Migration often requires the renegotiation of familial and gender roles as immigrants encounter potentially competing values and demands. Employing ethnographic methods and including in-depth interviewing and participant observation, the authors explore the experiences of 29 South Asian and Chinese Canadian female family caregivers. Caregiving was central to their role as women and members of their ethnocultural community. The women were often engaged in paid labor that compressed the time available to fulfill their duties as caregivers. Women’s role in the transmission (...) of cultural values that serve to shore up the boundaries of their ethnic community did not allow for significant renegotiation of their caregiving responsibilities despite disrupted family networks and increased demands. These caregiving arrangements are more costly to women in Canada than in their countries of origin. (shrink)

Donation after circulatory determination of death (DCDD) is an accepted practice in the United States, but heart procurement under these circumstances has been debated. Although the practice is experiencing a resurgence due to the recently completed trials using ex vivo perfusion systems, interest in thoracoabdominal normothermic regional perfusion (TA-NRP), wherein the organs are reanimated in situ prior to procurement, has raised many ethical questions. We outline practical, ethical, and equity considerations to ensure transplant programs make well-informed decisions about TA-NRP. We (...) present a multidisciplinary analysis of the relevant ethical issues arising from DCDD-NRP heart procurement, including application of the Dead Donor Rule and the Uniform Definition of Death Act, and provide recommendations to facilitate ethical analysis and input from all interested parties. We also recommend informed consent, as distinct from typical “authorization,” for cadaveric organ donation using TA-NRP. (shrink)

Spiritual Writer, theologian, and philosopher, Fr. Robert Spitzer S.J., tackles the topic of recognizing and overcoming spiritual evil. His focus is the human heart. His goal: our spiritual and moral transformation, which leads to true peace and genuine happiness. The book is divided into two main parts: (1) the realities of God's goodness and of spiritual evil, and (2) recognizing and overcoming the diabolical tactics of deception, temptation, and sin. The author synthesizes the best advice given by Catholic spiritual (...) masters throughout the ages and gives a practical guide to implementing it in our busy lives. Father Spitzer provides the biblical and theological background of Jesus' victory over evil. He also explores the reality of the devil, including extraordinary manifestations of diabolic activity such as possession. With insights from modern psychology, he shows how prayer can transform the subconscious psyche, making us better able to resist temptation, detach from the world, and grow in holiness. (shrink)

Surgical innovation involves practices, such as new devices, technologies, procedures, or applications, which are novel and untested. Although innovative practices are believed to offer an improvement on the standard surgical approach, they may prove to be inefficacious or even dangerous. This article considers how surgeons considering innovation should reason in the conditions of uncertainty that characterize innovative surgery. What attitude to the unknown risks of innovative surgery should they take? The answer to this question involves value judgments about the acceptability (...) of risk taking when satisfactory scientific information is not available. This question has been confronted in legal contexts, where risk aversion in the form of the precautionary principle has become increasingly influential as a regulatory response to innovative technologies that pose uncertain future hazards. This article considers whether it is appropriate to apply a precautionary approach when making decisions about innovative surgery. (shrink)

Prior researchers have studied individual components of a theoretical decision-making model. This paper presents the results of a more complete study of the model components and presents limited support of theory. The study examines the relative importance of regulatory, organizational, and personal constructs on an individual''s ethical sensitivity. Auditors from the major international accounting firms, located in two southeastern cities, are surveyed. Structural equation modeling is used to allow for the simultaneous evaluation of the three constructs of interest. The results (...) indicate that the regulatory and organizational constructs are negatively correlated with the personal experience construct. The three constructs are not significant causal factors on ethical sensitivity. This result may be due to the manner in which ethical sensitivity is typically measured or may indicate that the complexity of the ethical decision-making process is not fully captured in the theoretical models. Thus, the models suggested in the prior literature and the results presented in prior studies of the individual components may need to be reconsidered. (shrink)

Storage and secondary use of bloodspots collected for newborn screening raises controversies because of the particularly sensitive nature of the information that can be derived from them and the lack of national standards and consistent provincial policies that can serve to guide storage facilities. This report, derived through a review of Canadian and provincial policy statements, a survey of provincial newborn screening laboratory directors and program directors, as well as through a consultative workshop, illustrates the social, ethical and legal issues (...) regarding the storage, access and further uses of newborn bloodspots. The report indicates that there is a need for heightened transparency and clear recommendations concerning the criteria for storage, the duration of storage, and permissible secondary uses of dried bloodspots in Canada. (shrink)

What can the manifestations of schizophrenia and other mental disorders reveal about classical notions of philosophy such as thought, perception, self, and rationality? Philosophers, psychiatrists, and clinical psychologists got together to compare notes at Harvard in October 1989, and presented these 16 papers. Annotation copyrighted by Book News, Inc., Portland, OR.

In the Fall of 2007, ten neuroscientists published a proposal for an interdisciplinary research initiative, the Decade of the Mind, that would focus on four.

Images permeate and propel archaic thinking in diverse ways. How do philosophic texts from the Greek archaic period (ca. eighth through early-fifth centu­ries BCE) conceive of images and what do images accomplish in archaic philosophies? In what ways can attention to images in philosophic texts open perspectives onto the relations of myth, poetry, and philosophy in the archaic Greek period? With these questions guiding the inquiry, this paper explores texts from various traditions jointly related within the archaic Aegean cultural matrix. (...) Texts from what might be termed philosophy’s prehistory, such as the ancient Egyptian Leiden Hymns and Odysseia, pro­vide important context for understanding the continuity and development of images. (shrink)

Phenomenology represents a mainstream in the philosophy of subjectivity as well as a rich tradition of inquiry in psychiatry. The conceptual and empirical study of language has become increasingly relevant for psychiatric research and practice. Schizophrenia is still the most enigmatic and most relevant mental disorder. This volume represents an attempt to bring specialists from different fields together in order to integrate various conceptual and empirical approaches for the benefit of schizophrenic research. We hope that it will facilitate discussions among (...) members of such diverse fields as psychiatry, psychology, and philosophy. (shrink)

This is the most comprehensive scientific treatment of God and the afterlife to date. It combines natural scientific method, metaphysical method, medical studies, anthropological and genetics studies, and phenomenological descriptions, showing how each distinct method and data set reinforces the others.

The true story of ten tough and tattooed bikers who rescue animals in danger Using their combined 1700 pounds of muscle, Joe, Johnny O, Batso, Big Ant, G, Angel, Eric, Des, Bruce and Robert stop at nothing within the bounds of the law to save animals, be they furred, feathered, or scaled, from life-or-death situations throughout the New York City metropolitan area. Working from tips from concerned neighbors and anonymous sources, they have rescued countless animals, including a dognapped bulldog and (...) 180 cats from the home of a hoarder. In between rescues, they've protested the barbaric practices of a horse slaughterhouse, visited schools to educate children about animal kindness and that "abusers are losers," and participated in Puppy Mill Awareness Day in Lancaster, Pennsylvania. Former Newsday writer Denise Flaim chronicles their adventurous tales, detailing just what these brawny bikers, who will stop at nothing within the bounds of the law, can teach us all about respecting the creatures in our midst. (shrink)

BackgroundDecision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the (...) range of influences on these decisions.MethodsMedline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.Results53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.ConclusionsThere is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence. (shrink)

This article considers the issue of expanded access to innovative treatments in the context of recent legislative initiatives in the United Kingdom and the United States. In the United Kingdom, the supporters of legislative change argued that the common law principles governing medical negligence are a barrier to innovation. In an attempt to remove this perceived impediment, two bills proposed that innovating doctors sued for negligence should be able to rely in their defence on the fact that their decision to (...) innovate was “responsible.” A decision to innovate would be regarded as responsible if it followed a specified process. Although these changes to the law of medical negligence were not passed, this article argues that the idea of a process-based approach was sound. In the United States, a number of states have passed “Right to Try” laws that permit doctors to prescribe and companies to provide investigational products without the need for FDA approval. These laws do not purport to and nor are they able to alter the obligations of individuals and companies under federal law. They are consequently unlikely to achieve their stated aim of expanding access to investigational products. This article argues that they nevertheless have a cogent rationale in so far as they highlight the need for rights-based reform to federal regulations governing access. (shrink)

"The scholarship of Michael Spitzer's new book is impressive and thorough. The writing is impeccable and the coverage extensive. The book treats the history of the use of metaphor in the field of classical music. It also covers a substantial part of the philosophical literature. The book treats the topic of metaphor in a new and extremely convincing manner."-Lydia Goehr, Columbia University The experience of music is an abstract and elusive one, enough so that we're often forced to describe (...) it using analogies to other forms and sensations: we say that music moves or rises like a physical form that it contains the imagery of paintings or the grammar of language. In these and countless other ways, our discussions of music take the form of metaphor, attempting to describe music's abstractions by referencing more concrete and familiar experiences. Michael Spitzer's Metaphor and Musical Thought uses this process to create a unique and insightful history of our relationship with music--the first ever book-length study of musical metaphor in any language. Treating issues of language, aesthetics, semiotics, and cognition, Spitzer offers an evaluation, a comprehensive history, and an original theory of the ways our cultural values have informed the metaphors we use to address music. And as he brings these discussions to bear on specific works of music and follows them through current debates on how music's meaning might be considered, what emerges is a clear and engaging guide to both the philosophy of musical thought and the history of musical analysis, from the seventeenth century to the present day. Spitzer writes engagingly for students of philosophy and aesthetics, as well as for music theorists and historians. (shrink)

Over several articles, John McDowell sketches an analogy between virtue and perception, whereby the virtuous person sees situations in a distinctive way, a way that explains her virtuous behavior. Central to this view is his notion of silencing, a psychological phenomenon in which certain considerations fail to operate as reasons in a virtuous person's practical reasoning. Despite its influence on many prominent virtue ethicists, McDowell's ‘silencing view’ has been criticized as psychologically unrealistic. In this article, I defend a silencing view (...) of practical reasoning. I argue that the phenomenon of silencing has a narrower scope than is typically acknowledged. As a result, the view does not require the virtuous to be detached, unfeeling, or unpalatably stoic. Furthermore, I offer a psychologically plausible interpretation of McDowell's claim that the virtuous see situations in a distinctive sort of way. The salient fact at which the virtuous arrive in their view of a situation should be understood, I argue, in terms of subjective construal. (shrink)

Ethics consultants and critical care clinicians reflect on Seattle’s early experience as the United States’ first epicenter of COVID-19. We discuss ethically salient issues confronted at UW Medicin...

Toba Spitzer's God Is Here is a transformative exploration of the idea of God, offering new paths to experiencing the realm of the sacred. Most of us are hungry for a system of meaning to make sense of our lives, yet traditional religion too often leaves those seeking spiritual sustenance unsatisfied. Rabbi Toba Spitzer understands this problem firsthand, and knows that too often it is traditional ideas of the deity-he's too big, too impersonal, and too unbelievable-that get in (...) the way. In God Is Here, Spitzer argues that whether we believe in God or fervently disbelieve, what we are actually disagreeing about is not God at all, but a metaphor of a Big Powerful Person that limits our understanding and our spiritual lives. Going back to the earliest sources for Judaism as well as Christianity, Spitzer discovers in the Hebrew Bible a rich and varied palette of metaphors for the divine-including Water, Voice, Fire, Rock, Cloud, and even the process of Becoming. She addresses how we can access these ancient metaphors, as well as those drawn from rabbinic tradition and modern science, to experience holiness in our daily lives and to guide us in challenging times. In the section on water, for instance, she looks at the myriad ways water flows through the Biblical stories of the Israelites and emerges as a powerful metaphor for the divine in the Prophets and Psalms. She invites us to explore what it might mean to "drink from God," or to experience godly justice as something that "rains down" and "flows like a river." Each chapter contains insights from the Bible and teachings from Judaism and other spiritual traditions, accompanied by suggestions for practice to bring alive each of the God metaphors. Rabbi Toba Spitzer has helped many people satisfy their spiritual hunger. With God Is Here she will inspire you to find new and perhaps surprising ways of encountering the divine, right where you are. (shrink)

Radical Feminism Today offers a timely and engaging account of exactly what feminism is, and what it is not. Author Denise Thompson questions much of what has come to be taken for granted as `feminism' and points to the limitations of implicitly defining feminism in terms of `women', `gender', `difference' or `race//gender//class'. She challenges some of the most widely accepted ideas about feminism and in doing so opens up a number of hitheto closed debates, allowing for the possibility of (...) moving those debates further. (shrink)

An important contribution of Alan Patten’s Equal Recognition is the conception of neutrality that grounds his defence of minority cultural rights. Built in to his conception of neutrality of treatment is a notion of ‘fairness’ whose effect is to provide an upfront, across the board limitation on the demands cultural minorities may legitimately make on the rest of society. There must be limits on the duty to accommodate, but it obscures more than it illuminates to build this into the content (...) of the right to equal recognition itself. We see more clearly what is at stake in these conflicts by articulating the value of self-determination independently and taking account of necessary limits to its satisfaction as part of a second-stage analysis of what duties may be claimed and against whom. Familiar principles of discrimination law exemplify this alternative model. This presents the interest in self-determination more robustly, while acknowledging that the claims of duty arising out of it are defeasible. The result is a more flexible and nuanced exploration of the complex moral issues involved when fundamental interests clash. (shrink)

Gender has been shown to affect the persuasiveness of help-self and help-others appeals in fundraising: men prefer help-self appeals, and women help-others appeals. This gender difference has been attributed to world-view differences. Women have a care-oriented world-view and men a justice-oriented world-view – at least in masculine cultures. In feminine cultures, however, both men and women have a care-oriented world-view. The present study investigated whether in the feminine, Dutch culture the culturally adapted help-others appeal was more persuasive than the culturally (...) unadapted help-self appeal for both men and women. Results showed that the culturally adapted help-others appeal was the most persuasive appeal for men and women, who were both found to have a relatively care-oriented world-view. (shrink)