Susan Estrich, Real Rape Cambridge and London: Harvard University Press, 1987, 160 pp.

Stephen J. Schulhofer, Unwanted Sex: The Culture of Intimidation and the Failure of Law Cambridge, MA: Harvard University Press, 1998, xii + 284 pp.

Shared decision-making is a well-recognized model to guide decision-making in medical care. However, the shared decision-making concept can become exceedingly complex in adolescent patients with varying degrees of autonomy who have most of their medical decisions made by their parents or legal guardians. The complexity increases further in ethically difficult situations such as terminal illness. In contrast to the typical patient-physician dyad, shared decision-making in adolescents requires a decision-making triad that also includes the parents or guardians. The multifactorial nature of (...) these cases can overwhelm treatment teams, with minimal guidance on how to best approach the patient–parents–physician dynamic in an ethically appropriate manner. Estimated time left to live is the paramount ethical consideration for such cases with respect to shared decision-making. This paper offers a sliding scale to serve as a grounding reference for clinicians who care for terminally ill adolescents and hospital ethics committee members for initiating and guiding the ethical discussion for these patients. This paper also elucidates several other ethically salient features inherent to many of these cases, including quality of life, treatability of disease, cultural influences, among others. Yet how each of these variables is weighed is dependent upon the specific circumstances of each individual case. Ultimately, shared decision-making in adolescent patients with terminal illnesses must be a collaborative and ongoing process that thoughtfully weighs the values and ethical responsibilities of the patient, parents, and physician to ideally reconcile differences and come to a consensus on the best management option for each individual patient. (shrink)

Considering a growing nurse shortage and the need for qualified nurses to handle increasingly complex patient care situations, how ethical beliefs are influenced and the consequences that can occur when moral conflicts of right and wrong arise need to be explored. The aim of this study was to explore influencers identified by nurses as having the most impact on the development of their ethical beliefs and whether these influencers might impact levels of moral distress and the potential for conscientious objection. (...) Nurses whose ethical beliefs were most influenced by their religious beliefs scored higher in levels of moral distress and demonstrated greater differences in areas of conscientious objection than did nurses who developed their ethical beliefs from influencers such as family values, life and work experience, political views or the professional code of ethics. (shrink)

Uncertainty is inherent in new and unexpected viral outbreaks such as the current COVID-19 pandemic. It imposes challenges for health officials in soliciting cooperative behavioural changes based on incomplete information. In this paper, we use evolving mask recommendations in the United States as an example to analyse the ethical importance and practical demonstration of trustworthiness in pandemic messaging and decision-making. We argue that responsible public health interventions in the time of uncertainties requires explicit intersecting ethical considerations both in action and (...) in communication to promote trustworthiness. First, as public health decisions have to be made in the face of incomplete and evolving data, health officials need to exhibit competence while committing to epistemic humility. They can explain the methods used in making and updating mask recommendations as well as explicitly acknowledge the need to incorporate sociocultural and other contextual considerations in translating scientific data into mask recommendations. Second, officials and agencies must uphold and communicate decisional transparency as part of their effort to demonstrate accountability and promote the public’s understanding of the evolving pandemic. Third, especially since both the pandemic and mask recommendations may have disparate impact on different populations, officials should start with the fair implementation of the least restrictive measures that can help reduce harm. (shrink)

Adults apply ownership not only to objects but also to ideas. But do people come to apply principles of ownership to ideas because of being taught about intellectual property and copyrights? Here, we investigate whether children apply rules from physical property ownership to ideas. Studies 1a and 1b show that children (6–8 years old) determine ownership of both objects and ideas based on who first establishes possession of the object or idea. Study 2 shows that children use another principle of (...) object ownership, control of permission—an ability to restrict others’ access to the entity in question—to determine idea ownership. In Study 3, we replicate these findings with different idea types. In Study 4, we determine that children will not apply ownership to every entity, demonstrating that they do not apply ownership to a common word. Taken together, these results suggest that, like adults, children as young as 6 years old apply rules from ownership not only to objects but to ideas as well. (shrink)

This book brings together key players in the current debate on positive and normative science and philosophy and value judgements in economics. Both editors have engaged in these debates throughout their careers from its early foundations; Putnam as a doctorial student of Hans Reichenbach at UCLA and Walsh a junior member of Lord Robbinsâe(tm)s department at the London School of Economics, both in the early 1950s. This book collects recent contributions from Martha Nussbaum and Harvey Gram, as well as a (...) new chapter from the editors. (shrink)

This study used the latent profile transition analysis to analyze whether emotional labor profiles change across time and how these profiles relate to occupational well-being (i.e., job satisfaction, quality of work life, psychological distress, and work–family conflict). A total of 155 full-time Chinese employees completed the questionnaire survey at two time points. Three latent profiles were identified at Time 1 and the same profiles were replicated at Time 2. We determined that the majority of the participants retained the original profiles. (...) Lastly, occupational well-being differed significantly across the identified profiles. The limitations and implications of this study were also provided. (shrink)

In Phillip Kerr’s 1994 spellbinding novel A Philosophical Investigation, the medical test to which the protagonist refers is a functional brain scan based on positron emission tomography. It is used to run large studies of male and female brains and, following a lead suggested by animal studies, has been used to identify rare cases of human male subjects who lack the ventral medial nucleus. This nucleus, in the experiment, is hypothesized to inhibit the activity of the sexually dimorphic nucleus, a (...) preoptic area of the male brain believed to be a repository of male aggressive response. Prior research, we learn from the plot, shows that 3 in 100,000 human males are VMN-negative. Thirty percent of those affected are believed to be in prison or to have a criminal record; 70% are believed to stabilize levels of aggression by producing increased levels of estrogen. Identities of subjects participating in the brain scan studies are protected through the conversion of real names to those of famous figures of the past — Bertrand Russell, Charles Dickens. Those for whom results are unfavorable are recontacted, and they are offered counseling. (shrink)

BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. Most (...) physicians were male (66%) and of Southeast Asian descent (66%). All physicians explained the plan of care to the patients; most believed that their patient understood. However, many patients did not. Physicians rarely asked the patient for their opinion. In all those cases, the decision had been made previously by the doctors. No decisions were made with the patient. Patients sometimes disagreed. CONCLUSIONS: Shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict. PRACTICE IMPLICATIONS: Some hospitalized patients are interested in discussing treatment. Improving hospital communication can foster patient autonomy. (shrink)

Culturally Responsive Teaching (CRT) weaves together rigor and relevance while it improves student achievement and engagement. The Philippine Department of Education implemented Indigenous People’s education to respond to the demands for culturally responsive teaching. Teacher education graduates are expected to articulate the rootedness of education in sociocultural contexts in creating a learning environment that recognizes respect, connectedness, choice, personal relevance, challenges, engagement, authenticity, and effectiveness. Practice teachers need relevant exposure and immersion to fully develop their competence in CRT. This scenario (...) necessitates attention to assessing the competence of 191 practice teachers in CRT, correlating their competence across dimensions, and verifying the role of gender and degree programs in competence development. This investigation provides evidence on the role of gender in competence development toward culturally responsive teaching. Such competence is vital in practice teachers, especially because they are exposed to learners with diverse backgrounds during their teaching internship. This evidence informs supervising instructors in molding practice teachers. (shrink)

The present note will be concerned only with Sir Partha Dasgupta's recent article in this journal (Dasgupta 2005). What is more, it will concentrate on those parts of the article which contain a serious misreading of Hilary Putnam's position on the entanglement of facts, theories and values. These philosophical matters can perhaps be clarified for economist readers (they should require no clarification for philosophers) by considering, to begin with, Dasgupta's interpretation of the Bergson–Samuelson position. What (Bergson) Burk (1938) and Samuelson (...) (1947) were doing, according to Dasgupta, was to establish ‘the ethical foundations of the subject. . .over five decades ago’ (Dasgupta 2005: 221–2).2 Thus a major theme of the article is heard at once: economics is supposedly based on sound ethical foundations, and these can be traced (it is supposed) to specific work written long ago, and hence needing no augmentation. These ethical foundations, it is claimed, ‘are now regarded to be a settled matter’ (2005: 222). (shrink)

ABSTRACTThe aim of this study was to examine the extent to which cognitive emotion regulation strategies were “common or transdiagnostic correlates” of symptoms of depression and anxiety and/or “specific correlates” distinguishing one problem category from the other. The sample comprised 582 13- to 16-year-old secondary school students. Symptoms of depression and anxiety were measured by the SCL-90, and cognitive emotion regulation strategies were measured by the CERQ, in a cross-sectional design. Multivariate regression analyses were performed. Before controlling for comorbidity, the (...) same cognitive emotion regulation strategies that were related to symptoms of depression were also related to symptoms of anxiety. However, after controlling for comorbid anxiety symptoms, rumination, self-blame, positive reappraisal, and positive refocusing were uniquely associated with depression symptoms; and after controlling for comorbid depression symptoms, ca... (shrink)

Common everyday materials such as textiles, foodstuffs, soil or skin can have complex, mutable and varied appearances. Under typical viewing conditions, most observers can visually recognize materials effortlessly, and determine many of their properties without touching them. Visual material perception raises many fascinating questions for vision researchers, neuroscientists and philosophers, yet has received little attention compared to the perception of color or shape. Here we discuss some of the challenges that material perception raises and argue that further philosophical thought should (...) be directed to how we see materials. (shrink)

The assumption in current U.S. mainstream medicine is that birthing requires hospitalization. In fact, while the American College of Obstetricians and Gynecologists supports the right of every birthing person to make a medically informed decision about their delivery, they do not recommend home birth owing to data indicating greater neonatal morbidity and mortality. In this article, we examine the evidence surrounding home birth in the United States and its current limitations, as well as the ethical considerations around birth setting.

Slogans on commercial vehicles are a common sight in Ghana. These material artefacts can provide insight into beliefs and values about the sociocultural, spiritual, and political experiences of life in the contemporary Ghanaian context. In this study, we collected and analysed a total of 438 commercial vehicles’ slogans from 5 main transportation terminals in the Accra metropolitan area. Our thematic analysis of these slogans shows a major emphasis on religious and spiritual values to the extent that most of the recorded (...) slogans serve as positive affirmations of religious values and sources of spiritual encouragement. The dominance of religious references in such slogans highlights the importance of religiosity as a cultural value in everyday life in Ghana. (shrink)

Natural ecosystems provide important services upon which humans depend. Unfortunately, some people tend to believe that these services are provided by nature for free; therefore, the services have little or no value. One nearly forgotten ecosystem service is ecotherapy – the ability of interaction with nature to enhance healing and growth. While we do not pay for this service, its loss can result in a cost to humans resulting in slower recovery times, greater distress and reduced well-being. Losses in these (...) images of nature can diminish our basic happiness. Little is understood or, at least, appreciated concerning the potential ecotherapy benefits of the natural environment and its ecosystem services. The complex and interactive relationship of ecosystems, their services and human well-being is poorly acknowledged in the broad social, philosophical, psychological and economic well-being literature. In this article, we examine the role of nature and its ecosystem services in ecotherapy and its associated enhancement of recovery from physical and mental illness through a review of studies evaluating this ecosystem service-recovery connection. (shrink)

O presente artigo tem como objetivo principal uma rápida retomada dos pressupostos básicos do marxismo e a sua identificação com a Teoria histórico-cultural, em especial com o pensamento de Lev Semionovich Vigotski. A chave para a compreensão das teorias de Vigotski está nos princípios marxistas, cuja contribuição vai muito além da influência formal que emana da sua condição ideológica. Vigotski apreendeu o método dialético marxista, da mesma forma em que incorporou e desenvolveu alguns dos seus objetivos e princípios teóricos (os (...) conceitos de mediação e atividade, por exemplo), necessários para o desenvolvimento de uma psicologia de cunho científico, que teria um profundo impacto nas concepções educacionais contemporâneas. Tentar separar a obra de Vigotski da influência do marxismo é subestimar as suas escolhas metodológicas e, acima de tudo, desrespeitar as suas convicções teóricas e inclinações ideológicas. (shrink)

Pain and posttraumatic stress disorder frequently co-occur but underlying mechanisms are not clear. This study aimed to test the development and maintenance of pain and PTSD symptom clusters, i.e., intrusions, avoidance, and hyperarousal. The longitudinal study included 216 adults with burns. PTSD symptom clusters, indexed by the Impact of Event Scale-Revised, and pain, using a graphic numerical rating scale, were measured during hospitalization, 3 and 6 months post-burn. Cross-lagged panel analysis was used to test the relationships between pain and PTSD (...) symptom clusters. Cross-lagged results showed that in-hospital intrusions predicted pain and avoidance 3 months post-burn. In-hospital pain predicted intrusions and avoidance 3 months post-burn and a trend was found for hyperarousal. In the second wave, intrusions predicted pain and hyperarousal. Pain predicted hyperarousal. This study provides support for an entangled relationship between pain and PTSD symptoms, and particularly subscribes the role of intrusions in this bidirectional relationship. To a lesser extent, hyperarousal was unidirectionally related to pain. These results may subscribe the driving role of PTSD, particularly intrusions, which partly supports the Perpetual Avoidance Model. (shrink)

O caráter protocolar desempenhado pelas matemáticas na formulação do conceito cartesiano de ciência é amplamente difundido e frequentemente reinvocado na literatura especializada quando se trata de abordar a exigência apodítica inerente a este conceito. No entanto, pouco se explora o que a diversidade das disciplinas matemáticas bem como a relação entretida por elas permite trazer de elucidação à noção cartesiana de ciência. Nosso propósito consiste, aqui, em tomar posição quanto a um debate acerca do estatuto da álgebra e da geometria (...) como disciplinas que fixam os lineamentos da teoria cartesiana do conhecimento ao exibirem o que Descartes reputaria como a aplicação ideal do intelecto. Trata-se de insistir, por vias que assinalam uma decisão teórica em favor de uma concepção mais intelectualista e menos imaginativa da ciência, que não há hesitação quanto ao papel primitivo e fundacional da álgebra se comparada à geometria. (shrink)