AimsThis study evaluates a protocol for early, routine ethics consultation for patients on extracorporeal membrane oxygenation to support decision-making in the context of clinical uncertainty with the aim of mitigating ethical conflict and moral distress.MethodsWe conducted a single-site qualitative analysis of EC documentation for all patients receiving ECMO support from 15 August 2018 to 15 May 2019. Detailed analysis of 20 ethically complex cases with protracted ethics involvement identifies four key ethical domains: limits of prognostication, bridge to nowhere, burden of (...) treatment and system-level concerns. There are three subthemes: relevant contextual factors, the role of EC and observed outcomes. Content analysis of transcripts from interviews with 20 members of the multidisciplinary ECMO team yields supplemental data on providers’ perceptions of the impact of the early intervention protocol.ResultsLimited outcome data for ECMO, unclear indications for withdrawal, adverse effects of treatment and an obligation to attend to programme metrics present significant ethical challenges in the care of this patient population. Upstream EC mitigates ethical conflict by setting clear expectations about ECMO as a time limited trial, promoting consistent messaging among multiple services and supporting surrogate decision-makers. When ECMO becomes a ‘bridge to nowhere’, EC facilitates decision-making that respects patient values yet successfully sets limits on non-beneficial use of this novel therapy.ConclusionData from this study support the conclusion that ECMO poses unique ethical challenges that necessitate a standardised protocol for early, routine EC—at least while this medical technology is in its nascent stages. (shrink)

We distinguish two pathways people may follow when they join violent groups: compliance and internalization. Compliance occurs when individuals are coerced to join by powerful influence agents. Internalization occurs when individuals join due to a perceived convergence between the self and the group. We searched for evidence of each of these pathways in field investigations of former members of two renowned terrorist organizations: the Liberation Tigers of Tamil Eelam and Islamist radical groups. Results indicated that ex-fighters joined LTTE for reasons (...) associated with both compliance and internalization but that ex-fighters joined Islamist radical groups primarily for reasons associated with internalization. When compliance occurred, it often took the form of coercion within LTTE but involved charismatic persuasion agents within Islamist groups. This evidence of systematic differences in the reasons why fighters enter violent groups suggests that strategies for preventing radicalization and fostering de-radicalization should be tailored to particular groups. (shrink)

An increasing number of studies have addressed the psychological impact of the COVID-19 crisis on the general population. Nevertheless, far less is known about the impact on specific populations such as university students, whose psychological vulnerability has been shown in previous research. This study sought to examine different indicators of mental health in university students during the Spanish lockdown; we also analyzed the main sources of stress perceived by students in relation to the COVID-19 crisis, and the coping strategies adopted (...) when faced with the situation. Data was collected from 932 students through a web-based platform. Measures of anxiety, depression, irritability, and self-perceived change in mental health were administered, as well as ad hoc measures of stressors and coping strategies. Results indicated that students experienced considerable psychological problems during the confinement, with higher rates of emotional difficulties in women and undergraduate students than in men and postgraduates, respectively. Psychological distress was mainly related to several specific domains of stressors, as perceived by the participants: academic future, task overload, worsening of interpersonal conflicts, and restrictions in pleasant social contact; and far less related to the spread of the disease and its consequences for physical health. As regards coping strategies, both reframing skills and daily routines were shown to be the most effective. A path-analysis model integrating stressors, coping, and mental health revealed that coping strategies partially mediated the effect of stressors on psychological health. In general, results suggest that students’ psychological health was substantially affected by the COVID-19 situation and that the academic and relational changes were the most notable sources of stress. This study reinforces the need to monitor and promote mental health in university students to boost resilience in times of crisis. Our results on effective coping strategies may inform preventive programs aimed at helping students to deal with challenges like the COVID-19 pandemic. (shrink)

Before the advent of fibrinolytic therapy as a gold standard method of care for cases of acute ischemic stroke in Romania, issues regarding legal medicine aspects involved in this area of medical expertise were already presented and, in the majority of cases, the doctors seem to be unprepared for these situations. The present research illustrates some of the cases in which these aspects were involved, that adressed a clinical center having 6 years of professional experience in the application of fibrinolytic (...) treatment for stroke. The following cases report either situations in which the afore mentioned therapy was not rightfully administrated or legal aspects regarding the obtainment of informed consent. Obtaining informed consent is a mandatory procedure, which takes time, to the detriment of application of fibrinolytic treatment. (shrink)

Potential applications of genome editing in assisted reproductive technology (ART) raise a vast array of strong opinions, emotional reactions and divergent perceptions. Acknowledging the need for caution and respecting such reactions, we observe that at least some are based on either a misunderstanding of the science or misconceptions about the content and flexibility of the existing legal frameworks. Combining medical, legal and ethical expertise, we present and discuss regulatory responses at the national, European and international levels. The discussion has an (...) EU starting point and is meant as a contribution to the general international regulatory debate. Overall, this paper concludes that gene editing technologies should not be regulated autonomously. Rather, potential uses should be regulated under general, existing frameworks and where applicable by reference to sufficiently equivalent technologies and techniques already subject to specific regulation. To be clear, we do not argue for the hasty introduction of gene editing as a reproductive treatment option in the immediate future. We call for caution with regard to overreaching moratoria and prohibitions that will also affect basic research. We recommend flexible regulations that allow for further responsible research into the potential development of the technology. We call for an open and inclusive debate and argue that scientific communication should claim a more prominent role to counter the danger of widespread misinformation. A high level of transparency and accuracy should guide scientific communication while simultaneously global‐scale responsibility and governance should be fostered by promoting cross‐disciplinary thinking and multi‐level stakeholder involvement in legal and regulatory processes. (shrink)

Este artigo, um recorte de pesquisa de Doutorado, objetiva desvelar as percepções de 208 professores de filosofia do Paraná no sentido de buscar evidenciar quais seriam as especificidades da disciplina de filosofia em relação a outras disciplinas do currículo. Inicialmente, disserta-se sobre a intermitência da disciplina de Filosofia no currículo da Educação Básica, com base em Deleuze e Guattari (2010), os quais demarcam o entendimento da filosofia como criação de conceitos. Em seguida, fundamentado em Rodrigues e Gelamo (2019), entre outros (...) autores, reflete-se sobre o modo de compreender a filosofia, que pode oscilar entre uma compreensão enciclopédica com base na memorização dos sistemas filosóficos e experiência filosófica. Por fim, por meio da análise de conteúdo de Bardin (2016), a seguinte questão de um questionário que envolvia outras dez foi analisada: “Você acredita que a filosofia proporciona espaços ou momentos diferenciados em relação aos das outras disciplinas? Se sim, no que ela se diferencia?”. Das respostas dos 208 docentes, emergiram as seguintes categorias: criar conceitos, espaço para o debate/reflexão de ideias, possibilidade da experiência filosófica e superar o senso comum. Os resultados apontam, assim, em um sentido de que a disciplina de filosofia não deve limitar-se a um conhecimento enciclopédico, mas, sim, trata-se de um conhecimento que se relaciona com o cotidiano de seus interlocutores. Faz-se necessário, porém, um saber valorizar adequadamente a história da filosofia, pois, ao valorizar demais a história da filosofia, pode-se incorrer a um ensino meramente descritivista; contudo, ao não valorizar a história da filosofia, pode-se debruçar em discussões sem conteúdo filosófico. (shrink)

O objetivo deste artigo é refletir sobre os conceitos de verdadeiro e falso self e sua manifestação na clínica contemporânea; bem como as possibilidades de intervenção a partir da psicanálise winnicottiana. O conceito de falso self proposto por Winnicott é de grande valia para se pensar nos relatos ..

This article proposes to analyse some aspects of the appropriation of New School thinking in Brazil, particularly Deweyan pragmatism, in the 1950s and 1960s. The analysis is based on the assumption that the developmentalist ideology that punctuated the debate on the economic, political and social restructuring of the country in these two decades constituted fertile ground for the return and expansion of pragmatist thinking amongst Brazilian educators, articulating itself, sometimes in contradictory ways, with this ideology. The focus of the analysis (...) will be on the writings of the group of educators which circulated around the figure of Anísio Teixeira, at the time director of the National Institute for Pedagogic Studies, an organ linked to the Ministry of Education and Culture, which set itself the task of producing research that would support public policy in the field of education, as well as constituting itself as a center for teacher education and the stimulus and development of innovative experiences in the public school system. The appropriation of Deweyan pragmatism, in this context, had a triple perspective: pragmatism as scientific method, implying a specific conception of science, particularly the social sciences, with emphasis on the application of scientific knowledge in the solution of practical problems; as a way of democratic life; and as a synonym for experimentalism, in the sphere of schooling. (shrink)

Este estudo tem como objetivo conhecer as concepções de homem presentes na bibliografia utilizada pelas disciplinas de Psicologia Clínica das universidades gaúchas. Com esse intuito procedeu-se, inicialmente, a uma revisão bibliográfica sobre as formas de concepção de homem ao longo da história da humanidade, chegando-se à Idade Moderna e ao advento da Psicologia como ciência. Através da análise qualitativa dos planos de ensino de 11 universidades gaúchas, pode-se inferir que a concepção de homem predominante na Psicologia Clínica, como disciplina acadêmica, (...) é a concepção própria da Psicanálise.This article aims to know the concepts of man that can be found in the bibliography used in courses of clinical psychology in universities of Rio Grande do Sul. As a first step, we went through a bibliographical survey about the ways man has been comprehended along history up to Modern Age and the advent of Psychology as science. From the qualitative analysis of the teaching plans of eleven universities of Rio Grande do Sul, it is possible to infer that the psychoanalytical concept of man is the predominant conception found in clinical psychology as an academic discipline. (shrink)

A Lei de Diretrizes e Bases 9.394/96 inseriu a Filosofia nos currículos do Ensino Médio com o indicativo de interdisciplinaridade, permanecendo em aberto questões acerca de como fazer com que a Filosofia potencialize a experiência interdisciplinar. Com o objetivo de correlacionar interdisciplinaridade e Filosofia, o artigo resulta de uma análise hermenêutica que confronta reflexões de Hannah Arendt sobre a crise na educação e a proposta da comunidade de investigação de Lipman. Parte da noção de que em meados do século XX, (...) a educação tradicional foi substituída pela pedagogia progressista e a educação passou a ser pensada como ciência do ensino em geral, a fim de atender à dinâmica do avanço científico e tecnológico. A visão analítica e linear das especialidades não responde satisfatoriamente às demandas atuais de uma ciência complexa, articulada e em rápida transformação. Diante do requisito interdisciplinar da ciência, o específico da Filosofia é a problematização e a sistematização do filosofar; de mediação entre as disciplinas, em virtude da dimensão holística de seus conteúdos, e de vigilância epistemológica como recurso de revisão e atualização dos saberes. Palavras-chave: Interdisciplinaridade. Filosofia. Ciência. Crise na educação. Comunidade de investigação. (shrink)

The book analyses the two decades of the brutal civil war of northern Uganda. The author modified Lederach's peacebuilding framework to include peacemaking to bring out the argument that women and men make significant contributions to the peace processes and point out women's position as top leadership actors. The book uncovers the under-emphasised role of women in peacemaking and building. From grassroots to national level, women were found to have organised themselves and assumed roles as advocates, negotiators and mobilisers. The (...) actions by women became evident at the stalemated Juba peace talks when women presented the Peace Torch to the peace negotiating teams who on the occasion shook hands for the first time and peace was ushered inches Their initiatives and non-violent actions offer lessons to resolve civil conflicts in Africa. The book recommends that women should undergo relevant training in times of peace as this would make them more effective in times of need. (shrink)

: Freedom, understood as active participation in public life, connects the thinking of Rosa Luxemburg with that of Hannah Arendt. Biographically separated through the rise and victory of the totalitarian movements, they both developed a concept of the political that is oriented toward freedom and that demonstrates—in spite of their different historical experiences—essential common features: both authors emphasize the recognition of difference as a presupposition for a critical discussion of norms, traditions, and authorities, for the capacity to make unconstrained judgments, (...) and for the ability to take personal responsibility. (shrink)

Die Reise von Róewicz an die Ouellen der Kultur des Mittelmeerraumes ist ein der vielen Versuche, die den Ziel hatten, die Weltmitte neu aufzubauen. Die vergeblichen, metamorphischen Reisen des verlorenen Sohnes an die mit seiner Geburt genetisch verbundenen Orte, die missgelungenen Versuche der Wiederholung dieser Struktur, liessen den Dichter seine Hoffnung woanders suchen: die Wiege der Mittelmeerraumkultur, loci communes aller Topeen, Archetypen und Mythen unseres Kulturkreises. El in Arcadie ego beweist, dass die Italiamythe nichts mehr Neues zeigt, ihre Schönheit wurde (...) sprachlos. Die Gegenwart – der perfekte Mörder der Vergangenheit – zeigte die Unfruchtbarkeit der für die vergangenen Generationen mehrdeutigen Mythe des italienischen Kulturparadises. Meine Erorerung ist ein Versuch, den Poem im Zusammenhang mit dem Bankrott der bisherigen Esthetiksprachen abzulesen. (shrink)

In the history of Miron Białoszewski as a poet the main issues are on the exploitation of commonplace and the continuation of literary tradition of low and high culture. Apart from the mentioned traditional literary genres, allusions to certain literary texts and the visible traces of Hindu ideas, one can correspondingly find here references to the Biblical symbolism, the combination of elements from various artistic spheres and polemics with traditional literary patterns. In my study I described some particular references to (...) high literary culture and presented the examples of metatextual and intertextual references to such culture. At the same time I strove to explain the poet’s motives for using them. (shrink)

This series will include monographs and collections of studies devoted to the investigation and exploration of knowledge, information and data-processing systems of all kinds, no matter whether human, (other) animal or machine. Its scope is intended to span the full range of interests from classical problems in the philosophy of mind and phi losophical psychology through issues in cognitive psychology and socio biology (concerning the mental capabilities of other species) to ideas related to artificial intelligence and computer science. While primary (...) emphasis will be placed upon theoretical, conceptual and epistemologi cal aspects of these problems and domains, empirical, experimental and methodological studies will also appear from time to time. Among the most challenging and difficult projects within the scope of artificial intelligence is the development and implementation of com puter programs suitable for processing natural language. Our purpose in compiling the present volume has been to contribute to the foundations of this enterprise by bringing together classic papers devoted to crucial problems involved in understanding natural language, which range from issues of formal syntax and logical form to those of possible-worlds and situation semantics. The book begins with a comprehensive introduc tion composed by Jack Kulas, the senior editor of this work, which pro vides a systematic orientation to this complex field, and ends with a selected bibliography intended to promote further research. If our efforts assist others in dealing with these problems, they will have been worthwhile. J. H. F. (shrink)

In the Laws, Plato theorizes citizenship as simultaneously a political, ethical, and aesthetic practice. His reflection on citizenship finds its roots in a descriptive psychology of human experience, with sentience and, above all, volition seen as the primary targets of a lifelong training in the values of citizenship. In the city of Magnesia described in the Laws erôs for civic virtue is presented as a motivational resource not only within the reach of the 'ordinary' citizen, but also factored by default (...) into its educational system. Supporting a vision of 'perfect citizenship' based on an internalized obedience to the laws, and persuading the entire polity to consent willingly to it, requires an ideology that must be rhetorically all-inclusive. In this city 'ordinary' citizenship itself will be troped as a performative action: Magnesia's choral performances become a fundamental channel for shaping, feeling and communicating a strong sense of civic identity and unity. (shrink)

The aim of our study was to investigate the effects of a small therapeutic animal on the social behavior of nine autistic children. The social contacts of the autistic children were evaluated by a descriptive method of direct observation that was performed without and with the presence of a TA. In period one, contacts with an unfamiliar person and acquaintances were registered; in period two, contacts with the acquaintances and the TA were registered. The frequency of contacts of autistic children (...) with their acquaintances significantly increased in the presence of the TA . The frequency of contacts with the TA was significantly higher than the frequency of contacts with the UP . The form of the autistic children’s contacts with A, with the UP, and with the TA was individually dependent, and the presence of the TA changed the characteristics of contacts with A. Our results indicate that the presence of a small TA can positively influence the quantity and quality of the social behavior of autistic children and that the characteristics of social contacts were dependent on the individual. (shrink)

European countries; eminent thinkers; Turkish image; Islam image.

Der Band Matka odchodzi von Różewicz ist ein Buch über die Familie des Dichters. Zwischen der personlich Erklärung: „Ich bin ein Dichter”, und der ergreifenden Erinnerung: „Das Schönste und Wertwolle bei uns zu Hause ist die Muter”, ist ein Teil der Geschichte der Różewicz-Familie enthalten. Das ist auch ein Buch über eine alte Frau – die Muter, die einzige Ikone des für Różewicz charakteristischen Stils, die keine Banalität erlitten hat und den Weltzerfall nicht bewiest. Die Unabhängigkeit des Buches hat keinen (...) autonomischen Charakter, sondern ist eine schriftliche Bezeugungsweise der Ich – Identität. In den Band, in dem mehrere Lippenbekenntnisse von dem Beruf des Verfassers zu finden sind, gibt es kein einziges Gedicht. Man kann also keinesfalls einer Frage nach der originalität des Buches entweichen. Ich habe vor allem die Antwort darauf in Erwägung gezogen. (shrink)

As the concept of recognition shifts from philosophical theory to other fields of the humanities and social sciences, this volume explores the nature of this border category that exists in the space between sociological and philosophical considerations, related as it is to concepts such as status, prestige, the looking-glass self, respect, and dignity - at times being used interchangeably with these terms. Bringing together work from across academic disciplines, it presents theoretical conceptualizations of recognition, demonstrates its operationalization in historical and (...) literary research, considers recognition as a fundamental problem of sociological theory and examines the concept as a marker of social distances and redistribution. An examination and demonstration of the full potential of recognition as a category, Understanding Recognition: Conceptual and Empirical Studies explores the contemporary meanings and manifestations of recognition and sheds light on its capacity to complement the notions of status, class or prestige. As such, it will appeal to scholars of sociology and social theory, philosophy, history and literary studies. (shrink)

This paper describes a practice innovation: the addition of formal weekly discussions of patients with prolonged PICU stay to reduce healthcare providers’ moral distress and decrease length of stay for patients with life-threatening illnesses. We evaluated the innovation using a pre/post intervention design measuring provider moral distress and comparing patient outcomes using retrospective historical controls. Physicians and nurses on staff in our pediatric intensive care unit in a quaternary care children's hospital participated in the evaluation. There were 60 patients in (...) the interventional group and 66 patients in the historical control group. We evaluated the impact of weekly meetings to establish goals of care for patients with longer than 10 days length of stay in the ICU for a year. Moral distress was measured intermittently and reported moral distress thermometer scores fluctuated. "Clinical situations" represented the most frequent contributing factor to moral distress. Post intervention, overall moral distress scores, measured on the moral distress scale revised, were lower for respondents in all categories, and on three specific items. Patient outcomes before and after PEACE intervention showed a statistically significant decrease in PRISM indexed LOS, a statistically significant increase in both code status changes DNR, and in-hospital death, with no change in patient 30 or 365 day mortality. The addition of a clinical ethicist and senior intensivist to weekly inter-professional team meetings facilitated difficult conversations regarding realistic goals of care. The study demonstrated that the PEACE intervention had a positive impact on some factors that contribute to moral distress and can shorten PICU length of stay for some patients. (shrink)

A recent Carnegie Report on Nursing Education – Educating Nurses: A Call for Radical Transformation challenges the nursing profession to embrace an education model that integrates knowledge, skilled know how and ethical comportment. Placing ethics in such a prominent position in nursing education is a radical transformation. Teaching ethics must be intentional and it is integral to the development of individual nurses and the profession as a whole. The development of moral imagination has a prominent place in this new education (...) model. The moral imagination is the ability to ponder and wonder about the inherent rightness or wrongness of decisions, choices and behaviors. This paper will review some key issues relevant to teaching ethics and then explore what nurturing the moral imagination could do for nurses as they learn to apply abstract ethics concepts to their clinical practice. (shrink)

The general question to be considered in this paper points to the nature of the world described by chemistry: what is macro-chemical ontology like? In particular, we want to identify the ontological categories that underlie chemical discourse and chemical practice. This is not an easy task, because modern Western metaphysics was strongly modeled by theoretical physics. For this reason, we attempt to answer our question by contrasting macro-chemical ontology with the mainstream ontology of physics and of traditional metaphysics. In particular, (...) we introduce the distinction between stuff-ontology, proper of chemistry, and individual-ontology, proper of physics. These two ontologies differ from each other in the basic categories of their own structures. On this basis, we characterize individual-ontology in such a way that the features of stuff-ontology will arise by contrast with it. (shrink)

Political theorists have written a great deal about the ethics of “intervention,” defined as states using coercion or force to interfere in foreign societies’ politics. But this work leaves much of global politics un-analyzed—both because non-state actors play an increasingly significant role in it and because its practitioners use many tactics besides force and coercion.We need an ethics of foreign influence to help us navigate the global political arena in all its complexity. Here, I begin to develop a unified theory (...) of the ethics of deliberate attempts to promote justice in foreign societies, whether undertaken by state or non-state actors, and whatever tactics they employ. I identify two important but under-appreciated dimensions along which instances of foreign influence can differ and argue that, once we appreciate the full range of forms foreign influence can take, we’ll see it’s often immune to the common moral objections against intervention. (shrink)

El presente trabajo busca llevar a cabo una reconstrucción racional de un suceso histórico, tal como lo fue el surgimiento de la biología molecular, visto a la luz de la filosofía de Thomas Kuhn. Pese a que varios autores señalaron la inadecuación de la propuesta metateórica de _La Estructura_ (aún con los remiendos de la _Posdata del 69_) postulamos que es factible una reconstrucción del origen de esta (sub)disciplina bajo la categorías de paradigma-matriz disciplinar y ciencia normal con algunos refinamientos. (...) Pretendemos mostrar el surgimiento de un nuevo paradigma como la convergencia de dos líneas de investigación, una sobre la forma de la molécula de la vida, la otra sobre su función hereditaria. (shrink)

Resumo : O texto deseja investigar a categoria “estética” no campo da filosofia da educação. Formar-se significa dar a si mesmo o direito de escolher trajetórias diante do fecundo universo interpretativo à disposição no meio acadêmico. A força do educador na relação com o estudante implica ensinar a ruminar sobre suas escolhas estéticas para bem argumentar na relação com outras abordagens filosóficas. Cabe aos educadores no ensino superior e especialmente aqueles do campo da Filosofia e das Teorias da Educação provocar (...) os estudantes a fazer experiências com seus próprios conceitos, por vezes desmontando, refinando, sofisticando, incluindo, excluindo noções e conceitos para evitar que a solidez das convicções empobreçam as imagens da exuberância da vida e das estéticas educativas Palavras-chave : formação, filosofia da educação, estética, teorias da educação. (shrink)