Variability in the symptom experience in patients diagnosed with chronic conditions may be related to social determinants of health (SDoH). The purpose of this critical review was to (1) summarize the existing literature on SDoH and symptom clusters (i.e., multiple, co‐occurring symptoms) in patients diagnosed with common chronic conditions, (2) evaluate current variables and measures used to represent SDoH, (3) identify gaps in the evidence base, and (4) provide recommendations for the incorporation of SDoH into future symptom cluster research. We (...) identified 118 articles including information on SDoH in chronic condition symptom cluster research. Articles primarily focused on cancer populations. Few articles had the explicit purpose of investigating relationships between SDoH and symptom clusters, and the inclusion of SDoH was often limited to variables used to describe samples. Future studies should be designed to “move beyond Table 1” in their utilization of SDoH as variables and examine relationships between SDoH and symptom clusters. Attention should be paid to the appropriateness of measures being used to collect information on SDoH, and analysis methods that estimate causal connections between variables should be considered. Research regarding the relationship of SDoH with symptom clusters in patients with chronic conditions has the potential to reveal mechanisms of symptom disparities and guide changes to alleviate these disparities. (shrink)

We surveyed 1005 postdoctoral fellows by questionnaire about ethical matters related to biomedical research and publishing; 33% responded. About 18% of respondents said they had taken a course in research ethics, and about 31% said they had had a course that devoted some time to research ethics. A substantial majority stated willingness to grant other investigators, except competitors, access to their data before publication and to share research materials. Respondents’ opinions about contributions justifying authorship of research papers were mainly consistent (...) but at variance with those of many biomedical journal editors. More than half said they had observed what they considered unethical research practices. To increase the chances of getting a grant funded, 27% said they were willing to select or omit data to improve their results; to make publication of their work more likely or to benefit their career, 15% would select or omit data and 32% would list an undeserving author. Of respondents who thought they had been unfairly denied authorship on a paper, or been listed with or asked to list an undeserving author, 75% said they would be willing to list an undeserving author (P<0.001). Having taken a course dealing with research ethics had no effect on stated willingness to select or omit data or to fabricate data in the future, but was positively associated with willingness to grant undeserved authorship (P<0.04). Although these results do not controvert research demonstrating the effectiveness of ethics courses during professional education, they indicate that the research environment is a powerful component of a trainee’s experience and ethical development. (shrink)

Retribution? Restitution? Reconciliation? “Justice” comes in many forms as witnessed by the spike in war crimes tribunals, Truth & Reconciliation Commissions, hybrid tribunals and genocide trials. Which, if any form is appropriate should be influenced by the culture of the people affected. It took Cambodia over three decades to finally address the ghosts of its Khmer Rouge past with the creation of a hybrid Khmer Rouge Tribunal. But how meaningful is justice to the majority of survivors of the Khmer Rouge (...) auto-genocide when only a handful of top officials are tried? Further, given the persistent abuse of political and economic rights in post-conflict Cambodia, we are skeptical that justice or reconciliation is presently possible. (shrink)

Two years after the death of his small son, Ralph Waldo Emerson famously wrote of the experience, "I cannot get it nearer to me" (CW 3:29). Most readers have been troubled by this remark, reading it as a sign that Emerson's relationship to grief and even to his son was disturbingly oblique, and the predominant response has been that it demonstrates he was detached, cold, and disconnected in the service of his transcendental philosophy.1 Such a response is grounded in the (...) tacit assumption that philosophy seems to be, or to call for, some intellectually grounded transcendence of the personal, whether the personal is whimsical or fatal. Emerson himself worried at times that he was too cold, too intellectual, even as .. (shrink)

The Covid‐19 pandemic has exposed four myths in bioethics. First, the flood of bioethics publications on how to allocate scarce resources in crisis conditions has assumed authorities would declare the onset of crisis standards of care, yet few have done so. This leaves guidelines in limbo and patients unprotected. Second, the pandemic's realities have exploded traditional boundaries between clinical, research, and public health ethics, requiring bioethics to face the interdigitation of learning, doing, and allocating. Third, without empirical research, the success (...) or failure of ethics guidelines remains unknown, demonstrating that crafting ethics guidance is only the start. And fourth, the pandemic's glaring health inequities require new commitment to learn from communities facing extraordinary challenges. Without that new learning, bioethics methods cannot succeed. The pandemic is a wake‐up call, and bioethics must rise to the challenge. (shrink)

While parents have traditionally provided proxy consent for minors to participate in research, this has proven inadequate for adolescents who are mentally and emotionally capable of making their own decisions. Research has proven that even young children, and certainly most adolescents, are developmentally prepared to make such decisions for themselves. The author challenges the assumption that both consent and assent are static concepts, and proposes that a sliding scale of competence be created to ascertain the adolescent's comprehension of the proposed (...) research by shifting the burden of proof to those who believe a particular adolescent is unable to provide informed consent. (shrink)

In a well-known text called ‘The Communist Hypothesis’, first published in 2007, the renowned philosopher Alain Badiou breathed fresh life into the idea of communism as an intellectual representation that provides a critical perspective on existing politics and offers a systemic alternative to capitalism. Now, in the course of this wide-ranging conversation with Peter Engelmann, Alain Badiou explains why he continues to value the idea of communism against the background of current social crises and despite negative historical experiences. From the (...) anticipation of a communism without a state to the problem of the concept of democracy and an analysis of capitalism as a system, the two thinkers discuss the key political issues of our time. Whilst explaining his political philosophy, Badiou also reflects on current socio-political developments such as the turmoil in the Middle East and the situation in China. This compelling dialogue is both a highly topical contribution to the question of how we might organize our societies differently and an accessible introduction to Badiou's philosophical thinking. (shrink)

The popular press has claimed that Secretary of the Interior James Watt bases his philosophy of environmental management on his religious views as a charismatic Christian. An examination of Watt’s published statements indicates: his philosophy of environmental management sterns largely from economic and political considerations; he has a relatively simple ecotheology based on concepts such as God providing creation as a blessing for mankind, and mankind having a stewardship responsibility to use resources to provide for people; his ecotheology does not (...) incorporate any characteristically charismatic ideas; and his ecotheology does not strongly parallel that of conservative Christian theologians who have written on environmental issues. This analysis suggests that for the new “Christianpolitic” as a whole, there is a danger of confusing the scriptural with the cultural and political in the area of environmental ethics. If a Christian ecotheology is going to be used for environmental decision making, it should be developed fully and represent scripture accurately and completely. (shrink)

The question of how actin filaments are attached to membranes is of central importance to an understanding of how actin gives rise to shape and movement in cells. A number of approaches to this question have been taken, but there have been few definitive answers. Some of the limitations of these approaches are discussed, as well as possible avenues for overcoming them.

Grodzinsky examines Broca's aphasia in terms of some specific grammatical deficits. However, his grammatical models offer no way to characterize the distinctions he observes. Rather than grammatical deficits, his patients seem to have intact grammars but defective modules of parsing and production.

It is a widespread view that affective and emotional responses to many works of literature are often components of an appreciation of literature that is richer than it would be without them. In this paper, I raise three points designed to show that Lamarque does not give emotional and other affective responses their due. First, I propose that he does not sufficiently distinguish emotion and imagination from concerns about knowledge and truth. Second, he does not sufficiently distinguish appreciation, and the (...) role of emotions within it, from criticism. And third, there is a conflation of accounts of the value of individual works with accounts of the value of having literature as an institution around. (shrink)

Even with the passage of time, the misguided motivations of highly educated, physician-participants in the genocide known as the Holocaust remain inexplicable and opaque. Typically, the physician-patient relationship inherent within the practice of medicine, has been rooted in the partnership between individuals. However, under the Third Reich, this covenant between a physician and patient was displaced by a public health agenda that was grounded in the scientific theory of eugenics and which served the needs of a polarized political system that (...) relied on this hypothesis to justify society’s racial hygiene laws. As part of the National Socialist propaganda, Adolf Hitler ominously argued that the cultural decline of Germany after World War I could largely be based on interbreeding and a “resultant drop in the racial level.” This foundational premise defined those who could be ostracized, labeled and persecuted by society, including those who were assimilated. The indoctrination and implementation of this distorted social policy required the early and sustained cooperation and leadership of the medical profession. Because National Socialism promised it could restore Germany’s power, honor and dignity, physicians embraced their special role in the repair of the state. This article will explore the imperative role, moral risks and deliberate actions of physicians who participated in the amplification process from “euthanasia” to systemic murder to medically-sanctioned genocide. A goal of this analysis will be to explore what perils today’s physicians would face if they were to experience the transitional and collective behaviors of a corrupted medical profession, or if they would, instead, have the fortitude and courage necessary to protect themselves against this collaboration. Our premise is that an awareness of history can serve as a safeguard to the conceit of political ascendency and discrimination. (shrink)

This article presents a cross-cultural exploration of the interaction between religion and family in the lives of women. It focuses on elderly Middle Eastern Jewish women who, during the course of their life spans, moved from a conflicting to a complementary experience of family and religion. The author argues that opposition between religion and family seldom arises for women who control their own time or resources, or who control a domestic sphere they themselves see as sacred. Women who wish to (...) conduct their religious lives in the public sphere, especially in the context of an extrafamilial hierarchy or as religious professionals, are likely to come into conflict with their families over issues of competition for their time or allegiance. Official religious doctrines are not likely to determine how particular women experience family and religion; even women who maneuver within the same theological framework may experience the relationship between family and religion in very different ways. (shrink)

This study investigates the effectiveness of pedagogical practices used to teach business ethics. The business community has greatly increased its demands for better ethics education in business programs. Educators have generally agreed that the ethical principles of business people have declined. It is important, then, to examine how common methods of instruction used in business ethics could contribute to the development of higher levels of moral judgment competence for students. To determine the effectiveness of these methods, moral judgment competence levels (...) for undergraduate and graduate students from three institutions were measured and compared based upon the pedagogical method used in a business class. Significant differences were found for moral reasoning and moral competence scores depending on the method used for ethics instruction. Students in classes with more highly integrated ethics coverage scored higher in moral reasoning and moral competence. (shrink)

This article examines two questions pertaining to the extension of infertility treatment to postmenopausal women. First, what concepts and principles of infertility practice apply to assisted reproduction for the postmenopausal patient? Second, what role should these concepts play in the development of an ethical justification for extending women's reproductive lives past the menopausal boundary? The argument offered here supports their claim to infertility services on the basis of the formal principle of justice, which requires that similar cases be treated similarly. (...) The cases of many postmenopausal patients are argued to be relevantly similar to classes of patients who already receive assistance in reproduction. (shrink)

[M]y attention was drawn to the flower garden of the grey matter, which contained cells with delicate and elegant forms, the mysterious butterflies of the soul, the beating of whose wings may someday... clarify the secret of mental life. Art can actually facilitate scientific understanding, even discovery. Art can be, and has been, the entryway to vision and the understanding of natural phenomena as demonstrated in its role in the development of neuron theory. While developing a course on current brain (...) research and learning and then projects for S.T.E.A.M. curriculum, I was repeatedly drawn to the work of Santiago Ramon y Cajal, whose life work provides an extraordinary example of the.. (shrink)

At the end of Section III of “Freedom and Resentment,” just after he has drawn our attention to the reactive attitudes, P. F. Strawson remarks, “The object of these commonplaces is to try to keep before our minds something it is easy to forget when we are engaged in philosophy, especially in our cool, contemporary style, viz., what it is actually like to be involved in ordinary inter-personal relationships, ranging from the most intimate to the most casual.” It is striking, (...) then, that the proponent of so thoroughly naturalistic an account of moral responsibility seems himself largely to ignore the fact that moral agents do not spring into existence ab initio. The adult moral agent, who is the central character of normative theory and of accounts of moral responsibility, was once a child. Our juvenile selves get a mention in Strawson’s paper, but only as examples of creatures who are paradigmatically not responsible or who inhabit “a borderline, penumbral area ” with respect to responsibility. Thus it remains a mystery, on Strawson’s account, how we become the morally responsible creatures he takes us to be. (shrink)

In this paper, I argue that several features of Big Business in the United States, and its influence on our society, have caused far too many Americans to stop thinking about what is morally right as they choose their actions. An ethical vacuum has been created that Big Business has been only too glad to fill with questionable values that Americans have absorbed without consciously embracing. The time is right, and the stakes have never been higher, for us to reflect (...) on our values and change our thinking and behavior. Big Business and Philosophy each have important roles to play — one because of the power it now has and the other because of the power it ought to have — if we are to improve the moral climate in this country. (shrink)

What does it mean to claim Jesus as Lord over the principalities and powers in a world where oppression, terror, and death so often seem to have the last word? Jesus' “answer” is not an intellectual explanation but a charge and a benediction, to guide believers and empower them to persevere.