Background: The concept of dignity can be divided into two main attributes: absolute dignity that calls for recognition of an inner worth of persons and social dignity that can be changeable and can be lost as a result of different social factors and moral behaviours. In this light, the nursing profession has a professional dignity that is to be continually constructed and re-constructed and involves both main attributes of dignity. Objectives: The purpose of this study was to determine how nurses (...) described nursing’s professional dignity in internal medicine and surgery departments in hospital settings. Research design: The research design was qualitative. Ethical considerations: This study was approved by the ethics committees of the healthcare organizations involved. All the participants were provided with information about the purpose and the nature of the study. Participants: A total of 124 nurses participated in this study. Method: The data were collected using 20 focus group sessions in different parts of Italy. The data were analysed by means of a conventional inductive content analysis starting from the information retrieved in order to extract meaning units and sorting the arising phenomena into conceptually meaningful categories and themes. Results: Nursing’s professional dignity was deeply embedded in the innermost part of individuals. Regarding the social part of dignity, a great importance was put on the values that compose nursing’s professional identity, the socio-historical background and the evolution of nursing in the area considered. The social part of dignity was also linked to collaboration with physicians and with healthcare assistants who were thought to have a central role in easing work strain. Equally important, though, was the relationship with peers and senior nurses. Conclusion: The organizational environments under scrutiny with their low staffing levels, overload of work and hierarchical interactions did not promote respect for the dignity of nurses. To understand these professional values, it is pivotal to comprehend the role of different health professions in their cultural milieu and the evolution of the nursing profession in diverse countries. (shrink)

Avant de s’appliquer à un exemple, celui de la croyance, l’article expose ce qu’on peut entendre par « distinction conceptuelle » : un geste philosophique qui consiste à établir la distribution, à la fois exhaustive et génétique, de formes organiques, dotées d’attributs propres. Ces formes se rangent ainsi de façon réglée sous un genre, qui est doté d’une extension et d’un degré de généralité plus grands, puisqu’il les contient toutes. Par exemple, le concept de vérité ne se réduit pas à (...) la correspondance entre ce qui est dit et ce qui est (sous les formes organiques suivantes : objectivité et véracité – dont la sincérité, la franchise et l’authenticité), si ce qui est dit doit d’abord, et indépendamment de la correspondance, être doté de sens, lequel est une forme, particulière, de vérité. S’ouvre alors une autre branche qui porte le nom de cohérence, où se trouvent les formes organiques qui y ont leur place : évidence et vraisemblance, etc. (shrink)

Background: Nursing continues to gain legitimation epistemologically and ontologically as a scientific discipline throughout the world. If a profession gains respect as a true autonomous scientific profession, then this recognition has to be put in practice in all environments and geographical areas. Nursing professional dignity, as a self-regarding concept, does not have a clear definition in the literature, and it has only begun to be analyzed in the last 10 years. Objectives: The purpose of this meta-synthesis was to determine the (...) various factors that constitute the notion of nursing professional dignity. The target was to create a tentative model of the concept. Research design: The research design was a meta-synthesis (N = 15 original articles) of nursing professional dignity described in the literature, based on the guidelines by Noblit and Hare. Method and findings: Original studies were sought out from electronic databases and manual searches. The selection of literature was conducted on stages based on titles (n = 2595), abstracts (n = 70), and full-texts (n = 15) according to the inclusion and exclusion criteria. From this analysis, a clear definition of nursing professional dignity emerged that underscored two main macro-dimensions constituting this intertwined, multidimensional, and complex notion: characteristics of the human beings and workplace elements. Conclusion: The recognition of nursing professional dignity could have a positive impact on patients because the results clearly showed that nurses are more prone to foster patients’ dignity, patients’ safety, and a better quality of care if their own dignity is respected. If nurses are uncomfortable, humiliated, or not seen in their professional role, it is difficult to give to others good care, good support, or good relationships. (shrink)

This article details the results of a national survey conducted in 1999 of statewide laws and protocols providing for the creation and recognition of donot- resuscitate orders effective in nonhospital settings. Applicable primarily to emergency medical services personnel, most of these laws and protocols have been in existence for less than ten years, and there is little current comparative information on them. Such policies are commonly called out-of-hospital or prehospital DNR orders, although one state-Virginia-recently amended its DNR law to establish (...) a durable DNR order applicable to all health care providers and all settings. I will refer to the laws and policies examined here interchangeably as out-of hospital DNR protocols or EMS-DNR protocols. The survey produced a descriptive snapshot of such laws and protocols in effect on a statewide basis as of March 1999. (shrink)

Medical technology, specialization, and the corporatization of health delivery systems in the late twentieth century have all helped give birth to an unwelcome but unavoidable responsibility for individuals with family or friends—serving as a health care proxy. The responsibility comes without monetary compensation, is often involuntary, and lacks any real guidelines beyond the duty to make life-and-death decisions in circumstances over which the proxy has little control.The parameters of the proxy's job have evolved somewhat awkwardly in statutes and case law, (...) as lawmakers and judges have tried to apply conventional concepts to novel circumstances. This article examines the legal and functional status of the proxy, as well as the strengths and weaknesses of current public policy as reflected by state advance directive and surrogate decision-making laws. The first section of the article provides a historical perspective of our current notions of agency law as relevant to health care proxies. (shrink)

State law requirements for health care advance directive documents were reviewed in every state and the District of Columbia to determine whether they are consistent and/or flexible enough to permit the utilization by the public of “universal” advance directive forms, specifically a health care power of attorney, that would be valid under every state's advance directive statutes. Such documents would have to overcome the wide variability of state legal formalities for validity. If this could be accomplished, the public would benefit (...) from having a variety of multi-state or truly universal forms available that could be used with confidence in their validity.The review found that a basic, multi-state health care power of attorney appears to be feasible in 41 States and the District of Columbia, compared to 36 states and the District in 2005. Only nine states prevent recognition of a truly universal form. Some barriers were surmountable, including differing agent and witness requirements, execution requirements, and effectiveness triggers. Other barriers were insurmountable, including mandatory forms, mandatory disclosures, and decision-specific language requirements. The strategies identified for overcoming some barriers can be used by lawyers in drafting true multi-state directives. More importantly, states should simplify state advance directive laws to facilitate a more meaningful communication model of advance care planning. (shrink)

As of December 1991, the Patient Self-Determination Act mandated that health care institutions which receive funding from Medicare or Medicaid provide written information about persons rights to participate in medical decision-making and formulate advance directives. The PSDA required each state…acting through a State agency, association, or other private nonprofit entity develop a written description of the law of the State concerning advance directives that would be distributed by providers or organizations under the requirements of [the Act].

The Physician Orders for Life-Sustaining Treatment Paradigm is designed to improve end-of-life care by converting patients’ treatment preferences into medical orders that are transferable throughout the health care system. It was initially developed in Oregon, but is now implemented in multiple states with many others considering its use. Accordingly, an observational study was conducted in order to identify potential legal barriers to the implementation of a POLST Paradigm. Information was obtained from experts at state emergency medical services and long-term care (...) organizations/agencies in combination with a review of relevant state law. Legal analysis of survey responses and existing laws identified several potential state legal barriers to a POLST Paradigm implementation. The most potentially problematic barriers are detailed statutory specifications for out-of-hospital DNR protocols. Other potential barriers include limitations on the authority to consent to forgo life-sustaining treatments, medical preconditions, and witnessing requirements for out-of-hospital DNR protocols. (shrink)

Background: There is growing awareness that patient care suffers when nurses are not respected. Therefore, to improve outcomes for patients, it is crucial that nurses operate in a moral work environment that involves both recognition respect, a form of respect that ought to be accorded to every single person, and appraisal respect, a recognition of the relative and contingent value of respect modulated by the relationships of the healthcare professionals in a determined context. Research question/aim: The purpose of this study (...) was to develop better understandings of perceptions of nursing’s professional respect in community and hospital settings in England. Research design: The research design was qualitative. Focus groups were chosen as the most appropriate method for eliciting discussion about nursing’s professional respect. Participants and research context: A total of 62 nurses who had been qualified for at least a year and were working in two localities in England participated in this study. Methods: Data were collected using 11 focus group sessions. The data were analysed by means of an inductive content analysis, extracting meaning units from the information retrieved and classifying the arising phenomena into conceptually meaningful categories and themes. Ethical considerations: To conduct the research, permission was obtained from the selected universities. Results: Recognition respect of human beings was perceived as ingrained in the innermost part of nurses. Regarding appraisal respect, a great importance was placed on: the interactions among healthcare professionals, the time to build trust in these relationships, the influences of the workplace characteristics and nurses’ professional autonomy and decision-making. Conclusion: Recognition respect of persons was embedded in the inmost part of nurses as individuals. Concerning appraisal respect, it was thought to be deeply enshrined in the inter- and intra-healthcare professional interactions. The forging of trusting relationships over time was deemed to be strongly associated with good quality interactions with other healthcare professionals. (shrink)

It is natural to think of remembering in terms of causation: I can recall a recent dinner with a friend because I experienced that dinner. Some fifty years ago, Martin and Deutscher (1966) turned this basic thought into a full-fledged theory of memory, a theory that came to dominate the landscape in the philosophy of memory. Remembering, Martin and Deutscher argue, requires the existence of a specific sort of causal connection between the rememberer's original experience of an event and his (...) later representation of that event: a causal connection sustained by a memory trace. In recent years, it has become apparent that this reference to memory traces may be out of step with memory science. Contemporary proponents of the causal theory are thus confronted with the question: is it possible to develop an empirically adequate version of the theory, or is it time to move beyond it? This chapter traces the recent history of the causal theory, showing how increased awareness of the theory’s problems has led to the development of modified version of the causal theory and ultimately to the emergence of postcausal theories. (shrink)

Heidegger understands technology as an act of revealing rather than merely a human achievement. Within the modern era, technology represents the manner in which humans stand within and make manifest the open interplay and inter-relatedness that is world. The danger of this era is the extent to which everything has become available, accessible, and disposable to human manipulation, practically without limit. However, the very totalizing extent to which this is happening, and the forgetfullness that takes it all for granted, can (...) also make us suddenly aware that everything, including world itself, is at risk; that we ourselves are at risk; that we are the danger. He calls for an attitude of releasement that handles world with a sense of receiving, and not just taking, a sense of thankfulness. Such a change could directly impact how we see ourselves and our responsibilities as we go about developing and using technologies. (shrink)

We often find ourselves in situations where it is up to us to make decisions on behalf of others. How can we determine whether such decisions are morally justified, especially if those decisions may change who it is these others end up becoming? In this paper, I will evaluate one plausible kind of justification that may tempt us: we may want to justify our decision by appealing to the likelihood that the other person will be glad we made that specific (...) choice down the line. Although it is tempting, I ultimately argue that we should reject this sort of appeal as a plausible justification for the moral permissibility of our vicarious decisions. This is because the decisions that we make on behalf of another may affect the interests and values that that person will hold in the future. As I will show, this complicates the justificatory relationship between present decisions and future attitudes, since the latter can depend on the former. This is not to say that the predicted future attitudes of others can play no significant role in justifying our decisions on others’ behalf. Rather, appealing to the future attitudes in our moral justifications may play an important role in our practical thinking but only when we consider the future attitudes of all relevant possible futures. (shrink)

I develop the foundation for cosmopolitan care, an underexplored variety of moral cosmopolitanism. I begin by offering a characterization of contemporary cosmopolitanism from the justice tradition. Rather than discussing the political, economic or cultural aspects of cosmopolitanism, I instead address its moral dimensions. I then employ a feminist philosophical perspective to provide a critical evaluation of the moral foundations of cosmopolitan justice, with an eye toward demonstrating the need for an alternative account of moral cosmopolitanism as cosmopolitan care. After providing (...) an explanation of how care ethics in connection with Kantian ethics generates a duty to care, I consider one main feature of cosmopolitan care, namely the theory of obligation it endorses. In developing this account, I place special emphasis on the practical ramifications of the theory by using it to analyze gender violence in conflict zones. (shrink)

The digitization of society and academic research endeavours have led to an explosion of interest in the potential uses of population data in research. Alongside this, increasing attention is focussing on the conditions necessary for maintaining a social license for research practices. Previous research has pointed to the importance of demonstrating “public benefits” from research for maintaining public support, yet there has been very little consideration of what the term “public benefits” means or what public expectations of “public benefits” are. (...) In order to address this pressing issue a series of deliberative workshops with members of the public were held across Scotland in May and June 2017. The workshops aimed to engage a cross-section of the Scottish population in in-depth discussions of the ways that the public – or publics – might benefit from data-intensive health research. The findings reported here discuss workshop participants’ understandings and expectations of health research; who they considered to be “the public” that should benefit from health research and; in what ways they felt “the public” should benefit. Workshop participants’ preference was clearly for the widest possible public benefit to be felt by all, but they also acknowledged the value in research aiming to primarily benefit vulnerable groups within society. A key focus of discussions was the extent to which workshop participants were confident that potential public benefits would be realised. A crucial consideration then is the extent to which mechanisms and political support are in place to realise and maximise the public benefits of data-intensive health research. (shrink)

For years, attempts at ensuring the social sustainability of digital solutions have focused on ensuring that they are perceived as helpful and easy to use. A smooth and seamless work experience has been the goal to strive for. Based on document analysis and interviews with 15 stakeholders, we trace the setting up of a data infrastructure in Danish General Practice that had achieved just this goal – only to end in a scandal and subsequent loss of public support. The ease (...) of data access made it possible for data to be extracted, exchanged and used by new actors and for new purposes – without those producing the data fully realizing the expansion of the infrastructure. We suggest that the case has wider relevance for a still more data-intensive healthcare sector and a growing data economy: when those who produce the data are not made aware of new uses of data, it makes it more difficult to resolve potential conflicts along the way. In the Danish case, conflicting views on legitimate data use led to the collapse of the infrastructure. Therefore, while seamlessness may be a solution to the old problem of a poor fit between user and technology, this celebrated virtue may also involve new problems relating to social instability. As digital solutions tend to be integrated still more seamlessly in still more of our activities, we need to develop political mechanisms to define and protect the rights and obligations of both data suppliers and users in order to ensure the long-term sustainability of digital infrastructures. (shrink)

Farmers markets can offer solutions to several of the biggest problems besetting the US food system: fair prices to farmers; healthy, fresh food for consumers; direct contacts between consumers and farmers; food for food deserts; support for local economies. Awareness of these benefits led us to study the farmers markets of Greater Cincinnati. Markets grew rapidly in the early 1980s, peaked in 2012, and declined 17% by 2018. Sixty-one percent of the markets that started since 1970 have closed. Two types (...) of markets exist: farmer-focused markets, with farmer vendors, and consumer-focused markets, with farmers and specialist vendors. Detailed information about market management shows that managers, the majority of whom are volunteers or underpaid, have insufficient resources to be sustainable. Market decline is often blamed on an oversupply of markets, but other factors are involved: the inability of market personnel and customers to cross class and racial boundaries; the encroachment of online retailers; a scarcity of farmers; market manager failures. Individual markets need to form coalitions and gain sufficient resources from governments or private funders to employ specialists who can assist managers, expand the consumer base, and design promotion campaigns that effectively promote farmers markets in the changing retail food landscape. (shrink)

Increasingly, both mothers and fathers are expected to play an equal role in child rearing. Nonetheless, we know little about how child care arrangements affect couples’ sexual intimacy and relationship quality. Research has focused on the effect of the division of paid labor and housework on couples’ relationships, finding that egalitarianism is problematic for sexual intimacy, relationship quality, and relationship stability. These findings, however, come almost universally from studies utilizing decades-old data that fail to examine the division of child care. (...) In this study, we update this work by utilizing data from the 2006 Marital and Relationship Study to examine how the division of child care affects the relationship quality and sexual intimacy of heterosexual couples in the United States. Results indicate that men’s performance of child care is generally associated with more satisfaction with the division of child care, more satisfying sexual relationships, and higher quality relationships. Importantly, we find that egalitarian child care arrangements have positive consequences for both men and women. These findings contribute to a growing body of research that challenges the costs of egalitarianism and indicates instead that egalitarianism is associated with higher quality, more intimate relationships than gender traditional arrangements. (shrink)

During the COVID-19 pandemic, several hospitals implemented “birthing alone” policies, banning companions from accompanying individuals giving birth. We offer an ethical analysis of these policies. First, we examine them through a consequentialist framework of risks and benefits. Second, we consider the significance of birth, highlighting the unique ways in which risks, relationships, and rights are understood in the context of obstetrics. We conclude that birthing alone policies are largely unjustified, as the harm they are certain to cause outweighs their possible (...) benefits and because they fail to take into account what matters to mothers. (shrink)

This paper examines how digital technologies might be used to improve ethical attitudes towards nonhuman animals, by exploring the case study of nonhuman apes kept in modern zoos. The paper describes and employs a socio-ethical framework for undermining anti-ape prejudice advanced by philosopher Edouard Machery which draws on classic anti-racism strategies from the social sciences. We also discuss how digital technologies might be designed and deployed to enable and enhance rather than impede the three anti-prejudice strategies of contact and interaction, (...) enlightenment, and individualization. In doing so, the paper illuminates the broad potential and limitations of digital technology to both harm and benefit animals via its effects on human ethical attitudes. This examination provides guidance for future projects and empirical work on using digital technologies to promote moral respect for a range of nonhuman animals in different settings. (shrink)

The aim of this article is to examine whether informational manipulation, used intentionally by the researcher to increase recruitment in the research study, can be morally acceptable. We argue that this question is better answered by following a non-normative account, according to which the ethical justifiability of informational manipulation should not be relevant to its definition. The most appropriate criterion by which informational manipulation should be considered as morally acceptable or not is the researcher’s special moral duties towards their subjects. (...) We also propose that a broader definition of manipulation of information should be adopted (than that already existing in the literature) since informational manipulation can affect not only a person’s beliefs but also their desires in decision-making. We conclude that manipulation of information can either be used to protect the potential subject and facilitate the informed consent process or be used to exploit and merely use a person for scientific goals. (shrink)

Traditional approaches to character education have been viewed by many educators as an attempt to establish self control within students to habituate them to prescribed behaviour and as nothing more than a ‘bits‐and‐pieces’ approach to moral education. While this is accurate for many character education programmes, integrated multi‐dimensional character education embraces both moral education and character formation. Students learn to identify and process social conventions within the core values of the school and community and have opportunities to learn practical reasoning (...) skills in schools where character education is integrated into all aspects of the schooling process. Reported in this article are several studies, including two large‐scale experimental investigations, that show integrated character education results in an improved school environment, student pro‐social and moral behaviour, and reading and maths test scores. Schools become more caring communities; student discipline referrals drop significantly, particularly in areas related to bullying behaviour; and test scores in moderately achieving schools increase nearly 50%. (shrink)

Background With the huge number of patients who suffer from chronic and incurable diseases, medical scientists continue to search for new curative methods for patients in dire need of treatment. Interest in stem cells is growing, generating high expectations in terms of the possible benefits that could be derived from stem cell research and therapy. However, regardless of the hope of stem cells changing and improving lives, there are many ethical, religious, and political challenges and controversies that affect the research, (...) and mandated to establish ethical guidelines and regulations. In Saudi Arabia, key stakeholders play an active role in discussing the ethics of stem cell research and therapy. The focus of the study was to explore professionals’ perceptions related to the ethical challenges of using stem cells in research and treatment in Saudi Arabia. Results A qualitative research study was conducted to explore and describe the perceptions of 25 professionals employed at different tertiary hospitals in the various regions of Saudi. A thematic analysis was performed to search for and identify the most significant perceptions shared by the participants. Four themes were generated based on the ethical challenges of four areas related to stem cell use, including forbidden and permitted sources of stem cells, informed consent, beneficence, and ethical regulations and guidelines. Conclusion The study identified that there is a growing need to advance the knowledge, education, and awareness related to stem cell research and treatment in Saudi Arabia. (shrink)

This paper examines relationships between learning and technological change and argues that we urgently need new ways to approach what it means to learn in the context of a global Fourth Industrial Revolution. It briefly introduces the postdigital perspective, which considers the digital ‘revolution’ as something that has already happened and focuses to its reconfiguration. It claims that what we access, how we access it, what we do with it, and who then accesses what we have done, are important elements (...) of a postdigital world worthy of closer examination. Focusing to recent debates about postdigital collective intelligence, we develop the concept of postdigital we-learn by showing that it might help us, amongst other things, to counter the idea of a lone human accessing education primarily for future individual, economic profit, as prescribed by the neoliberal learning economy. Building on new schools of thought emerging in response to the expansion of non-human agency, we refine the concept of postdigital we-learn as a gathering between humans and machines. The consequences of this gathering are uncomfortable, as they imply unlearning elements of both capitalism and critical pedagogy. However, such unlearning is inherent to ‘a critical pedagogy of becoming’ and positions postdigital we-learn as a suitable framework for understanding and development of emancipatory, critical learning in our postdigital reality. (shrink)

As it becomes increasingly plausible that the mind–brain is explicable in naturalistic terms, science‐and‐religion scholars have the opportunity to engage creatively and proactively with facets of brain‐related research that better inform our understanding of human well‐being. That is, once mental health is recognized as being a whole‐body phenomenon, exciting theological conversations can take place. One fascinating area of research involves the “gut–brain axis,” or the interactive relationship between the microbiome in the gastrointestinal tract (i.e., gut bacteria), the central nervous system, (...) and mental health. A growing body of literature explores the immensely significant interactions between the gut microbiome and mental health issues involving depression, anxiety, gene expression, and stress responses. One's mental health does not occur in a disembodied state, but in a complex physical environment that is strongly influenced by environmental factors, many of which we can control. This article argues that science‐and‐religion can welcome scientific research in this area, creatively incorporating such insights into a theology of mental health and physical well‐being. (shrink)

Evidence‐based medicine (EBM) proponents have argued that mechanistic evidence concerning medical treatments should be considered secondary to evidence derived from randomized controlled trials (RCTs). One common criticism of RCTs is that they often do not yield results that are generalizable to clinical practice, and that for clinical practice application, mechanistic evidence is needed. However, proponents of EBM have argued that mechanistic reasoning is often unreliable and thus not very useful. Here we suggest an important role of mechanistic explanation that has (...) been left out of this discussion entirely, namely, its importance in a patient’s decision of whether or not to take certain drugs. We argue that in certain cases, knowing how a treatment works is just as important for the patient as knowing whether it does. In this paper, we explore how and why giving patients mechanistic information can be an important factor in obtaining informed consent for medical treatment, focusing on the example case of hormonal contraceptives. (shrink)

AI is becoming increasingly prevalent in creative fields that were thought to be exclusively human. Thus, it is non-surprising that a negative bias toward AI-generated artwork has been proclaimed. However, results are mixed. Studies that have presented AI-generated and human-created images simultaneously have detected a bias, but most studies in which participants saw either AI-generated or human-created images have not. Therefore, we propose that the bias arises foremost in a competitive situation between AI and humans. In a sample of N (...) = 952 participants, we show that different evaluations emerge only when AI-generated and human-created pieces of art are presented simultaneously. Importantly, we demonstrate that AI art is not devalued, but rather, human art is upvalued, indicating the existence of a positive bias toward humans, rather than a negative bias. Further, we show that attitudes toward AI and empathy partially explain the different valuations of AI and human art in competitive situations. (shrink)

o presente artigo objetiva abordar acerca da crítica consistente ao autoritarismo violento, degradante, racista e desumano dos “anos de chumbo” da ditadura militar no Brasil, constante na literatura afro-brasileira dramática negro-brasileira a partir, sobretudo, de três teatros peculiares, a saber: o Teatro Experimental Negro, o Teatro Profissional do Negro e o Grupo Teatro Palmares Iñaron. Metodologicamente, esclarece-se que esta escrita emprega uma abordagem qualitativa de natureza básica e é de cunho teórico exploratório quanto ao objetivo principal, pois se debruça ao (...) debate, visando aprimorar teorias, conceitos e ideias a partir do bojo de fontes secundárias que tratam da temática principal. Neste sentido, empregou-se o método procedimental bibliográfico utilizando-se da hermenêutica com a técnica de leituras pertinentes à temática proposta. Cabe salientar que, apesar da tentativa histórica do cânone da literatura autoritária e eurocentrada, não foi e nem tem sido capaz de silenciar os ecos objetivos e/ou subjetivos expressos na literatura afro-brasileira, nem mesmo durante o período mais duro e racista da ditadura militar no Brasil. (shrink)

Global university rankings have become increasingly important ‘calculative devices’ for assessing the ‘quality’ of higher education and research. Their ability to make characteristics of universities ‘calculable’ is here exemplified by the first proper university ranking ever, produced as early as 1910 by the American psychologist James McKeen Cattell. Our paper links the epistemological rationales behind the construction of this ranking to the sociopolitical context in which Cattell operated: an era in which psychology became institutionalized against the backdrop of the eugenics (...) movement, and in which statistics of science became used to counter a perceived decline in ‘great men.’ Over time, however, the ‘eminent man,’ shaped foremost by heredity and upbringing, came to be replaced by the excellent university as the emblematic symbol of scientific and intellectual strength. We also show that Cattell’s ranking was generative of new forms of the social, traces of which can still be found today in the enactment of ‘excellence’ in global university rankings. (shrink)

Deprescribing is the term used to describe the process of withdrawal of an inappropriate medication supervised by a clinician. This article presents a discussion of how the Four Principles of biomedical ethics that may guide medical practitioners’ prescribing practices apply to deprescribing medications in older adults. The view of deprescribing as an act creates stronger moral duties than if viewed as an omission. This may explain the fear of negative outcomes which has been reported by prescribers as a barrier to (...) deprescribing. Respecting the autonomy of older adults is complex as they may not wish to be active in the decision-making process; they may also have reduced cognitive function and family members may therefore have to step in as surrogate decision-makers. Informed consent is intended as a process of information giving and reflection, where consent can be withdrawn at any time. However, people are rarely updated on the altered risks and benefits of their long-term medications as they age. Cessation of inappropriate medication use has a large financial benefit to the individual and the community. However, the principle of justice also dictates equal rights to treatment regardless of age. (shrink)

Le Système de l’idéalisme transcendantal a paru en 1800 et fut traduit en français pour la première fois en 1842 par Paul Grimblot. La traduction de Christian Dubois, parue en 1978 et aujourd’hui rééditée chez Allia, est la deuxième, et dernière en date, transposition en français de ce texte. Cette traduction s’inscrivait, en 1978, dans le cadre d’un regain d’intérêt pour les études schellingiennes dans la sphère francophone, représentée par les travaux de Jean-François Courtine et Xavier Til...

Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centred outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated (...) patients’ real-world “quality of life” experiences. We propose a novel precision medicine approach to improving patient-centred TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centred TKA outcomes. Of particular importance to the model’s predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centred outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarised, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilisation of multivariate prediction models to inform individually-tailored interventions targeting a range of health conditions. (shrink)

Many debates in biomedical ethics today involve inconsistencies in defining the key term, person. Both sides of the abortion debate, for instance, beg the question about what constitutes personhood. This book explores the arguments concerning definitions of personhood in the history of modern philosophy, and then constructs a superior model, defined in terms of distinctive features. This model is shown to have distinct advantages over the necessary and sufficient condition models of personhood launched by essentialists. Philosophers historically have been correct (...) about what some of the pivotal distinctive features of personhood are, _e.q._, rationality, communications and self-consciousness, but they have been wrong about the _methods_ of recognizing and asserting personhood, and about the relative importance of feelings. In clinical care, complaints often surface that care is not personal. This book aims to improve care through providing a method of attending to patients as people. Charts in the Appendices show that where physicians attended to personal features important to their patients, sometimes the patients rated the care even higher than the physician did. The book will be useful to health-care providers whose goals include improving quality of care, listening to patients, and preventing malpractice. (shrink)

Within the theoretical framework of the moral intensity model of ethical decision making (Jones, 1991), two studies ascertained the contention that ethicality judgements are contingent upon the perceived intensity of the moral issue. In addition, Study 1 extended the validity of the moral intensity notion to whistle-blowing behaviour; Study 2 addressed the effect of the individual difference variable, need-for-cognition, on differential utilization of intensity dimensions in the ethical decision process. A scenario approach was used in both studies. Results have provided (...) convergent support for the issue-contingency nature of ethical decisions. Study 1 also showed that felt empathy for potential victims predicted the likelihood of whistle-blowing behaviour, and that the perceived overall ethicality of a wrongdoing predicted felt empathy when potential victims are psychologically and physically close. Results of Study 2 further suggested a greater utilization of issue-relevant information by high need-for-cognition individuals in ethical decision making. (shrink)

BackgroundSome people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions (...) are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team.MethodsA three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process?ResultsDecision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: Risks, burdens and benefits; Treatment goals; Normative ethical values; Interested parties.ConclusionsDecision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of ‘who decides’ cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum. (shrink)

Participatory action research always operates in the tension of extending the voice of people who are marginalised and unheard in the society. A workshop, ‘Extending Voice and Autonomy through Participatory Action Research: Ethical and Practical Issues’, was therefore organised to look at the issues arising from this tension. The workshop aimed to examine critically the potential of participatory action research to enable people whose voices are seldom heard and choices are often restricted to be seen, heard and to influence practice (...) and policy relevant to their lives. The paper first outlines the rationale for the workshop and then demonstrates how ‘co-impact’ of participatory action research projects can be achieved through having conversations and reflecting on the ideas of ‘voice and autonomy’, ‘knowledge’, ‘vulnerability’, ‘user involvement and participation’. Through reflecting on the experience of preparing for and delivering the workshop, we seek ways to transform the relationship(s) between service users/community partners and academic and service professionals in the hope of generating practical knowledge ethically. (shrink)

Consumers’ actual knowledge about modern food production is limited, and their judgment is often guided by assumptions or associations that are not necessarily in line with reality. Consumers’ rather unrealistic idea of livestock farming is driven by beautiful and romanticized pictures in advertising. If confronted with the reality of modern livestock farming, consumers’ responses are mainly negative. So far, dairy farming still has a more positive image and thus is less affected by public criticism. However, if made public, some of (...) the current production practices in dairy farming have the potential to reduce consumer acceptance which in turn can have a tremendous effect on farmers. A particularly urgent topic is the handling of male dairy calves. Such calves are often treated as surplus animals due to their low genetic merits for meat, with the risk of resulting in the deprivation of animal welfare. To maintain consumer acceptance of dairy products and find socially accepted alternatives for the handling of male calves, insights into consumer perception of current and future production practices in dairy farming are needed. Thus, the aim of this study is to analyze how consumers evaluate the current situation of male dairy calves and alternatives in male calf management. A quantitative online survey, representative for the German population in terms of gender, age, education, region, and income, was carried out with 1 194 participants in February 2022. Overall, 60% of participants were not aware of the fact that male dairy calves are less appropriate for fattening purposes. Respondents saw a clear need for alternative methods for handling male calves from dairy production. More, our results show that the use of sexed semen encounters consumer resistance, while other alternatives that were evaluated as more natural were more accepted. A cluster analysis identified 3 distinct consumer segments labelled “sexed semen opponents” (31.6%), “undecided” (30.4%), and “proponents of all alternatives” (38.0%) that differed in their acceptance of alternative handling practices of male dairy calves. The results emphasize the gap between consumers’ expectations and reality on farms and the importance of considering consumer preferences when developing future pathways for dairy farming. (shrink)

Fact-finding is at the heart of human rights advocacy, and is often at the center of international controversies about alleged government abuses. In recent years, human rights fact-finding has greatly proliferated and become more sophisticated and complex, while also being subjected to stronger scrutiny from governments. Nevertheless, despite the prominence of fact-finding, it remains strikingly under-studied and under-theorized. Too little has been done to bring forth the assumptions, methodologies, and techniques of this rapidly developing field, or to open human rights (...) fact-finding to critical and constructive scrutiny. The Transformation of Human Rights Fact-Finding offers a multidisciplinary approach to the study of fact-finding with rigorous and critical analysis of the field of practice, while providing a range of accounts of what actually happens. It deepens the study and practice of human rights investigations, and fosters fact-finding as a discretely studied topic, while mapping crucial transformations in the field. The contributions to this book are the result of a major international conference organized by New York University Law School's Center for Human Rights and Global Justice. Engaging the expertise and experience of the editors and contributing authors, it offers a broad approach encompassing contemporary issues and analysis across the human rights spectrum in law, international relations, and critical theory. This book addresses the major areas of human rights fact-finding such as victim and witness issues; fact-finding for advocacy, enforcement, and litigation; the role of interdisciplinary expertise and methodologies; crowd sourcing, social media, and big data; and international guidelines for fact-finding. (shrink)

L’infléchissement de l’économie vers la scientificité masque un paradoxe : moins l’économie s’annonce comme politique, plus elle l’est. L’approche critique de Marx rappelle en effet combien ce régime de discours est idéologique. Réciproquement, c’est le dépassement politique, indexé au matérialisme historique, qui donne à la critique marxienne sa fécondité heuristique. Celle-ci s’appuie sur un projet : l’appropriation politique des forces productives. Définissant ces trois sens dans la lecture de Marx mais aussi dans la distance qui nous en sépare, l’étude s’interroge (...) sur une question posée au présent : comment gagner en politicité? (shrink)

From reason to practice in bioethics brings together original contributions from some of the world's leading scholars in the field of bioethics. With a particular focus on, and critical engagement with, the influential work of Professor John Harris, the book provides a detailed exploration of some of the most interesting and challenging philosophical and practical questions raised in bioethics.

Objective: Persuasive messages regarding fruit and vegetable consumption often meet defensive reactions from recipients, which may lower message effectiveness. Individual differences in emotion regulation and gender are expected to predict these reactions. In the working memory account of persuasion, inducing voluntary eye movements during the processing of the auditory persuasive information might prevent defensiveness and thereby increase message effectiveness.Methods: Participants in two independently recruited samples from the general population listened to a negatively framed auditory persuasive message advocating fruit and vegetable (...) consumption. Half of them were asked to keep following a regularly moving stimulus on their screen with their eyes. At pretest, the individual differences of cognitive self-affirmation inclination and gender were assessed to predict defensive reactions.Results: In Study 1, induced eye movements significantly increased self-reported consumption after 2 weeks when CSAI was low, but only in males, as indicated by a significant three-way interaction. With negative self-evaluative emotions as dependent variable, this three-way interaction was also significant, suggesting that induced eye movements prevented defensiveness in low CSAI males. Study 2 did not assess consumption but replicated the latter three-way interaction.Conclusion: The studies replicated our earlier findings regarding the moderating effects of individual differences in emotion regulation on persuasion, but they also revealed gender differences in persuasion that are related to the working memory. The working memory account of persuasion provides new theoretical as well as practical angles on persuasion to target individuals in persuasion to increase fruit and vegetable consumption. (shrink)

Existe-t-il une porosité naturelle entre les Black Studies et les Cultural Studies? D’un bout à l’autre de l’océan atlantique, d’une expérience américaine à une expérience britannique, ces deux champs peuvent-ils aller au-delà de l’emprunt ponctuel d’outils et de concepts qui marquent aujourd’hui les démarches dites « interdisciplinaires »? Cette contribution discute de la flexibilité théorique et méthodologique des Black Studies vis-à-vis des Cultural Studies. J’argue que cette connexion apparemment logique entre deux studies se heurte à l’histoire des Black Studies, pensées (...) comme un champ voire une discipline dont l’institutionnalisation et la définition d’une démarche propre ont participé de sa reconnaissance politique. Malgré leur glissement vers les études africana et diasporiques au début des années 1990, les Black Studies demeurent un champ constitué encore peu perméable à d’autres studies. Enfin, je discute des African Diaspora Studies et les Black Cultural Studies comme troisième voie à l’intersection des Black Studies et des Cultural Studies. (shrink)

This commentary analyses the quantitative parameters of Reichle et al.'s model, using estimates when explicit information is not provided. The analysis highlights certain features that appear to be necessary to make the model work and ends by noting a possible problem concerning the variability associated with oculomotor programming.

Hennepin County is the largest metropolitan area in Minnesota and includes the city of Minneapolis and surrounding suburbs. On Tuesday, March 24, 2020, the weekly local shelter count identified 1,494 individuals accessing homeless shelters within Minneapolis—205 children with adults, 112 adults with children, 56 youth without an adult, 971 individual adults, and 115 adults accessing emergency hotel placement in response to COVID-19 pandemic. Beyond the shelter system, a recent local point-in-time count logged 732 individuals sleeping on transit, in encampments, in (...) abandoned buildings, or otherwise outdoors. This total of 2,226 Hennepin County residents identified who lacked residence in the late winter of 2020 is... (shrink)

Assuming live music can foster belonging in the workplace, this study linked companies in the secondary and tertiary sectors with the world of music performance. Specifically, students from a Swiss music university offered live mini-concerts on the premises of three companies over a period of 3 months. To analyze the impact of these brief musical interventions on the sense of belonging of staff in these companies, a mixed methods approach was adopted using a standardized questionnaire. The short concerts were much (...) appreciated. On the individual level, they led to a greater sense of pleasure and were perceived as a break, a possibility to connect to one’s emotions and above all, as a “moment for oneself.” On the group level, the short concerts allowed the members of teams to meet, prompted conversations and new ways of sharing, created links, and offered opportunities to get to know work colleagues differently and to discover them on a more personal level. (shrink)

Much ink has been spilled in philosophy over the question of whether morality is an objective or subjective matter. In the world of The Good Place, the answer to the moral question seems fairly firmly determined: right and wrong are objective matters, and there is a fact about whether our actions are good or bad. The ancient Greek philosopher Pythagoras believed that beauty was a quantifiable principle of nature, and that we could find the source of beauty in the harmony, (...) order, and regularity of beautiful things. In some ways, The Good Place appears to treat aesthetic goodness and badness as if they were objective matters. The Good Place is a sort of extended version of Jean‐Paul Sartre's (1905–1980) existentialist play No Exit. In The Good Place, hell is other people's tastes. (shrink)