Humans, animals, and the environment face a universal crisis: antimicrobial resistance. Addressing AR and its multi-disciplinary causes across many sectors including in human and veterinary medicine remains underdeveloped. One barrier to AR efforts is an inconsistent process to incorporate the plenitude of stakeholders about what AR is and how to stifle its development and spread—especially stakeholders from the animal agriculture sector, one of the largest purchasers of antimicrobial drugs. In 2019, The Wellcome Trust released Reframing Resistance: How to communicate about (...) antimicrobial resistance effectively, which proposed the need to establish a consistent and harmonized messaging effort that describes the AR crisis and its global implications for health and wellbeing across all stakeholders. Yet, Reframing Resistance does not specifically engage the animal agriculture community. This study investigates the gap between two principles recommended by Reframing Resistance and animal agriculture stakeholders. For this analysis, the research group conducted 31 semi-structured interviews with a diverse group of United States animal agriculture stakeholders. Participants reported attitudes, beliefs, and practices about a variety of issues, including how they defined AR and what entities the AR crisis impacts most. Exploration of Reframing Resistance’s Principle 2, “explain the fundamentals succinctly” and Principle 3, “emphasis that this is universal issue; it can affect anyone, including you” reveals disagreement in both the fundamentals of AR and consensus of “who” the AR crisis impacts. Principle 2 may do better to acknowledge that animal agriculture stakeholders espouse a complex array of perspectives that cannot be summed up in a single perspective or principle. As a primary tool to combat AR, behavior change must be accomplished first through outreach to stakeholder groups and understanding their perspectives. (shrink)

Several recent systematic and targeted reviews have highlighted limitations in our understanding of talent in sport. However, a comprehensive profile of where the scientific research has focused would help identify gaps in current knowledge. Our goal in this scoping review was to better understand what others have done in the field of research, to summarize the constituent areas of research in a meaningful way, to help identify gaps in the research, and to encourage future research to address these gaps. Peer-reviewed (...) articles written in English that met several inclusion criteria were analyzed. A total of 1,899 articles were identified, and the descriptive findings revealed a relatively narrow focus of research on talent in sport. Specifically, the majority of examined articles focused on males only, the sport of soccer, perceptual cognitive variables, developing athletes, adult samples, and cross-sectional designs. For better or worse, the concept of talent remains a central element of how coaches, practitioners, and scientists think about athlete development. Findings from this scoping review highlight the continued need to explore issues related to talent identification, selection, and development in more diverse samples and contexts. There is also a clear necessity to focus on under-researched areas using alternative methodologies. (shrink)

© JNCCN-Journal of the National Comprehensive Cancer Network.Background: Next-generation tumor sequencing panels, which include multiple established and novel targets across cancers, are emerging in oncology practice, but lack formal positive coverage by US payers. Lack of coverage may impact access and adoption. This study identified challenges of NGTS coverage by private payers.Methods: We conducted semi-structured interviews with 14 NGTS experts on potential NGTS benefits, and with 10 major payers, representing more than 125,000,000 enrollees, on NGTS coverage considerations. We used the (...) framework approach of qualitative research for study design and thematic analyses and simple frequencies to further describe findings.Results: All interviewed payers see potential NGTS benefits, but all noted challenges to formal coverage: 80% state that inherent features of NGTS do not fit the medical necessity definition required for coverage, 70% view NGTS as a bundle of targets versus comprehensive tumor characterization and may evaluate each target individually, and 70% express skepticism regarding new evidence methods proposed for NGTS. Fifty percent of payers expressed sufficient concerns about NGTS adoption and implementation that will preclude their ability to issue positive coverage policies.Conclusions: Payers perceive that NGTS holds significant promise but, in its current form, poses disruptive challenges to coverage policy frameworks. Proactive multidisciplinary efforts to define the direction for NGTS development, evidence generation, and incorporation into coverage policy are necessary to realize its promise and provide patient access. This study contributes to current literature, as possibly the first study to directly interview US payers on NGTS coverage and reimbursement. (shrink)

Part I. Reflections on the past : a mor et memoria / Ugo Perone -- Givenness, grace, and Marion's Augustinianism / Felix O Murchadha -- Way of being given / Pierre-Jean Renaudie -- On the threshold of distance / Ryan Coyne -- Part II. Present openings : reading textual dramatics / Stephen E. Lewis -- The moving icon / Jodie McNeilly -- Love without bodies / Cassandra Falke -- As an Orpheus of phenomenality -- Part III. Breaching future horizons : (...) discovering human insufficiency with Marion / Jennifer Rosato -- Marion's spirituality of adoration and its implications for a phenomenology of religion / Christina M. Gschwandtner -- From negative theology of hermeneutics / Claudio Tarditi -- An excess of happiness / Jeffrey L. Kosky -- Flight from the flesh / Brian Becker. (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

The Monographs produced by the International Agency for Research on Cancer (IARC) apply rigorous procedures for the scientific review and evaluation of carcinogenic hazards by independent experts. The Preamble to the IARC Monographs, which outlines these procedures, was updated in 2019, following recommendations of a 2018 expert Advisory Group. This article presents the key features of the updated Preamble, a major milestone that will enable IARC to take advantage of recent scientific and procedural advances made during the 12 years since (...) the last Preamble amendments. The updated Preamble formalizes important developments already being pioneered in the Monographs Programme. These developments were taken forward in a clarified and strengthened process for identifying, reviewing, evaluating and integrating evidence to identify causes of human cancer. The advancements adopted include strengthening of systematic review methodologies; greater emphasis on mechanistic evidence, based on key characteristics of carcinogens; greater consideration of quality and informativeness in the critical evaluation of epidemiological studies, including their exposure assessment methods; improved harmonization of evaluation criteria for the different evidence streams; and a single-step process of integrating evidence on cancer in humans, cancer in experimental animals and mechanisms for reaching overall evaluations. In all, the updated Preamble underpins a stronger and more transparent method for the identification of carcinogenic hazards, the essential first step in cancer prevention. (shrink)

The United States considers educating all students to a threshold of adequate outcomes to be a central goal of educational justice. The No Child Left Behind Act introduced evidence-based policy and accountability protocols to ensure that all students receive an education that enables them to meet adequacy standards. Unfortunately, evidence-based policy has been less effective than expected. This article pinpoints under-examined methodological problems and suggests a more effective way to incorporate educational research findings into local evidence-based policy decisions. It identifies (...) some things educators need to know and do to determine whether available interventions can play the right casual role in their setting to produce desired effects. It examines the value and limits of educational research, especially randomized controlled trials, for this task. (shrink)

Physicians, registered nurses (RNs) and enrolled nurses (ENs) engaged in geriatric (n = 49) and surgical (n = 59) care at a large hospital in Sweden gave 180 accounts of morally difficult care episodes. In total, the ENs (n = 40) gave 78, the RNs (n = 38) 55 and the physicians (n = 30) 47 accounts; there were 83 from geriatric care and 97 from surgical care. Forty-nine participants were male, and 59 were female; there were no differences in (...) gender in the form and content of the moral reasoning disclosed in either morally difficult care episodes or in the complete interviews when coded as mainly narrative or propositional, or as showing a care or a justice orientation. The ENs showed a care orientation, while RNs and physicians, to an equal degree, showed both a justice and a care orientation. The ENs also used narrative reasoning more often than RNs and physicians. No differences were seen between the two health care specialties. (shrink)

In Moral Passages, Kathryn Pyne Addelson presents an original moral theory suited for contemporary life and its moral problems. Her basic principle is that knowledge and morality are generated in collective action, and she develops it through a critical examination of theories in philosophy, sociology and women's studies, most of which hide the collective nature and as a result hide the lives and knowledge of many people. At issue are the questions of what morality is, and how moral theories (...) (whether traditional or feminist) are implemented. Addelson takes up a large number of historical cases and contemporary social problems, including teen pregnancy, contraception and abortion, and gay rights. These cases allow her to see how the knowledge and lives of some people are declared deviant or immoral, while those of others appear to show the public consensus. One case she uses throughout the book is Margaret Sanger's early work on birth control with the anarcho-syndicalist movement--a revisionist history that reveals rather than hides the collective nature of morality and knowledge. Addelson shows how the usual individualist philosophies promote theories which hide the authority of the professionals who make them. A collectivist approach, she argues, must show the part professionals play in collective action. Her aim is to allow professional knowledge makers to be morally and intellectually responsible. Based on Addelson's twenty years of work in feminist philosophy and interactionist sociology as well as her long-standing involvement in women's community organization, Moral Passages investigates how morality and knowledge are collectively enacted in today's world. (shrink)

Ethical sensitivity was introduced to caring science to describe the first component of decision making in professional practice; that is, recognizing and interpreting the ethical dimension of a care situation. It has since been conceptualized in various ways by scholars of professional disciplines. While all have agreed that ethical sensitivity is vital to practice, there has been no consensus regarding its definition, its characteristics, the conditions needed for it to occur, or the outcomes to professionals and society. The purpose of (...) this article is to explore the meaning of the concept of ethical sensitivity based on a review of the professional literature of selected disciplines. Qualitative content analysis of the many descriptors found within the literature was conducted to enhance understanding of the concept and identify its essential characteristics. Ethical sensitivity is considered to be an emerging concept with potential utility in research and practice. (shrink)

The finance industry is required to respond to public criticism of perceived immoral behaviour. To create legitimacy, financial firms not only undertake corporate social responsibility activities, but also support such activities with precise justifications. In this paper, we study CSR justifications appearing in annual and sustainability reports from the Swedish finance industry. Our objective is to investigate the ethical character of CSR justifications in the finance industry. This is an interesting topic, both because CSR carries ethical meaning and because CSR (...) justifications play a role in actual business activities. A secondary aim of this article is to test whether decoupled corporate claims about CSR can be recoupled, which would potentially help companies to act responsibly. The observed CSR justifications avoided the fundamental question of whether the finance industry does in fact have responsibilities, and they did not manifest awareness of stakeholders’ demands for CSR. Seemingly value-based CSR activities often lacked ethical justifications. These characteristics do not harmonize with the responsible image that the contemporary finance industry wants to portray. Our counterintuitive finding is that amorality prevails in the justifications that banks give for undertaking CSR activities. (shrink)

Marketers use autobiographical advertising as a means to create nostalgia for their products. This research explores whether such referencing can cause people to believe that they had experiences as children that are mentioned in the ads. In Experiment 1, participants viewed an ad for Disney that suggested that they shook hands with Mickey Mouse as a child. Relative to controls, the ad increased their confidence that they personally had shaken hands with Mickey as a child at a Disney resort. The (...) increased confidence could be due to a revival of a true memory or the creation of a new, false one. In Experiment 2, participants viewed an ad for Disney that suggested that they shook hands with an impossible character (e.g., Bugs Bunny). Again, relative to controls, the ad increased confidence that they personally had shaken hands with the impossible character as a child at a Disney resort. The increased confidence is consistent with the notion that autobiographical referencing can lead to the creation of false or distorted memory. ᭧ 2002 John Wiley & Sons, Inc. (shrink)

The arrival of image-making generative artificial intelligence (AI) programs has been met with a broad rebuke: to many, it feels inherently wrong to regard images made using generative AI programs as artworks. I am skeptical of this sentiment, and in what follows I aim to demonstrate why. I suspect AI generated images can be considered artworks; more specifically, that generative AI programs are, in many cases, just another tool artists can use to realize their creative intent. I begin with an (...) overview of how generative AI programs, like OpenAI’s DALL-E 2, work. Then, leveraging work by Claire Anscomb, I argue that generative AI programs are a new technique of automatic image-making that affords creative agency to its users, thereby qualifying the images they create as artworks. Finally, I show many of the objections brought against AI artworks—including accusations of plagiarism and artistic devaluation—are due to the social backdrop in which we currently find them, rather than the technology itself. In the end, I aim to open the door to further aesthetic debate concerning AI generated images and art. (shrink)

It is argued that the question of whether or not one is required to be or become a strict vegetarian depends, not upon a rule or ideal that endorses vegetarianism on moral grounds, but rather upon whether one's own physical, biological nature is adapted to maintaining health and well-being on a vegetarian diet. Even if we accept the view that animals have rights, we still have no duty to make ourselves substantially worse off for the sake of other rights-holders. Moreover, (...) duties to others, such as fetuses and infants, may require one to consume meat or animal products. Seven classes of individuals who are not required to be or become vegetarians are identified and their examption is related to nutritional facts; these classes comprise most of the earth's population. The rule of vegetarianism defines a special or provisional duty rather than any general or universal rule, since its observance it based upon the biological capacities of individual humans whose genetic constitution and environment makes them suitably herbivorous. It is also argued that generalizing the vegetarian ideal as a social goal for all would be wrongful because it fails to consider the individual nutritional needs of humans at various stages of life, according to biological differences between the sexes, and because it would have the eugenic effect of limiting the adaptability of the human species. The appeal to the natural interests of omnivores will not justify any claim that humans may eat amounts of meat or animal products in excess of a reasonable safety margin since animals have rights-claims against us. (shrink)

The Anthropocene marks a moment of wild destratification of the planet that requires analysis of the relations between geologic forces and social practices. Deleuze and Guattari’s concept of strata is examined in order to develop a geophilosophy for the Anthropocene. Establishing a model of strata that conjoins earth and social flows together into planes of interrelated production highlights how the fossil substratum subtends contemporary forms of social relations. Stratifications, it is argued, are planes of social reproduction that both constrain and (...) are expressive of possible modes of expression (and thus political freedom). If power, according to Foucault, is a relation between forces, geosocial strata conceptualizes how stratifications organize and capture forces into political geology. Concentrating on diagramming moments of crossing strata, it is suggested that Anthropocene geopolitics needs to be located at the intersection of geosocial formations and processes of fossilization, rather than through a new assemblage of planetary scale. (shrink)

A significant portion of the scholarship in analytic philosophy of psychiatry has been devoted to the problem of what kind of kind psychiatric disorders are. Efforts have included descriptive projects, which aim to identify what psychiatrists in fact refer to when they diagnose, and prescriptive ones, which argue over that to which diagnostic categories should refer. In other words, philosophers have occupied themselves with what I call “diagnostic kinds”. However, the pride of place traditionally given to diagnostic kinds in psychiatric (...) research has recently come under attack, most notably by a recent initiative of the National Institute of Mental Health, the Research Domain Criteria Project, that seeks to exclude diagnostic categories from experimental designs and focus on other sorts of psychiatric kinds. I argue that philosophical accounts privileging diagnostic kinds must respond to this new line of criticism, and conclude that philosophers need to either counter psychiatrists’ growing suspicion about the hegemony of diagnostic categories in the clinic and the laboratory, or join in redirecting their efforts toward the development of robust accounts of other sorts of psychiatric objects and processes. (shrink)

If the Anthropocene represents a new epoch of thought, it also represents a new form of materiality and historicity for the human as strata and stratigrapher of the geologic record. This collision of human and inhuman histories in the strata is a new formation of subjectivity within a geologic horizon that redefines temporal, material, and spatial orders of the human. I argue that the Anthropocene contains within it a form of Anthropogenesis – a new origin story and ontics for man (...) – that radically rewrites material modes of differentiation and concepts of life, from predominantly biopolitical notions of life toward an understanding of life’s geophysical origination. Here, I use the term Anthropogenesis to suggest that two things explicitly happen in the nomination of the Anthropocene: 1) the production of a mythic Anthropos as geologic world-maker/destroyer of worlds, and 2) a material, evolutionary narrative that re-imagines human origins and endings within a geologic rather than an exclusively biological context. In contrast to the homogeneous geomorphizing of the Anthropocene, I suggest that socializing the strata needs a more nuanced notion of ‘geologic life’ that challenges the construction of the Anthropocene as an undifferentiated social stratification. (shrink)

In this monograph, I offer feminist reasons to develop a multidimensional account of forgiveness as a moral, and therefore at least partially deliberative, action or set of actions, which functions as a remedy in responding to blame or condemnation, releasing offenders from the fullness of their blameworthiness, in relational contexts which therefore require considerations of power between relata. I rely on feminist philosophical account of the relational self in order to contextualise these power relations. I provide accounts of forgiveness as (...) a performative utterance, third-party forgiveness, and self-forgiveness based upon this feminist and multidimensional model of forgiveness. (shrink)

In the paper “An archeology of corruption in medicine”, Miles Little, Wendy Lipworth, and Ian Kerridge present an account of corruption and describe its prevalent forms in medicine. In presenting an individual-focused account of corruption found within “social entities”, Little et al. argue that these entities are corruptible by nature and that certain individuals are prone to take advantage of the corruptibility of social entities to pursue their own ends. The authors state that this is not preventable, so the way (...) to remedy corruption is via management and, where necessary, punishment. This commentary will briefly lay out the key features and functions of corruption as presented by Little et al., before providing a critical discussion that will focus on whether corruptibility is a necessary feature of social entities. I will propose that it is not a necessary feature, though it may frequently arise where individualistic values are unchecked. Corruption can be prevented within social entities by enhancing structures that direct toward virtue and which promote and reward cooperation instead of competition. (shrink)

This book explores the dynamic relationship between myth and philosophy in the Presocratics, the Sophists, and in Plato - a relationship which is found to be more extensive and programmatic than has been recognized. The story of philosophy's relationship with myth is that of its relationship with literary and social convention. The intellectuals studied here wanted to reformulate popular ideas about cultural authority and they achieved this goal by manipulating myth. Their self-conscious use of myth creates a self-reflective philosophic sensibility (...) and draws attention to problems inherent in different modes of linguistic representation. Much of the reception of Greek philosophy stigmatizes myth as 'irrational'. Such an approach ignores the important role played by myth in Greek philosophy, not just as a foil but as a mode of philosophical thought. The case studies in this book reveal myth deployed as a result of methodological reflection, and as a manifestation of philosophical concerns. (shrink)

A few years ago, the New York City Department of Health introduced a public health campaign entitled “Cut Your Portions, Cut Your Risk”, a series of posters in which images of food in increasingly large portion sizes appear. In one example, three packets of french fries are featured; in another, cheeseburgers are shown. In a red box in each, the text, in large, all-capital letters in English and Spanish, reads “Portions have grown,” and, below this, in all capitals, “so has (...) obesity, which can lead to many health problems” or “so has type 2 diabetes, which can lead to amputations.” Beneath the food, the posters admonish, again in all-capital... (shrink)

Culture, health, and medicine intersect in various ways—and not always without friction. This paper examines how liberal multicultural states ought to interact with diverse communities which hold different health-related or medical beliefs and practices. The debate is fierce within the fields of medicine and bioethics as to how traditional medicines ought to be regarded. What this debate often misses is the relationship that medical traditions have with cultural identity and the value that these traditions can have beyond the confines of (...) the clinical setting. This paper will attempt to bring some clarity to the discussion. In so doing, it will delve into some controversial areas: (1) the debate around whether liberal states ought to embrace multiculturalism, (2) the existence and nature of group-differentiated rights, (3) the question of whether healthcare systems ought to embrace medical pluralism, and (4) what this would entail for policymakers, clinicians, and patients. Ultimately, I argue that liberal democratic states with multicultural populations ought to recognize medical pluralism as a matter of respecting group-differentiated and individual human rights. (shrink)

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who (...) were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit. (shrink)

During a year when there is much tumult around the world and in the United States in particular, it might be surprising to encounter a paper about patience and argumentation. In this paper, I explore the notion of deep disagreement, with an eye to moral and political contexts in particular, in order to motivate the idea that patience is an argumentative virtue that we ought to cultivate. This is particularly so because of the extended nature of argumentation and the slow (...) rate at which we change our minds. I raise a concern about how calls for patience have been misused in the past and argue that if we accept patience as an argumentative virtue, we should hold people in positions of power, in particular, to account. (shrink)

In this paper, we conceptually explore the role of empathy as a connectedness organising mechanism. We expand ideas underlying positive organisational scholarship and examine leading-edge studies from neuroscience and quantum physics that give support to our claims. The perspective we propose has profound implications regarding how we organise and how we manage. First, we argue that empathy enhances connectedness through the unconscious sharing of neuro-pathways that dissolves the barriers between self and other. This sharing encourages the integration of affective and (...) cognitive consciousness which facilitates the ability to find common ground for solution building. Second, empathy enhances connectedness through altruistic action. In giving to others, feelings of joy and harmony are activated. This in turn allows personal freedom to be enriched and transcendence from the rational ego-self is reduced to develop a more expansive, integrated and enlightened state underlying connectedness. Finally, empathy enhances connectedness which results in sharing the quantum field of coherence where there is little separation between self and other. This means living beyond self-interest in a coherent world based upon interdependent wholeness rather than atomization and separation. Empathy allows us to find that state of coherent connectedness. (shrink)

o privacy regarding family matters, common law rule, and a general presumption that parents or guardians will act in the best interest of their incompetent child. However, over the years, the courts have gradually recognized that children younger than 18 years who show maturity and competence deserve a voice in determining their course of medical treatment. This article will explore the rights and interests of minors, parents, and the state in medical decision making and will address implications for nursing administrators (...) and leaders.... (shrink)

From his return to Europe in 1949 to his death in 1969, Adorno was one of the most prominent public voices in West Germany. As a professor and institute director, a frequently heard expert on radio, a prolific cultural critic, and even a sort of public counselor, he helped shape the self‐image of German postwar society. The very term “postwar society” is partly an achievement: Adorno approached Germany sociologically, as a configuration of organizations and groups, as opposed to a community (...) of blood, race, and fate, and he sought to encourage an earnest postwar and post‐genocide reckoning with the crimes committed under National Socialism, against widespread tendencies of evasiveness and disavowal. More insistently and effectively than most, Adorno reminded Germans that they lived “after Auschwitz.”. (shrink)

Research about codes of corporate ethics has hitherto taken a hypothetical, correct meaning of codes for granted. The article problematises the dichotomous categories intrinsic and subjective meanings of codes. I address the question if professionals in finance accept codes of business. The particular mentality of stockbrokers and traders constructs the way they judge restrictions such as company codes of ethics. While neglecting dimensions of ethics beyond known rules, brokers and traders distrust good ethics as a possible end in itself. Many (...) professionals in the financial market perceive efforts to integrate ethical reasoning in work as only means for maximising business opportunities. (shrink)

How Doctors Think defines the nature and importance of clinical judgment. Although physicians make use of science, this book argues that medicine is not itself a science but rather an interpretive practice that relies on clinical reasoning. A physician looks at the patient's history along with the presenting physical signs and symptoms and juxtaposes these with clinical experience and empirical studies to construct a tentative account of the illness. How Doctors Think is divided into four parts. Part one introduces the (...) concept of medicine as a practice rather than a science; part two discusses the idea of causation; part three delves into the process of forming clinical judgment; and part four considers clinical judgment within the uncertain nature of medicine itself. In How Doctors Think, Montgomery contends that assuming medicine is strictly a science can have adverse side effects, and suggests reducing these by recognizing the vital role of clinical judgment. (shrink)

Participant safety and data integrity, critical in trials of new investigational drugs, are achieved through honest participant report and precision in the conduct of procedures. HIV prevention post-trial access studies in middle-income countries potentially offer participants many benefits including access to proven efficacious but unlicensed technologies, ancillary care that often exceeds local standards-of-care, financial reimbursement for participation and possibly unintended benefits if participants choose to share or sell investigational drugs. This case study examines the possibility that this combination of benefits (...) may constitute an undue inducement for some participants in middle-income countries, where economic challenges are prevalent. A case study is presented of a single participant in a cohort of 382 participants who used concealment, fabrication and deception to ensure eligibility for a post-trial access study of an unlicensed HIV prevention technology at potential risk to her health and that of her fetus. A root cause analysis revealed her desire to access HIV prevention during an unplanned pregnancy with a partner whose faithfulness was in question. Researchers should consider implementation of systems to efficiently identify similar cases without inconveniencing the majority of participants Trial registration number NCT01691768. (shrink)

While acknowledging Hannah Arendt's keen philosophical and political insights, Kathryn T. Gines claims that there are some problematic assertions and oversights regarding Arendt’s treatment of the "Negro question." Gines focuses on Arendt's reaction to the desegregation of Little Rock schools, to laws making mixed marriages illegal, and to the growing civil rights movement in the south. Reading them alongside Arendt's writings on revolution, the human condition, violence, and responses to the Eichmann war crimes trial, Gines provides a systematic analysis (...) of anti-black racism in Arendt’s work. (shrink)

In response to Evelyn Pluhar'sWho Can Be Morally Obligated to Be a Vegetarian? in this journal issue, the author has read all of Pluhar's citations for the accuracy of her claims and had these read by an independent nutritionist. Detailed analysis of Pluhar's argument shows that she attempts to make her case by consistent misappropriation of the findings and conclusions of the studies she cites. Pluhar makes sweeping generalizations from scanty data, ignores causal explanations given by scientists, equates hypothesis with (...) fact, draws false cause conclusions from studies, and in one case claims a conclusion opposite of what the scientist published. Such poor reasoning cannot be the basis of an argument for moral vegetarianism. A broader search of the literature and attention to reviews and textbooks in nutrition shows that each of Pluhar's claims is suspect or incorrect. Pluhar has not undermined my central claims: even if animals have certain rights and well-planned vegetarian diets are safe in complex industrialized societies, these diets cannot be so regarded if the presuppositions of high levels of wealth, education, and medical care do not exist; and, women, children, the aged and some ill persons are at greater risk on restrictive vegan diets. Thus, any duty of moral vegetarianism is not categorical but provisional in nature. (shrink)