Discharges against medical advice (AMA) make up a significant number of hospital discharges in the United States, and often involve vulnerable patients who struggle to obtain adequate medical care. Unfortunately, much of the AMA discharge process focuses on absolving the medical center of liability for what happens to these patients once they leave the acute setting. Comparatively little attention is paid to the ethical obligations of the medical team once an informed decision to leave the acute care setting AMA has (...) been made. Via a case narrative, we offer an ethical framework that we believe can help guide an ethically defensible AMA discharge process. By emphasizing our duty to provide the best care possible under the circumstances, we contend, our ethical obligations to promote the patient's best interests can still be met despite their decision to leave the acute setting against medical advice. (shrink)

RESUMO Este texto propõe a trazer à tona alguns aspectos dos estudos do budismo e de sua filosofia no Brasil, que têm sido, de alguma forma, negligenciados ou tratados de modo pouco condizente com a proposta com que este filosofar foi inicialmente concebido. Não se trata de convencer ou "converter" acadêmicos brasileiros a pensarem de maneira similar aos eruditos budistas, mas simplesmente destacar pontos que parecem relevantes para dar continuidade a um debate que já vem sendo estabelecido, particularmente na última (...) década. Com este propósito, serão levantadas questões como as motivações e métodos do fazer filosófico, o dogmatismo, a ética e formas de transmissão de conhecimento. ABSTRACT This text aims to highlight some aspects of the study of Buddhism and its philosophy in Brazil, which have been either neglected or treated in a manner that is incongruous with the proposal upon which this philosophy was initially conceived. The motivation here is not to convince or "convert" Brazilian scholars to think in a similar way to the Buddhist scholars, but simply to bring out points that seem to be relevant to foster the debate that has already been established, particularly in the last decade. For this purpose, issues regarding motivation and method in philosophical work, dogmatism, ethics and modes of knowledge transmission will be raised. (shrink)

In this conversation, Berkeley-based philosopher Judith Butler offers insights into her understanding of the public sphere and its current transformations as a core dimension of political subjectivity. Beginning with her own understanding of Habermas’ classic, the interview centers around its connection to other classical texts (e.g. of Hannah Arendt) and timely political debates.

As companies increasingly communicate CSR initiatives through social media, viral message propagation has become a crucial prerequisite for CSR success. Evidence from two experimental studies, one based on a national representative online sample, shows that social media peers’ endorsement of a CSR message in terms of number of shares, likes and positive replies contributes to an individual’s intention to share it on the social network and thereby participate in message propagation, and that this process can be explained by normative influences (...) exerted by the social media community through the activation of injunctive and descriptive norms, as well as social identity motives. Findings further confirmed that the norm-activating effects of social media endorsement are moderated by the empowering qualities of the CSR message, the sharing source of the message by affecting CSR credibility, and the recipient’s interdependent self-construal. Corporate communication managers are advised to achieve a high degree of initial social media endorsement of their CSR message, for recipients of the message to perceive social pressure motivating message sharing with their social media peers. (shrink)

This article presents reflections on our experience with quilombola women, through the lens of the coloniality of power-knowledge. The text aims to challenge the contradictions we face as researchers and as women. We describe the workshop we presented over four days with the participation of the quilombola women, as well as the quilombo community where the activities were held. We discuss the performance of coloniality during the time we spent together and how it was present in the organization of knowledge (...) and in our bodies, the repercussions of coloniality on ourselves, and the possibility of decolonizing knowledge and subjects, in spite of the colonial pattern of power. The activities we carried out with these women left marks on us and served as a stimulus for us to decolonize ourselves, our judgments of the object-other, as well as our writing and research practices. (shrink)

This paper intends to establish a parallelism between Maurice Merleau-Ponty’ and Donald Davidson’s philosophies, based upon the criticism they both elaborate of the word/meaning separation, common to empiricist and rationalist traditions. Despite their apparent antagonis-tic starting points, and their obvious different styles of thinking, great af-finities can be seen in the attacks these two authors make to the scheme/experience dichotomy, present in the “metaphysics of represen-tation” as a whole.

O artigo trata da discussão travada entre Donald Davidson e os defensores do materialismo redutivo em torno da alegada “ineficácia causal” do mental que a doutrina da superveniência implica. Para defender sua posição, a da eficiência causal particular do mental, Davidson lançará mão da distinção entre “relações causais” e “explicações causais” . Sem ela Davidson seria obrigado a aceitar “o princípio da exclusão causal-explanatória” introduzido por Kim e, consequentemente, abandonar o não-reducionismo característico de seu monismo anômalo e da tese da (...) superveniência do mental em relação ao físico. (shrink)

Towards the middle of the 18th century, Pierre-Louis Moreau de Maupertuis proposed the “principle of least action” as a fundamental law of physics and as a proof of the existence of God. Samuel König and other contemporary authors criticized Maupertuis’ work. There ensued a fierce discussion concerning this subject, in which Leonhard Euler, the king Frédéric II of Prussia and Voltaire took part. This paper discusses that debate, emphasizing its extrascientific features and analyzing the interests that motivated the actions of (...) the people involved in that episode. RESUMO: Em meados do século XVIII, Pierre-Louis Moreau de Maupertuis propôs o “princípio de ação mínima”, que seria uma lei fundamental da física, além de constituir uma prova da existência de Deus. O trabalho de Maupertuis foi criticado por Samuel König e outros autores da época. Ocorreu uma violenta discussão a respeito desse assunto, da qual participaram Leonhard Euler, o rei Frédéric II da Prússia e Voltaire. Este artigo estuda o debate ocorrido, enfatizando especialmente os aspectos extracientíficos e analisando os interesses que motivaram as ações das pessoas envolvidas nesse episódio. (shrink)

ABSTRACTRecognising a facial expression is more difficult when the expresser's body conveys incongruent affect. Existing research has documented such interference for universally recognisable bodil...

A rational moral code must satisfy the condition of completeness. This same condition applies to a set of moral rights, where it takes the form of requiring that all the rights in that set be compossible: that their respective correlatively entailed duties be jointly fulfillable. Such joint fulfillability is guaranteed only by a set of fully differentiated individual domains. And if moral rights are to play any independent role in moral reasoning - any role logically independent of the values that (...) bring persons into conflict - those domains must be determined by rules which are not derived from those values. (shrink)

Nossa pesquisa procurou mapear a produção científica de mestres e doutores que atuam nos cursos de Educação Física do Maranhão, coletando e analisando informações sobre suas características epistemológicas, segundo as referências utilizadas na produção das teses e dissertações encontradas. Constatou-se que essa produção aborda temáticas distintas, incorrendo num ecletismo teórico ou numa indefinição epistemológica.

ABSTRACT The presence of truth and honesty is a permanent demand, and becomes vital the more committed and intimate a relationship is. Medical practice is relevant to this discussion when one questions whether or not a physician should always tell their patient the truth in the face of a progressive or potentially fatal disease, regarding the diagnosis, outcome, therapy and evolution of the specific disease. From this discussion we aim, with the present report, to look at the truth applicable to (...) the patient‐physician relationship, and its ethical and moral implications; and also to look at where the Brazilian Code of Medical Ethics (BCME) and the medical literature stand regarding this issue. One concludes that there are only two moments not to tell a patient the truth: when the patient does not want to be informed, and when the truth could be iatrogenic. The question now is, when would the truth be iatrogenic? Physicians, in our opinion, would not be able to judge solitarily when the truth might be deleterious to their patient. Alternatively, we propose the appointment of a multidisciplinary commission to help the doctor with such a decision. (shrink)

Ao analisar uma obra literária, Lukács a localiza em seu contexto histórico-social. Em seus estudos sobre Tolstói, por exemplo, ele busca demonstrar como a obra desse escritor supera certas dificuldades impostas em sua época para o “grande realismo”. Para tanto, foram essenciais as reverberações da revolução camponesa russa. Ela permitiu, de acordo com o filósofo, que Tolstói rompesse, até certo ponto, com as limitações de sua própria visão de mundo reacionária e atingisse uma figuração precisa, realista da realidade russa. Isso (...) é o que Lukács chama de “triunfo do realismo”. Ele remonta à compreensão de Engels sobre a relação entre literatura e o posicionamento ideológico do autor, explicando como é possível – sob determinadas circunstâncias – que a visão de mundo reacionária de um autor não só não deforme a figuração da realidade, mas também contribua – positivamente – para sua realização literária. Com essa apreciação, Lukács se distancia de alguns críticos da II. Internacional, em cuja avaliação Tolstoi não passava de um conde reacionário – o que ele era –, aproximando-se e desenvolvendo as análises de Lênin sobre o escritor russo. Para Lênin, Tolstói era o espelho literário da revolução russa de 1905. Lukács busca então desvelar como esse acontecimento histórico se imprime na composição de Tolstói. Por si só, tal reconstrução hermenêutica tem seu interesse; ela sugere, para além, o complexo de questões em torno da decadência ideológica, tão caro à fortuna crítica sobre Lukács. Pois, em paralelo a sua análise sobre Tolstói, Lukács menciona o destino de autores ocidentais como Flaubert, para quem, a despeito de sua honestidade inquestionável, tal caminho já não era mais acessível e sua obra permaneceu inferior às narrativas do grande realismo. em uma tensão constante. Esse e o outro lado da moeda, repleto de elementos que subjazem à compreensão de Lukács sobre a literatura moderna. Nosso artigo visa assim discutir essa tese, perguntando-se quais são as circunstâncias que tornam possível um tour de force realista. Também nos interessa avaliar o contexto em que Lukács desenvolve essa tese, considerando suas polêmicas contra o sociologismo vulgar, bem como seu engajamento na frente popular nos anos 1930. (shrink)

An experimental study was designed to analyze the effect of school-based training in self-regulation learning strategies on academic performance. Class-level variables were considered and the effects of the intervention were measured at the end of the intervention and 3 months later. A sample of 761 students from 3rd and 4th grades, from 14 schools, participated in the study. Data were analyzed using three-level analysis with within-student measurements at level 1, between-students within-classes at level 2, and between-classes at level 3. Data (...) showed a positive effect of the intervention on student performance, both at post-test and at follow-up considering the four school subjects together. However, the effect was significant just at follow-up when subjects were considered separately. Student performance was significantly related to the students’ variables and the context. Finally, students’ gender and level of reading comprehension, as well as the teacher’s gender, were found to moderate the effect of the intervention on students’ academic performance. Two conclusions were highlighted: first, data emphasize the importance of considering time while conducting intervention studies. Second, more teaching experience does not necessarily translate into improvements in the quality of students’ instruction. (shrink)

The focus on translational research in clinical trials has the potential to generate clinically relevant genetic data that could have importance to patients. This raises challenging questions about communicating relevant genetic research results to individual patients. An exploratory pharmacogenetic analysis was conducted in the international ovarian cancer phase III trial, AGO-OVAR 16, which found that patients with clinically important germ-line BRCA1/2 mutations had improved progression-free survival prognosis. Mechanisms to communicate BRCA results were evaluated, because these findings may be beneficial to (...) patients and their families. Communicating individual BRCA results was not anticipated during clinical trial design. Consequently, options were not available for patients to indicate their preference for receiving their individual results when they signed pharmacogenetic informed consent. Differences in local requirements, clinical practice, and opinion regarding the ethical aspects of how to convey genetic results to patients are all potential barriers to returning individual BRCA results to patients. Communicating the aggregate BRCA result from this study provided clinical investigators with a mechanism to disseminate the overall study finding to patients while taking individual circumstances, local guidelines and clinical practice into account. This study illustrates the importance of increasing the clarity and scope of informed consent and the need for patient engagement to ensure clinical trial participants can indicate their preference regarding receipt of potentially important individual pharmacogenetic results. This study was registered in the NCT Clinical Trial Registry under NCT00866697 on March 19, 2009, following approval from participating ethics committees. (shrink)

Ayant vécu un moment décisif de son enfance en France pendant la Deuxième Guerre mondiale, Claire Hsu Accomando y consacre ce livre de souvenirs qui, chose rare, est paru directement en anglais. Love and Rutabaga est un document-témoignage qui donne à réfléchir sur l’histoire des femmes, sur la vie quotidienne, et sur la mémoire. La singularité du projet consiste en la narration d’une grande personne qui raconte son enfance à cinquante ans d’intervalle du point de vue de l’enfant. Il en (...) résul... (shrink)

Ayant vécu un moment décisif de son enfance en France pendant la Deuxième Guerre mondiale, Claire Hsu Accomando y consacre ce livre de souvenirs qui, chose rare, est paru directement en anglais. Love and Rutabaga est un document-témoignage qui donne à réfléchir sur l’histoire des femmes, sur la vie quotidienne, et sur la mémoire. La singularité du projet consiste en la narration d’une grande personne qui raconte son enfance à cinquante ans d’intervalle du point de vue de l’enfant. Il en (...) résul... (shrink)

Pulmonary rehabilitation has demonstrated patients’ physiological and psychosocial improvements, symptoms reduction and health-economic benefits whilst enhances the ability of the whole family to adjust to illness. However, PR remains highly inaccessible due to lack of awareness of its benefits, poor referral and availability mostly in hospitals. Novel models of PR delivery are needed to enhance its implementation while maintaining cost-efficiency. We aim to implement an innovative community-based PR programme and assess its cost-benefit. A 12-week community-based PR will be implemented in (...) primary healthcare centres where programmes are not available. Healthcare professionals will be trained. 73 patients with CRD and their caregivers will compose the experimental group. The control group will include dyads age- and disease-matched willing to collaborate in data collection but not in PR. Patients/family-centred outcomes will be dyspnoea, fatigue, cough and sputum, impact of the disease, emotional state, number of exacerbations, healthcare utilisation, health-related quality of life and family adaptability/cohesion. Other clinical outcomes will be peripheral and respiratory muscle strength, muscle thickness and cross sectional area, exercise capacity, balance and physical activity. Data will be collected at baseline, at 12 weeks, at 3- and 6-months post-PR. Changes in the outcome measures will be compared between groups, after multivariate adjustment for possible confounders, and effect sizes will be calculated. A cost-benefit analysis will be conducted. This study will enhance patients access to PR, by training healthcare professionals in the local primary healthcare centres to conduct such programmes and actively involving caregivers. The cost-benefit analysis of this intervention will provide an evidence-based insight into the economic benefit of community-based PR in chronic respiratory diseases. The trial was registered in the ClinicalTrials. gov U.S. National Library of Medicine, on 10th January, 2019. (shrink)

Strong evidence shows that exposure and engagement with the natural world not only improve human wellbeing but can also help promote environmentally friendly behaviors. Human-nature relationships are at the heart of global agendas promoted by international organizations including the World Health Organization’s “One Health” and the United Nations “Ocean Decade.” These agendas demand collaborative multisector interdisciplinary efforts at local, national, and global levels. However, while global agendas highlight global goals for a sustainable world, developing science that directly addresses these agendas (...) from design through to delivery and outputs does not come without its challenges. In this article, we present the outcomes of international meetings between researchers, stakeholders, and policymakers from the United Kingdom and Brazil. We propose a model for interdisciplinary work under such global agendas, particularly the interface between One Health and the UN Ocean Decade and identify three priority research areas closely linked to each other: human-nature connection, conservation-human behavior, and implementation strategies. We also discuss a number of recommendations for moving forward. (shrink)

Este artículo parte de la perspectiva del materialismo posthumano, una línea de investigación que asume el presente como un contexto postantropocéntrico y postnatural en el que se ha vuelto indispensable volver a considerar las diversas lógicas de existencia que pueblan la Tierra. Es decir, se trata de pensar el espacio post/inhumano que se abre con la interacción, la hibridación y la co-emergencia de todo lo existente en la que los actores humanos están presentes pero no ya en el centro de (...) la acción, sino en una mezcla de agencialidades diversas. En esta oportunidad se presentará una lectura de Las aventuras de la China Iron, de Gabriela Cabezón Cámara, desde una estética materialista posthumana. Por un lado, en la medida en que la narradora es un animal humano, la novela será entendida como una descripción horizontal y no jerárquica del lugar de la “humanidad” en el planeta; y, por el otro, como la exploración de las mutuamente contaminadas potencias de actuar, pensar y sentir de lo existente en general: lo animal, lo vegetal y lo mineral no ya taxonomizados en reinos sino mezclados en el “compost” sin alambrado, ingobernable y fértil que podría ser el “desierto” argentino. De esta forma, en tanto que reescritura del Martín Fierro, texto considerado fundacional de la identidad nacional argentina, la novela de Cabezón Cámara podría ser la fabulación de una “matria” queer y holoéntica que alberga criaturas de múltiples especies y reinos. (shrink)

Brazil has one of the highest levels of economic disparity in the world. The educational system plays a large role in this reality, acting as a mechanism of social exclusion. Neoliberalism has resulted in the commodification of education, empowering private schools while undermining the public system. This has created a vicious cycle, whereby educational inequality reflects and reinforces social inequality. Such a system violates the rights of children not lucky enough to be born into wealth – the right to equal (...) education; to equal opportunity; and equal treatment. From within this context, we propose a model, dubbed The Eagle’s Flight, for psychological intervention in public schools. This will form an extension of our research group’s Psychosocial Assessment and Intervention – Prevention, Community and Liberation, which has been an on-going project for the past fourteen years. The intervention model advocates monitoring child development from a critical, social and historical perspective, focusing on how school and community affect everyday life. The analysis will be carried out via the daily immersion of psychologists in the public school setting, who pay attention to key aspects which include various expressions of violence, financial difficulties related to unemployment, informal employment or drug dealing, poor access to health services, and the developmental impact of factors such as poverty. Based on Paulo Freire's Emancipatory Education Proposal and Ignacio Martín-Baró’s Liberation Psychology, intervention in school and community must be an interdisciplinary procedure, employing professionals from a range of disciplines involved in the study of child development. The various subjects’ perspectives seek to provide support for everyday problems and solutions, whilst breaking down the hegemonic model of psychological practice that considers the child and family as responsible for their problems. A concrete example of this critical psychosocial intervention model is presented. (shrink)

En las últimas décadas, se han incrementado los estudios críticos acerca del vínculo entre el pensamiento de Martin Heidegger y de Walter Benjamin. Este trabajo intenta contribuir a este debate desde la perspectiva de la teología, problematizando su relación con la filosofía, su rol metodológico y sus derivas en la subjetividad en los escritos de la década del veinte de Heidegger y Benjamin. Este punto problemático al nivel de sus consideraciones teológicas permite conducir el análisis hacia la cuestión de la (...) temporalidad. Las lecciones tituladas Introducción a la fenomenología de la religión [Einleitung in die Phänomenologie der Religion], impartidas por Heidegger en el período 1920-1921, habilitan la introducción de nuevas líneas de discusión en torno a la teología y el tiempo -vinculadas a las tradiciones del cristianismo y el judaísmo- que permiten nuevos contrastes entre el pensamiento heideggeriano y el benjaminiano. (shrink)

The present investigation constitutes a summary of our doctoral thesis, where we analyze the conceptions of time of Martin Heidegger and Walter Benjamin in the period from 1916 to 1927. We carried out this study by articulating the question of time with the problems of language, history, and theology as fundamental issues running through the authors' early concerns and writings.

Recent developments in Continental philosophy have included the emergence of a school of “speculative realism,” which rejects the human-centered orientation that has long dominated Continental thought. Proponents of speculative realism differ on several issues, but many agree on the need for an object-oriented ontology. Some speculative realists identify realism with materialism, while others accord equal reality to objects that are non-material, even fictional. Several thinkers retain a focus on difference, a well-established theme in Continental thought. This paper looks at speculative (...) realism from the perspective of systems theory. Many of the tenets of speculative realism have long been features of systems metaphysics and are expressed clearly in a systems framework. However, some views of some speculative realists differ substantially from systems theoretic ideas. (shrink)

The phenomenon of altruism extends from the biological realm to the human sociocultural realm. This article sketches a coherent outline of multiple types of altruism of progressively increasing scope that span these two realms and are grounded in an ever-expanding sense of “self.” Discussion of this framework notes difficulties associated with altruism at different levels. It links scientific ideas about the evolution of cooperation and about hierarchical order to perennial philosophical and religious concerns. It offers a conceptual background for inquiry (...) into societal challenges that call for altruistic behavior, especially the challenge of environmental and social sustainability. (shrink)

In this lively collection ten philosophers tackle the notoriously elusive issues raised by religious discourse in a series of linked debates. The debates focus on reason and faith; the logic of mysticism; the meaning of the word 'God'; language, biblical interpretation and worship; and religion and ethics. Through contemporary philosophical analysis it is possible to shed new light on teh status and language of religion, and in many ways the contributors to Religion and Philosophy break new ground in this perennially (...) controversial field. The collection is addressed to philosophers, theologians and anyone with a general intellectual interest in religion. Certainly it will be a valuable addition to the reading list of all teachers or students of the philosophy of religion. (shrink)

Martin Wrights original ground-breaking and influential analysis of the defects of the adversarial system of justice, plus the arguments in favour of a more ...

Heidegger in America explores the surprising legacy of his life and thought in the United States of America. As a critic of modern life, Heidegger often lamented the growing global influence of all things American. However, it was precisely in America where his thought inspired the work of generations of thinkers – not only philosophers but also theologians, architects, novelists, and even pundits. As a result, the reception and dissemination of Heidegger's philosophical writings transformed the intellectual and cultural history of (...) the United States at a time when American influence was itself transforming the world. A case study in the complex and sometimes contradictory process of transnational exchange, Heidegger in America recasts the scope and methods of contemporary intellectual and cultural history in the age of globalization, challenging what we think we know about Heidegger and American ideas simultaneously. (shrink)

In this article, the author describes sweeping changes in the gender system and offers explanations for why change has been uneven. Because the devaluation of activities done by women has changed little, women have had strong incentive to enter male jobs, but men have had little incentive to take on female activities or jobs. The gender egalitarianism that gained traction was the notion that women should have access to upward mobility and to all areas of schooling and jobs. But persistent (...) gender essentialism means that most people follow gender-typical paths except when upward mobility is impossible otherwise. Middle-class women entered managerial and professional jobs more than working-class women integrated blue-collar jobs because the latter were able to move up while choosing a “female” occupation; many mothers of middle-class women were already in the highest-status female occupations. The author also notes a number of gender-egalitarian trends that have stalled. (shrink)

The discussion of collective agency involves the reduction problem of the concept of a collective. Individualism and Cartesian internalism have long restricted orthodox theories and made them face the tension between an irreducible concept of a collective and ontological reductionism. Heterodox theories as functionalism and interpretationism reinterpret the concept of agency and accept it as realized on the level of a collective. In order to adequately explain social phenomena that have relations as their essence, in this paper we propose a (...) relational, holistic account of collective agency and argue that functionalism and interpretationism can be integrated into such an account. (shrink)

Stigma taints individuals with a spoiled identity and loss of status or discrimination. This article is the first to examine the stigma attached to abortion and surrogacy and consider how law may stigmatize women for failing to conform to social expectations about maternal roles. Courts should consider evidence of stigma when evaluating laws regulating abortion or surrogacy to determine whether these laws are based on impermissible gender stereotyping.