The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of (...) patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form. (shrink)

The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...) other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency. (shrink)

Requiring family authorization for apnea testing subtracts health professionals control over death determination, a procedure that has traditionally been considered a matter of clinical expertise alone. In this commentary, we first provide evidence showing that health professionals’ (HPs) disposition to act on death determination without family’s prior consent could be much lower than that referred to by Berkowitz and Garrett (2020). We hypothesize that HPs may have reservations about their own expertise as regards death, and may thus hesitate to impose (...) their views on patients’ families. We then address the theoretical question of clinical expertise in death determination by distinguishing judgments about facts (e.g., the presence or absence of spontaneous breathing) from interpretations given of these facts (i.e., their meaning for the vital status of an individual). We argue that, while clinicians may claim some expert authority on the former, they hold no particular authority on the latter. (shrink)

The Habermasian concept of ‘interest’ has had a profound effect on the characterization of scientific disciplines. Going beyond issues unrelated to the theory itself, intra‐theoretical interest characterizes the specific ways of approaching any science‐related discipline, defining research topics and methodologies. This approach was developed by Jürgen Habermas in relation to empirical–analytical sciences, historical–hermeneutics sciences, and critical sciences; however, he did not make any specific references to health sciences. This article aims to contribute to shaping a general epistemological framework for health (...) sciences, as well as its specific implications for the medical and nursing areas, via an analysis of the basic knowledge interests developed by Habermas. (shrink)

As intergenerational interactions increase due to an ageing population, the study of emotion-related responses to the elderly is increasingly relevant. Previous research found mixed results regarding affective mimicry – a measure related to liking and affiliation. In the current study, we investigated emotional mimicry to younger and older actors following an encounter with a younger and older player in a Cyberball game. In a complete exclusion condition, in which both younger and older players excluded the participant, we expected emotional mimicry (...) to be stronger for younger vs. older actors. In a partial inclusion condition, in which the younger player excluded while the older player included the participant, we predicted that the difference in player behaviour would lead to a difference in liking. This increased liking of the older interaction partner should reduce the difference in emotional mimicry towards the two different age groups. Results revealed more mimicry for older actors following partial inclusion especially for negative emotions, suggesting inclusive behaviour by an older person in an interaction as a possible means to increase mimicry and affiliation to the elderly. (shrink)

La expansión de las actividades informales de feriantes en el conurbano bonaerense constituye una de las manifestaciones del fenómeno de la heterogeneidad no regulada del aprovisionamiento de bienes de consumo, que a su vez, emergen como intermediarios económicos que atienden a necesidades y demandas de consumidores territorialmente segregados y no articulados a los mercados formales, en su mayoría.Es en ese sentido que el presente artículo quiere rescatar y señalar los componentes centrales que asoman en un proceso que parte con el (...) supuesto de que la confianza constituye un elemento central cuando otras formas que actuarían como garante de las interacciones aparecen débiles, ausentes o no primordiales como garantía de las interacciones sociales, como es el caso de la feria de Solano. (shrink)

The rise of mathematical developments in the theories of consciousness has led to new measures to detect consciousness in a system. The Integrated Information Theory is one of the best mathematical rooted attempts to quantify the level of consciousness in a system with Φ as the effective information generated in a system above its parts. Recently, the IIT has inspired the Perturbational Complexity Index to detect conscious states in patients with disorders of consciousness, and it has shown to have almost (...) perfect classification accuracy. In this study, we explore the statistical correspondence between the theoretical Φ and the experimental PCI through a neurocomputational model of coupled oscillators that can be artificially perturbed, which mainly focuses on the dynamics of collective synchronization between subsets of brain areas. Our results reveal that both measures are statistically related but, in principle, this relationship is far to be perfect. These results are discussed in the context of the model of coupled oscillators, which mainly focuses on the dynamics of collective synchronization between subsets of brain areas. (shrink)

Biobanks correspond to different situations: research and technological development, medical diagnosis or therapeutic activities. Their status is not clearly defined. We aimed to investigate human biobanking in Europe, particularly in relation to organisational, economic and ethical issues in various national contexts. Data from a survey in six EU countries were collected as part of a European Research Project examining human and non-human biobanking. A total of 147 institutions concerned with biobanking of human samples and data were investigated by questionnaires and (...) interviews. Most institutions surveyed belong to the public or private non-profit-making sectors, which have a key role in biobanking. This activity is increasing in all countries because few samples are discarded and genetic research is proliferating. Collections vary in size, many being small and only a few very large. Their purpose is often research, or research and healthcare, mostly in the context of disease studies. A specific budget is very rarely allocated to biobanking and costs are not often evaluated. Samples are usually provided free of charge and gifts and exchanges are the common rule. Good practice guidelines are generally followed and quality controls are performed but quality procedures are not always clearly explained. Associated data are usually computerised. Biobankers generally favour centralisation of data rather than of samples. Legal and ethical harmonisation within Europe is considered likely to facilitate international collaboration. We propose a series of recommendations and suggestions arising from the EUROGENBANK project. (shrink)

En este texto se trata de pensar el proyecto que Foucault inició con el análisis de la parrhesía. Se aborda ese problema en relación a otros dos elementos de su obra: la reflexión sobre la función de los intelectuales y sus escritos sobre la noción de crítica. Desde esa perspectiva trataré de mostrar que las investigaciones sobre la parrhesía reflejan el intento de pensar una nueva política de la verdad.

En este artículo se presenta un abordaje general de la teoría de la justicia social de John Rawls. Revisamos algunas críticas desde diversos frentes teóricos. Consideramos que la justicia social permite enjuiciar las consecuencias regresivas para la humanidad del capitalismo en su fase neoliberal y comenzar a imaginar otros mundos posibles.

Based on an extensive review of the literature and field surveys, the paper proposes a conceptualization and operationalization of corporate citizenship meaningful in two countries: the United States and France. A survey of 210 American and 120 French managers provides support for the proposed definition of corporate citizenship as a construct including the four correlated factors of economic, legal, ethical, and discretionary citizenship. The managerial implications of the research and directions for future research are discussed.

El estudio examina mediante una revisión sistemática la literatura científica. La metodología se basó en la aplicación de los principios de la declaración PRISMA. Los resultados indicaron que la mayor producción de estudios fue en 2021, con predominancia de idioma inglés, España como el mayor productor, Reino Unido con el mayor número de revistas y el uso de realidad aumentada como la estrategia más estudiada. La producción científica en educación, y más particularmente en metodologías aplicada a la educación, ha generado (...) una serie de estudios bibliométricos, los cuales han demostrado la evolución de las mismas en lapsos de tiempo diversos. (shrink)

Alireza Bagheri supports a policy on organ procurement where individuals could choose their own definition of death between two or more socially accepted alternatives. First, we claim that such a policy, without any criterion to distinguish accepted from acceptable definitions, easily leads to the slippery slope that Bagheri tries to avoid. Second, we suggest that a public discussion about the circumstances under which the dead donor rule could be violated is more productive of social trust than constantly moving the line (...) between life and death. (shrink)

Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...) were performed by two or more independent reviewers for each record. -/- Results: Of the 1482 results, 467 studies were assessed in full-text form, and 33 were included in this synthesis. When the deceased has not expressed any preference, a majority of the public support the family's role as a surrogate decision-maker. When the deceased expressly consented, the respondents' answers depend on whether they see themselves as potential donors or as a deceased's next-of-kin. Answers also depend on the relationship between the deceased and the decision-maker(s) within the family, and on their ethnic or cultural background. -/- Conclusions: Public views on the authority of the family in organ donation decision-making require further research. A common conceptual framework and validated well-designed questionnaires are needed for future studies. The findings should be considered in the development of Government policy and guidance regarding the role of families in deceased organ donation. (shrink)

Information on the risks and benefits related to surgical procedures is essential for patients in order to obtain their informed consent. Some disciplines, such as sociolinguistics, offer insights that are helpful for patient—professional communication in both written and oral consent. Communication difficulties become more acute when patients make decisions through an informed consent document because they may sign this with a lack of understanding and information, and consequently feel deprived of their freedom to make their choice about different treatments or (...) surgery. This article discusses findings from documentary analysis using the sociolinguistic SPEAKING model, which was applied to the general and specific informed consent documents required for laparoscopic surgery of the bile duct at Torrecárdenas Hospital, Almería, Spain. The objective of this procedure was to identify flaws when information was provided, together with its readability, its voluntary basis, and patients’ consent. The results suggest potential linguistic communication difficulties, different languages being used, cultural clashes, asymmetry of communication between professionals and patients, assignment of rights on the part of patients, and overprotection of professionals and institutions. (shrink)

Introducción: La asignatura Metodología de la Investigación Cualitativa en Salud se imparte a los estudiantes de tercer año de la Licenciatura en Enfermería en la modalidad de clase teórico-práctica como forma organizativa de la docencia. Ello recalca la importancia del trabajo independiente. Las insuficiencias con relación a éste inciden directamente en la asimilación y apropiación de los conocimientos de la asignatura. Objetivo: Elaborar una estrategia didáctica que contribuya al desarrollo del trabajo independiente correspondiente a la asignatura Metodología de la Investigación (...) Cualitativa en Salud.Material y métodos: Se realizó una investigación de desarrollo, encaminada a perfeccionar el proceso docente educativo en la Facultad de Enfermería, de la Universidad de Ciencias Médicas de Camagüey, durante el curso escolar 2011-2012. Para el diagnóstico inicial se procedió al análisis de documentos: los planes de estudio y el programa de la asignatura. También se aplicaron encuestas a un grupo de estudiantes y al colectivo de profesores que imparten la asignatura. Una vez elaborada la estrategia se evaluó por criterio de expertos. Resultados y discusión: La estrategia pone a disposición de la comunidad académica un software educativo que relaciona los contenidos de la asignatura, lo que permitirá al estudiantado realizar las tareas docentes que se orientan en clases así como asimilar, consolidar y sistematizar los conocimientos con mayor facilidad. Introduction: The subject Methodology of Qualitative Research in Health is taught to the students of the third year of the Bachelor in nursing in the form of theoretical and practical lesson as organizational way of teaching. This underscores the importance of self-employment. The shortcomings in relation to this affect directly the assimilation and appropriation of knowledge in the subject. Objective: To develop a teaching strategy that contributes to the development of self-employ ment for the subject Methodology of Qualitative Research in Health. Material aids and methods: A development research was made which aims at improving the educational teaching process in the Faculty of nursing from the University of Medical Sciences in Camagüey, during the 2011-2012 course. For an initial diagnosis the analyses of documents was made: the curriculum and the program of the course. Surveys were also applied to a group of students and the staff of teachers of the subject. Once the strategy was made it was evaluated through criteria of experts. Results and discussion: Strategy makes available to the academic community educational software that relates to the contents of the course, allowing students to perform teaching tasks which are assigned in lessons as well as assimilate, consolidate and systematize the knowledge easiest. (shrink)

[ENGLISH] This article discusses the potential of synthetic biology to address fundamental questions in the philosophy of biology regarding the nature of life and biological functions. Synthetic biology aims to reduce living organisms to their simplest forms by identifying the minimal components of a cell and also to create novel life forms through genetic reprogramming, biobrick assembly, or novel proteins. However, the technical success of these endeavors does not guarantee their conceptual success in defining life. There is a lack of (...) consensus among researchers on how to define and classify the entities produced in the lab, whether they should be considered living or categorized differently. The criteria for minimal cells and minimal life are subject to arbitrary choices and varying interpretations. The concept of function, crucial to synthetic biology, is also difficult to define. The article highlights the need to consider the minimal set of functions that characterize life before determining the smallest genomes that code for those functions. The arbitrary nature of defining both life and function complicates the understanding and classification of these entities. The article suggests that the traditional dichotomy between the living and the non-living may no longer be valid and that the concept of life itself may not require precise scientific definition. As synthetic biology advances, the article emphasizes the importance of redefining or constructing new categories to encompass the expanding possibilities and creations in the field. The ability to create new life forms raises questions about recognition, identification, and ethical implications, requiring a conceptual and philosophical engagement beyond the technical achievements of synthetic biology. -/- [FRENCH] L'article aborde le potentiel de la biologie synthétique pour répondre à des questions fondamentales de la philosophie de la biologie concernant la nature de la vie et des fonctions biologiques. La biologie synthétique vise à réduire les organismes vivants à leurs formes les plus simples en identifiant les composants minimaux d'une cellule et à créer de nouvelles formes de vie grâce à la reprogrammation génétique, à l'assemblage de biobriques ou à des protéines nouvelles. Cependant, le succès technique de ces approches ne garantit pas leur réussite conceptuelle dans la définition de la vie. Il n'y a pas de consensus parmi les chercheurs sur la façon de définir et de classer les entités produites en laboratoire, qu'elles doivent être considérées comme vivantes ou catégorisées différemment. Les critères des cellules minimales et de la vie minimale sont soumis à des choix arbitraires et à des interprétations variables. La notion de fonction, essentielle en biologie synthétique, est également difficile à définir. L'article met en évidence la nécessité de prendre en compte l'ensemble minimal de fonctions qui caractérisent la vie avant de déterminer les plus petits génomes qui codent ces fonctions. La nature arbitraire de la définition de la vie et de la fonction complique la compréhension et la classification de ces entités. L'article suggère que la dichotomie traditionnelle entre le vivant et le non-vivant pourrait ne plus être valable et que le concept même de vie ne nécessite pas une définition scientifique précise. À mesure que la biologie synthétique progresse, l'article souligne l'importance de redéfinir ou de construire de nouvelles catégories pour englober les possibilités et créations croissantes dans le domaine. La capacité à créer de nouvelles formes de vie soulève des questions de reconnaissance, d'identification et d'implications éthiques, nécessitant une réflexion conceptuelle et philosophique au-delà des avancées techniques de la biologie synthétique. (shrink)

Finality, design and purpose have started to be excluded from the language of the natural sciences since the XVIIth century. Darwin succeeded in excluding them from his theory of evolution appealing to a blind and mechanical natural selection. Today, the most usual definitions for the concept of biological function take for granted that functions: 1) are not dependent on a goal; 2) are not dependent on observers, but only on nature; 3) are explicable in causal terms, either with reference to (...) the causal history of the organ (etiological definition), or with reference to its present structure and causal capabilities (dispositional definition). However, we shall see that such presuppositions cannot take into account the normative character of the concept of biological function. We show that a generalization of the concept of scientific objectivity lets us affirm that functions: 1’) are dependent on a goal; 2’) are dependent on both observers and nature; 3’) cannot be reduced to causality, nor break the laws of physics; and yet, 4) are truly objective. (shrink)

Alfred North Whitehead has never gone out of print, but for a time he was decidedly out of fashion in the English-speaking world. In a splendid work that serves as both introduction and erudite commentary, Isabelle Stengersâe"one of todayâe(tm)s leading philosophers of scienceâe"goes straight to the beating heart of Whiteheadâe(tm)s thought. The product of thirty yearsâe(tm) engagement with the mathematician-philosopherâe(tm)s entire canon, this volume establishes Whitehead as a daring thinker on par with Gilles Deleuze, Felix Guattari, and Michel Foucault. Reading (...) the texts in broadly chronological order while highlighting major works, Stengers deftly unpacks Whiteheadâe(tm)s often complicated language, explaining the seismic shifts in his thinking and showing how he called into question all that philosophers had considered settled after Descartes and Kant. She demonstrates that the implications of Whiteheadâe(tm)s philosophical theories and specialized knowledge of the various sciences come yoked with his innovative, revisionist take on God. Whiteheadâe(tm)s God exists within a specific epistemological realm created by a radically complex and often highly mathematical language. âeoeTo think with Whitehead today,âe Stengers writes, âeoemeans to sign on in advance to an adventure that will leave none of the terms we normally use as they were.âe. (shrink)

In the wake of the 2008 global financial crisis, an important conceptual battleground for democratic theorists ought to be, it would seem, the capitalist firm. We are now painfully aware that the typical model of government in so-called investor-owned companies remains profoundly oligarchic, hierarchical, and unequal. Renewing with the literature of the 1970s and 1980s on workplace democracy, a few political theorists have started to advocate democratic reforms of the workplace by relying on an analogy between firm and state. To (...) the extent that a firm is an organization comparable to the state, it too ought to be ruled along democratic lines. Our paper tests the robustness of the analogy between firm and state by considering six major objections to it: the objection from a difference in ends, the objection from shareholders’ property rights, the objection from worker’s consent, the objection from workers’ exit opportunities, the objection from workers’ expertise, and the objection from the fragility of firms. We find all of these objections wanting. While the paper does not ambition to settle the issue of workplace democracy at once, our goal is to pave the way for a more in-depth study of the ways in which firms and states can be compared and the possible implications this may have for our understanding of the nature of managerial authority and the governance of firms. (shrink)

El artículo contextualiza e investiga los detalles del «Mes de Reflexión Episcopal» organizado por el Departamento de Pastoral de Conjunto del Celam en julio de 1971, que reunió providencialmente varios obispos, algunos de los cuales no estuvieron en la II Conferencia General tres años antes, y que darían testimonio del espíritu de Medellín hasta el martirio o hasta una muerte trágica en cumplimiento de su misión: Oscar Arnulfo Romero, Juan Gerardi Conedera, Gerardo Valencia Cano y Raúl Zambrano Camader. El encuentro (...) se describe a partir de la revisión documental de las actas y de los pocos informes impresos. La tesis central del artículo es que el diálogo informal entre obispos, teólogos y otros expertos en el «Mes de Reflexión Episcopal» es fuente de propuestas novedosas para una Pastoral de Conjunto, contra la clericalización y el autoritarismo en la Iglesia latinoamericana. Desafortunadamente, no hay una reunión posterior similar debido a una controversia con la Congregación romana para los obispos. (shrink)

Concerned with the interplay between science, society, and power, Isabelle Stengers offers a unique perspective on the power of scientific theories to modify society, and vice versa. 9 diagrams.

"Isabelle Stengers presents us with a new way of understanding a remarkably diverse range of sciences and their relation to a material and living world. Playing with a position both inside the practices that constitute and transform science and outside the sciences as their mode of conceptualization, Stengers explores the limits, constraints, and inventions that fuse modern science and contemporary society." Elizabeth Grosz --.

This paper demonstrates how argumentation schemes can be used in decision support systems that help clinicians in making treatment decisions. The work builds on the use of computational argumentation, a rigorous approach to reasoning with complex data that places strong emphasis on being able to justify and explain the decisions that are recommended. The main contribution of the paper is to present a novel set of specialised argumentation schemes that can be used in the context of a clinical decision support (...) system to assist in reasoning about what treatments to offer. These schemes provide a mechanism for capturing clinical reasoning in such a way that it can be handled by the formal reasoning mechanisms of formal argumentation. The paper describes how the integration between argumentation schemes and formal argumentation may be carried out, sketches how this is achieved by an implementation that we have created and illustrates the overall process on a small set of case studies. (shrink)

An innovative, multifaceted approach to scientific experiments as designed by and shaped through interaction with the modeling process The role of scientific modeling in mediation between theories and phenomena is a critical topic within the philosophy of science, touching on issues from climate modeling to synthetic models in biology, high energy particle physics, and cognitive sciences. Offering a radically new conception of the role of data in the scientific modeling process as well as a new awareness of the problematic aspects (...) of data, this cutting-edge volume offers a multifaceted view on experiments as designed and shaped in interaction with the modeling process. Contributors address such issues as the construction of models in conjunction with scientific experimentation; the status of measurement and the function of experiment in the identification of relevant parameters; how the phenomena under study are reconceived when accounted for by a model; and the interplay between experimenting, modeling, and simulation when results do not mesh. Highlighting the mediating role of models and the model-dependence of data measurement, this volume proposes a normative and conceptual innovation in scientific modeling--that the phenomena to be investigated and modeled must not be precisely identified at the start but specified during the course of the interactions arising between experimental and modeling activities. Contributors: Nancy D. Cartwright, U of California, San Diego; Anthony Chemero, U of Cincinnati; Ronald N. Giere, U of Minnesota; Jenann Ismael, U of Arizona; Tarja Knuuttila, U of South Carolina; Andrea Loettgers, U of Bern, Switzerland; Deborah Mayo, Virginia Tech; Joseph Rouse, Wesleyan U; Paul Teller, U of California, Davis; Michael Weisberg, U of Pennsylvania; Eric Winsberg, U of South Florida. (shrink)

In the 1970s and 1980s, a multitude of cognitive rehabilitation programs proliferated to facilitate recovery after brain injury. However only a few programs provided a framework for ameliorating disturbances in the cognitive, psychological, and interpersonal spheres of the brain-injured patient. Greatly influenced by Leonard Diller and Yehuda Ben-Yishay’s ideas and methods, George P. Prigatano began, in early 1980, a holistic neuropsychological rehabilitation program at the Presbyterian Hospital in Oklahoma City (Oklahoma). The objective of this paper is to summarize the contributions (...) of George P. Prigatano to neuropsychological rehabilitation and clinical neuropsychology during his 50th year of practice. The main body of the paper is structured in three sections. The first section briefly explains the history of neuropsychological rehabilitation in the twentieth century and the emergence of holistic neuropsychological rehabilitation programs in the 1970s. The second section describes the contributions of George P. Prigatano to neuropsychological rehabilitation and clinical neuropsychology (written by AGM). In the third section, the second author (GPP) prepared an autobiographical statement, which attempts to summarize some of the personal and professional experiences which influenced his work. George P. Prigatano’s contributions to neuropsychological rehabilitation and clinical neuropsychology are essential to understanding the therapeutic approaches currently used in the treatment of brain-injured patients. (shrink)