Smajdor addresses the problem of inferior clinical outcomes among adults with impairments of capacity to give informed consent (AWIC). She notes that AWIC are generally excluded from clinical trials to protect them against harms and avoid exploitation and claims there is a causal link between involvement in clinical trials and favourable outcomes. She argues, given this link, that we should increase AWIC representation in clinical trials and can justifiably do so by recognising the capacity of AWIC to assent. AWIC form (...) a diverse group, with multiple aetiologies, including, for example, Down syndrome, traumatic brain injury and dementia. In some cases, the inability to consent may fluctuate so that the same person could be AWIC only at certain times. Yet despite these differences, the group has a shared unmet need. We agree with Smajdor that AWIC outcomes should be improved, but question whether simply increasing representation in clinical trials is sufficient to achieve this. We identify the following points: 1. AWIC are under-represented in clinical trials. There is evidence of widespread exclusion of AWIC in clinical trials within the UK and abroad and it is often a specific exclusion criterion.1 2. AWIC have worse clinical outcomes and a lower life expectancy. The life expectancy …. (shrink)

The study focused on the adventure-based experiential learning component of the North-West University peer helper training program. The aim of this study was to explore and describe a group of peer helpers’ subjective experiences of their participation in an ABEL program, with a focus on how these experiences related to the concept of grit. A total of 26 students at the North-West University, both male and female, participated in the study. A qualitative research approach with a case study research design (...) was used. The participants completed daily reflective diaries for the duration of the three-day ABEL program. After 3 months of performing their duties as peer helpers, the same individuals participated in focus group interviews. Themes were identified through inductive analysis and discussed regarding their relevance to the concept of grit. The main themes that emerged from both phases of data collection included intra-, inter-, and transpersonal/transcendent aspects, within which participants regularly referred to elements of grit. It was concluded that ABEL, due to its unique nature and demands, provides an ideal mechanism for the facilitation of personal growth on various levels. More specifically, through its clear association with the improvement and/or development of participants’ grit, it could equip these students to be more effective in their role as peer helpers. (shrink)

Background Stroke is a worldwide problem with a limited number of approved treatments. Obtaining informed consent for acute stroke therapy is complicated by the breadth of information that must be communicated in a short period of time, the hectic nature of the emergency environment, the possible lack of understanding by the patient and/or family, and the critically time-sensitive nature of treatment for stroke. Complicating matters even further, patients are often unable to consent for themselves, placing the burden on surrogates to (...) infer patients’ wishes regarding treatment, and potentially limiting acute treatment by practitioners. Innovation An advance directive for acute stroke therapy was created, entitled COAST (Coordinating Options for Acute Stroke Therapy). This clinical initiative is being piloted at a large comprehensive stroke center, including the development of the advance directive form, integration of the form with electronic medical records, training healthcare providers, and outreach to patients. Conclusions COAST is an advance directive for stroke designed to make stroke care more efficient, optimize patients’ autonomy, improve the quality of healthcare, and streamline the ethical management of complex care decisions in acute stroke. The inherent benefit of COAST is in providing patients and their families with more information regarding stroke and its treatment options, allowing them to take a more active role in their care. (shrink)

This paper focuses on the role of regulation in the shaping new scientific facts. Fleck chose to study the origins of a diagnostic test for a disease seen as a major public health problem, that is, a ‘scientific fact’ that had a direct and immediate influence outside the closed universe of fundamental scientific research. In 1935, when Fleck wrote his book, Genesis and development of a scientific fact, he believed that the tumultuous early history of the Wassermann reaction had come (...) to an end, and that this reaction was successfully stabilized through the standardization of laboratory practices and thanks to the rise of a specific professional segment—the serologists. He could not have predicted that in the 15 years that followed the publication of his book, regulatory measures—barely metioned in his historical narrative—would play a key role in the destabilization of the original meaning of this reaction. The introduction of mass screening for syphilis—mainly via legislation that introduced obligatory premarital tests and promoted the testing of pregnant women—weakened in fine the link between Wassermann serology and infection by the etiological agent of syphilis, the bacterium Treponema pallidum. Fleck elected to study the Wassermann reaction because of its novelty, its complexity, and because it became the focus of a controversy regarding its origins. However, the Wassermann reaction was also one the first examples of a medical technology regulated by the state and incorporated into legal dispositions. It may therefore be seen as an exemplary case of the close intertwining of scientific investigations, their practical applications and regulatory practices. (shrink)

In the inter-war period physicians elaborated numerous ‘biotherapies’ grounded in the complex interactions between physiology, bacteriology and immunology. The elaboration of these non-specific biological treatments was stimulated by the theory of generalized anaphylaxis that linked the violent reaction to a foreign protein to a broad array of chronic diseases, from asthma and urticaria to rheumatism or chronic colitis. Such diseases were perceived as the result of an ‘abnormal reactivity’ to a sensitisation of tissues and organs by bacteria and by foreign (...) proteins, a view that provided an effective bridge between new concepts derived from bacteriology and immunology and the long-standing pathological tradition. Accordingly, physicians attempted to treat these conditions through specific desensitisation and non-specific biological therapies: peptone treatment, protein therapy, haemotherapy, ‘antivirus’ or ‘opotherapy’. Therapies that attempted to neutralise the harmful effects of chronic infections through ‘desensitisation’ were not seen as marginal medical practices, but were promoted by leading advocates of the ‘Pasteurian sciences’, such as Richet, Widal, Vallery-Radot, Wright and Fleming. They also led to development of new products by the pharmaceutical industry. (shrink)

In 1910, Charles Richet suggested that studying individual variations in anaphylactic responses might both open a way to experimental investigation of the biological basis of individuality and help unify the immunological and physiological approaches to biological phenomena. The very opposite would happen however. In the next two decades, physiologists and immunologists interested in anaphylaxis and allergy experienced more and more difficulties in communicating. This divergence between the physiopathological and immunological approaches derived from discrepancies between the experimental systems used by each (...) of these scientific communities. Trying to develop a point of view that took into account all bodily reactions to stimuli, physiologists thought that individual variations between the laboratory animals they used (mainly dogs and cats) constituted important experimental data. Seeking to develop reproducible studies of infection, immunity and 'sensitisation', bacteriologists and immunologists considered that individual variations between the laboratory animals they used (mainly small rodents) constituted 'noise' and not a 'signal'. Each group's loyalty to the experimental models used in their discipline widened the gap between immunological and physiological explanations of allergies and led to the abandonment of studies on the biological basis of individuality. (shrink)

Le cancer est perçu aujourd’hui comme une maladie qui affecte à peu près autant d’hommes que de femmes. C’est cependant une conception relativement récente. Jusqu’au milieu du xxe siècle, le cancer était considéré comme une pathologie principalement féminine, les tumeurs malignes produisant des symptômes typiques faciles à détecter. Au xxe siècle, les cancers féminins – du sein et de l’utérus – sont les principales cibles des campagnes publiques pour la détection précoce des tumeurs malignes. Depuis les années 1950, le développement (...) de méthodes efficaces de diagnostic et l’augmentation des cancers du poumon, plus fréquents chez les hommes, met fin à l’image du cancer comme une pathologie féminine. Dans les discours publics et les medias, les cancers des organes reproducteurs féminins continuent cependant d’être plus visibles que ceux des organes reproducteurs masculins, et les femmes à risques sont plus souvent sujettes à une chirurgie de prévention mutilante. (shrink)

Le cancer est perçu aujourd’hui comme une maladie qui affecte à peu près autant d’hommes que de femmes. C’est cependant une conception relativement récente. Jusqu’au milieu du xxe siècle, le cancer était considéré comme une pathologie principalement féminine, les tumeurs malignes produisant des symptômes typiques faciles à détecter. Au xxe siècle, les cancers féminins – du sein et de l’utérus – sont les principales cibles des campagnes publiques pour la détection précoce des tumeurs malignes. Depuis les années 1950, le développement (...) de méthodes efficaces de diagnostic et l’augmentation des cancers du poumon, plus fréquents chez les hommes, met fin à l’image du cancer comme une pathologie féminine. Dans les discours publics et les medias, les cancers des organes reproducteurs féminins continuent cependant d’être plus visibles que ceux des organes reproducteurs masculins, et les femmes à risques sont plus souvent sujettes à une chirurgie de prévention mutilante. (shrink)

Key words: code of ethics; rejected patients; terrorism; terrorist victims; terrorists; values.

As mídias facilitam as aprendizagens e oportunizam a expressão das Habilidades Sociais dos estudantes. Este estudo objetiva caracterizar o uso das Tecnologias da Informação e Comunicação e as Habilidades Sociais de 456 estudantes de escolas privadas do Sul do Brasil. Trata-se de um estudo quantitativo, descritivo e transversal. Utilizou-se um questionário de dados sociodemográficos, Questionário de Utilização das Tecnologias de Informação e Comunicação e Inventário de Habilidades Sociais para Adolescentes Del-Prette. O celular/ smartphone e as redes sociais foram as principais (...) tecnologias utilizadas. Destaca-se maior frequência nas Habilidades Sociais de Civilidade e Desenvoltura social e menores frequências em Empatia, Autocontrole, Assertividade e Abordagem Afetiva. Além de alta dificuldade na emissão de Empatia, Autocontrole e Assertividade. Sugere-se estudos clínicos para desenvolvimento de maior repertório de habilidades sociais nesta população para fins de prevenção de comportamentos problemáticos relacionados a baixos níveis de habilidades sociais e alto uso de mídias. (shrink)

Doctors Pratt and de Vries propose a well-structured and courageous approach to analyse and repair an insufficiently recognised discussion about epistemologies and knowledge production in bioethics.1 The authors invite researchers, scholars, public health experts and bioethicists from the global North to reflect about their lack of imagination regarding different sources of narratives produced by the global South. There is a critical analysis of injustices and an urgent call for global bioethicists to reorient their field and focus on the analysis and (...) development of ethical interventions to achieve a comprehensive epistemic justice for global health ethics. Feminist bioethicists from the global South already argued about the importance of the voices and biographies of the people and groups in the communities to reframe the bioethical reasoning regarding the meaning of individual’s needs during public health and humanitarian emergencies.2 Over a decade ago, Diniz and Guilhem described the role and goal of feminist bioethics in Latin America, shaped in an oppressive context promoted and created by …. (shrink)

In Brazil, the epicenter of the Zika crisis, brown, black, and indigenous poor women living in municipalities with scarce resources were disproportionally affected. The gendered consequences of the epidemic exposed how intersectional lenses are central to understand the impact of public health emergencies in the lives of women and girls. The demand for Zika-affected children and women to be research participants is relevant for an ethical analysis of participant protection procedures during a crisis. We investigated how women experienced research participation (...) by analyzing their narratives. Two-year-long longitudinal qualitative study in Brazilian sites located in the epidemic's epicenter was performed using mixed methods: ethnography with women from two distinct states and individual semi-structured interviews with five women in different Zika-affected states, four of which were community leaders. All women in the study were mothers or grandmothers of Zika-affected children. Thematic analysis was used for data evaluation. Women perceived being pressured to participate in research and a lack of benefit sharing. Structural determinants of gender inequality, such as its effect on power distribution, were found to impact research participant protection. Formal procedures for research protocols approvals were insufficient in protecting participants because these instruments were unable to account for structural aspects. Communitarian mobilization, through WhatsApp groups, was found to be an important mechanism to create conditions to challenge oppressive structures. Strengthening public health, effective community-based participation in research planning and implantation of ethical strategies that promotes gender equality can have transformative effect on unequal power structures and promote participant protection. (shrink)

Linguistic forms with dedicated evidential meanings have been described for a number of Australian languages (eg. Donaldson 1980, Laughren 1982, Wilkins 1989) but there has been little written on how these are used in social interaction. This paper examines evidential strategies in ordinary Garrwa conversations, by taking into account what we know more generally about the status of knowledge and epistemic authority in Aboriginal societies, and applying this understanding to account for the ways knowledge is managed in `ordinary' interactions.

Fifteen years into a successful career as a college professor, Ilana Blumberg encounters a crisis in the classroom that sends her back to the most basic questions about education and prompts a life-changing journey that ultimately takes her from East Lansing to Tel Aviv. As she explores how civic and religious commitments shape the culture of her humanities classrooms, Blumberg argues that there is no education without ethics. When we know what sort of society we seek to build, our (...) teaching practices follow. In vivid classroom scenes from kindergarten through middle school to the university level, Blumberg conveys the drama of intellectual discovery as she offers novice and experienced teachers a pedagogy of writing, speaking, reading, and thinking that she links clearly to the moral and personal development of her students. Writing as an observant Jew and as an American, Blumberg does not shy away from the difficult challenge of balancing identities in the twenty-first century: how to remain true to a community of origin while being a national and global citizen. As she negotiates questions of faith and citizenship in the wide range of classrooms she traverses, Blumberg reminds us that teaching - and learning - are nothing short of a moral art, and that the future of our society depends on it. (shrink)

"In a complex world where competing groups claim to be speaking on behalf of incommensurate versions of 'humanity, ' the authors represented in "In the Name of ...

Linguistic studies of evidentiality, the coding of source of knowledge, have often appeared divided into two camps: those whose focus is the semantic, morphological and typological characteristics of grammaticalized morphological evidential systems, and those whose focus is on the social functions of non-grammaticalized evidential constructions as markers of epistemic authority and responsibility. While interest in the discourse functions of all evidential systems has been growing as seen in the recent special issue of the journal Pragmatics and Society on ‘Evidentiality in (...) Interaction’, there has been little direct attention on whether the deployment of evidential strategies in discourse varies according to the grammatical status of the grammatical resources available to the speaker. This article examines the nature of both grammaticalized and non-grammaticalized evidential systems in a number of languages to show that while the underlying pragmatics of evidentiality is the same regardless of grammatical system, nonetheless grammaticalized evidential systems provide important evidence of the particular features of knowledge sources that are used in routine ways in discourse sufficiently to motivate their development into grammatical systems. (shrink)

This article examines the ways in which 1970s French feminists who participated in the Women’s Liberation Movement (Mouvement de libération des femmes – MLF) wielded the spectre of lesbianism as an American idiosyncrasy to counteract the politicisation of lesbianism in France. It argues that the erasure of lesbian difference from the domain of French feminism was a necessary condition for making ‘woman’ an amenable subject for incorporation into the abstract unity of the French nation, wherein heterosexuality is conceived as a (...) democratic crucible where men and women harmoniously come together and differences are deemed divisive. Looking at the history of feminism from the standpoint of a lesbian perspective reveals unforeseen continuities between French ‘feminist’ and ‘anti-feminist’ genealogies insofar as they rest on common heterosexual and racial foundations. Finally, the article demonstrates that the alleged un-Frenchness ascribed to the word ‘lesbian’ in the 1970s feminist movement spectrally returned in the 1990s when the word ‘gender’ was, in its turn, deemed radically foreign to the French culture by feminist researchers. Fiercely reactionary constituencies against the legalisation of same-sex marriage have more recently taken up this rhetorical weapon against sexual and racial minorities. (shrink)

Musical Group Interaction (MGI) has been found to promote prosocial tendencies, including empathy, across various populations. However, experimental study is lacking in respect of effects of everyday forms of musical engagement on prosocial tendencies, as well as whether key aspects—such as physical co-presence of MGI participants—are necessary to enhance prosocial tendencies. We developed an experimental procedure in order to study online engagement with collaborative playlists and to investigate socio-cognitive components of prosocial tendencies expected to increase as a consequence of engagement. (...) We aimed to determine whether mereperceivedpresence of a partner during playlist-making could elicit observable correlates of social processing implicated in both MGI and prosocial behaviors more generally and identify the potential roles of demographic, musical, and inter-individual differences. Preliminary results suggest that for younger individuals, some of the social processes involved in joint music-making and implicated in empathic processes are likely to be elicited even by an assumption of virtual co-presence. In addition, individual differences in styles of listening behavior may mediate the effects of mere perceived partner presence on recognition memory. (shrink)

Orphei ad Musaeum -- Orphei hymni -- Procli Lycii philosophi hymni -- Magica dicta magorum ex Zoroastre.

Pragmatic sociology is often read as a reaction to and an alternative to Bourdieu’s ‘critical sociology’. This article, in contrast, offers an assessment of pragmatic sociology in terms of its contribution to the theory of culture in general and its affinities with repertoire theory in particular. Whereas the tendency has been to conceive of repertoires as largely unstructured entities, pragmatic sociology has demonstrated a systematic interest in their internal contents and structure, which it has even expanded through its more recent (...) turn to historical and macro comparative analysis. In the process, however, pragmatic sociology has also been leaning towards a form of cultural sociology that actually challenges some major aspects of repertoire theory–thus also bringing into relief the dilemmas facing any attempt at further elaboration of what is now a growing strand of cultural theory. (shrink)

Preferences for options that do not secure optimal outcomes, like the ones catalogued by Sunstein, derive from two sources: cognitive heuristics and deontological rules. Although rules may stem from automatic affective reactions, they are deliberately maintained. Because strongly held convictions have important behavioral implications, it may be useful to regard cognitive heuristics and deontological rules as separate sources of nonconsequential judgment in the moral domain.