BackgroundThe evaluation of pain remains one of the most difficult challenges that healthcare practitioners face. Chronic pain appears to affect more than 35% of the population in the West, and indeed, pain is the most common reason patients seek medical care. Despite its ubiquity, studies in the last decades reveal that many patients feel their pain is dismissed by healthcare practitioners and that, as a result, they are denied proper medical care. Buchman, Ho, and Goldberg (J Bioethic Inq 14:31-42, 2017) (...) point to this phenomenon as a form of “epistemic injustice”: an unfair and harmful downgrading of credibility affecting some individuals and groups, which prevents them from receiving appropriate and beneficial medical care.MethodsBy exploring the existing literature on this downgrading of patients’ credibility written by healthcare professionals and scholars in medical humanities, I identify and examine the reasons patients are often not believed about their pain and why healthcare is too-often unhelpful or hurtful to people presenting with chronic pain. I also explore to what extent it is possible to forge an alternative epistemological model.ResultsI suggest that most of the causes of this downgrading of patient’s credibility result from either the difficulty in communicating pain or the widespread belief that pathology is always the result of objective tissue damage. I examine whether pain has to be effectively communicated and have an objective cause in order for it to be deemed credible. In the end, I argue that in the case of pain, both communication and objectivity are highly problematic.ConclusionsI conclude by suggesting that, although alternative epistemological models might be impossible to build, believing patients has both moral and clinical benefits, and this warrants further research. (shrink)

ABSTRACTIn the last decades, narrative theory has collaborated with sociology and anthropology of health to account for the importance that illness narratives hold for those who are or have been si...

In this paper we claim educational leadership as an autonomous discipline whose goals and strategies should not mirror those typical of business and political leadership. In order to define the aims proper to educational leadership we question three common assumptions of what it is supposed to carry out. First, we turn to Hannah Arendt and her contemporary critics to maintain that education aims at opening up exceptions within the normal course of events rather than simply preserving it. This way, education (...) is not reduced to an instrument at the service of the reinforcement of a given social and economic system. This leads us to ask what should exactly educational leadership oppose by means of these exceptions. According to Tyson E. Lewis’s wise application to education of Giorgio Agamben’s ontology of impotentiality, the apparently reasonable idea that education must help the subject to develop his potentials is precisely an instrumentalization of education which brings about a desubjectification of the learner. Education should actually make the pupil aware of his right not to carry his potentiality to its actualization and dwell instead in a state of impotentiality. Third and last, we complicate this picture by alluding to Zygmunt Bauman’s critique of the rejection of Western individuals to realize certain possibilities, which they deem too costly. By analysing in conjunction Agamben’s encouragement to suspend one’s potential and Bauman’s insistence on the need of not suspending it, we conclude by defining what, in our opinion, defines the raison d’être of educational leadership. (shrink)

At the outbreak of the Covid-19 pandemic, several countries declared “states of exception,” that is, authorized legal devices that, in the face of circumstances deemed catastrophic, permit the implementation of extraordinary measures and the temporary suspension of some rights in order to restore the previous state of affairs as soon as possible. This paper offers a comparative textual analysis of the different states of exception declared in the USA, France, and Spain. I argue that these texts constitute a privileged site (...) to explore how prevalent global political logics and mainstream discourses on illness are interwoven. Regarding the global political logics in play, I hold that these declarations constitute an instantiation of democracy’s autoimmune character; it attacks itself in order to protect itself. Regarding mainstream discourses on illness, I explore how illness is regarded as a threat to one’s self (by something seemingly other) and the notion that therapy must consist of securing the self’s triumph over anything seemingly other. This twofold analysis reveals that an aporetic dialectic between self and other—as regards politics and illness—operates in these declarations, most likely because it is, in fact, one and the same dialectic, upon which Western epistemology rests. Furthermore, I suggest that these texts reflect and promote these dominant logics, contributing to shape human relationships around the globe in a certain dangerous way. (shrink)

Roberto Esposito (1998; 2002; 2008) examines how immunological apparatuses originally designed to protect communities end up undermining communities. This paper explores comparatively his view on the interplay between community and immunity with Giorgio Agamben’s and Jacques Derrida’s, although in their works these notions appear under other labels. Beyond pointing out their similarities, the paper concludes by analyzing what, in our view, constitute the raison d’être of their ultimate and irreconcilable differences: Agamben’s approach is _antinomic_, while Derrida’s is _aporetic_ and Esposito’s (...) is rather _dialectical_. (shrink)

The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of (...) patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form. (shrink)

En la poesía de Ramón López Velarde es fundamental la presencia del corazón y del alma. Ambos conceptos no son simples y únicos, sino complejos y diversos. Hay un corazón confesional e íntimo, llamado “Corazón de San Agustín”; un corazón como órgano del cuerpo, conocido como “Corazón de Harvey”; y un corazón simbólico, el cual recibe el nombre de “Corazón de León”. En correspondencia con estos elementos, hay un alma individual, perteneciente al sujeto lírico; un Anima mundi, relativa a la (...) belleza del mundo; y un Alma Superior, la cual remite al mundo de las ideas platónicas o arquetípicas. Con base en un enfoque propio de la Mitocrítica, se demuestra la importancia de la presencia del símbolo, del mito y del arquetipo en la poesía de López Velarde. Palabras clave: corazón, alma, mitocrítica, poesía, López Velarde. (shrink)

Altruism is a central concept in evolutionary biology. Evolutionary biologists still disagree about its meaning (E.O. Wilson 2005; Fletcher et al. 2006; D.S. Wilson 2008; Foster et al. 2006a, b; West et al. 2007a, 2008). Semantic disagreement appears to be quite robust and not easily overcome by attempts at clarification, suggesting that substantive conceptual issues lurk in the background. Briefly, group selection theorists define altruism as any trait that makes altruists losers to selfish traits within groups, and makes groups of (...) altruists fitter than groups of non-altruists. Inclusive fitness theorists reject a definition based on within- and between-group fitness. Traits are altruistic only if they cause a direct and absolute fitness loss to the donor. The latter definition is more restrictive and rejects as cases of altruism behaviors that are accepted by the former. Fletcher and Doebeli (2009) recently proposed a simple, direct and individually based fitness approach, which they claim returns to first principles: carriers of the genotype of interest “must, on average, end up with more net direct fitness benefits than average population members.” This seductively simple proposal uses the concept of assortment to explain how diverse kinds of altruists end up on average with more net fitness than their non-altruistic rivals. In this paper I shall argue that their approach implies a new concept of altruism that contrasts with and improves on the concept of the inclusive fitness approach. (shrink)

Recent developments in evolutionary game theory argue the superiority of punishment over reciprocity as accounts of large-scale human cooperation. I introduce a distinction between a behavioral and a psychological perspective on reciprocity and punishment to question this view. I examine a narrow and a wide version of a psychological mechanism for reciprocity and conclude that a narrow version is clearly distinguishable from punishment, but inadequate for humans; whereas a wide version is applicable to humans but indistinguishable from punishment. The mechanism (...) for reciprocity in humans emerges as a meta-norm that governs both retaliation and punishment. I make predictions open to empirical investigation to confirm or disconfirm this view. (shrink)

Introducción al dossier: Memorias desde las disidencias sexo-genéricas. Preguntas incómodas para desmontar el cisexismo heterosexual.

From its origins, the philosophy of liberation has had both a critical and a creative aspect. The first seeks to critically examine domination, dependency, and the permanent effects of colonization. The second aims to create and re-create the liberation of peoples, developing and reconstituting ways of existing, imagining, thinking, and philosophizing that surpass colonial ways of existing, imagining, thinking, and philosophizing. Thus, for the philosophy of liberation, the liberation of peoples is distinguished from the notions of emancipation and freedom that (...) hide reality under processes of ideologization. An example of the latter is modernity’s notion of emancipation. In this paper, I propose to approach the critical and creative function of the philosophy of liberation from a childist lens in which not only the voices of children are considered, but also the adultist and modern vision of emancipation is overcome. This will be particularly important to continue the legacy of the philosophy of liberation, and its mission to criticize and create from the political and philosophical participation of the victims in the processes of ideologization. From this legacy the children are participants, who, by engaging in pedagogical practices of liberation, act as un pueblo, a collective political actor without age. of the latter is modernity’s notion of emancipation. In this paper, I propose to approach the critical and creative function of the philosophy of liberation from a childist lens in which not only the voices of children are considered, but also the adultist and modern vision of emancipation is overcome. This will be particularly important to continue the legacy of the philosophy of liberation, and its mission to criticize and create from the political and philosophical participation of the victims of the processes of ideologization. Of this legacy, the children are participants, who, by engaging in pedagogical practices of liberation, act as un pueblo, a collective political actor without age. (shrink)

Since at least Hume and Kant, philosophers working on the nature of aesthetic judgment have generally agreed that common sense does not treat aesthetic judgments in the same way as typical expressions of subjective preferences—rather, it endows them with intersubjective validity, the property of being right or wrong regardless of disagreement. Moreover, this apparent intersubjective validity has been taken to constitute one of the main explananda for philosophical accounts of aesthetic judgment. But is it really the case that most people (...) spontaneously treat aesthetic judgments as having intersubjective validity? In this paper, we report the results of a cross‐cultural study with over 2,000 respondents spanning 19 countries. Despite significant geographical variations, these results suggest that most people do not treat their own aesthetic judgments as having intersubjective validity. We conclude by discussing the implications of our findings for theories of aesthetic judgment and the purpose of aesthetics in general. (shrink)

The free-energy principle (FEP) builds on an assumption that sensor–motor loops exhibit Markov blankets in stationary state. We argue that there is rarely reason to assume a system's internal and external states are conditionally independent given the sensorimotor states, and often reason to assume otherwise. However, under mild assumptions internal and external states are conditionally independent given the sensorimotor history.

Presentamos 2 casos de docentes de matemáticas activos, mientras estudian una Maestría en Matemática Educativa en línea y asincrónica; y las complicaciones que vivieron con el cierre de las escuelas donde imparten clases debido a la pandemia del COVID-19. El cambio de clases presenciales a clases en línea les exigió aprender nuevas herramientas y desarrollar nuevas habilidades, obligándolos a pasar más tiempo preparando sus clases y menos tiempo en sus estudios de maestría. El resultado fue que, en lugar de graduarse (...) en 4 semestres, los estudiantes tardaron 6 semestres en completar su investigación y escribir su tesis. (shrink)

El desarrollo local desde principios de los años noventa se encuentra influenciado por una corriente sociológica que propone el replanteamiento teórico de lo que la teoría ha llamado el sector rural. La Nueva Ruralidad en su perspectiva latinoamericana ubica aspectos de cambio fundamental en el territorio rural: encadenamientos urbano-rurales, el empleo rural no agrícola, la provisión de servicios ambientales, las certificaciones agroambientales o “sellos verdes”, los pueblos como centros de servicios, el papel activo de las comunidades y organizaciones sociales, y (...) la diversidad ecológica-cultural como patrimonio (Rojas, 2008). El objetivo de este documento es mostrar que existe un debate al interior de esta corriente que ha derivado en dos modelos de desarrollo regional sustentable contrapuestos, el enfoque basado en la participación del mercado y el que aboga por la autonomía, la autogestión y la autodirección del progreso de las comunidades rurales. (shrink)

Morele perceptie is het vermogen om de bijzonderheid van een morele ontmoeting en de implicaties daarvan voor te stellen en te interpreteren. Met behulp van de ecologische benadering van perceptie die is ontwikkeld door de psychologen James Gibson en Ulric Neisser wordt in dit artikel beargumenteerd dat de ervaring van dansers een ecologisch model biedt om morele situaties en de handelingsopties daarin waar te nemen en te verbeelden. Dit model biedt een visie op morele actoren als zelfbewuste, belichaamde actoren die (...) hun handelingen als onderdeel van sociale praktijken waarnemen. Ook kan dit ecologische begrip van het zelf dat door dans tot leven wordt gewekt helpen om het vermogen tot morele waarneming en verbeelding verder te ontwikkelen. (shrink)

Este artículo pretende contemplar la obra de Malebranche y poder determinar lo que la caracteriza: el pensar de carácter matemático hace posible los diversos saberes tales como moral, metafísica y teología. El conocimiento de las relaciones de perfección son a la par verdades y leyes inmutables de todos los momentos del espíritu. De la contemplación de los atributos divinos, poder, sabiduría y amor de Dios, Malebranche desprende nuestros deberes respecto a Dios, el prójimo y nosotros mismos.

As far as the judicial system is concerned, the legal actions that can be brought before the Union courts, the Court of Justice, the General Court, and specialized courts, do not provide for a comprehensive system of procedural remedies. The main procedural remedy to address this problem is the preliminary ruling procedure, which enables all national courts, and obliges some of them, to suspend the main proceedings before it and refer questions concerning the interpretation and validity of Union law to (...) the Court of Justice for a binding ruling. According to Article 267(1) Treaty on the Functioning of the European Union (TFEU), the Court of Justice have jurisdiction to give preliminary rulings concerning: the interpretation of the treaties and the validity and interpretation of acts of the institutions, bodies, offices, or agencies of the Union. A decision of the Court of Justice is given in the form of a judgment. (shrink)

Neste artigo, discutiremos os limites do modelo de estabilização empregado nas operações da Organização das Nações Unidas para construção da paz de longo prazo. Nosso argumento é que a estratégia política da estabilização, por ser baseada no uso robusto da força para combater grupos armados e apoiar governos no restabelecimento da autoridade estatal, acaba perdendo de vista os esforços de resolução dos conflitos, o que, no limite, contribui para o prolongamento da violência. Metodologicamente, o artigo se baseia no estudo do (...) caso do combate ao grupo armado M23 pela MONUSCO na RDC, por meio da análise de dados e documentos que nos permitam avaliar dois aspectos principais: (i) os níveis de violência armada; e (ii) a condução de um processo político de resolução do conflito. (shrink)

The study of corporate social responsibility has been the object of much research in recent decades, although there is a need to continue investigating its benefits as a marketing tool. In the current work we adopt a multi-dimensional perspective of social responsibility, and we carry out market research to determine the perceptions of users of mobile telephone services about economic, legal, ethical and social aspects of their operating companies. With these data we determine the structure and components of the concept (...) of social responsibility. Subsequently, this is related with the overall evaluation of the service and loyalty by means of a model of structural equations, in order to determine the influence of corporate social responsibility on these concepts, and hence its benefits as a commercial tool. (shrink)

La pandemia COVID-19 ha planteado retos, donde las TIC se ha convertido en una necesidad básica para la humanidad, en este contexto se cuestionó las capacidades de los docentes para hacer frente a los cambios. Tiene una metodología mixta pre- experimental, participaron 49 docentes y se aplicó cuestionario, rubrica y Pre Test/Post Test, con valores 0.890; 0.91, 0.97 de Cronbach. Los hallazgos demostraron que las dimensiones, comunicación, creación de contenidos, resultaron muy altas, mientras que la dimensión seguridad y solución de (...) problemas resultaron ser buenas. La investigación obtuvo resultados significativos para el desarrollo de las competencias digitales de los docentes de Piura. (shrink)

Outside Western, predominantly secular‐liberal environments, norms restricting bodily and sexual conduct are widespread. Moralization in the so‐called purity domain has been treated as evidence that some putative violations are victimless. However, respondents themselves disagree: They often report that private yet indecent acts incur self‐harm, or harm to one's family and the wider community—a result which we replicate in Study 1. We then distinguish two cognitive processes that could generate a link between harmfulness and immorality, and recreate them in Studies 2 (...) and 3: Colombian and British participants were randomly assigned to either reflect (decide whether acts are harmful and reconsider their initial moral judgments) or rationalize (decide whether acts are immoral and reconsider their initial harmfulness beliefs). In both countries, reflection promoted opposition to unjust, but not impure, behavior. Additionally, in both countries, ruminating on the moral status of impure acts elevated beliefs in the acts' harmfulness. We conclude by suggesting that rationalization aggravates, while reflection mitigates, intergroup disagreement regarding putative violations of purity and decency. (shrink)

This essay present shortly the differential character of the concepts of knowledge, epistemology and paradigm has in the development of the degree work or thesis. It begins with the discussion of these concepts, and then establishes the relation between those and the degree work.