Aim: This study explores experiences of patients suffering from Korsakoff’s syndrome. It contributes to improved reflection on the value of patient knowledge. Background: An ethics of care perspective states the importance of moving to patients in their vulnerable state of being, and to figure out patients’ individual needs necessary to provide good care. The information given by patients suffering from Korsakoff’s syndrome might be mistaken, invented and even not true. The value of these patients’ experiences and knowledge had not been (...) researched to date. Method: Data from six in-depth interviews were analysed concurrently through the constant comparative method. Ethical considerations: The principles of voluntariness, confidentiality and anonymity were respected during the research process. Findings: Four important themes within patients’ knowledge emerged: health condition, involuntary admission into the nursing home, the daily routine and interpretation of the caring abilities of healthcare professionals. The findings show that our respondents were able to provide a window into their inner perspective. Conclusion: This study deepens our understanding of the value of patient knowledge in situations where patients see the world in a different manner as do healthcare professionals. The conversations revealed personal subjective knowledge which our respondents create and live by. Healthcare professionals are encouraged to discover and affirm the understandings of these patients, and not be prepossessed due to the diagnosis or general nursing home rules. Understanding patients’ unique knowledge through appreciation of the complexity and richness of different views on the situation can assist to give a more humane response to individual needs and pain. Health staff in healthcare institutions are encouraged to evaluate the – unintended – effect of rigidly applied nursing home rules, and the government is challenged to rethink its policy about care, and provide more resources permitting relational care that nurtures the dignity of patients suffering from Korsakoff’s syndrome. (shrink)

In this article, we query binaries of mobility and immobility in language studies via an empirical focus on language/social practices in a site that bridges the global North and global South. To do so, we work from a Southern praxis perspective to analyze discourses/knowledges informing the performance of accounts from Cambodian men, interviewed about transactional same-sex relationship practices between (ostensibly immobile) local men and (ostensibly mobile) male tourists to Cambodia from the global North. The analysis focuses on a process in (...) which participants’ chronotopic awareness of language shapes a negotiation of power, knowledge, and action with respect to these relationships. Encompassing the discursive positioning of selves and others through the deployment of relevant and affective chronotopes, the talk from these Cambodian men allows us to challenge assumptions about (im)mobility, awareness, agency, sexuality, and power, and demonstrate how these are accessed in multiple ways at this site of North/South contact. (shrink)

In March 1996, the General Accounting Office issued the report Scientific Research: Continued Vigilance Critical to Protecting Human Subjects. It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always clear (...) to clinicians. Controversy exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

Biodefense and emerging infectious disease animal research aims to avoid or ameliorate human disease, suffering, and death arising, or potentially arising, from natural outbreaks or intentional deployment of some of the world’s most dreaded pathogens. Top priority research goals include finding vaccines to prevent, diagnostic tools to detect, and medicines for smallpox, plague, ebola, anthrax, tularemia, and viral hemorrhagic fevers, among many other pathogens (National Institute of Allergy and Infectious Diseases [NIAID] priority pathogens). To this end, increased funding for conducting (...) research, developing research facilities, and purchasing (stockpiling) developed vaccines, diagnostic tools, and therapeutics .. (shrink)

In March 1996, the General Accounting Office (GAO) issued the reportScientific Research: Continued Vigilance Critical to Protecting Human Subjects.It stated that “an inherent conflict of interest exists when physician-researchers include their patients in research protocols. If the physicians do not clearly distinguish between research and treatment in their attempt to inform subjects, the possible benefits of a study can be overemphasized and the risks minimized.” The report also acknowledged that “the line between research and treatment is not always cleartoclinicians. Controversy (...) exists regarding whether certain medical procedures should be categorized as research.”This problem currently plagues gene transfer research. A few months prior to the GAO report, an ad hoc committee appointed by National Institutes of Health (NIH) Director Harold Varmus expressed similar concerns in its assessment of NIH investment in research on gene therapy. (shrink)

In some practical uncertain situations decision makers are presented with described events that are out of sequence when having to make a causal attribution. A theoretical perspective concerning the causal coherence of the explanation is developed to predict the effect of this on causal attribution. Three experiments investigated the effect on causal judgement when the described order of events did not correspond to their causal order. Participants had to judge the relative probability of two possible causes of an outcome in (...) scenarios in which presentation order varied. All three experiments found that there was a preference to judge that the cause associated with events described in causal order was more responsible for the outcome when events associated with one cause were interleaved in their presentation order with those from a second cause. This occurred when there was a strong causal relationship between events. The results were consistent with the causal coherence explanation. (shrink)

While it is acknowledged that there is a need for more qualitative research on suicide, it is also clear that the ethics of undertaking such research need to be addressed. This article uses the case study of the authors’ experience of gaining ethics approval for a research project that asks people what it is like to feel suicidal to (a) analyse the limits of confidentiality and anonymity and (b) consider the ways in which the process of ethics review can shape (...) and constrain suicide research. This leads to a discussion of the ways in which ethics committees assess and monitor qualitative research more generally and some preliminary suggestions for how this might be improved. (shrink)

In everyday life, people frequently make decisions based on tacit or explicit forecasts about the emotional consequences associated with the possible choices. We investigated age differences in such forecasts and their accuracy by surveying voters about their expected and, subsequently, their actual emotional responses to the 2008 US presidential election. A sample of 762 Democratic and Republican voters aged 20 to 80 years participated in a web-based study; 346 could be re-contacted two days after the election. Older adults forecasted lower (...) increases in high-arousal emotions (e.g., excitement after winning; anger after losing) and larger increases in low-arousal emotions (e.g., sluggishness after losing) than younger adults. Age differences in actual responses to the election were consistent with forecasts, albeit less pervasive. Additionally, among supporters of the winning candidate, but not among supporters of the losing candidate, forecasting accuracy was enhanced with age, suggesting a positivity effect in affective forecasting. These results add to emerging findings about the role of valence and arousal in emotional ageing and demonstrate age differences in affective forecasting about a real-world event with an emotionally charged outcome. (shrink)

There is resistance to policies that would reduce overall consumption levels to promote sustainability. In part, this resistance is aided by the economic concept of consumer sovereignty (CS) and its presumption that choice promotes wellbeing. We investigate the concept of consumer sovereignty in the context of deepening concerns about sustainability and scrutinise whether the two concepts are compatible. We draw on new findings in psychology on human decision-making traits; we take into account increasing awareness about human dependencies on ‘functioning’ ecosystems (...) and uncertainties on how ecosystems, human activities and human wellbeing are interlinked. We conclude that commitment to the concept of consumer sovereignty is incompatible with sustainability due to human characteristics, the difficult-to-predict behaviour of ecological systems and ignorance about the impact of human action on natural systems. We propose that the choice-set of available goods and services on markets should be constrained when consumption patterns can be linked to degradation of services provided by nature when those services are seen as crucial for human wellbeing. We advocate constraining the available choice-set through established governmental institutions aided by deliberative processes that engage members of the general public. Finally, we acknowledge that such processes are imperfect; nevertheless, we foresee that they will be essential for fostering wise decision-making and moving towards sustainability. (shrink)

"Margaret L. King has put together a highly representative selection of readings from most of the more significant—but by no means the most obvious—texts by the authors who made up the movement we have come to call the 'Enlightenment.' They range across much of Europe and the Americas, and from the early seventeenth century until the end of the eighteenth. In the originality of the choice of texts, in its range and depth, this collection offers both wide coverage and (...) striking insights into the intellectual transformation which has done more than any other to shape the world in which we live today. It is _simply the best introduction to the subject now available_."_ —Anthony Pagden, UCLA, and author of _The Enlightenment and Why It Still Matters_ Contents:_ Chronology, Introduction _Chapter One - Casting Out Idols: 1620–1697_ _Idols, or false notions: _Francis Bacon, _The New Instrument_ _I think, therefore I am: _René Descartes, Discourse on Method _God, or Nature: _Baruch Spinoza, _Ethics_ _The system of the world: _Isaac Newton, _Mathematical Principles of Natural Philosophy_ _He searched for truth throughout his life: _Pierre Bayle, _Historical and Critical Dictionary_ _Chapter Two - _The Learned Maid: 1638–1740 _A face raised toward heaven:_ Anna Maria van Schurman, _Whether the Study of Letters Befits a Christian Woman_ _The worlds I have made:_ Margaret Cavendish, _The Blazing World_ _A finer sort of cattle:_ Bathsua Makin, _An Essay to Revive the Ancient Education of Gentlewomen_ _I warn you of the world:_ Madame de Maintenon, _Letter: On the Education of the Demoiselles of Saint-Cyr_, and _Instruction: On the World_ _The daybreak of your reason:_ Émilie Du Châtelet, _Fundamentals of Physics_ _Chapter Three - _A State of Perfect Freedom: 1689–1695 _The chief criterion of the True Church:_ John Locke, _Letter on Toleration_ _Freedom from any superior power on earth:_ John Locke, _Second Treatise on Civil Government_ _A white paper, with nothing written on it:_ John Locke, _Essay Concerning Human Understanding_ _Let your rules be as few as possible:_ John Locke, _Some Thoughts Concerning Education_ _From death, Jesus Christ restores all to life:_ John Locke, _The Reasonableness of Christianity, as Delivered in the Scriptures_ _Chapter Four - All Things Made New: 1725–1784_ _In the wilderness, they are reborn:_ Giambattista Vico, _The New Science_ _Without these Names, nothing can be known,_ Carl Linnaeus, _System of Nature_ _All the clouds at last are lifted:_ Anne Robert Jacques Turgot, _The Successive Advancement of the Human Mind_ _A genealogical or encyclopedic tree of knowledge:_ Jean le Rond d’Alembert, _Preliminary Discourse_ _Dare to know! :_ Immanuel Kant, _What Is Enlightenment?_ _Chapter Five - Mind, Soul, and God: 1740–1779_ _The narrow limits of human understanding:_ David Hume, _Anof a Book Lately Published_ _The soul is but an empty word:_ Julien Offray de La Mettrie, _Man a Machine_ _All is reduced to sensation:_ Claude Adrien Helvétius, _On the Mind_ _An endless web of fantasies and falsehoods:_ Paul-Henri Thiry, baron d’Holbach, _Common Sense_ _Let each believe that his own ring is real:_ Gotthold Ephraim Lessing, _Nathan the Wise_ _Chapter Six - Crush That Infamous Thing: 1733–1764_ _This is the country of sects:_ Voltaire, _Philosophical Letters_ _Disfigured by myth, until enlightenment comes:_ Voltaire, _The Culture and Spirit of Nations_ _The best of all possible worlds:_ Voltaire, _Candide_ _Are we not all children of the same God?:_ Voltaire, _Treatise on Tolerance_ _If a book displeases you, refute it! :_ Voltaire, _Philosophical Dictionary_ _Chapter Seven - Toward the Greater Good: 1748–1776_ _Things must be so ordered that power checks power,_ Charles de Secondat, baron de Montesquieu, _The Spirit of the Laws_ _Complete freedom of trade must be ensured:_ François Quesnay, _General Maxims for the Economic Management of an Agricultural Kingdom_ _The nation's war against the citizen: Cesare_ Beccaria, _On Crimes and Punishments_ _There is no peace in the absence of justice:_ Adam Ferguson, _An Essay on the History of Civil Society_ _Led by an invisible hand:_ Adam Smith, _An Inquiry into the Nature and Causes of the Wealth of Nations_ _Chapter Eight - Encountering Others: 1688–1785_ _Thus died this great man:_ Aphra Behn, _Oroonoko: or The Royal Slave_ _Not one sins the less for not being Christian: _Lady Mary Wortley Montagu, _Embassy Letters_ _Do you not restore to them their liberty?:_ Guillaume-Thomas Raynal, _Philosophical and Political History of European Colonies and Commerce in the Two Indies_ _Some things which are rather interesting:_ Captain James Cook, _Voyage towards the South Pole, and Round the World_ _The inner genius of my being:_ Johann Gottfried von Herder, _Ideas for a Philosophy of the History of Humankind_ _Chapter - Nine Citizen of Geneva: 1755–1782_ _The most cunning project ever to enter the human mind: _Jean-Jacques Rousseau, _Discourse on the Origin and Foundations of Human Inequality_ _The supreme direction of the General Will:_ Jean-Jacques Rousseau, The Social Contract _Two lovers from a small town at the foot of the Alps,_ Jean-Jacques Rousseau, _Julie, or the New Heloise_ _Build a fence around your child’s soul:_ Jean-Jacques Rousseau, _Emile, or On Education_ _This man will be myself:_ Jean-Jacques Rousseau, _Confessions_ _Chapter Ten - Vindications of Women: 1685–1792_ _No higher design than to get her a husband:_ Mary Astell, _Reflections on Marriage_ _The days of my bondage begin:_ Anna Stanisławska, _Orphan Girl_ _A dying victim dragged to the altar:_ Denis Diderot, _The Nun_ _Created to be the toy of man:_ Mary Wollstonecraft, _Vindication of the Rights of Woman_ _Man, are you capable of being just?:_ Olympe de Gouges, _Declaration of the Rights of Woman as Citizen_ _Chapter Eleven - American Reverberations: 1771–1792_ _I took upon me to assert my freedom:_ Benjamin Franklin, _Autobiography_ _Freedom has been hunted round the globe:_ Thomas Paine, _Common Sense_ _Endowed by their Creator with certain unalienable Rights:_ Thomas Jefferson and Others, _Declaration of Independence_ _A safeguard against faction and insurrection:_ James Madison, _Federalist No. 10_ _An end to government by force and fraud:_ Thomas Paine, _The Rights of Man_ _Chapter Twelve - Enlightenment's End: 1790–1794_ _A partnership of the living, the dead, and those unborn:_ Edmund Burke, _Reflections on the Revolution in France_ _The future destiny of the human species:_ Nicolas de Condorcet, _A Sketch of a Historical Portrait of the Progress of the Human Mind_ Texts and Studies, Index. 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CHAPTER I THE FRAMEWORK OF SELF-PERFECTION 1. Buddhism and Ethics Anyone who has read even a very little in the early Buddhist Scriptures is aware that from ...

Respect for autonomy is a central value in reproductive ethics, but it can be a challenge to fulfill and is sometimes an outright puzzle to understand. If a woman requests the transfer of two, three, or four embryos during fertility treatment, is that request truly autonomous, and do clinicians disrespect her if they question that decision or refuse to carry it out? Add a commitment to justice to the mix, and the challenge can become more complex still. Is it unfair (...) for insurance policies to exclude from coverage the costs of giving fertility to those who lack it or restoring fertility in those who have lost it? What does “just reproduction” look like in the face of multifarious understandings of both justice and autonomy and in light of increasingly complex and costly reproductive technologies? In today's dialogue about reproduction, medicine, and ethics in the United States, old ethical issues—such as whether women ought to be allowed to access pregnancy termination—are more contested than they have been in decades, while new technologies—like those used to edit the genes of human embryos—suggest that our species could face unprecedented questions about who should exist. As we considered the discussions accompanying these issues and contemplated a special report responding to them, we found ourselves consistently circling back to two ethical commitments: respect for autonomy and the pursuit of justice. As one of the nine essays in this collection asks, why should certain women receive help to establish a pregnancy while others are thrown in jail when they miscarry or their child is stillborn? Respect for autonomy is required where individuals have the ability to make fully informed and voluntary choices. Yet does respecting autonomy require acceding to all the choices of patients or consumers of medical care? We consider these and related questions in this special report from the Hastings Center Report. (shrink)

The aim of this study was to investigate the consistency between the self-reports and teacher ratings of students’ emotional and social inclusion at school as well as for their academic self-concept. The German version of the Perceptions of Inclusion Questionnaire (PIQ) was administered to 329 grade 8 students (50.8% female, Mage = 14.5 years, SDage = 0.5 years) and their teachers. First, the three-dimensional structure of both PIQ versions was confirmed by confirmatory item factor analysis. The  and  coefficients (...) demonstrated good reliability for all scales. Second, a correlated trait-correlated method minus one model provided evidence that the method-specificity of teacher ratings was larger than the consistency between the self-reports and teacher ratings. Third, the results of a latent difference model indicated that general method effects can partly be explained by a student’s gender or special educational needs. Finally, the low consistency between self-reports and teacher rating is discussed. (shrink)

A four-factor model of spiritual intelligence is first proposed. Supportive evidence is reviewed for the capacities of critical existential thinking, personal meaning production, transcendental awareness, and conscious state expansion. Based on this model, a 24-item self-report measure was developed and modified across two consecutive studies . The final version of the scale, the Spiritual Intelligence Self-Report Inventory , displayed excellent internal reliability and good fit to the proposed model. Correlational analyses with additional measures of meaning, metapersonal self-construal, mysticism, religiosity, and (...) social desirability offer support for construct and criterion-related validity. According to both intelligence criteria and current psychometric standards, findings validate the proposed model and measure of spiritual intelligence. Future directions are discussed. (shrink)

What makes for a good education? What does one need to count as well-educated? Knowledge, to be sure. But knowledge is easily forgotten, and today's knowledge may be obsolete tomorrow. Skills, particularly in critical thinking, are crucial as well. But absent the right motivation, graduates may fail to put their skills to good use. In this book, Nathan King argues that intellectual virtues-traits like curiosity, intellectual humility, honesty, intellectual courage, and open-mindedness-are central to any education worthy of the name. (...) Further, such virtues are crucial to our functioning well in everyday life, in areas as diverse as personal relationships, responsible citizenship, civil discourse, and personal success. Our struggles in these areas often result from a failure to think virtuously. Drawing upon recent work in philosophy and psychology, King paints a portrait of virtuous intellectual character-and of the vices such a character opposes. Filled with examples and applications, this book introduces readers to the intellectual virtues: what they are, why they matter, and how we can grow in them. (shrink)

Much recent work in virtue epistemology has focused on the analysis of such intellectual virtues as responsibility, conscientiousness, honesty, courage, open-mindedness, firmness, humility, charity, and wisdom. Absent from the literature is an extended examination of perseverance as an intellectual virtue. The present paper aims to fill this void. In Sect. 1, I clarify the concept of an intellectual virtue, and distinguish intellectual virtues from other personal traits and properties. In Sect. 2, I provide a conceptual analysis of intellectually virtuous perseverance (...) that places perseverance in opposition to its vice-counterparts, intransigence and irresolution. The virtue is a matter of continuing in one’s intellectual activities for an appropriate amount of time, in the pursuit of intellectual goods, despite obstacles to one’s attainment of those goods. In Sect. 3, I explore relations between intellectually virtuous perseverance and other intellectual virtues. I argue that such perseverance is necessary for the possession and exercise of several other intellectual virtues, including courage. These connections highlight the importance of perseverance in a comprehensive account of such virtues. (shrink)

Sarah McGrath has recently defended a disagreement-based argument for skepticism about moral knowledge. If sound, the argument shows that our beliefs about controversial moral issues do not amount to knowledge. In this paper, I argue that McGrath fails to establish her skeptical conclusion. I defend two main claims. First, the key premise of McGrath’s argument is inadequately supported. Second, there is good reason to think that this premise is false.

Contemporary Western culture is experiencing a heightened awareness of religious diversity. This article surveys a range of possible responses to such diversity, and distinguishes between responses that concern the salvation or moral transformation of persons (soteriological views) and those that concern the alethic or epistemic status of religious beliefs (doctrinal views). After providing a brief taxonomy of these positions and their possible relations to one another, the article focuses primarily on competing views about the truth and rationality of religious beliefs (...) (e.g., pluralism, exclusivism, and skepticism). Here a heavy emphasis is placed on arguments for and against the rationality and moral propriety of retaining one's religious beliefs in the face of disagreement. The article surveys some of the more prominent arguments from the literature on this topic and closes with suggestions for further research. (shrink)

Kalisch et al. propose a positive appraisal style as the key mechanism that underlies resilience. The present authors suggest that flexibility in emotion processing is more conducive to resilience than a general positivity bias. People may achieve emotional flexibility through counter-regulation – a dynamic processing bias toward positive stimuli in negative contexts and negative stimuli in positive contexts.

Most models of patient-physician communication take decision-making as a central concept. However, we found that often the treatment course of metastatic cancer patients is not easy to describe in straightforward terms used in decision-making models but is instead frequently more erratic. Our aim was to analyse these processes as trajectories. We used a longitudinal case study of 13 patients with metastatic colorectal and pancreatic cancer for whom palliative chemotherapy was a treatment option, and analysed 65 semi-structured interviews. We analysed three (...) characteristics of the treatment course that contributed to the ‘erraticness’ of the course: (1) The treatment (with or without chemotherapy) contained many options; (2) these options were not stable entities to be decided upon, but changed identity over the course of treatment, and (3) contrary to the closure (option X means no option Y, Z, etc.) a decision implies, the treatment course was a continuous process in which options instead remained open. When the treatment course is characterised by these many and changeable options that do not result in closure, the shared decision-making model should take these into account. More attention needs to be paid to the erratic character of the process in which the doctor has to provide continuous information that is related to the changing situation of the patient; also, flexibility in dealing with protocols is warranted, as is vigilance about the overall direction of the process. (shrink)

Much recent work in virtue epistemology has focused on the analysis of such intellectual virtues as responsibility, conscientiousness, honesty, courage, open-mindedness, firmness, humility, charity, and wisdom. Absent from the literature is an extended examination of perseverance as an intellectual virtue. The present paper aims to fill this void. In Sect. 1, I clarify the concept of an intellectual virtue, and distinguish intellectual virtues from other personal characters and properties. In Sect. 2, I provide a conceptual analysis of intellectually virtuous perseverance (...) that places perseverance in opposition to its vice -counterparts, intransigence and irresolution. The virtue is a matter of continuing in one’s intellectual activities for an appropriate amount of time, in the pursuit of intellectual goods, despite obstacles to one’s attainment of those goods. In Sect. 3, I explore relations between intellectually virtuous perseverance and other intellectual virtues. I argue that such perseverance is necessary for the possession and exercise of several other intellectual virtues, including courage. These connections highlight the importance of perseverance in a comprehensive account of such virtues. (shrink)

Functional magnetic resonance imaging is a powerful tool used in cognitive neuroscientific research. fMRI is noninvasive, safe, and relatively accessible, making it an ideal method to draw inferences about the brain–behavior relationship. When conducting fMRI research, scientists must consider risks associated with brain imaging. In particular, the risk of potentially identifying an abnormal brain finding in an fMRI research scan poses a complex problem that researchers should be prepared to address. This article illustrates how a social constructivism decision-making model can (...) be used as a framework to guide researchers as they develop protocols to address this issue. (shrink)

One widely recognized difference between laws and accidental generalizations lies in the ability of the former versus the inability of the latter to support certain sorts of related subjunctive conditionals. Nelson Goodman's theory of projectibility is here evaluated on the basis of its implications for the relative acceptability of conflicting subjunctive conditionals or counterfactuals. It is argued that the theory's extensionalistic character precludes its dealing adequately with cases of a certain type in which the difference between two counterfactuals, one acceptable (...) and the other unacceptable, is clearly related to a difference in nomological status between their indicative counterparts. (shrink)