of brain death evolved because advancements in medical science permitted unprecedented artificial maintenance of vital body functions by external means. Although the concept of brain death is accepted clinically, ethically, and legally in the United States, there is no national standard for the determination of brain death. There is evidence that variability and inconsistency in the process of determining brain death exist both in clinical settings and in State statutes. Several studies demonstrate that medical personnel determine brain death (...) in variable ways, and have variable understandings of the definition of brain death. The declaration of death has significant legal consequences such as probate proceedings and liability issues for wrongful death. Inconsistencies in the determination of death may therefore be medically, ethically, and legally problematic. (shrink)

While foregrounding the historiography of HIV and AIDS in the South African context, this article analyses AIDS as simultaneously existing in three spheres: first, virtually – as the subject matter of electronically measurable research; second, academically – as a topic of research in the discipline of History; and third, actually – as a complex health concern and signifier that, via the field of Medical and Health Humanities, could allow for new collaborations between historians and others interested in understanding AIDS. Throughout, (...) the central focus is the discipline of History and the global trends that become evident when examining metrics about AIDS research, particularly those that show the hierarchies of knowledge ‘production’, the reinforcement of disciplinary boundaries, and the discrepancy between the amount of research ‘produced’ by scientific and humanities disciplines. Overall, the article suggests that ‘post-AIDS’ is not currently helpful to health historians working on South African and other majority world contexts. More specifically, the article reflects on what AIDS histories still need to be written, and I argue that Medical and Health Humanities could provide a space for historians to work within and across disciplinary boundaries given the ever evolving remit of AIDS histories, temporalities, and narratives. (shrink)

Background Ethical decision making in intensive care is a demanding task. The need to proceed to ethical decision is considered to be a stress factor that may lead to burnout. The aim of this study is to explore the ethical problems that may increase burnout levels among physicians and nurses working in Portuguese intensive care units . A quantitative, multicentre, correlational study was conducted among 300 professionals.Results The most crucial ethical decisions made by professionals working in ICU were related to (...) communication, withholding or withdrawing treatments and terminal sedation. A positive relation was found between ethical decision making and burnout in nurses, namely, between burnout and the need to withdraw treatments , to withhold treatments and to proceed to terminal sedation . This did not apply to physicians. Emotional exhaustion was the burnout subdimension most affected by the ethical decision. The nurses' lack of involvement in ethical decision making was identified as a risk factor. Nevertheless, in comparison with nurses , it was the physicians who more keenly felt the need to proceed to ethical decisions in ICU.Conclusions Ethical problems were reported at different levels by physicians and nurses. The type of ethical decisions made by nurses working in Portuguese ICUs had an impact on burnout levels. This did not apply to physicians. This study highlights the need for education in the field of ethics in ICUs and the need to foster inter-disciplinary discussion so as to encourage ethical team deliberation in order to prevent burnout. (shrink)

Texto presentado en el Congreso Internacional “Recepciones de Ortega y Gasset en Chile” celebrado en el Centro Cultural de España en Santiago durante los días 30 y 31 de mayo de 2018, en Santiago de Chile. Forma parte de la compilación recogida en número especial de la Revista de Filosofía Otrosiglo, en junio del 2023.

This paper discusses the legal implications of setting up two new biobanks in Belgium. The first is hospital-based and will archive tissue from patients with haematologic cancer, whereas the second is linked to a general practice based morbidity registry and will involve storage of blood samples. To date, Belgium has no specific legislation that regulates storage of human tissue and related databases. Several issues concerning the protection of individuals with regard to the processing of personal medical data are discussed from (...) the existing privacy legislation. We will address the principle of consent (broad versus specific) and the type of data recorded (anonymous, encoded and identifiable) for both biobanks. (shrink)

Neoliberal ideology and exclusionary policies based on racialized identities characterize the current contexts in North America and Western Europe. Nursing knowledge cannot be abstracted from social, political and historical contexts; the task of examining the influence of race and racial ideologies on disciplinary knowledge and inquiry therefore remains an important task. Contemporary analyses of the role and responsibility of the discipline in addressing race‐based health and social inequities as a focus of nursing inquiry remain underdeveloped. In this article, we examine (...) nursing's engagement with ideas about race and racism and explore the ways in which nursing knowledge and inquiry have been influenced by race‐based ideological discourses. Drawing on Henry and Tator's framework ofdemocratic racism, we consider how strategic discursive responses—the discourses of individualism, multiculturalism, colour‐blindness, political correctness and denial—have been deployed within nursing knowledge and inquiry to reinforce the belief in an essentially fair and just society while avoiding the need to acknowledge the persistence of racist discourses and ideologies. Greater theoretical, conceptual and methodological clarity regarding race, racialization and related concepts in nursing inquiry is needed to address health and social inequities. (shrink)

Nowadays, it seems easy to regard some of the values and purposes that have led us to the society we live in today as dysfunctional. However, searching for a villain that justifies all our pain and confusion in recent years is a vain undertaking. It is imperative to protect the good in our society and to discover what we need to improve and accomplish. In this sense, spirituality is our unresolved issue. The purpose of this article is to survey the (...) different deliberations about capital as a measurable value of companies and to explore whether spiritual capital can be a new one, or even more importantly, an important one. (shrink)

This paper takes a constitutivist approach to self-deception, and argues that this phenomenon should be evaluated under several dimensions of rationality. The constitutivist approach has the merit of explaining the selective nature of self-deception as well as its being subject to moral sanction. Self-deception is a pragmatic strategy for maintaining the stability of the self, hence continuous with other rational activities of self-constitution. However, its success is limited, and it costs are high: it protects the agent’s self by undermining the (...) authority she has on her mental life. To this extent, self-deception is akin to alienation and estrangement. Its morally disturbing feature is its self-serving partiality. The self-deceptive agent settles on standards of justification that are lower than any rational agent would adopt, and thus loses grip on her agency. To capture the moral dimension of self-deception, I defend a Kantian account of the constraints that bear on self-constitution, and argue that it warrants more discriminating standards of agential autonomy than other contemporary minimalist views of self-government. (shrink)

People with mental illness are subjected to stigma and discrimination and constantly face restrictions in the exercise of their political, civil and social rights. Considering this scenario, mental health, ethics and human rights are key approaches to advance the well-being of persons with mental illnesses. The study was conducted to review the scope of the empirical literature available to answer the research question: What evidence is available regarding human rights and ethical issues regarding nursing care to persons with mental illnesses? (...) A scoping review methodology guided by Arksey and O’Malley was used. Studies were identified by conducting electronic searches on CINAHL, PubMed, SCOPUS and Hein databases. Of 312 citations, 26 articles matched the inclusion criteria. The central theme which emerged from the literature was “Ethics and Human Rights Boundaries to Mental Health Nursing practice”. Mental health nurses play a key and valuable role in ensuring that their interventions are based on ethical and human rights principles. Mental health nurses seem to have difficulty engaging with the ethical issues in mental health, and generally are dealing with acts of paternalism and with the common justification for those acts. It is important to open a debate regarding possible solutions for this ethical dilemma, with the purpose to enable nurses to function in a way that is morally acceptable to the profession, patients and members of the public. This review may serve as an instrument for healthcare professionals, especially nurses, to reflect about how to fulfil their ethical responsibilities towards persons with mental illnesses, protecting them from discrimination and safeguarding their human rights, respecting their autonomy, and as a value, keeping the individual at the centre of ethical discourse. (shrink)

An attempt is made to answer this question by first analyzing the structure of Darwinian inheritance as it is exemplified in the current biological theory of evolution. Based on this analysis a generalized framework for Darwinian inheritance containing conditions which must be met by all proper Darwinian evolutionary theories is developed. Subsequently this framework is employed to assess, in part, the adequacy of Toulmin's evolutionary epistemology. Although Toulmin asserts that Darwinian inheritance operates in conceptual development, the framework is used to (...) show that the structure of concepts which he presents is unable to support the requirements for this kind of inheritance. It is concluded that Toulmin's evolutionary theory is not truly Darwinian. (shrink)

Congenital hip dysplasia is an abnormal formation of the hip socket that can cause painful arthritis of the joints. Early intervention is essential to ensure proper development of the bones that make up the hip joint, because the longer the condition goes undetected and untreated, the more difficult it is to correct. The assessment test to detect congenital hip dysplasia in newborns was first described by Marino Ortolani, an Italian pediatrician.Marino Ortolani was born in 1904 in Altedo, a small town (...) between Bologna and Ferrara in northeastern Italy. His parents were agricultural workers. He studied medicine at the University of Bologna and, after graduating in 1929, was awarded a medal for being the first.. (shrink)

In this article, the right to health is discussed as a social right and an essential requisite in the construction and guarantee of human rights, more precisely human dignity, considering this right as a complex but effective process in the transformation of the social reality. In the first place, the activities of the public power and its difficulties to guarantee universal access to health are highlighted. This scenario ends up inhibiting the practice of the right to health and prevents users (...) from enjoying and using it. In that sense, this article challenges and explores some alternatives to solidify and put in practice the right to health in Brazil. Departing from the analysis of the Unified Health System (SUS) and social participation in Brazil, this article discusses the judicialization of health in the country, highlighting the difficulties the State faces to equitably offer universal healthcare to society. This context offers an opportunity for reflection and a paradigm change, from the “judicialization of health” to the “judicialization of health policies.” Finally, the public health policies adopted by other countries are emphasized, in the attempt to construct the empowerment of human beings in the practice of their rights, particularly social participation and the discussion about the States’ responsibility to put their citizens’ right to health in practice. In conclusion, the political and collective construction of the right to health needs to be encouraged, distinguishing the legitimate interests of the different interlocutors involved. (shrink)

In this paper, I ask feminist philosophers and science studies scholars to consider the goals of developing critical analyses of evolutionary psychology. These goals can include development of scholarship in feminist philosophy and science studies, mediation of the uptake of evolutionary psychology by other academic and lay communities, and improvement of the practices and products of evolutionary psychology itself. I evaluate ways that some practices of feminist philosophy and science studies facilitate or hinder meeting these goals, and consider the merits (...) of critical engagement with some of the scientists themselves. Finally, I describe a community of feminist evolutionary psychologists with whom it might be both fruitful and interesting to engage, and identify ways that these interactions may benefit the science and the study of the science. (shrink)

This paper argues that moral distress is a distinctive category of reactive attitudes that are taken to be part and parcel of the social dynamics for recognition. While moral distress does not demonstrate evidence of wrongdoing, it does emotionally articulate a demand for normative attention that is addressed to others as moral providers. The argument for this characterization of the deontic power of moral distress builds upon two examples in which the cognitive value of the victim’s emotional experience is controversial: (...) the case of micro-aggression, and the case of misplaced distress. In contrast to appraisal and perceptual models of distress, it is argued that its epistemic and normative value is dialogical rather than evidential, in that it presses claims that engage the audience in a normative discussion about the normative standing of the claimant, the proper grounds of the attitude, and the normative standards used to assess them. (shrink)

This paper explores cultural understandings of virtual sexual ageplay in the online world of Second Life. Online sexual ageplay is the virtual simulation of child abuse by consensual adults operating in-world with child computer characters. Second Life is primarily governed by Community Standards which rely on residents to recognise sexual ageplay and report it, which requires an appreciation of how residents view, understand and construct sexual ageplay. The research presented drew on 12 months of resident blog posts referring to sexual (...) ageplay: 263 total, with 91 residents. The analysis of this talk explores the cultural understandings of this banned behaviour and beliefs about the nature of Second Life which underpin residents’ likelihood to report sexual ageplay and so comply with the Community Standards. In considering these issues the paper is able to highlight issues regarding the unique cultural position of abuse against children and key concerns which underpin the reporting behaviour of residents. Key considerations relate to defining online sexual activity and child avatars; the moral status of ‘reporters’, and sexual ageplay as a form of edgeplay; belief in the harmfulness of sexual ageplay and its relationship to real world behaviours. (shrink)

Wildlife conservation aims to protect the natural world, plant and animal species, and the habitats they form part of and rely on for survival. More particularly, it focuses on species that are considered important, be it from economic, ecological and other perspectives, and preventing harm to these species. While conservation activities, based on common conservation values such as species fitness and biodiversity, are no doubt beneficial to animals in general, there seems to be a fundamental disjoint between this approach and (...) the mainstay of current ethical theories regarding animals, which focus on the treatment and welfare of individual entities. I will argue that the conflict between wildlife conservation and animal ethics arises both in the aims, as well as the application of conservation. In its aims, the focus on species as a whole often comes at a cost to individual animals, and in its application individual animals are often harmed as well. To demonstrate these two points, I will use the case study of the cloning and reintroduction of the currently extinct northern white rhino. I will then conclude that wildlife conservation, while aiming to benefit animals, is fundamentally at odds with any animal ethic that considers individual wellbeing as central. (shrink)

Introduction to the special issue by editor Carla Fehr.

The aim of this article is to analyze the deontic character of norms of competence, more than to define a concept of competence. Competence is here understood as a power given by the legal system to a certain authority, as the capacity to create, modify or extinguish legal relations or positions. Only a couple of theses are examined to evaluate whether these norms have an autonomous deontic character, a complex modality or present a combination of independent characters. The relevance of (...) the answers is related to questions about responsibility, coercion and legal consequences.Resumen:El objeto del artículo es analizar el carácter deóntico de las normas de competencia, más que definir el concepto de competencia. En este caso, la competencia es entendida como un poder conferido por el sistema jurídico a ciertas autoridades, como la capacidad de crear, modificar o extinguir relaciones jurídicas o posiciones. Sólo un par de tesis son examinadas, a fin de evaluar si esas normas tienen un carácter deóntico autónomo o presentan una combinación de características independientes. La relevancia de las respuestas está relacionada con cuestiones acerca de la responsabilidad, la coerción y las consecuencias jurídicas. (shrink)

Studies have found that academic dishonesty is widespread. Of particular interest is the case of business students since many are expected to be the leaders of tomorrow. This study examines the cheating behaviors and perceptions of 819 business and engineering students at three private Lebanese universities, two of which are ranked as the top two universities in the country. Our results show that cheating is pervasive in the universities to an alarming degree. We first analyzed the data by looking at (...) the variables gender, college, GPA, and whether the students had taken the business ethics course. We then supplemented this analysis by building an ordered logistic regression model to test whether these independent variables affect the level of engagement in cheating behavior when we control for the other variables. The results show that males engage in cheating more than females and that students with a lower GPA engage in cheating more. We initially find a difference between business and engineering students, but once we control for the other variables, this difference ceases to exist. Our most surprising result is that the business ethics course seems to have a detrimental effect on the cheating behavior of students. Finally, we find that perception plays a key role in defining the behavior of students. The more that students perceive that others are engaging in a certain behavior, the higher the probability that they will engage in the behavior, even if they believe that this behavior constitutes cheating. (shrink)

This article argues that cruelty, as a willingness to see or orchestrate the suffering of others, is not an unfortunate side-effect of neoliberal theories put into practice but is constitutive of the neoliberal project from its theoretical inception. Drawing on Lisa Duggan’s concept of ‘optimistic cruelty’ and treating the canonical texts of neoliberal economic theory as literary artefacts, the article develops this argument through a close reading of one of the central architects of the neoliberal project, the philosopher and economist (...) Friedrich Hayek. The first part of the article examines how Hayek attempts to justify the brutality of the market order he imagines – the catallaxy – by arguing that this brutality is the natural consequence of the spontaneous evolutionary processes that move civilisation forward. The second part brings to the fore the eugenicist undertones that suffuse this vision, despite Hayek’s apparent rejection of Social Darwinism. I analyse how Hayek’s market order operates through a series of disciplinary and biopolitical technologies that use pain, frustration, punishment and stigmatisation to eliminate bad habits, practices and subjectivities. These cruel mechanisms enable the catallaxy to sort between productive and unproductive lives to ensure that available resources are directed towards the former – even if it means that the others might be left to die. As such, cruelty is an affective atmosphere that permeates the catallaxy. (shrink)

The reform of the health care system will include a mandate: Individuals are required to purchase health insurance provided that affordable options are available. But what is affordable health insurance? Three accounts of affordability of health coverage have been advanced. The first two accounts are empirical. The third account is needs-based. All three accounts are inadequate. I propose a fourth, the reasonable tradeoff account, according to which individuals should only be required to make reasonable tradeoffs in order to pay for (...) their health coverage. That is, health insurance is affordable if in order to pay for it one does not to have to sacrifice other benefit(s) that are comparable in importance to the benefits of health coverage. (shrink)

Traditionally, philosophers have focused on whether and how emotions threaten autonomy, insofar as they lie outside the sphere of rational agency. That is, they have conceptualized emotional vulnerability as passivity. Second, they have considered how emotions are insensitive to rational judgment, focusing on cases in which emotions are dissonant or recalcitrant. Third, in recognizing the motivational force of emotions, philosophers have tracked their negative impact on rational deliberation. Indeed, emotions are often contrastive elements in rational deliberation. They appear to defeat (...) deliberative judgments about what to do, survive rational deliberation or preempt the very possibility of rational deliberation. But there are more interesting cases in which it is apparent that emotions bear a rather complicated relation to autonomy. Love and shame provide powerful examples of the ambivalences and complexities of such a relation. In analyzing such complexities, my aim is to present a case for appreciating various dimensions of vulnerability and, correspondingly, for exposing the importance of emotional vulnerability for agential autonomy. This view is rooted in a general account of agential autonomy marked by mutual respect and recognition of others, as a normative response to constitutive vulnerability, understood as the capacity to affect and be affected by others as well as by external agentive and non-agentive causes. (shrink)

This article explores twelve short narrative films created by women and trans people living with disabilities and embodied differences. Produced through Project Re•Vision, these micro documentaries uncover the cultures and temporalities of bodies of difference by foregrounding themes of multiple histories: body, disability, maternal, medical, and/or scientific histories; and divergent futurities: contradictory, surprising, unpredictable, opaque, and/or generative futures. We engage with Alison Kafer's call to theorize disability futurity by wrestling with the ways in which “the future” is normatively deployed in (...) the service of able-bodiedness and able-mindedness, a deployment used to render bodies of difference as sites of “no future”. By re-storying embodied difference, the storytellers illuminate ongoing processes of remaking their bodily selves in ways that respond to the past and provide possibilities for different futures; these orientations may be configured as “dis-topias” based not on progress, but on new pathways for living, uncovered not through evoking the familiar imaginaries of curing, eliminating, or overcoming disability, but through incorporating experiences of embodied difference into time. These temporalities gesture toward new kinds of futures, giving us glimpses of ways of cripping time, of cripping ways of being/becoming in time, and of radically re-presencing disability in futurity. (shrink)

This article investigates the relation between complicity and moral responsibility.

This paper posits that differences in corporate governance structure partly result from differences in institutional arrangements linked to business systems. We developed a new international triad of business systems: the Anglo-American, the Communitarian and the Emerging system, building on the frameworks of Choi et al. (British Academy of Management (Kynoch Birmingham) 1996, Management International Review 39, 257–279, 1999). A common factor determining the success of a corporate governance structure is the extent to which it is transparent to market forces. Such (...) transparency is more than pure financial transparency; as it can also be based on factors such as governmental, banking and other types of institutional transparency mechanism. There may also be a choice for firms to adopt voluntary corporate disclosure in situations where mandatory disclosure is not established. The Asian financial crisis of 1997–1999 and the more recent corporate governance scandals such as Enron, Andersen and Worldcom in the United States and Ahold and Parmalat in Europe show that corporate governance and business ethics issues exist throughout the world. As an illustration we focus on Asia’s emerging1 markets, as, both in view of the pressure of globalization and taking into account the institutional arrangements peculiar to the emerging business system, these issues are important there. Particularly for those who have to find an accommodation between the corporate governance structures and disclosure standards of the Emerging system and those of the Anglo-American and Communitarian systems. (shrink)

Este trabalho aborda a questão da fotografia como dispositivo para a memória institucional e, dessa forma, apresenta conceitos do que vem a ser memória e memória institucional. Nesse sentido, a pesquisa descreve a fotografia como documento, em consequência, explica a importância e a relação da fotografia como um dispositivo para a memória. A pesquisa caracterizou-se como bibliográfica e o levantamento bibliográfico foi realizado na base BRAPCI, com o objetivo geral de demonstrar a fotografia como um dispositivo para a memória institucional. (...) Os resultados elucidaram a relação entre fotografia e memória, destacando a primeira enquanto um dispositivo de memória institucional. (shrink)

Disabled‐2 (Dab2) is a multimodular scaffold protein with signaling roles in the domains of cell growth, trafficking, differentiation, and homeostasis. Emerging evidences place Dab2 as a novel modulator of cell–cell interaction; however, its mode of action has remained largely elusive. In this review, we highlight the relevance of Dab2 function in cell signaling and development and provide the most recent and comprehensive analysis of Dab2's action as a mediator of homotypical and heterotypical interactions. Accordingly, Dab‐2 controls the extent of platelet (...) aggregation through various motifs within its N‐terminus. Dab2 interacts with the cytosolic tail of the integrin receptor blocking inside‐out signaling, whereas extracellular Dab2 competes with fibrinogen for integrin αIIbβ3 receptor binding and, thus, modulates outside‐in signaling. An additional level of regulation results from Dab2's association with cell surface lipids, an event that defines the extent of cell–cell interactions. As a multifaceted regulator, Dab2 acts as a mediator of endocytosis through its association with the [FY]xNPx[YF] motifs of internalized cell surface receptors, phosphoinositides, and clathrin. Other emerging roles of Dab2 include its participation in developmental mechanisms required for tissue formation and in modulation of immune responses. This review highlights the various novel mechanisms by which Dab2 mediates an array of signaling events with vast physiological consequences. (shrink)