Background Our objective was to evaluate whether the description of a machine learning (ML) app or brain imaging technology to predict the onset of schizophrenia or alcohol use disorder (AUD) influences healthcare professionals’ judgments of stigma, empathy, and compassion. Methods We randomized healthcare professionals (N = 310) to one vignette about a person whose clinician seeks to predict schizophrenia or an AUD, using a ML app, brain imaging, or a psychosocial assessment. Participants used scales to measure their judgments of stigma, (...) empathy, and compassion. Results Participants randomized to the ML vignette endorsed less anger and more fear relative to the psychosocial vignette, and the brain imaging vignette elicited higher pity ratings. The brain imaging and ML vignettes evoked lower personal responsibility judgments compared to the psychosocial vignette. Physicians and nurses reported less empathy than clinical psychologists. Conclusions The use of predictive technologies may reinforce essentialist views about mental health and substance use that may increase specific aspects of stigma and reduce others. (shrink)

Adequate treatment of pain is essential to alleviate suffering, yet studies show that patients with terminal or serious illness receive inadequate pain relief. In the case of terminally ill patients, adequate palliation of pain may be likely to reduce requests for physician-assisted suicide. This issue of the journal addresses barriers to effective pain relief and suggests how treatment of pain can be improved. The symposium features the Pain Relief Act, which is designed to provide practitioners who prescribe controlled substances for (...) pain with protection from inappropriate legal sanctions. The Act is the product of the Project on Legal Constraints on Access to Effective Pain Relief, whose principal investigators were Nancy Neveloff Dubler, LL.B., Sandra H. Johnson, J.D., LL.M., Robert J. Levine, M.D., and Benjamin W. Moulton, J.D., M.P.H.The Project was supported by the Mayday Fund and the Emily Davie and Joseph S. Kornfeld Foundation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:President’s Council on BioethicsEdmund D. Pellegrino (bio) and F. Daniel Davis (bio)Approximately two weeks before what was to have been its final meeting, the White House dissolved the President’s Council on Bioethics by terminating the appointments of its 18 members. The letters of dismissal, dated 10 June 2009, informed the members that their service on the Council would end with the close of business the next day.The Council’s (...) term was set to expire on 30 September 2009. After President Obama’s election in November and during the transition, we were advised to proceed on the assumption that the Council would be permitted to cease on that date. Reasons for the abrupt move to disband the Council are unknown. We have accepted the fact that we Council members served at the pleasure of the President and that he simply exercised his rightful prerogative. No explanation is therefore required.Some observers have speculated that the action was retaliatory. They related to the fact that several members of the Council disagreed with the President’s stem cell policy in a signed statement published in the Hastings Center’s Bioethics Forum. Others have speculated that the move was pre-emptive. At its final meeting, scheduled for 25–26 June, the Council was set to sign-off on two of its final publications. One was a comprehensive report on the ethics of organ transplantation, and the other a white paper entitled Health Care and the Common Good. The aim was immediately to release the latter as a contribution to the intensifying debate about health care reform. Health Care and the Common Good could well have aided rather than impeded the President’s drive to better control health care costs and achieve universal coverage. The Council report attempted to ground both goals in the ethical framework of, as the title indicates, the common good of all Americans.In his letter terminating the members’ appointments, Assistant to the President for Presidential Personnel Don Gips said that the President “recognizes the values of having a commission of experts in bioethical issues to provide objective and non-ideological bioethics advice to his administration.” Gips went on to say that the President is “currently rethinking the purposes and goals of such a bioethics commission, and is carefully considering a revitalized mission and mandate.” And, [End Page 309] responding to media enquiries, White House press officer Reid Cherlin explained that the President’s Council was terminated because it was a “philosophically leaning advisory group” and, according to a New York Times account by Nicholas Wade, “because it favored discussion over developing a shared consensus.” As for the ultimate outcome of the President’s “rethinking,” Cherlin indicated that President Obama will appoint a new commission with the mandate of offering “practical policy options” in bioethics.In the light of our experiences with the Council, we leave it with hopes that certain questions of national importance will be addressed. In light of the nature of federal advisory commissions, what is or are the proper roles of a national bioethics commission? If the aim is to provide advice and counsel to the President or, perhaps to the U. S. Congress, is that advice best rendered as a group consensus or as an in-depth exploration of the inevitably conflicting ethical perspectives on a given issue? How should such a commission be constituted—with what sorts of individuals? And what is the nature of the expertise that they individually and collectively bring to the commission’s functions? If the commission is to promote public debate and discussion, how exactly should it go about that task? And how is the efficacy of a commission to be assessed? Such questions inevitably lead us deep into contested territory, as the experience of this Council has shown: into the intersections of politics, religion, and science and into the relations between practice and theory—between policy and what some seem to deride as “philosophy.” Indeed, policy without an underlying philosophy is an edifice without a foundation; philosophy without policy is a foundation without an edifice.At the last meeting of the Council in March 2009, we launched a discussion of these questions with the... (shrink)

The large body of literature labeled “ethics in nursing education” is entirely devoted to curricular matters of ethics education in nursing schools, that is, to what ought to be the ethics content that is taught and what theory or issues ought to be included in all nursing curricula. Where the nursing literature actually focuses on particular ethical issues, it addresses only single topics. Absent from the literature, however, is any systematic analysis and explication of ethical issues or dilemmas that occur (...) within the context of nursing education. The objective of this article is to identify the spectrum of ethical issues in nursing education to the end of prompting a systematic and thorough study of such issues, and to lay the groundwork for research by identifying and provisionally typologizing the ethical issues that occur within the context of academic nursing. (shrink)

An experiment investigated the relationship between the ability to encode verbal stimuli during an attentional lapse. The task employed a variation on the sustained attention to response task which involved the detection of an infrequent target against a background of words. As a manipulation, participants were either instructed to encode the stimuli or were merely exposed to the stimuli. Retrieval was measured using process dissociation. Irrespective of the instructions given to the participants during the task, participants were more likely to (...) retrieve information on the basis of recollection after an error was made than before, whilst the likelihood of retrieving information on the basis of familiarity remained invariant over the same period. The implications of this result for methods of investigating subjective experience are discussed. (shrink)

This article presents a theoretical framework that views interpersonal power as interdependent with broader structures of gender and class inequalities. In contrast to oversimplified, gender-neutral or gender-static approaches, this approach illuminates the ways that structures of inequality are expressed in ideological hegemonies, which enhance, legitimate, and mystify the interpersonal power of privileged men relative to lower-status men and women in general. The discussion centers on how the relational construction of ascendant and subordinated masculinities provide men with different modes of interpersonal (...) power that, when exercised, construct and reaffirm interclass male dominance. Examples of how the construction of femininity can undermine women's interpersonal power and implications for other forms of masculinities and femininities are discussed. Examples are drawn from an analysis of conjugal power in the accounts of remarried individuals' first and second marriages to illustrate the main points of this perspective. (shrink)

The experience of chronic pain can disrupt an understanding of oneself in terms of ability and possibility. In response, the pain sufferer needs an understanding conversation partner to help reinterpret their sense of self. Yet women in pain often encounter neglect, disbelief, or worse in today’s medical institutions. They may end up seeking the authoritative pronouncement of a diagnosis rather than a partner in recovery. We must develop new language and new relationships within the medical field for helping women in (...) pain renegotiate their self-understanding and reinvigorate their engagement with the world and others through dialogue and play. (shrink)

© 2015 NATCO, The Organization for Transplant Professionals.Despite the known benefits of kidney transplant, less than 30% of the 615 000 patients living with end-stage renal disease in the United States have received a transplant. More than 100 000 people are presently on the transplant waiting list. Although the shortage of kidneys for transplant remains a critical factor in explaining lower transplant rates, another important and modifiable factor is patients' lack of comprehensive education about transplant. The purpose of this article (...) is to provide an overview of known best practices from the broader literature that can be used as an evidence base to design improved education for ESRD patients pursuing a kidney transplant. Best practices in chronic disease education generally reveal that education that is individually tailored, understandable for patients with low health literacy, and culturally competent is most beneficial. Effective education helps patients navigate the complex health care process successfully. Recommendations for how to incorporate these best practices into transplant education design are described. Providing more ESRD patients with transplant education that encompasses these best practices may improve their ability to make informed health care decisions and increase the numbers of patients interested in pursuing transplant. (shrink)

Based on interviews with a random sample of white women who are in a second marriage, this article examines changes in women's marital power across marriage, divorce, and remarriage. In some marriages, women's market work is not considered a resource and hence does not have a positive effect on marital power, particularly when husbands are employed in low-status occupations. Conversely, women who are domestically oriented do not necessarily suffer a loss of power. Hochschild's concept of “economy of gratitude” illuminates the (...) way that marital power is affected by the meanings couples assign to women's paid and unpaid labor. Furthermore, women's previous market work and marital and divorce experiences affect the meaning of their paid and unpaid labor upon remarriage, as well as their desire for each. (shrink)

A panel held at the International Conference on Information Systems, December 5–7, 1993, addressed the importance and ethicality of several issues relating to ethics and information technology use. The substance of the debate and results of audience votes on the issues are presented in this paper as a means of initiating a broader debate on the issues, for it is with debate that we reach a group consensus on acceptable behavior and practice. With consensus, we can begin to develop codes (...) and policies that are feasible and practical for ethical computer use.Specific dilemmas debated involved the issues of privacy and ownership, including the ethicality of using company resources for personal use and monitoring compliance to company policies about computer use. In general, we found little consensus about ethicality of any of the types of conduct, although we found a high degree of consensus that the debated issues were important and should continue to be discussed. The final question concerned policies and codes. While policies and codes were believed to be necessary, they were also perceived as ineffective. Several suggestions for practical action to enhance the efficacy of ethical codes are presented. (shrink)

In the following paper, I argue that, although there are conditions that the injured person must satisfy in order to be properly said to have forgiven a wrongdoer, it is a mistake to believe that there are conditions that the wrongdoer must satisfy in order for it to be morally permissible to forgive her. Against arguments that a wrongdoer should only be forgiven if she has met specific conditions, I maintain that unconditional forgiveness may be a morally appropriate response to (...) being wronged.After discussing what it means to forgive someone and examining two attempts to defend unconditional forgiveness (by appealing to respect for persons and to human solidarity), I appeal to Søren Kierkegaard’s Works of Love to argue for a different reason to forgive unconditionally: because one loves the wrongdoer and wants to convey that love, perhaps in the hope that doing so will inspire repentance and apology. (shrink)

Whereas many philosophy courses focus upon the problem that skeptical doubts can play in knowledge claims, Kierkegaard suggests that the problem of despair is a much more significant as it encompasses not only the intellect but the entire person. This paper details this problem in the context of Kierkegaard’s “The Sickness Unto Death”, Camus’s “The Plague”, and Orwell’s “1984” (a list of suggested pages from these books is also provided). While the author discusses how this problem was broached in a (...) seminar on Kierkegaard, themes of this course could be integrated into a number of other philosophy courses, e.g. Existentialism, Philosophy of Literature, Introduction to Philosophy, and the Philosophy of Religion. (shrink)

Current brain research gives us the knowledge we need to create an Integral Society in every public school in America, pre-K through 12th and college level as well. The needed instructional strategies and curriculum development practices have been clearly described (Kovalik and Olsen, 2004) and are well within the grasp of current teachers. What is missing is the political will to implement what we know.

On the eve of the presidential inauguration, the U.S. health system faces rising costs of care, growing numbers of uninsured, wide variations in quality of care, and mounting public dissatisfaction. Despite spending more on health care than any other country, a recent Commonwealth Fund Commission on a High Performance Health Care System National Scorecard reports that the United States is lagging far behind other major industrialized countries — all of which provide universal health insurance — in five key domains: healthy (...) lives, access, quality, equity, and efficiency. U.S. national performance is well below benchmarks of top performance set by other countries or high performing states, hospitals, or health plans within the United States, with broad disparities in experience depending on geographic location, income, race/ethnicity, and insurance coverage. National leadership is required to manage the growing health care crisis in the United States and improve care for all Americans. (shrink)

Learning to map words onto their referents is difficult, because there are multiple possibilities for forming these mappings. Cross-situational learning studies have shown that word-object mappings can be learned across multiple situations, as can verbs when presented in a syntactic context. However, these previous studies have presented either nouns or verbs in ambiguous contexts and thus bypass much of the complexity of multiple grammatical categories in speech. We show that noun word learning in adults is robust when objects are moving, (...) and that verbs can also be learned from similar scenes without additional syntactic information. Furthermore, we show that both nouns and verbs can be acquired simultaneously, thus resolving category-level as well as individual word-level ambiguity. However, nouns were learned more quickly than verbs, and we discuss this in light of previous studies investigating the noun advantage in word learning. (shrink)

The general conceit of Schiller’s aesthetic education is that our experiences with art and beauty set us free from internal and external constraints and allow us to embrace our full humanity as rational and sensuous beings. Experiencing the aesthetic, or the play impulse, puts one in a state of aesthetic determinacy—or rather indeterminacy—that Schiller calls the highest sense of freedom, aesthetic freedom. Gail K. Hart examines Anthony Burgess’s A Clockwork Orange as an example of what Schillerian aesthetic education might look (...) like in practice. Though it represents a distortion of Schiller’s aesthetic education, Hart argues that it also reveals an ineradicable element of coercion in aesthetic education. I argue that Burgess’s Ludovico Technique leaves out a key element of Schiller’s conception of aesthetic cultivation—play—and that Hart’s analysis of Schiller’s work likewise lacks a robust analysis of his notion of play. I argue that, when Schiller’s account of the play impulse is taken seriously as a necessary condition for aesthetic cultivation to take place, coercion is by definition made impossible. Aesthetic play is accomplished by the mutual destruction of physical and moral determinations, and this mutual erasure leads to a higher and more expansive freedom. External constraints and coercion cannot induce the aesthetic state, so aesthetic education as Schiller presents it in On the Aesthetic Education of Man cannot contain the element of coercion Hart suspects. (shrink)

Preface: Blurring the boundary between human and nonhuman beings -- Only one Holocaust? -- Evidence of things not seen -- The henmaid's tale -- Holocaust victimization imagery -- Procrustean solutions -- Scapegoats and surrogates : falsifying the fate of victims -- The 9/11 controversy -- An atrocity can be both unique and general.

Integrating race and gender in a social constructionist framework, the authors examine the way that second-generation Asian American young women describe doing gender across ethnic and mainstream settings, as well as their assumptions about the nature of Asian and white femininities. This analysis of interviews with 100 daughters of Korean and Vietnamese immigrants finds that respondents narratively construct Asian and Asian American cultural worlds as quintessentially and uniformly patriarchal and fully resistant to change. In contradistinction, mainstream white America is constructed (...) as the prototype of gender equality. Hence, Asian American and white American women serve in these accounts as uniform categorical representations of the opposing forces of female oppression and egalitarianism. The authors consider how the relational construction of hegemonic and subordinated femininities, as revealed through controlling images that denigrate Asian forms of gender, contribute to internalized oppression and shape the doing of ethnicity. (shrink)

Scholars of hermeneutics have recently taken up the task of elucidating Gadamer’s ethics by studying his work on the structure of understanding and human experience. This article seeks to contribute to that scholarship through an examination of Gadamer’s aesthetics. I suggest that Gadamer’s notions of play and aesthetic non-differentiation provide further resources for understanding Gadamer’s hermeneutic ethics as an ethics of non-differentiation, i.e., a unification of theory and practice (understanding and application). For Gadamer, an understanding of the good is its (...) enactment in the context of the dialogical play we find ourselves engaged in with others. Furthermore, Gadamer’s identification of aesthetic non-differentiation with play reveals that his ethics aims not only to unify theory and practice but also to unite participants in the ethical play as intersubjective elements of a shared experience. Retrieving the ethical import of Gadamer’s aesthetics also helps to unfold Gadamer’s suggestion that hermeneutics itself is an ethical enterprise. (shrink)

Animal advocates cannot allow the idea to take hold that only the great apes and certain other “higher” animals are fit to be “persons.” Working to change the moral status of the great apes or sea mammals; for example; is a legitimate and important undertaking; but it should not be done at the expense of other animals. Such thinking is not only disconnected from real animals in the real world; it perpetuates the view that beings belonging to species deemed “nonpersons” (...) or “merely conscious” are of lesser; or no; moral significance until or unless; through an institutionalized system of painful; stressful; and demeaning experiments over decades or centuries; some of them might “prove” themselves worthy of being called persons or semi-persons or sort-of-persons entitled to whatever privileges such designations may confer. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Addressing Alterity:Rhetoric, Hermeneutics, and the Nonappropriative RelationDiane DavisTeaching is not reducible to maieutics; it comes from the exterior and brings me more than I contain.—Emmanuel Levinas, Totality and InfinityThere is always the matter of a surplus that comes from an elsewhere and that can no more be assimilated by me, than it can domesticate itself in me. A teaching that may part ways with Heidegger's motif of our being (...) able to learn only what we already understand—when does learning take place? what do we already understand?—the Conversation belongs, as ethical relation, to the effort of thinking the infinite, the transcendent, the Stranger. None of this amounts to thinking an object.—Avital Ronell, DictationsFrom Rhetorical Power to Reception Histories Steven Mailloux has brilliantly performed and explicated a "rhetorical hermeneutics" that demonstrates the "practical inseparability of interpretation and language use and thus of the discourses that theorize those practices, hermeneutics and rhetoric" (1998, 3). Many rhetoricians have challenged the specifics of Mailloux's various arguments and have more generally objected that "rhetorical hermeneutics" leans too far toward the hermeneutical, reducing rhetoric to an analytic or critical art and giving its productive (political) function the squeeze.1 Yet within these lively debates, very few have challenged his basic premise that rhetoric and hermeneutics are inextricably intertwined: the question has not been whether they are indissociable but which side of the production-reception coin rhetorical studies ought to emphasize.2 Michael Leff, for example, flipped Mailloux's adjective-noun relation to spotlight production, promoting a "hermeneutical rhetoric" that focuses more on political than literary texts; nonetheless, he agrees that "all interpretive work involves participation in a rhetorical exchange, and that every rhetorical exchange involves some interpretive work" (1997, 197-98). [End Page 191] Rosa Eberly goes further in Citizen Critics, offering a hermeneutical rhetoric that is less interested in "already-written discourses" than in spotlighting "rhetoric's power as an art productive of discourses and subjectivities for the present and the future" (2000, 34). Yet Eberly, too, affirms Mailloux's basic premise, which was nudged in the direction of conflation in the introduction to the 1997 collection Rhetoric and Hermeneutics in Our Time, in which the editors, Walter Jost and Michael Hyde note in passing that their title can "be understood as virtually tautological."And there is of course no doubt that rhetoric has a hermeneutic dimension; or, more carefully, that rhetoric constitutes the hermeneutic dimension. If "hermeneutics" indicates "the art of understanding," as Friedrich Schleirmacher wanted, then interpretation clearly depends upon production.3 "Rhetoric not only has its place within the sphere of objects surveyed by hermeneutics," as Werner Hamacher puts it, "but also constitutes an integral component of every hermeneutic operation. Every step in an interpretation corresponds to a rhetorical—or grammatical—figure" (1996, 70). Put more bluntly: intelligibility, including self-intelligibility, is a tropological product; cognition itself is a trope that can in no way be secured. Hermeneutics—as it's being used here—is completely dependent on, even absorbed by, rhetoric.4 I have no problem with this. Nor with Mailloux's suggestion that the reverse is also true:In some ways rhetoric and interpretation are practical forms of the same extended human activity: Rhetoric is based on interpretation; interpretation is communicated through rhetoric. Furthermore, as a reflection on practice, hermeneutics and rhetorical theory are mutually defining fields: hermeneutics is the rhetoric of establishing meaning, and rhetoric the hermeneutics of problematic linguistic situations.(Mailloux 1998, 4)I don't disagree: As the production and appropriation of meaning, rhetoric and hermeneutics are an indissociable team; together, they complete understanding's circle. I take this as a given.However, I want to suggest that there is also a non-hermeneutical dimension of rhetoric that has nothing to do with meaning-making, with offering up significations to comprehension. This dimension is reducible neither to figuration nor to what typically goes by the name persuasion; it is devoted to a certain reception, but not to the appropriation of meaning. Preceding and exceeding all hermeneutic interpretation, it deals not in signified meaning but in the address itself, in the exposure to the other; it deals not... (shrink)