Using data obtained during a retrospective interview study of 30 women who had undergone genetic testing—BRCA1/2mutation searching—this paper describes how women, previously diagnosed with breast/ovarian cancer, perceive their role in generating genetic information about themselves and their families. It observes that when describing their motivations for undergoing DNA testing and their experiences of disclosing genetic information within the family these women provide care based ethical justifications for their actions. Finally, it argues that generating genetic information and disclosing this information to (...) kin raise different types of ethical issues. The implications of these findings for ethical debates about informed choice in the context of genetic testing are discussed. (shrink)

Fictional realists hold that fictional characters are real entities. However, Anthony Everett [“Against Fictional Realism”, Journal of Philosophy (2005)] notes that some fictions leave it indeterminate whether character A is identical to character B, while other fictions depict A as simultaneously identical and distinct from B. Everett argues that these fictions commit the realist to indeterminate and impossible identity relations among actual entities, and that as such realism is untenable. This paper defends fictional realism: for fictions depicting non-classical identity between (...) A and B, the realist should hold that there are two salient fragments, one with a single character (named both ‘A’ and ‘B’) and the other with two (named ‘A’ and ‘B’, respectively). Truth according to the fiction depicting indeterminate identity is determined by supervaluating over truth according to those salient fragments. For fictions depicting impossible identity, truth is determined by subvaluating over truth according to those two salient fragments. (shrink)

Infinitism is often presented as a rival to foundationalism and coherentism as available answers to the epistemic regress problem. The most prominent contemporary defense of infinitism, due to Peter Klein, rests on the notion that an agent can perpetually amplify the justification for her belief insofar as they are able to iteratively answer an interlocutor’s questions why the proffered grounds for their belief should count as providing justification for that belief. We show that this argument does not offer any basis (...) for preferring infinitism over foundationalism and coherentism, because those views are able to accommodate the insight that justification for a belief can be continually amplified. Klein’s argument for infinitism thus falls short of its aspirations of proving that infinitism qua rival of foundationalism and coherentism is the most credible solution to the epistemic regress problem. (shrink)

Libertarian theories of freedom and responsibility face a worry about luck: if an action is undetermined, the action cannot be legitimately attributed to the agent; instead the action is a matter of luck, and so the agent is not responsible for the action. Robert Kane defends libertarianism by appealing to self-forming actions. These actions are undetermined because the agent is attempting to act on two conflicting motives, but the agent is responsible for the outcome if she is responsible for having (...) those motives. If the agent “endorsed” both motives in earlier SFAs, Kane argues that we can hold the agent responsible for both motives, and hence responsible for the later SFA. We will further develop others’ arguments that Kane’s appeal to earlier SFAs to explain responsibility for a later SFA is unsatisfactory. We then raise a second objection to Kane’s use of SFAs. On one formulation of an SFA, the agent does three things: she exerts two efforts of will to make opposing choices, and she also acts on one of them. On another formulation of an SFA, the agent does just two things: she exerts two efforts of will to make opposing choices. One of those efforts turns out to be successful, but that success doesn’t require any further intervention from the agent. We distinguish two worries involving luck, a problem of resultant luck and a problem of constitutive luck, and show that neither model of SFAs solves both problems. (shrink)

The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Children and young people -- Confidentiality -- Health records -- Contraception, abortion, and birth -- Assisted reproduction -- Genetics -- Caring for patients at the end of life -- Euthanasia and physician assisted suicide -- Responsibilities after a patient's death -- Prescribing and administering medication -- Research and innovative treatment -- Emergency situations -- Doctors with dual obligations -- Providing treatment and (...) care in detention settings -- Education and training -- Teamwork, referral, delegation, and shared care -- Public health dimensions of medical practice -- Reducing risk, clinical error, and poor performance. (shrink)

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

Names are rigid designators, but what kind of rigidity do they exhibit? Both “obstinately” and “persistently” rigid designators pick out O at every world at which they pick out anything at all. They differ in that obstinately rigid designators also pick out O at worlds at which O fails to exist; persistently rigid designators have no extension whatsoever at worlds at which O fails to exist. The question whether names are obstinate or persistent arises in two contexts: in arguments against (...) rigidified descriptivism (on the grounds that names and rigidified descriptions exhibit different kinds of rigidity) and in considerations about what it means for an expression to be “directly referential.” This paper contends that names are persistent, not obstinate. The position thus clarifies the relationship between Millian theories of names and rigid designation, in addition to undermining attempts to rehabilitate the modal argument against rigidified descriptivism. (shrink)

For those who endorse Millianism and take ‘Sherlock Holmes’ to be an empty name, the sentence ‘Sherlock Holmes is clever’ may not count as expressing a complete proposition. The sentence ‘According to the fiction, Sherlock Holmes is clever’, however, should count as expressing a true proposition. I attempt to reconcile these two intuitions by arguing that ‘According to the fiction’ is a two-dimensional operator: to evaluate a statement of the form ‘According to the fiction, S’ at world @ (where @ (...) is also taken to be the actual world), we evaluate S at the world of the fiction (where the fiction is also taken to be the actual world). (shrink)

We pose two arguments for the view that sentences containing definite descriptions semantically express multiple propositions: a general proposition as Russell suggested, and a singular proposition featuring the individual who uniquely satisfies the description at the world-time of utterance. One argument mirrors David Kaplan's arguments that indexicals express singular propositions through a context-sensitive character. The second argument mirrors Kent Bach's and Stephen Neale's arguments for pluralist views about terms putatively triggering conventional implicatures, appositive, and nonrestrictive relative clauses. After presenting these (...) arguments, we show that rival explanations (appeals to implicature, referential use, presupposition, etc.) do not offer equally compelling explanations of the data, and defend the methodology employed in the arguments against some criticisms. (shrink)

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

Body representations are known to be dynamically modulated or extended through tool use. Here, we review findings that demonstrate the importance of a user's tool experience or expertise for successful tool embodiment. Examining expert tool users, such as individuals who use tools in professional sports, people who use chopsticks at every meal, or spinal injury patients who use a wheelchair daily, offers new insights into the role of expertise in tool embodiment: Not only does tool embodiment differ between novices and (...) experts, but experts may experience enhanced changes to their body representation when interacting with their own, personal tool. The findings reviewed herein reveal the importance of assessing tool skill in future studies of tool embodiment. (shrink)

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were (...) collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (21.3%), (...) Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision‐making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

Husserlian phenomenology of time, as it is developed on theLectures on the Phenomenology of Inner Time Consciousness, shows some difficulties to explain certain temporal experiences. This is the case of the incompatibility between the rigidity of the retentional modification and the effective approach that a subject may have with his memories. On the one hand, according to the Lectures’ explanation, the darkening of the past occurs in an homogeneous way: The more distant an experience is, the lower the clarity of (...) the associated retention. However, our relation with the past is not so direct. Complementing the studies of the Lectureswith those of the Analysis concerning passive synthesiscould allow to explain this kind of temporal phenomena. (shrink)

RESUMEN Aunque las Lecciones de fenomenología de la conciencia interna del tiempo tienen pocas referencias al marco metódico, ciertos pasajes apuntan a la reducción fenomenológica, de modo que su status se diferenciaría del de las Investigaciones lógicas y se acercaría al de Ideas i. Se ha señalado que aun si la reducción es empleada en este texto, no lo sería en su "versión madura". Se busca determinar el estatus metodológico de las Lecciones a partir de una comparación entre los desarrollos (...) metódicos y las descripciones fenomenológicas que se presentan allí y aquellos consignados en Investigaciones e Ideas, teniendo como idea regulativa el esclarecimiento del papel del tiempo en la ampliación del dominio de la fenomenología como conjunto. ABSTRACT Although there are few references to the methodological framework in On the Phenomenology of the Consciousness of Internal Time, certain passages point to the phenomenological reduction. Therefore, its status would differ from that of the Logical Investigations and approach that of Ideas I. Some have argued that the reduction used in this text is not the "mature version" of the same. The article seeks to determine the methodological status of PCIT on the basis of the comparison between the methodological developments and phenomenological descriptions found in this work and those found in Investigations and Ideas. The regulative idea guiding the analysis is the clarification of the role of time in broadening the sphere of phenomenology as a whole. (shrink)

Este trabajo examina diferentes perspectivas docentes para externalizar criterios de evaluación. Se presentan hallazgos de una investigación doctoral que abordan, por una parte, una metodología analítica, que cautela la claridad y transparencia en la comunicación de criterios, segmentando la meta de aprendizaje en pequeñas secuencias, transmitiendo de este modo una idea atomizada acerca del conocimiento. Por otra parte, se explora una visión más holística, sustentada en la interdependencia de los criterios de evaluación, favoreciendo la comprensión del propósito de la tarea (...) en su conjunto. Se analiza la significancia de estos enfoques para la retroalimentación y evaluación formativa. (shrink)

We contribute to feminist and gender scholarship on cultural notions of motherhood by analyzing the importance of motherhood among mothers and non-mothers. Using a national probability sample of U.S. women ages 25-45, we find a continuous distribution of scores measuring perceptions of the importance of motherhood among both groups. Employing OLS multiple regression, we examine why some women place more importance on motherhood, focusing on interests that could compete with valuing motherhood, and controlling for characteristics associated with becoming a mother. (...) Contrary to cultural schemas that view mother and worker identities as competing, we find that education level is not associated with the importance of motherhood for either group and that valuing work success is positively associated with valuing motherhood among mothers. Consistent with feminist explanations for delayed fertility, valuing leisure is negatively associated with valuing motherhood for non-mothers. (shrink)

El canon literario implica un proceso de selección sistemático y jerárquico de escritores, obras y géneros con el fin de delimitar un corpus modélico imitableligado fuertemente a la instrucción pedagógica. En el presente trabajo se analizará el particular proceso de formación y conformación del canon –así como surecepción y transformación respecto de los cánones previos– establecido por Quintiliano en el Libro 10 de la Institutio Oratoria, a fin de demostrar que los criterios de selección que guían dicho canon exceden la (...) mera función didáctica. (shrink)

The article discusses a relatively obscure but significant aspect of work of the Russian and Soviet thinker Alexander Bogdanov—his science fiction novels. The author points out that, using the form...

En este trabajo presentamos el proceso del ordenamiento, catalogación y curaduría de los materiales fotográficos de un antropólogo estadounidense que realizó trabajo de campo en Atlixco, Puebla, México, con indígenas de la etnia nahua en las décadas de 1970 y 1980La metodología utilizada para este trabajo se basó en una propuesta propia de catalogación mínima de materiales fotográficos.Concluimos que la catalogación mínima es adecuada para la interoperabilidad con los estándares internacionales y resulta fácil de aplicar en los contextos universitarios y (...) de archivos locales. (shrink)

O objetivo deste artigo é apresentar uma argumentação sobre a possibilidade de se pensar a justiça como uma experiência do i m possível. Parte-se da distinção derridiana entre justiça e direito. Essa distinção trará algumas implicações no que tradicionalmente é entendido como ética. Partindo do jogo ou da différance marcada entre a presença/ausência, pretende-se estabelecer um ponto de diálogo entre Derrida e Levinas. O ponto de aproximação é a questão do terceiro na relação do face a face. Nesse sentido, problematiza-se (...) se a desconstrução pode ser adotada como um possível modo filosófico que fundamente a compreensão da justiça. (shrink)

Offers a historical-cultural context for the ethos of service in libraries and critically examines this professional value as it intersects with gender, sexuality, race and ethnicity, class, and (dis)ability"--Provided by publisher.

It is commonly thought that that the best system account of lawhood ((Mill (1843), Ramsey (1978)[fp. 1928], Lewis (1973)) makes available a nice explanation for why laws are ‘distinctively appropriate targets of scientific inquiry’ (Hall, 2015). The explanation takes the following general form: laws are especially valuable for agents like us because they efficiently encode a lot of valuable (non-nomic) information in a tractable format. The goal of this paper is to challenge this style of explanation: I argue that the (...) general principle it presupposes is in conflict with our best account of practical rationality. After considering and rejecting a number of proposals for dissolving the tension, I conclude that BSA proponents may need to scale back the explanatory ambitions of their theory; in particular, they may need to give up the hope of non-circular explanations of the value of nomic information. I end by outlining some challenges for the humean world-view that results after this shift. (shrink)

Abstract:Brain–computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition (...) to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS. (shrink)

It’s relatively easy to say that the debates about whether trans and intersex women athletes deserve full and equal inclusion in women’s sport is a contentious contemporary issue. I’ve already argued for the legal, ethical, and scientific basis for full and equal inclusion of trans and intersex women in women’s sport. In this paper, I want to analyze what I take to be a representative selection of recent arguments against full and equal inclusion of trans and intersex women in women’s (...) sport. In short, these arguments tend to be based on mere assumption, unsupported “common sense,” straw arguments, fallacious question begging, and a number of hypotheticals and unsupported counterfactuals rather than established fact. Essentially, they’re based on a lot of “ifs.”. (shrink)

The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...) embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full. (shrink)

Machine generated contents note: Chapter 1 -- The Prison of the Known -- Chapter 2 -- Can We Live without Conflict? -- Chapter 3 -- The Meaning of Dialogue -- Chapter 4 -- Practice and Solidarity: We Are the World -- Chapter 5 -- Science and the Religious Mind -- Chapter 6 -- A Call for Active Being: Being at Home in the World.

We live in dangerous times, ruled by the imperatives of what Hannah Arendt calls “the catastrophic interiority of the selfish I” 1 which threatens the planet and the survival of humanity. But I believe, nevertheless, that it is possible to reinvent the world since, by and large, it is evident that its shape reflects our notions of reality and value, the way we weave together the various strands of existence. Antonio Gramsci may have had something like this in mind when (...) he wrote that it is only by “the conquest of greater consciousness” that we will be able to bring a different kind of culture into being because, “man is above all spirit,” a creature, that is, with imagina- tion, the ability to reconfigure the way we see ourselves and the world. Just as importantly, he argues that this may mean returning to some things we once knew but have now forgotten or ignored. Poetry or, to be more accurate, poetic ways of seeing, may be one of these things, to the extent that it generates ways of seeing beyond the merely rational. In this essay I therefore want to explore the work of Judith Wright and the ways in which it explores the possibilities of being ‘true to the earth’. 2. (shrink)