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)

Suppose that one is at least a minimal realist about a given domain, in that one thinks that that domain contains truths that are not in any interesting sense of our own making. Given such an understanding, what can be said for and against the method of reflective equilibrium as a procedure for investigating the domain? One fact that lends this question some interest is that many philosophers do combine commitments to minimal realism and a reflective equilibrium methodology. Here, for (...) example, is David Lewis on philosophy: Our “intuitions” are simply opinions: our philosophical theories are the same. Some are commonsensical, some are sophisticated; some are particular; some general; some are more firmly held, some less. But they are all opinions, and a reasonable goal for a philosopher is to bring them into equilibrium. Our common task it to find out what equilibria there are that can withstand examination, but it remains for each of us to come to rest at one or another of them… Once the menu of well-worked out theories is before us, philosophy is a matter of opinion. Is that to say that there is no truth to be had? Or that the truth is of our own making, and different ones of us can make it differently? Not at all! If you say flatly that there is no god, and I say that there are countless gods but none of them are our worldmates, then it may be that neither of us is making any mistake of method. We may each be bringing our opinions to equilibrium in the most careful possible way, taking account of all the arguments, distinctions, and counterexamples. But one of us, at least, is making a mistake of fact. Which one is wrong depends on what there is (1983: x-xi). In addition to philosophy in general, the method of reflective equilibrium has also been endorsed as the appropriate procedure for investigating various other subject.. (shrink)

The study of the neural basis of memory has advanced over the past decade. A key contributor to this memory “renaissance” has been new tools. On its face, this matches what might be described as a neuroscientific revolution stemming from the development of tools, where this revolution is largely independent of theory. In this paper, we challenge this tool revolution account by focusing on a problem that arises in applying it to this “renaissance”: it is centered around memory, but the (...) tools were not developed for solving problems in memory science. To resolve this problem, we introduce an account that distinguishes tool development and tool uptake, and we argue that while theoretical considerations may not inform development, they do inform uptake. Acknowledging the distance between these stages of tool use draws our attention to the questions of why and how tool uptake occurs in the domains that it does. (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)

Shortages of life-saving medical resources caused by COVID-19 have prompted hospitals, healthcare systems, and governmentsto develop crisis standards of care, including 'triage protocols' to potentially ration medical supplies during the public health emergency. At the same time, the pandemic has highlighted and exacerbated racial, ethnic, and socioeconomic health disparities that together constitute a form of structural racism. These disparities pose a critical ethical challenge in developing fair triage systems that will maximize lives saved without perpetuating systemic inequities. Here we review (...) alternatives to 'utilitarian' triage, including first-come first-served, egalitarian, and prioritarian systems of allocating scarce medical resources. We assess the comparative advantages and disadvantages of these allocation schemes. Ultimately, we argue that while triage protocols should not exacerbate disparities, they are not an adequate mechanism for redressing systemic health inequities. Entrenched health disparities must be addressed through broader social change. (shrink)

Importance Informed consent is essential to ethical, rigorous research and is important to recruitment and retention in cancer trials.Objective To examine cancer clinical trial (CCT) participants’ perceptions of informed consent processes and variations in perceptions by cancer type.Design and Setting and Participants Cross-sectional survey from mixed-methods study at National Cancer Institute–designated Northeast comprehensive cancer center. Open-ended and forced-choice items addressed: (1) enrollment and informed consent experiences and (2) decision-making processes, including risk-benefit assessment. Eligibility: CCT participant with gastro-intestinal or genitourinary, hematologic-lymphatic (...) malignancies, lung cancer, and breast or gynecological cancer (N = 334).Main Outcome Measures Percentages satisfied with consent process and information provided; and assessing participation’s perceptions of risks/benefits. Multivariable logistic or ordinal regression examined differences by cancer type.Results Most patient-participants felt well informed by the consent process (more than 90% overall and by cancer type) and. most (87.4%) reported that the consent form provided all the information they wanted, although nearly half (44.8%) reported that they read the form somewhat carefully or less. More than half (57.9%) said that talking to research staff (i.e., the consent process) had a greater impact on participation decisions than reading the consent form (2.1%). A third (31.1%) were very sure of joining in research studies before the informed consent process (almost half of lung cancer patients did—47.1%). Most patients personally assessed the risks and benefits before consenting. However, trust in physicians played an important role in the decision to enroll in CCT.Conclusions and Relevance Cancer patients rely less on written features of the informed consent process than on information obtained from the research staff and their own physicians. Research should focus on information and communication strategies that support informed consent from referring physicians, researchers, and others to improve patient risk-benefit assessment and decision-making. (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)

Inspired by early proposals in philosophy, dominant accounts of language posit a central role for mutual knowledge, either encoded directly in common ground, or approximated through other cognitive mechanisms. Using existing empirical evidence from language and memory, we challenge this tradition, arguing that mutual knowledge captures only a subset of the mental states needed to support communication. In a novel theoretical proposal, we argue for a cognitive architecture that includes separate, distinct representations of the self and other, and a cognitive (...) process that compares these representations continuously during conversation, outputting both similarities and differences in perspective. Our theory accounts for existing data, interfaces with findings from other cognitive domains, and makes novel predictions about the role of perspective in language use. We term this new account the Multiple Perspectives Theory of mental states in communication. (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)

The purpose of this article is to understand how academic integrity educational tutorials are administered across Canadian higher education. Results are shared from a survey of publicly funded Canadian higher education institutions, including universities and colleges, across ten provinces where English is the primary language of instruction. The survey contained 29 items addressing institutional demographic details, as well as academic integrity education questions. Results showed that academic integrity tutorials are inconsistent across Canadian higher education, with further differences evident within the (...) university and college sectors. (shrink)

Pro-anorexia is an Internet-based movement that provides advice and support for the development/maintenance of an eating disorder. The movement is sometimes framed as a religion, with rituals, psalms, creeds and the invocation of a deity who personifies the ED. The latter aspect is likely to influence identities and behaviours as well as providing emotional support and motivation for community members. However, there is little sustained empirical analysis of how members themselves orient to and self-position within the religious discourse. Here, we (...) apply the concept of interdiscursivity to examine the construction of Ana as god. Drawing on a body of online interactions from one pro-ana website over a 47-day period, we discursively analyse members’ constructions of Ana and their relationship with her. With reference to biblical texts, we consider how these constructions directly reference concepts of Christian religion and faith. Implications for understanding pro-ana and interdiscursivity are discussed. (shrink)

Why are young women less likely than young men to persist in academic science and engineering? Drawing on 57 in-depth interviews with PhD students and postdoctoral scholars in the United States, we describe how, in academic science and engineering, motherhood is constructed in opposition to professional legitimacy, and as a subject of fear, repudiation, and public controversy. We call this the “specter of motherhood.” This specter disadvantages young women and amplifies anticipatory concerns about combining an academic career with motherhood. By (...) specifying the content of cultural discourses about motherhood in academic workplaces and the processes by which these ideas circulate, produce disadvantage, and inform young, childless scientists and engineers’ career plans, our findings offer novel insight into mechanisms contributing to inequality in academic careers. (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)

The research program Spit For Science was launched at Virginia Commonwealth University (VCU) in 2011. Since then, more than 10,000 freshmen have been enrolled in the program, filling out extensive questionnaires about their drinking, general substance use, and related behaviors, and also contributing saliva for genotyping. The goals of the program, as initially stated by the investigators, were to find the genes underlying the heritability of alcohol use and related behaviors, and in addition to put genetic knowledge to work in (...) ways that might aid university administrators and mental health professionals in the prevention and treatment of substance abuse. We review every empirical paper involving genetic data that has emerged from the program, and reach a surprising conclusion: the study has never identified a single genetic effect of more than trivial magnitude. Although the quantitative results of the studies were reported transparently, the theoretical ramifications of the negligible results have never been acknowledged. To the contrary, most of the papers ignore the tiny effects, reaching optimistic conclusions about the prospects for future genetic explanations of alcohol use. We explore the implications of these results for the broader prospects of applied psychiatric genetics. (shrink)

Although Western biomedical ethics emphasizes respect for autonomy, the medical decision-making of Muslim patients interacting with Western healthcare systems is more likely to be motivated by relational ethical and religious commitments that reflect the ideals of equity, reciprocity, and justice. Based on an in-depth cross-cultural comparison of Islamic and Western systems of biomedical ethics and an assessment of conceptual alignments and differences, we argue that, when working with Muslim patients, an ethics of respect extends to facilitating decision-making grounded in the (...) patient’s justice-related customs, beliefs, and obligations. We offer an overview of the philosophical contestations of autonomy-enhancing practices from the Islamic tradition of biomedical ethics, and examples that demonstrate a recommended shift of emphasis from an autonomy-centered to a justice-focused approach to culturally competent agency-promotion. (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)

Peu étudiée, la querelle de la méthode, qui eut lieu entre 1828 et 1840 et mit en discussion trois nations philosophiques (Allemagne, Écosse, France) s’avère déterminante pour comprendre l’élaboration, via la réception de Schelling, d’une philosophie française. À partir de l’étude de cette querelle, ce travail propose d’identifier et d’analyser la fonction de Schelling dans l’élaboration d’une identité philosophique française, en particulier dans les spiritualismes concurrents de Victor Cousin et Félix Ravaisson. En retour, il nous ouvre de nouvelles perspectives sur (...) la philosophie française du xixe siècle, mais aussi sur la philosophie schellingienne. (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)

How should educational research be contracted? And is there anything wrong with the way that public funding of educational research is currently administered? We endeavour to answer these questions by appeal to the work of two of the most prominent philosophers of science of the twentieth century, namely Popper and Kuhn. Although their normative views of science are radically different, we show that they would nonetheless agree on a number of key rules concerning the extent to which scientific practice should (...) be influenced ‘from the outside’. We then show that these rules are often broken in the way that research is publicly funded in the UK. (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.

This article examines the complex intertwinements of feminism, anti-colonial Marxism and imperialism in the work of the recent Literature Nobel Prize winner Doris Lessing, particularly in her writings on colonial Africa and the travelogue African Laughter. The article outlines the implications of these intersections for the representation of Zimbabwe against some political, aesthetic and epistemological developments in Lessing's oeuvre. Through a reading of African Laughter, the article argues that a crucial tension is at stake between Lessing's political project of giving (...) voice to black Zimbabweans and the western female protagonist as the authoritative subject of this project. The aim is to render an innovative perspective of Doris Lessing's status as a feminist icon, which she gained in the wake of her acclaimed novel The Golden Notebook, by proceeding from postcolonial feminist scholarship. (shrink)

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)

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)

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)

The ethics of adolescent decision making is a complicated mine­field with laws that vary from state to state. The case of a fourteen-year-old girl, who simultaneously was diagnosed with cancer and discovered she was pregnant, highlights several weaknesses in our current approach to adolescent decision making in the context of pregnancy. In addition, adolescents with life-limiting conditions face similar challenges that can be examined through the framework of Catholic doctrine.

Allied health professionals play an integral role in providing safe, affordable care to communities in need. Laws that define the permissible scope of practice for these professionals may take full advantage of these providers and may unnecessarily restrict safe and effective care. Nurse practitioners in many states may provide care independent of a physician; research reveals that this care is safe, affordable and accessible. Yet hurdles exist that prevent communities from securing the full benefit of NPs in independent practice. The (...) scope of independent practice for allied dental providers varies greatly across the country, often including stringent supervision requirements. Emerging approaches to allowing allied dental providers to practice independently in certain settings or with dentist supervision via telemedicine and creating the intermediate provider, the dental therapist, may increase access to safe, affordable dental care. Research on the impact of laws that allow broader independent practice by NPs to ferret out the hurdles to full implementation of the spirit of such laws is needed. That research could support expanded independent scope for allied dental providers and other allied health care providers. (shrink)

ArgumentThis paper challenges three assumptions common in the literature on expertise: that expertise is linearly derived from scientific knowledge; that experts always align with the established institutional order; and that expertise is a property acquired by individuals. We criticize these ideas by juxtaposing three distinct expert practices involved with flood risk management in England. Virtual engineering is associated with commercial consultancy and relies on standardized software packages to assess local flood inundation. Mathematical experimentation refers to academic scientists creating new digital (...) renderings of the physical dynamics of flooding. Participatory modeling denotes research projects that aim to transform the relationships between experts and local communities. Focusing on different modes of modeling we contribute an analysis of how particular models articulate with specific politics of knowledge as experts form relationships with flood risk management actors. Our empirical study also shows how models can contribute to re-distribution of expertise in local flood risk management. (shrink)

Instances in which we cannot retrieve information immediately but know that the information might be retrieved later are subjective states that accompany retrieval failure. These are expressed in feeling-of-knowing and Tip-of-the-tongue experiences. In Experiment 1, participants with Parkinson’s disease and older adult controls were given general questions and asked to report when they experienced a TOT state and to give related information about the missing word. The PD group experienced similar levels of TOTs but provided less correct peripheral information related (...) to the target when in a TOT state. In Experiment 2, participants were given a Semantic and an Episodic FOK task. PD patients failed to accurately predict their future memory performance in response to both episodic and semantic cues. Results are interpreted in the context of recent frameworks of memory and metacognition. (shrink)

Since at least the 1970s in Canada, there have been calls for health system reforms based on innovative roles and expanded scopes of practice for nurses. Professional regulatory organizations, through legislation, define the standards and parameters of professional nursing practice. Nursing regulators emphasize public protection over the advancement of nursing; regulatory processes and decisions tend to be conservative and risk‐averse. This study explored the impact that regulatory processes have on innovation in nursing roles. Nurses in a range of unique practice (...) situations were interviewed, including nurses in non‐traditional roles and/or settings, those with cross‐jurisdictional career histories, and those working in interdisciplinary practices and educational settings. For these nurses, nursing practice was viewed through a traditional clinical lens, which did not fit for them. They experienced hassle, delay, and inconsistencies in regulatory practices. They felt mistreated and fearful of the regulator and lamented the ways in which ambitious, creative, capable nurses were stymied in attempting new applications for nursing knowledge. Nursing is constraining its own mandate to contribute to health care through stringent licensing processes. Healthcare reform provides an opportunity for nursing regulators to rethink their processes and provide the latitude for nurse‐driven change. (shrink)

Los códigos éticos humanos no son coherentes en su diseño ni tampoco tienen una distribución universal. Por lo tanto, la imposible universalidad ni completitud de los sistemas éticos para la inteligencia artificial (IA) es algo evidente que tan sólo fue apuntado someramente por el estudio reciente del MIT (Moral Machine). Al tener toda ética un matiz cultural inequívoco, y también incluir grados de interpretación en sus principios (como el derecho universal a la vivienda, evidente si bien ninguna institución vela por (...) su cumplimiento, algo que una máquina no entendería). Al mismo tiempo se produce un problema formal: un sistema de IA no siempre cuenta con suficientes datos ni tiempo óptimo para procesar una situación, por lo que un factor de azar ético debe tenerse en cuenta en el diseño de tales sistemas. (shrink)

Descartes says that the Meditations contains the foundations of his physics. But how does the work advance his geometrical view of the corporeal world? His argument for this view of matter is often taken to be concluded with the proof of the existence of bodies in the Sixth Meditation. This paper focuses on the work that follows the proof, where Descartes pursues the question of what we should think about qualities such as light, sound and pain, as well as the (...) size and shape of particular bodies. His inquiry makes crucial use of the notion of a teaching of nature originating from God, as contrasted with an apparent teaching of nature originating from habit. I attempt to reconstruct Descartes's use of these notions in order to clarify the way in which he makes space for his geometrical conception of the corporeal world. (shrink)