Domination as opposed to what? Michel Foucault’s works on power and subject formation uncover the subtle ways in which disciplinary power structures create opportunities for domination. Yet Foucaul...

This article presents two studies that examine cause-related marketing promotions that require consumers’ active participation. Requiring a follow-up behavior has very valuable implications for maximizing marketing expenditures and customer relationship management. Theories related to ethical behavior, like motivated reasoning and defensive denial, are used to explain when and why consumers respond negatively to these effort demands. The first study finds that consumers rationalize not participating in CRM by devaluing the sponsored cause. The second study identifies a tactic marketers can utilize (...) to neutralize consumers’ use of defensive denial. Allowing the consumer to choose the sponsored cause seems to effectively refocus their attention and increases consumers’ threshold for campaign requirements. Implications for nonprofits and marketing managers include a tendency for consumers to be more likely to perceive a firm as ethical and socially responsible when they are allowed to choose the specific cause that is supported. (shrink)

The Clinical Ethics Credentialing Project (CECP) was intiated in 2007 in response to the lack of uniform standards for both the training of clinical ethics consultants, and for evaluating their work as consultants. CECP participants, all practicing clinical ethics consultants, met monthly to apply a standard evaluation instrument, the “QI tool”, to their consultation notes. This paper describes, from a qualitative perspective, how participants grappled with applying standards to their work. Although the process was marked by resistance and disagreement, it (...) was also noteworthy for the sustained engagement by participants over the year of the project, and a high level of acceptance by its conclusion. (shrink)

The Clinical Ethics Credentialing Project (CECP) was intiated in 2007 in response to the lack of uniform standards for both the training of clinical ethics consultants, and for evaluating their work as consultants. CECP participants, all practicing clinical ethics consultants, met monthly to apply a standard evaluation instrument, the QI tool , to their consultation notes. This paper describes, from a qualitative perspective, how participants grappled with applying standards to their work. Although the process was marked by resistance and disagreement, (...) it was also noteworthy for the sustained engagement by participants over the year of the project, and a high level of acceptance by its conclusion. (shrink)

As of the first week of February 2021, the COVID-19 pandemic has resulted in over two million people dead across the globe. This essay argues that in order to fully understand the politics arising from the COVID-19 pandemic, we need to focus on the individual and collective experiences of death, loss, and grief. While the emerging scholarly discourse on the pandemic, particularly in political science and international relations, typically considers death only in terms of its effects on formal state-level politics (...) and as a policy objective for mitigation, we argue that focusing on the particularities of the experience of death resulting from COVID-19 can help us fully understand the ways in which the pandemic is reordering our worlds. Examining the ambiguous sociopolitical meaning of death by COVID-19 can provide broader analytical comparisons with other mass death events. Ultimately, the essay argues that centering the impact of the pandemic on the experience of death and loss directly poses the question of how politics should value human lives in the post-pandemic world, helping us better formulate the normative questions necessary for a more ethical future. (shrink)

Early in the COVID-19 pandemic, researchers reported a surprising trend in disease outcomes: men were more likely to require hospitalization and die from COVID-19 than women. Researchers looked to sex-linked biology to explain these disparities, hypothesizing innate sex differences in immune function, suggesting the use of estrogens or androgen-suppressants as therapy, and even pushing for sex-specific vaccine strategies. Leading bioethicists like Dr. Ezekiel Emanuel at the University of Pennsylvania recently described the sex disparity in COVID-19 outcomes as "the unsolved mystery" (...) of the... (shrink)

In general, we know that gesture accompanying spoken instruction can help children learn. The present study was conducted to better understand how gesture can support children’s comprehension of spoken instruction and whether the benefit of teaching though speech and gesture over spoken instruction alone depends on differences in cognitive profile – prior knowledge children have that is related to a to-be-learned concept. To answer this question, we explored the impact of gesture instruction on children’s analogical reasoning ability. Children between the (...) ages of 4 and 11 years solved scene analogy problems before or after speech alone or speech and gesture instruction while their visual attention was monitored. Our behavioral results suggest a marginal benefit of gesture instruction over speech alone, but only 5-year-old children showed a distinct advantage from speech+gesture instruction when solving the post-instruction trial, suggesting that at this age, children have the cognitive profile in place to utilize the added support of gesture. Furthermore, while speech+gesture instruction facilitated effective visual attention during instruction, directing attention away from featural matches, and towards relational information, was pivotal for younger children’s success post instruction. We consider how these results contribute to the gesture-for-learning literature and consider how the nuanced impact of gesture is informative for educators teaching tasks of analogy in the classroom. (shrink)

La femme s'entête répond à La Femme sans tête (dite aussi Femme 100 têtes) de Max Ernst : loin de répéter les mêmes palinodies sur la créativité féminine (bridée, ou exaltée par le surréalisme), elle s'entête, passionnée tout en refusant la polémique à comprendre et à décrire. Voici donc, abondamment illustrés, un riche outil de travail et une série de portraits, souvent totalement inédits, d'artistes et d'écrivains.

End-of-life decision making is fraught with ethical challenges. Withholding or withdrawing life support therapy is widely considered ethical in patients with high treatment burden, poor premorbid status, or significant projected disability even when such treatment is not “futile.” Whether such withdrawal of therapy in the aftermath of attempted suicide is ethical is not well established in the literature. We provide a clinical vignette and propose criteria under which such withdrawal would be ethical. We suggest that it is appropriate to withdraw (...) life support, regardless of the cause of the critical illness or disability, when the following criteria are met: (1) Surrogates request withdrawal of care and the adequacy of surrogates is confirmed, (2) an external reasonability standard is met, (3) passage of time, perhaps 72 hours, to allow certainty regarding the patient's wishes, and (4) psychiatric morbidity should be considered as grounds for withdrawal only in truly treatment-refractory cases. Fundamentally, we believe the question to ask is, “If this were not an attempted suicide, would a request to withdraw care be reasonable?” We believe that under these circumstances, such withdrawal of life support, even in an individual who has attempted suicide, does not constitute physician assistance with suicide and is distinct from physician aid-in-dying in several important respects. (shrink)

End-of-life decision making is fraught with ethical challenges. Withholding or withdrawing life support therapy is widely considered ethical in patients with high treatment burden, poor premorbid status, or significant projected disability even when such treatment is not ?futile.? Whether such withdrawal of therapy in the aftermath of attempted suicide is ethical is not well established in the literature. We provide a clinical vignette and propose criteria under which such withdrawal would be ethical. We suggest that it is appropriate to withdraw (...) life support, regardless of the cause of the critical illness or disability, when the following criteria are met: (1) Surrogates request withdrawal of care and the adequacy of surrogates is confirmed, (2) an external reasonability standard is met, (3) passage of time, perhaps 72 hours, to allow certainty regarding the patient's wishes, and (4) psychiatric morbidity should be considered as grounds for withdrawal only in truly treatment-refractory cases. Fundamentally, we believe the question to ask is, ?If this were not an attempted suicide, would a request to withdraw care be reasonable?? We believe that under these circumstances, such withdrawal of life support, even in an individual who has attempted suicide, does not constitute physician assistance with suicide and is distinct from physician aid-in-dying in several important respects. (shrink)

We are grateful for the careful reading and insightful responses of the several peer commentaries to our proposed approach to requests to withhold or withdraw life support therapies among patients...

We are grateful for the careful reading and insightful responses of the several peer commentaries to our proposed approach to requests to withhold or withdraw life support therapies among patients...

Sterols and the reductant nicotinamide adenine dinucleotide phosphate (NADPH), essential for eukaryotic life, arose because of, and as an adaptation to, rising levels of molecular oxygen (O2). Hence, the NADPH and O2‐intensive process of sterol biosynthesis is inextricably linked to redox status. In mammals, cholesterol biosynthesis is exquisitely regulated post‐translationally by multiple E3 ubiquitin ligases, with membrane associated Really Interesting New Gene (RING) C3HC4 finger 6 (MARCHF6) degrading at least six enzymes in the pathway. Intriguingly, all these MARCHF6‐dependent enzymes require (...) NADPH. Moreover, MARCHF6 is activated by NADPH, although what this means for control of cholesterol synthesis is unclear. Indeed, this presents a paradox for how NADPH regulates this vital pathway, since NADPH is a cofactor in cholesterol biosynthesis and yet, low levels of NADPH should spare cholesterol biosynthesis enzymes targeted by MARCHF6 by reducing its activity. We speculate MARCHF6 helps mammalian cells adapt to oxidative stress (signified by low NADPH levels) by reducing degradation of cholesterogenic enzymes, thereby maintaining synthesis of protective cholesterol. (shrink)

This book's importance is derived from three sources: careful conceptualization of teacher induction from historical, methodological, and international perspectives; systematic reviews of research literature relevant to various aspects of teacher induction including its social, cultural, and political contexts, program components and forms, and the range of its effects; substantial empirical studies on the important issues of teacher induction with different kinds of methodologies that exemplify future directions and approaches to the research in teacher induction.

In the last of the group of papers from the conference on inatrogenic disease which we are publishing is this issue Katharine Whitehorn told the audience mainly of doctors and doctors in training - and tells many more through this Journal - what the patient expects from them. She envisages a generation of doctors who are coming to see their role rather differently from that of their fathers, and perhaps in the future a new medical scene.

In lieu of an abstract, here is a brief excerpt of the content:'kvieuJs SELECTED· LETTERS KATHARINE TAIT Carn Voel Porthcurno,- Cornwall TRI9 6LN, England Nicholas Griffin. The Selected Letters ofBertrand Russel~ Vol. I: The Private Years, I884-I9I4. London: Allen Lane the Penguin PreSs, 1992. Pp. xxi, 553.£25.00; C$47.99; US$35·00. Nicholas Griffin has done an admirable job of selecting and explaining the letters in this first volume. It is amazingly to his credit that he 'manages to be so well acquainted (...) with and to understand so well a world so remote from his own. In the whole volume, I found only two small points on which to augment his knowledge. If he had looked up Shakespeare's poem about greasy Joan, which we all know in part, he would have solved for himself the mystery of Marian's nose, referred to on page 93. It was red and raw from the cold, as Russell's always was from sunburn in the summer-and usually peeling besides. And on page 217, perhaps a more esoteric mystery: Milligan is a game of patience played with two packs of cards, which I have seen him playing with a special small set capable of being spread out on a small table. My only other quibble is that I think perhaps Griffin is a trifle too hard on Grandmother Russell, who may have been less calculating and more sentimental than he supposes. That she was not above emotional blackmail is clear from Russell's letter to Alys of 17 August 1894: I went to· my Grandmother, and found her on the sofa in her sitting-room. We embraced in silence for some time and then I looked at her sadly with tears in my eyes and she said "Well I'm worse than you thought I was": not with an air of triumph, but of mild reproof for my heartlessness in having felt so little anxiery. She besought me to consent to an absence; she says everybody who comes thinks it strange I should not be here when she is so ill, and that both thee and I are suffering in reputation in consequence. She gave repeated assurances (which I didn't need) of her absolute unselfishness in urging my home-duties; she really does care only about my moral welfare, which she feels to be imperilled by such neglect. (P. 98) Awful stuff, yet I think she may have rather been seizing any weapon that came to hand than laying deeply cunning schemes; but this is only opinion and I would bow to Griffin's greater knowledge of the facts. His analysis of Evelyn Whitehead's "attacks",their effect on Russell and his relations with russell: me Journal of me Bemand Russell Archives McMaster University Libraty Pr... n.s. I> (winter 1992-9~): 211-24 ISSN OO~6-O1631. 212 Reviews her, on the other hand, I found enlightening and quite the best thing I have read on the subject. Some other fine items must be singled out for special mention. First, the generous tribute to Russell's integrity over Frege on page 245. Russell had spent five years working in almost complete isolation on the Principles only to find, when it had gone to press, that much of what was best and most original in it had been anticipated by Frege. Yet, even in his private correspondence, he never gave so much as a hint of any concern about his loss of priority, but only his delight at having found a thinker with similar ideas. It required an integrity beyond the call of duty to add to the Principles an appendix drawing attention to Frege's work and generally to do what he could to make it better known. Griffin's editorial work is for the most part adlJIirably dispassionate, always informative, sometimes speculative, occasionally critical; but when the occasion warrants (usually over professional matters), he is unstinting in his praise. Russell's comments about The Principles ofMathematics in his letters seem absurdly modest. The book was undoubtedly a wotk of genius; in some ways, the greatest thing he ever wrote.... (I]r offered not merely a new philosophy ofmathematics bur a new way of doing philosophy. Yet Russell... (shrink)

A common reading of the Cyrenaics is that they are a school of extreme hedonist presentists, recognising only the pleasure of the present moment, and advising against turning our attention to past or future pleasure or pain. Yet they have some strange advice which tells followers to anticipate future harms in order to lessen the unexpectedness of them when they occur. It’s a puzzle, then, how they can consistently hold the attitude they do to our concern with our present selves, (...) and yet endorse the practise of dwelling on possible future painful scenarios. To establish that this is a puzzle, though, we must first be convinced that the report is true. Cicero is our only clear source for the Cyrenaic advice, and scholars have noted reasons to be suspicious of the reliability of his report. I discuss these doubts, and why they ultimately fail to undermine Cicero’s testimony as a source. Defending Cicero as a source for Cyrenaic thought removes a barrier to taking seriously an aspect of Cyrenaic psychology which could radically alter our understanding of their views. (shrink)

v. 1. Life of Thomas Paine, by W.M. Van der Weyde.--v. 2. Early essays. Common sense. The American crisis, I-IV.--v. 3. The American crisis, V-XIII. Patriotic papers.--v. 4. Political pamphlets.--v. 5. Open letters. Dissertations.--v. 6. Rights of man.--v. 7. Rights of man, concluded. Miscellaneous essays.--v. 8. The age of reason.--v. 9. Theological discussions.--v. 10. Miscellany. Songs and rhymes. Index.

Thomas Paine often declared himself a citizen of the world. This Norton Critical Edition presents Paine and his writing within the transatlantic and global context of the revolutionary ideas and actions of his time. Thomas Paine's loyalties were with universal and self-evident principles rather than with a particular group or nation, and it is this dimension that informed his most important works. This Norton Critical Edition shows how Paine's fury at the British Empire, including its injustices (...) to South Asians and Africans, shaped his first best seller, Common Sense, and how his direct involvement with the French Revolution pushed his ideas toward a unique form of democratic radicalism. Together with his rejection of organized religion, Paine's radicalism resulted in his being one of the most hated men in both monarchial Britain and republican America. This volume includes J. M. Opal's introduction, "Thomas Paine and the Revolutionary Enlightenment, 1770s-90s," which provides essential biographical and historical details across three tumultuous decades. Paine's most important works-from Common Sense (1776) through Agrarian Justice (1796)-are reprinted and are accompanied by explanatory annotations. Supporting materials include a wide range of documents from the turbulent years following the publication of both Common Sense and the Declaration of Independence. These include Pennsylvania's gradual emancipation statute of the 1780s, an ex-slave's impassioned call for revolutionary violence against European imperialists and masters, and a British conservative's witty rejoinder to Paine's vision of a brave new world. Four major interpretations of Paine's work are provided by Nathan R. Perl-Rosenthal, Robert A. Ferguson, Gary Kates, and Gregory Claeys. A Selected Bibliography is also included. (shrink)

I. Rights of man; being the first volume of an entirely new and unabridged issue. Ed. by Hypatia Bradlaugh Bonner, with a biographical and critical introduction by John M. Robertson. -- II. The age of reason; being the second volume of an entirely new and unabridged issue of the chief works of Thomas paine. Ed., with historical introduction, by Hypatia Bradlaugh Bonner.

This paper focuses on the possibility of conceiving a form of ontological nihilism, starting from D. M. Armstrong’s combinatorialism. This possibility has been suggested by Efird and Stoneham, by means of proposing an alternative strategy to the ‘subtraction argument’. They claim that it is possible to sustain such nihilism trough the concepts of construction and totality state of affairs. However, this hypothesis will require the acceptance of non-instanciated universals, that is, platonic universals. Yet this is opposite to requirements that are (...) basic for a combinatorial theory, which should uphold that universals exist only in their instantiations. Then, the assumption of platonic universals results in high costs for a combinatorial naturalism, according to which only exists what is located in space and time. (shrink)

This paper focuses on the possibility of conceiving a form of ontological nihilism, starting from D. M. Armstrong’s combinatorialism. This possibility has been suggested by Efird and Stoneham, by means of proposing an alternative strategy to the ‘subtraction argument’. They claim that it is possible to sustain such nihilism trough the concepts of construction and totality state of affairs. However, this hypothesis will require the acceptance of non-instanciated universals, that is, platonic universals. Yet this is opposite to requirements that are (...) basic for a combinatorial theory, which should uphold that universals exist only in their instantiations. Then, the assumption of platonic universals results in high costs for a combinatorial naturalism, according to which only exists what is located in space and time. (shrink)

This paper focuses on the possibility of conceiving a form of ontological nihilism, starting from D. M. Armstrong’s combinatorialism. This possibility has been suggested by Efird and Stoneham, by means of proposing an alternative strategy to the ‘subtraction argument’. They claim that it is possible to sustain such nihilism trough the concepts of construction and totality state of affairs. However, this hypothesis will require the acceptance of non-instanciated universals, that is, platonic universals. Yet this is opposite to requirements that are (...) basic for a combinatorial theory, which should uphold that universals exist only in their instantiations. Then, the assumption of platonic universals results in high costs for a combinatorial naturalism, according to which only exists what is located in space and time. (shrink)

Phenomenal knowledge is knowledge of what it is like to be in conscious states, such as seeing red or being in pain. According to the knowledge argument (Jackson 1982, 1986), phenomenal knowledge is knowledge that, i.e., knowledge of phenomenal facts. According to the ability hypothesis (Nemirow 1979; Lewis 1983), phenomenal knowledge is mere practical knowledge how, i.e., the mere possession of abilities. However, some phenomenal knowledge also seems to be knowledge why, i.e., knowledge of explanatory facts. For example, someone who (...) has just experienced pain for the first time learns not only that this is what pain is like, but also why people tend to avoid it. Some philosophers have claimed that experiencing pain gives knowledge why in a normative sense: it tells us why pain is bad and why inflicting it is wrong (Kahane 2010). But phenomenal knowledge seems to explain not (only) why people should avoid pain, but why they in fact tend to do so. In this paper, I will explicate and defend a precise version of this claim and use it as a basis for a new version of the knowledge argument, which I call the explanatory knowledge argument. According to the argument, some phenomenal knowledge (1) explains regularities in a distinctive, ultimate or regress-ending way, and (2) predict them without induction. No physical knowledge explains and predicts regularities in the same way. This implies the existence of distinctive, phenomenal explanatory facts, which cannot be identified with physical facts. I will show that this argument can be defended against the main objections to the original knowledge argument, the ability hypothesis and the phenomenal concept strategy, even if it turns out that the original cannot. In this way, the explanatory knowledge argument further strengthens the case against physicalism. (shrink)

The phenomenal powers view claims that phenomenal properties metaphysically necessitate their effects in virtue of how they feel, and thereby constitute non-Humean causal powers. For example, pain necessitates that subjects who experience it try to avoid it in virtue of feeling bad. I argue for this view based on the inconceivability of certain phenomenal properties necessitating different effects than their actual ones, their ability to predict their effects without induction, and their ability to explain their effects without appeal to laws (...) or regularities. I also offer a harmony argument according to which the view offers the best explanation for otherwise seemingly fortunate psychophysical regularities. I then outline the view’s main implications for the metaphysics of causation and philosophy of mind. (shrink)

Is consciousness a purely physical phenomenon? Most contemporary philosophers and theorists hold that it is, and take this to be supported by modern science. But a significant minority endorse non-physicalist theories such as dualism, idealism and panpsychism, among other reasons because it may seem impossible to fully explain consciousness, or capture what it's like to be in conscious states (such as seeing red, or being in pain), in physical terms. This Element will introduce the main non-physicalist theories of consciousness and (...) explain the most important arguments for them, and consider how they each respond to the scientific and other arguments in support of physicalism. This title is also available as Open Access on Cambridge Core. (shrink)

Epiphenomenalism is the view that phenomenal properties – which characterize what it is like, or how it feels, for a subject to be in conscious states – have no physical effects. One of the earliest arguments against epiphenomenalism is the evolutionary argument (James 1890/1981; Eccles and Popper 1977; Popper 1978), which starts from the following problem: why is pain correlated with stimuli detrimental to survival and reproduction – such as suffocation, hunger and burning? And why is pleasure correlated with stimuli (...) beneficial to survival and reproduction – such as eating and breathing? According to the argument, the fact that we have these particular correlations and not other ones must have an evolutionary explanation. But given epiphenomenalism, differences in phenomenal properties could not cause differences in fitness, so natural selection would not be expected to favor these correlations over any other ones. Epiphenomenalism thus renders these correlations an inexplicable coincidence, and should therefore be rejected. The evolutionary argument has been widely criticized and few have deemed it cogent (Broad 1925; Jackson 1982; Robinson 2007; Corabi 2014). In this paper, I will consider previous and potential criticisms and conclude some of them are indeed fatal to the argument if it is understood, as it traditionally has been, as an argument for any standard version of non-epiphenomenalism such as physicalism and interactionism. I will then offer a new and improved version of the argument, as an argument for a particular non-epiphenomenalist view, which I will call the phenomenal powers view. This is the view that phenomenal properties produce and thereby (metaphysically) necessitate their effects in virtue of how they feel, or in virtue of their intrinsic, phenomenal character alone – along the lines of C. B. Martin and John Heil’s powerful qualities view (Martin and Heil 1999; Heil 2003). I will argue that the phenomenal powers view explains the correlations given natural selection far better than any other view. It follows that if (and only if) understood as an argument for the phenomenal powers view, the evolutionary argument is far stronger than it is usually thought to be. (shrink)

This paper is another of the papers presented at a conference on Pain organised under the auspices of the London Medical Group. Mark Swerdlow deals with the work of pain relief clinics and explores their value. He gives the background as to what these clinics are, describes who is treated, how they are staffed and finally offers his opinion as to their effectiveness.

Background Paediatric clinical research faces unique challenges that compromise optimal recruitment of children into clinical trials. A main barrier to enrolment of children is parental misconceptions about the research process. In developing countries, there is a knowledge gap regarding parental perceptions of and attitudes towards their children's participation in clinical trials. Objective To explore such perceptions and attitudes in Lebanese parents. Study design 33 in-depth interviews were conducted with parents with and without previous research experience. Interviews were tape-recorded, transcribed in (...) colloquial Arabic, and later subjected to thematic analysis. Results Benefit/risk ratio assessment was a major determinant of parental consent. Fear of adverse events or painful procedures in research was a recurring theme in most interviews. Whereas perception of direct benefit to the child, trust in the physician or institution, financial gains or having a positive previous experience in research facilitated consent, a complex informed consent form and misunderstanding of the term ‘randomisation’ hindered parental approval of participation. Conclusion Lebanese parents have perceptions of and attitudes towards children's participation in clinical trials that are similar to those reported from the industrialised world. Improving communication with parents and building trust between researchers and parents is important for successful recruitment. Investigators planning to conduct paediatric trials in developing countries need to simplify consent forms and devise new ways to explain randomisation. (shrink)

Although activated spinal cord glia contribute importantly to neuropathic pain, how nerve injury activates glia remains controversial. It has recently been proposed, on the basis of genetic approaches, that toll-like receptor 4 may be a key receptor for initiating microglial activation following L5 spinal nerve injury. The present studies extend this idea pharmacologically by showing that TLR4 is key for maintaining neuropathic pain following sciatic nerve chronic constriction injury. Established neuropathic pain was reversed by intrathecally delivered TLR4 receptor antagonists derived (...) from lipopolysaccharide. Additionally, -naltrexone, -naloxone, and -naloxone, which we show here to be TLR4 antagonists in vitro on both stably transfected HEK293-TLR4 and microglial cell lines, suppressed neuropathic pain with complete reversal upon chronic infusion. Immunohistochemical analyses of spinal cords following chronic infusion revealed suppression of CCI-induced microglial activation by -naloxone and -naloxone, paralleling reversal of neuropathic pain. Together, these CCI data support the conclusion that neuron-to-glia signaling through TLR4 is important not only for initiating neuropathic pain, as suggested previously, but also for maintaining established neuropathic pain. Furthermore, these studies suggest that the novel TLR4 antagonists -naloxone and -naloxone can each fully reverse established neuropathic pain upon multi-day administration. This finding with -naloxone is of potential clinical relevance. This is because -naloxone is an antagonist that is inactive at the -opioid selective receptors on neurons that produce analgesia. Thus, these data suggest that -opioid antagonists such as -naloxone may be useful clinically to suppress glial activation, yet -opioid agonists suppress pain. (shrink)