The Institute of Medicine’s 2005 publication, Dietary Supplements: A Framework for Evaluating Safety, is authoritative and thorough, and thus representative of other reports by the Institute of Medicine. What makes this report particularly interesting, however, is the rich political subtext that exists in the interstices of the report, popping up here and there in brief comments and barely suppressed yelps of exasperation. To understand this context, it is useful to reflect for a moment on the special nature of the IOM (...) and its relationship to government.IOM is part of the National Academy of Sciences, and is a private, non-governmental organization that does not receive direct federal funding for its work. Rather, IOM studies are often funded by contract with governmental entities that request reports on particular topics. As a case in point, the dietary supplement study was requested and paid for by the FDA. (shrink)

New York City hospitals expanded resources to an unprecedented extent in response to the COVID pandemic. Thousands of beds, ICU beds, staff members, and ventilators were rapidly incorporated into h...

The philosophical life can be a nomadic life, both in thought and practice. In the engaging and insightful work of the Mexican-Uruguayan philosopher Carlos Pereda, the more important of these is nomadic thought—a mode of thinking that moves and explores, that is not stationary or static, that is not stubbornly hidebound. This is a kind of nomadism that characterizes healthy or epistemically virtuous thinking in general, and that might indeed be indispensable to it. But a nomadism in practice—of migration, or (...) exile, or cross-border transplantation—is certainly also central to Pereda’s philosophical outlook. "Mexico Unveiled" brings together for an English-speaking audience some of Pereda’s most recent reflections on the philosophical significance of these two different types of nomadism, with a special emphasis on nomadic thinking. That idea is the through-line for Pereda’s thinking here. But the book also offers an idiosyncratic synthesis of 20th-century Mexican philosophy that considers the persistent influence of European colonialism on Mexican intellectual life, the politics of identity and inclusion, and the changing ideas of what it means to be Mexican. (shrink)

What is behind the upsurge of virulent nationalism and intransigent politics across the globe today? In Fear of Breakdown, Noëlle McAfee contends that politics needs something that only psychoanalysis has been able to offer: an understanding of how to work through anxieties, ambiguity, fragility, and loss.

This article examines the relationship between banking access and farm household investment. The assets we examine are non-retirement financial assets, retirement financial assets, and real estate assets not owned by the farm operation. Using data from the Agricultural Resource Management Survey and the universe of commercial bank branches from the Federal Deposit Insurance Corporation, we find that distance to commercial banks is negatively related to the degree of investment in each of these assets for farm households. We also find that (...) internet availability, as measured by the share of farms in the county with internet, is positively associated with farm households’ investment in each of these assets. Further our results show that farm households that are located in the South have the lowest bank access as measured by bank proximity and internet availability. (shrink)

Political philosopher Noelle McAfee proposes a powerful new political theory for our post-9/11 world, in which an old pathology-the repetition compulsion-has manifested itself in a seemingly endless war on terror. McAfee argues that the quintessentially human desire to participate in a world with others is the key to understanding the public sphere and to creating a more democratic society, a world that all members can have a hand in shaping. But when some are effectively denied this participation, whether through (...) trauma or terror, instead of democratic politics, there arises a political unconscious, an effect of desires unarticulated, failures to sublimate, voices kept silent, and repression reenacted. Not only is this condition undemocratic and unjust, it may lead to further trauma. Unless its troubles are worked through, a political community risks continual repetition and even self-destruction. McAfee deftly weaves together her experience as an observer of democratic life with an array of intellectual schemas, from poststructural psychoanalysis to Rawlsian and Habermasian democratic theories, as well as semiotics, civic republicanism, and American pragmatism. She begins with an analysis of the traumatic effects of silencing members of a political community. Then she explores the potential of deliberative dialogue and other "talking cures" and public testimonies, such as the South African Truth and Reconciliation Commission, to help societies work through, rather than continually act out, their conflicts. _Democracy and the Political Unconscious_ is rich in theoretical insights, but it is also grounded in the practical problems of those who are trying to process the traumas of oppression, terror, and brutality and create more decent and democratic societies. Drawing on a breathtaking range of theoretical frameworks and empirical observations, _Democracy and the Political Unconscious_ charts a course for democratic transformation in a world sorely lacking in democratic practice. (shrink)

In recent years, there has been renewed interest in the development of formal languages for describing mereological (part-whole) and topological relationships between objects in space. Typically, the non-logical primitives of these languages are properties and relations such as `x is connected' or `x is a part of y', and the entities over which their variables range are, accordingly, not points, but regions: spatial entities other than regions are admitted, if at all, only as logical constructs of regions. This paper considers (...) two first-order mereotopological languages, and investigates their expressive power. It turns out that these languages, notwithstanding the simplicity of their primitives, are surprisingly expressive. In particular, it is shown that infinitary versions of these languages are adequate to express (in a sense made precise below) all topological relations over the domain of polygons in the closed plane. (shrink)

Do poststructuralist accounts of the self undermine the prospects for effective democratic politics? In addressing this question, Nolle McAfee brings together the theories of Jrgen Habermas and Julia Kristeva, two major figures whose work is seldom juxtaposed. She examines their respective notions of subjectivity and politics and their implicit definitions of citizenship: the extent to which someone is able to deliberate and act in community with others.. Habermas, Kristeva, and Citizenship begins by tracing the rise of modern and poststructural views (...) of subjectivity, and then critiques these views as they are represented in the writings of Habermas and Kristeva. McAfee argues that Habermas's theory of subjectivity is overly optimistic about the possibility for individuals to know their own interests and act autonomously. Kristeva's poststructuralism has its own problems: it seems to limit political agency, since it considers the subject to be split and at odds with itself. Nevertheless, this book shows how Kristevan conceptions of the self can contribute to Habermas's hope for a more democratic, deliberative politics. Combining an insight from poststructural theory--that identity is constituted by a web of relationships--with the theory of deliberative democracy, McAfee argues that we need not be the kinds of individuals supposed by the modern liberal tradition to be effective political agents. The more we recognize our indebtedness to and relationship with others in our midst, the more likely we are to be capable members of political communities. (shrink)

Older adults in the United States have been the age group hardest hit by the Covid pandemic. They have suffered a disproportionate number of deaths; Covid patients eighty years or older on ventilators had fatality rates higher than 90 percent. How could we have better protected older adults? Both the popular press and government entities blamed nursing homes, labeling them “snake pits” and imposing harsh fines and arduous new regulations. We argue that this approach is unlikely to improve protections for (...) older adults. Rather than focusing exclusively on acute and critical resources, including ventilators, a plan that respected the best interests of older adults would have also supported nursing homes, a critical part of the health care system. Better access to protective equipment for staff members, early testing of staff members and patients, and enhanced means of communication with families were what was needed. These preventive measures would have offered greater benefit to the oldest members of our population than the exclusive focus on acute care. (shrink)

Ethical lapses associated with the first facial transplant included breaches of confidentiality, bending of research rules, and film deals. However, discussions of the risk-benefit ratio for face transplantation are often deficient in that they ignore the needs, experience, and decision-making capability of potential recipients.

Graham, Noelle Comparisons are drawn between media reporting of eating disorders and other.forms of self-harm. Proper understanding of these illnesses can protect sufferers from further harm caused by inaccurate and insensitive reporting.

Undertaking engagement in public health research is ethically essential. There is a growing emphasis on practicing engagement as the co‐construction of knowledge, which goes beyond other common forms of engagement in health research practice: consulting and informing. Taking such an approach means researchers jointly construct knowledge with research users and beneficiaries; all parties design and conduct research together and share decision‐making power. This article makes the normative argument that such engagement is necessary to achieve the foundational moral aims of public (...) health research—building relations of equality and addressing the health needs of those considered disadvantaged—which reflect the field's underlying commitment to social justice. It next identifies and discusses three ways in which co‐constructing knowledge advances those moral aims: by facilitating self‐determination, supporting individuals’ right to research, and maximizing social knowledge to address cognitive and epistemic injustice. Objections to the arguments presented in the article are then articulated and defended against. (shrink)

The Aristotelian syllogistic cannot account for the validity of certain inferences involving relational facts. In this paper, we investigate the prospects for providing a relational syllogistic. We identify several fragments based on (a) whether negation is permitted on all nouns, including those in the subject of a sentence; and (b) whether the subject noun phrase may contain a relative clause. The logics we present are extensions of the classical syllogistic, and we pay special attention to the question of whether reductio (...) ad absurdum is needed. Thus our main goal is to derive results on the existence (or nonexistence) of syllogistic proof systems for relational fragments. We also determine the computational complexity of all our fragments. (shrink)

For over 30 years, Tias Little has explored yoga as a spiritual path. In this book he offers key teachings from his journey that will resonate with anyone who has dedicated themself to a mind/body discipline. In short, accessible chapters, Little shares his struggles and joys as a yogi and chronicles the transformation of his understanding and practice along the way.

This essay defends a realist account of normative reasons for action that can disclaim the need for a realist account of moral value. The account of reasons for action aims to undermine the widely held thought that such reasons must be constituted by, or at least derived from, some of the psychological states of the agent whose reasons they are. On the view defended here, there can be correct moral judgments that capture the reasons there are for acting in certain (...) ways; and the reasons themselves are just some of the morally relevant facts of the situation about which the judgment is made. Establishing such an account relies essentially, I argue, on an appeal to substantive ethical theory, to a theory that allows for the attribution of truth to the practical judgments in question. The account can in fact be equally well supported by ethical theories as otherwise diverse as those of Aristotle and Kant. The resulting account of reasons for action is a version of moral realism, but one that is not committed to defending a realist account of the nature of moral value. (shrink)

Most of the literature on teaching within nursing education presents teaching and learning strategies as unproblematic and widely generalized across contexts, content, learners, and educators. We argue that to be truly effective, teaching strategies must be harmonious with instructor’s beliefs, intentions, and actions. In this paper, we introduce the notion of a plurality of effective teaching based on five different ‘perspectives on teaching’– each composed of different beliefs, intentions, actions, and strategies and illustrated by cases from nursing education. We propose (...) that this foundational conceptualization provides a base from which nurse educators can (1) communicate across differences of philosophical perspective and intent; and (2) critically reflect on their educational practices. (shrink)

ABSTRACT:Translational ethics is a practice that aims to apply bioethics insights and process to the real-world contexts of clinical medicine, but also government policy, systems issues, and public health. This work has been a career focus for a relatively small number of bioethicists over the years, but it has drawn greater attention due to the pandemic and a greater realization of the impact of health inequities and systemic injustice. This essay discusses the pathway, rewards, and challenges of translational bioethics as (...) experienced by one bioethicist working with state and national groups on a range of translational ethics issues, often related to public health disasters. There is much remaining work to be done, and the goal of the essay is to encourage rising bioethicists to engage in translational bioethics. (shrink)

Le devenir socioprofessionnel des ex-apprentis footballeurs est un phénomène social encore insuffisamment analysé à ce jour. Les différents travaux de Frédéric Rasera, explorant les conditions sociales individuelles de la recomposition vocationnelle chez un ex-apprenti footballeur, font office d’exception. Face à ce constat, cet article entend contribuer à la réflexion portant sur ces jeunes sportifs. À travers l’étude des trajectoires d’une vingtaine d’ex-apprentis footballeurs, nous verrons qu’il est possible de trouver des similarités biographiques caractérisant leur processus de recomposition vocationnelle. Plus précisément, (...) nous montrerons qu’une analyse en termes de temporalités vécues permet de dévoiler la résurgence de quatre séquences de vie au cours de leur recomposition vocationnelle, révélant ainsi, les dimensions collectives de ce processus. (shrink)

Habermas élabore une théorie radicale de la démocratie qui entend répondre aux défis posés tant par la mondialisation économique que par la tentation de repli des « peuples » qui cherchent à retrouver une souveraineté perdue. Une telle théorie, qui prend une forme délibérative, projette la démocratie dans la constitutionnalisation du droit international, et implique une perspective cosmopolitique. Dans ce cadre, la réflexion sur la politique européenne et ses institutions est centrale, et permet de montrer que la théorie critique n’a (...) rien perdu de sa lucidité quand il s’agit de mettre en garde notamment contre un « fédéralisme postdémocratique de l’exécutif » dans lequel l’Europe risque de se perdre. (shrink)

One of the most original thinkers of the twentieth century, Julia Kristeva has been driving forward the fields of literary and cultural studies since the 1960s. This volume is an accessible, introductory guide to the main themes of Kristeva's work, including her ideas on: *semiotics and symbolism *abjection *melancholia *feminism *revolt. McAfee provides clear explanations of the more difficult aspects of Kristeva's theories, helpfully placing her ideas in the relevant theoretical context, be it literary theory, psychoanalysis, linguistics, gender studies or (...) philosophy, and demonstrates the impact of her critical interventions in these areas. Julia Kristeva is the essential guide for readers who are approaching the work of this challenging thinker for the first time, and provides the ideal opportunity for those with more knowledge to re-familiarise themselves with Kristeva's key terms. (shrink)

Since the 1970s, at least, and presumably under the influence of the later Wittgenstein, certain advocates of Aristotle’s ethics have insisted that a proper validation of the virtues of character must proceed only from within, or be internal to, the particular evaluative outlook provided by possession of the virtues themselves. The most influential advocate of this line of thinking is arguably John McDowell, although Rosalind Hursthouse and Daniel C. Russell have also more recently embraced it. Here I consider whether a (...) distinction between the ‘substantive virtues’ and the ‘virtues of will power’ ultimately threatens that way of thinking about Aristotle’s ethics. If so, it would encourage a different reading of Aristotle’s ethics, one that McDowell has described as a “historical monstrosity”. (shrink)

The current international healthcare focus on ensuring the perspectives and needs of individual persons, families or communities are met has led to the core tenet of person‐centred care for all. The nurse–patient relationship is central to the provision of care, and enhancing this relationship to ensure trust and respect supports optimal care outcomes for those accessing healthcare services. Engaging authentically is one of the recognised key approaches in person‐centred practice, and this scoping review of the literature aims to gain an (...) understanding of the role this process plays in developing effective relationships between nurses and the people they care for. A systematic search of databases and grey literature was undertaken, and twenty‐one research papers met the inclusion criteria. A thematic analysis revealed four themes: ‘getting to know the patient as a person’, ‘the complexity of relationship building—it takes time’, ‘the nurse: characteristics and behaviours that support the nurse–patient relationship’ and ‘the patient voice’. Nurses and patients both benefit from effective relationships, feeling valued and experiencing greater satisfaction with care. Key elements of engaging authentically were revealed as a nurse–patient relational process through this literature review; however, further research is needed to gain a greater understanding of this concept. (shrink)

Our goal in producing this special issue is to encourage our colleagues to incorporate topics related to LGBT populations into bioethics curricula and scholarship. Bioethics has only rarely examined the ways in which law and medicine have defined, regulated, and often oppressed sexual minorities. This is an error on the part of bioethics. Medicine and law have served in the past as society's enforcement arm toward sexual minorities, in ways that robbed many people of their dignity. We feel that bioethics (...) has an obligation to discuss that history and to help us as a society take responsibility for it.We can address only a small number of topics in this special issue of the Hastings Center Report, and we selected topics we believe will stimulate discourse. Andrew Solomon offers an elegant overview of the challenges that bioethics faces in articulating a solid basis for LGBT rights. Timothy F. Murphy asks whether bioethics still faces issues related to lesbian, gay, and bisexual people, given the deletion of homosexuality as a disease and the progress toward same‐sex marriage. Jamie Lindemann Nelson's essay addresses the search for identity for transgender persons and the role of science in that search. Two articles, those by Brendan S. Abel and by Jack Drescher and Jack Pula, take up the complex issue of medical treatment for children who reject their assigned birth gender. Celia B. Fisher and Brian Mustanski address the special challenges of engaging LGBT youth in research, balancing the need for better information about this vulnerable group against the existing restrictions on research involving children. Tia Powell and Edward Stein consider the merits of legal bans on psychotherapies intended to change sexual orientation, particularly in the light of current research on orientation. Mary Beth Foglia and Karen I. Fredricksen‐Goldsen highlight health disparities and resilience among LGBT older adults and then discuss the role of nonconscious bias in perpetuating disparities. Stephan Davis and Nancy Berlinger assess the challenges of access to care and health policy for transgender persons. Edward J. Callahan et al. tackle the ways in which diverse aspects of medicine should change to better incorporate the needs of LGBT patients, including through use of the electronic medical record, education of health professionals, and recruitment efforts for LGBT health professionals. Virginia Ashby Sharpe and Uchenna S. Uchendu describe multifaceted efforts within Veterans Administration facilities to create change for LGBT veterans across the largest integrated health care network in the United States. Lance Wahlert and Autumn Fiester find a mixed record in the use of case studies in teaching about LGBT issues. (shrink)

This article considers the ways in which Julia Kristeva's work aligns with process philosophy, resisting the essentialism of substance philosophy.