Patient decision aids enable patients to be better informed about the potential benefits and harms of their healthcare options. Certification of patient decision aids at the national level in the United States is a critical step towards responsible governance—primarily as a quality measure that increases patients’ safety, as mandated in the U.S. Patient Protection and Affordable Care Act (PPACA). Certification would provide a verification process to identify conflicts of interest that may otherwise bias the scientific evidence presented in decision aids. (...) Certification also benefits clinicians who may otherwise face malpractice claims based on harm to patients caused by possible reliance on patient decision aids that are inaccurate, incomplete, or presented in a manner that biases the patient’s decision. Existing work by the International Patient Decision Aid Standards Collaboration could guide the establishment of a certification process within the U.S. This article argues for national certification of patient decision aids and discusses how that may be achieved. (shrink)

BackgroundPersonal health information and biospecimens are valuable research resources essential for the advancement of medicine and protected by national standards and provincial statutes. Research ethics and privacy standards attempt to balance individual interests with societal interests. However these standards may not reflect public opinion or preferences. The purpose of this study was to assess the opinions and preferences of patients with kidney disease about the use of their health information and biospecimens for medical research.MethodsA 45-item survey was distributed to a (...) convenience sample of patients at an outpatient clinic in a large urban centre. The survey briefly addressed sociodemographic and illness characteristics. Opinions were sought on the research use of health information and biospecimens including consent preferences.ResultsTwo hundred eleven of 400 distributed surveys were completed. Respondents were generally supportive of medical research and trusting of researchers. Many respondents supported the use of their information and biospecimens for health research and also preferred consent be sought for use of health information and biospecimens. Some supported the use of their information and biospecimens for research without consent. There were significant differences in the opinions people offered regarding the research use of biospecimens compared to health information. Some respondent perspectives about consent were at odds with current regulatory and legal standards.ConclusionsClinical health data and biospecimens are valuable research resources, critical to the advancement of medicine. Use of these data for research requires balancing respect for individual autonomy, privacy and the societal interest in the greater good. Incongruence between some respondent perspectives and the regulatory standards suggest both a need for public education and review of legislation to increase understanding and ensure the public’s trust is maintained. (shrink)

A growing body of empirical literature challenges philosophers’ reliance on intuitions as evidence based on the fact that intuitions vary according to factors such as cultural and educational background, and socio-economic status. Our research extends this challenge, investigating Lehrer’s appeal to the Truetemp Case as evidence against reliabilism. We found that intuitions in response to this case vary according to whether, and which, other thought experiments are considered first. Our results show that compared to subjects who receive the Truetemp Case (...) first, subjects first presented with a clear case of knowledge are less willing to attribute knowledge in the Truetemp Case, and subjects first presented with a clear case of nonknowledge are more willing to attribute knowledge in the Truetemp Case. We contend that this instability undermines the supposed evidential status of these intuitions, such that philosophers who deal in intuitions can no longer rest comfortably in their armchairs. (shrink)

Changing the Wor(l)d draws on feminist publishing, postmodern theory and feminist autobiography to powerfully critique both liberal feminism and scholarship on the women's movement, arguing that both ignore feminism's unique contributions to social analysis and politics. These contributions recognize the power of discourse, the diversity of women's experiences, and the importance of changing the world through changing consciousness. Young critiques social movement theory and five key studies of the women's movement, arguing that gender oppression can be understood only in relation (...) to race, sexuality, class and ethnicity; and that feminist activism has always gone beyond the realm of public policy to emphasize improving women's circumstances through transforming discourse and consciousness. Young examines feminist discursive politics, critiques social science methodology, and proposes an alternative approach to understanding the women's movement. This approach explores feminist publishing and feminist autobiographical writing as examples of discursive activism with broadly subversive potential. (shrink)

Though stereotype threat is most well-known for its ability to hinder performance, it actually has a wide range of effects. For instance, it can also cause stress, anxiety, and doubt. These additional effects are as important and as central to the phenomenon as its effects on performance are. As a result, stereotype threat has more far-reaching implications than many philosophers have realized. In particular, the phenomenon has a number of unexplored “epistemic effects.” These are effects on our epistemic lives—i.e., the (...) ways we engage with the world as actual and potential knowers. In this paper I flesh out the implications of a specific epistemic effect: self-doubt. Certain kinds of self-doubt can deeply affect our epistemic lives by exacerbating moments of epistemic injustice and by interacting with pernicious ideals of rationality. In both cases, self-doubt can lead to a person questioning their own humanity or full personhood. Since we have reasons to believe that stereotype threat can trigger this kind of self-doubt, then stereotype threat can affect various aspects of ourselves besides our ability to perform to our potential. It can also affect our very sense of self. (shrink)

If asked whether stereotypes about people have the potential to help overcome injustice, I suspect that many think there is a clear-cut answer to this question, and that answer is “no.” Many stereotypes do have harmful effects, from the blatantly dehumanizing to the more subtly disruptive. Reasonably then, a common attitude toward stereotypes is that they are at best shallow, superficial assumptions, and at worst degrading and hurtful vehicles of oppression. I argue that on a broad account of stereotypes, this (...) is not is not an inherent feature of them nor a foregone conclusion about them. At least some positive stereotypes have the potential to help resist certain forms of epistemic injustice--though they likely can only play a limited or temporary role in this regard. The takeaway is that we should approach moral and epistemic analyses of stereotypes by thinking about them as (crude) cognitive tools, and as such, focus on what these tools are being used for, and what their actual impact is. (shrink)

In their article “Genomic Contextualism: Shifting the Rhetoric of Genetic Exceptionalism,” Garrison and colleagues (2019) make a compelling case for moving away from the rhetoric of genetic excepti...

The popular media has repeatedly pointed to pride as one of the key factors motivating leaders to behave unethically. However, given the devastating consequences that leader unethical behavior may have, a more scientific account of the role of pride is warranted. The present study differentiates between authentic and hubristic pride and assesses its impact on leader ethical behavior, while taking into consideration the extent to which leaders find it important to their self-concept to be a moral person. In two experiments (...) we found that with higher levels of moral identity, authentically proud leaders are more likely to engage in ethical behavior than hubristically proud leaders, and that this effect is mediated by leaders’ motivation to act selflessly. A field survey among organizational leaders corroborated that moral identity may bring the positive effect of authentic pride and the negative effect of hubristic pride on leader ethical behavior to the forefront. (shrink)

Digital Media: Human–Technology Connection examines the technologically textured world through case studies that illustrate the way humans and technology connect with each other and the world. An interdisciplinary array of sources from philosophy, postphenomenology, philosophy of technology, media studies, media ecology, and film studies shows that digital media and its content are not neutral. This technology textures the world in multiple and varied ways that transform human abilities, augment experience, and pattern the world.

In neocolonial contexts of globalization, the epistemological terrain of radical diversity poses significant ethical challenges to transnational feminisms. In view of historical associations between knowledge and discourses of love which were conditioned by imperialist brands of humanism and benevolence under colonialism, this paper argues for a deconstructionist approach to conceptualizing love in relation to knowledge and for an ethics that severs the association with benevolence, instead making alterity the basis for its account.

While the NSIGHT program was driven by a desire to define and gather data about both the benefits and harms of introducing genomic sequencing into the care of newborns, it remains to be seen how much influence these data will have in shaping the use of this technology in newborns. Ultimately, three additional forces—commercial interests, the technological imperative, and advocates—may play a significant role in shaping the use of sequencing in newborns. Policy‐makers and clinicians should be aware of the effects (...) of these additional forces when considering the appropriate use of this technology in clinical practice and public health screening programs. (shrink)

C. S. Peirce posits that the self is known only through negation—by the knower finding out that he or she is wrong. Even more importantly he considers a man to be nothing more than a sign. This is existentially inadequate. In this chapter, Stacey Ake shows the shortcomings of Peirce’s Firstness, Secondness, and Thirdness in creating human identity by utilizing and developing Walker Percy’s notion of Fourthness in order to show that there is a positive way to create identity (...) and, more importantly, community. (shrink)

In this article, we will consider how the regulation of populations is not just a feature of prisons, but of all institutions and organisations that control members though hierarchies, divisions and norms. While nurses and other allied health professionals are considered to be predominantly self‐regulatory, practice is guided by a code of conduct and codes of ethics that act as rules that serve to uphold the safety of the patient, whether they are a sick person in a hospital bed or (...) an inmate in a prison. The codes of conduct espouse a number of rules that to a certain extent govern the behaviour of individual and groups of practitioners through reciprocal rewards and punishments. Supervision is one method of monitoring the effectiveness of the codes of conduct and ethics while regulating both the minimum standard of individual practice and of training organisations. It is posited that one of the possible effects of clinical supervision is to make the person effectively self‐regulatory as, an autonomous practitioner. We take the view that professional autonomy is a highly problematic concept requiring closer examination. (shrink)

Advances in science and technology frequently raise new ethical, legal, and social issues, and developments in neuroscience and neuroimaging technology are no exception. Within the field of neuroethics, leading scientists, ethicists, and humanists are exploring the implications of efforts to image, study, treat, and enhance the human brain.This article focuses on one aspect of neuroethics: the confidentiality and privacy implications of advances in functional magnetic resonance imaging. Following a brief orientation to fMRI and an overview of some of its current (...) and proposed uses, this article highlights key confidentiality and privacy issues raised by fMRI in the contexts of health care, research, employment, insurance, criminal justice, litigation, and cognitive privacy. (shrink)

In Tanzania, the encounter between a traditional malady called degedege and the modern malady malaria is a fight to participate in the making of the bodies of women and children as well as the agents that afflict them. In their respective settings,degedege and malaria are considered two of the most common threats to the well-being of pregnant women and their young children. Local, national, and international public-health concerns for the early treatment of malaria compel biomedical practitioners to claim that degedege (...) is malaria. This article explores the power of this translation through an examination of the processes involved in treating degedege and the processes involved in treating malaria. I examine what is gained and what is lost through scientific or public health efforts to translate concepts, objects of practice, and agents of affliction from one form of care to another. (shrink)

Bridging disciplines have much to teach us about how to combine analytical tools to tackle problems and questions that cross traditional disciplinary boundaries. This article uses examples from the older bridging disciplines of geography and anthropology in order to consider what the relatively young undertaking labeled “interdisciplinary studies” can learn from their long existence. It explains what is meant by the fallacy of nomothetic claim and considers the fruitful production of answers and solutions by viewing process (methodology) not domain (academic (...) turf), as the key to interdisciplinary success. Staking claim to interdisciplinarity is shown to be unproductive while finding the need for interdisciplinary approaches and following the mandates of that need in the pursuit of solutions to problems and questions strengthens both the disciplines and the development of interdisciplinary studies. (shrink)

Philosophical and technoculture studies surrounding the existential understanding of the human–technology–world experience have seen a slow but steady increase that makes a turn to material hermeneutics in the second decade of the twenty-first century (Ihde in Postphenomenology: essays in the postmodern context. Northwestern University Press, Evanston, 1993; Capurro in AI Soc 25(1):35–42, 2010; Romele in Digital hermeneutics: philosophical investigations in new media and technologies. Routledge, Abingdon, 2020; among others). This renewed focus makes sense because human–technology–world experiences need to be interpreted. (...) And many of these are more complicated to study, precisely because technology is at the root of the experiences. One interesting subset of technologies is media technologies, also called digital media, which intertwines the device and the content to mediate together in the world (Irwin in Digital media: human-technology connection. Lexington Books, Lanham, 2016). Visual media technologies and media content, together, through what is called moving image technologies, create virtual role-playing, virtual and augmented reality, video games, and social media focused worlds that have become central experiences in contemporary culture. Just as image-based scientific instruments read the world in different ways, so to do these visual mediated experiences. How might this comingled “reading” of technology explain the digital film language and experience? I contend that understanding the existential “early” film experience helps understand the new age of cinema, with implications for digital media, digital representation of the visual, and technoscience and technoculture studies. The material hermeneutics perspective called postphenomenology is one way to study these visually focused human–technology–world perceptual and interpretive experiences. Don Ihde’s methodological framework (1990, 1993, 1996, 2002, 2010, 2012, 2016, 2019) is both an idea from technoscience studies and a set of nuanced vocabulary that helps to explore and reveal variations, patterns, and trajectories of the whole-body experience of technology. This use case will first explore traditional cinema and then the “new age” term “moving image”, to learn more about this complicated and radically transforming technological experience. Work by Don Ihde and Vivian Sobchack is considered. (shrink)

This article presents experiential reflections on the spiritual tasks for the last stage of human life. These tasks—experiencing escalating losses, accepting growing dependence on others, reframing the meaning of one’s life, and finding purpose even as one slowly lets go of life—are challenging, at least in part because they are counter-cultural for twenty-first century Americans. Exploring the spiritual tasks of aging towards death is necessary and important work for both aging elders and those who accompany them on the last stage (...) of their life’s journey. (shrink)

The central argument in this essay is that while the concept of entanglement offers materialism the promise of a conceptually rich field of new “entangled” entities, by itself, entanglement is ill-equipped to contend with the thorny questions of how power is organized among those entities. This essay proposes that decoherence provides a welcome complement to entanglement.

John Milbank's The Future of Love is a compilation of essays written over the last twenty-five years from which a nuanced political theology takes shape. As a collection of essays, it is impossible to find here a single unitary voice, but nor is that the point. The point, I believe, is to give a sample of Milbank's tripartite method of critique, which incorporates literature, theology, and philosophy. From this sample a string of interwoven arguments emerge: the need to prioritize excellence (...) over efficiency in all walks of life; that this demands a hierarchy of values; that a hierarchy of values…. (shrink)

In crisis situations, the authority of the nurse is legitimised by legal powers and professional knowledge. Crisis stakeholders include those who directly use services and their families, and a wide range of health, social service and justice agencies. Alternative strategies such as therapeutic risk taking from the perspective of socially inclusive recovery policy coexist in a sometimes uneasy relationship with mental health legislation. A critical discourse analysis was undertaken to examine mental health policies and guidelines, and we interviewed service users, (...) families, nurses and the police about experiences of accessing services. For those who attempt to access services early in crisis, as is suggested to lead to a better outcome, provision of services and rights appear to be reversed by an attempt to exclude them through practices that screen them out, rather than prioritising a choice in access. (shrink)

The concept of emotional intelligence has grown in popularity over the last two decades, generating interest both at a social and a professional level. Concurrent developments in nursing relate to the recognition of the impact of self‐awareness and reflexive practice on the quality of the patient experience and the drive toward evidence‐based patient centred models of care. The move of nurse training into higher education heralded many changes and indeed challenges for the profession as a whole. Traditionally, nurse education has (...) been viewed as an essentialist education, the main emphasis being on fitness for practice and the statutory competencies. However, the transfer into the academy confronts the very notion of what constitutes this fitness for practice.Many curricula now make reference in some way to the notion of an emotionally intelligent practitioner, one for whom theory, practice and research are inextricably bound up with tacit and experiential knowledge. In this paper we argue that much of what is described within curriculum documentation is little more than rhetoric when the surface is scratched. Further, we propose that some educationalists and practitioners have embraced the concept of emotional intelligence uncritically, and without fully grasping the entirety of its meaning and application. We attempt to make explicit the manner in which emotional intelligence can be more realistically and appropriately integrated into the profession and conclude by suggesting a model of transformatory learning for nurse education. (shrink)

This article examines the privacy and security issues associated with mobile application-mediated health research, concentrating in particular on research conducted or participated in by independent scientists, citizen scientists, and patient researchers. Building on other articles in this issue that examine state research laws and state data protection laws as possible sources of privacy and security protections for mobile research participants, this article focuses on the lack of application of federal standards to mobile application-mediated health research. As discussed in more detail (...) below, the voluminous and diverse data collected by some independent scientists who use mobile applications to conduct health research may be at risk for unregulated privacy and security breaches, leading to dignitary, psychological, and economic harms for which participants have few legally enforceable rights or remedies under current federal law. Federal lawmakers may wish to consider enacting new legislation that would require otherwise unregulated health data holders to implement reasonable data privacy, security, and breach notification measures. (shrink)

This reflection focuses on lived experience with the Technological Other (Quasi-Other) while pursuing creative video and film activities. In the last decade work in the video and film industries has been transformed through digital manipulation and enhancement brought about by increasingly sophisticated computer technologies. The rules of the craft have not changed but the relationship the artist/editor experiences with these new digital tools has brought about increasingly interesting existential experiences in the creative process. How might this new way of being (...) with technology change the craft and the crafter? Through a phenomenological understanding of Martin Heidegger, Maurice Merleau-Ponty, Don Ihde, and their contributions to the human-technology conversation, this essay moves to reveal the lived experiences of artists/editors who use computers to create by means of film and digital video formats. Exploring notions of lived space, lived body, lived time, and lived relation through the computer interface allows for digging deeper into inhabiting technology and experiencing the Technological Other. (shrink)

This article introduces and defines the Health in All Policies concept and examines existing state legislation, with a focus on California. The article starts with an overview of HiAP and then analyzes the status of HiAP legislation, specifically addressing variations across states. Finally, the article describes California's HiAP approach and discusses how communities can apply a HiAP framework not only to improve health outcomes and advance health equity, but also to counteract existing laws and policies that contribute to health inequities.

The following is an examination of two possible interpretations of the meaning of the “existence” of God. By using two different Danishterms—the word existence (Existents) and the concept “coming to be” (Tilværelse)—found in Kierkegaard’s writing, I hope to show that two very different theological outcomes arise depending upon which idea or term is used. Moreover, I posit which of these twooutcomes is closer in nature to the more famously used German term Dasein.

Walker Percy's use of the terms Umwelt and Welt as well as his separation of events into dyadic and triadic ones, where the latter involve human beings, is brought to bear on the relationship between science and religion with the upshot being that science is not equipped to really understand or explain triadic entities.

Supernatural illustrates two dominant ideals of masculinity, the warrior and the sovereign. The sovereign has what Isaiah Berlin described as both positive and negative liberty. Negative liberty is freedom from things, like restrictions, restraints, obstacles, coercion, or force. The season finale reveals that this feud is based on an overly simplistic understanding of their two masculine ideals. Positive liberty is the freedom to do things. For the sovereign, this means having the unfettered ability to choose goals and accomplish them. Supernatural (...) is largely about men navigating their masculinity. The characters and the show itself appear to have some vacillating opinions of women and femininity. Love is a paradox in Supernatural with its masculine ideals of strength and independence. But in order to be masculine, one must first and foremost be human. And to be human, one needs love. (shrink)

Perception and reciprocity are key understandings in the lived experience of driving while using a cellular phone. When I talk on a cell phone while driving, I interpret the world through a variety of technologically mediated perceptions. I interpret the bumps in the road and the bug on the windshield. I perceive the information on the dashboard and the conversation with the Other on the other end of the technological “line” of the phone. This reflection uses hermeneutical phenomenology to address (...) the things themselves in life with which we relate and interact with in our everydayness, as we talk on a cell phone while driving. (shrink)