Truth, Trust and Medicine investigates the notion of trust and honesty in medicine, and questions whether honesty and openness are of equal importance in maintaining the trust necessary in doctor-patient relationships. Jackson begins with the premise that those in the medical profession have a basic duty to be worthy of the trust their patients place in them. Yet questions of the ethics of withholding information and consent and covert surveillance in care units persist. This book boldly addresses these questions which (...) disturb our very modern notions of a patient's autonomy, self-determination and informed consent. (shrink)

Substitution and simple sentences -- Simple sentences and semantics -- Simple sentences and implicatures -- The enlightenment problem and a common assumption -- Abandoning (EOI) -- Beyond matching propositions -- App. A : extending the account -- App. B : belief reporting.

While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed (...) as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors. (shrink)

This paper describes the unique values of, challenges within, and opportunities presented by embedded ELSI ethnography. Drawing from our six‐year embedded ELSI study of the WISDOM (Women Informed to Screen Depending on Measures of Risk) trial, we present three examples of the variable ways we engaged with the WISDOM trial's scientific team. WISDOM is a preference‐sensitive, pragmatic, randomized controlled trial of risk‐based breast cancer screening informed by genomics. Our embedded ELSI approach included multiple modes of engagement: (a) Trial investigators sought (...) bioethics expertise; for example, we were asked to consult on traditional bioethics topics such as consent as well as more complex questions about whether to implement a specific risk‐assessment approach on only one race‐defined group of trial participants. (b) As the ELSI investigators, we identified ethical concerns in issues that surfaced via ethnography and considered them in the Bioethics Working Group; for example, there were concerns about the implementation processes that the WISDOM team viewed as logistical challenges. (c) Our presence in WISDOM working group conversations and our expertise on classic social science topics, including race and gender, offered opportunities to engage on the spot with topics such as how to include transgender participants in a trial initially focused on “women's health”; through such engagement, the value of social science became clear to the trial investigators. The paper elaborates on the dynamic relationship between our ethnographic observations, the Bioethics Working Group discussions, and the contributions of each to our real‐time ELSI interventions in these examples. The methods and experiences we describe here suggest modes of engagement that, in combination, have the potential to expand the role of ELSI to offer real‐time intervention on issues related to equity, inclusion, and justice in genetic and genomic research. (shrink)

Order of information plays a crucial role in the process of updating beliefs across time. In fact, the presence of order effects makes a classical or Bayesian approach to inference difficult. As a result, the existing models of inference, such as the belief-adjustment model, merely provide an ad hoc explanation for these effects. We postulate a quantum inference model for order effects based on the axiomatic principles of quantum probability theory. The quantum inference model explains order effects by transforming a (...) state vector with different sequences of operators for different orderings of information. We demonstrate this process by fitting the quantum model to data collected in a medical diagnostic task and a jury decision-making task. To further test the quantum inference model, a new jury decision-making experiment is developed. Using the results of this experiment, we compare the quantum inference model with two versions of the belief-adjustment model, the adding model and the averaging model. We show that both the quantum model and the adding model provide good fits to the data. To distinguish the quantum model from the adding model, we develop a new experiment involving extreme evidence. The results from this new experiment suggest that the adding model faces limitations when accounting for tasks involving extreme evidence, whereas the quantum inference model does not. Ultimately, we argue that the quantum model provides a more coherent account for order effects that was not possible before. (shrink)

One of the most important aspects of Grice’s theory of conversation is the drawing of a borderline between what is said and what is implic- ated. Grice’s views concerning this borderline have been strongly and influentially criticised by relevance theorists. In particular, it has become increasingly widely accepted that Grice’s notion of what is said is too lim- ited, and that pragmatics has a far larger role to play in determining what is said than Grice would have allowed. (See for (...) example Bezuidenhuit 1996; Blakemore 1987; Carston 1991; Recanati 1991, 1993, 2001; Sperber and Wilson 1986; Wilson and Sperber 1981.) In this paper, I argue that the rejection of Grice has moved too swiftly, as a key line of objection which has led to this rejection is flawed. The flaw, we will see, is that relevance theorists rely on a misunderstanding of Grice’s project in his theory of conversation. I am not arguing that Grice’s versions of saying and implicating are right in all details, but simply that certain widespread reasons for rejecting his theory are based on misconceptions. (shrink)

Most words in English are ambiguous between different interpretations; words can mean different things in different contexts. We investigate the implications of different types of semantic ambiguity for connectionist models of word recognition. We present a model in which there is competition to activate distributed semantic representations. The model performs well on the task of retrieving the different meanings of ambiguous words, and is able to simulate data reported by Rodd, Gaskell, and Marslen‐Wilson [J. Mem. Lang. 46 (2002) 245] on (...) how semantic ambiguity affects lexical decision performance. In particular, the network shows a disadvantage forwords with multiple unrelated meanings (e.g., bark) that coexists with a benefit for words with multiple related word senses (e.g., twist). The ambiguity disadvantage arises because of interference between the different meanings, while the sense benefit arises because of differences in the structure of the attractor basins formed during learning. Words with few senses develop deep, narrow attractor basins, while words with many senses develop shallow, broad basins. We conclude that the mental representations of word meanings can be modelled as stable states within a high‐dimensional semantic space, and that variations in the meanings of words shape the landscape of this space. (shrink)

Like more than two hundred thousand other Americans, George Floyd howled horribly for air before his death. But his breathlessness was not born from a virus. He was murdered with the burden of anti...

Previous research reveals that when leaders enact environmentally specific transformational leadership, they positively affect corporate environmental responsibility. While this research provides important insights into how leaders create and shape corporate environmental responsibility, confidence in the validity of these findings is limited because the psychometric properties of the measurement of environmentally specific transformational leadership has not yet been assessed. The goal of the current research was to develop and validate a measure of environmentally specific transformational leadership. To this end, four studies (...) were conducted, which together produced a reliable and valid scale from which future research can stem. Theoretical and practical limitations are discussed. (shrink)

Civil society organizations (CSOs) have significantly impacted on the politics of health research and the field of bioethics. In the global HIV epidemic, CSOs have served a pivotal stakeholder role. The dire need for development of new prevention technologies has raised critical challenges for the ethical engagement of community stakeholders in HIV research. This study explored the perspectives of CSO representatives involved in HIV prevention trials (HPTs) on the impact of premature trial closures on stakeholder engagement. Fourteen respondents from South (...) African and international CSOs representing activist and advocacy groups, community mobilisation initiatives, and human and legal rights groups were purposively sampled based on involvement in HPTs. Interviews were conducted from February-May 2010. Descriptive analysis was undertaken across interviews and key themes were developed inductively. CSO representatives largely described positive outcomes of recent microbicide and HIV vaccine trial terminations, particularly in South Africa, which they attributed to improvements in stakeholder engagement. Ongoing challenges to community engagement included the need for principled justifications for selective stakeholder engagement at strategic time-points, as well as the need for legitimate alternatives to CABs as mechanisms for engagement. Key issues for CSOs in relation to research were also raised. (shrink)

A series of studies investigated the capacity of children between the ages of 7 and 12 to give free and informed consent to participation in psychological research. Children were reasonably accurate in describing the purpose of studies, but many did not understand the possible benefits or especially the possible risks of participating. In several studies children's consent was not affected by the knowledge that their parents had given their permission or by the parents saying that they would not be upset (...) if the children refused. In contrast, other studies found that children were much more likely to stop their participation if the experimenter said explicitly that she would not be upset if they stopped. We suggest that experimenters should pay more attention to describing the possible risks and benefits of participation in research, and that they should also make it clearer to children that they are free to stop once they have begun. (shrink)

Background: The concept of dignity is recognised as a fundamental right in many countries. It is embedded into law, human rights legislation and is often visible in organisations’ philosophy of care, particularly in aged care. Yet, many authors describe difficulties in defining dignity and how it can be preserved for people living in long term care. Objectives: In this article, Nordenfelt’s ‘four notions of dignity’ are considered, drawing on research literature addressing the different perspectives of those who receive, observe or (...) deliver care in the context of the long-term care environment. Methods: A review of the literature was undertaken using the terms ‘nursing homes’, ‘residential care’ or ‘long-term care’. The terms were combined and the term ‘human dignity’ was added. A total of 29 articles met the inclusion criteria from the United Kingdom (14), United States (2), Australia (1), Sweden (3), Hong Kong (2), Norway (3), Nordic (1), Taiwan (1), Netherlands (1). Ethical Considerations: Every effort has been made to ensure an unbiased search of the literature with the intention of an accurate interpretation of findings. Discussion: The four notions of dignity outlined by Nordenfelt provide a comprehensive description of the concept of dignity which can be linked to the experiences of people living in long-term care today and provide a useful means of contextualising the experiences of older people, their families and significant others and also of staff in long-term care facilities. Of particular interest are the similarities of perspectives of dignity between these groups. The preservation of dignity implies that dignity is a quality inherent in us all. This links directly to the exploration and conclusions drawn from the literature review. Conversely, promoting dignity implies that dignity is something that can be influenced by others and external factors. Hence, there are a number of implications for practice. Conclusion: We suggest that two of Nordenfelt’s notions, ‘dignity of identity’ and ‘dignity of Menschenwüde’, are a common thread for residents, family members and staff when conceptualising dignity within long-term care environments. (shrink)

Take full advantage of your dSLR camera, and do it with confidence Many people buy dSLR cameras for their flexibility, but find themselves so intimidated by all the options and controls that they rarely venture beyond the automatic mode. With a friendly tone and clear, understandable instruction, photographer and educator Jen Bebb introduces you to every mode and setting on your sophisticated dSLR. After thoroughly explaining shutter speed, aperture, depth of field, ISO, and basic composition, she offers direction on what (...) each camera mode does and when it should be used. You'll gain the confidence to use the entire feature set you paid for. Beginning dSLR users are often intimidated by the scene, semi-automatic, and fully manual modes on their cameras; this guide gently explains each mode and setting Uses a conversational tone and liberal examples to define and explain basic concepts including shutter speed, aperture, ISO, depth of field, and composition Covers how each camera mode works and when to consider using it Helps those new to dSLR photography to gain confidence and begin taking advantage of all the flexibility a dSLR offers Written by a professional photographer who is also known for her skill as an instructor, Beyond Auto Mode encourages new and less experienced dSLR users to take the next step toward creative control. (shrink)

Rather than looking at protest in the ideal case, this book looks at how protest is actually practiced and argues that suitably constrained violent political protest is sometimes justified.

Part graphic novel, part feminist and philosophical analysis, The Pregnancy ≠ Childbearing Project explores how pregnancy can be a meaningful and distinct phenomenon from childbirth and does not equate with childbearing or the production of children.

Do English-speakers think about anger as “red” and sadness as “blue”? Some theories of emotion suggests that color(s) - like other biologically-derived signals- should be reliably paired with an emotion, and that colors should differentiate across emotions. We assessed consistency and specificity for color-emotion pairings among English-speaking adults. In study 1, participants (n = 73) completed an online survey in which they could select up to three colors from 23 colored swatches (varying hue, saturation, and light) for each of ten (...) emotion words. In study 2, different participants (n = 52) completed a similar online survey except that we added additional emotions and colors (which better sampled color space). Participants in both studies indicated the strength of the relationship between a selected color(s) and the emotion. In study 1, four of the ten emotions showed consistency, and about one-third of the colors showed specificity, yet agreement was low-to-moderate among raters even in these cases. When we resampled our data, however, none of these effects were likely to replicate with statistical confidence. In study 2, only two of twenty emotions showed consistency, and three colors showed specificity. As with the first study, no color-emotion pairings were both specific and consistent. In addition, in study 2, we found that saturation and lightness, and to a lesser extent hue, predicted color-emotion agreement rather than perceived color. The results suggest that previous studies which report emotion-color pairings are likely best thought of experiment-specific. The results are discussed with respect to constructionist theories of emotion. (shrink)

summaryQuine's ontological relativity thesis requires that objects be treated as «neutral nodes» in the logical structure of our total theory of the world. It is by treating objects as neutral that we are able to vary ontology yet leave the evidential support of our theory undisturbed. In this article, I present arguments against the possibility of treating objects as neutral.

In this dissertation, I argue that no account of propositional attitude reporting which does not include a significant degree of context-sensitivity can succeed in accommodating our intuitions about the truth conditions of such reports. Next, I argue that there are two general problems to be faced by any context-sensitive theory of attitude ascription, whether semantic or pragmatic. First, any theory which preserves our intuitions about which inference schemas are valid will violate our intuitions about truth conditions of particular attitude reports. (...) Second, all theories which depend upon speaker intentions and audience interests to supply the contextually-determined element will yield incorrect truth conditions for what attitude reports convey . I propose an alternative source for contextually-supplied elements: speaker dispositions. Speaker dispositions, I argue, succeed in securing the right truth conditions for the cases that speaker intentions could not handle. However, I suggest, they also point to a very different way of thinking about the way that communication takes place. (shrink)

(No abstract is available for this citation).

Journalism faces a series of ethics crises, particularly in Central Asia because journalism is marked by wide ethical misbehavior including lack of balance and impartiality, using multiple fake nam...

This paper examines Hannah Arendt’s contribution to recent debate concerning the urgency of Martin Heidegger’s original ethics. To this end, I turn to Arendt’s existential interpretation of birth as this takes shape in her discourse on the miracle. Though recent commentators have criticized Arendt’s emphasis on the miracle, I argue that she deepens a conversation about birth that Dennis Schmidt, following Jacques Derrida, has set in motion in his efforts to contribute to a more original ethics. Whereas Schmidt prioritizes the (...) helplessness of the newborn, Arendt’s interpretation of the miracle suggests that birth reminds us not simply of our responsibility to help the helpless, but also of our responsibility to prepare the world for the incalculable possibilities of the newcomer. In this, I argue that Arendt brings into focus the ground of our responsibility to make space in the world for what cannot be reduced and decided on in advance by calculative procedure, thereby opening new paths to thinking the task of original ethics. (shrink)

In conjunction with the growing feminist literature on pregnancy and visualization, this paper uses Foucault’s The Birth of the Clinic to demonstrate how the effort to make the interior of the pregnant body visible in medical discourse was a crucial part of the development of the modern medical gaze. In doing so I develop two concurrent arguments. First, I argue that the pathological corpse of the Clinic can conceptually serve as a double for the pregnant body as it emerged in (...) modern medicine in the 20th century. At the same time I use the insights of the Clinic to illustrate changes in pregnancy from early modernity to the 20th century. In early modernity, the pregnant body was understood in terms of generation, as a tree that bears fruit; by the 19th century, the pregnant body was a machine that reproduced the species. This transition can be seen in the overlap of pathology and pregnancy in early modernity, an overlap that continued throughout the 19 century and is inadvertently reinforced through the practice of ultrasound. (shrink)

Mass incarceration and the aging prison population in the United States is an ethical crisis, understudied in empirical bioethics research. In this article, I share one woman’s narrative to illustrate how older Black women describe accessing healthcare while incarcerated and identify sites for bioethical exploration. I argue that, due to the punitive nature of prison healthcare interactions, wherein women are seen as inmates first and patients second, healthcare providers are caught in a trap of competing ethical commitments to their patients (...) and the state. As the prison population ages, these challenges will become more acute. Feminist bioethics has a critical role to play in imagining new possibilities for accessing, giving, and receiving care in the carceral context. (shrink)

According to the standard model of accountability, holding another actor accountable entails sanctioning that actor if it fails to fulfill its obligations without a justification or excuse. Less powerful actors therefore cannot hold more powerful actors accountable, because they cannot sanction more powerful actors. Because inequality appears unlikely to disappear soon, there is a pressing need for second-best forms of accountability: forms that are feasible under conditions of inequality, but deliver as many of the benefits of standard accountability as possible. (...) This article describes a model of second-best accountability that fits this description, which I call surrogate accountability. I argue that surrogate accountability can provide some of the benefits of standard accountability, but not others, that it should be evaluated according to different normative criteria than standard accountability, and that, while surrogate accountability has some benefits that standard accountability lacks, it is usually normatively inferior to standard accountability. (shrink)

Mental disorder (earlier entitled “illness” or “disease”) is ascribed to deviations from normal thoughts, reasoning, feelings, attitudes, and actions that are considered socially or personally dysfunctional and apt for treatment. Schizophrenia, depression, and bipolar disorder are core examples. The concept of mental disorder plays a role in many domains, including medicine, social sciences such as psychology and anthropology, and the humanities, including literature and philosophy. Philosophical discussions are the primary focus of the present entry, which differs from the entry on (...) Philosophy of Psychiatry in noting several different approaches—not only those of the philosophy of science and mind, but also those arising from phenomenology and social theory. -/- Mental disorder is a widely contested concept and there are longstanding debates on whether disorders are biological or social in nature. Even uncontroversial disorders, such as those listed above, were not always regarded as disorders in the past (Porter 2002). Moreover, the status of mental disorder has frequently indicated ethical, as much as other deficiency (Irwin 2013). Such reminders direct our attention to contemporary medical psychiatry’s sometimes uncompromisingly neurobiological, and avowedly value-free “medical model”, with its incumbent analogies and assumptions, and to the general question of how the taxa of psychiatric classifications are to be viewed as objects of natural science. This model has received intensive philosophical scrutiny, including arguments that deny these conditions are deficiencies at all. Along with issues arising from cognitive psychology and the neurosciences, such foundational matters make up much of the following entry. Because of their focus on issues central to the philosophy of mind and ethics (e.g., the mind-body problem, moral responsibility, agency and identity), analyses of mental disorder have extensive implications for those fields. As clinical phenomena, they also reflect an inescapable, everyday, social reality, giving theoretical inquiries additionally urgent practical, moral, and legal implications. (shrink)

Medical interpreters play central roles in the care of patients with limited English proficiency, many of whom are vulnerable to challenges in care. Yet ethical tensions arise in the care of these patients, including tensions between translating with fidelity to spoken words versus ensuring understanding; supporting values of beneficence versus autonomy; reacting with passivity versus advocacy; and interacting with patients with neutrality versus compassion. These tensions reflect the commitment of interpreters featured in narratives to providing patient-centered care through challenging circumstances. (...) Yet interpreters are often poorly supported, with low wages, multiple stressors, and vicarious trauma as a result of witnessing difficult medical encounters and interpreting during them in the first person. Interpreters should be recognized as valued, integral care team members who recognize patients as individuals deserving of the best care. (shrink)

Both economists and psychologists are interested in understanding decision making under uncertainty. Yet, they rely on different concepts to analyse human behaviour: economists use economic preference parameters rooted in utility theory, while psychologists use personality traits to describe responses to uncertain situations. Using a large sample of university students, this study examines and contrasts five economic preference parameters and six psychological personality traits that are commonly used to study individuals’ attitudes towards uncertainty. A novelty of this paper is including both (...) the economic concept of ambiguity aversion as well as the personality trait of ambiguity intolerance. We find that standard economic preference measures based on incentivized choice tasks seem to capture rather different characteristics than psychological personality traits. In contrast, economic preference measures obtained from self-assessment questions appear more related to personality traits, especially ambiguity intolerance. (shrink)

While contractualism seems to solve some of the more pressing concerns of other moral theories, it does not conclusively address the moral status of non-human animals. Peter Carruthers claims that contractualism excludes animals from having full moral status. I argue that Carruthers’ arguments are fatally flawed due to his reliance on contradictory claims, unlikely assumptions, and flagrant violations of the contractualist method. However, Carruthers also claims that we can treat animals wrongly and that it deserves moral criticism. This claim is (...) based in indirect moral significance. However, this position makes it impossible for Carruthers to avoid endorsing two extremely counter-intuitive claims. The work of C. Tucker and C. MacDonald allows us to demonstrate that contractualism does give animals full moral standing. They ground the criteria for a contracting agent in three characteristics that animals possess. A look at some possible objections reveals nothing devastating to their proposal. (shrink)