In this piece I discuss when care providers should not contact suicidal patients’ families to get collateral information from them or hospitalize patients over their objections. I suggest that when these patients are chronically suicidal, overriding these wants may be best in the short run but increase their net risk in the longer run. I also discuss in this regard how contacted families may become overprotective and how hospitalization can be traumatic. I present an alternative approach that can increase these (...) patients’ safety over the longer run and relate three practical approaches care providers may find useful: explaining their decisions to patients, monitoring their own fear, and instilling hope. (shrink)

This paper refines a number of theoretical distinctions relevant to deceptive play, in particular the difference between merely misleading actions and types of simulation commonly considered beyond the pale, such as diving. To do so, I rely on work in the philosophy of language about conversational convention and implicature, the distinction between lying and misleading, and their relation to concepts of seduction and bullshit. The paper works through a number of possible solutions to the question of what is wrong with (...) simulation and its difference from strategic fouling, including the argument that games and their rules operate like contracts. I conclude that the wrongness lies in the injustice of unfair advantage gained through actions that silence opposition by resort to unanswerable play. (shrink)

A recently enacted law permits patients to see their electronic medical record (EMR) immediately after their careprovider writes in it. In this article I discuss a proposal that authors make in this issue of The Journal of Clinical Ethics, that ethics consultants (ECs) keep their notes in a separate section of the EMR that patients cannot access when their ethics notes may be troubling to patients, to avoid unduly harming them.I discuss this concern and three more widely applicable clinical goals: (...) to help patients feel safe; to gain patients’ trust; and to provide hope to patients, when possible. These goals apply to careproviders and ECs who seek to help patients and families resolve ethical conflicts. I explain why these goals are singularly important and how careproviders may pursue them, using as an example informing patients about temporal framing to help them find hope. (shrink)

This textbook offers the perfect introduction to the complex world of social work theory, giving a concise yet comprehensive overview of how practice is influenced by each theoretical approach described. The book begins by outlining the origins and historical context of social work, which allows the reader to see show how theoretical fashions have changed and adapted to certain times, and concludes with advice on the best way forward for the modern-day social worker. Packed with thought-provoking discussions surrounding the topic, (...) students will be encouraged to question the theories portrayed – a skill crucial to being a truly effective social work practitioner. Written by one social work's most highly regarded commentators, the book's accessible and easy-to-read writing style makes it a must-have companion for students and practitioners looking to gain an overall view of social work theory. (shrink)

In this article I will discuss how clinicians might best treat adolescents who may die. I initially discuss these patients’ cognition, emotional tendencies, and sensitivity to interpersonal cues. I next discuss their parents’ feelings of loss and guilt and their clinicians’ risk of imposing their own moral views without knowing this. I then address the practical concerns of helping these patients gain or regain resilience and to identify strengths they have had in the past. I finally explore who, among staff, (...) might be best able to do this. I highlight as the main goal that patients, their parents, and ideally also their clinicians are able to come to agree on the best course the patients should take. (shrink)

Mercier & Sperber (M&S) argue for their argumentative theory in terms of communicative abilities. Insights can be gained by extending the discussion beyond human reasoning to rodent and robot navigation. The selection of arguments and conclusions that are mutually reinforcing can be cast as a form of abductive reasoning that I argue underlies the construction of cognitive maps in navigation tasks.

Support for Howe et al.'s conclusion that musical talent is largely a myth is garnered from the sport literature. One issue germane to the nurture argument is how and when motivation to practice is formed.

For some time cognitive anthropology, and indeed cognitive science generally, have been concerned with issues of conceptual representation. Inadequacies in classical and more recent approaches, in particular, prototype theories, have motivated a search for alternative accounts. We propose an approach to conceptual representation that requires the specification of domain theories, from which conceptual definitions are generated, and within which the relations among concepts can be formalized. We demonstrate the utility of a formal characterization of this view of domains and concepts (...) in the analysis of an aspect of the basic metaphysics constructed by the people of West Futuna, Vanuatu. In the process, we expand the set of formal devices traditionally relied upon by anthropologists and others involved in cognitive studies, and thereby gain insight into the complexity of the metaphysical beliefs of an Oceanic people. (shrink)

The Creativity in Health and Care Workshops programme was a series of investigative workshops aimed at interrogating the subject of creativity with an over-arching objective of extending the understanding of the problems and possibilities of applying creativity within the health and care sector workforce. Included in the workshops was a concept analysis, which attempted to gain clearer understanding of creativity and innovation within this context. The analysis led to emergent theory regarding the central importance of aesthetics, emotion and empathetic imagination (...) to the generation of creative and innovative outcomes that have the capacity to promote wellbeing in the health and social care workforce. Drawing on expertise in the field, this paper outlines the concept analysis and subsequent reflection. (shrink)

Based on a qualitative study of 48 teenage mothers living in the Denver metropolitan area, this research examines the loss of multiple attachments, including mothers, siblings, and other extended family members and friends, among African American and Latina girls who become young mothers. Through life history narratives, this article explores the isolating effects of teen motherhood on the relational world of young mothers and the transition to “forced autonomy” that emerges out of the relationship strains in the teen mothers’ lives. (...) Faced with ruptures in significant childhood attachments and strains in the mother–daughter bond, young mothers develop strategies of accommodation to cope with the disruptions to connectivity and the demands of forced autonomy that are the result of early motherhood. These findings are interpreted through the frame of self-in-relation theory as this theoretical perspective has been informed by the scholarship on race and ethnicity. In reengaging the discourse on race, class, and gender, our findings contribute to the field in a number of significant and related ways: first, through an investigation into relationship loss and repair among teen mothers; second, by addressing the conditions under which teen mothers gain acceptance in their families; and third, in applying self-in-relation theory to the experience of adolescent girls of color whose relational lives are disrupted by the stigma and adversity of teen motherhood. (shrink)

BackgroundCommunity engagement in research has gained momentum as an approach to improving research, to helping ensure that community concerns are taken into account, and to informing ethical decision-making when research is conducted in contexts of vulnerability. However, guidelines and scholarship regarding community engagement are arguably unsettled, making it difficult to implement and evaluate.DiscussionWe describe normative guidelines on community engagement that have been offered by national and international bodies in the context of HIV-related research, which set the stage for similar work (...) in other health related research. Next, we review the scholarly literature regarding community engagement, outlining the diverse ethical goals ascribed to it. We then discuss practical guidelines that have been issued regarding community engagement. There is a lack of consensus regarding the ethical goals and approaches for community engagement, and an associated lack of indicators and metrics for evaluating success in achieving stated goals. To address these gaps we outline a framework for developing indicators for evaluating the contribution of community engagement to ethical goals in health research.SummaryThere is a critical need to enhance efforts in evaluating community engagement to ensure that the work on the ground reflects the intentions expressed in the guidelines, and to investigate the contribution of specific community engagement practices for making research responsive to community needs and concerns. Evaluation mechanisms should be built into community engagement practices to guide best practices in community engagement and their replication across diverse health research settings. (shrink)

Purpose We examine the levels of post-trial responsibility ascribed to different stakeholders, following a community-based clinical trial and how the ‘responsibility’ is understood. Methods We employed photovoice, unstructured observations and key informant interviews to gain insights into contexts of access to care following transition to the public health system post trial. We used an inductive narrative analysis to explore experiences and understandings of post-trial access. Results In their photovoice stories, many participants expressed a sense of abandonment after the trial. This (...) was viewed as a contributing factor to failing to re-engage with care available in the public health system. This led to the experiences of loss as some trial participants defaulted and died. Research investigators, department of health participants and sponsor agreed that PTA was especially important for communities in resource-limited settings. The government has an obligation towards its citizens while researchers have a responsibility to ensure a smooth transition of patients to public clinics. Sponsors have a responsibility to ensure that the trial is conducted in accordance with the protocol and post-trial agreements are in place and adhered to. Research partnerships among stakeholders were affected by power imbalances making it difficult to negotiate and plan for post-trial care responsibilities. Conclusions The research community still struggles with understanding the scope of PTA responsibilities. Power dynamics between public health actors and research sponsors need to be managed to ensure that government involvement is not tokenistic. The responsibility of trial participants and ethics committees needs to be investigated further. Data are available upon request. (shrink)

We invite systematic consideration of the metaphors of cycles and circulation as a long-term theme in the history of the life and environmental sciences and medicine. Ubiquitous in ancient religious and philosophical traditions, especially in representing the seasons and the motions of celestial bodies, circles once symbolized perfection. Over the centuries cyclic images in western medicine, natural philosophy, natural history and eventually biology gained independence from cosmology and theology and came to depend less on strictly circular forms. As potent ‘canonical (...) icons’, cycles also interacted with representations of linear and irreversible change, including arrows, arcs, scales, series and trees, as in theories of the Earth and of evolution. In modern times life cycles and reproductive cycles have often been held to characterize life, in some cases especially female life, while human efforts selectively to foster and disrupt these cycles have harnessed their productivity in medicine and agriculture. But strong cyclic metaphors have continued to link physiology and climatology, medicine and economics, and biology and manufacturing, notably through the relations between land, food and population. From the grand nineteenth-century transformations of matter to systems ecology, the circulation of molecules through organic and inorganic compartments has posed the problem of maintaining identity in the face of flux and highlights the seductive ability of cyclic schemes to imply closure where no original state was in fact restored. More concerted attention to cycles and circulation will enrich analyses of the power of metaphors to naturalize understandings of life and their shaping by practical interests and political imaginations. (shrink)

Reflective inquiry in nursing practice or 'revealing images'Nurses live and work in complex practice worlds; worlds of shrinking resources and expanding needs. Reflection through journaling offers unique opportunities to gain insight into practice. What might we learn from one's journal? A reflective journal can be a source of interplay between the self as written and the self as other. Likewise, the journal may act to situate ourselves in practice, while at the same time enabling us to illuminate how and in (...) what ways our understandings have become distorted. The extent to which one's journal is educative depends upon the manner in which one chooses to use it as a transformative tool, a tool that might well be described as a process of healing and enlightenment. In order to illustrate the reflexive nature of journaling, this paper is presented as a play reading, where a conversation about practice stories between the different aspects of the nurse's self is depicted. In adopting a play reading, an alternative pedagogical tool is used to illustrate different methodologies exemplifying the emergence of how and in what ways we develop and reconstruct our understanding in nursing. (shrink)

In this paper, we suggest some of the dimensions of the problematic concept of Alzheimer Disease as a natural disease discerned by increasingly sophisticated medical scientific progress. Taking a page from Max Weber concerning unique events, we show some of the conceptual building blocks and social processes that have coalesced into the perception of certain phenomena as abnormalities that are seen as implicated in the development of a degenerative disease distinct from the process of normal, but variable, brain aging. We (...) note some of the decisions and social forces pushing for particular conceptualizations, interpretations, and reifications of brain alterations. In so doing, we suggest that the mystery of the "there" may not be much different from, and probably is, the mystery of the "everywhere". (shrink)

Prior to its publication, Gary Cox's MakingVotesCount was widely and eagerly anticipated. (Indeed, some years ago, I received a referee report dismissing my submission as unnecessary because superior analysis would eventually appear in Cox's then forthcoming manuscript.) Upon its release in 1998, the book was instantly lauded: it collected multiple awards, including the prestigious Woodrow Wilson prize for best book published on government, politics, or international affairs. This acclaim was scarcely surprising – Cox has been one of the foremost scholars (...) of elections and legislatures for the whole of his professional career. He is responsible for an impressive body of work spanning multiple research topics, nations, and methods of analysis. This book is testimony to his breadth, as it catalogs the key electoral features of virtually the whole set of modern democracies (more than 70), and makes frequent forays into diverse nations in search of empirical support for novel theoretical findings. In brief, Cox's project is to bring together a large formal, deductive literature on voting rules and social choice with an equally voluminous empirical, inductive literature on elections and party systems in the world's democracies. The prizes it garnered are one measure of the book's success at this merger; a large boost in Cox's swelling citation count will doubtless follow, reiterating the judgement that this is the major work on electoral law and voting to date. (shrink)

We examined affection-giving, affection-denying, respect-giving, and respect-denying behaviors among men and women in heterosexual relationships. In a pilot study, although we had expected the latent variables of affectionate and respectful behaviors to emerge from exploratory factor analyses, we obtained the latent variables of socioemotional rewards and costs instead. In the main study, we replicated the factor patterns of socioemotional rewards and costs in confirmatory factor analyses. Moreover, we entered men’s and women’s self-reported narcissism alongside men’s and women’s socioemotional rewards and (...) costs, as reported by partners, into a dyadic model that we tested via covariance structure analyses. Results revealed that, although men and women reciprocated rewards as well as costs, narcissism was not reflected in the patterns of reciprocity We discuss implications for studies of relationship processes as two-person group dynamics. (shrink)

One of the primary aims of Christian ethics is to discover how we can convert our work toward God's purposes so that God can make our work holy. In this book, Gaines illuminates this topic as something the people of God can use to reorient our lives toward the way of Jesus and the mission of God in the world. Christians are called to action in God's created world, which is why reasoning engages practice in the chapters of this (...) book so that Wesleyan readers can think and act morally in ways that are faithfully Christian and holy in response to the leading of God. (shrink)

Hans Joas is one of the foremost social theorists in Germany today. Based on Joas’s celebrated study of George Herbert Mead, this work reevaluates the contribution of American pragmatism and European philosophical anthropology to theories of action in the social sciences. Joas also establishes direct ties between Mead’s work and approaches drawn from German traditions of philosophical anthropology. Joas argues for adding a third model of action to the two predominant models of rational and normative action—one that emphasizes the creative (...) character of human action. This model encompasses the other two, allowing for a more comprehensive theory of action. Joas elaborates some implications of his model for theories of social movements and social change and for the status of action theory in sociology in the face of competition from theories advanced by Luhmann and Habermas. The problem of action is of crucial importance in both sociology and philosophy, and this book—already widely debated in Germany—will add fresh impetus to the lively discussions current in the English-speaking world. (shrink)

Tarski’s conceptual analysis of the notion of logical consequence is one of the pinnacles of the process of defining the metamathematical foundations of mathematics in the tradition of his predecessors Euclid, Frege, Russell and Hilbert, and his contemporaries Carnap, Gödel, Gentzen and Turing. However, he also notes that in defining the concept of consequence “efforts were made to adhere to the common usage of the language of every day life.” This paper addresses the issue of what relationship Tarski’s analysis, and (...) Béziau’s further generalization of it in universal logic, have to reasoning in the everyday lives of ordinary people from the cognitive processes of children through to those of specialists in the empirical and deductive sciences. It surveys a selection of relevant research in a range of disciplines providing theoretical and empirical studies of human reasoning, discusses the value of adopting a universal logic perspective, answers the questions posed in the call for this special issue, and suggests some specific research challenges. (shrink)

Few observers of relationship dynamics would dispute the claim of interdependence theorists that a defining feature of close relationships is the extent to which partners influence each other's thoughts, feelings, or behaviors. However, partners do not behave simply in response to each other's behavior; both partners in a given relationship bring themselves - indeed, their selves - into the relationship as well. Not only are individuals' selves enormously complex and rich in content, but so too are the multitude of personality (...) characteristics, including traits, values, attitudes, motives, and emotions, that contribute to selves' richness. Gaines, Jr provides a major integration of research on personality with research on relationship science, and demonstrates how personality constructs can be readily incorporated into the two most influential theories of close relationships: attachment theory and interdependence theory. This study will be of value to scholars in the fields of close relationships, personality psychology, communication studies, and family studies. (shrink)

Semantic networks were developed in cognitive science and artificial intelligence studies as graphical knowledge representation and inference tools emulating human thought processes. Formal analysis of the representation and inference capabilities of the networks modeled them as subsets of standard first-order logic (FOL), restricted in the operations allowed in order to ensure the tractability that seemed to characterize human reasoning capabilities. The graphical network representations were modeled as providing a visual language for the logic. Sub-sets of FOL targeted on knowledge representation (...) came to be called description logics, and research on these logics has focused on issues of tractability of subsets with differing representation capabilities, and on the implementation of practical inference systems achieving the best possible performance. Semantic network research has kept pace with these developments, providing visual languages for knowledge entry, editing, and presenting the results of inference, that translate unambiguously to the underlying description logics. This paper discusses the design issues for such semantic network formalisms, and illustrates them through detailed examples of significant generic knowledge structures analyzed in the literature, including determinables, contrast sets, genus/differentiae, taxonomies, faceted taxonomies, cluster concepts, family resemblances, graded concepts, frames, definitions, rules, rules with exceptions, essence and state assertions, opposites and contraries, relevance, and so on. Such examples provide important test material for any visual language formalism for logic. (shrink)

JANET DELGADO RODRIGUEZ | : The concept of vulnerability is central to current developments in bioethics, not only because of its analytic nature, but also due to its capacity for criticism. However, this concept has not been sufficiently developed, neither in the area of moral philosophy nor in bioethics. For this reason, it is necessary to define and analyze the conceptual framework in which the notion of vulnerability has been developed within the scope of bioethics. Thus, the purpose of (...) this paper is to indicate how the concept of vulnerability in the field of bioethics has been developed and what the main problems that derive from this approach are. Secondly, the paper analyzes some of the main philosophical approaches that I consider should be articulated in the expansion of a critical bioethics approach focused on the notion of vulnerability. To address this issue, I analyze the reflections that we find in the work of Martha Fineman, emphasizing the main relevant aspects for bioethics. Finally, I highlight the main implications of a theory of vulnerability for bioethics. | : Le concept de vulnérabilité est au coeur des développements actuels de la bioéthique, non seulement en raison de sa nature analytique, mais aussi en raison de son potentiel critique. Cependant, ce concept n’a pas été suffisamment développé, que ce soit dans le domaine de la philosophie morale ou de la bioéthique. Pour cette raison, il est nécessaire de définir et d’analyser le cadre conceptuel dans lequel la notion de vulnérabilité a été développée en bioéthique. Ainsi, le but de cet article est d’indiquer comment le concept de vulnérabilité a été développé dans le domaine de la bioéthique et quels sont les principaux problèmes découlant de cette approche. Deuxièmement, l’article analyse certaines des principales approches philosophiques qui devraient selon moi être articulées à une approche bioéthique critique centrée sur la notion de vulnérabilité. Pour traiter ce problème, j’analyse la réflexion de Martha Fineman, en soulignant les principaux aspects pertinents pour la bioéthique. Enfin, je souligne les principales implications d’une théorie de la vulnérabilité pour la bioéthique. (shrink)

Significantly expanded from a special issue ofSouth Atlantic Quarterly(Spring 1989), these essays confront the extent to which formalism has continued to ...