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)

Hindu culture and political ethics in the character of Krishana, Hindu deity as decribed in Bhāgavatapurāṇa and Mahābhārata ; a study.

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)

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.

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)

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.

Central-state materialism is a very strong, but also very exciting theory of mind according to which each mental state is identical with a state of the central nervous system. CSM thus goes considerably beyond early versions of the identity theory of mind, since those early accounts held only that sensations are to be identified with neural events. CSM, by contrast, is a thesis about all mental states; every mental state is held to be a state of the central nervous system. (...) In fact, as we will see shortly, CSM is an even more sweeping thesis than this formulation of it suggests, since it is not concerned simply with mental states.One prominent defender of CSM, David Armstrong, has maintained that CSM can be established by means of a two-step argument. (shrink)