Down syndrome (DS) impacts several brain regions including the hippocampus and surrounding structures that have responsibility for important aspects of navigation and wayfinding. Hence it is reasonable to expect that DS may result in a reduced ability to engage in these skills. Two experiments are reported that evaluated route-learning of youth with DS, youth with intellectual disability (ID) and not DS, and typically developing (TD) children matched on mental age (MA). In both experiments, participants learned routes with eight choice point (...) presented via computer. Several objects were placed along the route that could be used as landmarks. Participants navigated the route once with turn indicators pointing the way and then retraced the route without them. In Experiment 1 we found that the TD children and ID participants performed very similarly. They learned the route in the same number of attempts, committed the same number of errors while learning the route, and recalled approximately the same number of landmarks. The participants with DS performed significantly worse on both measures of navigation (attempts and errors) and also recalled significantly fewer landmarks. In Experiment 2, we attempted to reduce TD and ID vs DS differences by focusing participants’ attention on the landmarks. Half of the participants in each group were instructed to identify the landmarks as they passed them the first time. The participants with DS again committed more errors than the participants in the ID and TD groups in the navigation task. In addition, they recalled fewer landmarks. While landmark identification improved landmark memory for both groups, it did not have a significant impact on navigation. Participants with DS still performed more poorly than did the TD and ID participants. Of additional interest, we observed that the performance of persons with DS correlated with different ability measures than did the performance of the other groups. The results the two experiments point to a problem in navigation for persons with DS that exceeds expectations based solely on intellectual level. (shrink)

In this essay Megan J. Laverty argues that Jean-Jacques Rousseau's conception of humane communication and his proposal for teaching it have implications for our understanding of the role of listening in education. She develops this argument through a close reading of Rousseau's most substantial work on education, Emile: Or, On Education. Laverty elucidates Rousseau's philosophy of communication, beginning with his taxonomy of the three voices—articulate, melodic, and accentuated—illustrating the ways in which they both enhance and obfuscate understanding. Next, Laverty (...) provides an account of Rousseau's philosophical psychology, with specific reference to amour-propre and amour de soi. Listening plays a central role in Rousseau's philosophy of communication, Laverty maintains, because it is in the act of listening that humans fulfill, or fail to fulfill, the imperative that we seek to understand others. (shrink)

Zusammenfassung Genuss spielt in ethischen Annäherungen an die Pflege bisher noch keine bedeutende Rolle. Dabei zeigen philosophische und theologische Ansätze wie die von Emmanuel Lévinas, Ina Praetorius und Corine Pelluchon die grundlegende Bedeutung von Leiblichkeit, Genährtwerden und Genuss auf. Ebenso werden Momente des sinnlichen Genusses im Pflegealltag sowohl von Pflegekräften als auch von Gepflegten als sinnstiftend erlebt. Momente des Genusses können sich sowohl während der Pflege selbst ereignen als auch in Momenten, die über pflegerische Tätigkeiten im engeren Sinne hinausgehen. Genuss (...) steht dabei in Zusammenhang mit Wohlbefinden, Lebensqualität, Glück und Gesundheit. Auch wenn Genuss der Gesundheit zuträglich sein kann, liegt in Momenten des Genusses selbst ein Zweck, der sich der Funktionalisierung entzieht. Eine Ethik des Genusses, die theoretische Ansätze und die Erfahrungen aus dem Pflegealltag miteinander verbindet, kann die Wahrnehmung von Pflege und die theoretische wie empirische Erforschung von Pflege bereichern. Der vorliegende Beitrag bietet hierzu eine ethische Einordnung des Themas und einen thesenartigen Aufschlag zu einer Ethik des Genusses in der Pflege. (shrink)

Elizabeth Lanphier and Uchenna E. Anani provide a powerful argument for the value of a trauma-informed approach to the ethics consultation, which acknowledges the perspectives of all stakeho...

Ethics courses are most commonly evaluated using reaction measures. However, little is known about the specific types of reaction data being collected and how these reaction data relate to improvements in trainee performance. Using a sample of 381 ethics training sessions, major reaction data categories were identified. Content and course satisfaction were the most frequently collected types of reaction criteria. Furthermore, content relevance and course satisfaction showed strong, positive relationships with performance criteria, whereas content satisfaction demonstrated a moderate, negative relationship. (...) These results and future directions for ethics training evaluation are discussed. (shrink)

This book brings together an international collection of experts in reproductive ethics, law, disability studies, and medicine to explore the challenging future of reproduction and children. From the medical to the social and from the financial to the legal, the authors explore the expanding impact of reproductive genetics on our society. New advances in genetic technologies are revolutionizing the practice of reproductive medicine. We have expanded our ability to detect genetic changes in embryos and fetuses in ways that potentially allow (...) to identify, treat, or prevent a growing range of diseases. The development of gene-editing technologies raises questions about the possibility of removing disease-causing variants from embryos before pregnancy implantation. The growing sophistication of prenatal genomic sequencing offers us glimpses into the whole genome of the developing fetus. And, the increasingly sophisticated science of 'gene matching' allows us greater and greater foreknowledge of how the genomes of two individuals will combine in a future child. This is an indispensable book on the newest developments in bioethics caused by the sciences. Chapter 5 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com. (shrink)

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...) significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

To write about the disease of breast cancer from both scientific and spiritual perspectives is to reflect upon our genetic and spiritual ancestry. We examine the issues involved in breast cancer at the intersections of spirituality, technology, and science, using the fundamental thing we know about being human: our bodies. Our goal in this essay is to offer close readings of women's spiritual and bodily journeys through the disease of breast cancer. We have discovered that both illness and health come (...) within the stories of particular people and particular disciplines. And to learn more about breast cancer, both scientific and spiritual aspects, one must be attentive to such particularities. Medicine and religion are bodily experiences, and being a body-self is what it means to be human. (shrink)

Driving is central to adult independence and autonomy; yet most autistic young adults do not acquire driver’s licenses. It is important to understand barriers to achieving this milestone for autistic adults. Differences in negative affect and emotion dysregulation associated with autism may interfere with managing difficult driving situations. The current study compared perceived driving difficulty, emotion dysregulation, and negative affect in emerging drivers with and without autistic traits, and investigated how emotion dysregulation and negative affect relate to perceived DD. We (...) expected greater perceived DD, emotion dysregulation, and negative affect in participants with AT and a positive correlation of perceived DD with both emotion dysregulation and negative affect in the whole sample. Thirty-seven adolescents and young adults self-reported perceived DD in 15 scenarios and completed the Difficulty in Emotion Dysregulation Scale and the Depression, Anxiety, and Stress Scale. Autistic participants scored significantly higher on mean perceived DD, DERS Impulse subscale, DASS total and DASS Stress subscale scores. Perceived DD positively correlated with the DERS and DASS total scores, all DASS subscales, and DERS Nonacceptance, Goals, and Impulse subscales across the whole sample. The findings highlight the roles of emotion dysregulation and negative affect in perceived DD in emerging drivers with AT. In particular, emotional stress and impulsivity may map onto mechanisms of over-reactivity to negative affect and explain why autistic people perceive particular situations as difficult when driving. Implications and directions for future research are discussed. (shrink)

Abortion prohibitions in some states include carve-outs based on the medical condition of either the mother or the fetus. These carve-outs, however, may be couched in limiting language structured by legislators rather than in language understandable in the context of medical care. In circumstances where legislative bodies fail to adequately incorporate medical professionals in the drafting of medical laws, the resulting vagueness or ambiguity may lead to a lack of utility or viability. This paper considers the consequences of such legislative (...) misreading of medicine. It does so with a particular example, Utah’s abortion trigger law, 2020 Senate Bill 174 (S.B. 174). S.B. 174 was enacted in 2020 (currently enjoined pending the outcome of _Planned Parenthood Association of Utah v. State of Utah_) and includes an exception for serious fetal anomaly—in other words, disability. While Utah is not alone in its inclusion of a disability exception for abortion, S.B. 174 is unique in the language it uses to carve out this exception: the law requires that the fetus has a “uniformly diagnosable and uniformly lethal” defect. This article explores the medical-legal mismatch in S.B. 174 through an analysis of the statute’s legislative history and its language, an academic and legal database review, and an application of the statutory language to multiple serious genetic diagnoses. In doing so, this paper unpacks just how mismatched these terms are and reveals the massive gap the law will leave between the legal consequences and the medical realities of abortion. (shrink)

Reductionism is a central issue in the philosophy of biology. One common objection to reduction is that molecular explanation requires reference to higher-level properties, which I refer to as the context objection. I respond to this objection by arguing that a well-articulated notion of a mechanism and what I term mechanism extension enables one to accommodate the context-dependence of biological processes within a reductive explanation. The existence of emergent features in the context could be raised as an objection to the (...) possibility of reduction via this strategy. I argue that this objection can be overcome by showing that there is no tenable argument for the existence of emergent properties that are not susceptible to a reductive explanation. (shrink)

While scholars of, and participants in, social movements, electoral politics, and organized labor are deeply engaged in contrasting different theories of how political actors should organize, little recent philosophical work has asked what social organizing is. This paper aims to answer this question in a way that can make sense of typical organizing- related claims and debates. It is intuitive that what social organizing does is bring about some kind of collectivity. However, I argue that the varieties of collectivity most (...) amply theorized by analytic philosophers in recent years, including grouphood and collective intentionality, are not the right kinds to embed in a theory of social organizing. I ultimately argue that the sort of collectivity that organizing characteristically brings about is a special kind of causal complementarity among agents’ actions— and that while this can exist alongside grouphood and collective intentionality, it is not the same thing as either. The notion of social organizing that emerges is one that can clarify, without trivializing, a number of pressing contemporary debates about how normal people should conduct themselves as interconnected political actors. (shrink)

ABSTRACT This article investigates drawing as a form of devotional attention. Engaging with the work of María Lugones and examples from Josef Albers, Corita Kent, Franz Opalka, Georgia O’Keeffe, and William Kentridge, each section revolves around drawing in relation to embodied practices of being together with others. In addition to a personal account of memories and rituals of drawings, this article examines the degree to which drawing hones a pragmatic sense for fallibility, fluidity, and open-ended research, while arguing for drawing (...) as a form of commitment to community that challenges historical associations of creativity with individualistic or uninhibited freedom. (shrink)

In their recent article Consideration and Disclosure of Group Risks in Genomics and Other Data-Centric Research: Does the Common Rule Need Revision? Chapman et al. (2025) thoughtfully explore aspec...

According to many accounts, propaganda is a variety of politically significant signal with a distinctive connection to irrationality. This irrationality may be theoretical, or practical; it may be supposed that propaganda characteristically elicits this irrationality anew, or else that it exploits its prior existence. The view that encompasses such accounts we will call irrationalism. This essay presents two classes of propaganda that do not bear the sort of connection to irrationality posited by the irrationalist: hard propaganda and propaganda by the (...) deed. Faced with these counterexamples, some irrationalists will offer their account of propaganda as a refinement of the folk concept rather than as an attempt to capture all of its applications. The author argues that any refinement of the concept of propaganda must allow the concept to remain essentially political, and that the irrationalist refinement fails to meet this condition. (shrink)

This paper provides an analysis of U.S. farmland owners, operators, and workers by race, ethnicity, and gender. We first review the intersection between racialized and gendered capitalism and farmland ownership and farming in the United States. Then we analyze data from the 2014 Tenure and Ownership Agricultural Land survey, the 2012 Census of Agriculture, and the 2013–2014 National Agricultural Worker Survey to demonstrate that significant nation-wide disparities in farming by race, ethnicity and gender persist in the U.S. In 2012–2014, White (...) people owned 98% and operated 94% of all farmland. They generated 98% of all farm-related income from land ownership and 97% of income from farm owner-operatorship. Meanwhile, People of Color farmers were more likely to be tenants rather than owners, owned less land, and generated less farm-related wealth per person than their White counterparts. Hispanic farmers were also disproportionately farm laborers. In addition to racial and ethnic disparities, there were disparities by gender. About 63% of non-operating landowners, 86% of farm operators, and 87% of tenant farmers were male, and female farmers tended to generate less income per farmer than men. This data provides evidence of ongoing racial, ethnic and gender disparities in agriculture in the United States. We conclude with a call to address the structural drivers of the disparities and with recommendations for better data collection. (shrink)

BackgroundThe proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.MethodsWe conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following (...) electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.ResultsOf the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in researchConclusionResearchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV. (shrink)

The topic of fake news has received increased attention from philosophers since the term became a favorite of politicians (Habgood-Coote 2016; Dentith 2016). Notably missing from the conversation, however, is a discussion of fake news and conspiracy theory media as a market. This paper will take as its starting point the account of noxious markets put forward by Debra Satz (2010), and will argue that there is a pro tanto moral reason to restrict the market for fake news. Specifically, we (...) begin with Satz’s argument that restricting a market may be required when i) that market inhibits citizens from being able to stand in an equal relationship with one another, and ii) this problem cannot be solved without such direct restrictions. Our own argument then proceeds in three parts: first, we argue that the market for fake news fits Satz’s description of a noxious market; second, we argue against explanations of the proliferation of fake news that are couched in terms of “epistemic vice”, and likewise argue against prescribing critical thinking education as a solution to the problem; finally, we conclude that, in the absence of other solutions to mitigate the noxious effects of the fake news market, we have a pro tanto moral reason to impose restrictions on this market. At the end of the paper, we consider one proposal to regulate the fake news market, which involves making social media outlets potentially liable in civil court for damages caused by the fake news hosted on their websites. (shrink)

Informed consent is the gateway to research participation. We report on the results of the formative evaluation that follows the electronic informed consent process for the All of Us Research Program. Of the nearly 250,000 participants included in this analysis, more than 95% could correctly answer questions distinguishing the program from medical care, the voluntary nature of participation, and the right to withdraw; comparatively, participants were less sure of privacy risk of the program. We also report on a small mixed-methods (...) study of the experience of persons of very low health literacy with All of Us informed consent materials. Of note, many of the words commonly employed in the consent process were unfamiliar to or differently defined by informants. In combination, these analyses may inform participant-centered development and highlight areas for refinement of informed consent materials for the All of Us Research Program and similar studies. (shrink)

Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

There is a long philosophical tradition of skepticism about the possibility of adequate paraphrases for metaphorical utterances. And even among those who favor paraphrasability, there is a tendency to think that paraphrases of metaphorical utterances may themselves have to be non-literal. I argue that even the most evocative and open-ended metaphorical utterances can be literally and adequately paraphrased, once we recognize that they are actually indirect speech acts—specifically, indirect directives that command the hearer to engage in an open-ended comparison. This (...) leads to an overall picture in which trite, unevocative metaphorical utterances admit of just straightforward, usually non-directive literal paraphrases, while the most evocative metaphorical utterances admit of only indirect directive paraphrases, and metaphorical utterances in a third category admit of two literal paraphrases, one of which is straightforward and usually non-directive, and the other of which takes the indirect directive form. This argument for literal paraphrasability is intended to demystify metaphor, but not to undercut metaphor’s tremendous value as a communicative device. (shrink)

As members of the fetal surgery advisory board at a large tertiary care center, we read with great interest Hendriks’ et al. target article proposing a new ethical framework for fetal therap...

The lymphatic vasculature plays a critical role in the regulation of body fluid volume and immune function. Extensive research into the molecular mechanisms that control blood vessel growth has led to identification of molecules that also regulate development and growth of the lymphatic vessels. This is generating a great deal of interest in the molecular control of the lymphatics in the context of embryogenesis, lymphatic disorders and tumor metastasis. Studies in animal models carried out over the past three years have (...) shown that the soluble protein growth factors, vascular endothelial growth factor (VEGF)‐C and VEGF‐D, and their cognate receptor tyrosine kinase, VEGF receptor‐3 (VEGFR‐3), are critical regulators of lymphangiogenesis. Furthermore, disfunction of VEGFR‐3 has recently been shown to cause lymphedema. The capacity to induce lymphangiogenesis by manipulation of the VEGF‐C/VEGF‐D/VEGFR‐3 signaling pathway offers new opportunities to understand the function of the lymphatic system and to develop novel treatments for lymphatic disorders. BioEssays 24:1030–1040, 2002. © 2002 Wiley‐Periodicals, Inc. (shrink)

This article argues that corporate management in the United States has expanded its scope beyond office walls and encompasses many aspects of workers' daily lives. One new element of corporate training is the micromanagement of sleep; self-help books, newspaper reports, magazine articles, and consulting firms currently advise workers and supervisors on optimizing productivity by cultivating certain sleep habits. Although consultants and self-help books make specific recommendations about sleep, most medical research is inconclusive about sleep's benefits for human performance. Using the (...) ideas of Michel Foucault and Gilles Deleuze as a philosophical backdrop, this article examines the complex and often contradictory links between self-help, medicine, and corporate governance. (shrink)

Growing interest in complementary and alternative veterinary medicine (CAVM) has sparked a debate among veterinarians, who claim such therapeutic modalities fall under the purview of veterinary medicine, and non-veterinarians, who argue that several modalities do not require the rigorous training of a veterinarian to be performed safely. The veterinary profession must proactively redefine its definition of the practice of veterinary medicine in the face of increasing challenges to state practice acts. By looking to human medicine as a model for how (...) to balance conventional and alternative modalities, the profession can develop a system that provides animal caregivers access to CAVM while still safeguarding animal health. (shrink)

A key feature of unregulated mHealth research is the diversity of participants in this space. Applying an approach drawn from user experience design, we describe a set of archetypal unregulated mHealth researcher “personas,” which range from individuals who seek empowerment or have philanthropic objectives to those who are primarily motivated by financial gain or have misanthropic objectives. These descriptions are useful for evaluating policies applicable to mHealth to understand how they will impact various stakeholders.

For much of their history, the relationship between anthropology and psychology has been well captured by Robert Frost's poem, “Mending Wall,” which ends with the ironic line, “good fences make good neighbors.” The congenial fence was that anthropology studied what people think and psychology studied how people think. Recent research, however, shows that content and process cannot be neatly segregated, because cultural differences in what people think affect how people think. To achieve a deeper understanding of the relation between process (...) and content, research must integrate the methodological insights from both anthropology and psychology. We review previous research and describe new studies in the domain of folk biology which examine the cognitive consequences of different conceptualizations of nature and the place of humans within it. The focus is on cultural differences in framework theories among Native Americans and European American children and adults living in close proximity in rural Wisconsin. Our results show that epistemological orientations affect memory organization, ecological reasoning, and the perceived role of humans in nature. This research also demonstrates that cultural differences in framework theories have implications for understanding intergroup conflict over natural resources and are relevant to efforts to improve science learning, especially among Native American children. (shrink)

Dynamic Consent is both a model and a specific web-based tool that enables clear, granular communication and recording of participant consent choices over time. The DC model enables individuals to know and to decide how personal research information is being used and provides a way in which to exercise legal rights provided in privacy and data protection law. The DC tool is flexible and responsive, enabling legal and ethical requirements in research data sharing to be met and for online health (...) information to be maintained. DC has been used in rare diseases and genomics, to enable people to control and express their preferences regarding their own data. However, DC has never been explored in relationship to historical collections of bioscientific and genetic heritage or to contexts involving Aboriginal and Torres Strait Islander people.In response to the growing interest by First Peoples throughout Australia in genetic and genomic research, and the increasing number of invitations from researchers to participate in community health and wellbeing projects, this article examines the legal and ethical attributes and challenges of DC in these contexts. It also explores opportunities for including First Peoples' cultural perspectives, governance, and leadership as a method for defining DC on cultural terms that engage best practice research and data analysis as well as respect for meaningful and longitudinal individual and family participation. (shrink)

The semantics/pragmatics distinction was once considered central to the philosophy of language, but recently the distinction’s viability and importance have been challenged. In opposition to the growing movement away from the distinction, I argue that we really do need it, and that we can draw the distinction sharply if we draw it in terms of the distinction between non-mental and mental phenomena. On my view, semantic facts arise from context-independent meaning, compositional rules, and non-mental elements of context, whereas pragmatic facts (...) are a matter of speakers’ mental states and hearers’ inferences about them. I argue for this treatment of the distinction by comparing it to some other extant treatments (in terms of “what is said,” and in terms of the involvement of context) and then defending it against several challenges. Two of the challenges relate to possible intrusion of mental phenomena into semantics, and the third has to do with possible over-restriction of the domain of pragmatics. (shrink)

Richard Stanley Peters appreciates the centrality of concepts for everyday life, however, he fails to recognize their pedagogical dimension. He distinguishes concepts employed at the first-order (our ordinary language-use) from second-order conceptual clarification (conducted exclusively by academically trained philosophers). This distinction serves to elevate the discipline of philosophy at the expense of our ordinary language-use. I revisit this distinction and argue that our first-order use of concepts encompasses second-order concern. Individuals learn and teach concepts as they use them. Conceptual understanding (...) is an obligation that all individuals, and not just academically trained philosophers, must fulfil. I conclude that the role of philosophy in education is to provide a conversational context for the pedagogical dimension of concepts. I draw upon the philosophies of Cora Diamond, Stephen Mulhall, Iris Murdoch and Rush Rhees. (shrink)

SUMMARYContemporary scholars seeking to advance the study of political phenomena identify their inquiry as a ‘science' that attains success through rigorous method. Thus the ‘methodological anarchism' of Paul Feyerabend's philosophy of science might seem an inauspicious place to find a fruitful disciplinary vision. Nonetheless, it echoes a longstanding conception of the ‘science' of politics articulated by Niccolò Machiavelli. Looking to Feyerabend, we propose to surmount the impasse between Machiavelli's account of politics and the demands of modern science and recover his (...) contribution to the scientific study of politics. In doing so, Machiavelli illustrates the potential of a Feyerabendian political science. (shrink)