An adolescent’s last moment of life is an emotionally and medically complex time. Children may grapple with understanding the things happening to them and with grief of a future lost; caregivers struggle to simultaneously balance deep sorrow, hope, and love; and healthcare providers fight to maintain sound medical and ethical decision making. Increased discussion regarding adolescent end-of-life care is needed so that clinicians may better understand how to engage in ethically based medical management during these events. This holds particularly true (...) in situations where potentially conflicting ideas exist between clinicians and family members. We describe the case of an acutely and terminally ill adolescent who remained cognitively intact but with rapidly advancing multiple organ failure and whose parents requested that he remain uninformed of his critical illness and prognosis. (shrink)

Background: While the solid organ transplant evaluation process is designed to function equitably, discriminatory practices remain, resulting in disparities in access for persons with disabilities. Physical function and frailty status are often-cited factors in establishing transplant, despite limited consensus on their assessment and impact. Objective: The purpose of this study was to describe how transplant healthcare professionals conceptualize the relationship between physical disability and transplant candidacy. Methods: A convenience sample of multidisciplinary transplant was solicited to respond to an electronic survey (...) between February and March 2024. Results: Of the 126 professionals contacted, 43 participants responded, yielding a response rate of 34 %. The majority of participants (88 %) held contradictory views of physical disability as it relates to transplant candidacy (p = 0.049). Men were more likely to endorse awareness of bias when evaluating transplant candidates (p = 0.008). Professional discipline was significantly associated with perception of transplant process fairness, impact of bias, and interpretation of quality of life. Iterative thematic analysis revealed a propensity to conflate frailty with physical disability. Conclusions: Multidisciplinary transplant professionals rarely endorsed overtly ableist sentiments. However, responses highlighted inconsistent, unclear, and at times contradictory conceptions of physical function and physical disability, which may contribute to disparate access to solid organ transplant for individuals with physical disability. (shrink)

The current study assessed potential relationships among childhood wayfinding experience, navigational style, and adult wayfinding anxiety in the Faroe Islands. The Faroe Islands are of interest because they have an unusual geography that may promote the use of an orientational style of navigation (e.g., use of cardinal directions). Faroese adults completed questionnaires assessing (1) their permitted childhood range sizes, (2) the types of navigational strategies they use, and (3) the amount of anxiety they experience when navigating in adulthood. Males had (...) more childhood wayfinding experience, used the orientation strategy at a higher rate, and showed lower levels of wayfinding anxiety. When compared with other cultures, both Faroese women and men appear to embrace orientation strategies at an unusually high rate. Childhood experience was not conclusively linked to later wayfinding anxiety. However, the current findings raise the possibility that children who have particularly small ranges in childhood may be especially anxious when navigating in adulthood. (shrink)

Media coverage of influencer marketing abounds with ethical questions about this emerging industry. Much of this coverage assumes influencers operate without an ethical framework and many social me...

This essay develops a renewed conception of autonomy through an explication of Judith Butler’s critique of liberal individualism in The Force of Nonviolence. I argue that while rejecting liberal individualism requires abandoning the fantasies of mastery and self-sufficiency, such a rejection need not imply a renunciation of autonomy. Instead, an ethics of nonviolence that is committed to equality demands a relational understanding of autonomy that affirms our radical interdependency. I contend, moreover, that for an account of the self to acknowledge (...) this interdependency, the body must be conceived as a threshold rather than an end. Put differently, to be a relational self means to be give over to others from the start. My argument proceeds in three steps. First, I explore Butler’s critical analysis of liberal political thought, while emphasizing the key role that the state-of-nature fantasy plays in the Western social and political imaginary. Next, I show how dependency, interdependency, and vulnerability are closely related but also distinct. Specifically, I argue that a relational understanding of autonomy is consistent with Butler’s emphasis on our interdependency and the social obligations that bind us to one another. Finally, I show how the social model of disability lends further support to a relational understanding of autonomy. Drawing on Butler’s brief discussion of instruments for support in The Force of Nonviolence, I propose that we think more closely about the everyday ways in which we are sustained by various modes of support. The fact that we never stop relying on this support, even when we disavow it, suggests that autonomy is not a given but rather an achievement. (shrink)

Spatial experience in childhood is a factor in the development of spatial abilities. In this study, we assessed whether American and Faroese participants’ (N = 246, Mage = 19.31 years, 151 females) early spatial experience and adult spatial outcomes differed by gender and culture, and if early experience was related to adult performance and behavior. Participants completed retrospective reports on their childhood spatial experience, both large-scale (permitted childhood range size) and small-scale (Lego play). They also completed assessments of their current (...) large-scale spatial behavior (navigational strategy) and small-scale ability (mental rotation task, MRT). We replicated earlier results showing better MRT performance among males and more reliance by males on orientation navigational strategies, although males and females reported similar ranges as children. However, there were cross-cultural differences, with Faroese having larger childhood ranges, less reliance on route strategies, better MRT scores, and a smaller gender difference in MRT. Larger permitted childhood ranges were associated with reduced use of route strategies for navigation in adulthood, and greater Lego play in childhood predicted better MRT performance as adults. There was also some evidence supporting relationships across spatial scales, with more Lego play predicting an orientation style of navigation and larger childhood ranges predicting better performance on the MRT, although the latter was not independent of country. In sum, we observed an association in both cultures between large-scale childhood experience and large-scale behavior in adulthood, small-scale experience in childhood and adult small-scale performance, and some associations between experience and behavior across spatial scales. (shrink)

It is widely held that intuitive dualism—an implicit default mode of thought that takes minds to be separable from bodies and capable of independent existence—is a human universal. Among the findings taken to support universal intuitive dualism is a pattern of evidence in which “psychological” traits (knowledge, desires) are judged more likely to continue after death than bodily or “biological” traits (perceptual, physiological, and bodily states). Here, we present cross-cultural evidence from six study populations, including non-Western societies with diverse belief (...) systems, that shows that while this pattern exists, the overall pattern of responses nonetheless does not support intuitive dualism in afterlife beliefs. Most responses of most participants across all cultures tested were not dualist. While our sample is in no way intended to capture the full range of human societies and afterlife beliefs, it captures a far broader range of cultures than in any prior study, and thus puts the case for afterlife beliefs as evidence for universal intuitive dualism to a strong test. Based on these findings, we suggest that while dualist thinking is a possible mode of thought enabled by evolved human psychology, such thinking does not constitute a default mode of thought. Rather, our data support what we will call intuitive materialism—the view that the underlying intuitive systems for reasoning about minds and death produce as a default judgment that mental states cease to exist with bodily death. (shrink)

The Research Topic “On poverty and its eradication” was inspired by the International Day for the Eradication of Poverty, first commemorated in Paris in 1987 and formally designated by the United Nations. This day is dedicated to renewing the commitment to universal human development, enabling all individuals to achieve their highest potential, and reflecting on how poverty hinders this progress. The urgency of addressing poverty has increased after the COVID-19 pandemic, which exacerbated existing issues and highlighted the critical need for (...) effective poverty eradication strategies. The studies included in this Research Topic aim to expand knowledge about poverty, its causes, consequences, and connections to crises, inequality, and fairness, and to assess policy measures for poverty reduction. The included contributions use various theoretical, empirical, quantitative, and qualitative approaches to drive sociological and policy-related discussions and initiatives, promoting fair and inclusive societies. (shrink)

The COVID‐19 pandemic has placed extraordinary stress on frontline healthcare providers as they encounter significant challenges and risks while caring for patients at the bedside. This study used qualitative research methods to explore nurses and respiratory therapists' experiences providing direct care to COVID‐19 patients during the first surge of the pandemic at a large academic medical center in the Northeastern United States. The purpose of this study was to explore their experiences as related to changes in staffing models and to (...) consider needs for additional support. Twenty semi‐structured interviews were conducted with sixteen nurses and four respiratory therapists via Zoom or by telephone. Interviews were transcribed verbatim, identifiers were removed, and data was coded and analyzed thematically. Five major themes characterize providers' experiences: a fear of the unknown, concerns about infection, perceived professional unpreparedness, isolation and alienation, and inescapable stress and distress. This manuscript analyzes the relationship between these themes and the concept of moral distress and finds that some, but not all, of the challenges that providers faced during this time align with previous definitions of the concept. This points to the possibility of broadening the conceptual parameters of moral distress to account for providers' experiences of treating patients with novel illnesses while encountering institutional and clinical challenges. (shrink)

Today the world observes the International Day for the Eradication of Poverty, first commemorated in Paris in 1987 and subsequently receiving official designation by the United Nations. It is a day for renewing commitment to the human project – to enable universal human development, making it possible for all humans to achieve their highest potential – and to reflect on poverty, how it thwarts human development, and how it might disappear. The challenge is not new, but it achieves new urgency (...) as we start to emerge from the COVID-19 pandemic and realize that the damage it caused, to well-being and human development, was deeply intensified by poverty. This volume aims for accelerated growth of knowledge about poverty, its causes and consequences, its links to crises and disasters, its connections to inequality and fairness, the direction and speed of its trajectory in different contexts, and strategies for reducing it and their assessment. (shrink)

Margaret Gilbert explores the phenomenon referredto in everyday ascriptions ofbeliefs to groups. She refers to this type ofphenomenon as ``collective belief'' andcalls the types of groups that are the bearersof such beliefs ``plural subjects''. Iargue that the attitudes that groups adoptthat Gilbert refers to as ``collectivebeliefs'' are not a species of belief in animportant and central sense, but rathera species of acceptance. Unlike proper beliefs,a collective belief is adopted bya group as a means to realizing the group'sgoals. Unless we recognize (...) that thisphenomenon is a species of acceptance, pluralsubjects will seem prone to changetheir ``beliefs'' for irrelevant reasons, andthus frequently appear to act in anirrational manner. (shrink)

Although there is universal consensus both in the science education literature and in the science standards documents to the effect that students should learn not only the content of science but also its nature, there is little agreement about what that nature is. This led many science educators to adopt what is sometimes called “the consensus view” about the nature of science (NOS), whose goal is to teach students only those characteristics of science on which there is wide consensus. This (...) is an attractive view, but it has some shortcomings and weaknesses. In this article we present and defend an alternative approach based on the notion of family resemblance. We argue that the family resemblance approach is superior to the consensus view in several ways, which we discuss in some detail. (shrink)

Mental health research and care in the twenty first century faces a series of conceptual and ethical challenges arising from unprecedented advances in the neurosciences, combined with radical cultural and organisational change. The Oxford Textbook of Philosophy of Psychiatry is aimed at all those responding to these challenges, from professionals in health and social care, managers, lawyers and policy makers; service users, informal carers and others in the voluntary sector; through to philosophers, neuroscientists and clinical researchers. Organised around a series (...) of case studies in five key topic areas - concepts of disorder, the philosophical history of psychopathology, philosophy of science, ethics and philosophical value theory, and philosophy of mind - the book provides a detailed introduction to the field and a framework for study and skill development. Each case study is supported by selected readings from both philosophy and mental health, thinking skills exercises, self-test questions, key learning points and detailed guides to further reading. There is an introduction for philosophers to classification and descriptive psychopathology, and for practitioners to philosophical methods (including logic). The philosophical topics covered include philosophical methods (analytic and Continental); phenomenology, hermeneutics and existentialism, logical empiricism and its successors; idealism and realism; reasons and causes; and modern theories of mind and brain, free will and personal identity. Topics from mental health include psychiatry and 'anti-psychiatry'; Jaspers' psychopathology and the new neurosciences; the future of psychiatric classifications; strengths-based approaches, recovery practice, social inclusion and diversity; and key topics in psychopathology, such as delusion, autism, disorders of volition, thought insertion and other experiences in schizophrenia. The Oxford Textbook of Philosophy of Psychiatry aims to secure the skills-base of the discipline by bringing philosophers closer to the realities of practice in mental health, and mental health practitioners closer to the resources of philosophy as a partner to the sciences in responding to the challenges of twenty-first century mental health and social care. (shrink)

E.J. Lowe claims that quantum physics provides examples of ontic indeterminacy, of vagueness in the world. Any such claim must confront the Evans-Salmon argument to the effect that the notion of ontic indeterminacy is simply incoherent (Evans 1978, Salmon 1981: 243-46). Lowe argues that a standard version of the Evans-Salmon argument fails quite generally (Lowe 1994). Harold Noonan (1995) has outlined a non-standard version of the argument, but Lowe argues that this non-standard version fails for specifically quantum mechanical reasons (Lowe (...) 1997). He claims that it is perfectly coherent to suppose that his quantum case is an example of ontic indeterminacy. In this paper, I raise some objections to Lowe's claim. (shrink)

Realists and anti-realists disagree about whether contemporary scientists are epistemically privileged. Because the issue of epistemic privilege figures in arguments in support of and against theoretical knowledge in science, it is worth examining whether or not there is any basis for assuming such privilege. I show that arguments that try to explain the success of science by appeal to some sort of epistemic privilege have, so far, failed. They have failed to give us reason to believe (i) that scientists are (...) prone to develop theories that are true, (ii) that our current theories are not apt to be replaced in the future, and (iii) that science is nearing its completion. (shrink)

The paper addresses the possibility of providing a meta-justification of what appears to be crucial epistemic desiderata involved in the method of reflective equilibrium. I argue that although the method of reflective equilibrium appears to be widely in use in moral theorising, the prospects of providing a meta-justification of crucial epistemic desiderata are rather bleak. Nor is the requirement that a meta-justification be provided obviously misguided. In addition, I briefly note some of the implications of these results for our use (...) of the method of reflective equilibrium and for the best interpretation of the method. (shrink)

Usually, modular construction involves the off-site manufacturing of standard building components in a factory before the components are assembled on the construction site. It is common to use terms like "prefabrication," "off-site construction," and "modular construction" interchangeably. The construction of modular constructions nowadays is flourishing all over the globe. The roots of the Albanian prefabricated constructions are extended for the first time around the 1970s. This paper will indeed analyze some recently built modular construction in Albania, considering and comparing it (...) with international case studies. The demand for new construction in Albania is rising rapidly. Currently, the most common structures are cast-in-place beam-column designs, driven by both traditional mindsets and industrial capabilities. However, with Albania's economic growth, there is an increasing need for affordable, quickly built, and technologically advanced buildings. Modular construction, which assembles prefabricated modules on-site, offers a solution. This method aligns with bioclimatic design principles, reducing environmental impact and optimizing resources, marking a shift toward sustainability in the construction industry. The purpose of this article is to explore the potential integration of “modular construction techniques” with “bioclimatic design concepts” to create buildings that are environmentally friendly, energy-efficient, and multipurpose by function. This study explores the use of modular construction techniques in conjunction with bioclimatic techniques to increase “building sustainability”. Combining these tactics encourages energy efficiency and a reduced environmental effect, making people far more resilient and weather-adaptable. The synergy between the two of them is necessary. (shrink)

This paper evaluates a recent method proposed by Jeremy Gwiazda for calculating the value of gambles that fail to have expected values in the standard sense. I show that Gwiazda’s method fails to give answers for many gambles that do have standardly defined expected values. However, a slight modification of his method (based on the mathematical notion of the ‘Cauchy principal value’ of an integral), is in fact a proper extension of both his method and the method of ‘weak expectations’. (...) I show that this method gives an appropriate value when the ‘tails’ of the gambles that are eliminated in the truncation are ‘stable’, but that the value is not appropriate when the tails are not stable. I do not attempt to give an argument for the use of this method, but just note that it is more general than Gwiazda’s method, and is mathematically quite natural. (shrink)

Unlike the principles of Kant, Mill, and Rawls, those of principlism are not action guides that stem from an underlying, integrated moral theory. Hence problems arise in reconciling the principles with each other and, indeed, in interpreting them as action guides at all, since they have no content in and of themselves. Another approach to "theory and method in bioethics" is presented as an alternative to principlism, though actually the "alternative" predates principlism by about 10 years. The alternative's account of (...) morality stays close to ordinary, common morality with its rules and ideals, which in turn are grounded in aspects of human nature. As such, morality must be understood to be a rational, impartial, and public system that is incumbent on everyone. Morality is a unified and integrated system. The moral rules and ideals are also "culture-" and "profession-sensitive" in that they are interpreted more specifically within these various contexts. (shrink)

The aim of this essay is to describe and reflect upon the concrete particulars of one academician's work as an expert ethics witness. The commentary on my practices and the narrative descriptions of three cases are offered as evidence for the thesis that it is possible to act honorably within a role that some have considered to be inherently illicit. Practical measures are described for avoiding some of the best known pitfalls. The discussion concludes with a listing of the distinctive (...) competencies and understandings that are useful in serving as an expert ethics witness. (shrink)

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined (...) for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy. (shrink)

This volume illustrates the central importance of diversity of human values throughout healthcare. The readings are organized around the main stages of the clinical encounter from the patient's perspective. They run from staying well and 'first contact' through to either recovery or to long-term illness, death and dying.

OBJECTIVES: To study the resources available and resources needed for ethics teaching to medical students in UK medical schools as required by the new GMC core curriculum. DESIGN: A structured questionnaire was piloted and then circulated to deans of medical schools. SETTING: All UK medical schools. RESULTS: Eighteen out of 28 schools completed the questionnaire, the remainder either indicating that their arrangements were "under review" (4) or not responding (6). Among those responding: 1) library resources, including video and information technology (...) were found to be fairly well developed; 2) many schools had a good supply of handouts and sample cases for teaching; 3) most had a written syllabus, and 4) two-thirds examined in the subject. However, many schools indicated that there was an urgent need for: 1) full-time teachers (most ethics teaching is still by part-time and voluntary staff); funding for books and journals, and 3) additional teaching materials (including further case vignettes, handouts and sample exam questions). CONCLUSIONS: There has been a considerable overall improvement in resources for medical ethics teaching since the time of the last national survey (The Pond Report). However, provision varies widely from medical school to medical school. The particular needs identified were for full-time teachers, library resources and teaching materials. Wider use of existing organisations concerned with medical ethics could help to meet these needs. (shrink)

Most of the economic models on basic income account just for pecuniary forms of work, i. e. “time spent making money”, in employment. This restriction is a drawback of these analyses and of the standard economic labor supply model itself. If one wants to understand the potential effects of basic income on individual and social welfare, one should not restrict observation to the pecuniary uses of time. The objective of this contribution is to rethink the meaning of work usually applied (...) in economic models, based on contributions of other social scientists. This reassessment is undertaken through the development of a microeconomic model, which discusses the effects of basic income on time use and interprets work not just as a source of income, but also of non-pecuniary benefits. Further, we disentangle the usual work-leisure dichotomy in two other ones. (shrink)

In the current climate of dramatic advances in the neurosciences, it has been widely assumed that the diagnosis of mental disorder is a matter exclusively for value-free science. Starting from a detailed case history, this paper describes how, to the contrary, values come into the diagnosis of mental disorders, directly through the criteria at the heart of psychiatry's most scientifically grounded classification, the American Psychiatric Association's DSM (Diagnostic and Statistical Manual). Various possible interpretations of the prominence of values in psychiatric (...) diagnosis are outlined. Drawing on work in the Oxford analytic tradition of philosophy, it is shown that, properly understood, the prominence of psychiatric diagnostic values reflects the necessary engagement of psychiatry with the diversity of individual human values. This interpretation opens up psychiatric diagnostic assessment to the resources of a new skills-based approach to working with complex and conflicting values (also derived from analytic philosophy) called 'values-based practice.' Developments in values-based practice in training, policy and research in mental health are briefly outlined. The paper concludes with an indication of how the integration of values-based with evidence-based approaches provides the basis for psychiatric practice in the twenty-first century that is both science-based and person-centred. (shrink)