Human connection is universally important, particularly in the context of serious illness and at the end of life. The presence of close family and friends has many benefits when death is close. Hospital visitation restrictions during the Coronavirus pandemic therefore warrant careful consideration to ensure equity, proportionality, and the minimization of harm. The Australian and New Zealand Society for Palliative Medicine COVID-19 Special Interest Group utilized the relevant ethical and public health principles, together with the existing disease outbreak literature and (...) evolving COVID-19 knowledge, to generate a practical framework of visiting restrictions for inpatients receiving palliative and end-of-life care. Expert advice from an Infectious Diseases physician ensured relevance to community transmission dynamics. Three graded levels of visitor restrictions for inpatient settings are proposed, defining an appropriate level of minimum access. These depend upon the level of community transmission of COVID-19, the demand on health services, the potential COVID-19 status of the patient and visitors, and the imminence of the patient’s death. This framework represents a cohesive, considered, proportionate, and ethically robust approach to improve equity and consistency for inpatients receiving palliative care during the COVID-19 pandemic and may serve as a template for future disease outbreaks. (shrink)

The psychological cost on emotional well-being due to the collateral damage brought about by COVID-19 in accessing oncological services for breast cancer diagnosis and treatment has been documented by recent studies in the United Kingdom. The current study set out to examine the effect of delays to scheduled oncology services on emotional and cognitive vulnerability in women with a breast cancer diagnosis in Iran, one of the very first countries to be heavily impacted by COVID-19. One hundred thirty-nine women with (...) a diagnosis of primary breast cancer answered a series of online questionnaires to assess the current state of rumination, worry, and cognitive vulnerability as well as the emotional impact of COVID-19 on their mental health. Results indicated that delays in accessing oncology services significantly increased COVID related emotional vulnerability. Regression analyses revealed that after controlling for the effects of sociodemographic and clinical variables, women’s COVID related emotional vulnerability explained higher levels of ruminative response and chronic worry as well as poorer cognitive function. This study is the first in Iran to demonstrate that the effects of COVID-19 on emotional health amongst women affected by breast cancer can exaggerate anxiety and depressive related symptoms increasing risks for clinical levels of these disorders. Our findings call for an urgent need to address these risks using targeted interventions exercising resilience. (shrink)

This paper describes an AFOSR-supported basic research program that focuses on developing a new framework for combining hard with soft data in order to improve space situational awareness. The goal is to provide, in an automatic and near real-time fashion, a ranking of possible threats to blue assets (assets trying to be protected) from red assets (assets with hostile intentions). The approach is based on Conceptual Spaces models, which combine features from traditional associative and symbolic cognitive models. While Conceptual Spaces (...) are revolutionary, they lack an underlying mathematical framework. Several such frameworks have attempted to represent Conceptual Spaces, but by far the most robust is the model developed by Holender. His model utilizes integer linear programming in order to obtain an overall similarity value between observations and concepts that support the formation of hypotheses. This paper will describe a method for building Conceptual Spaces models for threats that utilizes ontologies as a means to provide a clear semantic foundation for this inferencing process; in particular threat ontologies and space domain ontologies are developed and employed in this approach. A space situational awareness use-case is presented involving a kinetic kill scenario and results are shown to assess the performance of this fusion-based inferencing framework. (shrink)

In this study, Bethany Somma argues for a dichotomous interpretation of human desire developed by late ancient Greek and medieval Islamic philosophers in response to an ambiguity in Aristotle’s account of desire.

Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...) whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward. (shrink)

In response to the Covid‐19 pandemic, health care systems worldwide canceled or delayed elective surgeries, outpatient procedures, and clinic appointments. Although such measures may have been necessary to preserve medical resources and to prevent potential exposures early in the pandemic, moving forward, the indirect effects of such an extensive medical shutdown must not outweigh the direct harms of Covid‐19. In this essay, we argue for the reopening of evidence‐based health care with assurance provided to patients about the safety and necessity (...) of high‐value vaccinations, screenings, therapeutics, and procedures. To ensure that virtually all non‐Covid‐related services do not come to a halt again, health care systems and physician practices must preemptively increase their capacity, secure adequate personal protective equipment to safeguard health care personnel, and develop a measured approach to reclosing such routine health care, should it become necessary in the future. (shrink)

The poetry and journalistic essays of Katherine Tillman often appeared in publications sponsored by the American Methodist church. Collected together for the first time, her works speak to the struggles and triumphs of African-American women.

Environmental problems often outstrip the abilities of any single scientist to understand, much less address them. As a result, collaborations within, across, and beyond the environmental sciences are an increasingly important part of the environmental science landscape. Here, we explore an insufficiently recognized and particularly challenging barrier to collaborative environmental science: value pluralism, the presence of non-trivial differences in the values that collaborators bring to bear on project decisions. We argue that resolving the obstacles posed by value pluralism to collaborative (...) environmental science requires detecting and coordinating the underlying problematic value differences. We identify five ways that a team might coordinate their problematic value differences and argue that, whichever mode is adopted, it ought to be governed by participatory virtues, pragmatic resolve, and moral concern. Relying on our experiences with the Toolbox Dialogue Initiative, as well as with other dialogical approaches that support team inquiry, we defend the claim that philosophical dialogue among collaborators can go a long way towards helping teams of environmental scientists and fellow travelers detect their problematic value differences. Where dialogical approaches fare less well is in helping teams coordinate these differences. We close by describing several principles for augmenting philosophical dialogue with other methods, and we list several of these methods in an appendix with brief descriptions and links for further learning. Overall, the article makes three main contributions to the research collaboration and values in science literatures: It deepens our understanding of problematic value pluralism in team science; It provides actionable guidance and methods for improving values-oriented philosophical dialogue interventions; and It demonstrates one way of doing engaged philosophy. (shrink)

Recent ethics literature suggests that issues involved in non-heart-beating organ procurement are both highly charged and rather urgent. Some fear that NHB is a public relations disaster waiting to happen or that it will create a backlash against organ donation. The purpose of the study described below was to assess ethics committees' current level of involvement in and readiness for addressing the difficult issues that NHB organ retrieval raises—either proactively through policy development or concurrently through ethics consultation.

A request that an ethics committee or consultant analyze the ethical issues in a case, delineate ethical options, or make a recommendation need not automatically but often does elicit legal information. In a recent book in which ethics consultants described cases on which they had worked, almost all cited a legal case or statute that had shaped the consultation process. During a period of just a few months, case consultation done under the auspices of one university hospital ethics committee involved (...) interpretation of statutes on living wills, durable powers of attorney, competency, confidentiality, guardianship, AIDS testing, and disability. At another hospital, 30% of ethics consultations were thought to involve legal issues. Attorneys at a third hospital estimated that virtually every case involves legal issues. The notion that ethics consultation is an “amalgam” of medicine, ethics, interpersonal skills, and law is gaining currency. Ethics consultation has become a channel through which law enters the clinical setting. (shrink)

In this paper, we consider ethical issues related to the treatment of posttraumatic stress disorder (PTSD) in combat zones, via exposure therapy. Exposure-oriented interventions are the most well-researched behavioral treatments for PTSD, and rigorous studies across contexts, populations, and research groups provide robust evidence that exposure therapy for PTSD is effective and can be widely disseminated. Clinical procedures for Prolonged Exposure therapy, a manualized exposure-oriented protocol for PTSD, are reviewed, and we illustrate the potential benefits, as well as the potential (...) difficulties, associated with providing this treatment in combat zones. Several ethical considerations are identified: (1) Assuming successful treatment, is it ethical to send individuals with a known risk of developing PTSD back into combat? (2) If treatment is unsuccessful in theater (perhaps due to the confounding factor of ongoing danger), could that impact treatment effectiveness for soldiers who attempt therapy again post-deployment? (3) If the military finds combat-zone treatment effective and useful in maintaining an efficient work force, will treatment become mandatory for those diagnosed with PTSD? (4) What unintended consequences might be associated with large-scale dissemination of exposure therapy in or near combat, outside of mental health care infrastructures? (5) How would genetic variations known to be associated with PTSD risk influence decisions regarding who receives treatment or returns to combat? We conclude with a review of the personal and societal costs associated with not providing evidence-based PTSD treatments wherever possible. (shrink)

Treatment of military-related posttraumatic stress disorder is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have sought VA health care services for PTSD. This recent increased need (...) for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority. (shrink)

Decision making is a crucial element in the field of medicine. The physician has to determine what is wrong with the patient and recommend treatment, while the patient has to decide whether or not to seek medical care, and go along with the treatment recommended by the physician. Health policy makers and health insurers have to decide what to promote, what to discourage, and what to pay for. Together, these decisions determine the quality of health care that is provided. Decision (...) Making in Health Care is an up-to-date, comprehensive overview of the field of medical decision making. It includes quantitative theoretical tools for modeling decisions, psychological research on how decisions are actually made, and applied research on how physician and patient decision making can be improved. (shrink)

ABSTRACTThis study aimed to investigate the emotional impact of sarcasm. Previous research in this area has mainly required participants to answer questions based on written materials, and results have been mixed. With the aim of instead examining the emotional impact of sarcasm when used in a more conversational setting, the current study utilized animated video clips as stimuli. In each clip, one individual answered general knowledge questions while the other provided feedback that could be delivered either literally or sarcastically, and (...) either complimented or criticized the question answerer’s performance. Participants rated the feedback based on the anticipated emotional impact on the recipient, how the speaker intended the recipient to feel, and whether the speaker intended to be humorous. Results overall supported the Tinge Hypothesis, showing that sarcastic criticism was rated as less negative than literal criticism, and sarcastic compliments were rated as... (shrink)

Do cultural models facilitate particular ways of perceiving interactions in nature? We explore variability in folkecological principles of reasoning about interspecies interactions. In two studies, Indigenous Panamanian Ngöbe and U.S. participants interpreted an illustrated, wordless nonfiction book about the hunting relationship between a coyote and badger. Across both studies, the majority of Ngöbe interpreted the hunting relationship as cooperative and the majority of U.S. participants as competitive. Study 2 showed that this pattern may reflect different beliefs about, and perhaps different (...) awareness of, plausible interspecies interactions. Further probes suggest that these models of ecological interaction correlate with recognition of social agency in nonhuman animals. We interpret our results in terms of cultural models of nature and nonhuman agency. (shrink)

Anthropology of Consciousness, EarlyView.

Healthcare policies developed during the COVID-19 pandemic to safeguard community health have the potential to disadvantage women in three areas. First, protocols for deferral of elective surgery may assign a lower priority to important reproductive outcomes. Second, policies regarding the prevention and treatment of COVID-19 may not capture the complexity of the considerations related to pregnancy. Third, policies formulated to reduce infectious exposure inadvertently may increase disparities in maternal health outcomes and rates of violence towards women. In this commentary, we (...) outline these challenges unique to women’s healthcare in a pandemic, provide preliminary recommendations and identify areas for further exploration and refinement of policy. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Mary Somerville (1780-1872), after whom Somerville College Oxford was named, was the first woman scientist to win an international reputation entirely in her own right, rather than through association with a scientific brother or father. She was active in astronomy, one of the most demanding areas of science of the day, and flourished in the unique British tradition of Grand Amateurs, who paid their own way and were not affiliated with any academic institution. Mary Somerville was to science what Jane (...) Austen was to literature and Frances Trollope to travel writing. Allan Chapman's vivid account brings to light the story of an exceptional woman, whose achievements in a field dominated by men deserve to be very widely known. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hyper-Abjects:Finitude, “Sustainability,” and the Maternal Body in the AnthropoceneBethany DoaneThe concept of the Anthropocene prioritizes a new paradigmatic scale that seems to outweigh that of “the political”: imagining deep time or the death of the human species as a result of climate change tends to negate the (relatively speaking) smaller-scale concerns of race, class, gender, or capitalism. While feminist critique is often circumscribed by this political scale, and thus (...) may seem to be dwarfed or rendered obsolete by the geological, deep-time scale of the Anthropocene, examining issues of feminist concern from this geological perspective has profound implications for thinking not only of gender politics but also of how to construct something like the political at all in this new era. Suggesting a new and normative global politics is, of course, beyond the scope of this article, but perhaps we might begin to conceive of a political schema that would function more appropriately in light of this grander scale. At the very least we may begin to think the borders or limits of the species as it has existed in the modern era in a way that neither environmentalism nor posthumanism has yet been able to sufficiently tackle.The Anthropocene marks the epoch in which human activities have caused global environmental changes that will leave their mark in the geological strata of the earth itself.1 While the specific moments of its onset are contested, its beginnings are generally associated with the industrial age; Crutzen and Stoermer mark its onset at roughly 1800 with the beginnings [End Page 251] of the industrial revolution. (Timothy Morton pinpoints it more specifically with the invention of the steam engine in 1794.) The changes made in this era of geological, technological, and climate convergence have accelerated in the last seventy years or so in what scientists call the Great Acceleration, which began around 1940 and quickened anthropogenic impact with events like the testing/dropping of atomic bombs, the homogenization of biodiversity, mass extinctions as a result of human activity, and various types of drilling and mining.2 In the era broadly conceived as modernity, the steady march of “progress” that has so shaped the paradigm of the period has been made possible only through its own abjections: those phenomena that mark the era as limited, limiting, and unsustainable. In other words, the “birth of the modern world” was made possible only through devastating acts of violence: institutionalized inequalities like slavery, oppression, colonization, and war. These acts of violence translate as cannibalization at the global scale: the exploitation of most members of the species and the consumption of their resources for the benefit and luxury of the few. While these forms of violence have been criticized and confronted by political and theoretical movements since at least the middle of the twentieth century, thinking of them in terms of the Anthropocene and deep time allows us to consider their consequences in a new light. Our present awareness of the Anthropocene makes visible phenomena like climate, global warming, earth, and the “anthropos” that present us with the very real eventuality of species finitude. Species finitude calls into question not just the practices of modernity that have brought about the Anthropocene (the exploitation of the many for the benefit of the few), but the entire paradigm of global thinking that is invested in progress, growth, and even in any environmentalism that calls for stewardship of the earth. The notion of care for an entity like “nature” or “the environment” only reinforces the separation between the human and its milieu, a separation that is impossible to maintain in light of the absolute inextricability that the Anthropocene brings to light.At the heart of this essay are two theoretical concepts: Julia Kristeva’s abjection, and Timothy Morton’s hyperobjects, both of which stand for a sort of insufficiency or impossibility of discourse (politics, the Symbolic, etc.) in managing some Real object or phenomenon. Kristeva’s abject is generally thought of as functioning at two levels or scales: the personal, in which an individual must cast off the abject of the maternal body in order to become a proper subject; and the social or... (shrink)

Volume 19, Issue 11, November 2019, Page 37-39.

The field of narrative medicine holds that personal narratives about illness have the potential to give illness meaning and to create order out of disparate facets of experience, thereby aiding a patient’s treatment and resisting universalizing medical discourse. Two narratives of bipolar disorder, Kay Redfield Jamison’s prose memoir An Unquiet Mind and Ellen Forney’s graphic memoir Marbles challenge these ideas. These writers demonstrate that one result of bipolar disorder is a rupture to their sense of identity, making straightforward and verbal (...) forms of narrative impossible. During periods of relative mood stability, reliable memories of mania or depression are equally impossible. As a result, these memoirists seek to develop sources of self-knowledge other than memory and introspection, long the foundations of personal narrative. Finally, An Unquiet Mind and Marbles return attention to questions of selfhood at a time when scholarship on memoir rejects interpretations of life stories as clear and reliable expressions of identity. (shrink)

We used attractiveness judgements as a proxy to visualize the ideal female and male body for male and female participants and investigated how individual differences in the internalization of cultural ideals influence these representations. In the first of two studies, male and female participants judged the attractiveness of 242 male and female computer-generated bodies which varied independently in muscle and adipose. This allowed us to map changes in attractiveness across the complete body composition space, revealing single peaks for the attractiveness (...) of both men and women. In the second study, we asked our participants to choose the most attractive male and female bodies in a method of adjustment task in which they could independently vary muscle and adipose to create the most attractive body. We asked whether individual differences in internalization of cultural ideals, drive for muscularity, eating disorder symptomatology and depressive symptoms could systematically shift the location of peak attractiveness in body composition space. We found a clear preference by both genders for a male body with high muscle and low adipose, and a toned, low adipose female body. The degree of internalization of cultural ideals predicted large individual differences in the composition of the most attractive bodies. (shrink)

A progressive and uncompromising work that merges fiction and theory to create an intense yet gloriously deviant look at the world through the eyes of controversial Brit-artist, Jake Chapman (of the Chapman Brothers). With protagonists who -- like his mutated Nike-wearing child mannequins -- exhibit similar aberrations, Chapman engages with Freudian theory, genetic engineering and consumerism, to create a highly original and intellectually stimulating work that is as challenging and confrontational as any of his acclaimed works of (...) art. (shrink)

Philosophy for Linguists provides students with a clear, concise introduction to the main topics in the philosophy of language. Focusing on what linguists need to know and how philosophy relates to modern linguistics, the book is structured around key branches of linguistics: semantics, pragmatics, and language acquisition. Assuming no prior knowledge of philosophy, Siobhan Chapman traces the history and development of ideas in the philosophy of language and outlines the contributions of specific philosophers. The book is highly accessible and (...) includes: a general introduction and introductions to each chapter; numerous examples and quotations; comprehensive suggestions for further reading and an extensive glossary of linguistic terms. (shrink)

Volume 20, Issue 4, May 2020, Page 46-48.

Max Weber, the grandfather of organizational theory, recognized the close association between health care organizations and law. When he introduced the concept of a legallaw-saturated,rational bureaucracies, healthcare organizations have highly formalized rules and procedures. They pay a great deal of attention to legal criteria in decisionmaking, and some have entire departments devoted to legal risk management.

Extending literature on health information to entertainment television, we analyze the prostate cancer narrative presented in the police drama, NYPD Blue. We explain how the physician-patient interaction depicted on the show followed (and sometimes did not follow) the medical dialogue model. Findings reveal that the producers of this show advocate a more dialogic model of medical interaction. Portrayals of incompetent, ineffective physicians are contrasted with the superior, effective efforts of other physicians. The audience learns that a non-dialogic approach characterizes “bad (...) doctors,” while the dialogic method typifies “good doctors.” Likewise, medical professionals can use such texts to enhance physician-patient interaction. (shrink)

Conceptual and methodological changes in ecology have the potential to alter significantly the way we view the world. A result of embracing a dynamic model has been to make ecological restoration projects a viable alternative, whereas under 'equilibrium ecology' restoration was considered destructive interference. The logic of sustainability strategies within the context of dynamic forces promises a greater compatibility with anthropogenic activity. Unhappily, environmental restoration turns out to be paradoxical under the current identification of wilderness with wildness where wildness is, (...) at least, a necessary condition for the possession of natural value. The solution to the paradox is to separate wilderness from wildness both conceptually and ontologically by enlarging the domain of wildness to include certain human activities. (shrink)

This essay review of Margaret Atwood's Payback centers on the observation that the book does not dwell on the unnatural face of interest and finance. In this era of financialization, debt has been thoroughly uncoupled from the concept of payback. The least valuable debt is the one that is promptly repaid. It is this aspect of debt—the interest, not the principal—that has attracted the richest tradition of social condemnation. As stable forms of production and exchange were replaced by international arbitrage, (...) the link between debt and sorcery became evident to observers around the world. More profoundly, Atwood's widely shared commonsense impression that consumer debt is a measure of self-indulgence does not hold up empirically. It turns out that our unprecedented levels of household indebtedness were overwhelmingly a function of nondiscretionary spending. Even as Americans owed one hundred percent of GDP in individual debt in 2008, the real Faustian bargain was not a “enjoy now, pay later” scheme for “glitzy, short-term junk.” The truth is much scarier, and points toward a different set of cultural and theological references than the ones Atwood investigates. The dividing line between solvency and insolvency, it turns out, is not consumption but reproduction: the most certain route to financial disaster is having a child. (shrink)