Introduction: Evidence supporting the use of music interventions to maximize arousal and awareness in adults presenting with a disorder of consciousness continues to grow. However, the brain of a child is not simply a small adult brain, and therefore adult theories are not directly translatable to the pediatric population. The present study aims to synthesize brain imaging data about the neural processing of music in children aged 0-18 years, to form a theoretical basis for music interventions with children presenting with (...) a disorder of consciousness following acquired brain injury.Methods: We conducted a systematic review with narrative synthesis utilizing an adaptation of the methodology developed by Popay and colleagues. Following the development of the narrative that answered the central question “what does brain imaging data reveal about the receptive processing of music in children?”, discussion was centered around the clinical implications of music therapy with children following acquired brain injury.Results: The narrative synthesis included 46 studies that utilized EEG, MEG, fMRI, and fNIRS scanning techniques in children aged 0-18 years. From birth, musical stimuli elicit distinct but immature electrical responses, with components of the auditory evoked response having longer latencies and variable amplitudes compared to their adult counterparts. Hemodynamic responses are observed throughout cortical and subcortical structures however cortical immaturity impacts musical processing and the localization of function in infants and young children. The processing of complex musical stimuli continues to mature into late adolescence.Conclusion: While the ability to process fundamental musical elements is present from birth, infants and children process music more slowly and utilize different cortical areas compared to adults. Brain injury in childhood occurs in a period of rapid development and the ability to process music following brain injury will likely depend on pre-morbid musical processing. Further, a significant brain injury may disrupt the developmental trajectory of complex music processing. However, complex music processing may emerge earlier than comparative language processing, and occur throughout a more global circuitry. (shrink)

We report the identification of a recurrent, 520-kb 16p12.1 microdeletion associated with childhood developmental delay. The microdeletion was detected in 20 of 11,873 cases compared with 2 of 8,540 controls and replicated in a second series of 22 of 9,254 cases compared with 6 of 6,299 controls. Most deletions were inherited, with carrier parents likely to manifest neuropsychiatric phenotypes compared to non-carrier parents. Probands were more likely to carry an additional large copy-number variant when compared to matched controls. The clinical (...) features of individuals with two mutations were distinct from and/or more severe than those of individuals carrying only the co-occurring mutation. Our data support a two-hit model in which the 16p12.1 microdeletion both predisposes to neuropsychiatric phenotypes as a single event and exacerbates neurodevelopmental phenotypes in association with other large deletions or duplications. Analysis of other microdeletions with variable expressivity indicates that this two-hit model might be more generally applicable to neuropsychiatric disease. © 2010 Nature America, Inc. All rights reserved. (shrink)

Maximize Expected Choiceworthiness (MEC) is a theory of decision-making under moral uncertainty. It says that we ought to handle moral uncertainty in the way that Expected Value Theory (EVT) handles descriptive uncertainty. MEC inherits from EVT the problem of fanaticism. Roughly, a decision theory is fanatical when it requires our decision-making to be dominated by low-probability, high-payoff options. Proponents of MEC have offered two main lines of response. The first is that MEC should simply import whatever are the best solutions (...) to fanaticism on offer in decision theory. The second is to propose statistical normalization as a novel solution on behalf of MEC. This paper argues that the first response is open to serious doubt and that the second response fails. As a result, MEC appears significantly less plausible when compared to competing accounts of decision-making under moral uncertainty, which are not fanatical. (shrink)

We invoke the ideal of tolerance in response to conflict, but what does it mean to answer conflict with a call for tolerance? Is tolerance a way of resolving conflicts or a means of sustaining them? Does it transform conflicts into productive tensions, or does it perpetuate underlying power relations? To what extent does tolerance hide its involvement with power and act as a form of depoliticization? Wendy Brown and Rainer Forst debate the uses and misuses of tolerance, an (...) exchange that highlights the fundamental differences in their critical practice despite a number of political similarities. Both scholars address the normative premises, limits, and political implications of various conceptions of tolerance. Brown offers a genealogical critique of contemporary discourses on tolerance in Western liberal societies, focusing on their inherent ties to colonialism and imperialism, and Forst reconstructs an intellectual history of tolerance that attempts to redeem its political virtue in democratic societies. Brown and Forst work from different perspectives and traditions, yet they each remain wary of the subjection and abnegation embodied in toleration discourses, among other issues. The result is a dialogue rich in critical and conceptual reflections on power, justice, discourse, rationality, and identity. (shrink)

According to comparativist theories of quantities, their intrinsic values are not fundamental. Instead, all the quantity facts are grounded in scale-independent relations like "twice as massive as" or "more massive than." I show that this sort of scale independence is best understood as a sort of metaphysical symmetry--a principle about which transformations of the non-fundamental ontology leave the fundamental ontology unchanged. Determinism--a core scientific concept easily formulated in absolutist terms--is more difficult for the comparativist to define. After settling on the (...) most plausible comparativist understanding of determinism, I offer some examples of physical systems that the comparativist must count as indeterministic although the relevant physical theory gives deterministic predictions. Several morals are drawn. In particular: comparativism is metaphysically contingent if true, and it is most natural for a comparativist to accept an at-at theory of motion. (shrink)

I argue against pessimistic readings of the Buddhist tradition on which unawakened beings invariably have lives not worth living due to a preponderance of suffering (duḥkha) over well-being.

The desire to minimize the number of individual new entities postulated is often referred to as quantitative parsimony. Its influence on the default hypotheses formulated by scientists seems undeniable. I argue that there is a wide class of cases for which the preference for quantitatively parsimonious hypotheses is demonstrably rational. The justification, in a nutshell, is that such hypotheses have greater explanatory power than less parsimonious alternatives. My analysis is restricted to a class of cases I shall refer to as (...) additive. Such cases involve the postulation of a collection of qualitatively identical individual objects which collectively explain some particular observed phenomenon. Especially clear examples of this sort occur in particle physics. 1 Introduction 2 Particle physics: a case study 3 Three kinds of simplicity 4 Explanatory power 5 Explanation and non-observation 6 Parsimony and scientific methodology 7 Conclusions. (shrink)

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

Tolerance is generally regarded as an unqualified achievement of the modern West. Emerging in early modern Europe to defuse violent religious conflict and reduce persecution, tolerance today is hailed as a key to decreasing conflict across a wide range of other dividing lines-- cultural, racial, ethnic, and sexual. But, as political theorist Wendy Brown argues in Regulating Aversion, tolerance also has dark and troubling undercurrents. Dislike, disapproval, and regulation lurk at the heart of tolerance. To tolerate is not to (...) affirm but to conditionally allow what is unwanted or deviant. And, although presented as an alternative to violence, tolerance can play a part in justifying violence--dramatically so in the war in Iraq and the War on Terror. Wielded, especially since 9/11, as a way of distinguishing a civilized West from a barbaric Islam, tolerance is paradoxically underwriting Western imperialism. Brown's analysis of the history and contemporary life of tolerance reveals it in a startlingly unfamiliar guise. Heavy with norms and consolidating the dominance of the powerful, tolerance sustains the abjection of the tolerated and equates the intolerant with the barbaric. Examining the operation of tolerance in contexts as different as the War on Terror, campaigns for gay rights, and the Los Angeles Museum of Tolerance, Brown traces the operation of tolerance in contemporary struggles over identity, citizenship, and civilization. (shrink)

The Cambridge World History of Medical Ethics is the first comprehensive scholarly account of the global history of medical ethics. Offering original interpretations of the field by leading bioethicists and historians of medicine, it will serve as the essential point of departure for future scholarship in the field. The volumes reconceptualize the history of medical ethics through the creation of new categories, including the life cycle; discourses of religion, philosophy, and bioethics; and the relationship between medical ethics and the state, (...) which includes a historical reexamination of the ethics of apartheid, colonialism, communism, health policy, imperialism, militarism, Nazi medicine, Nazi "medical ethics," and research ethics. Also included are the first global chronology of persons and texts; the first concise biographies of major figures in medical ethics; and the first comprehensive bibliography of the history of medical ethics. An extensive index guides readers to topics, texts, and proper names. (shrink)

The American Medical Association enacted its Code of Ethics in 1847, the first such national codification. In this volume, a distinguished group of experts from the fields of medicine, bioethics, and history of medicine reflect on the development of medical ethics in the United States, using historical analyses as a springboard for discussions of the problems of the present, including what the editors call "a sense of moral crisis precipitated by the shift from a system of fee-for-service medicine to a (...) system of fee-for-system medicine, better known as 'managed care.'" The authors begin with a look at how the medical profession began to consider ethical issues in the 1800s and subsequent developments in the 1900s. They then address the sociological, historical, ethical, and legal aspects of the practice of medicine. Later chapters discuss current and future challenges to medical ethics and professional values. Appendixes display various versions of the AMA's Code of Ethics as it has evolved over time. Contributors: George J. Annas, J.D., M.P.H., Arthur Isak Applbaum, Ph.D., Robert B. Baker, Ph.D., Chester R. Burns, M.D., Ph.D., Arthur L. Caplan, Ph.D., Alexander Morgan Capron, J.D., Christine K. Cassel, M.D., Linda L. Emanuel, M.D., Ph.D., Eliot L. Freidson, Ph.D., Albert R. Jonsen, Ph.D., Stephen R. Latham, J.D., Ph.D., Susan E. Lederer, Ph.D., Florencia Luna, Ph.D., Edmund D. Pellegrino, M.D., Charles E. Rosenberg, Ph.D., Mark Siegler, M.D., Rosemary A. Stevens, Ph.D., Robert M. Tenery, Jr., M.D., Robert M. Veatch, Ph.D., John Harley Warner, Ph.D., Paul Root Wolpe, Ph.D. (shrink)

Neoliberalism and neoconservatism are two distinct political rationalities in the contemporary United States. They have few overlapping formal characteristics, and even appear contradictory in many respects. Yet they converge not only in the current presidential administration but also in their de-democratizing effects. Their respective devaluation of political liberty, equality, substantive citizenship, and the rule of law in favor of governance according to market criteria on the one side, and valorization of state power for putatively moral ends on the other, undermines (...) both the culture and institutions of constitutional democracy. Above all, the two rationalities work symbiotically to produce a subject relatively indifferent to veracity and accountability in government and to political freedom and equality among the citizenry. (shrink)

Critical Conversations in Philosophy of Education presents a series of conversations expressing many of the multiple voices that currently constitute the field of philosophy of education. Philosophy of education as a discipline has undergone several turns--the once marginal perspectives of the various feminisms, critical Marxism, and poststructuralist, postmodernist and cultural theory have gained ground alongside those of Anglo-analytic and pragmatic thought. Just as western philosophers in general are coming to terms with the "end of philosophy" pronouncement implicit in postmodernism, so (...) too are philosophers of education faced with similar challenges--challenges to long-held moral, political, aesthetic and epistemological commitments. The contributors take up these challenges through a dialogical structure, expressing differing positions without engaging in destructive critique. There is no intention to come to consensus; rather the point is to expand the number and kind of participating voices in the conversation and engage in a lively intellectual exchange that will insure the vitality of educational theorizing. (shrink)

In Sleeping with Extra-Terrestrials , Wendy Kaminer argues that we are a society intoxicated by the irrational: religion, spirituality, and popular therapies threaten to replace rational thought with supernaturalism and impassioned but unexamined personal testimony. Ranging from our fascination with angels, aliens, and near- death experiences to the rise of junk science, the recovery movement, and the digital culture, Kaminer points out the amusing and ominous effects of our deference to spiritual authorities and resistance to critical thinking. She questions (...) conventional wisdom about the association of religious belief with virtue, identifying the sectarianism of efforts to establish religion in the public square. With both wit and empathy, Kaminer takes on what many people hold sacred. Kaminer is an eloquent and incisive critic and rationalist living in a superstitious, evangelical age. In Sleeping with Extra-Terrestrials she challenges us to exercise skepticism, reason, and irreverence and to appreciate the pleasures of free inquiry. (shrink)

The aim of this book is to provide an accessible account of ethics in general practice, addressing concerns identified by practitioners. It contains many examples and allows the reader to gain practical insights into how to identify and analyze the ethical issues they encounter in everyday general practice.

That testimony is one of the principle bases on which many people hold their religious beliefs is hard to dispute. Equally hard to dispute is that our world contains an array of mutually incompatible religious traditions each of which has been transmitted down the centuries chiefly by way of testimony. In light of this latter it is quite natural to think that there is something defective about holding religious beliefs primarily or solely on the basis of testimony from a particular (...) tradition. The present chapter takes up the question of what that defect consists in. I first consider whether religious diversity entails that a religious believer’s testimony-based beliefs are not formed in a suitably epistemically reliable manner even conditional upon the truth of her religion. After casting doubt on this thought I turn to look at the idea that testimony-based beliefs are subject to defeaters in light of awareness of religious diversity, and I suggest that many such beliefs are not obviously so. According to my diagnosis the problem, rather, is that believers who base their religious beliefs just on testimony will be very unlikely to have reflective (that is, second-order) knowledge even if they possess first-order knowledge, and I explain why this is a notable shortcoming. (shrink)

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...) silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice. (shrink)

This article considers the contemporary effective altruism (EA) movement from a classical Indian Buddhist perspective. Following barebones introductions to EA and to Buddhism (sections one and two, respectively), section three argues that core EA efforts, such as those to improve global health, end factory farming, and safeguard the long-term future of humanity, are futile on the Buddhist worldview. For regardless of the short-term welfare improvements that effective altruists impart, Buddhism teaches that all unenlightened beings will simply be reborn upon their (...) deaths back into the round of rebirth (samsāra), which is held to be undesirable due to the preponderance of duhkha (unsatisfactoriness, dis-ease, suffering) over well-being that characterizes unenlightened existence. This is the samsāric futility problem. Although Buddhists and effective altruists disagree about what ultimately helps sentient beings, section four suggests that Buddhist-EA dialogue nonetheless generates mutually-instructive insights. Buddhists – including contemporaries, such as those involved in Socially Engaged Buddhism – might take from EA a greater focus on explicit prioritization research, which seeks knowledge of how to do the most good we can, given our finite resources. EA, for its part, has at least two lessons to learn. First, effective altruists have tended to assume that the competing accounts of welfare converge in their practical implications. The Buddhist conception of the pinnacle of welfare as a state free from duhkha and, correspondingly, the Buddhist account of the path that leads to this state weigh against this assumption. Second, contrasting Buddhist with effective altruist priorities shows that descriptive matters of cosmology, ontology, and metaphysics can have decisive practical implications. If EA wants to give a comprehensive answer to its guiding question – “how can we do the most good?” – it must argue for, rather than merely assume, the truth of secular naturalism. (shrink)

ABSTRACT:In a world filled with poverty, environmental degradation, and moral injustice, social enterprises offer a ray of hope. These organizations seek to achieve social missions through business ventures. Yet social missions and business ventures are associated with divergent goals, values, norms, and identities. Attending to them simultaneously creates tensions, competing demands, and ethical dilemmas. Effectively understanding social enterprises therefore depends on insight into the nature and management of these tensions. While existing research recognizes tensions between social missions and business ventures, (...) we lack any systematic analysis. Our paper addresses this issue. We first categorize the types of tensions that arise between social missions and business ventures, emphasizing their prevalence and variety. We then explore how four different organizational theories offer insight into these tensions, and we develop an agenda for future research. We end by arguing that a focus on social-business tensions not only expands insight into social enterprises, but also provides an opportunity for research on social enterprises to inform traditional organizational theories. Taken together, our analysis of tensions in social enterprises integrates and seeks to energize research on this expanding phenomenon. (shrink)

This book debates competing approaches to ethical decision-making for members of the armed forces of liberal-democratic states. In this volume, four prominent thinkers propose and debate competing approaches to ethical decision-making for military personnel. Deane-Peter Baker presents and expounds the 'Ethical Triangulation' model, an ethical decision-making method he has employed through much of his career as an applied military ethicist. Rufus Black advocates for a natural law-based approach, one which has heavily influenced the framework formally adopted by the Australian (...) Defence Force. Roger Herbert outlines the 'Moral Deliberation Roadmap', the moral reasoning framework recently adopted by the US Naval Academy. Iain King then sets out a model of quasi-utilitarian decision-making developed in several post-conflict settings and refined at the UK's Royal College of Defence Studies. After the opening chapters in which each author outlines their favoured decision-making approach, the four contributors then evaluate each other's proposals, often critically. Philosopher David Whetham offers some concluding thoughts in which he summarises areas of agreement between the authors, identifies key areas of difference, and suggests directions for future research. This book will be of great interest to students of military ethics, the ethics of war, moral philosophy, and International Relations, as well as military professionals. (shrink)

ABSTRACT:In a world filled with poverty, environmental degradation, and moral injustice, social enterprises offer a ray of hope. These organizations seek to achieve social missions through business ventures. Yet social missions and business ventures are associated with divergent goals, values, norms, and identities. Attending to them simultaneously creates tensions, competing demands, and ethical dilemmas. Effectively understanding social enterprises therefore depends on insight into the nature and management of these tensions. While existing research recognizes tensions between social missions and business ventures, (...) we lack any systematic analysis. Our paper addresses this issue. We first categorize the types of tensions that arise between social missions and business ventures, emphasizing their prevalence and variety. We then explore how four different organizational theories offer insight into these tensions, and we develop an agenda for future research. We end by arguing that a focus on social-business tensions not only expands insight into social enterprises, but also provides an opportunity for research on social enterprises to inform traditional organizational theories. Taken together, our analysis of tensions in social enterprises integrates and seeks to energize research on this expanding phenomenon. (shrink)

Loi recently proposed a libertarian right to direct to consumer genetic testing — independent of autonomy or utility—reflecting Cohen’s work on self-ownership and Hohfeld’s model of jural relations. Cohen’s model of libertarianism dealt principally with self-ownership of the physical body. Although Loi adequately accounts for the physical properties of DNA, DNA is also an informational substrate, highly conserved within families. Information about the genome of relatives of the person undergoing testing may be extrapolated without requiring direct engagement with their personal (...) physical copy of the genome, triggering rights and interests of relatives that may differ from the rights and interests of others, that is, individual consumers, testing providers and regulators. Loi argued that regulatory interference with exercise of the right required justification, whereas prima facie exercise of the right did not. Justification of regulatory interference could include ‘conflict with other people’s rights’, ‘aggressive’ use of the genome and ‘harming others’. Harms potentially experienced by relatives as a result of the individual’s exercise of a right to test include breach of genetic privacy, violation of their right to determine when, and if, they undertake genetic testing and discrimination. Such harms may justify regulatory intervention, in the event they are recognised; motives driving ‘aggressive’ use of the genome may also be relevant. Each of the above criteria requires clarification, as potential redundancies and tensions exist between them, with different implications affecting different groups of rights holders. (shrink)

Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...) only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim. (shrink)

In his article ‘Divine hiddenness and the demographics of theism’ (Religious Studies, 42 (2006), 177-191) Stephen Maitzen develops a novel version of the atheistic argument from divine hiddenness according to which the lopsided distribution of theistic belief throughout the world’s populations is much more to be expected given naturalism than given theism. I try to meet Maitzen’s challenge by developing a theistic explanation for this lopsidedness. The explanation I offer appeals to various goods that are intimately connected with the human (...) cognitive constitution, and in particular, with the way in which we depend upon social belief forming practices for our acquisition of much of our knowledge about the world – features about us that God would value but that also make probable a lopsided distribution of theistic belief, or so I argue. (shrink)

Across the Euro-Atlantic world, political leaders have been mobilizing their bases with nativism, racism, xenophobia, and paeans to “traditional values,” in brazen bids for electoral support. How are we to understand this move to the mainstream of political policies and platforms that lurked only on the far fringes through most of the postwar era? Does it herald a new wave of authoritarianism? Is liberal democracy itself in crisis? In this volume, three distinguished scholars draw on critical theory to address our (...) current predicament. Wendy Brown, Peter E. Gordon, and Max Pensky share a conviction that critical theory retains the power to illuminate the forces producing the current political constellation as well as possible paths away from it. Brown explains how “freedom” has become a rallying cry for manifestly un-emancipatory movements; Gordon dismantles the idea that fascism is rooted in the susceptible psychology of individual citizens and reflects instead on the broader cultural and historical circumstances that lend it force; and Pensky brings together the unlikely pair of Tocqueville and Adorno to explore how democracies can buckle under internal pressure. These incisive essays do not seek to smooth over the irrationality of the contemporary world, and they do not offer the false comforts of an easy return to liberal democratic values. Rather, the three authors draw on their deep engagements with nineteenth–and twentieth–century thought to investigate the historical and political contradictions that have brought about this moment, offering fiery and urgent responses to the demands of the day. (shrink)

Wendy Brown's work commands widespread attention and respect, and there has been considerable interest as to how it would develop after "States of Injury." This book will not disappoint.

'Is politics gendered? Wendy Brown things so, and argues for this point with elegance, imagination and pungent phrases. Brown's book is challenging, provocative and...original; it does force us to question the degree to which gender controls our politics.'-THE REVIEW OF POLITICS.

By way of essays and a selection of primary sources in parallel text, Biography, Historiography, and Modes of Philosophizing provides an introduction to a vast, significant, but neglected corpus of early modern literature: collective biography. It focuses especially on the various related strands of political, philosophical, and intellectual and cultural biography as well as on the intersection between biography, historiography, and philosophy. Individual texts from the fifteenth to the eighteenth century are presented as examples of how the ancient collective biographical (...) tradition--as represented above all by Plutarch, Suetonius, Diogenes Laertius, and Jerome--was received and transformed in the Renaissance and beyond in accordance with the needs of humanism, religious controversy, politics, and the development of modern philosophy and science"--Provided by publisehr. (shrink)

Beginning with the familiar -- The difference between families and political communities -- States of nature and social contracts -- Order, but not order alone -- On freedom (and liberty) -- Justice -- A brief attempt at describing good politics -- Focus on the Christian contribution -- Concluding thoughts.

The term compassion fatigue has come to be applied to a disengagement or lack of empathy on the part of care-giving professionals. Empathy and emotional investment have been seen as potentially costing the caregiver and putting them at risk. Compassion fatigue has been equated with burnout, secondary traumatic stress disorder, vicarious traumatization, secondary victimization or co-victimization, compassion stress, emotional contagion, and counter-transference. The results of a Canadian qualitative research project on nurses? experience of compassion fatigue are presented. Nurses, self-identified as (...) having compassion fatigue, described a change in their practice by which they began to shield and distance themselves from the suffering of patients and families. Time to help patients and families cope with suffering seemed unavailable, and many felt they were running on empty and, ultimately, impotent as nurses. Feelings of irritability, anger, and negativity arose, though participants described denying or ignoring these emotions as a way to try to survive their work day. Difficulties with work carried over into the nurses? personal lives, affecting their relationships with family and friends. Such experiences invariably called into question the participants? identity, causing them to reflect on the kind of nurse they were. The participants? compassion fatigue created a sense of hopelessness regarding positive change, although some nurses described strategies that seemed to help alleviate their compassion fatigue. (shrink)

Unable to answer the call of our patients: mental health nurses’ experience of moral distress When health practitioners’ moral choices and actions are thwarted by constraints, they may respond with feelings of moral distress. In a Canadian hermeneutic phenomenological study, physicians, nurses, psychologists and non‐professional aides were asked to identify care situations that they found morally distressing, and to elaborate on how moral concerns regarding the care of patients were raised and resolved. In this paper, we describe the experience of (...) moral distress related by nurses working in mental healthcare settings who believed that lack of resources (such as time and staff) leads to dispiritedness, lack of respect, and absence of recognition (for both patients and staff) which severely diminished their ability to provide quality care. The metaphors of flashlight and hammer are used to elaborate nurses’ possible responses to intolerable situations. (shrink)

Many explanations in science make use of mathematics. But are there cases where the mathematical component of a scientific explanation is explanatory in its own right? This issue of mathematical explanations in science has been for the most part neglected. I argue that there are genuine mathematical explanations in science, and present in some detail an example of such an explanation, taken from evolutionary biology, involving periodical cicadas. I also indicate how the answer to my title question impacts on broader (...) issues in the philosophy of mathematics; in particular it may help platonists respond to a recent challenge by Joseph Melia concerning the force of the Indispensability Argument. (shrink)

_John Stuart Mill_ investigates the central elements of the 19th century philosopher’s most profound and influential works, from _On Liberty_ to _Utilitarianism_ and _The Subjection of Women_. Through close analysis of his primary works, it reveals the very heart of the thinker’s ideas, and examines them in the context of utilitarianism, liberalism and the British empiricism prevalent in Mill’s day. • Presents an analysis of the full range of Mill’s primary writings, getting to the core of the philosopher’s ideas. • (...) Examines the central elements of Mill’s writings in easily accessible prose • Places Mill’s work and thought within the larger cultural and social context of 19th century Britain • Illustrates the continued relevance of Mill’s philosophy to today’s reader. (shrink)

Surveying a wide range of cultural controversies, from the Mapplethorpe affair to Salman Rushdie's death sentence, from canon-revision in the academy to the scandals that have surrounded Anthony Blunt, Martin Heidegger, and Paul de Man, Wendy Steiner shows that the fear and outrage they inspired are the result of dangerous misunderstanding about the relationship between art and life. "Stimulating. . . . A splendid rebuttal of those on the left and right who think that the pleasures induced by art (...) are trivial or dangerous. . . . One of the most powerful defenses of the potentiality of art."--Andrew Delbanco, New York Times Book Review "A concise and . . . readable account of recent contretemps that have galvanized the debate over the role and purposes of art. . . . [Steiner] writes passionately about what she believes in."--Michiko Kakutani, New York Times "This is one of the few works of cultural criticism that is actually intelligible to the nonspecialist reader. . . . Steiner's perspective is fresh and her perceptions invariably shrewd, far-ranging, and reasonable. A welcome association of sense and sensibility."-- Kirkus Reviews, starred review "Steiner has succeeded so well in [the] task she has undertaken. The Scandal of Pleasure is itself characterized by many of the qualities Steiner demans of art, among them, complexity, tolerance and the pleasures of unfettered thought."--Eleanor Heartly, Art in America "Steiner . . . provides the best and clearest short presentation of each of [the] debates."--Alexander Nehamas, Boston Book Review "Steiner has done a fine job as a historian/reporter and as a writer of sophisticated, very clear, cultural criticism. Her reportage alone would be enough to make this a distinguished book."--Mark Edmundson, Lingua Franca. (shrink)

Deliberation often begins with the question ‘What do I want to do?’ rather than the question of what one ought to do. This paper takes that question at face value, as a question about which of one’s desires is strongest, which sometimes guides action. The paper aims to explain which properties of a desire make that desire strong, in the sense of ‘strength’ relevant to this deliberative question. Both motivational force and phenomenological intensity seem relevant to a desire’s strength; however, (...) accounting for the strength of a desire in these terms opens up significant indeterminacy about what we want. The paper argues that this indeterminacy is often resolved simply by posing the question ‘What do I want to do?’ to oneself: there is reason to believe that one’s answer will play a verdictive role, partially determining what the agent most wants. Self-reflective beliefs can play a self-fulfilling role, and surprisingly this seems to follow from basic platitudes about the belief-desire model. (shrink)

In their article, Romanis and Adkins delineate pregnancy loss and procreative loss to show that the former is possible without the latter, as in the case of artificial amnion and placenta technology.1 Here, we are interested in examining the reverse—procreative loss without pregnancy loss—to further tease apart these two types of loss. We discuss two cases: being forced to continue a pregnancy despite fetal demise due to abortion restrictions and choosing to selectively reduce a multifetal pregnancy. Our analysis buttresses the (...) authors’ conclusion: due to our fetal-centric conception of pregnancy, we are only able to value pregnancy instrumentally (ie, for the fetus), not intrinsically. Understanding pregnancy as an embodied state rather than a process that not only acknowledges the intrinsic value of pregnancy for pregnant people but also encourages society to intrinsically value pregnant people is important. In 2022, the Supreme Court of the United States removed the constitutional right to an abortion in Dobbs v Jackson Women’s Health Organization, shifting the responsibility of determining abortion regulations to individual US states.2 Due to the Dobbs decision, there …. (shrink)