This article reports a follow-up study of Norwegian nursing students entitled ‘The helping motive -an important goal for choosing nursing education’. It presents and discusses a significant ambiguity within the altruistic helping motive of 301 nursing students in the light of classical and modern virtue ethics. A quantitative longitudinal survey design was used to study socialization and building professional identity. The follow-up study began after respondents had completed more than two-and-a-half years of the three-year educational programme. Data were collected using (...) a questionnaire with closed questions, supplemented by 18 semi-structured, in-depth, audiotaped interviews. A motive such as ‘desire for human contact/to help others’ appeared to be highly significant. The research questions employed were: What motivates nursing students at the end of their studies to help other people? What does helping others mean for nursing students? Factor analysis revealed two factors. Factor 1 can be expressed as an altruism factor and factor 2 can be interpreted as an ‘acknowledgement-from-the-patient factor’ that in fact indicates an ambiguity within the helping motive itself. Findings from the interviews also reveal ambiguous helping motives. On one hand the students want to be altruistic and on the other they wish to receive positive feedback from patients when giving help. The findings indicate that this positive feedback is essential to the students in order for them to provide altruistic care. (shrink)

The U.S. National Institute of Allergies and Infectious Diseases and the National Institute of Mental Health have a new research priority: inclusion of terminally ill persons living with HIV in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. As end-of-life HIV cure research is relatively new, the scientific community has a timely opportunity to (...) examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable. (shrink)

Philosophy with children (P4C) 1 presents significant positive challenges for educators. Its 'community of enquiry' pedagogy assumes not only an epistemological shift in the role of the educator, but also a different ontology of 'child' and balance of power between educator and learner. After a brief historical sketch and an outline of the diversity among P4C practitioners, epistemological uncertainty in teaching P4C is crystallised in a succinct overview of theoretical and practical tensions that are a direct result of the implementation (...) of P4C in mainstream education. These recurring pedagogical tensions in my practice as P4C teacher, teacher educator and mentor of teacher educators cause disequilibrium that opens up rich opportunities for philosophy of education in supporting novice P4Cers. Disequilibrium is a positive force that opens up a space in which educators need to reflect upon their values, their beliefs about learning and teaching, and ultimately encourages educators to rethink their own role. Plato's metaphor of the stingray highlights the role of the P4C teacher educator as model of the P4C teacher in any setting: 'to numb and to be numbed'. The P4C community and its institutions need to address the questions arising from these pedagogical tensions; and this needs to be done with integrity, that is, in communities of enquiry that include children. If not, in the long term, a more instrumental version of P4C may prevail. (shrink)

Recently, Weisbecker and Goswami presented the first comprehensive comparative analysis of brain size, metabolic rate, and development periods in marsupial mammals. In this paper, a strictly energetic perspective is applied to identify general mammalian correlates of brain size evolution. In both marsupials and placentals, the duration or intensity of maternal investment is a key correlate of relative brain size, but here I show that allomaternal energy subsidies may also play a role. In marsupials, an energetic constraint on brain size in (...) adults is only revealed if we consider both metabolic and reproductive rates simultaneously, because a strong trade‐off between encephalization and offspring production masks the positive correlation between basal metabolic rate and brain size in a bivariate comparison. In conclusion, starting from an energetic perspective is warranted to elucidate relations between ecology, social systems, life history, and brain size in all mammals. (shrink)

In this essay I discuss a person’s freedom to choose whatever that person may reasonably prefer to choose. This type of freedom of choice may be regarded as a candidate for a social good, being a hybrid between freedom of choice and preference satisfaction utility. To separate this preference dependent freedom of choice from other types, we may call it opportunity. The essay is concerned with the question of how opportunity should be identified and measured. I discuss what conditions an (...) opportunity measure should satisfy and propose that an opportunity measure should satisfy at least four specific conditions. I then present a new class of measures which satisfy the four conditions (the Root measures). Last I prove that these measures are the only ones that satisfy the conditions, given the extra assumption that the measures are analytic functions with non-zero partial derivatives. (shrink)

This paper suggests that the practice of anamnesis—the taking of a patient history in preparation for making a diagnosis, as well as the related form of investigation, historia—offers a way to understand the role of medical collections in generating medical knowledge. Anamnesis derives from ancient Greek “recollecting” or “opening of memory,” and “taking a history” from historia, an ancient and early modern epistemic practice of gathering empirical observations from the past and present. Doctors and medical researchers perform, this paper argues, (...) a form of anamnesis when they access collections—of pathological organs, experimental animals, diagnostic slides, samples, and data—and the collections may in turn be seen as constituting institutional and disciplinary memories. It moreover shows that doctors and medical researchers in their work with collections negotiate two ways of organizing observations that are also present in an anamnesis. One way clusters and classifies observations, while the other traces developments and requires significant past observations to understand the present. This double nature plays out in different ways in different historical collections. Last, the paper itself may also be seen as performing an anamnesis: looking for patterns and tracing a development in medical history. It “opens the memory” of medical collection practices, and shows that medicine is past-heavy and that the past plays a central role in modern biomedicine. Anamnesis is thus used as a historiographical stance that seeks to understand present practices of generating knowledge about diseases through an inquiry into the past. (shrink)

Background: Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent. Objectives: The goal was to understand caregivers’ concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of professional (...) ethics within the care setting. Research design: A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland. Participants and research context: A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels. Ethical considerations: Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland]. Findings: Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation. Discussion: Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics. Conclusion: Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities. (shrink)

The idea of personalized nutrition is to give tailored dietary advice based on personal health-related data, i.e. phenotoype, genotype, or lifestyle. PN may be seen as part of a general trend towards personalised health care and currently various types of business models are already offering such services in the market. This paper explores ethical issues of PN by examining how PN services within the contextual environment of four future scenarios about health and nutrition in Europe might affect aspects of social (...) justice according to Martha Nussbaum’s capability approach. The scenarios have been created by a mixed group of stakeholders and experts in three consecutive workshops. This resulted in the definition of four future scenarios within a scenario space consisting of two variables: the ‘logic of health care systems’ and ‘conception of health’. Within each scenario, PN is likely to play a more or less important role in improving health by influencing food consumption patterns in society. Nussbaum’s capability approach implies a concept of social justice as a function of a minimum standard of human dignity. This denotes an account for equality in terms of a minimum of entitlements. However, also the ability of achieving individual objectives is essential for social justice. Personalisation advice in health and food consumption patterns, as aimed for by PN, is therefore acceptable provided a minimum of entitlements is guaranteed to all members of a society, and at the same time freedom concerning personal preferences is respected. Potential variation of how different people might benefit from PN should therefore be consistent with the minimum required as defined by the list of capabilities. (shrink)

Because we tend to study fight books in isolation, we often forget how difficult it is to understand the precise place they occupy in the sociocultural and historical fabric of their time, and spill the many clues they inevitably contain on their owner, their local society, their precise purpose. In order to unlock that information, we need to study them in their broader sociocultural and historical context. This requires a background and research skills that are not always easily accessible to (...) everyone. To illustrate the point, in this paper I show in some detail what is required to make sense of the claim that Aristotelian philosophy and science influenced the medieval fight books in relevant ways, and that understanding this influence helps us to better understand the fight books per se. I give an outline of the general historical framework, and apply it to a testcase: Talhoffer’s Thott 290 2° Ms., with some interesting results. My hope is that this framework may be of some use to other researchers in HEMA Studies who want to dig deeper in sources of interest to them. (shrink)

The process of transmitting ballet’s complex technique to young dancers can interfere with the innate processes that give rise to efficient, expressive and harmonious movement. With the intention of identifying possible solutions, this article draws on research across the fields of neurology, psychology, motor learning, and education, and considers their relevance to ballet as an art form, a technique, and a training methodology. The integration of dancers’ technique and expressivity is a core theme throughout the paper. A brief outline of (...) the historical development of ballet’s aesthetics and training methods leads into factors that influence dancers’ performance. An exploration of the role of the neuromotor system in motor learning and the acquisition of expert skills reveals the roles of sensory awareness, imagery, and intention in cuing efficient, expressive movement. It also indicates potentially detrimental effects of conscious muscle control, explicit learning and persistent naïve beliefs. Finally, the paper presents a new theory regarding the acquisition of ballet skills. Recontextualization theory proposes that placing a problematic task within a new context may engender a new conceptual approach and/or sensory intention, and hence the genesis of new motor programs; and that these new programs may lead to performance that is more efficient, more rewarding for the dancer, more pleasing aesthetically, and more expressive. From an anecdotal point of view, this theory appears to be supported by the progress of many dancers at various stages of their dancing lives. (shrink)

The idea that dementia is essentially a return to childhood and those affected must somehow be similar to children constitutes a deeply rooted and pervasive cultural trope. While such tropes may be helpful in making sense of an otherwise elusive and inscrutable state, they can at the same time promote inadequate understandings of dementia and hence also influence our attitudes and behaviour towards those affected in several problematic ways. In the present work, we provide a detailed account of the origins (...) and implications of the idea that people with dementia are somehow similar to children. In order to spell out the normative significance of this trope and to analyse its shortcomings, we will rely on a life‐course perspective. We will point out that the second‐childhood trope does not do justice to the particularities of the life phases of both children and people with dementia. This lack of biographical sensitivity brings about undignified treatment of and harm to those who have previously lived more autonomous lives. In conclusion, we will argue that people with dementia should not be equated with children as they are at a different point in their lives. This critical analysis of the second‐childhood trope shows the usefulness of a culturally and biographically sensitive theoretical framework for bioethical reflection. In particular, it provides reasons to reject infantilizing attitudes and behaviours and instead take seriously the personality, values and preferences shaped throughout the course of an individual's life. (shrink)

Dementia is highly prevalent and up until now, still incurable. If we may believe the narrative that is currently dominant in dementia research, in the future we will not have to suffer from dementia anymore, as there will be a simple techno-fix solution. It is just a matter of time before we can solve the growing public health problem of dementia. In this paper we take a critical stance towards overly positive narratives of techno-fixes by placing our empirical analysis of (...) dementia research protocols and political statements in a framework of technology assessment. From this perspective, it becomes obvious that a techno-fix is just one of many ways to approach societal problems and more importantly that technologies are way less perfect than they are presented. We will argue that this narrow scope, which focusses on the usual suspects for solving illnesses, reduces dementia to organismic aspects, and may be counterproductive in finding a cure for dementia. We conclude with outlining how the narrow scope can be balanced with other narratives and why we should have a reasonable scepticism towards the usual suspects. (shrink)

Philosophy typically ignores biographical, historical, and cultural aspects of theorists' lives in an attempt to take a supposedly abstract and objective view of their work. This book makes some new conclusions about Arendt’s theory by emphasizing how her experience of the world as displayed in her archival materials impacted her thought. Some aspects of Arendt’s life have been examined in detail before, including the fact she was stateless as well as her affair with Heidegger. Instead, this work explores different topics (...) including the biographical and narrative moments of Arendt's own work, the role of archiving in her thought, pivotal events that have not been archived, her understanding of her own identities, and how it affected the role of identity politics in her work. Typically, group action is underemphasized in Arendt scholarship in comparison to individual action and often identity politics questions are considered to lie within the realm of the private. Although Arendt’s theory is problematic when discussing issues concerning identity politics, she did think identity politics could be public and political and that effective political actions may occur within groups. What makes this project unique are the innovative conclusions made by moving the archival and biographical evidence to the center in order to understand her theory more accurately and within its historical and cultural context. (shrink)

"Thinking about thinking", the topic of this section of our volume, leads us into an Escherian web of self-referential interconnections — which nevertheless make sense, at least if we do not shy away at once in the face of paradox, for fear of inconsistency. How do our critical faculties enter the picture? Adding a few conceptual dimensions to the merely linearly causal one may help us to shed light on the issue, and may help us also to understand some of (...) the basic strategies "Western" thought has developed throughout its historical pathway in its conscious dealings with the 'real'. Of course, in a few pages it is impossible to do justice to this complicated subject. But I'll try to give the reader an as clear as possible description of the, in my view, crucial issues, pointing out the ways they resonate into the many fields of interest represented in the intended readership, and leave it to the reader to dig deeper through the given references. (shrink)

We apply a framework developed by C. S. Peirce to analyze the concept of clarity, so as to examine a pair of rival mathematical approaches to a typical result in analysis. Namely, we compare an intuitionist and an infinitesimal approaches to the extreme value theorem. We argue that a given pre-mathematical phenomenon may have several aspects that are not necessarily captured by a single formalisation, pointing to a complementarity rather than a rivalry of the approaches.

This essay is an attempt to analyze, classify and illustrate different scholarly approaches to the Sanskrit philosophical commentaries as reflected in some influential and especially thoughtful studies of Indian philosophy; at the same time it highlights some specific features involving commentary and annotation in general, drawing from results of studies on commentaries conducted in other disciplines and fields, such as Classical and Medieval Studies, Theology, and Early English Literature. In the field of South Asian Studies, philosophical commentaries may be assessed (...) from various overlapping and not always exclusive points of view, such as preservation of otherwise lost historical information, historical authenticity and reliability, interpretational innovation, spiritual or experiential insight, philosophical creativity, intellectual liveliness, doxographic intent, degree of incidentality, expository breadth and explanatory depth. The essay provides numerous examples taken from classical to early modern philosophical literature, especially of the Brahminical and Buddhist traditions, and also discusses their diverging perception by modern scholars and interpretators. (shrink)

In this paper I argue that inconsistencies in scientific theories may arise from the type of causality relation they—tacitly or explicitly—embody. All these seemingly different causality relations can be subsumed under a general strategy developed to defeat the paradoxes which inevitably occur in our experience of the real. With respect to this, scientific theories are just a subclass of the larger class of metaphysical theories, construed as theories that attempt to explain a (part of) the world consistently. All metaphysical theories (...) share a common structural backbone specificially designed to defeat paradoxes, their often wildly diverging ontological claims notwithstanding. This common structure shapes the procedures which govern the invention of ideas in the context of such theories, by codifying some onto-logical a priori assumptions regarding the consistency of reality into its bare conceptual framework. Causality plays a key rôle here, because it implies conservation of identity, itself a far from simple notion. It imposes strong demands on the universalising power of the theories concerned. These demands are often met by the introduction of a metalevel which encompasses the notions of ‘system’ and ‘lawful behaviour’. In classical mechanics, the division between universal and particular leaves its traces in the separate treatment of cinematics and dynamics. The fundamental backbone’s specific gestalt thus functions as a theory’s individual signature and paves the way to a comparative historical approach towards their study. An important part of my paper therefore explores the strong connections between paradoxes as they appear and are dealt with in ancient philosophy and their re-appearance in early modern natural philosophy and science. This analysis is applied to the mechanical theories of Newton and Leibniz, with some surprising results. (shrink)

This article attempts to bridge the philosophical gap between Western music education philosophers and practicing Suzuki music teachers. Specifically addressed is Estelle Jorgensen's critique of Suzuki-trained educators who may rely too heavily on rote pedagogical methods without careful reflection of the philosophical principles underlying their approach. By first discussing the cultural relativity of philosophical expression, this article suggests that Suzuki's philosophy may be better (although differently) articulated than Western scholars give it credit. On the other hand, this article also invites (...) contemporary string pedagogues who use Suzuki's methods to candidly consider how much attention they pay to Suzuki's (and their own) educational philosophy as they teach. Finally, this article articulates Suzuki's philosophy of music education, named here "Music Education as Love Education" (a play on words with the familiar term "Music Education as Aesthetic Education," to reflect Suzuki's principal focus on the nurturing of students)—in order to offer a fresh look at a philosophy that may be often, though differently, disregarded by both sides of the debate. Suzuki's writings and interviews with individuals who worked with Suzuki are used to demonstrate his belief in the spiritual nature of musical tone, and the high priority he placed upon character development. (shrink)

Autism spectrum disorder is characterized by atypical perception, including processing that is biased toward local details rather than global configurations. This bias may impact on memory. The present study examined the effect of this perception on both implicit and explicit memory in conditions that promote either local or global processing. The first experiment consisted of an object identification priming task using two distinct encoding conditions: one favoring local processing and the other favoring global processing of drawings. The second experiment focused (...) on episodic memory with two different cartoon recognition tasks that favored either local or a global processing. In addition, all the participants underwent a general clinical cognitive assessment aimed at documenting their cognitive profile and enabling correlational analyses with experimental memory tasks. Seventeen participants with ASD and 17 typically developing controls aged from 10 to 16 years participated to the first experiment and 13 ASD matched with 13 TD participants were included for the second experiment. Experiment 1 confirmed the preservation of priming effects in ASD but, unlike the Comparison group, the ASD group did not increase his performance as controls after a globally oriented processing. Experiment 2 revealed that local processing led to difficulties in discriminating lures from targets in a recognition task when both lures and targets shared common details. The correlation analysis revealed that these difficulties were associated with processing speed and inhibition. These preliminary results suggest that natural perceptual processes oriented toward local information in ASD may impact upon their implicit memory by preventing globally oriented processing in time-limited conditions and induce confusion between explicit memories that share common details. (shrink)

ObjectiveThe aim of this study was to investigate possible associations between obstructive sleep apnea and fatigue. This naturally led to considering the association between OSA and excessive sleepiness, depression, and anxiety.BackgroundOSA is a highly prevalent sleep disorder, associated with a risk of hypertension, cardiovascular events, daytime sleepiness, poor cognitive function, and sudden death during sleep. Both excessive sleepiness, fatigue, and symptoms of depression are frequently reported.Method5,464 patients referred to a university hospital for obstructive sleep apnea underwent standard respiratory polygraphy. The (...) severity of OSA was defined as either mild, moderate, or severe, using the apnea–hypopnea index. Validated questionnaires were used to assess excessive sleepiness, pathological fatigue, depression, and anxiety.ResultsNearly 70% of the patients were men, and median age was 50 years. One in three had moderate-to-severe OSA. Excessive sleepiness and pathological fatigue were present in 43 and 39%, respectively. The prevalence of possible depression and anxiety was 19 and 28%, respectively. The proportion of patients with male sex, obesity, and excessive sleepiness increased with the severity of OSA. In contrast, the proportion of patients with pathological fatigue did not increase with OSA severity, and there was a decrease in depression and anxiety with increasing OSA severity.ConclusionOur study reports that pathological fatigue, as well as anxiety and depression, did not increase with OSA severity, whereas excessive sleepiness did. Knowledge concerning conditions related to OSA severity may be indicative of pretest probability of OSA and thus change the priority for polygraphy. Furthermore, the high prevalence rates of fatigue, anxiety, and depression among these patients warrant further investigations. (shrink)

This article aims to show how critical-feminist studies can improve research on funerals by contributing to a more complex understanding of ritualization and how it can be explored. The article discusses central issues within critical-feminist theory in relation to previous studies of funerals in Sweden and presents theoretical approaches that may improve the field of funeral studies. Intersectionality, queer phenomenology and ritual practice theory are introduced as examples of approaches that might help the researcher deal with questions of representation in (...) research, rejection of othering and application of non-essentialism – central issues in critical-feminist theory. Critical-feminist studies may, for example, uncover intersections of power relations in the ritual field, reveal experiences of inclusion/exclusion and contribute to a relational and dynamic understanding of ritual practice. Thereby, they provide complex knowledge of funerals, essential for understanding their functions for individuals and societies in times of ritual change. (shrink)

ArgumentThe famousCahiersof Paul Valéry cannot be reduced to a single scientific discipline, a specific philosophical tradition, or a literary genre. For today's reader these notebooks constitute a formatsui generis, one very often characterized by an “observation of a second order”: in theCahiersValéry uses writing, drawing, and calculating not only for purposes of argumentation; he also pays attention to the significance of such writing, drawing, and calculating processes for the production of knowledge. It is particularly thepracticeof note-taking and sketching in Valéry's (...) notebooks that documents, rehearses, or questions the medial and instrumental conditions of both scientific research and artistic production. This is especially true of the early stages of theCahiersin the years beginning around 1894 when Valéry was intensely searching for notation systems that would be conducive to his research interests. At the time the problem of how to write was intrinsically bound up with the way he established his notebooks as a specific scene of writing. By closely examining a number of pages from the early notebooks I hope to show that the emerging regulation of Valéry's writing in theCahiersresults from simple operations that are noted and repeated by the writer until they gradually become procedures. What Valéry'sCahiersshow us, however, is that procedures do not always work in favor of a final synthesis, but may also give rise to a format of eternal beginning. In the following I will present some of the constitutive procedures found in Valéry's early notebooks, procedures that range from a tentative gathering together and simple forms of recursion and variation to the rehearsing or invention of symbolic or graphic forms of notation. (shrink)

The paper investigates how the politeness marker please is used by young people to distinguish themselves from adults and create an identity of their own. The analysis of please is based on the Bergen Corpus of London Teenage Language. The distribution and uses of please in COLT are compared with similar data from the British component of the International Corpus of English. We can recognize several functions of the “impolite” please in the COLT Corpus. To begin with, it is used (...) strategically to establish or confirm harmonious relationships between the speakers. Secondly, “mock impoliteness” may be understood in a positive way because it is amusing or entertaining. In young people’s circles entertainment skills are for example highly valued. Finally, impoliteness is used creatively in interaction by the participants who use repetition, reformulation and escalation to construct ritualized sequences of apparent insults. (shrink)

Participation in healthcare decision-making is considered to be an important right of minors, and is highlighted in both international legislation and public policies. However, despite the legal recognition of children’s rights to participation, and also the benefits that children experience by their involvement, there is evidence that legislation is not always translated into healthcare practice. There are a number of factors that may impact on the ability of the child to be involved in decisions regarding their medical care. Some of (...) these factors relate to the child, including their capacity to be actively involved in these decisions. Others relate to the family situation, sociocultural context, or the underlying beliefs and practices of the healthcare provider involved. In spite of these challenges to including children in decisions regarding their clinical care, we argue that it is an important factor in their treatment. The extent to which children should participate in this process should be determined on a case-by-case basis, taking all of the potential barriers into account. (shrink)

The aim of this paper is to expose the unique muddle in which moral philosophy finds itself with regard to genetic engineering. The latter can be essentially defined as the correcting of nature's mistakes at their source, the DNA acid molecule of the gene. I shall discuss the moral nature of genetic engineering with respect to a single issue: the potential harm it may inflict upon the autonomous individual. I shall also consider the distinctions between genetic engineering and other activities (...) affecting human existence, in order to establish that the moral issues presented by genetic engineering are unique to it. (shrink)

Contrary to Müller's claims, and in support of modular theories, genetic factors play a substantial and significant role in language. The finding that some children with specific language impairment (SLI) have nonlinguistic impairments may reflect improper diagnosis of SLI or impairments that are secondary to linguistic impairments. Thus, such findings do not argue against the modularity thesis. The lexical/functional distinction appears to be innate and specifically linguistic and could be instantiated in either symbolic or connectionist systems.

To offer engaging neurorehabilitation training to neurologic patients, motor tasks are often visualized in virtual reality. Recently introduced head-mounted displays allow to realistically mimic the body of the user from a first-person perspective in a highly immersive VR environment. In this immersive environment, users may embody avatars with different body characteristics. Importantly, body characteristics impact how people perform actions. Therefore, alternating body perceptions using immersive VR may be a powerful tool to promote motor activity in neurologic patients. However, the ability (...) of the brain to adapt motor commands based on a perceived modified reality has not yet been fully explored. To fill this gap, we “tricked the brain” using immersive VR and investigated if multisensory feedback modulating the physical properties of an embodied avatar influences motor brain networks and control. Ten healthy participants were immersed in a virtual environment using an HMD, where they saw an avatar from first-person perspective. We slowly transformed the surface of the avatar from human to stone. We enforced this visual change by repetitively touching the real arm of the participant and the arm of the avatar with a hammer, while progressively replacing the sound of the hammer against skin with stone hitting sound via loudspeaker. We applied single-pulse transcranial magnetic simulation to evaluate changes in motor cortical excitability associated with the illusion. Further, to investigate if the “stone illusion” affected motor control, participants performed a reaching task with the human and stone avatar. Questionnaires assessed the subjectively reported strength of embodiment and illusion. Our results show that participants experienced the “stone arm illusion.” Particularly, they rated their arm as heavier, colder, stiffer, and more insensitive when immersed with the stone than human avatar, without the illusion affecting their experienced feeling of body ownership. Further, the reported illusion strength was associated with enhanced motor cortical excitability and faster movement initiations, indicating that participants may have physically mirrored and compensated for the embodied body characteristics of the stone avatar. Together, immersive VR has the potential to influence motor brain networks by subtly modifying the perception of reality, opening new perspectives for the motor recovery of patients. (shrink)

In 2011 it emerged that to induce the death penalty, United States authorities had begun giving injections of pentobarbital, a substance provided by Danish pharmaceutical company Lundbeck. Lundbeck's product pentobarbital is licensed for treatment of refractory forms of epilepsy and for usage as an anaesthetic, thus for a very different purpose. The Lundbeck case offers a difficult, but also interesting Corporate Social Responsibility (CSR) dilemma between choices facing a pharmaceutical company to stop the distribution of a medical substance in order (...) to avoid complicity in human rights violations, or to retain distribution of the substance in order not to impede access to the medicine for those patients who need it. The dilemma arose at a time when the United Nations (UN) Secretary General's Special Representative on Business and Human Rights, Professor John Ruggie, was finalizing a set of Guiding Principles to operationalize recommendations on business and human rights that he had presented to the UN Human Rights Council in 2008. The article discusses the dilemma in which Lundbeck was placed in from the perspective of the Guiding Principles on business and human rights and the 2008 Protect, Respect, Remedy UN Framework. The analysis seeks to assess what guidance may be gauged from the Guiding Principles in relation to the dilemma at hand and discusses the adequacy the Guiding Principles for dealing with acute human rights dilemmas of conflicting requirements in which a decision to avoid one type of violation risks causing violation of another human right. The article concludes by drawing up perspectives for further development of guidance on implementation of the UN Framework that could be considered by the newly established Working Group on Business and Human Rights and related UN bodies. (shrink)

Governments are particularly salient stakeholders for business ethics. They act on societal needs and social expectations, and have the political and legal powers to restrict or expand the economic freedoms of business as well as the legitimacy and often urgency to do so. We draw on two examples: the Business & Human Rights regime from a UN Global Compact perspective; and mandatory CSR reporting. Supplying integrated teaching notes and generalising on the examples, we explain how legal method may help students (...) of business ethics, organisation and management – future managers – in their analysis of governments as stakeholders and their interests that drive expectations on firms. With a focus on analysis for responding adequately to stakeholder concerns,this article contributes to the emerging literature recognising the relevance of public regulation for CSR. More specifically, we contribute to the business ethics literature by explaining how legal method complements stakeholder theory for organisational practice. (shrink)

The debate in the Federal Republic of Germany on the estimation of the social compatibility of the consequences of technology as a criterion for the evaluation of technical systems has been going on since the mid seventies. The approach presented discusses the normative structurally transcending perspective of the viability and developmental capacity of society. The question of desirable social development as opposed to the technically possible is raised. A criteria system for evaluating social compatibility of new information and communication technologies (...) including AI is focused on and may serve as a consensus building forum for public technology policy discussion. (shrink)

The history of twentieth-century life sciences is not exactly a new topic. However, in view of the increasingly rapid development of the life sciences themselves over the past decades, some of the well-established narratives are worth revisiting. Taking stock of where we stand on these issues was the aim of a conference in 2015, entitled “Perspectives for the History of Life Sciences”. The papers in this topical collection are based on work presented and discussed at and around this meeting. Just (...) as the conference, the collection aims at exploring fields in the history of life sciences that appear understudied, sources that have been overlooked, and novel ways of engaging with this material. The papers convened in this collection may not be representative of the field as a whole; but we feel that they do indicate some elements that have received emphasis in recent years, and may become more central in the years to come, such as the history of previously neglected contexts and domains of the life sciences, the question of continuity and change on the level of practices, the history of complexity and diversity in twentieth-century life sciences and the reconsideration of the relationship between history and philosophy of life sciences. (shrink)

This article presents the results of a study concerning the impact of physical changes accompanying female puberty. It examines the meanings these changes have for the girls themselves, as well as for their mothers and fathers. The hypothesis, essentially rooted in psychoanalytical theory, is that the reactions of mothers and fathers to the bodily changes of their daughter communicate messages about these changes that, in turn, impact on the girl’s perception and experience of her body. These messages are influenced by (...) the often unconscious desires, fantasies and fears of the adults as well as by societal gender images. Depending on how adult care providers confront the psychic issues raised by their daughter’s adolescence and, in turn, how they interact with their daughter during her transition to adulthood, these psychic events may either serve to perpetuate societal gender images or offer a means of revising them. (shrink)

Using Hannah Arendt's theory as a template, this essay analyzes American foreign policy decisions that led to the Iraq war. Obviously, Arendt would find the misinformation concerning "links" between Iraq and al-Qaeda to be problematic, as well as the unjustified allegation of weapons of mass destruction. In addition, the Bush administration sought to justify the war in roughly two other ways: the liberation of the people of Iraq from the dictatorship of Saddam Hussein and the need to stabilize the region (...) by providing a model for democracy in the Middle East. One may wonder whether Arendt would support the administration's actions for these other reasons, as Arendt was worried about the emergence of nuclear weapons and certainly was against dictatorships in favor of governments that support the public freedom of the people. However, I argue that Arendt's overall political theory would not support the war and may, in fact, give us reasons to believe that it will not produce a fully functioning democracy in Iraq. In conclusion, I will contrast the Bush administration's method to the Arab Spring, which Arendt would more fully support, if the outcome focuses on writing and adopting Constitutions that secure freedom for the people involved. (shrink)

Background On a daily basis, healthcare professionals deal with various ethical issues and it can be difficult to determine how to act best. Clinical ethics support (CES) has been developed to provide support for healthcare professionals dealing with complex ethical issues. A long-term perspective of participating in inter-professional dialogue and reflective-based CES sessions is seemingly sparse in the literature. Research aim The aim was to describe experiences of impact of Inter-professional Ethics Communication in groups (IEC) based on Habermas’ theory of (...) communicative actions, after 6 months from the perspective of an inter-professional team. Research design A qualitative inductive approach was chosen, and individual interviews ( n = 13) were conducted. Interview data were analysed using qualitative content analysis. Participants The participants, 10 females and two males, represented assistant nurses, registered nurses, physicians, occupational therapists, physiotherapists, welfare officers and psychologists. Each had attended at least four IEC sessions. Ethical considerations The study was approved by the Regional Ethical Review Board in Umeå, Sweden, and it has been undertaken in accordance with the Helsinki Declaration. Findings Overall, the descriptions expressed a perceived achievement of a deepened and integrated ethical awareness that increased the participants’ awareness of ethically difficult situations as well as their own ethical thinking, actions and approaches in daily work. Perspectives were shared and the team become more welded. They carried the memories of the reflections within them, which was perceived as supportive when encountered new ethically situations. Discussion Putting words to unarticulated thoughts may stimulate repeated reflections, leading to new insights and alternative thoughts. Conclusion The outcome of IEC sessions 6 months following the last session can be described as an incorporated knowledge that enables actions in ethically difficult situations based on an ethical awareness both at a ‘We-level’ and an ‘I-level’. (shrink)

Scientific and medical practice both relate to and differ from each other, as do discussions of how to handle decisions under uncertainty in the laboratory and clinic respectively. While studies of science have pointed out that scientific practice is more complex and messier than dominant conceptions suggest, medical practice has looked to the rigour of scientific and statistical methods to address clinical uncertainty. In this article, we turn to epistemological studies of the laboratory to highlight how clinical practice already has (...) strategies for dealing with messiness. We draw on Hans-Jo ̈rg Rheinberger’s Toward a History of Epistemic Things, in which he invokes the metaphor of a spider’s web to explain the role of tacit practices in experimental biochemistry for helping practitioners manage messiness. We argue that diagnostic practices in clinical medicine employ similar, albeit codified, procedures to evaluate epistemic significance, ensure sensitivity to the unforeseen, and allow focused grounds for action. We consider three practices: (a) the pre-set structure of medical records, ensuring broad coverage in initial anamnesis, (b) the use of lists of differential diagnoses and ongoing ‘anchoring and adjusting’ as inquiry progresses, and (c) shared decision-making as an occasion to synthesize empirical evidence and reopen inquiry for potential missed information. We end by suggesting that while philosophy of medicine may learn from laboratory epistemology, the sciences may learn something from medical practice. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

This article discusses the idea of intra-generational education. Drawing on Braidotti’s nomadic subject and Barad’s conception of agency, we consider what intra-generational education might look like ontologically, in the light of critical posthumanism, in terms of natureculture world, nomadism and a vibrant indeterminacy of knowing subjects. In order to explore the idea of intra-generationalism and its pedagogical implications, we introduce four concepts: homelessness, agelessness, playfulness and wakefulness. These may appear improbable in the context of education policy-making today, but they are (...) born of theorising our practices in the age-transgressive field of Philosophy with Children. We argue that these concepts help to reconfigure intra-generational relations, ways of being and becoming. They express the longing, corporeality and visionary epistemology of nomadic enquiry. These inventions express a non-hierarchical philosophy of immanence. We draw some tentative conclusions about educational practices more generally. (shrink)

The discovery of the molecular structure of deoxyribonucleic acid and the science of molecular biology have profoundly changed medicine’s diagnostic capability and promise to transform the therapeutic realm. When some genetic disorders are diagnosed, physicians can intervene for prevention or treatment. While the basic structure of DNA is the same for all human beings, no two individuals, other than identical twins, have the same DNA sequence. This discovery has had important repercussions in the criminal justice system, where DNA can serve (...) as an identification tool.At the crossroads of these different uses of DNA, there are great concerns about potential misuses of genetic information. Preventing disease, curing illness, and convicting criminals are all seen as worthwhile uses of the technology, but concerns of potential misuse in medicine or in the criminal justice system are not unfounded. A 1998 American Medical Association study showed that 68 percent of patients had fears that their genetic test results would be used against them by their employers or insurers. Others, pointing to racial profiling, have suggested that we may now face genetic profiling. (shrink)

The small, the tiny, and the infinitesimal have been the object of both fascination and vilification for millenia. One of the most vitriolic reviews in mathematics was that written by Errett Bishop about Keisler’s book Elementary Calculus: an Infinitesimal Approach. In this skit we investigate both the argument itself, and some of its roots in Bishop George Berkeley’s criticism of Leibnizian and Newtonian Calculus. We also explore some of the consequences to students for whom the infinitesimal approach is congenial. The (...) casual mathematical reader may be satisfied to read the text of the five act play, whereas the others may wish to delve into the 130 footnotes, some of which contain elucidation of the mathematics or comments on the history. (shrink)

The discovery of the molecular structure of deoxyribonucleic acid and the science of molecular biology have profoundly changed medicine’s diagnostic capability and promise to transform the therapeutic realm. When some genetic disorders are diagnosed, physicians can intervene for prevention or treatment. While the basic structure of DNA is the same for all human beings, no two individuals, other than identical twins, have the same DNA sequence. This discovery has had important repercussions in the criminal justice system, where DNA can serve (...) as an identification tool.At the crossroads of these different uses of DNA, there are great concerns about potential misuses of genetic information. Preventing disease, curing illness, and convicting criminals are all seen as worthwhile uses of the technology, but concerns of potential misuse in medicine or in the criminal justice system are not unfounded. A 1998 American Medical Association study showed that 68 percent of patients had fears that their genetic test results would be used against them by their employers or insurers. Others, pointing to racial profiling, have suggested that we may now face genetic profiling. (shrink)

Background Whether patients' life-style should involve lower priority for treatment is a controversial question in bioethics. Less is known about clinicians' views. Aim To study how clinical doctors' attitudes to questions of patient responsibility and priority vary over time. Method Surveys of doctors in Norway in 2008, 2014, 2021. Questionnaires included statements about patients' lifestyle's significance for priority to care, and vignettes of priority cases (only in 2014). Results Attitudes were fairly stable between 2008 and 2021. 17%/14% agreed that patients' (...) lifestyle should count, while 19%/22% agreed that it should involve lower priority to scarce organs. 42/44% agreed that smokers should have lower priority. Substantially more agreed in 2014. Regression analyses showed that being male, working in hospital, and younger age increased the likelihood of agreeing. Conclusion A substantial minority of doctors agreed that lifestyle should be a priority criterion, possibly contrary to Norwegian legislation and professional ethics. The finding might be explained by the unspecified meaning of priority, increased scarcity-awareness, or socio-cultural trends towards individualism. The 2014 results indicate a framing effect; the vignettes may have primed the respondents towards accepting lifestyle as a criterion. We conclude that attitudes to normative questions are unstable and depend on context. A substantial minority of doctors seems to be positive to deprioritizing patients allegedly responsible for their illness. However, what deprioritization implies in practice is not clear. (shrink)

Luke Demaitre's Leprosy in Premodern Medicine: A Malady of the Whole Body is a highly interesting study of the medical history of leprosy and the medical and social perceptions on leprosy that have been around for centuries. Remarkably, it is likely that leprosy will disappear from the face of the Earth in our generation, thanks to the development of a curative treatment and its increasing availability (although the battle has not yet been won completely). Demaitre's book is a very good (...) read not only for its information about leprosy but also for all interested in or affected by the social phenomenon of stigma. In illnesses such as leprosy, HIV/AIDS, epilepsy, and mental disorders such as schizophrenia, the stigma attached to the condition may be worse than the condition itself. (shrink)

While the realm of bioethics has traditionally focused on the rights of the individual and held autonomy as a defining principle, public health ethics has at its core a commitment to the promotion of the common good. While these two domains may at times conflict, concepts arising in one may also be informative for concepts arising in the other. One example of this is the concept of a “right not to know.” Recent debate suggests that just as there is a (...) “right to know” information about one's genetic status, there is a parallel “right not to know” when it comes to genetic information that if communicated, could be detrimental to an individual's social or psychological well-being. As new genetic technologies continue to change the nature of genetic testing and screening, it is crucial that normative frameworks to guide and assess genetic public health initiatives be developed. In this context, the question of whether a “right not to know” may also be said to exist for populations on a public health level merits attention. (shrink)

Refugees and asylum seekers may experience challenges related to pre-arrival experiences, structural disadvantage after migration and during resettlement requiring the need for special protection when participating in research. The aim was to review if and how people with refugee and asylum seeker backgrounds have had their need for special protection addressed in national and international research ethics guidelines. A systematic search of grey literature was undertaken. The search yielded 2187 documents of which fourteen met the inclusion criteria. Few guidelines addressed (...) specific ethical considerations for vulnerable groups much less people with refugee and asylum seeker backgrounds. One guideline explicitly addressed vulnerability for refugees and asylums seekers. To ensure members of ethics committees and researchers consider the potential challenges of conducting research with these groups, guidelines may need to be supplemented with a refugee and asylum seeker specific research ethics framework. Such a framework may be necessary to optimally protect people with refugee and asylum seeker backgrounds in research. (shrink)

Mobilising International Law for 'Global Justice' provides new insights into the dynamics between politics and international law and the roles played by state and civic actors in pursuing human rights, development, security and justice through mobilising international law at local and international levels. This includes attempts to hold states, corporations or individuals accountable for violations of international law. Second, this book examines how enforcing international law creates particular challenges for intergovernmental regulators seeking to manage tensions between incompatible legal systems and (...) bringing an end to harmful practices, such as foreign corruption and child abduction. Finally, it explores how international law has local resonance, whereby, for example, cities have taken it upon themselves to give effect to the spirit of international treaties that national governments fail to implement, or even may have refused to ratify. (shrink)

Gene drive technologies (GDTs) have been proposed as a potential new way to alleviate the burden of malaria, yet have also raised ethical questions. A central ethical question regarding GDTs relates to whether it is morally permissible to intentionally modify or eradicate mosquitoes in this way and how the inherent worth of humans and non-human organisms should be factored into determining this. Existing analyses of this matter have thus far generally relied on anthropocentric and zoocentric perspectives and rejected an individualist (...) biocentric outlook in which all living organisms are taken to matter morally for their own sake. In this paper, we reconsider the implications of taking a biocentric approach and highlight nuances that may not be evident at first glance. First, we shortly discuss biocentric perspectives in general, and then outline Paul Taylor’s biocentric theory of respect for nature. Second, we explore how conflicting claims towards different organisms should be prioritised from this perspective and subsequently apply this to the context of malaria control using GDTs. Our ethical analysis shows that this context invokes the principle of self-defence, which could override the pro tanto concerns that a biocentrist would have against modifying malaria mosquitoes in this way if certain conditions are met. At the same time, the case study of GDTs underlines the relevance of previously posed questions and criticism regarding the internal consistency of Taylor’s egalitarian biocentrism. (shrink)

Purpose This paper aims to formalize long-term trajectories of human civilization as a scientific and ethical field of study. The long-term trajectory of human civilization can be defined as the path that human civilization takes during the entire future time period in which human civilization could continue to exist. -/- Design/methodology/approach This paper focuses on four types of trajectories: status quo trajectories, in which human civilization persists in a state broadly similar to its current state into the distant future; catastrophe (...) trajectories, in which one or more events cause significant harm to human civilization; technological transformation trajectories, in which radical technological breakthroughs put human civilization on a fundamentally different course; and astronomical trajectories, in which human civilization expands beyond its home planet and into the accessible portions of the cosmos. -/- Findings Status quo trajectories appear unlikely to persist into the distant future, especially in light of long-term astronomical processes. Several catastrophe, technological transformation and astronomical trajectories appear possible. -/- Originality/value Some current actions may be able to affect the long-term trajectory. Whether these actions should be pursued depends on a mix of empirical and ethical factors. For some ethical frameworks, these actions may be especially important to pursue. (shrink)

Sustainable development is a common goal in the public sector but may be difficult to implement due to epistemic uncertainties and the long time frames required. This paper proposes that some of these problems can be solved by formulating cautious utopias, entailing a relationship between means and goals differing from both utopian and realistic goal-setting. Cautiously utopian goals are believed, but not certain, to be achievable and to remain desirable, but are open to future adjustments due to changing desires and/or (...) factual circumstances. Quality criteria for such goals are suggested. (shrink)