Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that (...) poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. (shrink)

Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that (...) poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. (shrink)

Kenneth Kipnis (2006) presents a normative defense of strict confidentiality, but it follows from an empirical claim that allowing breach would result in all parties being worse off, including, par...

Life history theory predicts that exposure to high mortality in early childhood leads to faster and riskier reproductive strategies. Individuals who grew up in a high mortality regime will not overly wait until they find a suitable partner and form a stable union because premature death would prevent them from reproducing. Cox proportional hazard models were used to determine whether women who experienced sibling death during early childhood (0–5 years) reproduced earlier and were at an increased risk of giving birth (...) to an illegitimate child, with illegitimacy serving as a proxy for risky sexual behavior. Furthermore, we investigate whether giving birth out of wedlock is influenced by individual mortality experience or by more promiscuous sexual behavior that is clustered in certain families. Models are fitted on pedigree data from the eighteenth- and nineteenth-century Krummhörn population in Germany. The results show a relationship between sibling death in early childhood and the risk of reproducing out of wedlock, and reproductive timing. The risk of giving birth out of wedlock is linked to individual mortality experience rather than to family-level effects. In contrast, adjustments in connubial reproductive timing are influenced more by family-level effects than by individual mortality experience. (shrink)

In this article we try to give a philosophically reflected introductory overview of the current theoretical developments in the field of evolutionary aesthetics. Our aim is not completeness. Rather, we try to depict some of the central assumptions and explanatory tools frequently used in evolutionary accounts of human aesthetical preferences and address a number of currently debated, open research questions.

Based on historical data pertaining to the Krummhörn population (eighteenth and nineteenth centuries, Germany), we compared reproductive histories of mothers according to whether the maternal grandmother (MGM) or the paternal grandmother (PGM) or neither of them was resident in the parents’ parish at the time of the mother’s first birth. In contrast to effects of PGMs, we discovered conditional differences in the MGM’s effects between landless people and wealthier, commercial farmers. Our data indicate that the presence of the MGM only (...) lowers the woman’s age at marriage (AAM) and her age at the birth of her first child (AFB) in the case of landless families. However, among commercial farmers, who can generally be characterized by a lower AAM and AFB, we found opposite tendencies for the MGM’s effect leading to a relatively small delay in AAM and AFB. Moreover, we also analyzed differences in the completed fertility (i.e., children ever born: CEB). Results indicate that landless families in general do have fewer CEB compared with commercial farmers except for those families in which the MGM has been present. Emphasizing that the adaptiveness of investment decisions should depend on the interaction of genetic, lineage-specific (intrinsic) and ecologically imposed (extrinsic) constraints, we conclude that kin strategies consequently address different fitness components under different conditions. (shrink)

Commentary on J. Gowdy & L. Krall "The economic origins of ultrasociality": We question the sequence of evolutionary transitions leading to ultrasociality in humans proposed by Gowdy & Krall. Evidence indicates that families are, and likely always have been, the primary productive units in human agricultural economies, suggesting that genetic relatedness is key to understanding when the suppression of individual autonomy to the benefit of subsistence groups, i.e. extended families, evolved.

The clinical vignette remains the standard means by which medical ethics are taught to students in the healthcare professions. Although written or verbal vignettes are useful as a pedagogic tool for teaching ethics and introducing students to real cases, they are limited, since students must imagine the clinical scenario. Medical ethics are almost universally taught during the early years of training, when students are unfamiliar with the clinical reality in which ethics issues arise. Film vignettes fill in that imaginative leap. (...) By providing vivid details with images, film vignettes offer rich and textured details of cases, including the patient’s perspective and the clinical reality. Film vignettes provide a detailed ethnography that allows for a more complete discussion of the ethical issues. Film can serve as an additional tool for teaching medical ethics to members of the healthcare professions. (shrink)

A family reconstitution study of the Krummhörn population (Ostfriesland, Germany, 1720–1874) reveals that infant mortality and children’s probabilities of marrying or emigrating unmarried are affected by the number of living same-sexed sibs in farmers’ families but not in the families of landless laborers. We interpret these results in terms of a “local resource competition” model in which resource-holding families are obliged to manipulate the reproductive future of their offspring. In contrast, families that lack resources have no need to manipulate their (...) offspring and are more likely to benefit from allowing their offspring to capitalize on whatever opportunities to reproduce present themselves. (shrink)

The wealthy elite males of nineteenth-century Krummhörn (Ostfriesland, Germany) achieved an above-average reproductive success. Membership in the elite class was determined from a list of the 300 richest men in the Ostfriesland district compiled by authorities in 1812. The main components establishing the link between cultural success and reproductive success aredifferences in the number of offspring owing to differences both in time spent in fecund marriage (mating success) and in rate of reproduction;differences in the probabilities of one’s adult offspring marrying (...) locally vs. emigrating unmarried owing to differential ability to allocate resources that enhance the “social placement” of adult offspring; anddifferences in the probability of total reproductive failure (lineage extinction).Contrary to what might be expected, infant survivorship was lowest amongst the richest families. We conclude that to a great extent females’ reproductive decisions contribute to the greater reproductive success of the elite males. (shrink)

Self-deception may be the result of social manipulation and conflict management of social in-groups. Although self-deception certainly has offensive and defensive aspects, a full evolutionary understanding of this phenomenon is not possible until strategies of other parties are included into a model of self-perception and self-representation.

In Einklang und in Verlängerung der „Social Brain Hypothesis” wird hier das Argument entfaltet, dass die Freiheitsintuition evolutionär im Zuge der sozialen Evolution der Primaten entstanden ist. Der Hauptselektionsdruck lastete auf der Fähigkeit, soziales Wissen über andere zu generieren, um Sozialpartner in ihren Verhaltenstendenzen berechenbar zu machen und die eigene Verhaltensproduktion strategisch vorteilhaft darauf einstellen zu können. In der sozialen Evolution der Primaten wurde deshalb ein Fremdverstehen prämiert und nicht etwa eine zunehmende Fähigkeit zur Selbsterkenntnis. Die Intuition des freien Willens (...) kann deshalb besser als biologisch funktionale soziale Attribution denn als introspektiv gewonnene Einsicht verstanden werden. (shrink)

This is a welcome reprint of a book that continues to grow in importance.

The author presents and defends three theses: (1) "the first is that it is not profitable for us at present to do moral philosophy; that should be laid aside at any rate until we have an adequate philosophy of psychology." (2) "the second is that the concepts of obligation, And duty... And of what is morally right and wrong, And of the moral sense of 'ought', Ought to be jettisoned if this is psychologically possible...." (3) "the third thesis is that (...) the differences between the well-Known english writers on moral philosophy from sidgwick to the present day are of little importance." (staff). (shrink)

Dieser Beitrag widmet sich der Darstellung des systematischen Zusammenhangs des mit dem Aufkommen der Experimentellen Philosophie neu entstandenen Teilbereichs der Experimentellen Ethik mit der spätestens seit den 1980er Jahren wieder populär gewordenen Evolutionären Ethik, einer Teildisziplin des philosophischen Naturalismus. Nach einer kurzen Charakterisierung beider ethischer Teilbereiche wird am Beispiel der metaethischen Frage nach der Objektivität moralischer Urteile dafür argumentiert, dass die partikulären Ergebnisse experimenteller Methoden in der Moralphilosophie erst in einer umfassenderen Perspektive auf menschliches Handeln vollständig interpretierbar werden: Ohne eine (...) rahmenbildende Hintergrundtheorie moralischen Urteilens, wie z.B. die Evolutionäre Ethik, liefert die Experimentelle Ethik nicht mehr als proximate Erklärungen moralischer Urteilsmechanismen. Zweifelsohne sind dies wertvolle Erkenntnisse über die Funktionsweise moralischer Urteilsfindung – ohne Ordnungsrahmen drohen sie jedoch unverbunden nebeneinander stehen zu bleiben. Andererseits beinhaltet gerade die Evolutionäre Ethik empirische Hintergrundannahmen über menschliches moralisches Urteilen, die erst mit den Methoden der Experimentellen Ethik ihre unabdingbare empirische Überprüfung finden können. Diese zwei Teilbereiche der Moralphilosophie stehen daher in enger systematischer Beziehung. (shrink)

The relations between reason, motivation and value present problems which, though ancient, remain intractable. If values are objective and rational how can they move us and if they are dependent on our contingent desires how can they be rational? E. J. Bond makes a bold attack on this dilemma. The widespread view among philosophers today is that judgements contain an irreducible element of personal commitment. To this Professor Bond proposes an account of values as objective and value judgements as true (...) or false, employing a distinction between grounding and motivating reasons to establish their connection with action. He defines and tests his position against a number of recent theories, providing in the process forceful criticism of Williams, Wiggins, Foot, Narveson and Nagel, among others. A distinctive contribution to the subject, it will stimulate interest and worthwhile debate among philosophers, while also serving as an introduction to this vital topic. (shrink)

Derek Parfit’s view of personal identity raises questions about whether advance decisions refusing life-saving treatment should be honored in cases where a patient loses psychological continuity; it implies that these advance decisions would not be self-determining at all. However, rather than accepting that an unknown metaphysical ‘further fact’ underpins agential unity, one can accept Parfit’s view but offer a different account of what it implies morally. Part II of this article argues that contractual obligations provide a moral basis for honoring (...) advance decisions refusing life-saving and/or life-sustaining medical treatment; advance decisions have similarities to contracts, such as life insurance policies and will-contracts, that come into effect when the psychological discontinuity is through death. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

Arguing that psychologists and their predecessors have invariably relied on metaphors in articulation, the contributors to this volume offer a new "key" to understanding a critically important area of human knowledge by specifying the major metaphors.

Released in 1984, Steven E. Rhoads' classic was considered by many to be among the best introductions to the economic way of thinking and its applications. This anniversary edition has been updated to account for political and economic developments - from the greater interest in redistributing income and the ascendancy of behaviorism to the Trump presidency. Rhoads explores opportunity cost, marginalism, and economic incentives and explains why mainstream economists - even those well to the left - still value free markets. (...) He critiques economics for its unbalanced emphasis on narrow self-interest as controlling motive and route to happiness, highlighting philosophers and positive psychologists' findings that happiness is far more dependent on friends and family than on income or wealth. This thought-provoking tour of the economist's mind is a must read for our times, providing a clear, lively, non-technical insight into how economists think and why they shouldn't be ignored. (shrink)

A dialogue between a foreign philosopher and a powerful statesman outline Plato's reflections on the family, the status of women, property rights, and criminal law.

В статье философия характеризуется на основе дискурсной парадигмы анализа: как текст, интеллектуальная деятельность и коммуникация. Характеризуются два равнозначных аспекта философского дискурса - когнитивный и коммуникативный. Обсуждается феномен философских контроверз, специфика философского спора, выразительные (знаковые) средства философского дискурса, роль мировоззренческого дискурса в современной общественно-политической ситуации в стране.