Abstract“Comprehensive Healthcare for America” is a largely single-payer reform proposal that, by applying the insights of behavioral economics, may be able to rally patients and clinicians sufficiently to overcome the opposition of politicians and vested interests to providing all Americans with less complicated and less costly access to needed healthcare.

We applaud and support the call by Mithani et al. for “a proactive form of bioethics that actively resists and denounces i...

Astrobiologists are aware that extraterrestrial life might differ from known life, and considerable thought has been given to possible signatures associated with weird forms of life on other planets. So far, however, very little attention has been paid to the possibility that our own planet might also host communities of weird life. If life arises readily in Earth-like conditions, as many astrobiologists contend, then it may well have formed many times on Earth itself, which raises the question whether one or (...) more shadow biospheres have existed in the past or still exist today. In this paper, we discuss possible signatures of weird life and outline some simple strategies for seeking evidence of a shadow biosphere. Key Words: Weird life—Multiple origins of life—Biogenesis—Biomarkers—Extremophiles—Alternative biochemistry. Astrobiology 9, 241–249. (shrink)

Illness narratives from patients with colorectal cancer commonly record patterns of change in social relationships that follow the diagnosis and treatment of the condition. We believe that these changes are best explained as a process of facework, which reflects losses of face on the part of the patient, and which assists in the creation of new faces that convey new senses of identity. Facework is familiar in the work by E. Goffman (1955) and has been extensively reworked since his time. (...) There is considerable agreement that face is a pervasive and universal constituent of all social interaction, and that it expresses the subject's view of the way he or she would like to be considered by others in interactions. Ho's concept of multiple faces negotiated dynamically according to social context is particularly useful in understanding the purpose and techniques of facework (D. Y.-F. Ho, 1994). We propose a model of face that uses dignity as the face-expression of personal attributes and acquisitions, and honor as the face-expression of systemic capabilities and attainments. This model can be used to examine individual variations in response and adaptation to colon cancer and its treatment, and it provides a useful means of teaching health care workers about the experience of illness. (shrink)

Narrative analysis is well established as a means of examining the subjective experience of those who suffer chronic illness and cancer. In a study of perceptions of the outcomes of treatment of cancer of the colon, we have been struck by the consistency with which patients record three particular observations of their subjective experience: the immediate impact of the cancer diagnosis and a persisting identification as a cancer patient, regardless of the time since treatment and of the presence or absence (...) of persistent or recurrent disease; a state of variable alienation from social familiars, expressed as an inability to communicate the nature of the experience of the illness, its diagnosis and treatment; and a persistent sense of boundedness, an awareness of limits to space, empowerment and available time. These subjectivities were experienced in varying degree by all patients in our study. Individual responses to these experiences were complex and variable. The experiences are best understood under the rubric of a category we call “liminality”. We believe that all cancer patients enter and experience liminality as a process which begins with the first manifestations of their malignancy. An initial acute phase of liminality is marked by disorientation, a sense of loss and of loss of control, and a sense of uncertainty. An adaptive, enduring phase of suspended liminality supervenes, in which each patient constructs and reconstructs meaning for their experience by means of narrative. This phase persists, probably for the rest of the cancer patient’s life. The experience of liminality is firmly grounded in the changing and experiencing body that houses both the disease and the self. Insights into the nature of the experience can be gained from the Existentialist philosophers and from the history of attitudes to death. Understanding liminality helps us to understand what it is that patients with cancer seek from the system to which they turn for help. Its explication should therefore be important for those who provide health care, those who educate health care workers and those concerned to study and use outcomes as administrative and policy making instruments. (shrink)

Murayama and Jach rightfully aim to conceptualize motivation as an emergent property of a dynamic system of interacting elements. However, they do not embrace the ontological and paradigmatic constraints of the dynamic systems approach. They therefore miss the very process of emergence and how it can be formally modeled and tested by specific types of computer simulation.

The dialectic of private desire and public imperative — their conflict and interpenetration and mutual causation — has been the theme of the Troy story through three millennia. When W. B. Yeats wrote a poem about the irruption of sexual passion in the pattern of human events, and its incalculable aftermath in history, he restated powerfully for the twentieth century a perception which nevertheless goes back to Homer.

Background Following passage of the Patient Self Determination Act in 1990, health care institutions that receive Medicare and Medicaid funding are required to inform patients of their right to make their health care preferences known through execution of a living will and/or to appoint a surrogate-decision maker. We evaluated the impact of external factors and perceived patient preferences on physicians’ decisions to honor or forgo previously established advance directives (ADs). In addition, physician views regarding legal risk, patients’ ability to comprehend (...) complexities involved with their care, and impact of medical costs related to end-of-life care decisions were explored. Methods Attendees of two Mayo Clinic continuing medical education courses were surveyed. Three scenarios based in part on previously court-litigated matters assessed impact of external factors and perceived patient preferences on physician compliance with patient-articulated wishes regarding resuscitation. General questions measured respondents’ perception of legal risk, concerns over patient knowledge of idiosyncrasies involved with their care, and impact medical costs may have on compliance with patient preferences. Responses indicating strength of agreement or disagreement with statements were treated as ordinal data and analyzed using the Cochran Armitage trend test. Results Three hundred eighty-eight of 951 surveys were completed (41% response rate). Eighty percent reported they were likely to honor a patient’s AD despite its 5 year age. Fewer than half (41%) would honor the AD of a patient in ventricular fibrillation who had expressed a desire to “pass away in peace.” Few (17%) would forgo an AD following a family’s request for continued resuscitative treatment. A majority (52%) considered risk of liability to be lower when maintaining someone alive against their wishes than mistakenly failing to provide resuscitative efforts. A large percentage (74%) disagreed that patients could not appreciate complexities surrounding their care while 69% agreed that costs should never impact a physician’s decision as to whether to comply with a patient’s AD. Conclusions Our findings highlight the impact, albeit small, external factors have on physician AD compliance. Most respondents based their decision on the clinical situation at hand and interpretation of the patient’s initial wishes and preferences expressed by the AD. (shrink)

Analysis of sites of newly integrated DNA in cellular genomes is important to several fields, but methods for analyzing and visualizing these datasets are still under development. Here, we describe tools for data analysis and visualization that take as input integration site data from our INSPIIRED pipeline. Paired-end sequencing allows inference of the numbers of transduced cells as well as the distributions of integration sites in target genomes. We present interactive heatmaps that allow comparison of distributions of integration sites to (...) genomic features and that support numerous user-defined statistical tests. To summarize integration site data from human gene therapy samples, we developed a reproducible report format that catalogs sample population structure, longitudinal dynamics, and integration frequency near cancer-associated genes. We also introduce a novel summary statistic, the UC50, which provides a single number summarizing possible clonal expansion. Using these tools, we characterize ongoing longitudinal characterization of a patient from the first trial to treat severe combined immunodeficiency-X1, showing successful reconstitution for 15 years accompanied by persistence of a cell clone with an integration site near the cancer-associated gene CCND2. Software is available at https://github.com/BushmanLab/INSPIIRED. (shrink)

Paul C. Johnson begins his new work, Automatic Religion, with the observation that two of the capacities commonly taken to distinguish humans from nonhumans-free will and religion-are fundamentally opposed. Free will enjoys a central place in our ideas of spontaneity, authorship, and the conscious weighing of alternatives. Meanwhile, religion is less a quest for agency than a series of practices--possession rituals being the most spectacular though by no means the only examples--that temporarily relieve individuals of their will. What, then, (...) is agency and why has it occupied such a central place in theories of the human? Based on a dozen years of archival and ethnographic research in Brazil and France, this book tests the boundaries between humans and non-humans in an unlikely series of episodes from the closing decades of the nineteenth century, when ideas related to automatism lurched into motion on multiple tracks and, not incidentally, "religion" as a topic of study was being born. Brazil provided a particularly fertile place for reflection as the nearest site of what Europeans and Euro-Americans too often, too naïvely, and too imperially saw as raw nature, and thus also a laboratory of the human. In this context, the French would call Brazil's people monkeys; its slaves were called automatons; and Afro-Brazilian spirit possession priests were classed in the terms of French psychiatry's newly minted terms, dissociation and hysteria. Johnson shows not just how automatons can take on unexpectedly human-like lives when animated but also traces how certain groups have been excluded as less-than-human. In so doing, Johnson reanimates one of the most mysterious and yet foundational questions of trans-Atlantic thought-what is agency? (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need (...) to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent. (shrink)

The 2013 Rostock Symposium on Systems Biology and Bioinformatics in Aging Research was again dedicated to dissecting the aging process using in silico means. A particular focus was on ontologies, as these are a key technology to systematically integrate heterogeneous information about the aging process. Related topics were databases and data integration. Other talks tackled modeling issues and applications, the latter including talks focussed on marker development and cellular stress as well as on diseases, in particular on diseases of kidney (...) and skin. (shrink)

In this groundbreaking, cross-disciplinary work of philosophy and biblical studies, New Testament scholar C. Kavin Rowe explores the promise and problems inherent in engaging rival philosophical claims to what is true. Juxtaposing the Roman Stoics Seneca, Epictetus, and Marcus Aurelius with the Christian saints Paul, Luke, and Justin Martyr, and incorporating the contemporary views of Jeffrey Stout, Alasdair McIntyre, Charles Taylor, Martha Nussbaum, Pierre Hadot, and others, the author suggests that in a world of religious pluralism there is negligible (...) gain in sampling from separate belief systems. This thought-provoking volume reconceives the relationship between ancient philosophy and emergent Christianity as a rivalry between strong traditions of life and offers powerful arguments for the exclusive commitment to a community of belief and a particular form of philosophical life as the path to existential truth. (shrink)

C’est en présence de Karl Mannheim et Paul Tillich, entre autres, que Günther Anders a présenté son anthropologie philosophique de l’homme utopique à la fin des années 1920. De ces auteurs, il a tiré une conception chiliastique ou millénariste de l’utopie impliquant un certain rapport à l’Histoire et à la politique. Celle-ci est morte en lui après s’être inversée dans la réalité pendant la Seconde Guerre mondiale. Replacer Anders dans ce contexte permet de montrer d’où proviennent certains schémas religieux (...) que l’on retrouve sécularisés dans son œuvre et de donner un sens au tour « religieux » que prend parfois sa pensée. (shrink)

Prowse, Christopher C On 27 October 2010, His Holiness, Pope Benedict XVI, announced that the topic for the XIII Ordinary General Assembly in Rome (7-28 October 2012) would be 'The New Evangelisation for the Transmission of the Christian Faith.' This was not entirely unexpected given the importance this topic has generated in the documents of the Second Vatican Council, and in the teachings of Popes Paul VI, John Paul II and now Benedict XVI. Clearly, with the establishment (...) of the ad hoc dicastery (21 September 2010) on evangelisation, the Holy Father, Benedict XVI, wishes to raise the promotion of this vital topic to an even higher level. (shrink)

A semimeasure is a generalization of a probability measure obtained by relaxing the additivity requirement to superadditivity. We introduce and study several randomness notions for left-c.e. semimeasures, a natural class of effectively approximable semimeasures induced by Turing functionals. Among the randomness notions we consider, the generalization of weak 2-randomness to left-c.e. semimeasures is the most compelling, as it best reflects Martin-Löf randomness with respect to a computable measure. Additionally, we analyze a question of Shen, a positive answer to which would (...) also have yielded a reasonable randomness notion for left-c.e. semimeasures. Unfortunately, though, we find a negative answer, except for some special cases. (shrink)

As a 2006 Institute of Medicine report highlights, surprisingly little empirical attention has been paid to how prisoners arrive at decisions to participate in modern research. With our study, we aimed to fill this gap by identifying a more comprehensive range of factors as reported by prisoners themselves during semistructured interviews. Our participants described a diverse range of motives, both favoring and opposing their eventual decision to join. Many are well-recognized considerations among nonincarcerated clinical research participants, including a desire for (...) various forms of personal benefit, altruism, and concern about study risks and inconveniences. However, a number of influences seem unique to prisoners. Participants did not report that they were not coerced into enrolling, and they have even been under pressure not to enroll. However, many sought to enroll in order to obtain access to better health care, raising a concern about whether they were unfairly exploited. (shrink)

This thesis modifies the wording of William Clifford’s 1877 evidence principle (that ‘it is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence’) to propose an explicitly moral principle, restricted to descriptive beliefs (about what is or is not the case) and excluding prescriptive beliefs (about what ought or ought not to be the case). It considers potential counter-examples, particularly William James’s 1896 defence of religious belief; and concludes that the modified principle survives unscathed. It then searches (...) for suitable criteria for ‘sufficient’ and ‘insufficient’ evidence, first within a Bayesian framework enriched by pragmatic considerations, and finally by returning to Clifford’s conception of our shared responsibilities to our shared epistemic asset. Combined with elements of Edward Craig’s (1990, 1999) ‘state-of-nature’ theory of knowledge this gets us to a minimum threshold to avoid insufficient evidence and an aspirational criterion of sufficient evidence. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Psychiatric Hospitalization—Bridging the Gap Between Respect and ControlPaul P. ChristopherIntroductionThis issue of Narrative Inquiry in Bioethics offers varied and somewhat unique perspectives on the experience of psychiatric hospitalization. This commentary highlights a number of salient themes that emerge from reading these essays and attempts to explore how they relate to the broader academic literature on psychiatric hospitalization, particularly with regard to ethical considerations. In reading these narratives, each several (...) times, I was repeatedly struck by the courage required of the authors, both to share their stories publicly and to endure the challenges that the writing process no doubt demanded of them—revisiting and suspending themselves in deeply emotional and, at times, traumatic experiences in order to share the most compelling narrative. Their hard work clearly paid off—the stories are at once intimate and indelible. Still, in many instances, I found myself wanting to know more; to enter the story and sit with the individual through these events; to ask what they were thinking or feeling in a particular situation; to see and hear the world in which they found themselves. Such is the nature of good story telling—the reader, left with the lingering vision created in his mind, turns over the last page, eagerly hoping for more.Narrative ThemesI. Loss of Autonomy or ControlPerhaps the most notable theme had to do with the loss of control or freedom that followed from hospitalization. On first consideration, it may seem odd that this issue appears so often since patient autonomy constitutes one of the fundamental principles of medical ethics. Only under specific circumstances—e.g., when there is a risk of imminent harm—may autonomy be curtailed, and even then only to the extent that is minimally necessary. Yet, as these narratives highlight, there are a multitude of ways in which psychiatric hospitalization engenders actual or perceived restrictions in freedom (Newton-Howes & Mullen, 2011).Consistent with prior research (Goodwin et al., 1999), many of the authors describe a fear or the actual experience of not being able to leave the hospital freely, even when the admission seems to have been voluntary. For example, one writer worries, “I was so afraid that if I ever went ‘in,’ I would never get ‘out’... I thought I would never taste freedom again... alive.” Another describes:When it came time for my possible discharge they told me that I might not get discharged because I was ‘acting up the previous evenings.’ My anxiety level at this point went through the roof. The only reason I was discharged was because my father knew some politicians. If not [End Page 29] for him I would have been a patient there for perhaps years and my life would have been ruined.A third gives this example: “When I asked to sign the form to leave after three days, [the psychiatrist] told me if I did that she would have me committed.” Another writer fears not having any control of how the psychiatrist might approach the treatment: “... I was totally vulnerable... would the doctors blame me, drug me, shock me, kill me?”Somewhat surprising, however, was the fact that so few of the narratives take issue with the decision to hospitalize. This omission is especially striking in light of the fact that prior reports consistently note that a substantial minority (up to nearly half) of voluntarily admitted patients nevertheless experience their admission as coerced (Bonsack & Borgeat, 2005; Hiday et al., 1997; Katsakou et al., 2010; Rogers et al., 1993; Sheehan & Burns, 2011). Because many of these narrators had been hospitalized more than once, the relative absence of expressed resistance to being hospitalized seems strange, particularly when earlier hospital experiences or their aftermath are often described as negative. For example, one individual characterized the time after being released from the hospital as, “My sense of self was questioned. I felt as if I lost my soul.” Another put it this way:When I got out of the private hospital, I felt like my soul had been ripped out of me. I felt like I had a gaping hole in the center of my body... I felt psychically raped, dazed, and confused.Given these... (shrink)

In light of scientific advances such as genomics, predictive diagnostics, genetically engineered agriculture, nuclear transfer cloning, and the manipulation of stem cells, the idea that genes carry predetermined molecular programs or blueprints is pervasive. Yet new scientific discoveries—such as rna transcripts of single genes that can lead to the production of different compounds from the same pieces of dna—challenge the concept of the gene alone as the dominant factor in biological development. Increasingly aware of the tension between certain empirical results (...) and interpretations of those results based on the orthodox view of genetic determinism, a growing number of scientists urge a rethinking of what a gene is and how it works. In this collection, a group of internationally renowned scientists present some prominent alternative approaches to understanding the role of dna in the construction and function of biological organisms. Contributors discuss alternatives to the programmatic view of dna, including the developmental systems approach, methodical culturalism, the molecular process concept of the gene, the hermeneutic theory of description, and process structuralist biology. None of the approaches cast doubt on the notion that dna is tremendously important to biological life on earth; rather, contributors examine different ideas of how dna should be represented, evaluated, and explained. Just as ideas about genetic codes have reached far beyond the realm of science, the reconceptualizations of genetic theory in this volume have broad implications for ethics, philosophy, and the social sciences. Contributors. Thomas Bürglin, Brian C. Goodwin, James Griesemer, Paul Griffiths, Jesper Hoffmeyer, Evelyn Fox Keller, Gerd B. Müller, Eva M. Neumann-Held, Stuart A. Newman, Susan Oyama, Christoph Rehmann-Sutter, Sahotra Sarkar, Jackie Leach Scully, Gerry Webster, Ulrich Wolf. (shrink)

High-dose chemotherapy and autologous stem cell transplantation is used to treat some advanced malignancies. It is a traumatic procedure, with a high complication rate and significant mortality. ASCT patients and their carers draw on many sources of information as they seek to understand the procedure and its consequences. Some seek information from beyond orthodox medicine. Alternative beliefs and practices may conflict with conventional understanding of the theory and practice of ASCT, and ‘contested understandings’ might interfere with patient adherence to the (...) strict and demanding protocols required for successful ASCT.The present study, conducted in Sydney, Australia, examines narrative-style interviews with 10 sequentially recruited ASCT patients and nine of their carers conducted at the time of transplant and three months later. Transcripts were read for instances of mention of alternative advice, and for instances of contested understanding of information relevant to the transplant.Patients and carer pairs expressed closely concordant views about alternative advice. Five pairs were consulting alternative practitioners. Contested understanding was expressed in four domains—understandings of the transplant itself and its underlying theory, of the relationship between the components of the ‘transplant’, of the nature and role of stem cells, and of beliefs about bodily function and life-style. Contested understandings of the transplant treatment were expressed as predominantly personal interpretations of orthodox informationPatients and carers seemed to recognise that alternative and conventional systems were discordant, yet they were able to separate the two, and adhere to each practice without prejudicing their medical treatment. A single case of late, post-transplant repudiation of Western medicine is discussed to emphasise some of the possible determinants of dissonance when it does occur. (shrink)

BackgroundAn analysis of the position statements of secular US medical and surgical professional societies on physician-assisted suicide (PAS) and euthanasia have not been published recently. Available statements were evaluated for position, content, and sentiment.MethodsIn order to create a comprehensive list of secular medical and surgical societies, the results of a systematic search using Google were cross-referenced with a list of societies that have a seat on the American Medical Association House of Delegates. Societies with position statements were identified. These statements (...) were divided into 5 categories: opposed to PAS and/or euthanasia, studied neutrality, supportive, acknowledgement without statement, and no statement. Linguistic analysis was performed using RapidMinder in order to determine word frequency and sentiment respective to individual statements. To ensure accuracy, only statements with word counts > 100 were analyzed. A 2-tailed independentttest was used to test for variance among sentiment scores of opposing and studied neutrality statements.ResultsOf 150 societies, only 12 (8%) have position statements on PAS and euthanasia: 11 for PAS (5 opposing and 4 studied neutrality) and 9 for euthanasia (6 opposing and 2 studied neutrality). Although the most popular words used in opposing and studied neutrality statements are similar, notable exceptions exist (suicide,medicine, andtreatmentappear frequently in opposing statements, but not in studied neutrality statements, whereaspsychologists,law, andindividualsappear frequently in studied neutrality statements, but not in opposing statements). Sentiment scores for opposing and studied neutrality statements do not differ (mean, 0.094 vs. 0.104;P = 0.90).ConclusionsFew US medical and surgical societies have position statements on PAS and euthanasia. Among them, opposing and studied neutrality statements share similar linguistic sentiment. Opposing and studied neutrality statements have clear differences, but share recommendations. Both opposing and studied neutrality statements cite potential risks of PAS legalization and suggest that good palliative care might diminish a patient’s desire for PAS. (shrink)

The practice of paying prisoners to for their participation in research has long been debated, and the controversy is reflected in the differing policies in the U.S. prison systems. Empirical study of financial payments to inmates who enroll in research has focused on whether this practice is coercive. In this study, we examined whether monetary incentives have the potential to be unduly influential among fifty HIV‐positive prisoners. The majority of prisoners surveyed believed that inmates should receive some compensation for their (...) involvement in research and disagreed with statements suggesting that the offer of payment constitutes undue influence. However, a sense of potentially being susceptible to undue influence was significantly higher among participants who had spent a longer time in prison and had less education. Overall, our findings suggest that most prisoners feel that they would be able to make a decision about research enrollment that is not solely based on an offer of monetary payment. (shrink)

Discourse communities are groups of people who share common ideologies, and common ways of speaking about things. They can be sharply or loosely defined. We are each members of multiple discourse communities. Discourse can colonize the members of discourse communities, taking over domains of thought by means of ideology. The development of new discourse communities can serve positive ends, but discourse communities create risks as well. In our own work on the narratives of people with interests in health care, for (...) example, we find that patients speak of their illness experiences as victims of circumstance; policy makers construct adverse experiences and challenges as opportunities to be taken; health care workers speak from a mixed perspective, seeing themselves as both victims and opportunists depending on context. To be trapped within the discourse of a particular community is to put at risk the ability to communicate across discourses. Membership of a discourse community can impair the habit of critique, and deny opportunities for heteroglossic discourse. Privileging critique as a mode of discourse perhaps might define the ethical community, suggesting that ethical community may be an antidote to the constraining effects of conventional discourse community. (shrink)

Miles Little is an Australian surgeon, poet, and philosopher whose published work spans diverse topics in surgery, medicine, philosophy, and bioethics. In 1974 he co-authored a survey that included an analysis of interviews conducted with amputees. This was his first foray into qualitative research. Twenty years later he established a research centre at the University of Sydney that initiated a programme of qualitative research in cancer medicine. For twenty years after that, the centre acted as a hub for research that (...) applied qualitative methods from the social sciences to study the experiences of people who endure illness and onerous treatments and to reveal their evaluations of what medicine does to and for them. This essay explains why Little turned to qualitative research instead of pursuing two other research paradigms that were better established in the 1990s, namely, evidence-based medicine and quality-of-life research. It also notes a development in qualitative research methods that Little’s legacy helps to explain, one which can augment the symbolic power of socially marginalized individuals and groups. With reference to a current controversy in surgery, I argue that Little’s survey of amputees models a laudable response to criticism, and in this respect, it is still relevant today. (shrink)

Dead reckoning is a feature of the navigation behaviour shown by several creatures, including the desert ant. Recent work by C. Randy Gallistel shows that some connectionist models of dead reckoning face important challenges. These challenges are thought to arise from essential features of the connectionist approach, and have therefore been taken to show that connectionist models are unable to explain even the most primitive of psychological phenomena. I show that Gallistel’s challenges are successfully met by one recent connectionist model, (...) proposed by Ulysses Bernardet, Sergi Bermúdez i Badia, and Paul F.M.J. Verschure. The success of this model suggests that there are ways to implement dead reckoning with neural circuits that fall within the bounds of what many people regard as neurobiologically plausible, and so that the wholesale dismissal of the connectionist modelling project remains premature. (shrink)

Editors Rachel Brown and Deva Woodly bring together Mara Marin, Shatema Threadcraft, Christopher Paul Harris, Jasmine Syedullah, and Miriam Ticktin to examine the question: what would be required for care to be an ethic and political practice that orients people to a new way of living, relating, and governing? The answer they propose is that a 21st-century approach to the politics of care must aim at unmaking racial capitalism, cisheteropatriarchy, the carceral state, and the colonial present. The politics (...) of care is an approach to political thought and action that moves beyond the liberal approach which situates care as a finite resource to be distributed among autonomous individuals, or as a necessarily feminine virtue. Instead, those elucidating the politics of care for the contemporary era draw on rich interdisciplinary traditions and social movements to theorize and practice care as an inherently interdependent survival strategy, a foundation for political organizing, and a prefigurative politics for building a world in which all people can live and thrive. (shrink)

The prospect of using genome technologies to modify the human germline has raised profound moral disagreement but also emphasizes the need for wide-ranging discussion and a well-informed policy response. The Hinxton Group brought together scientists, ethicists, policymakers, and journal editors for an international, interdisciplinary meeting on this subject. This consensus statement formulated by the group calls for support of genome editing research and the development of a scientific roadmap for safety and efficacy; recognizes the ethical challenges involved in clinical reproductive (...) applications of genome editing but, importantly, rejects the idea that human reproductive germline modification is necessarily morally unacceptable; and highlights the importance of meaningful engagement in discussions of genome editing and the development of regulation and oversight mechanisms to govern future uses of such technologies. (shrink)

Umbilical cord blood banking is one of many biomedical innovations that confront pregnant women with new choices about what they should do to secure their own and their child’s best interests. Many mothers can now choose to donate their baby’s umbilical cord blood (UCB) to a public cord blood bank or pay to store it in a private cord blood bank. Donation to a public bank is widely regarded as an altruistic act of civic responsibility. Paying to store UCB may (...) be regarded as a “unique opportunity” to provide “insurance” for the child’s future. This paper reports findings from a survey of Australian women that investigated the decision to either donate or store UCB. We conclude that mothers are faced with competing discourses that force them to choose between being a “good mother” and fulfilling their role as a “good citizen.” We discuss this finding with reference to the concept of value pluralism. (shrink)

Health industries attempt to influence the public through the news media and through their relationships with expert academics and opinion leaders. This study reports journalists' perceptions of their professional roles and responsibilities regarding the relationships between industry and academia and research results. Journalists believe that responsibility for the scientific validity of their reports rests with academics and systems of peer review. However, this approach fails to account for the extent of industry-academy interactions and the flaws of peer review. Health journalists' (...) retention of a critical stance regarding industry-academia relationships will include advocacy for and adoption of mandatory reporting of these relationships. (shrink)

English summary: It seems that reason is less a universal principle than something inherently bound to the contexts in which it appears. These contributions to a conference held on the occasion of Christoph Schwobel's 60th birthday explore the character of reason's manifold contexts: the grounding of reason in the inner word of God 's Trinitarian life as well as the disclosure of reason and and its limits in human conversation. German description: Vernunft scheint in der Gegenwart weniger ein allgemeines Prinzip (...) als eine in Kontexte eingebundene Grosse zu sein. Die Beitrage einer Tagung anlasslich von Christoph Schwobels 60. Geburtstag, gehen der Frage nach dem Charakter dieser Kontextbindung nach: der Begrundung der Vernunft im trinitarischen Gesprach wie der Erschliessung und Problematisierung der Vernunft im menschlichen Gesprach. Mit Beitragen von V. Brummer, G. van den Brink, C. Drobe, H. J. Eckstein, D.-M. Grube, J. Halfwassen, S. Heine, F. Hermanni, E. Herms, W. Harle, W. Homolka, W. Jeanrond, R. W. Jenson, D. Kelsey, A. F. Koch, A. Kupsch, V. Leppin, P.-C. Lai, P. Lo, A. Min, J. Moltmann, M. Muhling, P. Peterson, M. Sarot, F. Schweitzer, A. Torrance, J. Webster, M. Welker, M. Wendte, M. Wisse, H. Wisskirchen und L. Zak. (shrink)

Various models have been used to “emplot” our collective experience of the COVID-19 pandemic, including the epidemiological curve, threshold models, and narrative. Drawing on a threshold model that was designed to frame resource-allocation decisions in clinical care, I offer an ethical justification for taking caring responsibilities into consideration in such decisions during pandemics. My basic argument is that we should prioritize the survival of patients with caring responsibilities for similar reasons we should prioritize the survival of healthcare professionals. More generally, (...) the pandemic reveals the fundamental importance of informal care and affords an opportunity to raise questions of justice relating to it. (shrink)

The purpose of this research is to investigate the effectiveness of Digital Content Marketing on a Mixed Reality training platform environment with the consideration of online purchase intention through social media. E-commerce today encounters several common issues that cause customers to have reservations to purchase online. With the absence of physical contact points, customers often perceive more risks when making purchase decisions. Furthermore, online retailers often find it hard to engage customers and develop long-term relationships. In this research, a Structural (...) Equation Model is proposed to examine the efficacy of DCM from both immediate and long-term OPI. The results examine whether adopting DCM on an MR training platform environment through social media brings positive results in OPI. Empirical research was carried out through online questionnaires collected in 2021 and 2022. A total of 374 questionnaires were qualified for data analysis in this study, conducted with IBM SPSS and AMOS. The results imply that DCM is critical to stimulating both immediate and long-term OPI. The immediate OPI is positively affected by increasing perceived value through MR in DCM. Regarding the long-term OPI, increased customer engagement with DCM under MR environment can cultivate brand trust and significantly affect the long-term OPI. (shrink)

Formulated by Aquinas, commented on by post-Copernican philosophers and theologians, analysed in depth by C.S. Lewis, and deliberated by some contemporary writers, the question of multiple incarnations either within humanity or amongst extra-terrestrial sentient species is all too intermittently examined: ‘Can the Christ be incarnated more than once in our reality, or somewhere else in the universe, or another reality?’ In this paper, we examine the debate and the conclusions: that is, Lewis’s position within his philosophical theology and his analogical (...) narratives; also, some contemporary philosophers of religion and theologians (Karl Rahner, with Christopher L. Fisher and David Fergusson; Sjoerd L. Bonting and William B. Drees; E.L. Mascall and Brian Hebblethwaite; Oliver Crisp and Keith Ward). How do they relate to Aquinas’s handling of the question and how do they compare with Lewis’s approach based on a theology of the imagination (grounded in Augustine and Alice Meynell)? Can Lewis resolve the argument? Could alien species have witnessed wholly different acts, equally unique, costly to God, and necessary to the process of salvation? Any answer or explanation relates to the function and purpose of the incarnation: the Fall, original sin—therefore, how we define the boundaries, limits, of atonement. (shrink)

The mass media is a major source of health information for the public, and as such the quality and independence of health news reporting is an important concern. Concerns have been expressed that journalists reporting on health are increasingly dependent on their sources—including representatives of industries responsible for manufacturing health-related products—for story ideas and content. Many critics perceive an imbalance of power between journalists and industry sources, with industry being in a position of relative power, however the empirical evidence to (...) support this view is limited. The analysis presented here—which is part of a larger study of industry-journalist relationships—draws on in-depth, semi-structured interviews with representatives of health-related industries in Australia to inductively examine their perceptions of power relations between industry and journalists. Participants painted a picture in which journalists, rather than themselves, were in a position to control the nature, extent, and outcome of their interactions with industry sources. Our results resonate with the concept of “mediatisation” as it has been applied in the domain of political reporting. It appears that, from the perspective of industry representatives, the imposition of media logic on health-related industries may inappropriately influence the information that the public receives about health-related products. (shrink)

Issues of interest, identity and values intertwine in environmental conflicts, creating challenges that cannot generally be overcome using rationalities grounded in generalised argumentation and abstraction. To address the growing need to engage interests and identities along with plural values in the conservation of biodiversity and ecological systems, we introduce the concept of ‘appropriateness of actions’ and ground it in a relational understanding of environmental ethics. A determination of appropriateness for actions comes from combining outputs from value elicitation with those of (...) interest and identity negotiation in ways that are salient to specific people and their relationships to specific places. Drawing on the Blue Mountain Forest Partnership in the Pacific Northwest, we propose factors of success for supporting appropriate actions: 1) understanding context and identifying key stakeholders; 2) surfacing a diversity of interests and building system-level trust; 3) building empathy for different identities grounded in specific places; 4) eliciting diverse values and seeking to understand their links to worldviews and knowledge systems and; 5) seeking out appropriate actions. (shrink)

Carter and Leslie (1996) have argued, using Bayes's theorem, that our being alive now supports the hypothesis of an early 'Doomsday'. Unlike some critics (Eckhardt 1997), we accept their argument in part: given that we exist, our existence now indeed favors 'Doom sooner' over 'Doom later'. The very fact of our existence, however, favors 'Doom later'. In simple cases, a hypothetical approach to the problem of 'old evidence' shows that these two effects cancel out: our existence now yields no information (...) about the coming of Doom. More complex cases suggest a move from countably additive to non-standard probability measures. (shrink)

This article examined the effects of body–object interaction (BOI) on semantic processing. BOI measures perceptions of the ease with which a human body can physically interact with a word's referent. In Experiment 1, BOI effects were examined in 2 semantic categorization tasks (SCT) in which participants decided if words are easily imageable. Responses were faster and more accurate for high BOI words (e.g., mask) than for low BOI words (e.g., ship). In Experiment 2, BOI effects were examined in a semantic (...) lexical decision task (SLDT), which taps both semantic feedback and semantic processing. The BOI effect was larger in the SLDT than in the SCT, suggesting that BOI facilitates both semantic feedback and semantic processing. The findings are consistent with the embodied cognition perspective (e.g.,, Perceptual Symbols Theory), which proposes that sensorimotor interactions with the environment are incorporated in semantic knowledge. (shrink)

Web-based platforms play an increasingly important role in managing and sharing research data of all types and sizes. This article presents a case study of the data storage, sharing, and management platform Figshare. We argue that such platforms are displacing and reconfiguring the infrastructure of norms, technologies, and institutions that underlies traditional scholarly communication. Using a theoretical framework that combines infrastructure studies with platform studies, we show that Figshare leverages the platform logic of core and complementary components to re-integrate a (...) presently splintered scholarly infrastructure. By means of this logic, platforms may provide the path to bring data inside a scholarly communication system still optimized mainly for text publications. Yet the platform strategy also risks turning over critical scientific functions to private firms whose longevity, openness, and corporate goals remain uncertain. It may amplify the existing trend of splintering infrastructures, with attendant effects on equity of service. (shrink)

The convergence of India’s rich cultural and religious heritage with its rapidly transforming economy provides a unique opportunity to understand how senior executives navigate the demands of the business environment within the context of their religious convictions. Forty senior executives with varying religious backgrounds and global responsibilities within Indian multinational corporations participated in this study. Drawing from virtue ethics theory and using systematic content analysis, several themes emerged for ethical virtues. The analysis illustrates how these deeply seated ethical virtues helped (...) to form and refine these executives’ ethical mindsets via guiding principles such as an ethical culture, environment, molding, education, commitment and leadership. In turn, these ethical mindsets influenced the executives’ ethical decision-making processes. We find that these executives’ ethical virtues and mindsets are inspired by their religious backgrounds. In summary, a very complex mental tug-of-war appears to take place as these executives rationalize and negotiate unethical circumstances while being cognizant of personal religious beliefs. We contend that in a pluralistic multi-faith society such as India, it is critical for corporations to align the virtues of its senior executives with those of the corporation so that virtues are applied consistently when dealing with various stakeholders. The findings present several theoretical and practical implications, which are discussed. (shrink)

This chapter, which concentrates on the violent imaginaries that informed the reports and deeds of the 1994 Rwandan genocide, reviews the perseverance of pre-colonial notions of a sacred king whose “wild sovereignty” and inability to promote the flow of imaana earns him fateful sacrifice. The term imaana denotes a supreme being and, in a more generalized way, a “diffuse, fecundating fluid” of celestial origin whose activity upon livestock, land, and people brought fertility and abundance. As imaana's earthly representative, the king (...) channeled fertility to the rest of humanity. The chapter also discusses symbolism of the sovereign's body and its implicit link with the process of liquid flow. Habyarimana is an inadequate conduit of imaana and thus not a worthy king. He is the antithesis of Ruganzu Ndori. -/- . (shrink)