Previous work has shown that concerns of breast cancer patients after finishing radiotherapy are responsive to conversations with radiographers during the treatment period. This study seeks to further understand radiographer and patient experiences, determine shared priorities for improvement in clinical interaction and develop communication guidelines and training to help radiographers support patients.Methods: Using the principles of Experience-Based Co-Design, semi-structured interviews were held with N = 4 patients and N = 4 radiographers, followed by feedback events to validate findings. Patients and (...) radiographers exchanged experiences in a joint co-design session, agreed with shared priorities and generated ideas for further support. A survey was conducted for process evaluation. To scale up findings, UK-wide representatives from patient networks and radiographers and managerial staff provided consultative input utilizing an iterative, adaptive procedure.Results: Radiographers expressed a need for support with “difficult conversations,” especially those on Fear of Cancer Recurrence, and their appropriate management. Important pointers for reassuring communication were identified, including: being treated like a person, knowing what to expect, and space to ask questions. The co-design process was rated positively by both staff and patients. Thematic collation of findings and mapping these on literature evidence resulted in the “KEW” communication guidelines for radiographers: Know, Encourage, Warmth. National stakeholder consultations validated and helped fine-tune the training model. The resulting training package, included: trigger videos, a simulated patient scenario and interactive handouts on fears of cancer recurrence and the patient pathway.Conclusions: The co-design process captured good practice to help standardize quality in empathic communication in the radiotherapy service. The resulting KEW: Know, Encourage, Warmth guidelines, and training package are user-centered as well as evidence-based. Supplementing single-site co-design with national consultative feedback allows for the development of interventions that are relevant to the clinical practice, even in detail, and helps to generate appropriate buy-in for roll out on a wider scale after evaluation.Trial Registration:www.ClinicalTrials.gov ID: NCT03468881. (shrink)

An intellectual history of the philosophers who grappled with the problem of evil, and the case for why pessimism still holds moral value for us today In the seventeenth and eighteenth centuries, philosophers engaged in heated debates on the question of how God could have allowed evil and suffering in a creation that is supposedly good. Dark Matters traces how the competing philosophical traditions of optimism and pessimism arose from early modern debates about the problem of evil, and makes a (...) compelling case for the rediscovery of pessimism as a source for compassion, consolation, and perhaps even hope. Bringing to life one of the most vibrant eras in the history of philosophy, Mara van der Lugt discusses legendary figures such as Leibniz, Hume, Voltaire, Rousseau, Kant, and Schopenhauer. She also introduces readers to less familiar names, such as Bayle, King, La Mettrie, and Maupertuis. Van der Lugt describes not only how the earliest optimists and pessimists were deeply concerned with finding an answer to the question of the value of existence that does justice to the reality of human suffering, but also how they were fundamentally divided over what such an answer should look like. A breathtaking work of intellectual history by one of today's leading scholars, Dark Matters reveals how the crucial moral aim of pessimism is to find a way of speaking about suffering that offers consolation and does justice to the fragility of life. (shrink)

Few assumptions, argues Mara van der Lugt, are so stagnant, so rigid, so deeply walled in as the assumption that the decision to have children is by default a good thing; that having children is one of the most elevated aspects of human activity, and, indeed, of the human condition. This book is conceived as an open and reflective challenge to that assumption. The author argues that there are two questions in life that every person needs to answer for (...) themselves: one is the question of religion; the other is the question of begetting, a term which she chooses deliberately to restore a sense of 'strangeness and magnitude' to the idea. What does it mean to bring a new creature into the world? Or rather what does it mean to decide to perform an act of creation? What does it mean to make the decision that life is worth living on behalf of a person who cannot be consulted? To ask this question is to interrogate one's own responsibility and commitments, morally, philosophically, and personally. The question of begetting can never be purely one of preference or inclination, however we might wish it to be. This book is the author's attempt to raise some of these questions, if not fully to answer them. It is both a personal and philosophical exercise of filling out that moral background, in full awareness of the things that are at stake, and not in judgment but out of concern and compassion both for creators and created, and for those who are not yet created and those who are not (or not yet) creators. (shrink)

Despite decades of action to reduce global malnutrition, rates of undernutrition remain stubbornly high and rates of overweight, obesity and chronic disease are simultaneously on the rise. Moreover, while volumes of robust research on causes and solutions to malnutrition have been published, and calls for interdisciplinarity are on the rise, researchers taking different epistemological and methodological choices have largely remained disciplinarily siloed. This paper works to open a scholarly conversation between “mainstream” public health nutrition and “critical” nutrition studies. While critical (...) nutrition scholars collectively question aspects of mainstream nutrition approaches, they also chart a different way to approach malnutrition research by focusing on politics, structural conditions, and the diverse ways people make sense of food and malnutrition. In this paper, we highlight the key research agendas and insights within both mainstream and critical nutrition in order to suggest spaces for their potential conversation. We ultimately argue that global public health nutrition interventions might achieve greater success in more equitable ways if they are informed by critical nutrition research. We aim for this intervention to facilitate more substantial crossing of disciplinary boundaries, critical to forging more socially and environmentally just dietary futures in the global South and beyond. (shrink)

ABSTRACTTaking its cue from Hannah Arendt’s comment that ‘truth gets lost in the Enlightenment’ and Lessing’s parable of God’s ‘left hand’, this paper traces a historical shift in moral and religious thought: roughly from truth to sincerity. From traditional conceptions of conscience as conditional on the objective truth of its content, the paper moves on, via the Reformation and seventeenth-century Augustinian turn, to early modern debates on toleration and the ‘erring conscience’. It is argued that Pierre Bayle’s Commentaire Philosophique of (...) 1686 can be read as a crucial catalogue for understanding the substitution of truth with sincerity : so that not truth but truthfulness is considered to be essential for moral and religious justification. Moving from Bayle to Immanuel Kant, the paper then shows how many of the same questions rise in Kant’s late essay on theodicy, which is also an essay on sincerity or integrity, via the Book of Job. Through these two thinkers, various themes are connected: from conscience and sincerity to the problem of the conscientious persecutor. Finally, these themes of truth, error and integrity are linked to the modern debate on authenticity, and a framework is proposed for conceptualising these various shifts. (shrink)

In his own day, the name of Pierre Bayle was as famous as that of any philosopher in Europe. Yet despite his vast influence on the eighteenth century and the Enlightenment, Bayle's name was eclipsed by those of other, more methodical thinkers of his age, eliciting the following remark from one modern scholar, J.C. Laursen: 'Why do professional philosophers spend so much time on Descartes and so little time on Pierre Bayle, when Bayle was clearly the better philosopher?'In the past (...) decades a surge of new interest in Bayle has led to the rediscovery of the depth of his philosophical thought as well as the extent of his influence-yet the scholarly debate is shadowed by deep uncertainty as to how to tackle his eclectic writings, especially the expansive historical-philosophical publication that became one of the Enlightenment's best-sellers: the Dictionnaire Historique et Critique, first published in 1696 and counting more than six million words.This volume provides an important new study of both Bayle and the Dictionnaire. (shrink)

Central to this volume are two philosophical powerhouses of the early modern period: Gottfried Wilhelm Leibniz and Pierre Bayle. Born in, respectively, 1646 and 1647, both made for an astonishing career in a variety of scholarly disciplines and reached, if not equal, then certainly comparable fame in the course of their lives. Nowadays, Bayle's reputation is eclipsed by that of Leibniz, who is the focus of yearly conferences and libraries of scholarship, while Bayle had to await the later twentieth century (...) to be rediscovered. He has since been at the center of a quickly expanding body of scholarship, which continues to be sharply divided over the vexed question how to interpret his religious stance.This imbalance... (shrink)

Background The allocation of scarce deceased donor kidneys is a complex process. Transplant providers are increasingly relying on constructs such as frailty and cognitive function to guide kidney transplant (KT) candidate selection. Patient views of the ethical issues surrounding the use of such constructs are unclear. We sought to assess KT candidates’ attitudes and beliefs about the use of frailty and cognitive function to guide waitlist selection.Methods KT candidates were randomly recruited from an ongoing single-center cohort study of frailty and (...) cognitive function. Semi-structured interviews were conducted, and thematic analysis was performed. Inductively derived themes were mapped onto bioethics principles.Results Twenty interviews were conducted (65% contact rate, 100% participation rate) (60% male; 70% White). With respect to the use of frailty and cognitive function in waitlisting decisions, four themes emerged in which participants: (1) valued maximizing a scarce resource (utility); (2) prioritized equal access to all patients (equity); (3) appreciated a proportional approach to the use of equity and utility (precautionary utility); and (4) sought to weigh utility- and equity-based concerns regarding social support. While some participants believed frailty and cognitive function were useful constructs to maximize utility, others believed their use would jeopardize equity. Patients were uncomfortable with using single factors such as frailty or cognitive impairment to deny someone access to transplantation; participants instead encouraged using the constructs to identify opportunities for intervention to improve frailty and cognitive function prior to KT.Conclusions KT candidates’ values mirrored the current allocation strategy, seeking to balance equity and utility in a just manner, albeit with conflicting viewpoints on the appropriate use of frailty and cognitive impairment in waitlisting decisions. (shrink)

Developing social skills is essential to succeed in social relations. Two important social constructs in middle childhood, prosocial behavior and reactive aggression, are often regarded as separate behaviors with opposing developmental outcomes. However, there is increasing evidence for the co-occurrence of prosociality and aggression, as both might indicate responsivity to the social environment. Here, we tested whether a bi-dimensional taxonomy of prosociality and reactive aggression could predict internalizing and externalizing problems over time. We re-analyzed data of two well-validated experimental tasks (...) for prosociality and reactive aggression in a developmental population sample. Results revealed no associations between prosociality and reactive aggression, confirming the independence of those constructs. Interestingly, although prosociality and reactive aggression independently did not predict problem behavior, the interaction of both was negatively predictive of changes in externalizing problems over time. Specifically, only children who scored low on both prosociality and reactive aggression showed an increase in externalizing problems 1 year later, whereas levels of externalizing problems did not change for children who scored high on both types of behavior. Thus, our results suggest that at an individual level, reactive aggression in middle childhood might not always be maladaptive when combined with prosocial behavior, thereby confirming the importance of studying social competence across multiple dimensions. (shrink)

Strengthening the abilities of smallholder farmers in developing countries, particularly women farmers, to produce for both home and the market is currently a development priority. In many contexts, ownership of assets is strongly gendered, reflecting existing gender norms and limiting women’s ability to invest in more profitable livelihood strategies such as market-oriented agriculture. Yet the intersection between women’s asset endowments and their ability to participate in and benefit from agricultural interventions receives minimal attention. This paper explores changes in gender relations (...) and women’s assets in four agricultural interventions that promoted high value agriculture with different degrees of market-orientation. Findings suggest that these dairy and horticulture projects can successfully involve women and increase production, income and the stock of household assets. In some cases, women were able to increase their control over production, income and assets; however in most cases men’s incomes increased more than women’s and the gender-asset gap did not decrease. Gender- and asset-based barriers to participation in projects as well as gender norms that limit women’s ability to accumulate and retain control over assets both contributed to the results. Comparing experiences across the four projects, especially where projects implemented adaptive measures to encourage gender-equitable outcomes, provides lessons for gender-responsive projects targeting existing and emerging value chains for high value products. Other targeted support to women farmers may also be needed to promote their acquisition of the physical assets required to expand production or enter other nodes of the value chain. (shrink)

Mara van der Lugt’s Dark Matters is elegant in its composition and beautifully written. It offers a brilliant attempt to give both early modern optimism and pessimism their due as philosophical sta...

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Dark Matters: Pessimism and the Problem of Suffering by Mara van der LugtStefano BrogiMara van der Lugt. Dark Matters: Pessimism and the Problem of Suffering. Princeton, NJ: Princeton University Press, 2021. Pp. xi + 450. Hardback, $37.00.Mara van der Lugt's book (awarded Honorable Mention for the JHP Book Prize in 2022) has the merit of bringing attention to some crucial yet often overlooked topics by providing (...) a contribution that cannot fail to elicit broad interest. Her book does not simply discuss the theodicy and anti-theodicy of the modern age; against this background, she also brings out the often-ignored tradition of philosophical pessimism. What interests van der Lugt, however, is not "future-oriented" pessimism, which is opposed to "progressivist" theories of history, but an ontological or "value-oriented" pessimism that stresses "the terrible side of [End Page 163] life" in order to answer a series of crucial questions in a way very different from Leibniz's or Pope's approaches: Are there more evils than goods in our lives? Is life worth living for all of us, for any of us? Why do some people choose death despite their blessings? Why do some people choose life despite their sufferings? Do animals suffer as we do? Are we responsible for our own happiness? Is it better never to have been? According to van der Lugt, "The various ways in which these questions have been answered throughout the centuries have created the competing philosophical traditions known as optimism and pessimism. This book traces the intersection of the debate on the problem of evil with the debate on pessimism from the late seventeenth century onwards, seeking throughout to evaluate pessimism on its own terms" (20).A reassessment of this kind of pessimism serves an explicitly theoretical and moral purpose: van der Lugt herself states that her book is not exclusively a contribution to the history of philosophy, but "partly ethical or evaluative" (18). Indeed, pessimism and optimism "go hand in hand": they stem from a moral need and aim to respond to the evil present in the world by opening up glimmers of "hope, compassion, and consolation" (12, emphasis in original). Pessimism, in particular, is not intended to be "a philosophy of despair"; rather, it draws its strength from an "ethical commitment." Stemming from the latter is a tradition that "may be reinterpreted as a moral source" (22) and which "has not only its own epistemological and methodological concerns and presuppositions but, crucially, its own sets of virtues and moral aims" (13).The theoretical/moral purpose of Dark Matters is evident through its unfolding, even though eight of its nine chapters are roughly devoted to providing an accurate historical-philosophical reconstruction. Here, in brief, are the titles of the chapters that make up the over four hundred pages of this volume, which provide a good idea of the main authors discussed: (1) "The Complaint: Bayle and Malebranche on Physical Evil"; (2) "The Optics of Optimism: Leibniz and King Respond to Bayle"; (3) "Of Hope and Consolation: Voltaire and the Deists"; (4) "When Stoicism Meets Pessimism: La Mettrie and Maupertuis"; (5) "The Dispositional Problem of Evil: David Hume"; (6) "The Art of Suffering: Jean-Jacques Rousseau"; (7) "The Failure of Theodicy: Immanuel Kant"; (8) "The Flute-Playing Pessimist: Arthur Schopenhauer"; and (9) "Dark Matters: Pessimism as a Moral Source." To some extent, the rich itinerary provided by van der Lugt may be compared to those studies that have long undermined the idea of a monolithic and compact Enlightenment, characterized by unlimited faith in reason and its potential for liberation, and—more specifically—by a fundamental optimism with regard to human nature and the possibility of reformulating social and political structures in such a way as to enable each person to pursue happiness. However, the historical reconstruction provided here is based on an attempt to bring out the recurrent theoretical core of a philosophical perspective that first emerges with Pierre Bayle and runs through the modern and contemporary age, resurfacing in an evident way in the present-day antinatalism of David Benatar (often cited in the footnotes).According to van der Lugt, it is with Bayle (and not... (shrink)

Scholars in history and philosophy know the extraordinary difficulty of producing original research that is simultaneously creative, well-documented, and methodologically rigorous. But this is exactly what Mara van der Lugt manages in her recent book, a comprehensive treatment of Pierre Bayle's magnum opus. Reading Bayle is not for the faint of heart; he is a complex thinker with a controversial legacy. Van der Lugt exhibits appropriate caution, and though other interpreters have professed similar caution, van der Lugt's methodological commitments (...) necessitate it. Her approach imitates Bayle's own by suspending judgment on his intentions as author; attending meticulously... (shrink)

The global crisis of the COVID-19 pandemic has considerably accelerated the adoption of teleconsultation—a form of consultation between patient and health care professional that occurs via videoconferencing platforms. For this reason, it is important to investigate the way in which this form of interaction modifies the nature of the clinical encounter and the extent to which this modification impacts the healing process. For this purpose, I will refer to insights into the clinical encounter as a face-to-face encounter drawn from the (...) phenomenology of medicine (R. Zaner, K. Toombs, E. Pellegrino). I will also take into account a criticism that has been expressed by various contemporary phenomenologists (H. Dreyfus, T. Fuchs, L. Dolezal, H. Carel), namely, that due to the lack of physical proximity to the other in all types of online encounters, such encounters lack significant features that are present in face-to-face encounters, with the most important of these being the possibility of attaining an empathetic perception of the other and a sense of embodied risk. As these elements are essential features of the clinical encounter, the aim of this paper is to determine whether teleconsultation exhibits these features. To do that, I will integrate phenomenological philosophy with qualitative research drawing materials from both the philosophical tradition, particularly with respect to the concepts of the face-to-face encounter and embodied risk (A. Schutz and H. Dreyfus), and qualitative research study regarding patient experiences of teleconsultation. I will argue that teleconsultation does involve both the possibility of perceiving the other empathetically and the possibility of experiencing a sense of embodied risk. (shrink)

Argument-mapping software abounds, and one of the reasons is that using the software has been shown to teach/promote/improve critical thinking skills. These positive results are very encouraging, but they also raise the question of whether the computer tutorial environment is producing these results, or whether learning argument mapping, even with just paper and pencil, is sufficient. Based on the results of two empirical studies, I argue that the basic skill of being able to represent an argument diagrammatically plays an important (...) role in the improvement of critical-thinking skills. While these studies do not offer a direct comparison between the two methods, it is important for anyone wishing to employ argument mapping in the classroom to know that significant results can be obtained even with the most rudimentary of tools. (shrink)

Knowing Nature brings together political ecologists and science studies scholars to showcase the key points of encounter between the two fields and how this ...

A key topic within the field of the phenomenology of medicine has been the relationship between body and self in illness, including discussions about the otherness and mineness of the body. The aim of this article is to distinguish between different meanings of bodily otherness and mineness in illness with reference to the interpretation of the body as “saturated phenomenon,” inspired by the phenomenology of Jean-Luc Marion. With the help of Marion’s ideas it is possible to distinguish between two meanings (...) of bodily otherness and of mineness (objective and non-objective forms). These distinctions support and elaborate on ideas already found in the phenomenology of medicine and offer further insights into the nature of the experience of illness. (shrink)

Nowadays, managing change in complex services requires that middle management re-designs its objects and professional practices, in order to cope with new needs. It seems therefore crucial to activate training settings that allow managers to: develop research and analytical skills on their own work practices and professional objects; face and manage conflict, related to every change, that represents an opportunity to reflect and review one's own practices; and build new and shared repertories of managerial practices, able to support a better (...) form of living and working together within the management community. Moving from these hypotheses, inside the setting of a training intervention conducted in an educational service, the article discusses a specific tool used to generate opportunity of exchange, and reflection, within a challenging framework of change. (shrink)

In this paper, I defend a novel skeptical view about moral disgust. I argue that much recent discussion of moral disgust neglects an important ontological question: is there a distinctive psychological state of moral disgust that is differentiable from generic disgust, and from other psychological states? I investigate the ontological question and propose two conditions that any aspiring account of moral disgust must satisfy: it must be a genuine form of disgust, and it must be genuinely moral. Next, I examine (...) two prominent accounts of moral disgust by John Kekes and Victor Kumar and argue that neither successfully establishes the existence of genuinely moral disgust: Kekes’ account does not satisfy the second condition, and Kumar’s view does not meet the first. I claim that an important general lesson can be drawn from my critiques of Kekes’ and Kumar’s accounts: to establish the existence of moral disgust, one must provide unequivocal evidence that genuinely moral disgust, not generic disgust or anger, is being elicited in response to relevant moral violations. I conclude by considering why we ought to be skeptical about the general prospect of giving a positive answer to the ontological question, given the available evidence. (shrink)

Background Bioethical debates about privacy, big data, and public health surveillance have not sufficiently engaged the perspectives of those being surveilled. The data justice framework suggests that big data applications have the potential to create disproportionate harm for socially marginalized groups. Using examples from our research on HIV surveillance for individuals incarcerated in jails, we analyze ethical issues in deploying big data in public health surveillance. -/- Methods We conducted qualitative, semi-structured interviews with 24 people living with HIV who had (...) been previously incarcerated in county jails about their perspectives on and experiences with HIV surveillance, as part of a larger study to characterize ethical considerations in leveraging big data techniques to enhance continuity of care for incarcerated people living with HIV. -/- Results Most participants expressed support for the state health department tracking HIV testing results and viral load data. Several viewed HIV surveillance as a violation of privacy, and several had actively avoided contact from state public health outreach workers. Participants were most likely to express reservations about surveillance when they viewed the state’s motives as self-interested. Perspectives highlight the mistrust that structurally vulnerable people may have in the state’s capacity to act as an agent of welfare. Findings suggest that adopting a nuanced, context-sensitive view on surveillance is essential. -/- Conclusions Establishing trustworthiness through interpersonal interactions with public health personnel is important to reversing historical legacies of harm to racial minorities and structurally vulnerable groups. Empowering stakeholders to participate in the design and implementation of data infrastructure and governance is critical for advancing a data justice agenda, and can offset privacy concerns. The next steps in advancing the data justice framework in public health surveillance will be to innovate ways to represent the voices of structurally vulnerable groups in the design and governance of big data initiatives. (shrink)

In recent years, philosophers have looked to empirical findings about psychopaths to help determine whether moral agency is underwritten by reason, or by some affective capacity, such as empathy. Since one of psychopaths’ most glaring deficits is a lack of empathy, and they are widely considered to be amoral, psychopaths are often taken as a test case for the hypothesis that empathy is necessary for moral agency. However, people with autism also lack empathy, so it is reasonable to think that (...) any empirically-informed attempt to answer the question of whether empathy is necessary for moral agency should give due attention to autism as well as psychopathy. Jeanette Kennett’s thought-provoking paper ‘Autism, Empathy and Moral Agency’ (2002) is an early and arguably the most notable example of such an attempt. Kennett argues that although autistic people and psychopaths both lack empathy, autistic people possess a ‘reverence for reason’ that enables them to become capable moral agents. By contrast, psychopaths lack this rational capacity, and it is this defect of reason rather than an empathic impairment that explains why they are amoral. Kennett thus concludes that empathy is not necessary for moral agency. In this chapter, I challenge Kennett’s argument. First, I review the empirical evidence in order to demonstrate that there is a component of empathy called affective empathy that is impaired in psychopaths but largely preserved in autistics. As such, the claim that psychopaths and autistics share a common lack of empathy is unjustified. Second, I challenge Kennett’s claim that empathy plays no role in explaining the moral difference between psychopaths and autistics. Instead, I contend that the intact affective empathy of autistic people is a crucial component of their capacity to act from reverence for reason. (shrink)

"Science is rooted in conversations," wrote Werner Heisenberg, one of the twentieth century's great physicists. In Quantum Dialogue, Mara Beller shows that science is rooted not just in conversation but in disagreement, doubt, and uncertainty. She argues that it is precisely this culture of dialogue and controversy within the scientific community that fuels creativity. Beller draws her argument from her radical new reading of the history of the quantum revolution, especially the development of the Copenhagen interpretation. One of several (...) competing approaches, this version succeeded largely due to the rhetorical skills of Niels Bohr and his colleagues. Using extensive archival research, Beller shows how Bohr and others marketed their views, misrepresenting and dismissing their opponents as "unreasonable" and championing their own not always coherent or well-supported position as "inevitable." Quantum Dialogue, winner of the 1999 Morris D. Forkosch Prize of the Journal of the History of Ideas, will fascinate everyone interested in how stories of "scientific revolutions" are constructed and "scientific consensus" achieved. "[A]n intellectually stimulating piece of work, energised by a distinct point of view."—Dipankar Home, Times Higher Education Supplement "[R]emarkable and original. . . . [Beller's] arguments are thoroughly supported and her conclusions are meticulously argued. . . . This is an important book that all who are interested in the emergence of quantum mechanics will want to read."—William Evenson, History of Physics Newsletter. (shrink)

While feelings of disgust and repulsion are experienced and accepted as part of care practices of nurses who work in palliative care, they are often silenced. Working alongside two palliative care nurses in a hospice setting, we engaged in a narrative inquiry to inquire into their experiences of disgust. The study took place in a palliative care setting in a large urban city in Germany. We understand care practices as actions that follow a logic of care. According to a logic (...) of care, actions are situated within a social context, given by specific relationships including power, and individual needs. Various aspects of disgust are visible in the experiences of the participants and highlighted in the narrative threads of disgust and silence, disgust and protection, and disgust and boundaries. Embedded in the experience of disgust of nurses working in palliative care, we see that there are borderlands of care that challenge who we are and are becoming. Opening discussion about disgust in nursing makes visible the complexity of care. (shrink)

On 19 July 2016, three medical organisations filed a federal lawsuit against representatives from several Vermont agencies over the Patient Choice and Control at End of Life Act. The law is similar to aid-in-dying laws in four other US states, but the lawsuit hinges on a distinctive aspect of Vermont's law pertaining to patients' rights to information. The lawsuit raises questions about whether, and under what circumstances, there is an ethical obligation to inform terminally ill patients about AID as an (...) end-of-life option. Much of the literature on clinical communication about AID addresses how physicians should respond to patient requests for assisted dying, but neglects the question of how physicians should approach patients who may not know enough about AID to request it. In this article, I examine the possibility of an affirmative duty to inform terminally ill patients about AID in light of ethical concerns about professional responsibilities to patients and the maintenance of the patient–provider relationship. I suggest that we should not take for granted that communication about AID ought to be patient-initiated, and that there may be circumstances in which physicians have good reasons to introduce the topic themselves. By identifying ethical considerations that ought to inform such discussions, I aim to set an agenda for future bioethical research that adopts a broader perspective on clinical communication about AID. (shrink)

Rather than focus on effects, the isolatable and measureable outcomes of events and interventions, the papers assembled here offer different perspectives on the affective dimension of the meaning and politics of human/non-human relations. The authors begin by drawing attention to the constructed discontinuity between humans and non-humans, and to the kinds of knowledge and socialities that this discontinuity sustains, including those underpinned by nature-culture, subject-object, body-mind, individual-society polarities. The articles presented track human/non-human relations through different domains, including: humans/non-humans in history (...) and animal welfare science (Fudge and Buller); the relationship between the way we live, the effects on our natural environment and contested knowledges about ‘nature’ (Whatmore); choreographies of everyday life and everyday science practices with non-human animals such as horses, meerkats, mice, and wolves (Latimer, Candea, Davies, Despret). Each paper also goes on to offer different perspectives on the human/non-human not just as division, or even as an asymmetrical relation, but as relations that are mutually affective, however invisible and inexpressible in the domain of science. Thus the collection contributes to new epistemologies/ontologies that undercut the usual ordering of relations and their dichotomies, particularly in that dominant domain of contemporary culture that we call science. Indeed, in their impetus to capture ‘affect’, the collection goes beyond the usual turn towards a more inclusive ontology, and contributes to the radical shift in the epistemology and philosophy of science’s terms of engagement. (shrink)

Problem-Based Learning has become an increasingly popular instructional method for a variety of disciplines at all levels. Many studies and meta-analyses of these studies have shown the efficacy of this method for developing knowledge and skills. I adopted this method for teaching Engineering Ethics at Carnegie Mellon University, which has as its main course objectives the development of moral reasoning skills, as well as collaboration and communication skills, with special attention given to ethical dilemmas that may arise in the normal (...) course of an engineer’s professional career. In the most recent iteration of the course, I used the Engineering and Science Issues Test as a pretest and posttest to test the development of my students’ moral reasoning skills over the course of the semester. Based on the results of these tests, I argue that the students in my Engineering Ethics course did in fact significantly develop their moral reasoning skills. (shrink)

Interpretation of first four sutras of Brahmasūtra of Bādarāyaṇa on the basis of Śaṅkarācārya's commentary on Vedanta.

Political ecology and science studies have found fertile meeting ground in environmental studies. While the two distinct areas of inquiry approach the environment from different perspectives—one focusing on the politics of resource access and the other on the construction and perception of knowledge—their work is actually more closely aligned now than ever before. Knowing Nature brings together political ecologists and science studies scholars to showcase the key points of encounter between the two fields and how this intellectual mingling creates a (...) lively and more robust ecological framework for the study of environmental politics. The contributors all actively work at the interface between these two fields, and here they use empirical material to explore questions of theoretical and practical import for understanding the politics that surround nature-society relations, from wildlife management in the Yukon to soil fertility in Kenya. In addition, they examine how various environmental knowledge claims are generated, packaged, promoted, and accepted (or rejected) by the different actors involved in specific cases of environmental management, conservation, and development. Finally, they ask what is at stake in the struggles surrounding environmental knowledge, how such struggles shape conceptions of the environment, and whose interests are served in the process. (shrink)

The word “philosophy” comes from the Greek “philos” (meaning love) and “sophia” (meaning wisdom); thus philosophy literally is the “love of wisdom.” Whatever else philosophy may be, most people agree that it still retains this spirit of its etymological roots, and that when we are engaged in philosophy we are pursuing wisdom for the sake of itself. Wisdom, however, is not the same thing as knowledge or information. We aren’t merely trying to amass list of interesting ideas, or believe anything (...) that sounds good. Wisdom is, at least in part, the reflection on and critical evaluation of what we ourselves and others around us believe about some very heady topics. (shrink)

Supercommentary on Siddhāntabindu of Madhusūdana Sarasvatī, exegesis of Daśaślokī, treatise of the Advaita school in Indic philosophy, by Śaṅkarācārya.

Social context shapes negotiators’ actions, including their willingness to act unethically. We use a simulated negotiation to test how three dimensions of social context—dyadic gender composition, negotiation strategy, and trust—interact to influence one micro-ethical decision, the use of deception. Deception in all-male dyads was relatively unaffected by trust or the other negotiator’s strategy. In mixed-sex dyads, negotiators consistently increased their use of deception when three forms of trust were low and opponents used an accommodating strategy. However, in all-female dyads, negotiators (...) appeared to use multiple and shifting reference points in deciding when to deceive the other party. In these dyads, the use of deception increased when a competitive strategy combined with low benevolence-based trust or an accommodating strategy combined with high identity-based trust. Deception in all-female dyads decreased when a competitive strategy was used in the context of low deterrence-based trust. (shrink)

During the last few decades, many thinkers have advocated for the importance of the phenomenological approach in developing the understanding of the lived experience of illness. In their attempts, they have referred to ideas found in the history of phenomenology, most notably, in the works of Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty and Jean-Paul Sartre. The aim of this paper is to sketch out an interpretation of illness based on a yet unexplored conceptual framework of the phenomenology of French thinker (...) Jean-Luc Marion. Focusing on concepts of the saturated phenomenon and flesh, the paper develops an interpretation of illness as the saturated phenomenon, which highlights a variety of dimensions of illness already elaborated within the phenomenology of medicine, such as the affective dimension of illness, the disruptive dimension of illness, the transformed perception of the self in illness, mineness of flesh in illness and the inexpressible and hermeneutical dimension of illness. In addition to that, the paper explores some of the consequences the proposed interpretation of illness offers regarding the nature of illness and health. It is argued that illness in its essence is very similar to the experience of other saturated phenomena, suggesting that the difference between them does not lie within the character of the affective givenness, but rather within the dynamic relationship between the affective givenness and its conceptualization. It is also shown that the experience of health is compatible with the experience of saturation and thus is not limited to the tacit and harmonious background state. (shrink)

This essay looks closely at metaphors and other figures of speech that often feature in how Americans talk about dementia, becoming part of cultural narratives: shared stories that convey ideas and values, and also worries and fears. It uses approaches from literary studies to analyze how cultural narratives about dementia may surface in conversations with family members or health care professionals. This essay also draws on research on a notable social effect of legalizing medical aid in dying: patients may find (...) it easier to bring up a range of concerns, regardless of whether they have any interest in hastening their own death. The essay proposes that health care professionals rethink an idea prominent within their own culture: that conversations about the end of a person's life are inherently difficult. This framing may make it hard for people facing dementia to bring up their concerns about what lies ahead. We suggest a different way to think about these conversations, using the metaphor of “opening the door” to represent inviting a patient to bring up issues of deepest concern. (shrink)