A recent qualitative study published in Neuroethics by Schembs and colleagues explores how functional neurodiagnostics of consciousness inform surrogate decision making in cases of disorders of consciousness. In this commentary, we argue that the chosen methodology significantly limits the scope of the potential conclusions and suggest an embedded ethnographic approach of co-presence as an alternative.

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights and (...) challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

This article provides a deeper understanding of how meaning can be created in everyday life at a nursing home. It is based on a primary study concerning dignity involving 12 older people living in two nursing homes in Sweden. A secondary analysis was carried out on data obtained from three of the primary participants interviewed over a period of time (18—24 months), with a total of 12 interviews carried out using an inductive hermeneutic approach. The study reveals that sources of (...) meaning were created by having a sense of: physical capability, cognitive capability, being needed, and belonging. Meaning was created through inner dialogue, communication and relationships with others. A second finding is that the experience of meaning can sometimes be hard to realize. (shrink)

While it is generally agreed that companies need to manage their relationships with their stakeholders, the way in which they choose to do so varies considerably. In this paper, it is argued that when companies want to communicate with stakeholders about their CSR initiatives, they need to involve those stakeholders in a two-way communication process, defined as an ongoing iterative sense-giving and sense-making process. The paper also argues that companies need to communicate through carefully crafted and increasingly sophisticated processes. Three (...) CSR communication strategies are developed. Based on empirical illustrations and prior research, the authors argue that managers need to move from ‘informing’ and ‘responding’ to ‘involving’ stakeholders in CSR communication itself. They conclude that managers need to expand the role of stakeholders in corporate CSR communication processes if they want to improve their efforts to build legitimacy, a positive reputation and lasting stakeholder relationships. (shrink)

Cognitive Phenomenology Phenomenal states are mental states in which there is something that it is like for their subjects to be in; they are states with a phenomenology. What it is like to be in a mental state is that state´s phenomenal character. There is general agreement among philosophers of mind that the category of mental states includes at least some sensory states. For example, there is something that it is like to taste chocolate, to smell coffee, to feel the (...) wind in one´s hair, to see the blue sky and to feel a pain in one´s toe. Is there also something that it is like to consciously think, to consciously judge and to consciously believe something? Are such cognitive states, when conscious, phenomenal states? Is there a clear distinction between sensory states and cognitive states? Or, can our knowledge, thoughts and beliefs influence our sensory experiences? Is there a cognitive phenomenology? It is challenging to give a clear characterization of the cognitive phenomenology debate, since different contributors conceive of the debate in different ways. Central for the debate is the question of whether conscious thoughts possess a non-sensory phenomenology. Intuitively, there is something that it is like to consciously think, consciously judge and consciously believe something. However, the debate about cognitive phenomenology is not, strictly speaking, about whether there is something that it is like to consciously think. Rather, the debate concerns the nature of cognitive phenomenology. Is the phenomenology of cognitive states reducible to purely sensory phenomenology? Or, is there an irreducible cognitive phenomenology? A sceptic about cognitive phenomenology claims that conscious cognitive states are non-phenomenal. But, conscious cognitive states may seem to be phenomenal because they are accompanied by sensory states. For instance, when one thinks that ´Paris is a beautiful city`, one´s thought may be expressed in inner-speech and an image of Paris may accompany it. These accompanying sensory states are phenomenal states, and not the thought itself. Contrary to this, the proponent of cognitive phenomenology claims that a conscious cognitive state can have a phenomenology that is irreducible to purely sensory phenomenology. Other debates have also been placed under the ´cognitive phenomenology’ label. There is an ongoing debate within the philosophy of perception about how cognition influences our sensory experiences. Philosophers tend to agree that, for example, an expert ornithologist´s perceptual experience of a type of bird can differ from that of a novice, even if the viewing conditions for both expert and novice are the same. The expert´s knowledge of birds can influence her experience. However, what philosophers disagree about is how the expert´s knowledge influences her experience, and how her knowledge contributes to what her experience is like. (shrink)

Discussion about a dignified death has almost exclusively been applied to palliative care and people dying of cancer. As populations are getting older in the western world and living with chronic illnesses affecting their everyday lives, it is relevant to broaden the definition of palliative care to include other groups of people. The aim of the study was to explore the views on dignity at the end of life of 12 elderly people living in two nursing homes in Sweden. A (...) hermeneutic approach was used to interpret the material, which was gathered during semi-structured interviews. A total of 39 interviews were transcribed. The analysis revealed three themes: (1) the unrecognizable body; (2) fragility and dependency; and (3) inner strength and a sense of coherence. (shrink)

While it is generally agreed that companies need to manage their relationships with their stakeholders, the way in which they choose to do so varies considerably. In this paper, it is argued that when companies want to communicate with stakeholders about their CSR initiatives, they need to involve those stakeholders in a two-way communication process, defined as an ongoing iterative sense-giving and sense-making process. The paper also argues that companies need to communicate through carefully crafted and increasingly sophisticated processes. Three (...) CSR communication strategies are developed. Based on empirical illustrations and prior research, the authors argue that managers need to move from ‘informing’ and ‘responding’ to ‘involving’ stakeholders in CSR communication itself. They conclude that managers need to expand the role of stakeholders in corporate CSR communication processes if they want to improve their efforts to build legitimacy, a positive reputation and lasting stakeholder relationships. (shrink)

Chief executive officers (CEOs) engage in activism when they take public stances on sensitive socio-political issues. In this study, we address the less-explored activities that constitute CEO activism beyond single stances as the activism is maintained over time. The data cover 6 years of campaign and media materials from a case company with several CEO-initiated activist campaigns. Our findings from an inductive analysis contribute to CEO activism theorizing in three ways. First, we extend CEO activism conceptually by identifying five underlying (...) activities that support a public stance: anchoring motivations, modeling action, taking agency, enduring criticism, and normalizing activism. Second, we bridge individual- and organization-level analyses by depicting how a CEO involves a company in activism through activities that justify interrelated topic frame and role frame. Third, we develop a processual model that includes the pre-stance, stance-taking, and post-stance phases and explains how the underlying activities are interrelated and follow a pattern that serves to maintain CEO activism. Accordingly, CEO activism includes activities, through the pre-stance, stance-taking, and post-stance phases, whereby a CEO deliberately engages personally and through a company in public debate about sensitive socio-political issues and the role of businesses in addressing them. (shrink)

Background: In this study, we aimed to investigate the effects of a mindfulness program including Mindfulness-Based Stress Reduction on the mental health of student teachers when offered at their educational institution in a real-life context.Methods: A parallel randomized controlled trial was conducted among self-selected student teachers at a Danish undergraduate program for teacher education in the autumns of 2019 and 2020. Participation was not recommended in case of clinical depression or a diagnosis of psychosis or schizophrenia, abuse of alcohol, drugs, (...) and/or medicine. Randomization was performed by a Statistician who was blinded to the identity of the students. Data was collected using self-reported questionnaires. The primary outcome was a change in perceived stress 3 months from baseline. Secondary outcome measures were symptoms of anxiety and depression, well-being, resilience, mindfulness, and thoughts and feelings during rest. The effects were analyzed according to the intention-to-treat principle using mixed-effect linear regression models. Mediating effects of mindfulness skills on the mental health outcomes were explored using structural equation modeling.Results: The study group included 67 student teachers with 34 allocated to the intervention group ; and 33 students allocated to a waiting list control group. At baseline, mean Perceived Stress Scale scores were 18.88 in the intervention group and 17.91 in the waiting list control group. A total of 56 students completed the questionnaire at a 3-month follow-up. Statistically significant effects of the intervention were found on perceived stress, symptoms of anxiety and depression, well-being, and on three of seven resting-state dimensions. No effects were found on resilience or mindfulness. Statistically significant mediated effects via resting-state dimensions were found.Conclusion The findings suggested that offering a mindfulness program at an undergraduate program for teacher education could significantly improve the mental health among self-selected students within 3 months. Results of mediation analysis supported the hypothesis that some of the effects might be explained by reduced distracting thoughts.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT04558099]. (shrink)

In this paper we argue that the collective grandness of small business is often underestimated in CSR research and policy‐making. We emphasize the importance of understanding the contexts and the ways in which small‐ and medium‐sized companies engage in CSR and how they differ from multinational companies. We suggest that it might be that researchers and practitioners are asking the wrong questions in their ambitions to prove ‘the business case for CSR’. Perhaps we should rather focus on the ‘how’ and (...) the ‘with what impact’ questions to understand better the SME engagement in CSR. (shrink)

In this paper we argue that the collective grandness of small business is often underestimated in CSR research and policy-making. We emphasize the importance of understanding the contexts and the ways in which small- and medium-sized companies engage in CSR and how they differ from multinational companies. We suggest that it might be that researchers and practitioners are asking the wrong questions in their ambitions to prove 'the business case for CSR'. Perhaps we should rather focus on the 'how' and (...) the 'with what impact' questions to understand better the SME engagement in CSR. (shrink)

This collection of new essays addresses emotion in relation to the arts. The essays consider such topics as the paradox of fiction, emotion in the pure and abstract arts, and the rationality and ethics of emotional responses to art.

Surgical castration of sex offenders has been used in several countries to prevent sexual recidivism and is still practiced in several states in the United States. In Europe, it has remained in limited use in Germany and in the Czech Republic (Douglas et al. 2013). Since the 1960s, most jurisdictions have replaced irreversible surgical castration of sex offenders with reversible chemical castration with anti-androgen drugs. In Denmark, use of surgical castration was stopped in 1970, and since the late 1980s, serious (...) sex offenders have on a trial basis been treated with anti-androgen drugs (Hansen and Lykke-Olesen 1997). In 1997, an official treatment program for sex offenders was introduced on a trial basis, and in 2011 this scheme was made permanent (Nielsen 2001).The first part of the scheme covers persons with a suspended sentence with conditions of sexological treatment. This program serves as an alternative to suspended sentences of up to one and a half years of prison for crimina. (shrink)

Beliefs about the importance of ethical behavior to competent practice have prompted major shifts in psychology ethics over time. Yet few studies examine ethical beliefs and behavior after training, and most comprehensive research is now 30 years old. As such, it is unclear whether shifts in the field have resulted in general improvements in ethical practice: Are we psychologists “ships in the rising sea,” lifted by changes in ethical codes and training over time? Participants completed a survey of ethical beliefs (...) and behaviors. Analyses examined group differences, consistency of frequency and ethicality ratings, and comparisons with past data. More than half of behaviors were rated as less ethical and occurring less frequently than in 1987, with early career psychologists generally reporting less ethically questionable behavior. Recommendations for enhancing ethics education are discussed. (shrink)

In recent years, policymakers have begun to problematize how legislation stands in the way of the digitalization of the public sector. We are witnessing the emergence of a new phenomenon, digital-ready legislation, which implies that, whenever possible, new legislation should build on simple rules and unambiguous terminology to reduce the need for professional discretion and allow for the extended use of automated case processing in public-sector organizations. Digital-ready legislation has potentially wide-ranging consequences because it creates the conditions for how public (...) organizations are digitalized. The processes, practices, choices, and responsibilities for drafting digital-ready legislation, however, are not well-described or debated. Digital-ready legislation is a dormant issue. This paper develops the notion of the “double darkness” of digitalization to account for this. Based on a qualitative study, the paper investigates how digital-ready legislation as a sociotechnical arrangement is shaped by policy tools and by a complex, collaborative process where responsibility for legislation is fragmented. It argues that although the policy tools are aimed at making actors responsible for digitalization and creating clarity about the process, actors seem to be reluctant to take on the responsibility for making political decisions related to digitalization. (shrink)

Responsible conduct of research and research integrity has become a key concern in both research policy and public media resulting in a number of soft law documents, such as codes of conduct at national and supranational levels. This article zooms in on the institutions that are supposed to translate these overall policies and guidelines into workable and recognizable structures for researchers, that is, the mediating layer between the policy articulations and the individual researchers and research groups; a perspective which has (...) been notably lacking in the literature on research integrity. Document analysis demonstrated how research organizations translated and integrated demands for research integrity measures differently, and interviews explored how department heads made sense of these organizational efforts. Results show that department heads did not seem to use organizational policies in their sensemaking around research integrity. To a much larger degree, they used disciplinary norms, systemic pressures and other cues to construct the meaning of integrity. The heads of department articulated integrity as a “non-problem” in their own local context, rather, it was other departments and other countries that experienced lack of research integrity. This meant that the origin of the problem of integrity is located in the system, but to a large extent the department heads describe the solution of the problem to be in the culture of research. The implications of this dis-location and externalizing of integrity are discussed. (shrink)

One of the key features of the contemporary data economy is the widespread circulation of data and its interoperability. Critical data scholars have analysed data repurposing practices and other factors facilitating the travelling of data. While this approach focused on flows provides great potential, in this article we argue that it tends to overlook questions of attachment and belonging. Drawing upon ethnographic fieldwork within a Danish data-linkage infrastructure, and building upon insights from archival science, we discuss the work of data (...) practitioners enabling the repurposing of pathology samples extracted from patients for the conduct of ‘personal medicine’ – our term to discuss the so-called old-fashioned treatment of patients – towards personalised medicine. This first involves ‘getting to know’ the tissues and unpacking their previous uses and meanings, then detaching them from their original source to extract data from such tissues and making them flow towards a new container where they can be worked on and connected with other data. As data practitioners make these tissues travel, transforming them into research data, they organise the attachments of data to new agendas, persons and places. Crucially, in our case, we observe the prominence of national attachments, whereby managing tissues and data in and out of containers involves tying them to the nation to serve its interests. We thus expose how the building of data linkage infrastructures entails more than the accumulation and curation of data, but also involves crafting meanings, futures and belonging to specific communities and territories. (shrink)

Στο άρθρο εκτίθενται τα αποτελέσματα των ανασκαφικών τομών που πραγματοποιήθηκαν κάτω από τα ΤΜ III στρώματα της Συνοικίας Ν των Μαλίων. Η ανεύρεση αρχιτεκτονικών λειψάνων της παλαιοανακτορικής εποχής δηλώνει ότι το τμήμα της πόλης που βρίσκεται μεταξύ της Συνοικίας Γ και της Συνοικίας Μ είχε κατοικηθεί από τη MM IIB. Προτείνεται η αποκατάσταση της κάτοψης ενός σπιτιού του οποίου ήλθαν στο φως ορισμένα δωμάτια. Τα δωμάτια αυτά παρουσιάζουν αρχιτεκτονικά χαρακτηριστικά της παλαιοανακτορικής περιόδου: τοίχους, θρανία και σκάλες από πηλόχωμα με επάλειψη (...) κονιάματος, δάπεδα από μεγάλες πλάκες σκληρού ασβεστόλιθου και αρμούς από κονίαμα κόκκινου χρώματος. Η συναφής κεραμική χρονολογείται στη MM IIB φάση, όταν το σπίτι καταστράφηκε από πυρκαγιά. Τα αρχιτεκτονικά λείψανα κάτω από το νότιο τμήμα της Συνοικίας Ν υποδηλώνουν την παρουσία μιας άλλης παλαιοανακτορικής οικίας. (shrink)

© The Author 2016. Published by Oxford University Press on behalf of The Scots Philosophical Association and the University of St Andrews. All rights reserved. For permissions, please e-mail: [email protected] Nanay provides an original and interesting discussion of the connections between aesthetics and the philosophy of perception. According to Nanay, many topics within aesthetics are about experiences of various kinds. Aesthetics is not philosophy of perception, but there are important questions within aesthetics that we can address in an interesting way (...) by using the conceptual apparatus of the philosophy of perception.The main theme of this book is the role of attention in those perceptual experiences that are relevant for aesthetics. Nanay claims that in some paradigmatic examples of aesthetic experiences our attention is exercised in the way of being distributed across properties. He argues that various versions of distributed attention can explain our experiences of aesthetic... (shrink)

Bioethical research has tended to focus on theoretical discussion of the principles on which the analysis of ethical issues in biomedicine should be based. But this discussion often seems remote from biomedical practice where researchers and physicians confront ethical problems. On the other hand, published empirical research on the ethical reasoning of health care professionals offer only descriptions of how physicians and nurses actually reason ethically. The question remains whether these descriptions have any normative implications for nurses and physicians? In (...) this article, we illustrate an approach that integrates empirical research into the formulation of normative ethical principles using the moral-philosophical method of Wide Reflective Equilibrium (WRE). The research method discussed in this article was developed in connection with the project ‘Bioethics in Theory and Practice’. The purpose of this project is to investigate ethical reasoning in biomedical practice in Denmark empirically. In this article, we take the research method as our point of departure, but we exclusively discuss the theoretical framework of the method, not its empirical results. We argue that the descriptive phenomenological hermeneutical method developed by Lindseth and Norberg (2004) and Pedersen (1999) can be combined with the theory of WRE to arrive at a decision procedure and thus a foundation for the formulation of normative ethical principles. This could provide health care professionals and biomedical researchers with normative principles about how to analyse, reason and act in ethically difficult situations in their practice. We also show how to use existing bioethical principles as inspiration for interpreting the empirical findings of qualitative studies. This may help researchers design their own empirical studies in the field of ethics. (shrink)

Med udgangspunkt i værkerne "Schopenhauer als Erzieher" og "Also sprach Zarathustra" tager forfatteren Nietzsches filosofiske status op til overvejelse og søger at rehabilitere ham som etiker.

Dans cet ouvrage directement tiré de sa thèse intitulée « Female Public Nudity in Belle Époque Paris » et soutenue en 2006 à l’université de Floride, Lela F. Kerley retrace et interroge le processus conflictuel qui a accompagné la normalisation de l’exhibition publique de la nudité féminine à Paris entre 1889 et 1914 sous l’effet d’expérimentations artistiques et de la prolifération du nu féminin dans le répertoire des music-halls. L’enquête s’intéresse aussi bien aux pratiques et motivations...

Ce bilan historiographique repose sur une vaste enquête menée à travers les différents champs historiographiques susceptibles d’informer l’évolution des pratiques et représentations de la nudité. L’objectif est d’éclairer les rapports dialectiques que le corps dénudé entretient avec les normes et les relations de genre en France au cours du second xixe siècle. Au cœur de la fabrique des archétypes du féminin et du masculin, les représentations différenciées du dénudement constituent un maillon essentiel dans la perpétuation de la domination masculine tout (...) au long de la période. Cependant, au tournant du siècle, le dénudement représente paradoxalement un instrument de libération individuelle pour une série de pionnières, artistes et sportives qui, en s’emparant de nouvelles représentations du corps, ont pu subvertir les normes de genre propres à la culture bourgeoise et conquérir ainsi une marge d’autonomie et de liberté sans précédent. (shrink)

The first of its kind, this book provides a full account of 'referential expressions' in language. It offers an integrated framework, which combines perspectives from functional grammar and cognitive linguistics with psycholinguistic evidence. It is essential reading for academic researchers in syntax, discourse analysis and cognitive linguistics.

A narrow focus on the jaw (or on motor generators) does not account for individual and language-specific differences in babbling and early speech. Furthermore, data from Yoshinaga-Itano's laboratory support earlier findings that show glottal rather than oral stops in deaf infants' babbling: audition is crucial for developing normal syllables.

In 2004, twelve capuchin monkeys were moved from the labs of the Danish psychiatric hospital of Sankt Hans to a small private-owned zoo in another part of Denmark in order to be rehabilitated. These monkeys were the last nonhuman primates to be used as research animals in Danish biomedical laboratories. The normal procedure would be to kill research animals after the termination of an experiment; in this case, however, a decision was reached to close down the lab. The moral landscape (...) had changed, and it was no longer considered acceptable to use nonhuman primates in Danish biomedicine. From being considered a biological resource serving as a model of man, the monkeys had become moral subjects with a claim to a life suiting their natural needs. Simultaneously, the monkeys became instrumental in creating moral legitimacy for the actors involved in their rescue. What we see is an instance of pathfinding in a changing moral landscape where actors negotiate nonhuman primate nature as they create new moral positions for themselves. (shrink)

BackgroundThis study presents an empirical investigation of the ethical reasoning and ethical issues at stake in the daily work of physicians and molecular biologists in Denmark. The aim of this study was to test empirically whether there is a difference in ethical considerations and principles between Danish physicians and Danish molecular biologists, and whether the bioethical principles of the American bioethicists Tom L. Beauchamp and James F. Childress are applicable to these groups.MethodThis study is based on 12 semi-structured interviews with (...) three groups of respondents: a group of oncology physicians working in a clinic at a public hospital and two groups of molecular biologists conducting basic research, one group employed at a public university and the other in a private biopharmaceutical company.ResultsIn this sample, the authors found that oncology physicians and molecular biologists employed in a private biopharmaceutical company have the specific principle of beneficence in mind in their daily work. Both groups are motivated to help sick patients. According to the study, molecular biologists explicitly consider nonmaleficence in relation to the environment, the researchers' own health, and animal models; and only implicitly in relation to patients or human subjects. In contrast, considerations of nonmaleficence by oncology physicians relate to patients or human subjects. Physicians and molecular biologists both consider the principle of respect for autonomy as a negative obligation in the sense that informed consent of patients should be respected. However, in contrast to molecular biologists, physicians experience the principle of respect for autonomy as a positive obligation as the physician, in dialogue with the patient, offers a medical prognosis based upon the patients wishes and ideas, mutual understanding, and respect. Finally, this study discloses utilitarian characteristics in the overall conception of justice as conceived by oncology physicians and molecular biologists from the private biopharmaceutical company. Molecular biologists employed at a public university are, in this study, concerned with allocation, however, they do not propose a specific theory of justice.ConclusionThis study demonstrates that each of the four bioethical principles of the American bioethicists Tom L. Beauchamp & James F. Childress – respect for autonomy, beneficence, nonmaleficence and justice – are reflected in the daily work of physicians and molecular biologists in Denmark. Consequently, these principles are applicable in the Danish biomedical setting. (shrink)

In 2005, The International Federation of Organic Agricultural Movements (IFOAM) developed four new ethical principles of organic agriculture to guide its future development: the principles of health, ecology, care, and fairness. The key distinctive concept of animal welfare in organic agriculture combines naturalness and human care, and can be linked meaningfully with these principles. In practice, a number of challenges are connected with making organic livestock systems work. These challenges are particularly dominant in immature agro-ecological systems, for example those that (...) are characterized by industrialization and monoculture. Some of the current challenges are partly created by shortages of land and manure, which encourage zero-grazing and other confined systems. Other challenges are created in part by the conditions for farming and the way in which global food distribution systems are organized, e.g., how live animals are transported, how feed is traded and transported all over the globe, and the development of infrastructure and large herds. We find that the overall organic principles should be included when formulating guidelines for practical organic animal farming. This article explores how the special organic conceptions of animal welfare are related to the overall principles of organic agriculture. The aim is to identify potential routes for future development of organic livestock systems in different contexts and with reference to the specific understanding of animal welfare in organic agriculture. We include two contrasting cases represented by organic livestock systems in northwestern Europe and farming systems in tropical low-income countries; we use these cases to explore the widely different challenges of organic livestock systems in different parts of the world. (shrink)

A recent single cell mRNA sequencing study by Dueck et al. compares neuronal transcriptomes to the transcriptomes of adipocytes and cardiomyocytes. Single cell ‘omic approaches such as those used by the authors are at the leading edge of molecular and biophysical measurement. Many groups are currently employing single cell sequencing approaches to understand cellular heterogeneity in cancer and during normal development. These single cell approaches also are beginning to address long‐standing questions regarding nervous system diversity. Beyond an innate interest in (...) cataloging cell type diversity in the brain, single cell neuronal diversity has important implications for neurotypic neural circuit function and for neurological disease. Herein, we review the authors’ methods and findings, which most notably include evidence of unique expression profiles in some single neurons. (shrink)

BackgroundHealthcare professionals and surrogate decision-makers often face the difficult decision of whether to initiate or withhold antibiotics from people with dementia who have developed a life-threatening infection after losing decisional capacity.MethodsWe conducted a vignette-based survey among 1050 Quebec stakeholders (senior citizens, family caregivers, nurses and physicians; response rate 49.4%) to (1) assess their attitudes toward withholding antibiotics from people with dementia lacking decisional capacity; (2) compare attitudes between dementia stages and stakeholder groups; and (3) investigate other correlates of attitudes, including (...) support for continuous deep sedation (CDS) and medical assistance in dying (MAID). The vignettes feature a woman moving along the dementia trajectory, who has refused in writing all life-prolonging interventions and explicitly requested that a doctor end her life when she no longer recognizes her loved ones. Two stages were considered after she had lost capacity: the advanced stage, where she likely has several more years to live, and the terminal stage, where she is close to death.ResultsSupport for withholding antibiotics ranged from 75% among seniors and caregivers at the advanced stage, to 98% among physicians at the terminal stage. Using the generalized estimating equation approach, we found stakeholder group, religiosity, and support for CDS and MAID, to be associated with attitudes toward antibiotics.ConclusionsFindings underscore the importance for healthcare professionals of discussing underlying values and treatment goals with people at an early stage of dementia and their relatives, to help them anticipate future care decisions and better prepare surrogates for their role. Findings also have implications for the scope of MAID laws, in particular in Canada where the extension of MAID to persons lacking decisional capacity is currently being considered. (shrink)

Visual Associative agnosia is a rare perceptual impairment generally resulting from lesions in the infero temporal cortex. Patients suffering from associative agnosia are able to make accurate copies of line drawings, but they are unable to visually recognize objects - including those represented in line drawings - as belonging to familiar high-level kinds. The Rich Content View claims that visual experience can represent high-level kind properties. The phenomenon of associative agnosia appears to present us with a strong case for the (...) Rich Content View. There are reasons for thinking that the experiences of an agnosic patient differ from those of a healthy subject. Given that there is a phenomenal contrast between the experiences of an associative agnosic and those of a healthy perceiver, one may argue that this contrast is due to differences in abilities to represent high-level kinds. I claim that there is indeed a phenomenal contrast between the visual experiences of an agnosic and those of a healthy perceiver. However, the explanation of this contrast that best fits the empirical data is compatible with the view that visual experience does not represent high-level kinds. (shrink)