Nursing prides itself on a commitment to caring for patients and their families. Daily, nurses support patients and their families as they face life-threatening disease and injury and help them through the painful decisions to initiate or remove ventilators, artificial nutrition and hydration, and other life-sustaining technology.The opinions of the Second and Ninth Circuit Courts of Appeals, in Compassion in Dying v. State of Washington and Quill v. Vauo, strike at the heart of the nursing value system. If the United (...) States Supreme Court upholds either opinion, physicians will be legally allowed to help patients die, and nurses will be called on to assist with this process, just as nurses have assisted with electroconvulsive treatment, abortion, and other controversial procedures. Advanced practice nurses, who are licensed to prescribe drugs, may also be allowed by law to assist patients to end their own lives. (shrink)

The purpose of this research was to understand institutional review board (IRB) challenges regarding youth-focused research submissions and to present advice from administrators. Semistructured self-report questionnaires were sent via e-mail to administrators identified using published lists of universities and hospitals and Internet searches. Of 183 eligible institutions, 49 responded. One half indicated they never granted parental waivers. Among those considering waivers, decision factors included research risks, survey content, and feasibility. Smoking and substance abuse research among children was generally considered more (...) than minimal risk. These findings are consistent with those from a study conducted by Mammel and Kaplan (1995), which investigated IRB practices concerning protocols involving adolescent participants. IRBs and investigators need to become aware of regulations' flexibility to ensure adequate participant protection. Investigators need to limit jargon and assumptions about participants' understanding of research objectives. (shrink)

As the millennium approaches, the United States is on the verge of major health care reform. While swallowing scarce national resources, our health care system produces unenviable results and major inconsistencies. In 1992, $838.5 billion were spent on health care, biting more than 14 percent out of our gross national product. From 35 to 37 million Americans, or approximately 14 percent of the populationn, are uninsured. Our health care system is inherently inconsistent: We have the highest birthweight-specific survival rate of (...) any country in the world, yet we rank 19th worldwide in infant mortality rate, i.e., state-of-the-art medical technology allows us to save a 500-gram infant, yet the mother of that infant may not have had access to basic, minimal prenatal care. (shrink)

Background: People with traumatic brain injury face a range of mental health challenges during the adjustment process post-injury, but access to treatment can be difficult, particularly for those who live in regional and remote regions. eHealth provides the potential to improve access to evidence-based psychological therapy for people with a severe TBI. The aim of the current study is to assess the efficacy of a psychological intervention delivered via video consulting to reduce psychological distress in people with TBI.Methods: This paper (...) outlines the protocol for a multi-center, three-arm, parallel, non-inferiority randomized controlled trial of an evidence-based manualized psychological intervention, ACT-Adjust. ACT-Adjust provides nine sessions for adults with a moderate to severe TBI experiencing clinical levels of psychological distress. Fifty-six participants referred from Brain Injury Rehabilitation Units across New South Wales and the NSW icare scheme will be randomly allocated to three conditions; video consulting, face-to-face and, a waitlist control.Discussion: This is the first RCT to evaluate the efficacy of a psychological therapy delivered via video consulting for individuals with a moderate to severe TBI.Trial Registration:www.anzctr.org.au, Australian New Zealand Clinical Trials Registry ANZCTRN2619001602112. (shrink)

This Second Edition is an essential resource for librarians, scholars, and students. This succinct handbook includes more than 1,000 entries covering the persons, organizations, campaigns and court cases, goals and achievements, and current and future directions of the feminist movement, 75 percent of which are new and revised from the first edition. An expanded chronology and a thoroughly revised and updated bibliography round out this comprehensive reference.

Over 150 entries of the second edition of the Historical Dictionary of Feminism have been updated, corrected, or revised for The A to Z of Feminism. Furthermore, several new entries and additional cross-references have also been added, and the chronology of feminism now extends through 2005. This paperback edition has a short bibliography of classic and contemporary materials for use by students and the general public. The dictionary, which contains several hundred cross-referenced entries on persons, organizations, key terms, canonical publications, (...) public policies, and campaigns, addresses feminism as both a social movement and a political theory in all nations and periods. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Fertility preservation has become more common for various populations, including oncology patients, transgender individuals, and women who are concerned about age-related infertility. Little attention has been paid to fertility preservation for patients with differences/disorders of sex development (DSD). Our goal in this article is to address specific ethical considerations that are unique to this patient population. To this end, we present a hypothetical DSD case. We then explore ethical considerations related to patient’s age, risk of cancer, concern about genetic transmission (...) of a DSD condition to children, co-occurring gender dysphoria, and access to experimental fertility preservation procedures. Given the limitations of current technologies, we recommend offering fertility preservation to individuals living with DSD using an informed decision-making approach that instills realistic expectations and minimizes the potential for false hope. Finally, we conclude with practical recommendations for this case based on the ethical considerations. (shrink)

We conducted focus groups to assess patient attitudes toward research on medical practices in the context of usual care. We found that patients focus on the implications of this research for their relationship with and trust in their physicians. Patients view research on medical practices as separate from usual care, demanding dissemination of information and in most cases, individual consent. Patients expect information about this research to come through their physician, whom they rely on to identify and filter associated risks. (...) In general, patients support this research, but worry that participation in research involving randomization may undermine individualized care that acknowledges their unique medical histories. These findings suggest the need for public education on variation in practice among physicians and the need for a collaborative approach to the governance of research on medical practices that addresses core values of trust, transparency, and partnership. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

Several lines of evidence suggest that children born via Cesarean section are at greater risk for adverse health outcomes including allergies, asthma and obesity. Vaginal seeding is a medical procedure in which infants born by C-section are swabbed immediately after birth with vaginal secretions from the mother. This procedure has been proposed as a way to transfer the mother's vaginal microbiome to the child, thereby restoring the natural exposure that occurs during vaginal birth that is interrupted in the case of (...) babies born via C-section. Preliminary evidence indicates partial restoration of microbes. However, there is insufficient evidence to determine the health benefits of the procedure. Several studies, including trial, are currently underway. At the same time, in the clinic setting, doctors are increasingly being asked to by expectant mothers to have their babies seeded. This article reports on the current research on this procedure and the issues it raises for regulators, researchers, physicians, and patients. (shrink)

Introduction Future HIV vaccine efficacy trials with adolescents will need to ensure that participants comprehend study concepts in order to confer true informed assent. A Hepatitis B vaccine trial with adolescents offers valuable opportunity to test youth understanding of vaccine trial requirements in general. Methods Youth reviewed a simplified assent form with study investigators and then completed a comprehension questionnaire. Once enrolled, all youth were tested for HIV and confirmed to be HIV-negative. Results 123 youth completed the questionnaire (mean age=15 (...) years; 63% male; 70% Hispanic). Overall, only 69 (56%) youth answered all six questions correctly. Conclusions Youth enrolled in a Hepatitis B vaccine trial demonstrated variable comprehension of the study design and various methodological concepts, such as treatment group masking. (shrink)

Early educators are in a bind. Teacher education programs are calling on them more and more to help students practice critical thinking and develop intellectual character ; yet school funding depends on meeting Common Core standards, which do not explicitly assess critical thinking until the high-school level. Add to that an over-engineered content curriculum, and thinking becomes a luxury that is quickly lost amid more immediate concerns. As a result, we are raising a generation of “excellent sheep” who flourish amid (...) standardized tests but are increasingly unable to think for themselves. The problem, we suggest, is that today’s teachers are in such a rush to give students the answers that they are not allowing them time to ask the questions. As a result, students cannot find the “deep structure” of issues. Bodies of knowledge thus strike them as disconnected facts, quickly forgotten. The solution, as suggested by recent work in cognitive science, is to teach critical thinking through teaching content. In what follows, we propose a way of organically integrating content and thinking through games, story books and art. With this, we put children into the driver’s seat, encouraging them to ask their own questions, to propose their own answers and to join their peers in joint inquiry through dialogue. In a word, we propose teaching children philosophy as early as possible. Tom Wartenberg has made considerable progress with his picture-book philosophy curriculum designed for elementary schools. But what of younger children? Combining the resources of Rollins College’s Philosophy Department and Child Development and Student Research Center, we set out to find “how low can we go?” Over four terms’ of trial and error, we have adapted and distilled Wartenberg’s methods into a model that works for the Center’s 4-year-olds, and we have tested this model on a larger scale through a one-term collaboration with the Winter Park Day Nursery. (shrink)

Few conditions have sparked as much controversy as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Professional consensus has long suggested that the condition should be classified as psychiatric, while patients and advocacy groups have insisted it is a serious biological disease that requires medical care and research to develop it. This longstanding debate shifted in 2015, when U.S. governmental health authorities fully embraced medical classification and management. Given that some globally respected health authorities now insist that ME/CFS is a serious biological disease, (...) this paper asks whether it can be ethical for the U.K. practice guideline now in development to characterize the condition as a mental health disorder. Following a brief history of ME/CFS controversy, I offer three arguments to show that it would be unethical for the U.K. to now characterize ME/CFS as a mental health condition, considering the relevance of that conclusion for ME/CFS guidelines elsewhere and for other contested conditions. (shrink)

This book provides practical and research-based chapters that offer greater clarity about the particular kinds of teacher reflection that matter and avoids talking about teacher reflection generically, which implies that all kinds of reflection are of equal value.

Despite external environmental changes in walking, such as manipulating gait speed, previous studies have shown that the underlying muscle synergy structures (synergy weights or vectors) rarely vary. The purpose of this study is to examine if external environmental changes to the walking task influence muscle synergies in children with cerebral palsy (CP) and/or typical development (TD). To identify muscle synergies, we extracted muscle synergies from eight children with CP and eight age-matched TD in three treadmill walking conditions, e.g., baseline (adjusted (...) to individual comfortable walking speed), variable speed (VS), or restricted foot width (RW). Then, we grouped similar muscle synergies using k-mean clustering and discriminant analyses from all datasets of individual synergy structures. Proportion tests exhibited six clusters of muscle synergies predominantly arising from children with CP and four clusters from children with TD. Also, the proportion of muscle synergies was significantly different in four of the CP-preferred clusters across conditions. Specifically, the proportion of the baseline condition was significantly different from VS and RW conditions in one and two clusters, respectively. The proportion was significantly different between VS and RW conditions in four clusters. Cadence and step lengths differed across conditions but not groups which makes the group differences in proportion even more notable. In contrast, step width, while significantly lower in CP, did not differ across conditions. Our findings demonstrate that muscle synergies in children with CP are more sensitive to changes in the external walking environment than in typically developing children. (shrink)

Was society’s response adequate in the cases of Mrs Pretty and Ms B?On the 11th of May, less than two weeks after losing her final legal appeal, Mrs Diane Pretty died, under sedation and in the care of a hospice. It was not the end she had pursued through the English High Court, the Court of Appeal, the House of Lords, and the European Court of Human Rights. Paralysed by motor neurone disease and unable to take her own life, (...) Mrs Pretty wanted her husband to be allowed to help her to die when they decided the time had come. But in England, assisting suicide is a crime, although suicide itself no longer is, and the English courts refused Mrs Pretty’s request to grant her husband legal immunity. In turning to the European Court of Human Rights, Mrs Pretty argued that the English courts’ refusal had violated the European Convention on Human Rights.The European court, however, judged that there had been no violation. The right to life could not be construed as conferring a “right to die”, and consequently the state could not be required to “sanction actions intended to terminate life” in order to protect Mrs Pretty from the “inhuman or degrading treatment” to which she claimed the law on assisted suicide subjected her. The right to respect for private life , moreover, had to be exercised “in accordance with the law” of the state concerned. “States were entitled to regulate through the operation of the general criminal law activities which were detrimental to the life and safety of other individuals”; and such activities were what the English law against assisting suicide was designed to prevent. Exceptions to this law could not be allowed without undermining the …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:John P. Sisk DOCTOR JOHNSON KICKS A STONE Readers OF Boswell's Life ofJohnson will remember the great Doctor's refutation of Bishop Berkeley's idealism. He and Boswell had just come out of a church in Harwich and were discussing the Bishop's "ingenious sophistry to prove the nonexistence of matter." Boswell observed "that though we are satisfied his doctrine is not true, it is impossible to refute it." To mis Johnson (...) responded, "striking his foot with mighty force against a large stone, till he rebounded from it, T refute it thus.'" For Boswell diis was an argument from first principles diat are as fundamental to metaphysics as axioms are to mathematics. To use Johnson's own phrase, it is an argument based on "the experience of mankind" — the ground upon which he confidendy stood when he expressed his disapproval of such other phUosophical contemporaries as Hume, Voltaire, and Rousseau (the latter "a rascal who ought to be hunted out of society"). Or as WalterJackson Bate puts it in TheAchievement ofSamuelJohnson, the first principle ofhis thinking was "To go back to the living and concrete nature of experience."1 Boswell thought Johnson a philosopher, though he admits in a famous passage that his table manners might have suggested otherwise. Apparently G. K. Chesterton thought he had some claim to the term, for he called Johnson's novel Rasselas "a sort of philosophical satire on philosophy." Most likelyJohnson thought ofhimselfas among many other things a philosopher: the humanities had not yet setded snugly into dieir modern compartments. Now, of course, any undergraduate student of philosophy is willing to believe that Johnson's argument against Berkeley isn't worth much (he may be no less willing to believe that the Bishop's argument isn't worth much eitiier). He may also know that in the perspective of die modern physicist Johnson's stone was not as solid as Johnson thought it was — though it is likely he would have thought diis information 65 66Philosophy and Literature no more relevant to die argument dian Thaïes' belief diat all diings are made of water or Pydiagoras' diat all diings are numbers. The important thing was whether a drinker violated die experience of mankind. When the Scotchman Lord Hunderland praised the ancient philosophers for the candor and good humor widi which they disputed with one anotherJohnson would have none of it: "They disputed with good humour upon dieir fanciful dieories," he said, "because diey were not interested in the truth of them." It is not hard to imagine the Doctor's reaction to our own fanciful theories in philosophy, linguistics, and literary criticism. Suppose him at the Mitre Tavern for an evening's defense of die experience of mankind against die ingenious sophistries of a company made up ofJacques Derrida, Geoffrey H. Hartman, Stanley Fish, Michel Foucault, Paul de Man, and Jacques Lacan — the lot of them variously committed to the belief diat the proper job of philosophy is not the pursuit of the truth but the pursuit of die trudi about die pursuit of die truth. Johnson eyes die group warily, expecting the worst. There are too many Frenchmen present, and as he made clear at supper one July evening in the Turk's Head coffee house, French writers are superficial "because they are not scholars, and so proceed upon the mere power of dieir own minds." Nevertheless, the assembled gendemen present their positions: we are all prisoners ofthe total epistemological environment of our age, our episteme; locked linguistically into interpretive communities, we cannot know die text in itself; die proper function of the critic is creative free play, the text being merely a convenient occasion; language, being self-referential, cannot reveal a subject; human agency is a flattering but deceptive myth; transcendent systems of thought are impossible; if literature touches reality anywhere we cannot know it. MeanwhileJohnson, than whom no man ever had "a more ardent love of literature, or a higher respect for it," is in high dudgeon, kicking figurative stones right and left, no real ones being available inside the Mitre. His adversaries observe him with indulgent good humor, amused but not impressed with this crude bourgeois display, having... (shrink)

Kaum ein Buch hat so viele und so kontroverse Reaktionen verursacht wie Simone de Beauvoirs "Das Andere Geschlecht". Der Sammelband gibt einen Einblick in die aktuelle internationale Beauvoir-Debatte und die Art und Weise wie das fünfzigjährige Jubiläum des "Anderen Geschlechts" gefeiert wurde. Die Autorinnen versuchen die verschiedenen Grundthemen von Beauvoirs Werk, wie Geschlecht und Körper (D. Lamoureux, M. Couillard, M. L. Femenías), Gleichheit und Differenz (S. Kruks, Y. Raynova, S. Bainbrigge), Ausschluss und Anerkennung (D. Bergoffen, S. Moser), Verantwortung und Engagement (...) (F. Rétif, N. Bauer, K. Arp, Dauphin, C. Gater), aus der Perspektive der Gegenwart neu zu beleuchten. Darüber hinaus enthält der Band biographische (K. Vintges, B. Weisshaupt) und bibliographische Beiträge, die ihn zu einem Nachschlagewerk und zu einer Dokumentation der gegenwärtigen Beauvoirforschung werden lassen. Aus dem Inhalt: Françoise Rétif: Zur Aktualität von Simone de Beauvoir oder die Dialektik des Engagements - Nancy Bauer: First Philosophy, "The Second Sex", and the Third Wave - Debra Bergoffen: Simone de Beauvoir and Jean-Paul Sartre: Woman, Man and the Desire to be God - Elaine Stavro-Pearce: Transgressing Sartre: embodied situated subjects in "The Second Sex" - Susanne Moser: Subjekt und Anerkennung: Zum Problem des Ausschlusses von Frauen und Weiblichkeit im" Anderen Geschlecht" - Diane Lamoureux: Der Paradox des Körpers bei Simone de Beauvoir - Marie Couillard: Die Lesbierin bei Simone de Beauvoir und Nicole Brossard - María Luisa Femenías: Beauvoir revisited: Butler and the "gender" question - Sonia Kruks: Panopticism and Shame: Reading Foucault through Beauvoir - Yvanka B. Raynova: Für eine postmoderne Ethik der Gerechtigkeit: Simone de Beauvoir und Jean-François Lyotard - Kristana Arp: Moral obligation in Simone de Beauvoir's "The Ethics of Ambiguity" - Susan Bainbrigge: The Impact of Simone de Beauvoir's "universel singularisé" on the Politics of Representation and the Representation of Politics - Sandrine Dauphin: From Socialism to radical Feminism: Militant foundations in Simone de Beauvoir's Writings - Claudia Gather: Simone de Beauvoir, eine Klassikerin der feministischen Soziologie? - Karen Vintges: Beauvoir's autobiography: "autofiction" or selftechnique? - Brigitte Weisshaupt: Simone de Beauvoir und Jean-Paul Sartre. Eine Anmerkung - Susanne Moser/Yvanka B. Raynova: "50 Jahre 'Das andere Geschlecht'": Zur internationalen Konferenz in Paris (19.-23.01.1999). (shrink)

Introduction : but is it ethics? -- Alterity : the problem of transcendence -- Singularity : the unrepresentable face -- Responsibility : the infinity of the demand -- Ethics : normativity and norms -- Scarce resources? : Levinas, animals, and the environment -- Failures of recognition and the recognition of failure : Levinas and identity politics.

55 chapters cover the cutting edge in this dynamic field. Includes foundational perspectives, reasoning, ontology, design processes, methods, values, responsibilities, and reimagining of engineering. Essential for students and researchers studying the philosophy/ethics of engineering, technology, or design.

Philosophical reflections on our ethical responsibilities toward urban wildlife populations have tended to be based on a “parallel planes” framework. This framework is insufficient when it comes to looking after the well-being of city-dwelling wild animals. A different starting-point in thinking about urban wildlife ethics, informed by phenomenology, can bring a number of possible obligations to the fore—for example, an ethics of attentiveness, flexibility, adjustment, and change; virtues associated with an ethic of care from attentiveness through generosity to empathy; and (...) a practice of hospitality. These obligations are moral rather than political; their “ought” is generated from the perspective of an ethic of care. (shrink)

According to Richard Routley, a comprehensive theory of fiction is impossible, since almost anything is in principle imaginable. In my view, Routley is right: for any purported logic of fiction, there will be actual or imaginable fictions that successfully counterexample the logic. Using the example of ‘impossible’ fictions, I test this claim against theories proposed by Routley’s Meinongian contemporaries and also by Routley himself and his 21st century heirs. I argue that the phenomenon of impossible fictions challenges even today’s modal (...) Meinongians. (shrink)

Explores the political forces underlying shifts in thinking about the respective influence of heredity and environment in shaping human behavior, and the feasibility and morality of eugenics.

The widespread tendency, even within AI, to anthropomorphize machines makes it easier to convince us of their intelligence. How can any putative demonstration of intelligence in machines be trusted if the AI researcher readily succumbs to make-believe? This is (what I shall call) the forensic problem of anthropomorphism. I argue that the Turing test provides a solution. This paper illustrates the phenomenon of misplaced anthropomorphism and presents a new perspective on Turingʼs imitation game. It also examines the role of the (...) Turing test in relation to the current dispute between human-level AI and ‘mindless intelligence’. (shrink)

Text of and reflection on the 1981 encounter between Hans-Georg Gadamer and Jacques Derrida, which featured a dialogue between hermeneutics in Germany and post-structuralism in France. <br.

On a recent evening, while working in a children's hospital emergency department as a pediatric emergency medicine physician, I picked up the chart of yet another patient without a true emergency: a sixteen-year-old with vaginal discharge. After reviewing her chart, her nurse and I spoke with her in her room. Her story was all too familiar. She was sexually active. She did not use contraception. She had also been treated for pelvic inflammatory disease three times before, but luckily, she had (...) not yet been pregnant. And like many adolescents, she did not have a primary care physician, so the emergency department was her primary care clinic. I informed her that she would need a pelvic exam and a pregnancy test. I .. (shrink)