BackgroundNational guidelines require programmes use subjective assessments of social support when determining transplant suitability, despite limited evidence linking it to outcomes. We examined how transplant providers weigh the importance of social support for kidney transplantation compared with other factors, and variation by clinical role and personal beliefs.MethodsThe National survey of the American Society of Transplant Surgeons and the Society of Transplant Social Work in 2016. Using a discrete choice approach, respondents compared two hypothetical patient profiles and selected one for transplantation. (...) Conditional logistic regression estimated the relative importance of each factor; results were stratified by clinical role and beliefs.ResultsFive hundred and eighy-four transplant providers completed the survey. Social support was the second most influential factor among transplant providers. Providers were most likely to choose a candidate who had social support, always adhered to a medical regimen, and had a 15 years life expectancy with transplant. Psychosocial providers were more influenced by adherence and quality of life compared with medical/surgical providers, who were more influenced by candidates' life expectancy with transplant. For providers concerned with avoiding organ waste, social support was the most influential factor, while it was the least influential for clinicians concerned with fairness.ConclusionsSocial support is highly influential in listing decisions and may exacerbate transplant disparities. Providers’ beliefs and reliance on social support in determining suitability vary considerably, raising concerns about transparency and justice. (shrink)

Philosophy and Phenomenological Research, EarlyView.

True to his longstanding bias against grand unifying theories, Hacking chooses to pursue these questions by focusing on a specific case of memory-thinking: the history of multiple personality. His excavation of the contemporary terrain leads him, however, to the surprisingly grand conclusion that the various sciences of memory—including neurological studies of localization, experimental studies of recall, and studies in the psychodynamics of memory—all emerged in connection with attempts to “scientize the soul,” as a result of which spiritual battles have been (...) recast as scientific controversies “where we suppose there is such a thing as knowledge to be had”. (shrink)

Health and Social Justice (Ruger 2009a) developed the ?health capability paradigm,? a conception of justice and health in domestic societies. This idea undergirds an alternative framework of social cooperation called ?shared health governance? (SHG). SHG puts forth a set of moral responsibilities, motivational aspirations, and institutional arrangements, and apportions roles for implementation in striving for health justice. This article develops further the SHG framework and explains its importance and implications for governing health domestically.

The idea of integrating evolutionary biology and psychology has great promise, but one that will be compromised if psychological functions are conceived too abstractly and neuroscience is not allowed to play a contructive role. We argue that the proper integration of neuroscience, psychology, and evolutionary biology requires a telelogical as opposed to a merely componential analysis of function. A teleological analysis is required in neuroscience itself; we point to traditional and curent research methods in neuroscience, which make critical use of (...) distinctly teleological functional considerations in brain cartography. Only by invoking teleological criteria can researchers distinguish the fruitful ways of identifying brain components from the myriad of possible ways. One likely reason for reluctance to turn to neuroscience is fear of reduction, but we argue that, in the context of a teleological perspective on function, this concern is misplaced. Adducing such theoretical considerations as top-down and bottom-up constraints on neuroscientific and psychological models, as well as existing cases of productive, multidisciplinary cooperation, we argue that integration of neuroscience into psychology and evolutionary biology is likely to be mutually beneficial. We also show how it can be accommodated methodologically within the framework of an interfield theory. (shrink)

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)

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)

Camisha Russell has written a beautiful essay articulating why race and racism should be centered within bioethics. I agree with her assertion that Black Lives Matter (and the subsequent backlash t...

Few contemporary philosophers discuss the ways in which the emotion of shame may be gendered. This paper addresses this situation, examining Gabriele Taylor's account of genuine vs. false shame. 1 argue that, by attending to the social pressures placed on many women to conform to a certain vision of femininity, an analysis of the shame to which women may be prone shows that Taylor's account of shame remains incomplete.

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)

Neoliberal cultural frames of individual choice inform mothers’ accounts of why they refuse state-mandated vaccines for their children. Using interviews with 25 mothers who reject recommended vaccines, this article examines the gendered discourse of vaccine refusal. First, I show how mothers, seeing themselves as experts on their children, weigh perceived risks of infection against those of vaccines and dismiss claims that vaccines are necessary. Second, I explicate how mothers see their own intensive mothering practices—particularly around feeding, nutrition, and natural living—as (...) an alternate and superior means of supporting their children’s immunity. Third, I show how they attempt to control risk through management of social exposure, as they envision disease risk to lie in “foreign” bodies outside their networks, and, therefore, individually manageable. Finally, I examine how these mothers focus solely on their own children by evaluating—and often rejecting—assertions that their choices undermine community health, while ignoring how their children benefit from the immunity of others. By analyzing the gendered discourse of vaccines, this article identifies how women’s insistence on individual maternal choice as evidence of commitment to their children draws on and replicates structural inequality in ways that remain invisible, but affect others. (shrink)

Recent years have seen growing concerns about threats to academic freedom in light of the changing norms of and demands on the university. This volume brings together contributions from leading philosophers about the latest issues - ranging from safe spaces to social media controversies - and traditional challenges for academic freedom.

Although early emotion theorists posited that bodily changes contribute to emotion, the primary view in affective science over the last century has been that emotions produce bodily changes. Recent findings from physiology, neuroscience, and neuropsychology support the early intuition that body representations can help constitute emotion. These findings are consistent with the modern psychological constructionist hypothesis that emotions emerge when representations of bodily changes are conceptualized as an instance of emotion. We begin by introducing the psychological constructionist approach to emotion. (...) With Schachter as inspiration, we next examine how embodied representations contribute to affective states, and ultimately emotion, with inflammation as a key example. We close by looking forward to future research on how body representations contribute to human experience. (shrink)

This discussion is about the moods characteristic of depressive and manic states. Moods are distinguished from the emotions they often accompany, and the relationship between these less and more cognitive, and seemingly less and more intentional, states is provided preliminary clarification. Epistemic deficiencies identified here, when combined with differences of quality and quantity in the moods and motivations that beset the depression and mania sufferer, seem likely to hinder self-knowledge and self-integration. These deficiencies, it is argued, may help explain why (...) the extreme moods found in states of depression and mania contribute to our inclination to regard these conditions as disorder. (shrink)

Psychiatric ethics as professional and biomedical ethics -- The distinctiveness of the psychiatric setting -- Psychiatric ethics as virtue ethics -- Elements of a gender-sensitive ethics for psychiatry -- Some virtues for psychiatrists -- Character and social role -- Case studies in psychiatric virtues.

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)

Dugald Stewart claims that conjectural history is ‘the peculiar glory of the latter half of the eighteenth century’. Yet it is hard to see why, in his view, conjectural histories are not merely confabulated just-so stories. This paper examines Stewart's views about the epistemic and moral value of conjectural history.

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)

Women continue to remain underrepresented in STEM, and this gender disparity is particularly pronounced in leadership positions. Through in-depth, qualitative interviews of 39 women leaders in STEM, we identify common gender microaggressions they experience, and explore how these microaggressions affect their leadership experience and outcomes in the workplace. Our findings highlight five types of gender microaggressions women most often encounter, and how and when these microaggressions occur. We explore the negative impact that microaggressions can have on women’s work identities and (...) how they can trigger a cycle of rumination and self-doubt that may ultimately result in women choosing to leave STEM. Importantly, we surface the interventional and empowering role that allies play in triggering a redemptive sensemaking process that can support women leaders to build resilience and counter the negative effects of microaggressions. (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)

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.

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.

ABSTRACT In Making Things Up, Bennett defends an impressive array of theses surrounding the notion of building. My focus is on Bennett’s use of modal recombination principles in her arguments, including in particular the principle that contingent fundamental entities are freely recombinable. I have argued that such principles are motivated by mere intuition, and that we have reasons to reject them. I discuss how worries about modal recombination principles affect three of her key arguments, which concern whether building is necessitating, (...) whether relative fundamentality is primitive, and whether building is fundamental. I argue that while Bennett’s appeal to modal recombination is unjustified, she has other resources available to her in each of the three cases. (shrink)

Name der Zeitschrift: Philologus Jahrgang: 159 Heft: 2 Seiten: 272-281.

Dispositional forgiveness is positively associated with many facets of wellbeing and has protective implications against depression and anxiety in adolescents. However, little work has been done to examine neurobiological aspects of forgiveness as they relate to clinical symptoms. In order to better understand the neural mechanisms supporting the protective role of forgiveness in adolescents, the current study examined the middle frontal gyrus, which comprises the majority of the dorsolateral prefrontal cortex and is associated with cognitive regulation, and its relationship to (...) forgiveness and clinical symptoms in a sample of healthy adolescents. In this cross-sectional study, larger MFG volume was significantly associated with higher self-reported dispositional forgiveness scores and lower levels of depressive and anxiety symptoms. Forgiveness mediated the relationship between MFG volume and both depressive and anxiety symptom levels. The mediating role of forgiveness in the relationship between MFG volume and clinical symptoms suggests that one way that cognitive regulation strategies supported by this brain region may improve adolescent mental health is via increasing a capacity for forgiveness. The present study highlights the relevance of forgiveness to neurobiology and their relevance to emotional health in adolescents. Future longitudinal studies should focus on the predictive quality of the relationship between forgiveness, brain volume and clinical symptoms and the effects of forgiveness interventions on these relationships. (shrink)

Henry et al. (2007) claim they are concerned with the overmedicalization of bad memories and its subsequent exploitation by the pharmaceutical industry. However, they downplay the contributing role...

Frank Herbert's gholas are a curious twist on the golem, a creature inspired by Jewish theology and folklore. Although Herbert's gholas differ in interesting ways from the traditional golem, the historic similarities can enrich and add to our appreciation of these creatures, especially Dune 's most famous and enduring ghola, Duncan Idaho. As is often the case with good science fiction, Herbert demonstrates remarkable foresight for many scientific and technological developments that had yet to occur when he wrote the Dune (...) series. This chapter explores Herbert's gholas from both of the perspectives; gholas as an extension of the golem tradition and as the anticipation of contemporary breakthroughs in biological science. The creators of the gholas, the Tleilaxu, retain their closely guarded, highly secretive knowledge, just as the golem creators of the legends. (shrink)

Outlines and evaluates the political, legal, and ethical objections to humanitarian intervention. In so doing, it questions not only whether the doctrine of ‘sovereignty as responsibility’ has taken hold in international society, but also whether it should – particularly in the form suggested by Western states. The author argues that the ethical position of pluralism – as articulated by non-Western states – represents the most compelling case against humanitarian intervention, by emphasizing the impact on international society of relaxing the norm (...) of non-intervention. Despite these pluralist objections, military intervention in cases of supreme humanitarian emergency can be defended on moral grounds, provided the intervention meets certain tests of legitimacy. Given the unintended consequences of military action, the author also suggests that more attention should be paid to the non-military means of operationalizing ‘sovereignty as responsibility’. (shrink)

My title refers to three accounts of interpersonal love: the rationalist account that Terence Irwin ascribes to Plato; the anti-rationalist but strikingly similar account that Harry Frankfurt endorses in his own voice; and the ‘ekstatic’ account that I – following the lead of Martha Nussbaum – find in Plato's Phaedrus. My claim is that the ekstatic account points to important features of interpersonal love to which the other accounts fail to do justice, especially reciprocity and a regulative ideal of equality.

It has been shown that when participants are asked to make sensibility judgments on sentences that describe a transfer of an object toward or away from their body, they are faster to respond when the response requires a movement in the same direction as the transfer described in the sentence. This phenomenon is known as the action compatibility effect. This study investigates whether the ACE exists for volunteers with Alzheimer's disease, whether the ACE can facilitate language comprehension, and also whether (...) the ACE can still be produced if the order of the two events is inverted, that is, whether overt movement can prime comprehension of transfer sentences. In Study 1, participants with AD, younger, and older adults were tested on an adaptation of the ACE Paradigm. In Study 2, the same paradigm was modified to include an arm movement that participants had to perform prior to sentence exposure on screen. In Study 1, young, older adults, and individuals with AD were faster to respond when the direction of the response movement matched the directionality implied by the sentence. In Study 2, no traditional ACE was found; participants were faster when the direction of the movement immediately preceding the sentence matched the directionality of the sentence. It was found that compatibility effects generated a relative advantage, that transfer schemata are easier to process, and that an ACE-like effect can be the result of mutual priming between language and movement. Results suggested preservation in AD of the neural systems for action engaged during language comprehension, and conditions under which comprehension in AD can be facilitated in real life may be identified. (shrink)