Patients in specialist mental healthcare services who are at risk of suicide may experience their struggles as existential in nature. Yet, research on meaning in life has been relatively scarce in suicidology. This qualitative study aimed to explore how patients at risk of suicide perceived their encounters with specialist healthcare professionals after a suicide attempt (SA), with special reference to meaning in life experiences. The study was conducted in specialised mental healthcare services in Norway. Data were collected via individual interviews (...) with eight patients aged 20–75 years. Using a four-step procedure, the interviews were analysed by systematic text condensation. The participants understood their feelings of shame, self-contempt and challenging life experiences as contributing factors to their SA. They perceived that existential themes in relation to financial difficulties, shame and trauma were resolved, while issues associated with the SA, such as death, loss and beliefs, were given less attention. The participants were either ambivalent about continuing to live or wished to rebuild a meaningful life. Overall, their experiences of meaningfulness were hampered. Assisting patients with meaning in life experiences may help them alter their life interpretations and increase their ability to rebuild their lives as meaningful. The present study should be seen as a contribution to meaning-informed approaches in specialist mental healthcare services. More research is needed to equip healthcare personnel in their overall aims of preventing suicide and supporting patients at risk in their efforts to live a meaningful life. (shrink)

Assembled here for the first time in English translation, Sigrid Weigel and Georgina Paul offer illuminating new insights into Benjamin's theory, combining impulses from post-structuralism, feminism, cultural anthropology and psychoanalysis.

The term “value of life” can refer to life’s intrinsic dignity: something nonincremental and time-unaffected in contrast to the fluctuating, incremental “value” of our lives, as they are longer or shorter and more or less flourishing. Human beings are equal in their basic moral importance: the moral indignities we condemn in the treatment of e.g. those with dementia reflect the ongoing human dignity that is being violated. Indignities licensed by the person in advance remain indignities, as when people might volunteer (...) their living, unconscious bodies for surrogacy or training in amputation techniques. Respect for someone’s dignity is significantly impacted by a failure to value that person’s very existence, whatever genuine respect and good will is shown by wanting the person’s life to go well. Valuing and respecting life is not, however, vitalism: there can be good and compelling reasons for eschewing some means of prolonging life. (shrink)

KJORVEN M, RUSH K and HOLE R. Nursing Inquiry 2011; 18: 325–335 A discursive exploration of the practices that shape and discipline nurses’ responses to postoperative deliriumAlthough delirium is classified as a medical emergency, it is often not treated as such by health care providers. The aim of this study was to critically examine, through a poststructural, Foucauldian concept of discourse, the language practices and discourses that shape and discipline nurses' care of older adults with postoperative delirium (POD) with a (...) purpose to question accepted nursing practice. The study was based on data collected from face‐to‐face, in‐depth, personal interviews with six nurses who work on an acute postoperative patient care unit. Five analytic readings of the data identified two prominent discourses at work in nursing practice which influenced the care of patients with POD. These were identified as discourses of legitimacy/illegitimacy and discourses of nursing work. Through the process of poststructural analysis it became evident that one overriding discourse – the biomedical/scientific discourse – served to direct, legitimize and govern all other discourses. The findings of this study have implications for nursing knowledge and practice, length of hospital stay and improved patient outcomes. This study builds on previous work and is the first study to conduct a discourse analysis illuminating nurses’ responses to POD through comparison with other acute medical emergencies from a poststructural perspective. (shrink)

Mix & Stir', this book's aim is an endeavour to understand art as being a panhuman phenomenon of all times and cultures; to steer away from the persistent Eurocentric/Western-centric viewpoint towards a transcultural and transnational interconnected model of exchange and processes of interculturalization. Mix & Stir wants to expand this landscape by bringing to the fore new, recalcitrant, queer, idiosyncratic practices and discourses, theories and topics, methods and concerns that open up ways to approach art from a global perspective. Analogous (...) to a cookery book filled with recipes and instruction, Mix & Stir explores new outlooks on contemporary art from global perspectives. It intends to encourage studying art beyond national constraints, cultural dominances, and hierarchies: a voyage similar to that of culinary discovery. The book brings a variety of tastes and flavours to the table, and breaks new ground by allowing innovative, contrary, queer, idiosyncratic practices and discourses, theories and topics, methods, and concerns to access art in its global dimensions. Researchers, curators and artists with a special interest in this topical issue were invited to present, develop, outline, and contemplate compelling frames of reference, both theoretical and artistic, in order to arrive at a true 'world art studies'. Their contributions are structured in seven thematic fields: Undecidability and Spectatorship, Collectives, Circulations, Exhibitions, Artists at Work, Postcolonial Perspectives, and Deep Art History. The reader is invited to explore the vast supply of dishes, to taste and test the aromas and to feast. (shrink)

Wie müssen wir zurückschauen, um Was sehen zu können und darüber unseren Blick für das Gegenwärtige und Kommende zu schärfen?0Die Beiträge des Bandes, der zu Ehren von Sigrid Schade erscheint, beziehen sich auf vielschichtige Diskursgeschichten an den Schnittstellen von Kunst-, Kultur- und Medienwissenschaften. Sie beleuchten künstlerische, kulturelle und soziale Praktiken und Ordnungen als Aushandlungsort komplexer Bedeutungs- und Beziehungsgefüge.

This article investigates a multiparty interaction in an accounting office by applying a multimodal approach to discourse. This approach allows the incorporation of all relevant communicative modes and is based on the following three notions: 1) the notion of mediated action; 2) the notion of modal density; and 3) the notion of a foreground– background continuum of attention/awareness. The article illustrates that a social actor in a multiparty interaction simultaneously co-constructs several higher-level actions with the various participants on different levels (...) of their attention/awareness. On a theoretical level, the article argues that traditional approaches to discourse analysis, with their unconditional focus on language as the primary mode, misconstrue the multiple higher-level actions that a social actor is engaged in simultaneously as dyadic or triadic interactions in quick succession. (shrink)

A semantics for interrogatives is presented which is based on Karttunen's theory, but in a flexible manner incorporates both weak and strong exhaustivity. The paper starts out by considering degree questions, which often require an answer picking out the maximal degree from a certain set. However, in some cases, depending on the semantic properties of the question predicate, reference to the minimal degree is required, or neither specifying the maximum nor the minimum is sufficient. What is needed is an operation (...) which defines the maximally informative answer on the basis of the Karttunen question denotation. Shifting attention to non-degree questions, two notions of answerhood are adopted from work by Heim. The first of these is weakly exhaustive and the second strongly exhaustive. The second notion of answerhood is proven to be equivalent to Groenendijk and Stokhof's interrogative semantics. On the basis of a wide range of empirical data showing that questions often are not interpreted exhaustively, it is argued that a fairly rich system of semantic objects associated with questions is needed to account for the various ways in which questions contribute to the semantics and pragmatics of the utterances in which they appear. (shrink)

An ‘Information Centre’ has recently been established by law which has the power to collect, collate and provide access to the medical information forall patients treated by the National Health Service in England, whether in hospitals or by General Practitioners. This so-called ‘care.data’ scheme has given rise to major and ongoing controversies. We will sketch the background of the scheme and look at the responses it has elicited from citizens and medical professionals. In Autumn 2013, NHS England set up a (...) care.data website where citizens could record their concerns regarding the collection of health-related data by the Information Centre. We have reviewed all the comments on this website up until June 2015. We have also analysed the readers’ comments on the coverage of the care.data scheme in one of the main national UK newspapers. When discussing the responses of citizens, we will make a distinction between the problems that citizens detect and the solutions they propose. The solutions that are being perceived as the most relevant ones can be summarized as follows: citizens wish to further the common good without being manipulated into doing it, while at the same time being safeguarded against various abuses. The issue of trust turns out to figure prominently. Our analysis of reactions to the scheme in no way pretends to be exhaustive, yet it provides various relevant insights into the concerns identified by citizens as well as medical professionals. These concerns, moreover, have a more general relevance in relation to other contexts of medical data-mining as well as biobank research. Our analysis also offers important pointers as to how those concerns might be addressed. (shrink)

The paper provides a semantic analysis of intervention effects in wh-questions. The interpretation component of the grammar derives uninterpretability, hence ungrammaticality, of the intervention data. In the system of compositional interpretation that I suggest, wh-phrases play the same role as focused phrases, introducing alternatives into the computation. Unlike focus, wh-phrases make no ordinary semantic contribution. An intervention effect occurs whenever a focus-sensitive operator other than the question operator tries to evaluate a constituent containing a wh-phrase. It is argued that this (...) approach can capture the universal as well as the crosslinguistically variable aspects of intervention effects, in a way that is superior to previous approaches. Further consequences concern other focus-related constructions: multiple focus data, NPI licensing, and alternative questions. (shrink)

The likely adverse effects of climate change call for political action. In this paper, we argue that the public reason framework—with its insistence on justifiability to all reasonable citizens, in spite of their profound disagreements—despite initial misgivings recommends itself as a framework for debate and decisions pertaining to climate change. We address two possible stumbling blocks: the exclusion of non-anthropocentric points of view, and the controversy over intergenerational justice. We argue that public reason can deal with these problems. Moreover, we (...) argue that both strongly idealized and moderately idealized versions are able to address these issues. Moreover, public reason, as a family of views emphasizing disagreement and justifiability to all reasonable citizens, can help secure the stability of political orders, and hence contribute to sustained and demanding efforts to combat the adverse effects of climate change. (shrink)

Management of the renewable natural resources in Madagascar is gradually being transferred to the local communities, particularly that of forest resources. However, these local communities are struggling to assess the consequences of management plans that they themselves must develop and implement on ecologically, economically and socially sustainable grounds. In order to highlight key aspects of different management options beforehand, we have developed MIRANA, a computer model to simulate various scenarios of management plan implementation. MIRANA differs from other simulation models by (...) not only taking into account individual practices and economic exchanges, but also by accounting for the applicable regulations. These regulations are taken into consideration by means of a multiplicity of normative structures within a spatial context. The objective of this paper is to describe the representations of institutions, norms and territories proposed by MIRANA and to discuss these representations in relation to the state of the art in the field of normative multi-agent systems. (shrink)

Research regarding the drivers of acceptance of clinical decision support systems by physicians is still rather limited. The literature that does exist, however, tends to focus on problems regarding the user-friendliness of CDSS. We have performed a thematic analysis of 24 interviews with physicians concerning specific clinical case vignettes, in order to explore their underlying opinions and attitudes regarding the introduction of CDSS in clinical practice, to allow a more in-depth analysis of factors underlying acceptance of CDSS. We identified three (...) general themes from the results. First, ‘the perceived role of the AI’, including items referring to the tasks that may properly be assigned to the CDSS according to the respondents. Second, ‘the perceived role of the physician’, referring to the aspects of clinical practice that were seen as being fundamentally ‘human’ or non-automatable. Third, ‘concerns regarding AI’, including items referring to more general issues that were raised by the respondents regarding the introduction of CDSS in general and/or in clinical medicine in particular. Apart from the overall concerns expressed by the respondents regarding user-friendliness, we will explain how our results indicate that our respondents were primarily occupied by distinguishing between parts of their job that should be automated and aspects that should be kept in human hands. We refer to this distinction as ‘the division of clinical labor.’ This division is not based on knowledge regarding AI or medicine, but rather on which parts of a physician’s job were seen by the respondents as being central to who they are as physicians and as human beings. Often the respondents’ view that certain core parts of their job ought to be shielded from automation was closely linked to claims concerning the uniqueness of medicine as a domain. Finally, although almost all respondents claimed that they highly value their final responsibility, a closer investigation of this concept suggests that their view of ‘final responsibility’ was not that demanding after all. (shrink)

(1) a. Satoshi sent Thilo the Schw¨abische W¨orterbuch. b. Satoshi sent the Schw¨abische W¨orterbuch to Thilo. Many have entertained the notion that there is a rule that relates sentences such as these. This is suggested by the fact that it is possible to learn that a newly coined verb licenses one of them and automatically know that it licenses the other. Marantz (1984) argues for the existence of such a rule in this way, noting that once one has learned of (...) the new verb shin by exposure to (2a), the grammaticality of (2b) is also learned. (2) a. Thilo shinned the ball to Satoshi. b. Thilo shinned Satoshi the ball. This is explained if there is a rule that ties the double object frame together with the NP+PP frame, making it sufficient to know that a verb licenses one if it licenses the other. Frequently, the rule involved has been taken to be syntactic in nature. See, among many others, Fillmore (1965), Oehrle (1976), Baker (1988), and Larson (1988). The leading idea under this view is that the two frames are simply different surface manifestations of the same underlying structure. Typically, this approach posits that the NP+PP frame represents that underlying structure from which the double object frame is transformationally derived. There is evidence, however, that the two frames instead have different underlying structures, and are not related by transformation. This evidence, then. (shrink)

Helen Steward argues that determinism is incompatible with agency itself--not only the special human variety of agency, but also powers which can be accorded to animal agents. She offers a distinctive, non-dualistic version of libertarianism, rooted in a conception of what biological forms of organisation might make possible in the way of freedom.

This chapter considers the ways in which whiteness as a skin color and ideology becomes a dominant level that sets the background against which all things, people and relations appear. Drawing on Merleau-Ponty's phenomenology, it takes up a series of films by Bruce Nauman and Marlon Riggs to consider ways in which this level is phenomenally challenged providing insights into the embodiment of racialization.

In this paper I argue for a restriction on certain types of LF movement, which I call ‘wh-related LF movement’. Evidence comes from a number of wh-in-situ constructions in German, such as the scope-marking construction and multiple questions. For semantic reasons, the in situ element in those constructions has to move at LF to either a position reserved for wh-phrases, or even higher up in the structure. The restriction (the Minimal Quantified Structure Constraint, MQSC) is that an intervening quantified expression (...) blocks this movement. In the case of every, the MQSC leads to an unambiguously distributive interpretation of the question. In the case of all other intervening operators, including negation, it leads to ungrammaticality. (shrink)

This paper proposes that elementary reciprocal sentences have four semantic readings: a strongly reciprocal interpretation, a weakly reciprocal interpretation, a situation-based weakly reciprocal reading, and a collective reading. Interpretational possibilities of reciprocal sentences that have been discussed in the literature are identified as one of these four. A compositional semantic analysis of all of these readings is provided in which the reciprocal expression is uniformly represented as 'the other ones among them' (recasting Heim, Lasnik and May 1991a, b). A reciprocal (...) sentence is thus a special kind of relational plural. Interpretational variability comes about by the same mechanisms of plural predication at work in relational plurals: pluralization operators, LF operations like QR, and addition of contextual information. (shrink)

We expand on Della Croce’s ambition to interpret “epistemic injustice” as a specification of non-maleficence in the use of the influential four-principle framework. This is an alluring line of thought for conceptual, moral, and heuristic reasons. Although it is commendable, Della Croce’s attempt remains tentative. So does our critique of it. Yet, we take on the challenge to critically address two interrelated points. First, we broaden the analysis to include deliberations about hermeneutical injustice. We argue that, if due consideration of (...) epistemic injustice is to require more than negative ethical obligations in medicine, dimensions of hermeneutical injustice should be explored as an avenue to arrive at such positive duties. Second, and relatedly, we argue that this may encompass moral responsibilities beyond the individual level, that is: positive obligations to take action on a structural level. Building on Dotson’s concept of “contributory injustice” and Scheman’s concept of “perceptual autonomy,” we suggest that the virtues of testimonial and hermeneutical justice may provide additional content not only to negative prohibitions of action (i.e. non-maleficence) but also to positive requirements of action, like respecting patient autonomy. (shrink)

The role of physicians in armed conflict -- International humanitarian law -- International criminal law -- Customary status of international humanitarian law -- The relevant human rights norms applicable to the work of physicians in armed conflict -- The interpretation of the reference to medical ethics and generally accepted medical standards pursuant to the Vienna Convention on the Law of Treaties -- Medical ethics in international law -- A pluralistic approach to medical ethics -- The documents by the World Medical (...) Association (WMA) -- Conclusion, recommendations and outlook. (shrink)

Since the adoption of the WTO-TRIPS Agreement in 1994, there has been significant controversy over the impact of pharmaceutical patent protection on the access to medicines in the developing world. In addition to the market exclusivity provided by patents, the pharmaceutical industry has also sought to further extend their monopolies by advocating the need for additional ‘regulatory’ protection for new medicines, known as data exclusivity. Data exclusivity limits the use of clinical trial data that need to be submitted to the (...) regulatory authorities before a new drug can enter the market. For a specified period, generic competitors cannot apply for regulatory approval for equivalent drugs relying on the originator's data. As a consequence, data exclusivity lengthens the monopoly for the original drug, impairing the availability of generic drugs. This article illustrates how the pharmaceutical industry has convinced the US and the EU to impose data exclusivity on their trade partners, many of them developing countries. The key arguments formulated by the pharmaceutical industry in favor of adopting data exclusivity and their underlying ethical assumptions are described in this article, analyzed, and found to be unconvincing. Contrary to industry's arguments, it is unlikely that data exclusivity will promote innovation, especially in developing countries. Moreover, the industry's appeal to a property rights claim over clinical test data and the idea that data exclusivity can prevent the generic competitors from ‘free-riding’ encounters some important problems: Neither legitimize excluding all others. (shrink)

This paper investigates the semantics of adverbials like ‘page by page’ and ‘stone upon stone’. An analysis is developed in which sentences containing such adverbials have a pluractional semantics; that is, pluralization affects simultaneously the event- and the individual-argument slot of a predicate. Sternefeld's system of plural operators is used and extended for this purpose. The adverbial constrains the relation that is pluralized and makes visible a higher plural operator. In the case of ‘page by page’-type adverbials, this is a (...) fairly standard operator that leads to a simple divisional interpretation. In the case of ‘stone upon stone’-type adverbials, the operator has a stronger semantics that leads to a sequence interpretation. The generality of our theory permits straightforward extension to data like ‘she ran and ran’ and ‘she climbed higher and higher’, among others. Finally we propose that inclusive alternative ordering reciprocals have a pluractional sequence interpretation as well. (shrink)

An extensive body of research documents that women experience a motherhood penalty at work whereas men experience a fatherhood premium. Yet much of this work presupposes that employers are aware of a worker’s parental status. Given the different consequences that parenthood has on outcomes such as pay and promotions, it is conceivable that men and women may deploy their status as parents differently when interacting with employers. Drawing on in-depth interviews with a racially diverse sample, this article examines how mothers (...) and fathers working in the service sector use their parental status when negotiating work and child care responsibilities. Mothers, particularly black mothers, were less likely to openly discuss their children at work. In some cases, women purposefully concealed from their employers the fact that they were mothers or found other ways of signaling their commitment to their jobs. Fathers, on the other hand, were more likely to discuss their children with their employers and overwhelmingly characterized their managers as understanding of their parenting obligations. Together, these findings help us understand how mothers and fathers navigate the consequences of parenthood in the workplace and add nuance to previous studies of motherhood penalties and fatherhood premiums. (shrink)

The semantic literature takes degree operators like the comparative, but also measure phrases, the equative, the superlative and so on, to be quantifiers over degrees. This is well motivated by their semantic contribution, but leads one to expect far more scope interaction than is actually observed. This paper proposes an alternative-semantic analysis of certain degree constructions, in particular constructions with little and other negative antonyms. Restrictions on scope can then be explained as intervention effects.

Considéré de nos jours comme l’un des principaux représentants de la phénoménologie expérimentale, le psychologue Albert Michotte n’a adopté que sur le tard le terme de « phénoménologie expérimentale » pour qualifier sa démarche. Dans cet article, j’étudie l’usage qu’il fait de cette dénomination, les implications de ce choix ainsi que l’interprétation qu’il en a donnée. Je montre, notamment, comment une discussion entre Michotte et le traducteur anglais de son livre, Tim R. Miles, a été importante pour déterminer l’orientation de (...) la seule présentation explicite que Michotte a publiée de sa phénoménologie expérimentale. L’étude des différents rôles que ce terme a été amené à jouer dans l’œuvre de Michotte montre également les problèmes soulevés par la communication entre différentes disciplines et écoles psychologiques dans lesquelles ce concept a été à la fois employé et débattu : cette communication demandait un véritable travail de traduction. (shrink)

Considéré de nos jours comme l’un des principaux représentants de la phénoménologie expérimentale, le psychologue Albert Michotte (1881-1965) n’a adopté que sur le tard le terme de « phénoménologie expérimentale » pour qualifier sa démarche. Dans cet article, j’étudie l’usage qu’il fait de cette dénomination, les implications de ce choix ainsi que l’interprétation qu’il en a donnée. Je montre, notamment, comment une discussion entre Michotte et le traducteur anglais de son livre, Tim R. Miles, a été importante pour déterminer l’orientation (...) de la seule présentation explicite que Michotte a publiée de sa phénoménologie expérimentale. L’étude des différents rôles que ce terme a été amené à jouer dans l’œuvre de Michotte montre également les problèmes soulevés par la communication entre différentes disciplines (la philosophie et la psychologie expérimentale) et écoles psychologiques dans lesquelles ce concept a été à la fois employé et débattu : cette communication demandait un véritable travail de traduction. (shrink)

Continuous sedation until death is an increasingly common practice in end-of-life care. However, it raises numerous medical, ethical, emotional and legal concerns, such as the reducing or removing of consciousness, the withholding of artificial nutrition and hydration, the proportionality of the sedation to the symptoms, its adequacy in actually relieving symptoms rather than simply giving onlookers the impression that the patient is undergoing a painless 'natural' death, and the perception that it may be functionally equivalent to euthanasia. This book brings (...) together contributions from clinicians, ethicists, lawyers and social scientists, and discusses guidelines as well as clinical, emotional and legal aspects of the practice. The chapters shine a critical spotlight on areas of concern and on the validity of the justifications given for the practice, including in particular the doctrine of double effect. (shrink)

More than a third of the world's population has no access to essential drugs. More than half of this group of people live in the poorest regions of Africa and Asia. Several factors determine the accessibility of drugs in developing countries. Hardly any medicines for tropical diseases are being developed, but even existing drugs are often not available to the patients who need them.One of the important determinants of access to drugs is the working of the patent system. This paper (...) first maps out some facts about the global patent regime that has emerged as a consequence of the conclusion of the WTO‐TRIPs Agreement in 1994. Attempts to construct a moral justification of the patent system have been based on three grounds: natural rights, distributive justice, and utilitarian arguments. This paper examines to what extent and on which grounds drug patents can be justified. The final section looks at the so‐called ‘Doha Declaration on the TRIPs Agreement and Public Health’, which was adopted by the WTO Ministerial Conference two years ago, recognising the primacy of public health over the interests of patent proprietors. (shrink)

The paper develops a uniform compositional analysis of the various readings of the scalar particle still and its German counterpart noch. Noch/still is a presuppositional scalar particle that gives rise to implicatures. Interpretive possibilities arise through different choices for the scale that the particle associates with, different attachment sites in the syntax, and interaction with focus. These interpretive parameters allow for a wide range of possible sentence interpretations, which overlap, but do not coincide for still and noch. The contrastive perspective (...) allows us to examine the role of scales in the grammar. The implicatures triggered by the scalar item open an interesting perspective for the generation of implicatures in general. (shrink)

This paper develops a semantic analysis of data like It is getting colder and colder. Their meaning is argued to arise from a combination of a comparative with pluractionality. The analysis is embedded in a general theory of plural predication and pluractionality. It supports a semantic theory involving a family of syntactic plural operators.