Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

In clinical practice, evidence suggests that teaching ethics using normative ethical theory has little influence on the ethical actions of providers in practice. Thus, new training methods are needed that improve clinician response to ethical problems. A sensemaking approach to ethics training has demonstrated promise as an evidence-based pedagogical method to improve ethical reasoning and response. Project ECHO is theoretically linked to improved sensemaking. This study examines the effectiveness of ECHO and training in use of sensemaking approaches to ethical response (...) by clinicians. A quasi-experimental design study using univariate linear regression was used to examine the effect of the three types of ethics training on ethical response self-efficacy scores, while controlling for participant characteristics of years in practice, discipline and sex. We found evidence that training in sensemaking through participation in ECHO promotes improved ethical response self-efficacy of clinicians. However, results also suggest that a traditional ECHO format that does not explicitly introduce sensemaking strategies into the training does not result in the same learning outcomes as measured through an ethical response self-efficacy survey. This study found important preliminary results to support use of sensemaking approaches in clinical ethics training. (shrink)

Most current dental ethics curricula use a deontological approach to biomedical and dental ethics that emphasizes adherence to duties and principles as properties that determine whether an act is ethical. But the actual ethical orientation of students is typically unknown. The purpose of the current study was to determine the ethical orientation of dental students in resolving clinical ethical dilemmas. First-year students from one school were invited to participate in an electronic survey that included eight vignettes featuring ethical conflicts common (...) to the health care setting. The Multidimensional Ethics Scale was used to evaluate the students’ ethical judgments of these conflicts. Students rated each vignette along 13 ethically relevant items using a 7-point scale. Nine of the thirteen items were analyzed because they represent the dominant ethical theories, including deontology. One hundred sixteen dental students successfully completed the survey. Of the analyzed items, those associated with deontology had comparatively weak associations with whether students judged the action to be ethical and whether students judged themselves likely to perform the action. Whether an action was judged to be caring had the strongest association with whether the action was judged to be ethical and whether students judged themselves likely to perform the action. These results suggest that adherence to duties or principles has weaker association with students’ ethical judgments and behavior compared to caring, which was found to be more influential in their ethical judgments and behavior. Current dental school curricula with a primary focus on deontology may no. (shrink)

This article adopts an ecological view of cognition to analyze the role of the environment in scaffolding metaphorical experience. Using ethnographic material collected from two real estate showrooms in China, we describe how each showroom setting is equipped with to-be-phenomenologically-experienced objects designed to stimulate desirable sensorimotor experiences and altered bodily states during the guided showroom tours. By analyzing the qualities of such settings and identifying the processes through which visitors become environmentally coupled—including active and passive touch in highly organized auditory, (...) olfactory, and gustatory environs—we demonstrate how the showrooms constitute an affordance space for enacting metaphoricity through doubleness in experience. Implications for conceptual metaphor theory relating to the nature of environments and bodies are discussed. (shrink)

Science fiction is often held up as a particularly philosophical genre. For, beyond actualising mind-experiment-like fantasies, science fiction films also commonly toy with speculative ideas, or else engineer encounters with the strange and unknown. Denis Villeneuve's Arrival is a contemporary science fiction film that does exactly this, by introducing Lovecraft-esque tentacular aliens whose arrival on Earth heralds in a novel, but ultimately paralysing, inhuman perspective on the nature of time and reality. This article shows how this cerebral film invites viewers (...) to confront a counterintuitive model of time that at once recalls and reposes what Gilles Deleuze called a “third synthesis” of time, and that which J. M. E. McTaggart named the a-temporal “C series” of “unreal” time. We finally suggest that Arrival's a-temporal conception of the future as having already happened can function as a key to understanding the fate of humanity as a whole as we pass from the anthropocene, in which humans have... (shrink)

This essay examines Gaspar Noë's film, Enter the Void, in light of the work of both Gilles Deleuze and Alain Badiou. Arguing that the film shows to viewers the 'void' that separates subjects from objects, the essay also considers Noë's film in the light of drug literature and the altered states induced by cinema and describe by Anna Powell. Finally, the essay proposes that Enter the Void is a work of 'unbecoming' cinema, which in turn points to expansion of cinematic (...) form through the use of digital technologies. (shrink)

Taking a schizoanalytic approach to audio-visual images, this article explores some of the radical potentia for deterritorialisation found within David Fincher's Fight Club (1999). The film's potential for deterritorialisation is initially located in an exploration of the film's form and content, which appear designed to interrogate and transcend a series of false binaries between mind and body, inside and outside, male and female. Paying attention to the construction of photorealistic digital spaces and composited images, we examine the actual (and possible) (...) ways viewers relate to the film, both during and after screenings. Recognising the film as an affective force performing within our world, we also investigate some of the real-world effects the film catalysed. Finally, we propose that schizoanalysis, when applied to a Hollywood film, suggests that Deleuze underestimated the deterritorialising potential of contemporary, special effects-driven cinema. If schizoanalysis has thus been reterritorialised by mainstream products, we argue that new, ‘post-Deleuzian’ lines of flight are required to disrupt this ‘de-re-territorialisation’. (shrink)

In this article I explore the pedagogical value of Gilles Deleuze and Félix Guattari’s philosophical concepts for helping make an ‘event’ of thought, with a view towards fostering deep learning in Chinese students' learning theory and criticism in a second language. Paying attention to the qualitative role of bodies, humour and creativity alongside an expanded trans-personal concept of ‘educational life forms’ that stretches out to include an affective assemblage of inhuman elements (such as art and technology), I explore how Deleuze (...) and Guattari’s philosophical models provide a ethical alternative to corporate, Confucian and Cartesian models otherwise inhibiting students and teachers in the modern Sino-international university context. (shrink)

In his temporal philosophy based on the writing of Henri Bergson, Gilles Deleuze describes duration ( durée ) as a becoming that endures in time. Reifications of this complex philosophical concept become artistically expressed, I argue, in the form and content of South African artist William Kentridge's series of 'charcoal drawings for projection.' These exhibited art works provide intriguing and illuminating 'philosophical' examples of animated audio-visual media, which expressively plicate distinct images of movement and time. The composition of Kentridge's films (...) at once illuminate a regime of animated 'movement-images' that can trace their aetiological roots to classical forms of film and animation, whilst concurrently folding in complex philosophical expressions of time as duration which invoke the crystalline 'time-image' concepts of philosophers such as Bergson and Deleuze, as well as literary authors like Marcel Proust. Over and above these co-existent regimes of movement and time, Kentridge's artistic technique and exhibition practices further expose a multifarious 'geology' of other embedded time lines that serve to enrich/complicate these temporal expressions. I argue here that diegetic time- and movement-images ostensibly co-exist alongside different 'archaeologies' of time relevant to the context and creation of the artworks. For this reason, the animated drawings formulate intriguing artistic/philosophical expressions that muse on the nature of matter, memory, time and space. (shrink)

By creatively expanding Deleuze's concept of the time-image crystal, I productively fold together and engineer an encounter between two comparable cinematic movements otherwise separated by huge vistas of time and space. Here, I work to plicate the post-war Italian neorealist movement which Deleuze saw inaugurating the modern cinema, with a ‘postsocialist’ mainland Chinese movement that I playfully call ‘neo-realism’. The films of both historical moments formulate comparable break-away cinemas which are often considered moral or socially responsible art cinemas best approached (...) through André Bazin's ‘ontological’ film philosophy lens. By using Deleuze, however, I hope to move beyond these realist discussions to explore how both movements are also fruitfully thought in terms of introducing distinct yet analogous mental relations into the image during historical junctures defined by radically transforming psycho-geographies. Like Deleuze's discussions of neorealism, neo-realism is considered a loose impulse or mode that collectively bears witness to confusing and bewildering mental experiences from within a turbulent period of cultural, ideological and historical upheaval: which demands new ways of perceiving, thinking and acting. Without wanting to fall into a problematic auteur paradigm, I necessarily employ the films of Wang Xiaoshuai as emblematic examples of the wider impulse or trend. Indeed, Wang's films perfectly reify a new ethico-aesthetic form of Chinese cinema marked by a proliferation of new spaces, characters, experiences and narrative structures. Here, I also strive to do what Deleuze did not in his writing upon film, and explore the break-ups, breakdowns and breakthroughs in specific relation to a complex contextual web of political and cinematic ecosystems. Throughout this process I try to put Deleuze to work by using the films and context to re-interrogate and re-evaluate the time-image models as they appear within and across his Cinema books. (shrink)

In the target article “Universal and Uniform Protections of Human Subjects in Research,” Shamoo and Schwartz (2008) argue for state action to address the fact that significant numbers of human-rese...

The enemy must fear us. When this is over, there will be much more fear in the world. […] Give the government an ultimatum. Say, “This was just the trailer. Just wait till you see the rest of the film.”The overhanging statement – which draws attention to troubling links interconnecting action cinema and acts of terrorism – is delivered towards the end of Dan Reed’s Terror in Mumbai, an insightful documentary that unfolds a balanced enquiry into the November 2008 massacre (...) by the South Asian terrorist organization Lashkar-e-Tayyaba. The film weaves hours of phone intercepts between a Pakistani handler and Lashkar-e-Tayyaba agents into a collage of recovered CCTV footage, live... (shrink)

This essay explores the unique perspective of medical students regarding the ethical challenges of providing full disclosure to patients and their families when medical mistakes are made, especially when such mistakes lead to tragic outcomes. This narrative underscores core precepts of the healing profession, challenging the health care team to be open and truthful, even when doing so is uncomfortable. This account also reminds us that nonabandonment is an obligation that assumes accountability for one’s actions in the healing relationship and (...) that apologizing for mistakes can serve to heal. It argues that even medical students have an obligation to speak up when actions violate their moral beliefs, even if this means confronting a superior. Ethical principles cannot be abandoned in fear of adverse evaluation or failure to conform. Healthcare workers have an obligation to address mistakes made around the time of a patient’s death with the patient’s family. This responsibility trumps any selfish desire to avoid unpleasant feelings of guilt or regret. Such events often bring closure to already anguished relatives and spouses, and may help to facilitate the grieving process. This includes pressing forward the need to apologize to patients and/or their families when mistakes are made and when decisions are made that lead to poor outcomes for the patient, even when benevolently intended. (shrink)

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by (...) those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups. (shrink)

In this paper, I explore connections between two disciplines not typically linked: argumentation theory and urban design. I first trace historical ties between the art of reasoned discourse and the idea of civic virtue. I next analyze discourse norms implicit in three theories of urban design: Jane Jacobs' The Death and Life of Great American Cities (1961), Christopher Alexander's A Pattern Language: Towns, Buildings, Construction (1977), and Peter Katz's The New Urbanism: Toward an Architecture of Community (1994). I then propose (...) a set of ‘settlement’ issues of potential interest to both urban designers and argumentation theorists: size, density, heterogeneity, publicity, security, and identity. I conclude by suggesting that the ‘good city’ be seen as both a spatial and a discursive entity. From such a perspective, good public discourse is dependent, at least in part, on good public space; and good public space is defined, at least in part, as a context conducive to good public discourse. (shrink)