Background and PurposeMany critically ill patients in intensive care units (ICUs) are unable to communicate their wishes about goals of care, particularly about the use of life-sustaining treatments. Surrogates and clinicians struggle with medical decisions because of a lack of clarity regarding patients’ preferences, leading to prolonged hospitalizations and increased costs. This project focused on the development and implementation of a tool to facilitate a better communication process by (1) assuring the early identification of a surrogate if indicated on admission (...) and (2) clarifying the decision-making standards that the surrogate was to use when participating in decision making. Before introducing the tool into the admissions routine, the staff were educated about its use and value to the decision-making process.Project and MethodsThe study was to determine if early use of a simple method of identifying a patient’s surrogate and treatment preferences might impact length of stay (LOS) and total hospital charges. A pre- and post-intervention study design was used. Nurses completed the surrogacy information tool for all patients upon admission to the neuroscience ICU. Subjects (total N=203) were critically ill patients who had been on a mechanical ventilator for 96 hours or longer, or in the ICU for seven days or longer. The project included staff education on biomedical ethics, critical communication skills, early identification of families and staff in crisis, and use of a simple tool to document patients’ surrogates and previously expressed care wishes. Data on hospital LOS and hospital charges were collected through a retrospective review of medical records for similar four-month time frames pre- and post-implementation of the assessment tool.ResultsSignificant differences were found between pre- and post-groups in terms of hospital LOS (F=6.39, p=.01) and total hospital charges (F=7.03, p=.009).ConclusionsProject findings indicate that the use of a simple admission assessment tool, supported by staff education about its completion, use, and available resources, can decrease LOS and lower total hospital charges. The reasons for the difference between the pre- and post-intervention groups remain unclear. Further research is needed to evaluate if the quality of communications between patients, their legally authorized representatives, and clinicians—as suggested in the literature—may have played a role in decreasing LOS and total hospital charges. (shrink)

This paper provides an overview of Group Duties: Their Existence and Their Implications for Individuals.

In these essays, we are concerned with virtue in journalism and the media but are mindful of the tension between the commercial foundations of publishing and broadcasting, on the one hand, and journalism's democratic obligations on the other. Adam outlines, first, a moral vision of journalism focusing on individualistic concepts of authorship and craft. Next, Craft attempts to bridge individual and organizational concerns by examining the obligations of organizations to the individuals working within them. Finally, Cohen discusses the importance of (...) resisting the powerful corporate logic that pervades the news media in the United States and calls on journalists to be courageous. (shrink)

We consider four mechanisms by which apparent discontinuities in the distribution of antisociality could arise: (1) executive genes or hormonal systems, (2) multiplicative interactions of predisposing factors, (3) environmental tracking into a limited number of social roles, and (4) cross-generational gene—environment interactions. A more explicit consideration of complex self-organizing dynamic systems may help us understand the maintenance of antisocial subpopulations.

Philosophers increasingly argue that collective agents can be blameworthy for wrongdoing. Advocates tend to endorse functionalism, on which collectives are analogous to complicated robots. This is puzzling: we don’t hold robots blameworthy. I argue we don’t hold robots blameworthy because blameworthiness presupposes the capacity for a mental state I call ‘moral self-awareness’. This raises a new problem for collective blameworthiness: collectives seem to lack the capacity for moral self-awareness. I solve the problem by giving an account of how collectives have (...) this capacity. The trick is to take seriously individuals’ status as flesh-and-blood material constituents of collectives. The idea will be: under certain conditions that I specify, an individual can be the locus of a collective's moral self-awareness. The account provides general insights concerning collectives’ dependence on members, the boundaries of membership, and the locus of collectives’ phenomenology. (shrink)

It is well established that beliefs provide powerful cues that influence reasoning. Over the last decade research has revealed that judgments based upon logical structure may also pre-empt deliberative reasoning. Evidence for ‘intuitive logic’ has been claimed using a range of measures (i.e. confidence ratings or latency of response on conflict problems). However, it is unclear how well such measures genuinely reflect logical intuition. In this paper we introduce a new method designed to test for evidence of intuitive logic. In (...) two experiments participants were asked to make random judgments about the logical validity of a series of simple and complex syllogistic arguments. For simple arguments there was an effect of logical validity on random responding, which was absent for complex arguments. These findings provide a novel demonstration that people are intuitively sensitive to logical structure. (shrink)

When engaging in community-based research, it is important to consider ethical research practices throughout the project. While current research practices require many investigators to obtain approval from an ethics review board before starting a project, more is required to ensure that ethical principles are applied once the investigations begin and after the investigations are complete. In response to this concern, as expressed by workers at a feminist non-profit during a community placement, we developed a tool to foster both greater ethical (...) and feminist research practice in community-based research. Using feminist theories, methodologies, and concepts such as epistemic justice, epistemic trust, and coauthorship, a tool was developed to support researchers and other collaborators in building relationships of reciprocity. This tool, called the Research Responsibility Agreement (RRA) invites all members of a research project to explicitly reflect on their role in the research, their relationships with other collaborators, their responsibility to contributing meaningfully in the project, and their plans to remain accountable to one another. In doing so, the RRA adds to existing tools that support ethical research by sharing explicit reflections from all collaborators on how to prevent harm and by asking them to reflect on ethical practices beyond the initial stages of the project. The RRA also encourages greater engagement from researchers and collaborators toward building meaningful relationships with each other, and with participants, to work together in advancing social change. As a practical tool that promotes reflection, that builds relationships, and that holds all parties accountable to ethical and feminist research practices, the RRA has the potential to generate impactful change in community-based research projects and beyond. While the RRA is tailored to community-based research, it can be applied widely to any research project and has the potential to revolutionize how research relationships are built across disciplines. (shrink)

Research that is integrated into ongoing clinical activities holds the potential to accelerate the generation of knowledge to improve the health of individuals and populations. Yet integrating research into clinical care presents difficult ethical and regulatory challenges, including how or whether to obtain informed consent. Multiple empirical studies have explored patients' and the public's attitudes toward approaches to consent for pragmatic research. Questions remain, however, about how to use the resulting empirical data in resolving normative and policy debates and what (...) kind of data warrants the most consideration. We recommend prioritizing data about what people consider acceptable with respect to consent for pragmatic research and data about people's informed, rather than initial, preferences on this subject. In addition, we advise caution regarding the weight given to majority viewpoints and identify circumstances when empirical data can be overridden. We argue that empirical data bolster normative arguments that alterations of consent should be the default in pragmatic research; waivers are appropriate only when the pragmatic research would otherwise be impracticable and has sufficiently high social value. (shrink)

While popular cultural representations portray the “new father” of the past two decades as more involved, more nurturing, and capable of coparenting, many argue that actual fathering conduct has not kept pace. Others, however, question the extent to which the culture of fatherhood does indeed support involved fathering and, if so, what this involvement entails. This study aims to contribute to the exploration of the culture of fatherhood through an analysis of a yearlong Canadian newspaper series dedicated to family issues. (...) Findings suggest that through representations of parental guilt, parental responsibility, work—family balance issues, and hegemonic masculinity, mothers continue to be positioned as primary parents. Support for father involvement, to the extent that it exists, occurs within the framework of fathers as part-time, secondary parents whose relationship with children remains less important than mothers'. (shrink)

The theory of consequences was one of the most important developments in logic during the Middle Ages. The distinction between formal consequences and material consequences was probably introduced by Ockham and soon became the main division of consequences, to be found in nearly all 14th-century treatises on the theory of consequences. This paper discusses the concept of a formal and material consequence according to the English tradition. It is based mainly on Richard Bil­lingham’s De consequentiis, but also takes into account (...) other 14th-century authors. Billingham defines the formal consequence as one where the consequent is understood in the antecedent and differentiates this kind of consequence from the material one. The definition is followed by a list of rules for valid consequences. However, with respect to some of these valid consequences the question arises whether they are formal or not and, if they are formal, how it is possible to explain the criterion of the intelligitur in. After explaining the material and the formal consequence and discussing these difficulties, the question is raised whether the intelligitur in is an appropriate structural criterion to distinguish between formal and material consequences. Finally, two interpretations for the intelligitur in compatible with the text situation are proposed. (shrink)

Ethical issues in biomedical research are traditionally examined as distinct from those of clinical care. However, this traditional framing may obscure questions of equity and fairness in both rese...

Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopment advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.In a letter sent out to 2600 hospitals across the country they [Public Citizen] demand that healthcare facilities “immediately discontinue the distribution of commercial infant formula manufacturer discharge bags,” claiming it undermines women’s success at breastfeeding. What they failed to explain is (...) why a woman’s decision regarding her own tits is anyone’s fucking business but her own.Clearly, policies to promote breast-feeding.. (shrink)

Il est convenu de considérer dans la littérature scientifique que Delphes a eu, comme Délos, « Apollon pour rempart ». De l’arrivée des Amphictions, au plus tard au moment de ce qu’il est convenu d’appeler la Première Guerre sacrée (début du vie s. av. J.‑C.), jusqu’à la fin du paganisme, le sanctuaire et la cité de Delphes ont en effet été protégés par l’interdit religieux que les membres de l’Association internationale étaient chargés de faire respecter. Cette configuration politico-religieuse a évité (...) à la petite cité des Delphiens d’avoir à assumer la charge de défendre le riche sanctuaire. De cet idéal antique a résulté un vide scientifique et bibliographique, alors même que les études sur les fortifications ou, plus largement, sur les systèmes défensifs, ont été nombreuses ces dernières décennies. Les fouilles menées en 2017 et 2018 ont cependant permis en quelques semaines de renouveler entièrement le questionnement sur les fortifications de Delphes dans l'Antiquité. (shrink)

The primary goal of this article is point out certain close parallels between some ideas of the radical feminist theorist Mary Daly and those of the French philosopher Henri Bergson. These similarities are particularly striking regarding distinctions made by both authors between two fundamentally contrasting types of cognitive faculty, of time and temporal experience, and of self and emotion. Daly departs from Bergson inasmuch as she employs these distinctions in her own way. She does not—like Bergson—employ them to depict the (...) result of a natural process of consciousness or life, and the dangers for human freedom and thought of not properly respecting these differences. Rather, she locates these differences within a more liberatory, ethical perspective to ground a sharp, inimical contrast between feminist creative movement on the one hand, and static, fixing, and “fixating” patriarchy, with its “technocratic” pretensions, on the other. My hope is that highlighting the similarities between Daly and Bergson will open new paths of appreciation and critique of Daly’s work. (shrink)

This book is a collection of essays exploring adaptive systems from many perspectives, ranging from computational applications to models of adaptation in living and social systems. The essays on computation discuss history, theory, applications, and possible threats of adaptive and evolving computations systems. The modeling chapters cover topics such as evolution in microbial populations, the evolution of cooperation, and how ideas about evolution relate to economics. The title Perspectives on Adaptation in Natural and Artificial Systems honors John Holland, whose 1975 (...) Book, Adaptation in Natural and Artificial Systems has become a classic text for many disciplines in which adaptation play a central role. The essays brought together here were originally written to honor John Holland, and span most of the different areas touched by his wide-ranging and influential research career. The authors include some of the most prominent scientists in the fields of artificial intelligence evolutionary computation, and complex adaptive systems. Taken together, these essays present a broad modern picture of current research on adaptation as it relates to computers, living systems, society, and their complex interactions. (shrink)

Ann Margaret Sharp, American philosopher of education, believed that friends could, in fact, be quite critical of one another. Writing in her essay, “What is a Community of Inquiry,” she states,... but children know that the group has taken on a great significance for them: each one’s happiness means as much to each of them as their own. They truly care for each other as persons, and this care enables them to converse in ways they never have before. They can (...) engage in inquiry without fear of rebuff or humiliation. They can try out ideas that they never would have thought of expressing before just to see what happens.I am grateful to the friends of Sharp who spent time in pursuit of understanding her work and its... (shrink)

This exploratory research aims to identify the accommodation and support measures, the challenges and the needs, for students with disabilities in teaching internship context. By answering an online questionnaire, 158 SH trainees in teaching in Belgium and Quebec, affirm, for the most part, that their situation of disability has repercussions on their internships. Their main challenges and needs are related to organization and written communication. However, few accommodation and support measures have been established during the internship.

This article explores how leadership is done in a ‘leaderless’ team. Drawing on a corpus of more than 120 hours of audio-recorded meetings of different interdisciplinary research groups and using a discourse analytic framework and tools, we examine how leadership is enacted in a team that does not have an assigned leader or chair. Our specific focus is the discursive processes through which team members conjointly solve disagreements and negotiate consensus – which are two activities associated with leadership. More specifically, (...) we analyse how meaning is collaboratively constructed and how team members arrive at a solution in those instances where there is some kind of disagreement, or even conflict, among team members. This discourse analytic study thus contributes to leadership research in two ways: i) by exploring some of the discursive processes through which leadership is actually performed in a ‘leaderless team’; and ii) by looking at a largely under-researched leadership constellation, namely distributed leadership. We thereby illustrate some of the benefits that discourse analytical approaches offer to an understanding of the specific processes that are involved in the complexities of leadership performance. (shrink)

This essay briefly introduces and contextualizes the extant work on aesthetic snobbery, and identifies some areas for further inquiry. Currently four kinds of snobbery have been identified—social contagion snobbery, attitudinal snobbery, contextual snobbery, and straight-up classist snobbery. Interestingly, each kind of snobbery is thought to manifest itself as a distinct epistemic failing, and for this reason they are advanced as distinct, non-competing kinds of snobbery. Some snob’s aesthetic judgments will be false or unjustified (social-contagion and straight-up classist), some will be (...) unfitting (contextual), and some will fail to have an apt attitude toward their aesthetic judgment (attitudinal). Because the debate has been framed so narrowly, on how the vice of aesthetic snobbery undermines aesthetic judgment, several fruitful areas of philosophical investigation remain unexplored. (shrink)

Mainstream political philosophy traditionally follows Jean-Jacque’s Rousseau’s lead, ‘taking men as they are and laws as they can be made’ (Rousseau, 1998, p. 3). The non-enforceable responsibiliti...

Volume 3, Issue 1, March 2019, Page 90-94.

In his groundbreaking and fantastic new book, Games: Agency as Art, C. Thi Nguyen asks us to see gameplay, and hence the ‘humorous, the playful, and the ridiculous’, as an important sphe...

This excellent volume from the series Oxford Studies in Philosophy and Literature, edited by Richard Eldridge, does an admirable job of examining Ulysses from a.

Cet article porte sur les enjeux de l’émergence de la Révolution française comme moment de rupture fondatrice dans l’œuvre du second Lukács, à partir des années 1930. Ce prisme permet de reconsidérer ce qui est généralement présenté comme le tournant stalinien de l’auteur. Lukács voit dans les prises de position à l’égard de la Révolution française le révélateur de lignes de fracture philosophiques, esthétiques et idéologiques majeures du monde moderne. Sur cette base, il élabore une lecture marxiste hétérodoxe du champ (...) intellectuel comme lieu d’affrontement entre irrationalisme et rationalisme, romantisme et réalisme. Cette réinterprétation n’est pas sans conséquences politiques : elle justifie une ligne qu’on peut qualifier de marxiste humaniste, qui implique une critique des travers du stalinisme. (shrink)

This paper engages with the artistic practice and work of Vanessa Dion Fletcher from my perspective as a non-Indigenous academic and curator. Dion Fletcher and I have worked together over the past several years through discussions about her work, studio visits, and various events. In her art practice, Dion Fletcher uses porcupine quills and menstrual blood to inquire into a range of issues and concepts including Indigenous language revitalization, feminist Indigenous corporeality, Land as pedagogy, decolonization, and neurodiversity. In particular her (...) work confronts the ways that Indigeneity, the queer and gendered body, and disability are rendered expendable. In this paper I engage with Dylan Robinson’s “sovereign sense”: a transcorporeal mode of perception that is affective, land-based, and formed through relations between human and non-humans. Dion Fletcher’s work makes palpable this sense of sovereignty through its unruly and mutating feltness. Further, her work makes visible feminist Indigenous artistic acts of resurgence alongside the frictions at the intersections of settler colonialism and disability. Following Karyn Recollet, I contend that Dion Fletcher’s work activates an Indigenous affective experience of futurity and creative intimacy that in turn imagines disability and Indigeneity as sites through which new pedagogical relations can be formed. (shrink)

Background Standard interpretations of the ethical principle of respect for persons have not incorporated the views and values of patients, especially patients from groups underrepresented in research. This limits the ability of research ethics scholarship, guidance, and oversight to support inclusive, patient-centered research. This study aimed to identify the practical approaches that patients in community-based settings value most for conveying respect in genomics research. Methods We conducted a 3-round, web-based survey using the modified Delphi technique to identify areas of agreement (...) among English-speaking patients at primary care clinics in Washington State and Idaho who had a personal or family history of cancer. In Round 1, respondents rated the importance of 17 items, identified in prior qualitative work, for feeling respected. In Round 2, respondents re-rated each item after reviewing overall group ratings. In Round 3, respondents ranked a subset of the 8 most highly rated items. We calculated each item’s mean and median rankings in Round 3 to identify which approaches were most important for feeling respected in research. Results Forty-one patients consented to the survey, 21 (51%) completed Round 1, and 18 (86% of Round 1) completed each of Rounds 2 and 3. Two sets of rankings were excluded from analysis as speed of response suggested they had not completed the Round 3 ranking task. Respondents prioritized provision of study information to support decision-making (mean ranking 2.6 out of 8; median ranking 1.5) and interactions with research staff characterized by kindness, patience, and a lack of judgment (mean ranking 2.8; median ranking 2) as the most important approaches for conveying respect. Conclusions Informed consent and interpersonal interactions are key ways that research participants experience respect. These can be supported by other approaches to respecting participants, especially when consent and/or direct interactions are infeasible. Future work should continue to engage with patients in community-based settings to identify best practices for research without consent and examine unique perspectives across clinical and demographic groups in different types of research. (shrink)

This article explores the therapeutic potential of narrative fiction during a global health crisis. We focus on The Decameron Project (2020), a collection of short fiction by writers from around the world, commissioned by the New York Times Magazine. The Decameron Project references the narrative framework established by Giovanni Boccaccio in the mid-14th century, when the Black Death devastated Europe. Drawing on aspects of psychoanalytic theory and principles of bibliotherapy employed since the Middle Ages, we argue that The Decameron Project (...) offers strategies to simultaneously confront and contain the anxious mind. Storytelling, according to both Boccaccio and to the editors of The Decameron Project, is not merely a source of distraction but a means of survival. (shrink)

Poetry and informational text showcase the work of community animal shelters. Ten different fictional animals represent the millions of pets brought to shelters every day. Suggestions on animal adoption, including how to prepare and appropriate pet selection, are included, along with resources list.