WQ.1 “Independent men and women, in independent homes, leading separate and independent lives, with full freedom to form and dissolve relations, and with perfectly equal opportunities to happiness, development, and love.” I leave out the word “rights,” doubtful I can use it without being misunderstood. Perhaps I can succeed in dispensing with its use altogether. This ideal, so stated, is attractive to me and completely in harmony with my idea of the course in life which will best further human happiness. (...) WQ.2 I am not sure that I quite understand Victor’s position in regard to the number of.. (shrink)

How does talk work, and can we engage the public in a dialogue about the scientific study of talk? This article presents a history, critical evaluation and empirical illustration of the public science of talk. We chart the public ethos of conversation analysis that treats talk as an inherently public phenomenon and its transcribed recordings as public data. We examine the inherent contradictions that conversation analysis is simultaneously obscure yet highly cited; it studies an object that people understand intuitively, yet (...) routinely produces counter-intuitive findings about talk. We describe a novel methodology for engaging the public in a science exhibition event and show how our ‘conversational rollercoaster’ used live recording, transcription and public-led analysis to address the challenge of demonstrating how talk can become an informative object of scientific research. We conclude by encouraging researchers not only to engage in a public dialogue but also to find ways to actively engage people in taking a scientific approach to talk as a pervasive, structural feature of their everyday lives. (shrink)

This article focuses on Guyanese efforts in the ​postcolonial present to address environmental issues that have become increasingly complex in the face of an awareness of climate change. It opens with an account of how the preservation of Indigenous forests contributes to international efforts to reduce carbon, while making visible the instability that the discovery of oil and gas reserves in the seabed might portend for the Guyanese economy. Specifically, the article examines how engineers have historically confronted settler-colonial discourses about (...) terra nullius unfold as they invest in sea defense. In doing so, the article foregrounds what engineers call slips—the slow or sudden displacement of a sea defense’s structural foundation. Slips are phenomena of energy conversion between land and sea. Rather than arguing for the claims of the pre-Anthropocene earth, the article suggests how many factors are in play in developing policy in the present, in an era of heightened awareness of the different forces in a changing climate. (shrink)

Any philosophy of science ought to have something to say about the nature of mathematics, especially an account like constructive empiricism in which mathematical concepts like model and isomorphism play a central role. This thesis is a contribution to the larger project of formulating a constructive empiricist account of mathematics. The philosophy of mathematics developed is fictionalist, with an anti-realist metaphysics. In the thesis, van Fraassen's constructive empiricism is defended and various accounts of mathematics are considered and rejected. Constructive empiricism (...) cannot be realist about abstract objects; it must reject even the realism advocated by otherwise ontologically restrained and epistemologically empiricist indispensability theorists. Indispensability arguments rely on the kind of inference to the best explanation the rejection of which is definitive of constructive empiricism. On the other hand, formalist and logicist anti-realist positions are also shown to be untenable. It is argued that a constructive empiricist philosophy of mathematics must be fictionalist. Borrowing and developing elements from both Philip Kitcher's constructive naturalism and Kendall Walton's theory of fiction, the account of mathematics advanced treats mathematics as a collection of stories told about an ideal agent and mathematical objects as fictions. The account explains what true portions of mathematics are about and why mathematics is useful, even while it is a story about an ideal agent operating in an ideal world; it connects theory and practice in mathematics with human experience of the phenomenal world. At the same time, the make-believe and game-playing aspects of the theory show how we can make sense of mathematics as fiction, as stories, without either undermining that explanation or being forced to accept abstract mathematical objects into our ontology. All of this occurs within the framework that constructive empiricism itself provides the epistemological limitations it mandates, the semantic view of theories, and an emphasis on the pragmatic dimension of our theories, our explanations, and of our relation to the language we use. (shrink)

“Ambivalence” is the key word in much of this book; “comic” [is the book’s] most obscure and I think absolutely without use value. I don’t know what B[urke] means by “comic,” as a matter of fact. I wonder if he does, and could define it briefly. Readers of Kenneth Burke are well aware of the importance of comedy and its associated cluster of concepts in his work: comic, comic frame, comic attitude, comic corrective. This cluster of terms figures prominently in (...) his 1937 book Attitudes Toward History, most notably in two key passages that scholars turn to time and again. In the first, from the “Poetic Categories” section of the book, Burke explains how different genres serve as guides for how to act in the... (shrink)

This article sets my own acquaintance with Asphodel in the context of her academic and life achievements. In this long life, she has both seen and influenced changes in the work of theology and social attitudes. Her own work has been seminal and inspiring. Her life has been as radical as her writing. The article draws on conversations with others of her acquaintance, as well as her writings. I end by honouring Asphodel as a gevirah, in scriptural terms.

Commitments agreed upon internationally by Irish political representatives often escape scrutiny at home.1 One outcome of this omission is evidenced in the debate regarding the family: Is it pivotal to the achievement of the common good, or does its unity act as an obstacle to full equality? This article examines this debate from the standpoint afforded by MacIntyre’s formulation of tradition-constituted enquiries, asking whether current political trends entail a shift in the very basis on which the Irish reason practically.

Deals with Vaughan's connection with the "Occult" philosophy which his brother Thomas embraced & practiced & discusses Henry's indebtedness to the philosophies of Jacob Boehme, Cornelius Agrippa, Paracelsus, & others.

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.

Mastery imagery has been shown to be associated with more positive cognitive and emotional responses to stress, but research is yet to investigate the influence of mastery imagery ability on imagery’s effectiveness in regulating responses to acute stress, such as competition. Furthermore, little research has examined imagery’s effectiveness in response to actual competition. This study examined (a), whether mastery imagery ability was associated with stress response changes to a competitive stress task, a car racing computer game, following an imagery intervention, (...) and (b), the effects of different guided imagery content on pre-task cognitive and emotional responses. In Session 1, 78 participants (M age = 20.03 years, SD = 1.28) completed ratings of pre-task anxiety intensity and direction, confidence, and perceived control. Imagery ability was also assessed before completing the task. In Session 2, participants were randomly allocated to an imagery condition (positive mastery, negative mastery, relaxation) or control group (no imagery) before completing the task and outcome measures again. For the negative mastery group, greater positive mastery imagery ability was associated with greater perceived control and perceiving anxiety as more facilitative. Furthermore, mastery imagery ability moderated the relationship between anxiety intensity and direction. Altogether, results suggest that positive mastery imagery ability may act as a potential buffer against the effects of negative images. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

Many of those teaching at the intersection of medicine and the humanities are siloed within institutional spaces. This essay recounts the teaching of Sarah Manguso’s The Two Kinds of Decay to students across different academic contexts and considers what we can learn when we put classrooms in conversation with each other. This essay argues for the value of texts like Manguso’s, which explicitly hold the narrating subject and form of illness narrative up for critical examination. The authors call for (...) more collaborative teaching, which has special resonance in the health humanities, where conversations already depend on bridging disciplines and listening to the stories others can tell. (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

An emerging approach to complement randomised controlled trial (RCT) data in the development of radiotherapy treatments is to use routinely collected ‘real-world’ data (RWD). RWD is the data collected as standard-of-care about all patients during their usual cancer care pathway. Given the nature of this data, important questions remain about the permissibility and acceptability of using RWD in routine practice. We involved and engaged with patients, carers and the public in a two-day citizens’ jury to understand their views and obtain (...) decisions regarding two key issues: (1) preferred approaches to consent for the use of RWD within the context of patients receiving radiotherapy for lung cancer in RAPID-RT and (2) how RWD use should be best communicated to patients. Individual views were polled using questionnaires at various stages of the jury, whilst group discussion activities prompted further dialogue about the rationale behind choices of consent. Key decisions obtained from the jury include: (1) an opt-out approach to consent for the use of RWD; (2) the opt-out approach to consent should be informed. Furthermore, it was advised that information and communication regarding the consent process and use of RWD should be accessible, clear and available in a variety of formats. It is important that the consent process for patient data use is underpinned by principles of autonomy and transparency with clear channels of communication between those asking for and giving consent. Moreover, the process of seeking consent from patients should be proportionate to the risks presented from their participation. (shrink)

The American Journal of Bioethics, Volume 12, Issue 6, Page 35-37, June 2012.

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)

Research examining non-suicidal self-injury (NSSI) in daily life has grown substantially; thus, it is essential in conducting ecological momentary assessment (EMA) research with individuals who self-injure to follow important ethical guidelines. Given the challenges faced by researchers in monitoring, assessing, and responding to risk among those who self-injure, further guidance and research is warranted in informing best-practices for conducting EMA research examining NSSI. We suggest ethics-based approaches to professional competence, responding to and monitoring risk, and ensuring inclusive and representative approaches (...) to NSSI research in daily life. Related empirical and practical issues in need of further investigation are discussed. (shrink)

Graduates of doctoral programs are expected to be competent at designing and conducting research independently. Given the level of research competence needed to successfully conduct research, it is important that assessors of doctoral programs have a reliable and validated tool for measuring and tracking perceived research competence among their students and graduates. A high level of research competence is expected for all Ph.D. graduates worldwide, in addition to in all disciplines/fields. Moreover, graduates of Ph.D. programs may complete their studies in (...) one country but then obtain a research position in another country, emphasizing the need to ensure that all doctoral programs are fostering similar levels of research competence. Thus, the purpose of this study was to gather additional evidence for validity and reliability of the Research Competence scale. Specifically, we sought to extend the findings of by adapting the scale, translating it to other languages, and applying the tool with a sample of early stage researchers. Our findings provide initial evidence that the adapted PR-Comp is appropriate for use in three languages and across a variety of disciplines/programs of study. (shrink)

The view from inside : gendered embodiment and the medical representation of sex / Shelley Wall -- The politics of medico-legal recognition : the terms of gendered subjectivity in the UK Gender Recognition Act / Sarah Burgess -- Journeys of choice? : abortion, travel, and women's autonomy / Christabelle Sethna and Marion Doull -- The code of ethics in medicine : intertextuality and meaning in Plato's Sophist and Hippocrates' oath / Twyla Gibson -- Sleeping ethics : gene, episteme, and (...) the body politic / Deborah Lynn Steinberg -- The last temptation of Marion Woodman : the anorexic remainder in bone : dying into life / David L. Clark. (shrink)

Venturing into novel terrain poses physical risks to a female and her offspring. Females have a greater tendency to avoid physical harm, while males tend to have larger range sizes and often outperform females in navigation-related tasks. Given this backdrop, we expected that females would explore a novel environment with more caution than males, and that more-cautious exploration would negatively affect navigation performance. Participants explored a novel, large-scale, virtual environment in search of five objects, pointed in the direction of each (...) object from the origin, and then navigated back to the objects. We found that females demonstrated more caution while exploring as reflected in the increased amounts of pausing and revisiting of previously traversed locations. In addition, more pausing and revisiting behaviors led to degradation in navigation performance. Finally, individual levels of trait harm avoidance were positively associated with the amount of revisiting behavior during exploration. These findings support the idea that the fitness costs associated with long-distance travel may encourage females to take a more cautious approach to spatial exploration, and that this caution may partially explain the sex differences in navigation performance. (shrink)

As a research team focused on vulnerable youth, we increasingly need to find ways to acknowledge non‐binary genders in health research. Youth have become more vocal about expanding notions of gender beyond traditional categories of boy/man and girl/woman. Integrating non‐binary identities into established research processes is a complex undertaking in a culture that often assumes gender is a binary variable. In this article, we present the challenges at every stage of the research process and questions we have asked ourselves to (...) consider non‐binary genders in our work. As researchers, how do we interrogate the assumptions that have made non‐binary lives invisible? What challenges arise when attempting to transform research practices to incorporate non‐binary genders? Why is it crucial that researchers consider these questions at each step of the research process? We draw on our own research experiences to highlight points of tensions and possibilities for change. Improving access to inclusive health‐care for non‐binary people, and non‐binary youth in particular, is part of creating a more equitable healthcare system. We argue that increased and improved access to inclusive health‐care can be supported by research that acknowledges and includes people of all genders. (shrink)

Background While it is generally acknowledged that self-prescribing among physicians poses some risk, research finds such behaviour to be common and in certain cases accepted by the medical community. Largely absent from the literature is knowledge about other activities doctors perform for their own medical care or for the informal treatment of family and friends. This study examined the variety, frequency and association of behaviours doctors report providing informally. Informal care included prescriptions, as well as any other type of personal (...) medical treatment (eg, monitoring chronic or serious conditions). Method A survey was sent to 2500 randomly-selected physicians in Colorado, 600 individuals returned questionnaires with usable data. The authors hypothesised: (1) physicians would prescribe the same types of treatment at home as they prescribed professionally; and (2) physicians who informally prescribed addictive medications would be more likely to engage in other types of informal medical care. Results Physicians who wrote prescriptions for antibiotics, psychotropics and opioids at work were more likely to prescribe these medications at home. Those prescribing addictive drugs outside of the office treated more serious illnesses in emergency situations, more chronic conditions and more major medical/surgical conditions informally than did those not routinely prescribing addictive medications. Physicians reported a variety of informal care behaviour and high frequency of informal care to family and friends. Discussion The frequency and variety of informal care reported in this study strongly argues for profession-wide discussion about ethical and guideline considerations for such behaviour. These areas are discussed in the paper. (shrink)

To understand why autistic people are misperceived in the way Jaswal & Akhtar suggest, we should embrace concepts like the “double empathy problem” and camouflaging and recognize the negative consequences these have for mental health in autism. Moreover, we need to value expertise from experience so that autistic people have a voice and indeed a stake in research into autism.

Nurse engagement, empowerment and strong relationships among staff, residents and families, are essential to attract and retain a suitably qualified and skilled nursing workforce for safe, quality care. There is, however, limited research that explores engagement, empowerment and relational coordination in long‐term care (LTC). Nurses from an older persons’ mental health and dementia LTC unit in Australia participated in this study. Forty‐one nurses completed a survey measuring psychological empowerment, work engagement and relational coordination. Twenty‐nine nurses participated in individual interviews to (...) further explore these concepts. Although nurses reported high psychological empowerment and work engagement, their relationships with key stakeholders varied. Our findings suggest that nurses in LTC require both supports and opportunities to contribute as active members of the multiprofessional care team that includes tailored education, professional development and positive interactions within the care team. Regular support is needed to enable nurses to feel empowered, foster relationships and communication, and facilitate work engagement. Based on these findings, we suggest that it is important to find ways to ensure that all who provide care perceive that they are part of the whole care team and able to contribute to the care and well‐being of people in LTC. (shrink)

ObjectivesThe end of life is an ethically challenging time requiring complex decision-making. This study describes ethical frameworks among physician trainees, explores how these frameworks manifest and relates these frameworks to experiences delivering end-of-life care.DesignWe conducted semistructured in-depth exploratory qualitative interviews with physician trainees about experiences of end-of-life care and moral distress. We analysed the interviews using thematic analysis.SettingAcademic teaching hospitals in the United States and United Kingdom.ParticipantsWe interviewed 30 physician trainees. We purposefully sampled across three domains we expected to be (...) associated with individual ethics in order to elicit a diversity of ethical and experiential perspectives.ResultsSome trainees subscribed to a best interest ethical framework, characterised by offering recommendations consistent with the patient’s goals and values, presenting only medically appropriate choices and supporting shared decision-making between the patient/family and medical team. Others endorsed an autonomy framework, characterised by presenting all technologically feasible choices, refraining from offering recommendations and prioritising the voice of patient/family as the decision-maker.ConclusionsThis study describes how physician trainees conceptualise their roles as being rooted in an autonomy or best interest framework. Physician trainees have limited clinical experience and decision-making autonomy and may have ethical frameworks that are dynamic and potentially highly influenced by experiences providing end-of-life care. A better understanding of how individual physicians’ ethical frameworks influences the care they give provides opportunities to improve patient communication and advance the role of shared decision-making to ensure goal-aligned end-of-life care. (shrink)