Cette étude de cas explore les complexités éthiques entourant le traitement de Mme H, une femme âgée atteinte d’un myélome multiple. Des objectifs divergents entre sa famille, ancrée dans des valeurs culturelles et religieuses, et l’équipe médicale ont suscité des délibérations éthiques. Les objectifs divergents étaient centrés sur le désir de la famille d’un traitement agressif du cancer, motivé par leurs croyances Ubuntu et chrétiennes dans le caractère sacré de la vie et l’espoir d’une intervention divine, contrastant avec l’accent mis (...) par l’équipe médicale sur les soins palliatifs, donnant la priorité au confort plutôt qu’à des interventions médicales agressives dont les bénéfices sont peu probables. Face à cette tension, l’équipe soignante, guidée par les principes de solidarité et d’humilité culturelle, s’est engagée dans un dialogue constructif facilité par un éthicien expérimenté. La résolution respecte les croyances culturelles et religieuses de la famille tout en adhérant à l’éthique médicale. Ce cas souligne l’importance de comprendre et d’intégrer les valeurs culturelles dans la prise de décision en matière de soins de santé, afin de parvenir à une approche centrée sur le patient qui respecte la diversité des points de vue. (shrink)

Most adult persons with anorexia satisfy the existing criteria widely used to assess decision-making capacity, meaning that incapacity typically cannot be used to justify coercive intervention. After rejecting two other approaches to justification, Professor Radden concludes that it is most likely not possible to justify coercive medical intervention for persons with anorexia in liberal terms, though she leaves it open whether some other framework might succeed. I shall assume here that the standard approach to assessing decisionmaking capacity is adequate.1 The (...) question then is whether we can justify—within a liberal framework—coercive intervention with the decision of a competent... (shrink)

This paper investigates a moral conflict that care workers, defined as workers who care for dependent others, confront when they go on strike. Care workers who confront decisions about whether to go on strike are, in my analysis, caught between impossible options: Should they prioritize the needs of those who are currently dependent upon them, and forego striking, or prioritize their long-term ability to provide the best possible care, and partake in strikes? I argue that care workers who confront these (...) decisions are often caught in a tragic moral conflict where “moral failure” is inevitable. However, I argue that we should place blame for said moral failures not upon striking care workers themselves but upon employers and others responsible for creating the decision contexts in which care workers must morally fail. I also argue that those responsible for creating the decision contexts in which care workers must morally fail are guilty of various moral and material harms to care workers. (shrink)

Commentators often claim that medical research subjects are coerced into participating in clinical studies. In recent years, such claims have appeared especially frequently in ethical discussions of research in developing countries. Medical research ethics is more important than ever as we move into the 21st century because worldwide the pharmaceutical industry has grown so much and shows no sign of slowing its growth. This means that more people are involved in medical research today than ever before, and in the future (...) even more will be involved. However, despite the pressing need for reflection on research ethics, it is important to carefully identify the concerns we have about research. Otherwise we run the risk that the moral language we use, and which we hear other people use, may do our moral thinking for us. We argue that many recent claims about the occurrence of coercion in medical research are misguided and misuse the word "coercion." We try to identify the real problems, and urge people to attend carefully to the implications of their descriptions of moral problems in research. (shrink)

Recent debates over adults' theory of mind use have been fueled by surprising failures of perspective-taking in communication, suggesting that perspective-taking may be relatively effortful. Yet adults routinely engage in effortful processes when needed. How, then, should speakers and listeners allocate their resources to achieve successful communication? We begin with the observation that the shared goal of communication induces a natural division of labor: The resources one agent chooses to allocate toward perspective-taking should depend on their expectations about the other's (...) allocation. We formalize this idea in a resource-rational model augmenting recent probabilistic weighting accounts with a mechanism for (costly) control over the degree of perspective-taking. In a series of simulations, we first derive an intermediate degree of perspective weighting as an optimal trade-off between expected costs and benefits of perspective-taking. We then present two behavioral experiments testing novel predictions of our model. In Experiment 1, we manipulated the presence or absence of occlusions in a director–matcher task. We found that speakers spontaneously modulated the informativeness of their descriptions to account for “known unknowns” in their partner's private view, reflecting a higher degree of speaker perspective-taking than previously acknowledged. In Experiment 2, we then compared the scripted utterances used by confederates in prior work with those produced in interactions with unscripted directors. We found that confederates were systematically less informative than listeners would initially expect given the presence of occlusions, but listeners used violations to adaptively make fewer errors over time. Taken together, our work suggests that people are not simply “mindblind”; they use contextually appropriate expectations to navigate the division of labor with their partner. We discuss how a resource-rational framework may provide a more deeply explanatory foundation for understanding flexible perspective-taking under processing constraints. (shrink)

Abstract In this paper I analyze and critique Charles Griswold’s work Forgiveness: A Philosophical Exploration. Griswold’s theory of forgiveness is structured around the notion that human frailty, imperfection, and susceptibility to unfortunate circumstances are cornerstones of the human experience. While Griswold’s paradigm of forgiveness is compelling on the whole, I argue that this “human frailty thesis” creates unintentional and problematic consequences that undermine major goals of his paradigm. In particular, the human frailty thesis undermines Griswold’s requirement that forgiveness hold an (...) offender accountable for wrongdoing. After identifying and discussing the consequences of the human frailty thesis, I will propose revisions to Griswold’s paradigm that redeem it from the problems I have identified. Content Type Journal Article Pages 1-19 DOI 10.1007/s11406-011-9327-4 Authors Hailey Huget, 430 7th St, Brooklyn, NY 11215, USA Journal Philosophia Online ISSN 1574-9274 Print ISSN 0048-3893. (shrink)

In this profound book, based on a popular audio program, Dr. David Hawkins gives a primer on his world-famous map of consciousness that will help the reader embark on their own journey to an advanced state of consciousness. David Hawkins, M.D., Ph.D, conducted a 29-year study that demonstrated that the human body becomes stronger or weaker depending on a person's mental state. He created a scale from 1 to 1,000 that mapped human consciousness. Furthermore, he demonstrated that this (...) map can be used as a blueprint to reach higher states of consciousness that can be identified simply by applying a small amount of pressure on an outstretched arm! Not only that, but this simple method has also been demonstrated to be an effective tool for instantly calibrating human consciousness. Dr. Hawkins created a scale of consciousness based on current discoveries in advanced theoretical physics and the nonlinear dynamics of chaos theory. And this “map of consciousness” now makes it possible for anyone to advance toward higher levels of enlightenment faster than ever imagined! (shrink)

Psychopathy refers to a range of complex behaviors and personality traits, including callousness and antisocial behavior, typically studied in criminal populations. Recent studies have used self-reports to examine psychopathic traits among noncriminal samples. The goal of the current study was to examine the underlying factor structure of the Self-Report of Psychopathy Scale–Short Form (SRP-SF) across complementary samples and examine the impact of gender on factor structure. We examined the structure of the SRP-SF among 2,554 young adults from three undergraduate samples (...) and a high-risk young adult sample. Using confirmatory factor analysis, a four-correlated factor model and a four-bifactor model showed good fit to the data. Evidence of weak invariance was found for both models across gender. These findings highlight that the SRP-SF is a useful measure of low-level psychopathic traits in noncriminal samples, although the underlying factor structure may not fully translate across men and women. (shrink)

Ranchers and pastoralists worldwide manage and depend upon resources from rangelands across Earth’s terrestrial surface. In the Great Plains of North America rangeland ecology has increasingly recognized the importance of managing rangeland vegetation heterogeneity to address conservation and production goals. This paradigm, however, has limited application for ranchers as they manage extensive beef production operations under high levels of social-ecological complexity and uncertainty. We draw on the ethics of care theoretical framework to explore how ranchers choose management actions. We used (...) modified grounded theory analysis of repeated interviews with ranchers to compare rancher decision-making under relatively certain and uncertain conditions and describe a typology of practices used to prioritize and choose management actions that maintain effective stewardship of these often multi-generational ranches. We contrast traditional decision-making frameworks with those described by interviewees when high levels of environmental and market uncertainty or ecological complexity led ranchers toward use of care-based, flexible and relational frameworks for decision-making. Ranchers facing complexity and uncertainty often sought “middle-ground” strategies to balance multiple, conflicting responsibilities in rangeland social-ecological systems. For example, ranchers’ care-based decision-making leads to conservative stocking approaches to “manage for the middle,” e.g. to limit risk under uncertain weather and forage availability conditions. Efforts to promote heterogeneity-based rangeland management for biodiversity conservation through the restoration of patch burn grazing and prairie dog conservation will require increased valuation of ranchers’ care work. (shrink)

The dominant approach to assessing decision-making capacity in medicine focuses on determining the extent to which individuals possess certain core cognitive abilities. Critics have argued that this model delivers the wrong verdict in certain cases where patient values that are the product of mental disorder or disordered affective states undermine decision-making without undermining cognition. I argue for a re-conceptualization of what it is to possess the capacity to make medical treatment decisions. It is, I argue, the ability to track one’s (...) own personal interests at least as well as most people can. Using this idea, I demonstrate that it is possible to craft a solution for the problem cases—one that neither alters existing criteria in dangerous ways (e.g. does not open the door to various kinds of abuse) nor violates the spirit of widely accepted ethical constraints on decision-making assessment. (shrink)

Transhumance is a form of extensive livestock production that involves seasonal movements among ecological zones or landscape types. Rangeland-based transhumance constitutes an important social and economic relationship to nature in many regions of the world, including across the Western US. However, social and ecological drivers of change are reshaping transhumant practices, and managers must adapt to increased demands for public rangeland use. Specifically, concerns for wildlife conservation have led to reduced access to seasonal public lands grazing for western US livestock (...) producers. To understand how managers adapt to loss of grazing areas (called “seasonal ranges”) we create agroecological calendars from manager records spanning 35 years (1986–2021) at the US Sheep Experiment Station in Idaho and Montana, US. The calendars illustrate how a loss of winter and summer ranges after 2013 coincided with shifts in the operation’s adaptive strategies, leading to more grazing of fall crop residue and purchased winter feed, and reducing flexibility to move livestock to cope with variable forage conditions. These changes shifted the job duties and experiences of farm workers and managers, and raised several new questions related to sheep production and vegetation management outcomes that merit future research. Transhumant system transformation has implications for human relationships with nature, rural communities, sheep genetics, production, and vegetation communities. For livestock operations that rely on government-managed lands to sustain transhumant traditions, innovative forms of collaboration and social adaptation that help secure access to seasonal ranges will be as important as technological innovations to address biodiversity conservation, climate change adaptation, and food system sustainability issues that are reshaping access to grazing lands. (shrink)

Late in their architectural career, Alison and Peter Smithson designed an eighty-square-foot, indoor-outdoor space for a man and his cat. The Smithsons described this modest space in methodological and phenomenal terms, noting that the addition to Axel Bruchhäuser’s Hexenhaus could be read “as an exemplar of a method by which a small physical change—a layering-over of air adhered to an existing fabric—can bring about a delicate tuning of persons with place.” The Hexenhaus’ tuning elements—second skin, tree screen, and double-acting mesh—create (...) a “treillage’d space” that supplants mediation, reframes attunement, and elicits an active weaving of person, place, and phenomena. This paper seeks to understand what the architects meant by “tuning” and in the process to outline operations for spatial weaving. (shrink)

There are, broadly speaking, two kinds of knowledge—analytic and intuitive, explicit and tacit. Analytic knowledge is arrived at by logical deductive thinking, and is a sequential thought process in which each step can be explained and defended. Intuitive knowledge, in contrast, is frequently alogical or nonrational, and often involves nonconscious mental processes. Though intuitive ways of knowing are essential to both scientific research and scientific medicine, the culture of medicine celebrates only the analytic, evidentiary kind of knowledge, while eschewing intuition (...) as being “nonscientific.” The popularity and prevalence of what is known as evidence-based medicine reflects this bias in favor of the analytic and the explicit. Though the evidence-based approach has contributed greatly to standardizing medical care, favoring treatments for which there is evidence of effectiveness, it has limitations. An overreliance on evidence-based medicine is problematic, because this approach leaves out important factors in the actual practice of clinical medicine such as diagnosis, nonverbal cures provided by patients, and the way the doctor–patient relationship bears on patient management and compliance, and because it is not appropriate for dealing with medical conditions that do not lend themselves to study by controlled clinical trials. (shrink)

A hallmark of positive‐sense RNA viruses is the formation of membranous shelters for safe replication in the cytoplasm. Once considered invisible to the immune system, these viral shelters are now found to be antagonized through the cooperation of autophagy proteins and anti‐microbial GTPases. This coordinated effort of autophagy proteins guiding GTPases functions against not only the shelters of viruses but also cytoplasmic vacuoles containing bacteria or protozoa, suggesting a broad immune‐defense mechanism against disparate vacuolar pathogens. Fundamental questions regarding this process (...) remain: how the host recognizes these membranous structures as a target, how the autophagy proteins bring the GTPases to the shelters, and how the recruited GTPases disrupt these shelters. In this review, these questions are discussed, the answers to which will significantly advance our understanding of the response to vacuole‐like structures of pathogens, thereby paving the way for the development of broadly effective anti‐microbial strategies for public health. (shrink)

Spoil islands are overlooked places combining dirt with paradise, waste-land with “brave new world,” and wildness with human intervention. Mundane products of dredging, these islands form an uninvestigated archipelago that demonstrates the potential value and contested re-valuation of landscapes of waste. Research navigates the U.S. east coast from New York City to Key West, examines these marginalized topographies to understand emergent concerns of 21st-century placemaking, public space, and infrastructure, and discovers that spoil islands constitute an unprecedented public commons, where human (...) agency and nature are inextricably linked. (shrink)

In this original and insightful new work, Alice Crary proposes that we see human beings and animals as creatures that are “inside ethics,” which is to say that they possess “characteristics that are simultaneously empirically discoverable and morally loaded”. This view rejects what Crary sees as the dominant paradigm in moral philosophy, wherein empirical observations about human beings and animals are viewed as morally neutral and shorn of any evaluative characteristics. Her view has implications for a range of topics in (...) moral philosophy and bioethics, including debates about disability, moral status, moral individualism, animal ethics, and animal mindedness. Here, I’ll focus primarily on summarizing... (shrink)

This book traces the translation history of German philosophy, with long and well-justified layovers in Paris, proposing an innovative translation strategy toward addressing the long-standing difficulties in its translation. The volume discusses the context around why German philosophy, whose profundity is often understood to lie in German's iconic polysemous vocabulary, has been so difficult to translate. To best grapple with its complexity, Hawkins outlines a strategy of "differential translation," which involves translating conceptually dense German terms with multiple different terms (...) in the target text, rather than the conventional standard of selecting one term and using it consistently. The book explores how this strategy, which runs counter to the expectation of readers and translators, has played out in debates across both the French-language and English-language translation landscapes, with well-known translators such as Adam Phillips and Joan Stambaugh boldly in favor and others such as Jean Laplanche polemically against it. The book encourages researchers and translators to continue to question norms in translation practice and write translations that do justice to the multifarious meanings in Germanic vocabulary. This book will be of interest to researchers interested in the German language, translation studies, philosophy, and intellectual history. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction:Beyond Nature/Culture Dualism: Let's Try Co-Evolution Instead of "Control"Ronnie Hawkins (bio)In the original call for papers for this special issue, nature/culture dualism was characterized as a way of thinking that holds human culture and nonhuman nature to be radically different ontological spheres, hyperseparated and oppositional, or, as Val Plumwood maintains in her essay, an orientation that assumes "separate casts of characters in separate dramas." In the human sphere, (...) individuals are unique and their lives are precious (at least theoretically), with concerns understood "from the inside," in terms of experience, intention and agency. In the sphere of nature, on the other hand, nonhuman beings are seen "from the outside," at best as replaceable members of species or populations needed for ecosystem functioning and, at worst, as unagentive, thinglike objects open for unbridled human exploitation. With our vast information and communication systems now largely in place, however, our human "noösphere" is rapidly enlarging to place us firmly within the biosphere (which, of course, in the imagery of Venn diagrams, must make up the larger circle on the screen), illuminating "both casts in both dramas," or perhaps joining all actors on the stage in a many-act, multidimensional play, the denoument of which, whether or not the extant lifeforms on this [End Page 1] planet will continue to evolve, remains as yet unwritten. The five essays in this collection speak to these points, and together they develop an alternative vision to our present dualistic impasse, seeing multiple natural agencies engaged with humanity in ongoing co-evolution and, as Freya Mathews suggests, raising the hope for a synergistic restructuring of lifeways that may yet save us from anthropogenic catastrophe.In "The Culture of Nature As Seen Through Mississippian Geographies," Jeff Baldwin shows us the broad scope of interacting agents, human and nonhuman, biological and geological, in what he terms "the nature-culture of the Mississippi River," as highlighted by the recent devastation of human habitation along the Gulf Coast of the United States wrought by Hurricanes Katrina and Rita. By enacting a role in which we "believe [our]selves to rule over a mechanistic world," we humans have, over the last century or so, stemmed the natural flooding of the Mississippi, rerouting the sediments that maintained and extended the delta, funneling them into the sea and thereby bringing about the subsidence and erosion of hundreds of square miles of coastal land. Concomitantly, we have let agricultural runoff from the huge Mississippi drainage basin eject excess nutrients into the Gulf of Mexico, stimulating algal blooms and die-offs, depleting the water of oxygen so as to create a hypoxic "dead zone" that is now the size of Massachusetts, and (though Baldwin does not discuss this aspect of the problem) we have released enough petrochemical pollution in the area to have earned the lower reaches of the River the name "Cancer Alley" decades ago. A failure to grasp the import of these large anthropogenic effects is, sadly, evident in calls for rebuilding the New Orleans area according to the same mechanistic model that has already proven so inadequate. Baldwin observes that the earth changes wrought through human cultural innovation often occur so rapidly, or have their negative feedbacks technologically so displaced through time and space, that their eventual impacts on the larger system may initially go unappreciated. His vision of "the culture of nature," however, is ultimately an optimistic one, since his functional understanding of culture is that it ultimately works toward mutualism, promoting increasingly appropriate relationships among all interacting components, and he finds evidence of a growing effort to establish an "intentional co-evolution," a conscious alignment of human projects with the ongoing projects of a living nature that encompasses them. [End Page 2]If Baldwin's essay helps us see our human activities "from the outside"—not just "from within" prevailing human culture, where they seem taken-for-granted necessities given a certain form of social construction, but as they alternatively appear inside biospherical space, often as inappropriate, exploitative interferences and intrusions—Stacey Sowards' essay, "Identification Through Orangutans: Destabilizing the Nature/Culture Dualism," explores the potential for our connecting with nonhuman life "from the inside," relating... (shrink)

This book was inspired originally by the debates at the turn of the century about placebo controlled trials of antiretrovirals in HIV positive pregnant women in developing countries. Moving forward from this one limited example, the book includes several additional controversial cases of clinical research conducted in developing countries, and asks probing philosophical questions about the ethics of such trials. All clinical research by its very nature uses people to acquire generalizable knowledge to help future people. But what sorts of (...) "use" are morally permissible? What is it to exploit people? Suppose that a trial conducted in a developing country would not be ethically permissible in the developed world. Can we automatically conclude from this that the trial is unethical, that some sort of morally problematic double standard is in operation? Or might the differences in the two settings justify differences in trial design? This collection of philosophical essays examines these important questions about what exploitation is and when clinical research counts as exploitative. -/- "This is an outstanding contribution to the growing literature on the ethics of research with human subjects and a fine example of what bioethics can offer at its best. Anyone with a serious interest in these issues will need to read this book from start to finish." -Daniel Wikler, Harvard School of Public Health "This book contributes significantly to the literature on exploitation in clinical research conducted in the developing world."--Patricia Marshall, Case Western Reserve University . (shrink)

Le texte de Hailey est une présentation didactique des 10 principes de justice handie du collectif Sins Invalid. Ceux-ci ont été rédigés en 2015, dans un contexte nord-américain où les milieux de justice sociale peinaient à considérer les effets combinés du racisme et du validisme systémique.

Word Order Universals is a detailed account of word order universals and their role in theories of historical change. The starting point is the Greenberg data set, which is comprised of a sample of 142 languages for certain limited co-occurrences of basic word orders, and a 30-language sample for more detailed information. In the Language Index, the 142 have been expanded to some 350 languages. Using the original Greenberg samples and the Expanded Sample, an alternative set of descriptive word order (...) statements is provided. Comprised of eight chapters, this book begins with an introduction to the theory of word order universals, encompassing topics such as word order variation across languages and theories of universal grammar. The reader is then introduced to the work of Joseph Greenberg and Theo Vennemann on word order universals; implicational universals in Greenberg's data and the Expanded Sample; and the predictions made by implicational and distributional universals for word order change. Reformulated universals for historical reconstruction are also discussed, along with some laws of reconstruction derived from synchronic universals. The final chapter is devoted to the Expanded Sample, with particular reference to its quantities as well as its typological and genetic classification. This monograph will be a useful resource for specialists in grammar and linguistics. (shrink)

Theories of well-being are typically divided into subjective and objective. Subjective theories are those which make facts about a person’s welfare depend on facts about her actual or hypothetical mental states. I am interested in what motivates this approach to the theory of welfare. The contemporary view is that subjectivism is devoted to honoring the evaluative perspective of the individual, but this is both a misleading account of the motivations behind subjectivism, and a vision that dooms subjective theories to failure. (...) I suggest that we need to revisit and reinstate certain features of traditional hedonism, in particular the idea that felt experience plays a role that no theory of welfare can afford to ignore. I then offer a sketch of a theory that is subjective in my preferred sense and avoids the worst sins of hedonism as well as the problems generated by the contemporary constraints of subjective theorists. (shrink)

This volume of the Thinker’s Guide Library introduces healthcare students and professionals to the foundations of critical thinking and offers examples of applications within clinical fields. It is an essential companion for all healthcare courses as it advances critical thinking within all specialties with the clinical professions.

Desire is commonly spoken of as a state in which the desired object seems good, which apparently ascribes an evaluative element to desire. I offer a new defence of this old idea. As traditionally conceived, this view faces serious objections related to its way of characterizing desire's evaluative content. I develop an alternative conception of evaluative mental content which is plausible in its own right, allows the evaluative desire theorist to avoid the standard objections, and sheds interesting new light on (...) the idea of evaluative experience. (shrink)

The literature of economic theory, like that of philosophy, abounds in prefaces and prolegomena. Methodology and analysis of concepts take an important place in a science which has not found the sure path of development. But there is no sure path for methodology either. The selfconscious methodology of social science has been largely a borrowing from that of physical science, where procedures have developed to a stage of considerable maturity. But the analogy falls down where guidance is most needed, at (...) the points where social science is most likely to develop new concepts and new types of structure. Philosophers have not been lacking, indeed, to belittle the entire enterprise, and to deny the possibility of anything that could strictly be called social science. (shrink)

Philosophers concerned with what would be good for a person sometimes consider a person’s past desires. Indeed, some theorists have argued by appeal to past desires that it is in the best interests of certain dementia patients to die. I reject this conclusion. I consider three different ways one might appeal to a person’s past desires in arguing for conclusions about the good of such patients, finding flaws with each. Of the views I reject, the most interesting one is the (...) view that prudential value is, at least partly, concerned with the shape of a life as a whole. (shrink)

Medical ethics would be better if people were taught to think more clearly about well-being or the concept of what is good for a person. Yet for a variety of reasons, bioethicists have generally paid little attention to this concept. Here, I argue, first, that focusing on general theories of welfare is not useful for practical medical ethics. I argue, second, for what I call the “theory-without-theories approach” to welfare in practical contexts. The first element of this approach is a (...) focus on examining important and relatively uncontroversial constituents of welfare as opposed to general theories. The second key element is a framework for thinking about choice in relation to welfare, a framework I refer to as “the mild objectivity framework.” I conclude with illustrations of the way in which the “theory without theories approach” can improve thinking in medicine. (shrink)