Data documenting poor understanding among research participants and real-time efforts to assess comprehension in large-scale studies are focusing new attention on informed consent comprehension. Within the context of biobanking consent, we previously convened a multidisciplinary panel to reach consensus about what information must be understood for a prospective participant’s consent to be considered valid. Subsequently, we presented them with data from another study showing that many U.S. adults would fail to comprehend the information the panel had deemed essential. When asked (...) to evaluate the importance of the information again, panelists’ opinions shifted dramatically in the direction of requiring that less information be understood. Follow-up interviews indicated significant uncertainty about defining a threshold of understanding and what should happen when prospective participants are unable to grasp key information. These findings have important implications for urgently needed discussion of whether... (shrink)

This paper examines faculty perceptions regarding ethical behavior among colleagues and students, and faculty practices with regard to teaching ethics in three institutions over a 4-year period. Faculty reported an uneven pattern of unethical behavior among colleagues over the period. A majority of business courses included ethics, however as both a specific topic on the syllabus and within course discussions. The percentage of courses with ethics discussions increased in 2006, however, the time allocated to these discussions decreased. These results suggest (...) that faculty are approaching ethics instruction less formally, raising concerns over the success of curriculum integration. (shrink)

Sexual self-determination is considered a fundamental human right by most of us living in Western societies. While we must abide by laws regarding consent and coercion, in general we expect to be able to engage in sexual behaviour whenever, and with whomever, we choose. For older people with dementia living in residential aged care facilities (RACFs), however, the issue becomes more complex. Staff often struggle to balance residents' rights with their duty of care, and negative attitudes towards older people's sexuality (...) can lead to residents' sexual expression being overlooked, ignored, or even discouraged. In particular, questions as to whether residents with dementia are able to consent to sexual activity or physically intimate relationships pose a challenge to RACF staff, and current legislation does little to assist them. This paper will address these issues, and will argue that, while every effort should be made to ensure that no resident comes to harm, RACFs must respect the rights of residents with dementia to make decisions about their sexuality, intimacy and physical relationships. (shrink)

The debate over the propriety of cognitive enhancement evokes both enthusiasm and worry. To gain further insight into the reasons that people may have for endorsing or eschewing pharmacological enhancement, we used empirical tools to explore public attitudes towards PE of twelve cognitive, affective, and social domains. Participants from Canada and the United States were recruited using Mechanical Turk and were randomly assigned to read one vignette that described an individual who uses a pill to enhance a single domain. After (...) reading the vignette, participants were asked how comfortable they were with the individual using the enhancement. People were significantly more comfortable when they read about enhancement of certain CAS domains than others. We found a modest negative correlation between comfort level and the degree to which the PE was perceived as changing core features of the person. We also found a modest correlation between comfort level and the degree to which the PE was perceived as improving success in life. Finally, using a sequential mixed method technique, we found that participants who felt uncomfortable about PE use overwhelmingly focused on a lack of need and, to a lesser degree, expressed concerns about safety; those who felt comfortable about PE use most frequently mentioned the safety of the pill and its ability to provide a positive outcome. The data provide novel insights into public enthusiasms and concerns over the use of PE. (shrink)

Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying (...) ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. (shrink)

This note argues that Laura Schroeter's [2005] critique of David Chalmers's epistemic two-dimensional semantics is not touched by a reply by Edward Elliott, Kelvin McQueen, and Clas Weber [2013].

In recent years, discussion around memory modification interventions has gained attention. However, discussion around the use of memory interventions in the criminal justice system has been mostly absent. In this paper we start by highlighting the importance memory has for human well-being and personal identity, as well as its role within the criminal forensic setting; in particular, for claiming and accepting legal responsibility, for moral learning, and for retribution. We provide examples of memory interventions that are currently available for medical (...) purposes, but that in the future could be used in the forensic setting to modify criminal offenders’ memories. In this section we contrast the cases of dampening and enhancing memories of criminal offenders. We then present from a pragmatic approach some pressing ethical issues associated with these types of memory interventions. The paper ends up highlighting how these pragmatic considerations can help establish ethically justified criteria regarding the possibility of interventions aimed at modifying criminal offenders’ memories. (shrink)

ABSTRACT Against empiricist and rationalist prejudices concerning the nature of issues related to “mental health,” this article offers a phenomenological account of identity as developed in a meaningful system with the environment or world. Drawing on the work of Merleau-Ponty and Dewey, I argue that behavioral and emotional health and illness must be understood in terms of the plasticity or rigidity, respectively, of the individual's responses in the face of new and threatening environmental demands. However, individual plasticity and rigidity are (...) not given qualities of the individual but are themselves developed in healthy or unhealthy interpersonal environments. I discuss three cases of emotional and behavioral trouble in order to explore the manner in which unhealthy self-environment systems can undermine individuals' powers of adaptability and growth. (shrink)

In this article, I shall analyze Schopenhauer's conception of Buddhism in the context of the Western reception of Buddhism from the seventeenth century onwards. I will focus on Schopenhauer's notion of the Buddhist palingenesis and provide an overview of the Buddhist sources Schopenhauer read before the publication of the second edition of his main work The World as Will and Representation in 1844.

Apoptotic pathways have always been regarded as a key‐player in preserving tissue and organ homeostasis. Excessive activation or resistance to activation of cell death signaling may indeed be responsible for several mechanisms of disease, including malignancy and chronic degenerative diseases. Therefore, targeting apoptotic factors gained more and more attention in the scientific community and novel strategies emerged aimed at selectively blocking or stimulating cell death signaling. This is also the case for the TMEM219 death receptor, which is activated by a (...) circulating ligand, the Insulin‐like growth factor binding protein 3 (IGFBP3) and induces a caspase‐8‐dependent apoptosis of the target cells. Interestingly, stimulation of the IGFBP3/TMEM219 axis exerts an anti‐proliferative effect, while blockade of the TMEM219 deleterious signal protects TMEM219‐expressing cells of the endocrine pancreas, lung, and intestine from damage and death. Here, we summarize the most updated reports on the role of the IGFBP3/TMEM219 apoptotic axis in disease conditions, including intestinal disorders and diabetes, and we describe the advancements in designing and testing novel TMEM219‐based targeting approaches in emerging potential clinical applications. (shrink)

Phytase is an enzyme that frees the phosphorus bound in feed grains and thus reduces the amount of dicalcium phosphate supplementation required for non-ruminants, reducing phosphorous excretion and thus reducing water pollution. This innovation has been widely adopted by feed companies in the US due to decreased phytase production costs and increased dicalcium phosphate costs. The roles played by phytase characteristics and choice architecture in the widespread use of this win–win technology are examined. A recent survey has also revealed that (...) Midwestern farmers are largely unaware of this technology even though they are using it. One implication is that further research on win–win technologies that will be adopted by industries, rather than being dependent on adoption by individuals, may be beneficial. (shrink)

In his Letter on the Blind, Denis Diderot describes, based on mathematical physics, a method for evaluating hypotheses in situations where certainty cannot be reached. This article's thesis is that the author of the Letter extends this method to metaphysical questions of finalism and idealism. Diderot presents each pair of antagonistic positions (finalism-antifinalism and idealism-realism) in such a way that readers are invited to carefully weigh the arguments and to choose the one that appears to be the best, or most (...) probable, position. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Organizational Ethics and Health Care: Expanding Bioethics to the Institutional Arena **Laura Jane Bishop (bio), M. Nichelle Cherry (bio), and Martina Darragh* (bio)In 1995, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) expanded its patient rights standards to include requirements for assuring that hospital business practices would be ethical. Renamed “Patient Rights and Organization Ethics,” these standards are based on the realization that a hospital’s obligation to (...) its patients is derived from two relationships: the patient-provider relationship governed by “clinical ethics,” and the customer-supplier relationship governed by “business ethics.” “[This] boundary between ‘clinical’ ethics and ‘business’ ethics is not clear and in many cases is nonexistent. While marketing and admission practices are seen as issues related to ‘business’ ethics, they can lead to unneeded admissions or demand for unneeded services, both of which can unnecessarily expose the patient to the risk of side effects or complications. Likewise, underutilization of needed services is likely to lead to less than optimal health outcomes” (I. Schyve 1996, p. 17). “These new standards arose out of well-publicized concerns about abuses in which patients were admitted to hospitals unnecessarily and were discharged or transferred only after their insurance expired” (I. Schyve 1996, pp. 15–16).These abuses also sparked eloquent protests against threats to patient well-being and to the nature of the patient-provider relationship in the bioethics literature. The fiduciary responsibility of the provider to inform and to protect the patient was fragmented by insurer business practices such as gag clauses and economic credentialing of providers (VII. Scope Note 31, 1996). The background role that the institution plays, though poorly articulated historically, has been brought sharply into focus by the explosive growth of the managed practice of medicine. The context of medical ethics is no longer limited to the resolution of individual cases, but instead encompasses the adoption of institutional structures to protect and promote patient welfare (IV. Emanuel 1995, p. 335). In this new configuration, the institution and the providers are co-fiduciaries for populations [End Page 189] of patients, and the medicine that is practiced is “appropriately economically disciplined.” The expression “My patient always comes first” is no longer “... intellectually serious or morally responsible.” But, “... to be sure, both conceptually and in practice, being an economically disciplined fiduciary professional or institution is ethically unstable.... The task is to identify the boundaries outside of which institutional policy and behavior will not count as an ethically defensible form of being... [a] fiduciary.” (IV. McCullough 1997, pp. 143–44). This process of delimiting and enforcing boundaries requires the development of “... a language for talking about the ethical values of the organization. If such a language does not exist, discussions about ethics become cumbersome and unlikely to occur” (IV. Cleveland Clinic Foundation 1998, p. 2).As with bioethics generally, the literature addressing organizational ethics is multidisciplinary. JCAHO’s compliance guide for its revised standards, Ethical Issues and Patient Rights, draws on a wealth of ideas from both clinical ethics and business ethics. This is often an awkward alliance. “Because the study of organizational ethics is in its infancy compared to other areas of healthcare ethics, discussions about it often seem like hot air with no palpable payoff” (I. Boyle 1998, p. 2). The fact that “... there is an ancient history that reflects widespread doubt about the moral probity of business” (II. Frederick 1995, p. 209) does not help. To begin, “Aristotle had rude things to say about business” (II. Jackson 1998, p. 401). A brief review of introductions to several of the business ethics textbooks cited in this bibliography reveals that a rebuttal of “business ethics as an oxymoron” is the standard opening paragraph. This stigma is unfounded, and “increased stability” has characterized the state of business ethics literature during the 1990s (II. Beauchamp and Bowie 1997, p. ix). Significant attention has been given to elaborating two often overlapping theories—stakeholder and social contractarian.Originating in the 1960s as a pun on “stockholder,” proponents of stakeholder theory claim that a corporation’s fiduciary responsibility extends beyond increasing its profitability to protecting the rights of individuals or groups affected by its actions. Popular as a strategic planning tool in the... (shrink)

Working in the weakening of constructive Zermelo-Fraenkel set theory in which the subset collection scheme is omitted, we show that the binary refinement principle implies all the instances of the exponentiation axiom in which the basis is a discrete set. In particular binary refinement implies that the class of detachable subsets of a set form a set. Binary refinement was originally extracted from the fullness axiom, an equivalent of subset collection, as a principle that was sufficient to prove that the (...) Dedekind reals form a set. Here we show that the Cauchy reals also form a set. More generally, binary refinement ensures that one remains in the realm of sets when one starts from discrete sets and one applies the operations of exponentiation and binary product a finite number of times. (shrink)

This chapter contains sections titled: Lafayette's American Plants English Agrarian Influences Transforming La Grange Planting Politics at La Grange Notes.

The scholarly turn toward visual culture has left in place the sensory hierarchy that subtends Western philosophy. Yet given the commodification of sense experience, an inversion of the sensory hierarchy with the proximal senses of touch, taste, and smell at the top is not necessarily any more conducive to knowledge or justice. I argue that proximal sense experience may be a vehicle of knowledge, beauty and even ethics. Operating at a membrane between the sensible and the thinkable, the proximal senses (...) have an affective dimension that permits an immanent epistemology. My examples and olfactory ‘illustrations’ emphasize the sense of smell, which, I posit, given its intimacy with emotion and memory, gives rise to an ‘olfactory unconscious’. (shrink)

We surveyed IRB chairs' perspectives on offering individual genetic research results to participants and families, including family members of deceased participants, and the IRB's role in addressing these issues. Given a particular hypothetical scenario, respondents favored offering results to participants but not family members, giving choices at the time of initial consent, and honoring elicited choices. They felt IRBs should have authority regarding the process issues, but a more limited role in medical and scientific issues.

This article proposes an analysis of the use of emotions, in particular the shame, characterizing the elenctic method performed by Socrates in the dialogue with Callicles in the third part of Plato’s Gorgias. The elenchus aims at improving the interlocutor through a process of purification that is capable of changing his whole existence. However, Plato’s dialogues only rarely give testimony of a successful transformation occurring in the interlocutor. This is due to the interlocutor’s attitude towards shame : the feeling of (...) shame can be accepted as a mean for self-transformation or hidden to protect a social status. The article will explore the way in which this fundamental difference is delineated within the dialogue by providing appropriate textual examples. Arguably, by outlining the distinction between the types of shame, it is possible to notice how the purification of the interlocutor implies a turning point for the public. This is what I call „outreach elenchus”, a specific hermeneutic figure that allows to understand a form of purification of the audience and the spectators witnessing the debate. This type of elenchus steps in at the very moment in which the Socratic interlocutor attempts to protect his social image, concealing his shame. The audience, thanks to Plato’s literary strategy, realizes the failures of the interlocutor even as he refuses to accept them. As a result, his social image becomes tarnished. (shrink)

Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research has found that Mental Health Literacy (MHL)—the knowledge and positive beliefs about mental disorders—tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our study was fourfold: (a) (...) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs. (shrink)

The Author presents the theoretical framework of this «Governare lapaura»’ issue on the Fear of Secession. Starting from the recent cases of the Brexit and the Catalonian referendum, the main goal of this issue is reflecting on the relationship between the political crisis of unitary State and the revival of secession.

Comparative philosophy is gaining traction in professional academic philosophy, with specialist journals, organizations, books, and public campaigns. These inroads have been made in canonical areas of philosophy, including epistemology, metaphysics, logic, and value theory. Yet comparative philosophy still plays little role in practical applied ethics, an interdisciplinary research area in which work with practice and policy implications are dominated by the anglophone world. In this article, I explain why comparative work might be especially difficult in this type of applied ethics, (...) and I suggest how comparative philosophers might overcome these challenges to connect their theoretical work with contemporary practical issues. (shrink)

La ciudad de Antigua, en Guatemala, ha sido y continúa siendo evocada a través de la palabra diluida en la historia y la memoria. Prueba de ello es el libro Poesía-documento, titulado Antigua Luna (2017), de la escritora costarricense Magda Zavala, publicado en 2017 por la editorial Letra Maya, dentro de la Colección Kayab, en Costa Rica. Este poemario, dividido en tres secciones; I. Capital de los Confines, II. Espacios y voces y III. La visitante, recoge entre sus versos los (...) resabios coloniales de un pasado épico, que convive con un presente transnacional y postmoderno. Ahí es donde los cimientos indígenas sostienen identidades en permanente reconstrucción, aprendida a través de cinco siglos de sobrevivencia en la desigualdad. (shrink)

In the „Cena Trimalchionis“ Encolpius is continually faced with Trimalchio’s oddities (res novae, sat. 27, 2). The paper aims to highlight the occurrence of a ‚scheme of the res novae‘, a narrative pattern that repeats itself during the „Cena“ and in which the only variation is constituted by Encolpius’ reactions to Trimalchio’s jokes: while the host is never tired of testing his guests’ intelligence with (mostly gastronomic) enigmas, Encolpius moves from amazement to skepticism to the desire of competing with Trimalchio (...) in foreseeing his plans. Encolpius’ suppositions mainly link Trimalchio’s stratagems to the world of the theatre and of the Saturnalia: following his footsteps modern critics often used the same references to explain Trimalchio’s eccentric ideas. The present essay will show that the point of view of the narrator, Encolpius, is not to be confused with the strategy of Trimalchio, who takes over the imaginary of the theatre and of the Saturnalia only to overthrow them in search of a totally new and ‚not foreseeable‘ transgression. (shrink)

The paper is based on and the educational program “Jóvenes y Memoria-Córdoba”, carried out in the “Espacio para la Defensa y la Promoción de los Derechos Humanos Campo de la Ribera”. It aims to analyze the way in which this program introduces young people to philosophical interrogation, especially through a pedagogical work with testimonies.

Empirical evidence suggests a broad impact of communication mode on cognition at large, beyond language processing. Using a sign language since infancy might shape the representation of words and other linguistic stimuli – for example, incorporating in it the movements and signs used to express them. Once integrated into linguistic representations, this visuo-motor content can affect deaf signers’ linguistic and cognitive processing.

Comments on Arendt's views on the link between politics and history, referring to her work on antisemitism and on the "Jewish question" (pp. 44-51). Defines Arendt's historiographical method as non-temporal - she focuses on individualized experiences which express a historical conflict; she prefers biographies, portraits, and chronicles. Arendt's non-temporal approach is expressed in the assertion that the tragedy of the Jews in Europe was rooted in the paradox that the political powers granted them rights and privileges, but excluded them, in (...) differing degrees, from political participation. This fact made the Jews a strange implant in European society. Pp. 84-92 present Arendt's definition of evil, based on her experience in the Eichmann trial. While the Christian philosophical tradition defines evil as a deficiency in character, Arendt considered it to be a banal component of the human personality. The deeds of the Nazis were, consequently, the result of Philistinism and lack of moral judgment. (shrink)