The covert administration of medication occurs with incapacitated patients without their knowledge, involving some form of deliberate deception in disguising or hiding the medication. Covert medication in food is a relatively common practice globally, including in institutional and homecare contexts. Until recently, it has received little attention in the bioethics literature, and there are few laws or rules governing the practice. In this paper, we discuss significant, but often overlooked, ethical issues related to covert medication in food. We emphasise the (...) variety of ways in which eating has ethical importance, highlighting what is at risk if covert administration of medication in food is discovered. For example, losing trust in feeders and food due to covert medication may risk important opportunities for identity maintenance in contexts where identity is already unstable. Since therapeutic relationships may be jeopardised by a patient’s discovery that caregivers had secretly put medications in their food, this practice can result in an ongoing deception loop. While there may be circumstances in which covert medication is ethically justified, given a lack of suitable alternatives, we argue that in any particular case this practice should be continually re-evaluated in light of the building moral costs to the relational agent over time. (shrink)

In this discussion paper we consider the influence of ethnicity, religiosity, spirituality and health literacy on Advance Care Planning for older people. Older people from cultural and ethnic minorities have low access to palliative or end-of-life care and there is poor uptake of advance care planning by this group across a number of countries where advance care planning is promoted. For many, religiosity, spirituality and health literacy are significant factors that influence how they make end-of-life decisions. Health literacy issues have (...) been identified as one of the main reasons for a communication gaps between physicians and their patients in discussing end-of-life care, where poor health literacy, particularly specific difficulty with written and oral communication often limits their understanding of clinical terms such as diagnoses and prognoses. This then contributes to health inequalities given it impacts on their ability to use their moral agency to make appropriate decisions about end-of-life care and complete their Advance Care Plans. Currently, strategies to promote advance care planning seem to overlook engagement with religious communities. Consequently, policy makers, nurses, medical professions, social workers and even educators continue to shape advance care planning programmes within the context of a medical model. The ethical principle of justice is a useful approach to responding to inequities and to promote older peoples’ ability to enact moral agency in making such decisions. (shrink)

In this article the public-theological motives in the film As it is in heaven is analised to demonstrate the film producer Kay Pollack's ideal to communicate through the film that people should live their lives here and now authentically without seeking excuses for being happy. In this article the principles of narratology is applied in the analysis of the film's plot, characterisation, plotted time and narrated spaces. It is also argued that the protagonist in the film can be regarded as (...) a 'Christ-figure' and that the film conveys a 'Christ narrative' in a secularised context. Societal issues such as emotional abuse and violence against children, women, people with disability and animals constitute building blocks of the narrative. Ecclesiastical hypocrisy and outdated sexual values endorsed by the institutional church are replaced by a choir consisting of common people which leads a whole world to sing in harmony. (shrink)

Elizabeth A. Kaye specializes in communications as part of her coaching and consulting practice. She has edited Requirements for Certification since the 2000-01 edition.

Elizabeth A. Kaye specializes in communications as part of her coaching and consulting practice. She has edited Requirements for Certification since the 2000-01 edition.

This article examines the contribution that poetry written over the last fifty years might make to the established and burgeoning field of Medical Humanities. It takes poems by women about cancer and depression as a case study of how they can offer insight into the impact of these conditions on the sufferer. Collectively, the poems document and effect shifts in knowledge about, and the associated stigmas concerning, illnesses that carry secrecy and shame, specifically cancer and depression. Additionally, drawing on Virginia (...) Woolf’s remarkable essay “On Being Ill”, we see how the non-verbal features of poems, particularly metaphors and symbols, mark the space of what a patient cannot fully articulate. Accordingly, the poems discussed illuminate how literature can express human interiority but at the same time remind the reader – or health professional – that interiority can never be fully presented. Thus, poetry both contributes to and also checks the ways in which literature is appropriated by the biomedical sciences. The poets included are Eavan Boland, Julia Darling, U.A. Fanthorpe, Jackie Kay, Gwyneth Lewis, Carol Satyamurti and Jo Shapcott. Some poems specify a female subjectivity, some express agency as autonomous individuals, while others presume to speak of common human experience. (shrink)

Four-month-old infants can perceive bimodally speciiied events. They respond to relationships between the optic and acoustic stimulation that carries information about an object. Infants can do this by detecting the temporal synchrony of an object’s sounds and its optically specified impacts. They are sensitive both to the common tempo and to the simultaneity of such sounds and visible impacts. These findings support the view that intermodal perception depends at least in part on the detection of invariant relationships in patterns of (...) light and sound. (shrink)

Liebe Grete, hier mein Briefwechsel mit Lorenzen mit der Bitte, ihn mir baldigst zurückzuschicken, da ich ihm auf seinen letzten Brief noch nicht geantwortet habe.

In arguing about justice, different sides often accept common moral principles, but reach different conclusions about justice because they disagree about facts. I argue that motivated reasoning, epistemic injustice, and ideologies of injustice support unjust institutions by entrenching distorted representations of the world. Working from a naturalistic conception of justice as a kind of social contract, I suggest some strategies for discovering what justice demands by counteracting these biases. Moral sentiments offer vital resources to this end.

What is the proper role of politics in higher education? Many policies and reforms in the academy, from affirmative action and a multicultural curriculum to racial and sexual harassment codes and movements to change pedagogical styles, seek justice for oppressed groups in society. They understand justice to require a comprehensive equality of membership: individuals belonging to different groups should have equal access to educational opportunities; their interests and cultures should be taken equally seriously as worthy subjects of study, their persons (...) treated with equal respect and concern in communicative interaction. Conservative critics of these egalitarian movements represent them as dangerous political meddling into the disinterested pursuit of knowledge. They cast the pursuit of equality as a threat to freedom of speech and academic standards. In response, some radical advocates of such programs agree that the quest for equality clashes with free speech, but view this as an argument for sacrificing freedom of speech. (shrink)

The Christian faith holds out the promise of abundant life and yet many writers have exposed the ambiguities experienced from the words used when that faith is expressed or discussed or described. While there are many aspects to this exploration, this article investigates a set of words that are used to and for the divine because the one spoken of as the author of this abundant life is described in terms that limit the possibilities for too many people. This article (...) will draw on insights gained through the use of the discipline of psycholinguistics and extrapolate from these insights to offer a methodology for developing a language that expresses abundant life. (shrink)

I argue that our traditional conception of the duties imposed by human rights is unable to acknowledge the nature of many contemporary human rights violations. The traditional conception is based on a broadly deontological view according to which human rights impose primarily negative and perfect duties, and these duties are held to be specific prohibitions on certain kinds of actions . I argue that given this conception of the nature of the duties imposed by human rights, not only claims to (...) aid, but in addition, claims against many of the most serious and prevalent contemporary active harms will not count as genuine human rights claims. These harms increasingly result from extremely complex causal chains involving the behaviour of a huge number of agents, few or none of whom can be singled out as responsible for a serious harm to any specific victim. Institutional structures can have just as central a role to play in specifying and allocating responsibility for fulfilling many of the negative duties imposed by human rights as the positive duties. These structures can therefore be equally important in the realisation of both kinds of rights. Before the necessary institutional reforms have taken place, both kinds of rights are equally genuine, and ground the imperative of justice to reform existing social institutions. (shrink)

I outline some of my work and results on my matter-gravity entanglement hypothesis, according to which the entropy of a closed quantum gravitational system is equal to the system’s matter-gravity entanglement entropy. The main arguments presented are: that this hypothesis is capable of resolving what I call the second-law puzzle, i.e. the puzzle as to how the entropy increase of a closed system can be reconciled with the asssumption of unitary time-evolution; that the black hole information loss puzzle may be (...) regarded as a special case of this second law puzzle and that therefore the same resolution applies to it; that the black hole thermal atmosphere puzzle can be resolved by adopting a radically different-from-usual description of quantum black hole equilibrium states, according to which they are total pure states, entangled between matter and gravity in such a way that the partial states of matter and gravity are each approximately thermal equilibrium states ; that the Susskind–Horowitz–Polchinski string-theoretic understanding of black hole entropy as the logarithm of the degeneracy of a long string cannot be quite correct but should be replaced by a modified understanding according to which it is the entanglement entropy between a long string and its stringy atmosphere, when in a total pure equilibrium state in a suitable box, which ) goes over, at strong-coupling, to a black hole in equilibrium with its thermal atmosphere. The modified understanding in is based on a general result, which I also describe, which concerns the likely state of a quantum system when it is weakly coupled to an energy-bath and the total state is a random pure state with a given energy. This result generalizes Goldstein et al.’s ‘canonical typicality’ result to systems which are not necessarily small. (shrink)

Amartya Sen’s ethical theorizing helps feminists resolve the tensions between the claims of women’s particular perspectives and moral objectivity. His concept of ‘‘positional objectivity’’ highlights the epistemological significance of value judgments made from particular social positions, while holding that certain values may become widely shared. He shows how acknowledging positionality is consistent with affirming the universal value of democracy. This article builds on Sen’s work by proposing an analysis of democracy as a set of institutions that aims to intelligently utilize (...) positional information for shared ends. This epistemological analysis of democracy offers a way to understand the rationale for reserving political offices for women. From a political point of view, gendered positions are better thought of as an epistemological resource than as a ground of identity politics – that is, of parochial identification and solidarity. (shrink)

Le 11 mai 1793, Sir Gilbert Elliot écrit une lettre à sa femme dans laquelle il s’étonne d’une nouvelle mode qu’il a observée au bal offert par une amie. Lady Abercorn organise une soirée dansante « où se trouve une douzaine de femmes vêtues en statues, c’est-à-dire, avec la gaine placée juste en dessous des seins et une draperie de tissu qui tombe ». Sir Elliot précise que ces femmes « n’étaient pas tout à fait dénudées, mais l’effet était néanmoins (...) celui de la nudité ». Il témoigne que son... (shrink)

In this essay I discuss Edith Stein's analysis of empathy and note its application in the field of clinical medicine. In identifying empathy as the basic mode of cognition in which one grasps the experiences of others, Stein notes, 'I grasp the Other as a living body and not merely as a physical body'. The living body is given in terms of five distinctive characteristics - characteristics that disclose important facets of the illness experience. Empathy plays an important role in (...) clinical practice in aiding physicians to grasp the content of first-person reports of bodily disorder, and to comprehend the meaning of illness-as-lived. I suggest that an important task for medical education should be that of developing students' capacity for empathic understanding and I note several ways in which this task might be accomplished. (shrink)

When a cell divides, it produces two daughter cells initially connected by a cytokinesis bridge, which is eventually cut through abscission. One of the two daughter cells inherits a bridge “remnant”, which has been proposed to be degraded by autophagy. The fate and function of remnants is attracting increasing attention, as their accumulation appears to influence proliferation versus differentiation of the daughter cells. Here, we present a simple model for bridge and remnant turnover in a dynamic cell population. We demonstrate (...) that remnant proportions depend on the ratio of remnant and bridge lifetimes to the cell population doubling time. Our results yield new alternative interpretations for published experimental data, leading us to believe that autophagy‐independent pathways for remnant degradation may exist. In addition, using the model, we determined experimentally inaccessible parameters such as remnant lifetime. Our model proves to be a useful tool for studying bridge and remnant populations. (shrink)

Pharmacists with religious or ethical objections to prescribing emergency contraception won the latest round in the fight over conscience clauses in a case that could have broader implications for attempts to restrict access to contraception. In Stormans, Inc. v. Selecky, a federal District Court in Washington State granted an injunction to block the enforcement of regulations that would have forbidden pharmacists to refuse to dispense emergency contraception on the grounds of religious or ethical objections. In its decision, the court applied (...) Supreme Court abortion precedent without explicitly ruling whether emergency contraception should be legally categorized as a form of abortion or as contraception. However, the legal status of emergency contraception affects the strength of the defendants’ claims that the law was justified on the grounds of preventing sex discrimination. In neglecting to rule one way or the other, the court not only failed to adequately consider the sex discrimination claim but also may have opened the door to more restrictive regulation on contraceptives generally. (shrink)

ABSTRACT This essay meditates on the entanglement of history and memory with forgetfulness, with silencing, with what is before or outside speech. Recalling along the way a few of the manifold varieties of the unthinkable made manifest in recent events, it notes the same mute iteration that led Freud to the death drive, only to be troubled once again by the very same repetitions enfolded in the diagnosis of cultural malaise Freud built upon his insight. Turning to Georg Simmel’s Philosophy (...) of Money for an alternative, non-psychoanalytic account of unconscious purpose as a trans-individual, cultural phenomenon, it arrives once again at the hypertrophic life-technologies of the modern—and at Simmel’s account of money as the ultimate being without qualities, “the most extreme … configuration of Geist” itself, which so thoroughly underpins ways of living that, obscuring dimensions of value that cannot be quantified, silently hum on in the face of catastrophe. (shrink)

Most readers of Louis Althusser first enter his work through his writings on ideology. In an important new essay Étienne Balibar, friend and colleague of Althusser, offers an original reading of Althusser’s idea of ideology, drawing on both recently published posthumous writing and Althusser's work on the Piccolo Teatro di Milano. Balibar’s essay uncovers the intricate workings of interpellation through Althusser’s essays on the theater. If debates on dialectical materialism belong to a distant history, Balibar suggests, the question of ideology (...) remains crucial for thinking the present. The issue includes commentaries on Balibar’s essay from five influential scholars who engage critically with Althusser’s philosophy: Judith Butler, Banu Bargu, Adi Ophir, Warren Montag, and Bruce Robbins. This issue reanimates Althusser’s concept of ideology as an analytic tool for contemporary cultural and political critique. (shrink)