Network is a device for organizing and conceptualizing non-linear complexity. Networks defy narrative, chronology and thus also genealogy because they entail a multiplicity of traces. Networks problematize boundaries and centrality but intensify our ability to think in terms of flows and simultaneity. As a concept, network has been highly conducive to theorizing phenomena and processes such as globalization, digital media (Internet), speed, symbiosis and complexity. This in turn enables us to rethink what constitutes the foundations of intelligence, knowledge and even (...) life itself. One particularly useful application of network as a concept is the notion of the gift, which is often seen as the archetypical figure for understanding the nature of economics and social relationships. (shrink)

Health care organizations are constantly seeking ways to improve quality of care and one of the often-posed solutions to deliver ‘good care’ is reflexivity. Several authors stress that enhancing the organizations’ and caregivers’ reflexivity allows for more situated, and therefore better care. Within quality improvement initiatives, devices that guarantee quality are also seen as key to the delivery of good care. These devices do not solely aim at standardizing work practices, but are also of importance in facilitating reflexivity. In this (...) article, we study how quality improvement devices position the relationship between situated reflection and standardization of work processes. By exploring the work of Michel Callon, Michael Lynch, and Lucy Suchman on reflexivity in work practices, we study the development and introduction of the Care Living Plan. This device aimed to transform care organizations of older people from their orientation towards the system of care into organizations that take a client-centred approach. Our analysis of the construction of specific forms of reflexivity in quality devices indicates that the question of reflexivity does not need to be opposed to standardization and needs to be addressed not only at the level of where reflexivity is organizationally situated and who gets to do the reflecting, but also on the content of reflexivity, such as what are the issues that care workers can and cannot reflect upon. In this paper we point out the theoretical importance of a more detailed empirical study of the framing of reflexivity in care practices. (shrink)

This article deals with the birth of `the virus' as an object of technoscientific analysis. The aim is to discuss the process of objectification of pathogen virulence in virological and medical discourses. Through a short excursion into the history of modern virology, it will be argued that far from being a matter of fact, pathogen virulence had to be `produced', for example in petri-dishes, test-kits and hyper-real signification-practices. The now commonly accepted objective status of `the virus' has been an accomplishment (...) of a complex ensemble of actors. Indeed, this illustrates why objectification rather than objectivity has become the main focus of science and technology studies. The objectification of `the' virus was by no means a smooth process. It involved more than five decades of highly speculative and fragmented research projects before it became actualized as a separate discipline under the heading of virology. The specific objectification of viruses took place through an inter-disciplinary de-differentiation of research questions, methodologies, techniques and technologies. The main argument of this article is that viruses only became intelligible after the establishment of a virology-assemblage. Its inauguration in the early 1950s was radical and sudden because only then could the various substrands of virological technoscience affect each other through deliberate enrolment, and engender a universal intelligibility. (shrink)

Marie van Loon | : In this paper, I argue that Alfred Mele’s conception of self-deception is such that it always fulfils the reasons-responsiveness condition for doxastic responsibility. This is because self-deceptive mechanisms of belief formation are such that the kind of beliefs they bring about are the kind of beliefs that fulfil the criteria for doxastic responsibility from epistemic reasons responsiveness. I explain why in this paper. Mele describes the relation of the subject to the evidence as a (...) biased relation. The subject does not simply believe on the basis of evidence, but on the basis of manipulated evidence. Mele puts forward four ways in which the subject does this. The subject could misinterpret positively or negatively, selectively focus, or gather evidence. Through these ways of manipulation, the evidence is framed such that the final product constitutes evidence on the basis of which the subject may believe a proposition that fits that subject’s desire that P. Whichever form of manipulation the subject uses, the evidence against P must be neutralized in one way or another. Successful neutralization of the evidence requires the ability to recognize what the evidence supports and the ability to react to it. These abilities consist precisely in the two parts of the reasons-responsiveness condition, reasons receptivity and reasons reactivity. In that sense, self-deceptive beliefs always fulfil the reasons-responsiveness condition for doxastic responsibility. However, given that reasons responsiveness is only a necessary condition for doxastic responsibility, this does not mean that self-deceived subjects are always responsible for their belief. | : Dans cet article, je soutiens que la conception d’auto-illusion chez Alfred Mele remplit toujours l’une des conditions de la responsabilité doxastique, à savoir la « sensibilité aux raisons ». Il en est ainsi car les mécanismes d’auto-illusion dans la formation de croyances produisent des types de croyances qui remplissent les critères pour la responsabilité doxastique quant à la sensibilité aux raisons épistémiques. J’explique pourquoi dans cet article. Mele décrit la relation du sujet à la preuve comme biaisée. Le sujet ne croit pas seulement sur la base de preuves, mais de preuves manipulées. Mele avance quatre façons qu’a le sujet de faire ceci. Le sujet peut mal interpréter positivement ou négativement, focaliser de façon sélective, ou accumuler des preuves. Par ces formes de manipulations, la preuve est formulée de sorte qu’elle produise un fondement pour la croyance en une proposition qui s’accorde avec le désir du sujet que P. Peu importe la forme de manipulation qu’emploie le sujet, la preuve contre P doit être neutralisée d’une façon ou d’une autre. Une neutralisation réussie de la preuve requiert la capacité de reconnaître ce que soutient la preuve et la capacité d’y réagir. Ces capacités consistent précisément en ces deux parties de la condition de la sensibilité aux raisons, soit la réceptivité et la réactivité aux raisons. En ce sens, les croyances d’auto-illusion remplissent toujours la condition de la sensibilité aux raisons pour la responsabilité doxastique. Toutefois, étant donné que la sensibilité aux raisons n’est une condition nécessaire que pour la responsabilité doxastique, cela ne veut pas dire que les sujets souffrant d’auto-illusion sont toujours responsables de leurs croyances. (shrink)

According to a popular view, excuses undermine blameworthiness. At the same time, philosophers commonly accept that blameworthiness is composed of two necessary conditions: a moral objectionability condition and a responsibility condition. For excuses to do their job, they must undermine at least one of these conditions. In this paper, I conclude that excuses do neither. By inference to the best explanation, I propose a view that reconciles this conclusion with the function of excuses.

This special issue arises from the observation that an exploration of the role of non-evidential considerations in epistemology through a broader lens is missing from the current landscape of philosophical research. The present collection of contributions fills this research gap by bringing together three central and much-discussed epistemological topics for which non-evidential considerations become relevant.

It is widely believed that implicit bias is common and that it contributes, in part, to the perpetuation of systemic injustice. Hence, the existence of implicit bias raises the question: can individuals be blameworthy for their implicit bias? Here, I consider what it is about implicit bias that renders agents blameworthy. I defend the claim that, when individuals omit to engage in activities that could prevent the influence of implicit bias on their behavior, they may be blamed for their implicit (...) bias. The plausibility of my proposal depends on whether individuals are able to engage freely in such activities and on whether there exists an obligation not to be biased (broadly put). I will answer positively to the former question and open the way for an answer to the latter, and tougher, question. (shrink)

Ulrich Beck's best selling Risk Society established risk on the sociological agenda. It brought together a wide range of issues centering on environmental, health and personal risk, provided a rallying ground for researchers and activists in a variety of social movements and acted as a reference point for state and local policies in risk management. The Risk Society and Beyond charts the progress of Beck's ideas and traces their evolution. It demonstrates why the issues raised by Beck reverberate widely throughout (...) social theory and covers the new risks that Beck did not foresee, associated with the emergence of new technologies, genetic and cybernetic. The book is unique because it offers both an introduction to the main arguments in Risk Society and develops a range of critical discussions of aspects of this and other works of Beck. (shrink)

BackgroundRadiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve all patients who would benefit from it. Allocation systems are needed to guide patient prioritization for radiotherapy in resource-limited contexts. These systems should be informed by allocation principles deemed relevant to stakeholders. This study explores the ethical dilemmas and views of decision-makers engaged in real-world prioritization of scarce radiotherapy resources at a cancer center in Rwanda in order to identify relevant principles.MethodsSemi-structured interviews (...) were conducted with a purposive sample of 22 oncology clinicians, program leaders, and clinical advisors. Interviews explored the factors considered by decision-makers when prioritizing patients for radiotherapy. The framework method of thematic analysis was used to characterize these factors. Bioethical analysis was then applied to determine their underlying normative principles.ResultsParticipants considered both clinical and non-clinical factors relevant to patient prioritization for radiotherapy. They widely agreed that disease curability should be the primary overarching driver of prioritization, with the goal of saving the most lives. However, they described tension between curability and competing factors including age, palliative benefit, and waiting time. They were divided about the role that non-clinical factors such as social value should play, and agreed that poverty should not be a barrier.ConclusionsMultiple competing principles create tension with the agreed upon overarching goal of maximizing lives saved, including another utilitarian approach of maximizing life-years saved as well as non-utilitarian principles, such as egalitarianism, prioritarianism, and deontology. Clinical guidelines for patient prioritization for radiotherapy can combine multiple principles into a single allocation system to a significant extent. However, conflicting views about the role that social factors should play, and the dynamic nature of resource availability, highlight the need for ongoing work to evaluate and refine priority setting systems based on stakeholder views. (shrink)

Pediatric biobanking is considered important for generating biomedical knowledge and improving health care. However, the inclusion of children’s samples in biobanks involves specific ethical issues. One of the main concerns is how to appropriately engage children in the consent procedure. We suggest that children should be involved through a personalized assent procedure, which means that both the content and the process of assent are adjusted to the individual child. In this paper we provide guidance on how to put personalized assent (...) into pediatric biobanking practice and consider both the content and process of personalized assent. In the discussion we argue that the assent procedure itself is formative. Investing in the procedure should be a requirement for pediatric biobank research. Although personalized assent will require certain efforts, the pediatric community must be aware of its importance. The investment and trust earned can result in ongoing engagement, important longitudinal information, and stability in/for the research infrastructure, as well as increased knowledge among its participants about research activity. Implementing personalized assent will both respect the child and support biobank research. (shrink)

Involving patients in decisions on primary prevention can be questioned from an ethical perspective, due to a tension between health promotion activities and patient autonomy. A nurse-led intervention for prevention of cardiovascular diseases, including counselling (risk communication, and elements of shared decision-making and motivational interviewing) and supportive tools such as a decision aid, was implemented in primary care. The aim of this study was to evaluate the nurse-led intervention from an ethical perspective by exploring in detail the experiences of patients (...) with the intervention, and their views on the role of both the nurse and patient. The study had a qualitative design. 18 patients who had received the intervention participated. Data were gathered by in-depth interviews. The interviews were analysed using directed content analysis. The findings revealed that patients perceived the consultations not as an infringement on their autonomy, but as supportive to risk reduction efforts they tried but found hard to realise. They specifically emphasised the role of the nurse, and appreciated the nurse's realistic advice, encouragement, and help in understanding. Patients' views on and experiences with risk management are in line with notions of relational autonomy, caring cooperation and communicative action found in the literature. We conclude that patients define the relationship with the nurse as shared work in the process of developing a healthier lifestyle. (shrink)

_Mothers and Daughters and the Origins of Female Subjectivity_ challenges the theory of the Oedipus complex, which permeates psychoanalytic theory, psychology, semiotics and cultural studies. The book focuses on the re-examination of women’s development through the theories of primitive mental states. Women’s subjectivity has been profoundly limited by continuing anxieties about the mother’s body. Jane Van Buren describes how women are gradually escaping the curse of inferiority and finding a voice, enabling the mother to provide their daughters with a (...) legacy of rightful agency over their bodies and minds. Drawing on the theories of Klein, Bion and Winnicott, and incorporating recent developments in psychobiology, this book provides a novel approach to subjects including the dreams, myths and phantasies of individuals, the nature of mother and daughter relationships, sexuality, pregnancy, menstruation and the idea of the mother’s body as problematic and dangerous. This interdisciplinary investigation into curtailed female subjectivity and its many ramifications in society, culture and individual mental growth will be of great interest to all practising psychoanalysts, and those studying psychoanalytic theory and gender studies. (shrink)

Traditional psychoanalysis relies on the presence of certain meaning-making capacities in the patient for its effectiveness. _Primitive Mental States_ examines how particular capacities including those for symbolising, fantasising, dreaming, experiencing and finding meanings in those experiences, can be taken for granted. Many of us lack these capacities in certain dimensions of our minds making traditional psychoanalysis ineffective. In this book, international contributors are brought together to consider a radical evolution in contemporary psychoanalytic theory developed from a combination of ultrasound studies, (...) infant analysis, and observation of mothers and babies. These findings demonstrate how much mental life exists even before birth and considers unevolved, unborn and barely born aspects of the self such as the birth of emotion and the birth of alpha functioning. Topics covered include: prenatal imprints on the mind and body difficult to treat patients non-verbal, non-symbolic, disembodied states of being early relational and attachment trauma. Illustrated throughout with original data and extensive clinical discussions from some of the biggest names in the field, _Primitive Mental States_ will be a useful resource for students and seasoned analysts alike. (shrink)

Self‐trust is essential to the well‐being of people with chronic illnesses and those who care for them. In this exploratory essay, we draw on a trove of health narratives to catalyze examination of this important but often overlooked topic. We explore how self‐trust is impeded at both personal and structural levels, how it can best be nourished, and how it is related to self‐advocacy. Because people's ability to trust themselves is intrinsically linked to the trust others have in them, we (...) pay particular attention to the role that allies such as clinical professionals play in the development of self‐trust, highlighting the importance of eliciting patient narratives, of curious listening, and of compassionately raising questions. We also contrast the self‐trust paradigm with that of self‐management, which tends to replace the former's attention to patients’ experiences, abilities, qualities, or judgments with a professionally dominated discourse dedicated to addressing illness through behavior changes prescribed by clinicians. We close with a call to action, exhorting readers to focus on supporting self‐trust in health care settings and on creative research in this critical yet heretofore underrepresented domain. (shrink)

Cigarette smoking and other addictive behaviors are among the main preventable risk factors for several severe and potentially fatal diseases. It has been argued that addictive behavior is controlled by an automatic-implicit cognitive system and by a reflective-explicit cognitive system, that operate in parallel to jointly drive human behavior. The present study addresses the formation of implicit attitudes towards smoking in both smokers and non-smokers, using a Go/NoGo association task, and behavioral and electroencephalographic measures. The GNAT assesses, via quantifying participants’ (...) reaction times, the strength of association between a target category and either pole of an evaluative dimension. EEG analysis is performed to determine the temporal course of the event-related potential components underlying Go/NoGo decisions and implicit attitude formation. Both smokers and non-smokers showed prolonged reaction times to smoking-related pictures when the pictures were coupled with positive evaluative words. This indicates negative implicit attitudes towards smoking in both groups alike at the time point of the behavioral response. However, only the non-smokers, not the smokers, were found to show a delay of the N200 component in the incongruent condition. This is interpreted as reflecting ambivalent or even positive implicit attitudes towards smoking in the smoker group at the time point of the N200. Our study thus provides evidence for the hypothesis that implicit attitudes are subject to changes within several hundred milliseconds after stimulus presentation, and can be altered in the course of their formation. (shrink)

This article provides current Schwartz Values Survey (SVS) data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societal-level analyses. At the individual-level, we report on the ten circumplex values sub-dimensions and two sets of values dimensions (collectivism and individualism; openness to change, conservation, self-enhancement, and self-transcendence). At the societal-level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective (...) autonomy, intellectual autonomy, egalitarianism, and harmony. For each society, we report the Cronbach’s α statistics for each values dimension scale to assess their internal consistency (reliability) as well as report interrater agreement (IRA) analyses to assess the acceptability of using aggregated individual level values scores to represent country values. We also examined whether societal development level is related to systematic variation in the measurement and importance of values. Thus, the contributions of our evaluation of the SVS values dimensions are two-fold. First, we identify the SVS dimensions that have cross-culturally internally reliable structures and within-society agreement for business professionals. Second, we report the society cultural values scores developed from the twenty-first century data that can be used as macro-level predictors in multilevel and single-level international business research. (shrink)

Background Outbreaks of infectious disease cause serious and costly health and social problems. Two new technologies – pathogen whole genome sequencing and Big Data analytics – promise to improve our capacity to detect and control outbreaks earlier, saving lives and resources. However, routinely using these technologies to capture more detailed and specific personal information could be perceived as intrusive and a threat to privacy. Method Four community juries were convened in two demographically different Sydney municipalities and two regional cities in (...) New South Wales, Australia to elicit the views of well-informed community members on the acceptability and legitimacy of: making pathogen WGS and linked administrative data available for public health researchusing this information in concert with data linkage and machine learning to enhance communicable disease surveillance systems Fifty participants of diverse backgrounds, mixed genders and ages were recruited by random-digit-dialling and topic-blinded social-media advertising. Each jury was presented with balanced factual evidence supporting different expert perspectives on the potential benefits and costs of technologically enhanced public health research and communicable disease surveillance and given the opportunity to question experts. Results Almost all jurors supported data linkage and WGS on routinely collected patient isolates for the purposes of public health research, provided standard de-identification practices were applied. However, allowing this information to be operationalised as a syndromic surveillance system was highly contentious with three juries voting in favour, and one against by narrow margins. For those in favour, support depended on several conditions related to system oversight and security being met. Those against were concerned about loss of privacy and did not trust Australian governments to run secure and effective systems. Conclusions Participants across all four events strongly supported the introduction of data linkage and pathogenomics to public health research under current research governance structures. Combining pathogen WGS with event-based data surveillance systems, however, is likely to be controversial because of a lack of public trust, even when the potential public health benefits are clear. Any suggestion of private sector involvement or commercialisation of WGS or surveillance data was unanimously rejected. (shrink)