Background: Little is known about U.S. healthcare provider views and practices regarding evidence, counseling, and shared decision-making about in-hospital versus out-of-hospital birth settings. Methods: We conducted 19 in-depth, semistructured, qualitative interviews of eight obstetricians, eight midwives, and three pediatricians from across the United States. Interviews explored healthcare providers’ interpretation of the current evidence and their personal and professional experiences with childbirth within the existing medical, ethical, and legal context in the United States. Results: Themes emerged concerning risks and benefits, decision-making, (...) and patient-provider power dynamics. Collectively, the narratives illuminated fundamental ideological tensions between in- and out-of-hospital providers arising from divergent assignment of value to described risks and benefits. The majority of physicians focused on U.S.-specific data demonstrating increased neonatal morbidity and mortality associated with delayed access to hospital-based interventions, thereby justifying hospital birth as the standard of care. By contrast, midwives emphasized data demonstrating fewer interventions and superior maternal and neonatal outcomes in high-income European countries, where out-of-hospital birth is more common for low-risk birthing people. A key gap in counseling was revealed, as no interviewees offered anticipatory counseling regarding birth setting options. Providers directly and indirectly illustrated the propensity for asymmetric power relations between birth providers and pregnant people, especially in hospital settings. Conclusions: The narratives highlight the common goal of optimizing maternal and neonatal outcomes despite tensions arising from divergent prioritization of specific maternal and neonatal risks. Our findings suggest opportunities to foster collaboration and optimize outcomes via mutual respect and improved integration of care. (shrink)

Upshot: In this response, I address the points raised in the commentaries, in particular those related to the scalability and robustness of the mechanism CALM, to its relation with the CAES architecture, and to the transition from sensorimotor to symbolic.

The Buddha’s final illness, brought on by his last meal prior to his death, was traditionally seen as one of a set of ailments suffered by him at various points during his lifetime. This paper looks at different Buddhist explications of the causes of these ailments and applies them to the episode of the Buddha’s final illness. In both instances, three explanatory strategies are detected: the first stresses the causative importance of the Buddha’s own negative karmic deeds in past lives; (...) the second looks to the negative deeds and karma of others than the Buddha; the third offers non-karmic explanations. The first two engendered two rather different kinds of j?taka stories; the last did not involve any j?takas but highlighted various kinds of ‘natural’ explanations. (shrink)

Although it is common in liberal and progressive circles to scoff at the idea that the Unites States is “exceptional”—a derision driven by an admirable suspicion of the chauvinistic connotations of the exceptionalist view—doing so obscures a significant reality. The United States is different, or at least rather unusual, in its social, cultural, and geo-strategic circumstances, especially when compared to the nations of Europe from which it draws the core of its intellectual traditions. What's more, the critique of American exceptionalism (...) has acquired its own troublesome politics. “It is extremely dangerous to encourage people to see themselves as exceptional, whatever…. (shrink)

This article examines the term “Radical Enlightenment” as a historiographical category through the lens of the philosophical work of Dorothea Christiane Erxleben (1715–1762), a keen advocate for women’s education and the first female medical doctor in Germany. The aim of the article is to develop a methodological framework that makes it possible to critically assess the radicalism of Erxleben’s philosophical position as it is presented in her highly systematic work Rigorous Investigation (1742). In the first part of the article, the (...) term “Radical Enlightenment” is briefly discussed in the German context. The second part is dedicated to articulating two methodological problems concerning the use of the term “radical” with regards to early feminist writings of the seventeenth and eighteenth centuries. The aim of this section is to develop a new approach to the classification of radical thinkers of this period. In the remaining three parts, this methodological approach is applied to the analysis of Erxleben’s views on equality and education, focusing on her call for women’s active participation in society. Finally, it is concluded that there is sufficient evidence to categorize vital parts of Erxleben’s philosophy as radical. (shrink)

William James is famous for his investigations of the “Varieties of Religious Experience” in which people encounter (what they take to be) the divine. But in his essay, “On a Certain Blindness in Human Beings,” his interest is in our experiences, not of anything purportedly supernatural, but of one another. He thinks we need to cultivate the capacity to apprehend the intrinsic value of others, even and especially of strangers. We do so in experiences of the wonder and beauty of (...) our fellow citizens, and of our harmony with them. Democratic societies require a sense of attraction to one another’s form of life if they are to inspire shared commitments to public goods. Whereas we shouldn’t reject the political significance of aversion, contestation, and dissonance, these negative attitudes do not suffice. Sustaining democratic engagement requires attractive attitudes, and among these are the wonder, beauty, and harmony that James promotes. (shrink)

Bradley and Whitehead certainly deserve a book-length comparison on such topics as experience, internal and external relations, particularly whole-part relations, time, and God. Leemon McHenry has explored these issues soberly and responsibly, and his conclusions are most informative. Yet I sometimes wonder whether the connection would be as firmly made had there not been one remark about Bradley in the preface to Process and Reality.

Purpose. The paper is aimed at analyzing in a comparative way the philosophical conceptions of the human, proposed by Ludwig Wittgenstein and Martin Heidegger as the main representatives of the analytic and continental tradition of philosophizing in the XXth century. The theoretical basis of the study is determined by Wittgenstein’s legacy in the field of logical and linguistic analysis, as well as Heidegger’s existential, hermeneutical, and phenomenological ideas. Originality. Based on the analysis of the philosophical works of Wittgenstein and Heidegger, (...) the initial principles of their anthropological concepts in the unity of transcendental preconditions, essential foundations, and correlations to the world in the technosphere are reconstructed. It is demonstrated that, despite the difference in the explanation of the peculiarities in the interpretation of the realm of the transcendental and basic characteristic of the inner world of human, both philosophers emphasized the understanding of the human being through the prism of language and the need for anthropologization of science and technology. Conclusions. Wittgenstein and Heidegger developed their own original considerations on the nature of human being, which fully conform to the basic theoretico-methodological principles of their philosophical conceptions. The former focused on how language reflects a human’s world and serves as a means of expressing their knowledge and aspirations. The latter, on the contrary, interpreted the world as a reflection of language that expresses itself through human. As a supporter of analytic methodology and, accordingly, of accuracy in formulations, Wittgenstein came to the concept of the unspeakable in the process of reflection on the being of human over the language. But in Heidegger’s existential discourse, which is full of metaphors and neologisms, being of human is limited by the concept of Nothing. As a consequence, it is noted that the ontological status of values is transcendental to the world according to Wittgenstein, but it is immanent to the world, according to Heidegger. It is argued that the Austrian thinker developed a linguo-psychological approach to the study of human through the prism of the mental, but the German philosopher comprehended the human on the basis of the concept of self in the ontological sphere. It has been demonstrated that both thinkers have pointed to the challenges faced by humans in the development of science and technology while emphasizing the importance of substantiating their anthropological foundations. (shrink)