BackgroundWhereas many adolescents and young people with HIV require the transfer of care from paediatric/adolescent clinics to adult ART clinics, this transition is beset with a multitude of factors that have the potential to hinder or facilitate the process, thereby raising ethical challenges of the transition process. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a smooth (...) and successful transition. The purpose of this study was to analyze the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics.MethodsData presented were derived from 191 adolescents attending nine different health facilities in Uganda, who constituted 18 focus group discussions. In the discussions, facilitators and barriers regarding adolescents transitioning to adult HIV clinics were explored. Guided by the Silences Framework for data interpretation, thematic data analysis was used to analyze the data. The principles of bioethics and the four-boxes ethics framework for clinical care (patient autonomy, medical indications, the context of care, and quality of life) were used to analyze the ethical issues surrounding the transition from adolescent to adult HIV care.ResultsThe key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort, and contextual factors are critical to a successful transition.ConclusionThe priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition such as loss of autonomy, stigma, loss of privacy, and discontinuity of care to ensure retention in HIV care, facilitate long-term self-care, offer ongoing all-inclusive healthcare, promote adolescent health and wellbeing and foster trust in the healthcare system. Identifying and addressing the ethical issues related to what hinders or facilitates successful transitions with targeted interventions for the transition process may ensure adolescents and young people with HIV infection remain healthy across the healthcare transition. (shrink)

Recent work on distributed cognition and self-narrative has emphasised how autobiographical memories and their narration are, rather than being stored and created by an individual, distributed across embodied organisms and their environment. This paper postulates a stronger form of distributed narration than has been accommodated in the literature so far, which I call narrative deference. This describes the phenomena whereby a person is significantly dependent upon another person for the narration of some significant aspect of their own autobiographical self-narrative. I (...) suggest that a person is more likely to narratively defer where they suffer a mnemonic impairment regarding some significant adverse life experience like trauma, illness or injury. Following a recent turn in the literature towards investigating the harmful aspects of distributed cognition as well as its many advantageous features, this paper explores how the benefits of autobiographical self-narrative deference within close personal relationships are complexly related to its harms. (shrink)

Miranda Fricker’s influential concept of epistemic injustice has recently seen application to many areas of interest, with an increasing body of healthcare research using the concept of epistemic injustice in order to develop both general frameworks and accounts of specific medical conditions and patient groups. This paper illuminates tensions that arise between taking steps to protect against committing epistemic injustice in healthcare, and taking steps to understand the complexity of one’s predicament and treat it accordingly. Work on epistemic injustice is (...) therefore at risk of obfuscating legitimate and potentially fruitful inquiry. This paper uses Chronic Fatigue Syndrome/Myalgic Encephalomyelitis as a case study, but I suggest that the key problems identified could apply to other cases within healthcare, such as those classed as Medically Unexplained Illnesses, Functional Neurological Disorders and Psychiatric Disorders. Future work on epistemic injustice in healthcare must recognise and attend to this tension to protect against unsatisfactory attempts to correct epistemic injustice. (shrink)

I argue that the best spacetime setting for Newtonian gravitation (NG) is the curved spacetime setting associated with geometrized Newtonian gravitation (GNG). Appreciation of the ‘Newtonian equivalence principle’ leads us to conclude that the gravitational field in NG itself is a gauge quantity, and that the freely falling frames are naturally identified with inertial frames. In this context, the spacetime structure of NG is represented not by the flat neo-Newtonian connection usually made explicit in formulations, but by the sum of (...) the flat connection and the gravitational field. 1 Introduction2 Newtonian Gravity: The Orthodox Approach3 Newtonian Gravity: Additional Symmetries4 Cosmological Considerations5 A Newtonian Equivalence Principle: Inertial Frames in Newtonian Gravitation6 Theory Equivalence?7 Conclusion. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Focusing on The Experience:Exploring Alternative Paths for ResearchEleanor Stubley, Anneli Arho, Päivi Järviö, and Tuomas MaliWriting and speaking are essential means of understanding, studying, and sharing music in the Western art music tradition. As a group of researchers, our story begins with the gap that seemingly exists between theoretical definitions or accounts of music and our experience of it as music makers—that is to say as composers, performers, conductors, (...) and teachers. Poignantly sensitive to the ways in which our musical experience and knowledge is embodied, we found ourselves one day four years ago sitting around an electrically-charged dinner table where ideas, questions, and the joy of having found someone like-minded seemed to be the main entrée. Since then, we have been working as a group, [End Page 39] experimenting with different ways of collaborating, using writing as a means of exploring and sharing our experiences across long distances. At first, the goal was simply to find a common ground, a platform for developing an extended dialogue that would draw on our unique backgrounds and divergent ways of our thinking. But, in the absence of a common language, both linguistic and theoretical, there were problems. We had, for example, to come to understand what each of us meant by the word experience and the role it could play as the ground of research, not as a series of defining moments or events but as the largely invisible flow of human life. We also had to deal with the inter-wovenness of mind and body, individual, and culture, not to mention our individual musical sensitivity and artistry. Confronted by these larger issues, our differences soon became the means to explore gaps or openings that could be entered to reveal the continuous becoming of music and language, the places where they intersect and diverge, and our own being in relationship to both.The papers presented in this symposium were the outgrowth of our dialogue during the summer of 2004. Each of us worked independently, yet each of us was also aware of the direction, the themes, and the ways of the others. The result is kaleidoscopic, each author starting from a different place, but seemingly working from the same palette of colors.Eleanor Stubley writes as a philosopher and conductor. Her work here is part of a larger on-going study that examines the way in which the body fills both language and our experience of music, with a particular focus on the way in which an interest in the body renews our understanding of music, language, and thought. Through a series of inter-connecting meditations inspired by the letter A, she challenges the practice of grounding research and practice in definitions of music as "organized sound." Her writing makes visible the habitual of a variety of educational practices, asking us to think anew about instructional technologies such as the alphabet, scale, and taxonomies of musical form, and to find in what we have traditionally thought of as practices of the mind, the omnipresence of the body. It also offers a new perspective on the hand, not as a tool or muscle to be trained as a skill, but as the very ground from which to develop an aesthetics of music that combines and recognizes the multiple ways in which we know and encounter music, through sight, sound, movement, and touch.Anneli Arho writes as a composer, educator, and philosopher/researcher. She explores the power of working from within the factical situation of a musician making music, focusing in particular on the embodiedness of music, questions of meaningfulness, and the ways in which phenomenological reflection on her own musical experiences has allowed her to move beyond traditional research discourses. Her writing asks us as educators to re-think curricular definitions of [End Page 40] composition, not simply as a collection of skills to be acquired or languages to be learned, but rather as embodied ways of living in and through sound. Using notation as an example, she argues that composing generates its own practical and existential questions distinct from those of listener, performer, and researcher, and which can never be totally shared with others... (shrink)

This paper looks at the relationship between spacetime functionalism and Harvey Brown’s dynamical relativity. One popular way of reading and extending Brown’s programme in the literature rests on viewing his position as a version of relationism. But a kind of spacetime functionalism extends the project in a different way, by focussing on the account Brown gives of the role of spacetime in relativistic theories. It is then possible to see this as giving a functional account of the concept of spacetime (...) which may be applied to theories that go beyond relativity. This paper explores the way in which both the relationist project and the functionalist project relate to Brown’s work, despite being incompatible. Ultimately, these should not be seen as two conflicting readings of Brown, but two different directions in which to take his project. (shrink)

Over the past 15 years or so, Clinical Ethics Committees (CECs) have been established in many healthcare settings in the UK. How do they work, who sits on them, and what do they discuss? How formal should they be? Should their decisions be binding on clinicians, or purely advisory? Should they offer their services to patients and their families too? Are they valuable additions to clinical support, or simply intellectual talking-shops for their members? Should other countries set up CECs as (...) part of their own approach to Clinical Ethics? (shrink)

This paper aims to understand how recent discussion of novel and robust behaviour in physics might be applied in biology and other special sciences. In particular, it looks at the prospects for extending an account of novel explanation to biological examples. Despite the differences in the disciplines, the prospects look good, at least when we look at a biological example in which a certain kind of reduction is possible.

Acoustic experiences of nature represent a growing area in restorative environments research and are explored in this narrative literature review. First, the work surveyed indicates that nature is broadly characterized by the sounds of birdsong, wind, and water, and these sounds can enhance positive perceptions of natural environments presented through visual means. Second, isolated from other sensory modalities these sounds are often, although not always, positively affectively appraised and perceived as restorative. Third, after stress and/or fatigue nature sounds and soundscapes (...) can lead to subjectively and objectively improved mood and cognitive performance, as well as reductions in arousal, although some inconsistencies in findings are observed. Fourth, theoretical frameworks of restorative environments would benefit from inclusion of acoustic environmental properties such as sound intensity or frequency. Fifth, findings regarding positive, learned semantic associations with nature have arisen as a result of recent work on sounds and restoration. This represents another important area of potential theoretical development for broader restorative environments research. (shrink)

Biofunctionalism appears to be a pioneering effort to formulate a portrait of the body&endash;mind which acknowledges intuitions we have about human functioning that go beyond the analytic approach of the cognitive sciences but that can yet remain within the worldview and methods of the analytic portrait. The intuitions are : wholeness, interdependent causality, present temporality, effortless action, realness, panoramic knowing, and value. Such themes are most fully developed in the meditative and contemplative traditions of the world. Biofunctionalism is evaluated both (...) in terms of how well it instantiates those themes and in terms of its ability to generate explanations and predictions within the scientific context. (shrink)

Several modern accounts of explanation acknowledge the importance of abstraction and idealization for our explanatory practice. However, once we allow a role for abstraction, questions remain. I ask whether the relation between explanations at different theoretical levels should be thought of wholly in terms of abstraction, and argue that changes of the quantities in terms of which we describe a system can lead to novel explanations that are not merely abstractions of some more detailed picture. I use the example of (...) phase transitions as described by statistical mechanics and thermodynamics to illustrate this, and to demonstrate some details of the relationship between abstraction, idealization, and novel explanation. (shrink)

Until recently, leading work on the philosophy of thought experiments mistakenly credited Mach with coining the term. While Ørsted’s prior use has become more widely acknowledged, there remains a c...

I argue that the need to understand spacetime structure as emergent in quantum gravity is less radical and surprising it might appear. A clear understanding of the link between general relativity's geometrical structures and empirical geometry reveals that this empirical geometry is exactly the kind of thing that could be an effective and emergent matter. Furthermore, any theory with torsion will involve an effective geometry, even though these theories look, at first glance, like theories with straightforward spacetime geometry. As it's (...) highly likely that there will be a role for torsion in quantum gravity, it's also highly likely that any theory of quantum gravity will require us to get to grips with emergent spacetime structure. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Why the Family is Beautiful (Lacan Against Badiou)Eleanor Kaufman (bio)The theory of ethics that can be distilled from the work of Jacques Lacan and Alain Badiou bears no resemblance to many commonly received notions of the ethical, especially any that would link ethics to a system of morality. In fact, ethics is not necessarily the central concept in their work, even in Lacan's The Ethics of Psychoanalysis or (...) Badiou's recent Ethics: An Essay on the Understanding of Evil. If anything, it is defined vicariously and in relation to other more central concepts, such as the workings of desire for Lacan and the fidelity to an event—or truth-process—for Badiou. Nonetheless, an examination of the network of concepts held together under the umbrella of the ethical allows for a sharp distinction between the work of Lacan and Badiou, one that Badiou—himself avowedly indebted to Lacan—is hesitant to make. Where Lacan elevates the beautiful over the good in his reading of Sophocles's Antigone, Badiou elevates the truth-process over the evil betrayal of such an event, drawing on examples ranging from National Socialism to the love relation between two people. A truth-process is a situation-specific adherence, or fidelity, to the revolutionary potential of an event that may take place in one of the four realms of politics, art, science, and love. Perhaps Badiou's best example of a truth-process—what I will also refer to as fidelity to an event—is one not described in the text under consideration here: the apostle Paul's proclamation of and fierce loyalty to the event of Christ's resurrection. It is in the particular form in which the ethical fidelity to a truth-process may be hard to distinguish from evil that I will take issue with Badiou, for both his political examples and his evocation of love as one of four conduits to a truth-process reflect a difficult inflexibility in his extraordinarily lucid and provocative system. Lacan, on the other hand, uses Antigone's strange family values to suggest a more flexible model of ethics, one that is focused on the encounter with the inhuman and the fragile boundary between life and death.Lacan's most sustained discussion of ethics occurs in his seminal Seminar Seven from 1959-60, entitled The Ethics of Psychoanalysis.1 Not only does this seminar register a gradual shift from an earlier emphasis on desire to a later focus on the real and the drive, but it is also a crucial articulation of what might seem for some to be an oxymoronic conjunction—psychoanalysis and ethics. Such a conjunction, as opposed to a Sartrean or Levinasian model that would situate ethics in relation to the Other,2 takes as its [End Page 135] touchstone Freud's stinging critique in Civilization and Its Discontents of the biblical injunction to love the neighbor as oneself. Here it is not merely a question of understanding why the neighbor may be equally an object of hatred, but of understanding how contradictory sentiments are also to be found at the heart of the self, and hence why a viable system of ethics must take this into consideration.3 In other words, ethics is not to be thought primarily as a relation to the other so much as a nonrelation to the self.4 Thus, when Lacan opposes the good to the beautiful, it is precisely the relational aspect of the good that he denigrates.Lacan links the good to the dialectic and to the power to deprive others, situating it squarely in the realm of morality. The beautiful, by contrast, marks a space of nonrelation where it is not so much a matter of two distinct selves but rather of a single self whose desire is not its own. In Seminar Six from the previous year, Lacan analyzes Hamlet and suggests that the reason Hamlet does not kill Claudius is that he is traversed by his mother's desire. He emphasizes that Hamlet's desire is "the desire not for his mother, but of his mother."5 Between Seminars Six and Seven, Lacan shifts his focus from desire to ethics, from... (shrink)

ABSTRACT Current attempts to understand unusually high rates of psychiatric illness in complex, chronic illnesses can be guilty of operating within an explanatory framework whereby there are two options. Either (a) that the psychiatric predicaments are secondary to the bodily condition, and (b) that they are primary. In this paper, I draw upon philosophical work on affect, contemporary empirical work, and qualitative first-person patient data to illustrate a much messier reality. I argue that affective experience is generally more complex in (...) such conditions, and that a variety of pre- and post-morbid causal factors dynamically interact such that the resultant psychiatric predicaments do not permit to classification as strictly primary or secondary to the bodily condition. Affective scaffolding, in my view, provides an apt theoretical framework for capturing this nuance. (shrink)

Large, black, flightless birds with unpredictable tempers and colourful heads and necks, cassowaries have enthralled European audiences for centuries, but perhaps no one more so than private collector and zoologist Lionel Walter Rothschild (1868-1937). Throughout the late 19th and early 20th centuries, Rothschild acquired hundreds of living cassowaries which were kept in his private zoological collection. This paper explores the nature of Rothschild's private zoo and how the collection of living cassowaries was used to support his zoological activities. Spread across (...) three sites-the family estate at Tring Park, the zoological gardens in Regent's Park, and the business premises of Cambridge-based taxidermist Frederick Doggett-it will examine how Rothschild used the living birds kept in his private zoo to devise and inform a process for the preparation and display of cassowary specimens in museum galleries. It will show how he recruited specialist artists and taxidermists to perfect the art, and the significant financial investment this entailed. This is followed by exploration of how Rothschild's access to and observations of living birds informed his taxonomic work and, in particular, the identification of species and subspecies. The argument is made that Rothschild's private zoo and access to living cassowaries enabled his dedication to the study of the genus and ultimately underpinned his reputation as a world authority on cassowaries in the early 20th century. (shrink)

This investigation places recent research about changes in wives' and husbands' domestic labor in the context of well-known reporting differences between different kinds of housework surveys. An analysis of the “reporting gap” between direct-question reports of housework hours from the National Survey of Families and Households and time-diary reports from Americans' Use of Time, 1985, shows that both husbands and wives overreport their housework contributions. Furthermore, gender attitudes, total housework, class, education, income, family size, and employment status together significantly affect (...) the overreport, although the variables operate in different ways for wives and husbands. It is concluded that changing and uneven social perceptions of the appropriate domestic roles of women and men have resulted in reporting biases that do not necessarily correspond to actual changes in housework behavior. These findings cast doubt on claims that contemporary husbands are doing more housework than their predecessors. (shrink)

This paper recognizes the complexity of the debate on informed consent and discusses the importance of the ongoing process of consent for people affected by Huntington's disease (HD). Although written information may not be the most appropriate form of obtaining informed consent in qualitative research, it remains an important part of the ethical approval process for health research in the UK. This paper draws on a study in which the information sheet and consent form were specifically designed to help obtain (...) consent from people who may be impaired by the cognitive and physical effects of HD. The forms were developed by drawing on expert opinion and relevant literature and fall in line with recommendations from the Mental Capacity Act 2005 to encourage people to make their own decisions. The paper describes the feasibility of a method for obtaining consent as an ongoing process with patients affected by HD using information sheets and consent forms specifically designed for people with potential cognitive and/or physical impairments. In conclusion, this paper adds a pragmatic approach to the debate on informed consent by describing the development of a written information sheet and consent form being used in a current social research study. Particular emphasis is placed on the importance of written information being adapted according to the needs of potential participants. (shrink)

The authors of the target article briefly discuss the issue of “sample ownership” when scientists collaborate with citizen science partners (Wiggins and Wilbanks 2019). This is an important issue,...

ExcerptIn the tradition of classical political economy, Marx is usually read as an oppositional figure, rejecting the optimistic dogma of free trade and replacing it with a catastrophic vision of capitalism's self-destruction. Yet Marx was also a cosmopolitan figure who, like the classical economists, rejected a narrow nationalism for the vision of an internationally just economic sphere. The Communist Manifesto, for example, is addressed to “Workers of All Nations” and not just German workers. Marx saw his intervention as a combination (...) of idealist German philosophy, radical French politics, and English economics.1 Marx's own travels from the Rhineland of his birth…. (shrink)

The conflict between Jupiter and Juno in the Aeneid is commonly read as a battle between the forces of order and chaos. The present article argues that this schematization, though morally and aesthetically satisfying, fails to account for most of the data. Virgil's Jupiter is in fact concerned solely with power and adulation, despite persistent attempts by readers——and characters in the poem——to see him as benign. By systematically discussing every appearance of Jupiter in the poem, the article seeks to correct (...) the distorted or incomplete views of the god that arise from selective examination. The first section looks at Jupiter's own speeches to illustrate his motivations. The second section demonstrates how these motivations, though frequently misconstrued by the human characters, are confirmed by the glimpses of Jupiter focalized through the omniscient narrator. The third discusses the implications of this portrait of Jupiter for Virgil's vision of Rome and of human happiness. (shrink)

The problem of the finite and the infinite.--Pragmatism and a theory of knowledge.

Stephen Arnott 'Deleuze's Idea of Cinema' _Film-Philosophy_, Deleuze Special Issue vol. 5 no. 32, November 2001.

In lieu of an abstract, here is a brief excerpt of the content:Klossowski, Deleuze, and OrthodoxyEleanor Kaufman (bio)Among the many strange and wonderful things to be found there, Pierre Klossowski's oeuvre is a preeminent illustration of what divides univocity and equivocity and therefore serves as one of the twentieth century's most instructive models for thinking the complexity of the dialectic. Univocity and equivocity are significant both in their roots in Scholastic philosophy, as the idea that Being is expressed in either (...) one or several senses, and as belonging to a longstanding framework that helps demarcate the differences, nuanced yet significant, among members of the extraordinary generation of French intellectuals of which Klossowski was a part. Thus, these terms, apart from their theological and philosophical import, will serve as a heuristic for renarrating points of filiation and divergence among a series of prominent French thinkers, primarily Bataille, Klossowski, and Deleuze, but also extending backward to Sartre and forward to Badiou to frame the series. I will approach this in segmented fashion, first opposing Bataille's dialectic of transgression to Klossowski's more univocal method of disjunctive synthesis. When juxtaposed with Deleuze's Spinozist affirmation of univocity, however, Klossowski would seem to be more on the side of the equivocal. Whereas Deleuze criticizes the realm between the univocal and the equivocal as the lukewarm space of the analogical, my contention is that this middle realm allows for a space of movement and reversal that escapes the pitfalls Deleuze locates in the dialectic, and does so without a strict adherence to Spinozist univocity. Whereas Bataille and Deleuze remain closer to Klossowski in the tenor of their thought, I will nonetheless suggest in conclusion that Sartre and Badiou are actually closer to Klossowski on a formal level, in that each poses a similarly analogical challenge to the thought of the dialectic.For many reasons Bataille and Klossowski can be paired together. They were contemporaries, both born around the turn of the century, both writing in a variety of literary and philosophical genres, including pornographic or semi-pornographic fiction, and working outside the academy. Both wrote studies of Nietzsche, of Sade, and radical economic treatises. They were friends and fellow members in the late 1930s of the College of Sociology, which was modeled after a secret society, the members taking great interest in such topics as sacrifice and headlessness. Bataille and Klossowski wrote about each other. Both were at different points obsessed with Roman Catholicism, both at different points prepared to enter monastic orders, both in different fashions fell away. As might easily be imagined, their fiction is an outrageous mixture of the sacred and the profane, including sexual encounters and other desecrations staged at church alters and the like. Both work in that realm where pornography and theology come together. Yet while the more familiar Bataille uses pornography toward transgressive aims, the lesser-known Klossowski uses a more nuanced and interesting mechanism of boredom to elaborate an intrinsically disjunctive structure.Even boredom, for Bataille, partakes of the transgressive. In his novella The Story of the Eye, the narrator describes offhandedly how he and his companion Simone have just found their friend Marcelle's body. She has hung herself. The narrator and Simone [End Page 47] take the body down and have sex for the first time next to it. Then the narrator describes the boredom that ensues even in the face of death: "We were perfectly calm, all three of us, and that was the most hopeless part of it. Any boredom in the world is linked, for me, to that moment and, above all, to an obstacle as ridiculous as death. But that won't prevent me from thinking back to that time with no revulsion and even with a sense of complicity. Basically, the lack of excitement made everything far more absurd, and thus Marcelle was closer to me dead than in her lifetime, inasmuch as absurd existence, so I imagine, has all the prerogatives" [59–60]. This is actually an unusually meditative moment in Bataille's story of murder, priests, bullfights, and constant sex.1 Here his narrator links boredom to death, and to a reflection on the absurd boundary between life and death. But by commenting on boredom... (shrink)

International Studies in the Philosophy of Science, Volume 25, Issue 2, Page 199-202, June 2011.