Volume 25, Issue 2, February 2025, Page 85-87.

Chapman et al. (2025) frame the issue of ethical regulation of data-centric research, including AI and large language models, in an important and challenging manner. While we agree that the risks t...

This paper argues that practical wisdom represents a useful framework for understanding the synthesis of the scientific, technical, and moral dimensions of medical practice and may, therefore, guide the meaningful integration of concepts of competence and character into the education and support of both the technical and moral agency of medical professionals. The authors show the importance of practical wisdom in three distinct domains: (1) in effective deliberation in clinical judgments; (2) in helping clinicians flourish by making wise (...) decisions in light of the moral and emotional challenges they face in their practice; and (3) in helping physicians navigate between the rights of patients, the physician’s own moral good, and the objective good intrinsic to medicine. To promote the physician’s own moral good and the objective good intrinsic to medicine, the authors propose a philosophical position, the agential view, that preserves an essentialist view of medicine but emphasizes the necessity to develop a personal moral philosophy of clinical practice. (shrink)

Challenges in Medical Care Edited by Andrew Grubb School of Law and Centre of Medical Law and Ethics, King’s College, London, UK The sixth volume in the series of King’s College Studies takes a reflective view of medical law and ethics, the health care system and challenges raised by modern technology. A distinguished team of authors returns to problems and controversies that have long challenged medical law and ethics, and shows how new issues (...) are constantly arising as a result of developments in medical care. Topics such as the legal status of the frozen human embryo, medical accountability and the future of the National Health Service are discussed. The need for responsibility, accountability and respect for individual human rights forms a strong linking theme throughout the book. This thought-provoking collection constitutes a useful and informative reference source which will be of value to a wide range of professionals and students including doctors, nurses, lawyers, philosophers and medical sociologists. (shrink)

This interdisciplinary and ecumenical collection of essays honors the transformative work of Margaret A. Farley, Gilbert L. Stark Professor of Christian Ethics at Yale Divinity School, using it as a starting point for reflection on the contribution of feminist method to theology and ethics. Through a variety of perspectives, contributors show that by resisting classical oppositions between “interpersonal” and “social” ethics and by insisting that social, economic, and political realities be taken seriously in considerations of justice, feminist concerns challenge the (...) very categories of Christian ethics. With essays ranging from sexual ethics to human rights, medical ethics to freedom, _A Just and True Love_ offers a broad perspective on the last twenty-five years of feminist innovation in Christian ethics and a glimpse of its global future, particularly in continents such as Africa. “This book brings together a number of the most prominent thinkers in Christian theology and ethics today in a justly deserved tribute to the work and influence of Margaret Farley. The essays explicitly acknowledge and engage Farley in various degrees; one comes away appreciating both the integrity of her work and its versatility.” —_Darlene Fozard Weaver, Villanova University _ “Inevitably while listening to or reading Margaret Farley, we find her refrain, ‘I want to ask all over again.’ Reexamining, reframing, and rethinking is Farley’s method of engaging anew human experience and relationality. The authors of these essays capture that method as they reconsider feminism and sexuality, love and freedom, justice and truth, contraception and women’s rights. Like her own work, they reset the ethical agenda to recapture a more loving truth. A very successful collection for a most admired colleague. Ryan and Linnane are to be congratulated!” —_James F. Keenan, S.J., Boston College_ “In_ A Just and True Love,_ a host of distinguished scholars consider fundamental themes of feminist theological ethics and their significance for global justice, the meaning of Christian love, creative casuistry, and truthful life in the Church. I can imagine no higher praise than to affirm that these authors have succeeded marvelously in doing exactly what they set out to do: to produce a volume worthy of the theological work and wisdom of Margaret Farley.” —_William Werpehowski, Villanova University_. (shrink)

The question at hand is whether or not a liberal arts education can be politically neutral, but the very fact that this question is phrased in the curious manner that it is, which is to say that we place emphasis on "can" as opposed to "is" or "how we might better ensure," speaks to the nature of a problem that much more deeply rooted than the mere question of scholarly polarization. Borrowing from Christopher Schlect of New Saint Andrews College, (...) we might say that the "liberal arts teach us how to learn—how to freely gain knowledge and understanding," and that the manner in which they do this is by teaching students not only methodologies for solving problems that are presented to them, but also how to identify problems of their own accord (79). That would mean, by definition, that a political neutral liberal arts curriculum would necessitate not only an active awareness of one's ethical orientation, but also an active tempering of the biases that accompany that orientation out of respect for the spirit of liberalism and in recognition of one's own fallible nature. Unfortunately, since, as I intend to illustrate, our moral and therefore political senses are similar to aesthetic taste as described by Kant in his third critique, they carry with them the paradoxicality of pure subjectivity tethered to the expectation of universality, making the possibility of political neutrality in the liberal arts a grim proposition, to put it at its absolute mildest. In order to determine whether this problem is in any way manageable, it is necessary to analyze of the nature of moral and political taste in a general sense, the rhetoric that educator use toward members of opposing moral frameworks, how that rhetoric is buttressed by institutional teloi, and finally, how different systems of normative ethics might contribute to neutrality in the liberal arts. (shrink)

Book Symposium on Andrew Feenberg’s Between Reason and Experience: Essays in Technology and Modernity Content Type Journal Article Pages 203-226 DOI 10.1007/s13347-011-0017-8 Authors Inmaculada de Melo-Martín, Division of Medical Ethics, Weill Cornell Medical College, New York, NY 10065, USA David B. Ingram, Loyola University Chicago, 6525 North Sheridan Road, Chicago, IL 60626, USA Sally Wyatt, e-Humanities Group, Royal Netherlands Academy of Arts and Sciences (KNAW) & Maastricht University, Cruquiusweg 31, 1019 AT Amsterdam, The Netherlands Yoko Arisaka, (...) Forschungsinstitut für Philosophie Hannover, Gerberstrasse 26, 30169 Hannover, Germany Andrew Feenberg, School of Communication, Simon Fraser University at Harbour Centre, 515 West Hastings Street, Vancouver, BC V6B 5K3, Canada Journal Philosophy & Technology Online ISSN 2210-5441 Print ISSN 2210-5433 Journal Volume Volume 24 Journal Issue Volume 24, Number 2. (shrink)

: Ulysses contracts have faced paternalism objections since they first were proposed. Since the contracts are designed to override a present request from a legally competent patient in favor of a past request made by that patient, enforcement of these contracts was argued to be unjustifiable strong paternalism. Recent legal developments and new theories of practical reasoning suggest that the discussion of Ulysses contracts should be revived. This paper argues that with a proper understanding of the future-directed planning embodied in (...) Ulysses contracts, the charge of strong paternalism can be answered, and the enforcement of some Ulysses contracts may be justified under the rubric of weak paternalism. (shrink)

How research studies should use social media to recruit research participants is a timely question. Importantly, the question is how, not if, studies should use...

Deception, cheating, and loopholes within the IRB approval process have received significant attention in the past several years. Surveys of clinical researchers indicate common deception ranging from omitting information to outright lying, and controversy surrounding the FDA's decision not to ban “IRB shopping” has raised legitimate concerns about the integrity of the IRB process. One author has described a multicenter trial as being withdrawn from consideration at one institution when rejection was imminent, in order to avoid informing other IRBs reviewing (...) the protocol of the study's rejection. This practice and IRB shopping seem at odds with the spirit, if not the “letter,” of the regulations. While at first blush these practices seem to cast aspersions on the integrity of clinical researchers, the moral issues raised go deeper than the ethics of cheating. (shrink)

Community and patient stakeholder partners serve in many roles. One particularly important role of community and patient organizations and representatives is to serve as gatekeepers; in this role, they monitor, and in some cases even determine, what research does and does not get conducted with their communities. Such gatekeeping can prevent “helicopter” research and community research fatigue. Gatekeeping can also aid in identifying and mitigating harms that might occur not only to individual participants but to third parties (who do not (...) provide consent for participation) or to the community as a whole. Although individual informed consent and independent review both aim to protect against research risks, in research with identifiable communities these protections may be insufficient to protect from other types of harms. Given the gaps in protection, the gatekeeping role of community research partners is an important supplement to informed consent and independent IRB review, but it also raises its own set of ethical challenges. Here, we discuss the limitations of informed consent and independent review in research with identifiable communities, the benefits of gatekeeping for protecting third parties and groups, types of gatekeepers, and issues in the selection of gatekeepers. (shrink)

In clinical mental health research with children, both child and parent are essential members of the research team. The 3 R's of parent/child team membership are respect, rapport, and recognition. Respect and recognition include fair reimbursement for time, expense, and inconvenience, but the most important compensation for many families is the appreciation of the other team members for their sacrifice and cooperation. Reimbursement, although honoring the principles of justice and respect for persons, raises difficult issues about appropriate amount, particularly in (...) research involving children. The 3 R's are supported by the investigator 5 A's: attitude, adaptability, availability, attachment, and appreciation. Although the principles seem clear in the abstract, implementation encounters many practical problems. Perhaps the most difficult of these is determining the appropriate amount of compensation that avoids undue inducement but not at the expense of the 3 R's and 5 A's. (shrink)

In this article, we develop a non-rights-based argument based on beneficence (i.e., the welfare of individuals and communities) and justice as the disposition to act justly to promote equity in health care resource allocation. To this end, we structured our analysis according to the following main sections. The first section examines the work of Amartya Sen and his equality of capabilities approach and outlines a framework of health care as a fundamental human need. In the subsequent section, we provide a (...) definition of health equity based on the moral imperative to guarantee that every individual ought to have the freedom to pursue health goals and well-being. In the later part of the article, we outline a non-right approach to health care based on three pillars: (1) human flourishing, (2) justice as a disposition not a process, and (3) solidarity. (shrink)

Patients with persistent pain who lack adetectable underlying disease challenge thetheories supporting much of biomedicalbody-mind discourse. In this context,diagnostic labeling is as inherently vulnerableto the same pitfalls of uncertainty that besetany other interpretative endeavour. The endpoint is often no more than a name ratherthan the discovered essence of a pre-existentmedical condition. In 1990 a Committee of theAmerican College of Rheumatology (ACR)formulated the construct of Fibromyalgia in anattempt to rectify a situation of diagnosticconfusion faced by patients presenting withwidespread pain. It (...) was proposed thatFibromyalgia existed as a ``specific entity'',separable from but curiously able to co-existwith any other painful condition. Epistemological and semiotic analyses ofFibromyalgia have failed to find any sign,clinical or linguistic, which coulddifferentiate it from other diffusemusculoskeletal pain states. The construct ofFibromyalgia sought to define a discernablereality outside the play of language and topass it off as a natural phenomenon. However,because it has failed both clinically andsemiotically, the construct also fails the testof medical utility for the subject inpersistent pain. (shrink)

In this case, it is noted that while DNA testing and methylation are being studied as biomarkers for high-grade squamous intraepithelial lesions in the anal canal, their efficacy is no...

Michael Ryan (d. 1840) remains one of the most mysterious figures in the history of medical ethics, despite the fact that he was the only British physician during the middle years of the 19th century to write about ethics in a systematic way. Michael Ryan’s Writings on Medical Ethics offers both an annotated reprint of his key ethical writings, and an extensive introductory essay that fills in many previously unknown details of Ryan’s life, analyzes the (...) significance of his ethical works, and places him within the historical trajectory of the field of medical ethics. (shrink)

Volume 24, Issue 8, August 2024, Page 109-111.

In this case, the investigator should be allowed to enroll incompetent adults into this study, with certain safeguards. If an incompetent adult has an agent or a legally authorized representative (...

Summary Principles Timely support for patients and people close to them, and effective, sensitive communication are essential. Decisions must be based on the individual patient's circumstances and reviewed regularly. Sensitive advance discussion should always be encouraged, but not forced. Information about CPR and the chances of a successful outcome needs to be realistic. Practical matters Information about CPR policies should be displayed for patients and staff. Leaflets should be available for patients and people close to them explaining about CPR, how (...) decisions are made and their involvement in decisions. Decisions about attempting CPR must be communicated effectively to relevant health professionals. In emergencies If no advance decision has been made or is known, CPR should be attempted unless: the patient has refused CPR; the patient is clearly in the terminal phase of illness; or the burdens of the treatment outweigh the benefits. Advance decision making Competent patients should be involved in discussions about attempting CPR unless they indicate that they do not want to be. Where patients lack competence to participate, people close to them can be helpful in reflecting their views. Legal issues Patients' rights under the Human Rights Act must be taken into account in decision making. Neither patients nor relatives can demand treatment which the health care team judges to be inappropriate, but all efforts will be made to accommodate wishes and preferences. In England, Wales and Northern Ireland relatives and people close to the patient are not entitled in law to take health care decisions for the patient. In Scotland, adults may appoint a health care proxy to give consent to medical treatment. Health professionals need to be aware of the law in relation to decision making for children and young people.IntroductionWhy policies are neededCardiopulmonary resuscitation can be attempted on any person whose cardiac or respiratory functions cease. Failure of these functions is part of dying and thus …. (shrink)

The American Journal of Bioethics, Volume 12, Issue 7, Page 53-54, July 2012.

Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention—a bridge to recovery or transplant—not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of (...) withdrawal, including distributive justice, quality of life, patients’ rights, professional integrity, and the Equivalence Thesis. We find that existing justifications for unilateral withdrawal of ECMO support in capacitated patients are problematic, which leads us to conclude that either: (1) additional ethical arguments are necessary to defend this approach or (2) the claim that it is not appropriate to use ECMO as a destination therapy should be questioned. (shrink)

This paper argues that it will be important for new genomic technologies to recognize the limits of traditional approaches to informed consent, so that other-regarding implications of genomic information can be properly contextualized and individual rights respected. Respect for individual autonomy will increasingly require dynamic consideration of the interrelated dimensions of individual and broader community interests, so that the interests of one do not undermine fundamental interests of the other. In this, protection of individual rights will be a complex interplay (...) between individual and community concerns. (shrink)

La investigación se desarrolla en la circunscripción número 66 del Consejo Popular Puerto Príncipe en el período 2008-2014, tiene como objetivo proponer acciones para la educación ambiental en la Circunscripción para la transformación de una cultura ambiental comunitaria. Se tuvo en cuenta las principales necesidades ambientales de sus moradores, lo que se constató a través del diagnóstico realizado previamente mediante la aplicación de un sistema de métodos y técnicas. A research was carried out with the objective of proposing actions for (...) the transformation of a community environmental culture at Circumscription 66 of Puerto Príncipe Popular Council during 2008-2014. The main environmental needs of residents were taken into account, which were verified by means of a previously performed diagnosis through the application of a system of methods and techniques. (shrink)

Assume that, even with a time machine, Tim does not have the ability to travel to the past and kill Grandfather. Why would that be? And what are the implications for traditional debates about freedom? We argue that there are at least two satisfactory explanations for why Tim cannot kill Grandfather. First, if an agent’s behavior at time _t_ is causally dependent on fact _F_, then the agent cannot perform an action (at _t_) that would require _F_ to have not (...) obtained. Second, if an agent’s behavior at time _t_ is causally dependent on fact _F_, then the agent cannot perform an action (at _t_) that would prevent _F_ from obtaining. These two explanations have distinct upshots for more traditional debates over freedom. The first implies that causal determinism is incompatible with the ability to do otherwise and also raises questions about the traditional arguments for the incompatibility of divine foreknowledge and the ability to do otherwise; the second does neither. However, both explanations imply that the Molinist account of divine providence renders agents unable to do otherwise, at least in certain circumstances. (shrink)

This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a self-administered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The (...) most common source of knowledge on ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. “Doctors know the best irrespective of patients’ opinion” was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patient’s wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on end-of-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be - principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee. (shrink)

In Understanding Social Action, Promoting Human Rights, editors Ryan Goodman, Derek Jinks, and Andrew K. Woods bring together a stellar group of contributors from across the social sciences to apply a broad yet conceptually unified array of advanced social science research concepts to the study of human rights and human rights law.

For many in the United States, an important step in dismantling the structural evil of racism would be the total removal of Confederate monuments from the southern landscape. While the motivation behind this recommendation is laudable, such a move may also serve to assuage white guilt while leaving the structures of white privilege basically untouched. This essay uses recent work in theology and memory to assess these monuments as well as calls for their removal, and suggests that at least some (...) should remain standing as signs of a crisis that remains with us, bent toward the goal of justice by means of remembering a devastating history under the aspect of God’s judgment. The upshot is that Christians have a strong theological warrant to support calls to add markers around certain Confederate monuments in order to contextualize and “fill out” the untruthful story they currently tell. (shrink)

Political action has a long history in the health workforce. There are multiple historical examples, from civil disobedience to marches and even sabotage that can be attributed to health workers. Such actions remain a feature of the healthcare community to this day; their status with professional and regulatory bodies is far less clear, however. This has created uncertainty for those undertaking such action, particularly those who are engaged in what could be termed ‘contentious’ forms of action. This study explored how (...) advocacy and activism were presented in nursing and medical codes of ethics, comparing disciplinary and temporo‐spatial differences to understand how such action may be promoted or constrained by codes. The data for this study comes from 217 codes of ethics. Because of the size of the corpus and to facilitate analysis, natural language processing was utilised, which allowed for an automated exploration of the data and for comparisons to be drawn between groups. This was complemented by a manual search and contextualisation of the data. While there were noticeable differences between medical and nursing codes, overall, advocacy, activism and even politics were rarely discussed explicitly in most codes. When such action was spoken about, this was often vague and imprecise with codes speaking of ‘political action’ and ‘advocacy’ in general terms. While some codes were far more forthright in what they meant about advocacy or broader political action (i.e., Nursing codes in Denmark, Norway, Canada) more forceful language that spoke in specific terms or in terms of oppositional or specific actions (e.g., civil disobedience or marches) was almost completely avoided. These results are discussed in relation to the broader literature on codes and the normative questions they raise, namely whether such action should be included in codes of ethics at all. (shrink)

While many scholars agree that the ‘‘separation thesis’’ (Freeman in Bus Ethics Quart 4(4):409–421, 1994)—that business issues and ethical issues can be neatly compartmentalized—is harmful to business ethics scholarship and practice, they also conclude that eliminating it is either inadvisable because of the usefulness of the positive/ normative distinction, or actually impossible. Based on an exploration of the fact/value dichotomy and the pragmatist and virtue theoretic responses to it, we develop an approach to eliminating the separation thesis that integrates ‘‘business’’ (...) with ‘‘ethics’’ while still permitting a positive/ normative distinction, which we call ‘‘ethics from observation.’’. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On PartnershipRyan Schwarz, Duncan Smith-Rohrberg Maru, Dan Schwarz, Bibhav Acharya, Bijay Acharya, Ruma Rajbhandari, Jason Andrews, Gregory Karelas, Ranju Sharma, and Mark ArnoldyRecently, Bayalpata Hospital, in the rural district of Achham, Nepal almost collapsed under the weight of its own staff's discontent. The hospital had been largely abandoned until 2009 when our organization, Nyaya Health, renovated and opened it in partnership with the Nepali government. Since then, the hospital (...) has seen great progress and has experienced widespread community support. Nonetheless, earlier this year, a broad-based staff revolt occurred, led primarily by our senior clinical staff members, raising concerns that Nyaya's management policies were ineffective, and wages and benefits were too low. The unrest included everything from a strike, limiting services to our patients, to aggression against non-strikers and slander and racist comments in public media against the Nyaya Health Board of Directors. Ultimately, the conflict was resolved, though not without the departure of our three most senior clinicians. The incident deeply damaged staff morale [End Page 101] and impeded basic services to our patients, and from our perspective as a leadership and management team, it was deeply troubling and spiritually challenging. We have learned much in the wake of the strike, but here we focus more narrowly on the concept of partnerships in our work by examining the recent strike and the two key issues that lead to it: wages and benefits, and management policies at Bayalpata Hospital.In grappling with the recent staff crisis, some of our leadership team expressed concerns that we would never be able to develop a true partnership in Achham if our senior-level employees led strikes against the organization. The leaders of the strike were our most well-educated and high-ranking staff. They were also individuals who had come to work for us specifically citing the moral imperative of our work, and their pride in helping to serve the poorest of the poor. One leadership team member asked, "What is 'partnership' then? We came into this work with the premise that we would work together, with our partnership built around the right to health—but who are our partners if they lead strikes damaging the very services our collective mission aims to offer?"Another leadership team member commented, "The first time I visited Achham I was invited for tea at Meena's* house (one of Nyaya's midwives). We arrived at her house and Meena greeted us warmly. She showed us in to a small room: there was no furniture, but there was an immaculately swept mat which we joined her on. We drank tea, seated on her rug, and listened to her tell us how she had come to live in the house, how she had come to work for Nyaya, and her pride in now being able to provide both for her own children, as well as, the children of her relatives. As the only employed family member, she now had the challenge of providing for all of them. When we question our partnership, I'm taken back to Meena's warm, but extremely poor, home. She has worked for Nyaya for almost four years. She has helped our organization provide free care to over 75,000 people. Is this not a type of 'partnership'?"Allow us to offer some background on the issue of wages—Meena has been with our team since 2008, and has been paid about $2,500 per year—a generous wage compared to other employers in the region. Meena was one of the striking staff members. Among other concerns about the way the hospital was being run, she and other staff asked indignantly why we couldn't provide them with higher wages, better benefits, and more resources, both for her and the hospital. Notably, Meena's salary (and the rest of our staff's) was well above her equivalent in other, more urban hospitals (to compensate for the extremely remote area in which we work), and in a district where most families are farmers, our staff's salaries occupy the highest income bracket in the region. Nonetheless, as is common throughout the world in both rich and poor areas... (shrink)

If spacetime does not exist, it does so in a very unusual way. It curves in response to massive objects. It warps in response to high velocities. The Substance of Spacetime treats spacetime, not merely as a geometric abstraction, but as a real physical substance, opening a window onto reality that would otherwise be impossible to even contemplate.

The Association of American Medical Colleges (AAMC) is urging academic medical centers to ban pharmaceutical detailing. This policy followed from a consideration of behavioral and neuroeconomics research. I argue that this research did not warrant the conclusions drawn from it. Pharmaceutical detailing carries risks of cognitive error for physicians, as do other forms of information exchange. Physicians may overcome such risks; those determined to do so may ethically engage in pharmaceutical detailing. Whether or not they should do so (...) is a prudential judgment about which reasonable people may disagree. The AAMC's ethical condemnation of detailing is unwarranted and will subvert efforts to maintain a realm of physician discretion in clinical work that is increasingly threatened in our present practice environment. (shrink)

(2010). Response to Open Peer Commentaries on “The Pitfalls of Deducing Ethics from Economics: Why the Association of American Medical Colleges is Wrong About Pharmaceutical Detailing”. The American Journal of Bioethics: Vol. 10, No. 1, pp. W1-W3.

Fundamento. La historia de la Neurocirugía en el territorio está estrechamente relacionada con la de otras especialidades como la Cirugía General y la Ortopedia. Tiene sus primeras referencias establecidas en la etapa colonial en el Hospital General, documentadas en el Boletín del Colegio Médico de Camagüey. Objetivo es resaltar la importancia que tuvieron el Hospital General y el Colegio Médico de Camagüey con su boletín en la historia de la Neurocirugía y la Ortopedia. Método. Es una investigación histórica que se (...) basa en la revisión documental y utiliza el submétodo cronológico para establecer el orden de los hechos que se describen. Desarrollo. El Hospital General a partir de su reconstrucción a finales del siglo XIX, se convirtió en el principal centro médico quirúrgico de la provincia en la época colonial. Muchos de los resultados de la actividad asistencial y científica de sus médicos apareció publicada en el Boletín del Colegio Médico de Camagüey, prestigiosa revista científica que se encargó de divulgar los resultados de la medicina camagüeyana y donde aparecen artículos que evidencian cómo cirujanos generales realizaron las primeras intervenciones neuroquirúrgicas y ortopédicas. Conclusiones. Se consideran al Hospital General y al Colegio Médico de Camagüey y su boletín, como elementos indispensables al escribir la historiografía de la Neurocirugía y la Ortopedia en el territorio. Ground: the history of Neurosurgery in this place is closely linked to other specialties like General Surgery and Orthopedics. The first documented references went back to the colonial period in the General Hospital, documented in the bulletin of the medical college in Camagüey. The objective is to highlight the importance of the General Hospital and the medical college and its bulletin in the history of Neurosurgery and Orthopedics in Camagüey. Methods: This a historical investigation that was carried out taking documented revision and using chronologic sub method to establish the order of the facts that have been described. Development: Since the reconstruction of the General hospital at the end of the XIX century, it became the main medical_ surgical center in the province during the colonial period. Many of the scientific results and medical activities were published in the bulletin of the medical college, which became a well-known scientific magazine that was in charge of publishing the medical success in Camagüey. There are articles to prove that general surgeons performed the first neurosurgical and orthopedic interventions. Conclusions: The General hospital, the medical college and its bulletin are considered crucial elements to describe the history of Neurosurgery and Orthopedics in the territory. (shrink)

In this paper we use a critically reflective research approach to analyze our efforts at transformative learning in food systems education in a land grant university. As a team of learners across the educational hierarchy, we apply scholarly tools to the teaching process and learning outcomes of student-centered inquiries in a food systems course. The course, an interdisciplinary, lower division undergraduate course at the University of California, Davis is part of a new undergraduate major in Sustainable Agriculture and Food Systems. (...) We provide an overview of the course’s core elements—labs, exams, assignments, and lectures—as they relate to social constructivist learning theory and student-centered inquiries. Then, through qualitative analysis of students’ reflective essays about their learning experiences in the course, we demonstrate important transformative outcomes of student-centered inquiries: (1) most students confronted the commodity fetish and tried to reconcile tensions between what the food system is and ought to be, and (2) students repositioned themselves, their thinking, and social deliberation in relation to the food system. Students’ reflections point to the power of learning that emerges through their inquiry process, including in the field, and from critical self-reflection. We also highlight the importance of reflective essays in both reinforcing experiential learning and in helping instructors to better understand students’ learning vis-à-vis our teaching. (shrink)

In mental health policy, a central ethical dilemma concerns involuntary outpatient commitment (OPC), which aims to treat vulnerable individuals with serious mental illness who decline services. The first concern regards whether coercive services undermine the quality of clinical interactions within treatment, particularly as it relates to psychiatric medication use. The second concern is the unexamined role that OPC, and coercive psychiatric programs more broadly, play in the broader landscape of social welfare policy. To examine these concerns, the purpose of this (...) dissertation is to analyze how the management of psychiatric medications in involuntary outpatient services is undergirded by (a) provider and client interpretations of psychiatric medication effects and (b) moral discourses related to coercion and client autonomy. To achieve this aim, I examined data from a team-based ethnography that consisted of 1000 hours of participant observations and 56 semi-structured interviews with 20 clients, 21 providers, and 12 client family members with diverse backgrounds. I analyzed how medication compliance was discussed, monitored, and enforced in an involuntary outpatient program. My analysis demonstrates that medications were interpreted as a technology to control clinical symptoms (clinical control) though, particularly among clients, were also viewed as a method to control client mental experiences, behavioral expression, and autonomy (social control). Providers believed that medications were a necessary component of services (compulsory compliance) and could reduce client vulnerability to violence victimization and perpetration related to clinical symptoms (medicating vulnerability). To address client noncompliance, providers employed several strategies that I categorized as client manipulation. These strategies included providers, family members, and court officials strategizing ways to undermine client autonomy without clients’ knowledge (concealed collusion), deceiving clients into believing that medications were mandated when they were not (performing coercion), and minimizing the role of client consent and preferences in decision-making processes (circumventing consent). These findings demonstrate the pervasive role of manipulation to gain client medication compliance in OPC, which I named institutional coercion. They also highlight that the broader moral justifications for manipulating clients relate to their status as structurally vulnerable in their community settings and a growing relationship between the erosion of the welfare state and psychiatric coercion. (shrink)

A series of essays on the development of medicine in the century of the Enlightenment, illustrating the decline in the role of religion in medical thinking, and the increased use of reason.

Review of Will Bunch, After the Ivory Tower Falls: How College Broke the American Dream and Blew Up Our Politics--And How to Fix It.