The framework proposed by Dupras and Bunnik was developed in response to their recognition that standard regulations are increasingly inadequate to address the complex privacy issues created by the...

Maddie’s story illustrates the critical importance of healthcare teams (HCTs) having inclusive multidisciplinary provider meetings prior to siloed conversations with families. It is paramount that...

Identifying ethically allowable options for infants with trisomy 18 has become more challenging as medical standards of practice shift, based on emerging scientific data and changing societal perceptions of disability. Lack of a stable professional standard of practice ought not prevent ethicists from facilitating a consensus; rather, these “unsettled cases” require an individualized, narrative approach that allows the values of the family and the particularities of each case to provide the necessary additional moral grounding.

A case of conflict in pediatric end-of-life decision making is presented to compare the complementary roles of clinical ethics consultants and palliative care specialists. The progression of the case illustrates the differing structures, goals, and methods of the majority of such teams. The strengths of each of consultation are emphasized. Particularly in centers where palliative care services are not available, it can be important for careproviders and clinical ethics consultants to focus on alliance-building and a longitudinal relationship with patients and (...) families. (shrink)

We agree with Berger and Miller that the focus on cultural competence in medical education fails to name or confront key drivers of health inequity such as structural racism, social determin...

Childress et al. (2023) critically examine claims used to support unilateral withdrawal of life-sustaining ECMO over the objections of capacitated patients. The authors raise important concerns abo...

In the years just prior to the COVID-19 pandemic, American clinicians and health care systems were focused on another life-threatening disease: opioid use disorder and the epidemic of deaths...

This case describes an adolescent in a crisis of a chronic medical condition whose situation is complicated by substance abuse and mental illness. D. Micah Hester provides an analytic approach, teasing apart the multiple layers of medical, developmental, and moral issues at hand and describing possible responses and outcomes. Amy T. Campbell examines existing legal guidelines for adolescent decision making, arguing that greater space exists for clinical discretion in these matters than commonly thought. Cheryl D. Lew discusses the development of (...) agency in adolescent patients, the ideal of autonomous decision making in the context of impairment and chronic illness, and the obligation of healthcare teams to examine an adolescent patient’s decisions in relation to her identity. (shrink)

Metabolic pathways underlying brain function remain largely unexplored during neurodevelopment, predominantly due to the lack of feasible techniques for use with awake infants. Broadband near-infrared spectroscopy provides the opportunity to explore the relationship between cerebral energy metabolism and blood oxygenation/haemodynamics through the measurement of changes in the oxidation state of mitochondrial respiratory chain enzyme cytochrome-c-oxidase alongside haemodynamic changes. We used a bNIRS system to measure ΔoxCCO and haemodynamics during functional activation in a group of 42 typically developing infants aged between (...) 4 and 7 months. bNIRS measurements were made over the right hemisphere over temporal, parietal and central cortical regions, in response to social and non-social visual and auditory stimuli. Both ΔoxCCO and Δ[HbO2] displayed larger activation for the social condition in comparison to the non-social condition. Integration of haemodynamic and metabolic signals revealed networks of stimulus-selective cortical regions that were not apparent from analysis of the individual bNIRS signals. These results provide the first spatially resolved measures of cerebral metabolic activity alongside haemodynamics during functional activation in infants. Measuring synchronised changes in metabolism and haemodynamics have the potential for uncovering the development of cortical specialisation in early infancy. (shrink)

This article presents a study on the dialogue between the ideas and the aesthetics of Augusto dos Anjos. What is meant to be postulated is that the Paraiba’s poet puts his vigorous aesthetic to the service of ideas that were expurgated from the literary and academic scene under the label of vitalism, in favor of the hegemony of mechanism. Aesthetic images, the use of a nearly completely denotative scientific language, and morbidity, as paroxysms of this aesthetic project are not really (...) an isolated initiative of the poet, but not even his contemporaries understood the greatness of his project and how it was neces-sary, to accomplish it, that he raises his poetics to an unusual aesthetic level. Augusto dos Anjos, even on the fringes of the elitist epicenter of Ouvidor Street (where his accent and his color would have no place), succeeded in constructing a true poetics of denotation that became one of the most radical bulwarks of a literature that, by yours hands, entered modernity. Keywords: Augusto dos Anjos. Vitalism and mechanism. Denotation. Scientific poetry.1 Introdução1.1 Do propósitoNeste artigo pretendemos dissertar sobre um aspecto da poética diversificada de Augusto dos Anjos. Motiva esta pesquisa a observação de que sua obra ensejou interpretações controversas entre os estudio-sos, sobretudo quanto à uma categorização de ordem taxonômica, que a dispusesse sob o rótulo de um estilo. De fato, o Eu (1912), essa obra única de Augusto dos Anjos, é rica em elementos característicos de várias escolas e de diferentes estilos literários, e tais elementos são, não raro, antagônicos. Transitam pela poética de Augusto dos Anjos o Simbolismo, o SEÇÃO: ENSAIOSA ciência da poesia da ciência em Augusto dos AnjosThe science of science’s poetry in Augusto dos Anjos . (shrink)

The most common approach to understanding the semantics of the concept of pain is third-person thought experiments. By contrast, the most frequent and most relevant uses of the folk concept of pain are from a first-person perspective in conversational settings. In this paper, we use a set of linguistic tools to systematically explore the semantics of what people communicate when reporting pain from a first-person perspective. Our results suggest that only a pluralistic view can do justice to the way we (...) talk about pain from a first-person perspective: The semantic content of the folk concept of pain consists of information about both an unpleasant feeling and a disruptive bodily state. Pain linguistics thus provides new insights into ordinary pain language and poses an interesting challenge to the dominant unitary views of pain. (shrink)

Ce texte correspond au chapitre 4 de l'ouvrage suivant : E. Prak-Derrington, Magies de la répétition, Lyon, ENS Editions, 2021, 406 p. Il est disponible intégralement ici. Les figures proposées pour illustrer les lois particulières de la Gestalt au chapitre précédent illustraient notre perception visuelle, la structuration de l'espace ; or la parole se déroule dans le temps. La répétition figurale structure le temps autrement que ne le fait la parole à vocation prioritairement informative, c'est en - Poétique et (...) Études littéraires – GALERIE – Nouvel article. (shrink)

Dans cet article, nous examinons les constructions interrogatives portant sur un groupe prépositionnel dans un réseau de 10 points d’enquête en Kabylie. Certaines de ces constructions sont caractérisées par la préfixation de la préposition (P) sur le complémenteur (C). Nous mettons en évidence que si, dans une construction interrogative portant sur un complément prépositionnel, C est spécifié par un constituant interrogatif, alors C ne porte pas de P préfixée. Si C est spécifié par un constituant non interrogatif ou bien si (...) le spécificateur de C n’est pas réalisé morphologiquement, alors C est préfixé par P. Cet article fait partie d’un projet plus large portant sur la phonologie, la morphologie et la syntaxe des groupes prépositionnels dans différentes variétés du taqbaylit. (shrink)

Extant research provides compelling conceptual and empirical arguments that company-external as well as company-internal CSR efforts positively affect employees, but does so largely in studies assessing effects from the two CSR types independently of each other. In contrast, this paper investigates external–internal CSR jointly, examining the effects of consistent external–internal CSR strategies on employee attitudes, intentions, and behaviors. The research takes a social and moral identification theory view and advances the core hypothesis that inconsistent CSR strategies, defined as favoring external (...) over internal stakeholders, trigger employees’ perceptions of corporate hypocrisy which, in turn, lead to emotional exhaustion and turnover. In Study 1, a cross-industry employee survey indicates that inconsistent CSR strategies with larger external than internal efforts increase employees’ turnover intentions via perceived corporate hypocrisy and emotional exhaustion. In Study 2, a multi-source secondary dataset demonstrates that inconsistent CSR strategies increase firms’ actual employee turnover. Combined, the two studies demonstrate the importance of taking into account the interests of both external and internal stakeholders of the firm when researching and managing CSR. (shrink)

Winner, 2020 Body and Embodiment Best Publication Award, given by the American Sociological Association Honorable Mention, 2020 Sociology of Sex and Gender Distinguished Book Award, given by the American Sociological Association How the female body has been racialized for over two hundred years There is an obesity epidemic in this country and poor Black women are particularly stigmatized as “diseased” and a burden on the public health care system. This is only the most recent incarnation of the fear of fat (...) Black women, which Sabrina Strings shows took root more than two hundred years ago. Strings weaves together an eye-opening historical narrative ranging from the Renaissance to the current moment, analyzing important works of art, newspaper and magazine articles, and scientific literature and medical journals—where fat bodies were once praised—showing that fat phobia, as it relates to Black women, did not originate with medical findings, but with the Enlightenment era belief that fatness was evidence of “savagery” and racial inferiority. The author argues that the contemporary ideal of slenderness is, at its very core, racialized and racist. Indeed, it was not until the early twentieth century, when racialized attitudes against fatness were already entrenched in the culture, that the medical establishment began its crusade against obesity. An important and original work, Fearing the Black Body argues convincingly that fat phobia isn’t about health at all, but rather a means of using the body to validate race, class, and gender prejudice. (shrink)

Food poverty and food waste are two major contemporary food system problems, which have gained prominence amongst both scholars and policy-makers, due to recent economic and environmental concerns. In this context, the culturally dominant perspective portrays charitable food redistribution as a “win–win solution” to confront food poverty and food waste in affluent societies, although this view is contested by many scholars. This paper applies the notions of framings and flat/sharp keyings to unpack the different narratives entailed by public discourses on (...) food waste and food poverty in Italy. The aim is to problematize the representation of the recent anti-waste/pro-donations law as the optimal policy measure to effectively rectify both food poverty and food waste. The paper argues that the widespread public support for the law reflects the interpretation of charitable food redistribution as a consensus frame, standing for the convergence between flat positions and is reinforced by confusion on terms and responsibilities. Indeed, the strength of the law lies in the capacity to reconcile different positions and bring actors together around a short-term objective, whose foundations have deep roots in the common ethics. However, if the debate is to be moved forward, trade-offs between different framings of problems at stake should be explicitly navigated when designing policy instruments. (shrink)

This article describes the results of qualitative research into the moral issues faced by social work professionals working in projects targeted at teenage mothers. The research is part of the tradition of empirical and practice-driven ethics. The main questions were: How does morality become visible in the social services for teenage mothers and how do social workers deal with the moral dimension of their work? (How) can education, training and peer review offer space for moral reflection? Interviews and group meetings (...) ('focus groups') were held to answer these questions. Nineteen professionals (front-line professionals as well as professionals in executive roles) participated in the research. The findings describe the moral issues and the moral actions of professionals and the organizational context respectively. The results reveal that the everyday practice of social work professionals can raise complex issues inherent to their work and that there is often no explicit reflection on the moral dimension of these issues. The authors argue that there needs to be greater focus on the complexity of moral issues and elaborate on three dimensions of this complexity. (shrink)

Although pain is one of the most fundamental and unique experiences we undergo in everyday life, it also constitutes one of the most enigmatic and frustrating subjects for many scientists. This book provides a detailed analysis of why this issue is grounded in the nature of pain itself. It also offers a philosophically driven solution of how we may still approach pain in a theoretically compelling and practically useful manner. Two main theses are defended: (i) Pain seems inscrutable because there (...) exists no property that is commonly shared by all types of pain and that is at the same time particular to pain, setting it apart from other bodily sensations. This applies irrespective of whether we consider the psychological dimensions, neural networks, causal relations or biological functions of pain. Consequently, it is impossible to refer to ideal far-reaching and ideal distinct generalizations on the matter of pain. (ii) Despite this challenge, by focusing on the resemblance relations that hold across pains, we can generate scientific progress in explaining, predicting and treating pain. In doing so, the book aims to provide a clear conceptual basis for interdisciplinary communication and a useful heuristic for future research. (shrink)

In this paper, we argue that the concept of environmental scaffolding can contribute to a better understanding of our affective life and the complex manners in which it is shaped by environmental entities. In particular, the concept of environmental scaffolding offers a more comprehensive and less controversial framework than the notions of embeddedness and extendedness. We contribute to the literature on situated affectivity by embracing and systematizing the diversity of affective scaffolding. In doing so, we introduce several distinctions that provide (...) classifications of different types of environmentally scaffolded affectivity. Furthermore, we differentiate eight dimensions that allow us to evaluate the quality and effectivity of scaffolds in particular applications. On that basis, we develop a taxonomy using paradigmatic examples of affective scaffolding. This taxonomy enriches the current debate by emphasizing distinctions that are often conflated and by identifying fields of application that are commonly overlooked. (shrink)

We discuss the implementation of Responsible Research and Innovation (RRI) within a project for the development of an AI-supported exergame for assisted movement training, outline outcomes and reflect on methodological opportunities and limitations. We adopted the responsibility-by-design (RbD) standard (CEN CWA 17796:2021) supplemented by methods for collaborative, ethical reflection to foster and support a shift towards a culture of trustworthiness inherent to the entire development process. An embedded ethicist organised the procedure to instantiate a collaborative learning effort and implement RRI (...) in a translational context. Within the interdisciplinary setting of the collaboration and with the support of a technoethicist, we successfully identified relevant, project-specific challenges and developed a roadmap with derived actions, thus meaningfully integrating RRI into the development process. We discuss the methodological procedure in terms of its effectiveness and efficiency, the allocation of responsibilities and roles, particularly regarding potential frictions in the interdisciplinary context with embedded ethics, and the challenges of the translational context. We conclude that the responsibility-by-design standard effectively established a productive workflow for collaborative investigation and work on ethical challenges. We reflect on methodological difficulties and propose possible avenues to our approach. (shrink)

Bodily sensations, such as pain, hunger, itches, or sexual feelings, are commonly characterized in terms of their phenomenal character. In order to account for this phenomenal character, many philosophers adopt strong representationalism. According to this view, bodily sensations are essentially and entirely determined by an intentional content related to particular conditions of the body. For example, pain would be nothing more than the representation of actual or potential tissue damage. In order to motivate and justify their view, strong representationalists often (...) appeal to the reliable causal covariance between bodily sensations and certain kinds of bodily conditions or to the corresponding biological function that these bodily sensations are supposed to fulfill. In this paper, I argue on the basis of recent empirical research that arguments from reliable causal covariance and biological function cannot motivate the introduction of corresponding intentional content. In particular, I argue that bodily sensations are caused by a heterogeneous class of physiological and psychological factors and their biological functions are too diverse to be reduced to the representation of a particular bodily condition. Responses are available to strong representationalists, but they either require substantial alterations to their core assumptions or incur a significant empirical burden. (shrink)

Die Leitfragen dieser wahrheitstheoretischen Interpretation lauten: Welche Rolle spielt die Wahrheitsfrage in der ‚Kritik der reinen Vernunft‘ generell und in den einzelnen Abteilungen der Untersuchung? Welche Wahrheitskonzeption vertritt Kant, mit welchen Argumenten und welche Kritik konkurrierender philosophischer Positionen ist damit verbunden? Alle Hauptabteilungen der Kritik der reinen Vernunft werden in diesem Lichte erklärt, geprüft und kommentiert. Entgegen der verbreitenden Tendenz, den Wahrheitsbegriff bei der Interpretation der Kritik der reinen Vernunft in den Hintergrund treten zu lassen, wird demonstriert, dass sich deren (...) zentrale Philosopheme in wahrheitstheoretischer Perspektive erschließen. Indem sie die Wahrheitsfrage als Schlüssel zum adäquaten Verständnis der Kritik der reinen Vernunft erweist, eröffnet die Arbeit ein neues Verständnis der Kritik der reinen Vernunft und der kantischen Transzendentalphilosophie. Das zentrale Ergebnis der Arbeit integriert exegetischen und die systematischen Fragestellungen: Es besteht in dem Nachweis, dass Kant in der ‚Kritik der reinen Vernunft‘ durch die immanente Kritik des Erkenntnisvermögens das Widerspruchsprinzip, das transzendentale Prinzip analytischer Urteile, um ein transzendentales Prinzip synthetischer Urteile ergänzt. Dadurch wird die Wahrheitsskepsis sowohl in der rationalistischen als auch in der empiristischen Variante ausgeräumt und die Erkenntnisansprüche reiner Vernunft in ihre Grenzen gesetzt. (shrink)

In recent years, the societal and personal impacts of pain, and the fact that we still lack an effective method of treatment, has motivated researchers from diverse disciplines to try to think in new ways about pain and its management. In this paper, we aim to develop an enactive approach to pain and the transition to chronicity. Two aspects are central to this project. First, the paper conceptualizes differences between acute and chronic pain, as well as the dynamic process of (...) pain chronification, in terms of changes in the field of affordances. This is, in terms of the possibilities for action perceived by subjects in pain. As such, we aim to do justice to the lived experience of patients as well as the dynamic role of behavioral learning, neural reorganization, and socio-cultural practices in the generation and maintenance of pain. Second, we aim to show in which manners such an enactive approach may contribute to a comprehensive understanding of pain that avoids conceptual and methodological issues of reductionist and fragmented approaches. It proves particularly beneficial as a heuristic in pain therapy addressing the heterogenous yet dynamically intertwined aspects that may contribute to pain and its chronification. (shrink)

In the face of massively increased technological complexity, it is striking that so many of today’s computational and networked things follow design ideals honed decades ago in a much different context. These strong ideals prescribe a presentation of things as useful tools through design and a withdrawal of aspects of their functionality and complexity. Beginning in the mid-twentieth century, we trace this ‘withdrawal program’ as it has persisted in the face of increasing computational complexity. Currently, design is in a dilemma (...) where computational products can be seen as brilliantly designed and engaging to use yet can also be considered very problematic in how they support hidden agendas and often seem less than trustworthy. In this article, we analyse factors shaping this emergent ethical dilemma and reveal the concept of _a widening rift_ between what computational _things actually are and do_ and _the ways in which they are presented as things for use_. Against this backdrop, we argue that there is a need for a new orientation in design programs to adequately address this deepening rupture between the aesthetics and ethics in the design of computational things. (shrink)

In her article the author shows the relevance of the concept of compromise for protestant ethics after 1945. Coming from the current discussion about the significance of compromise in the german society today she asks for the role of compromises for community building and as a guarantee for plurality in the civil society nowadays. The author illustrates the relation between compromise, plurality and democracy in protestant ethics after World War II by presenting an article of the German pastor Eberhard Müller, (...) who was the founder of the Protestant Academy of Bad Boll in Wuerttemberg/west-germany in 1945. In his article compromise, published in the Evangelisches Soziallexikon (Protestant Encyclopedia of social ethics, Kreuz-Verlag Stuttgart) 1954 Müller emphasizes his conviction, that after the ideology of Nazi-Germany only a culture of communication and exchance, a culture, that is based on compromises could anchor an understanding of democracy in the young German society. (shrink)

Niche construction denotes the alteration, destruction, or creation of environmental features through the activities of an organism, modifying the relation between organism and environment. The concept of niche construction found application in various fields of research: evolutionary biology, enculturation, ontogenetic development, and local organism-environment coordination. This is because it provides a useful tool emphasizing different aspects of the dynamic interplay between organisms and their actively constructed environment. Traditionally, niche construction is considered a positive mechanism in the complementarity of organism and (...) environment. In contrast, this paper sheds light on the dark side of niche construction, that is, the different manners in which organisms may modify environmental features that are in some way or another harmful to them. First, the paper introduces a paradigmatic distinction of four kinds of niche construction as commonly addressed in recent literature, using more or less extended spatio-temporal scales as the distinguishing feature. Second, the paper elaborates on the concept of negative niche construction, providing normative criteria of (mal)adaptation that are suitable for the evaluation of environmental alterations, given the chosen spatio-temporal scale. Of particular interest are inter-scale conflicts: those cases of environmental constructions which appear adaptive concerning one spatio-temporal scale but maladaptive concerning another. Third, the paper distinguishes the concept of niche construction as a valuable instrument to better understand central aspects of modern medicine and the entangled contribution of evolutionary, socio-cultural, personal, and situational aspects to different health issues, using chronic pain as an illustrative case study. (shrink)

This article examines how the so-called disembodied criminal subject is given structure and form through the law of homicide and assault. By analysing how the body is materialised through the criminal law’s enactment of death and injury, this article suggests that the biological positioning of these harms of violence as uncontroversial, natural, and universal conditions of being ‘human’ cannot fully appreciate what makes violence wrongful for us, as embodied entities. Absent a theory of the body, and a consideration of corporeality, (...) the criminal law risks marginalising, or altogether eliding, experiences of violence that do not align with its paradigmatic vision of what bodies can and must do when suffering its effects. Here I consider how the bionic body disrupts the criminal law’s understanding of human violence by being a body that is both organic and inorganic, and capable of experiencing and performing violence in unexpected ways. I propose that a criminal law that is more receptive to the changing, technologically mediated conditions of human existence would be one that takes the corporeal dimensions of violence more seriously and, as an extension of this, adopts an embodied, embedded, and relational understanding of human vulnerability to violence. (shrink)

Pain is often used as the paradigmatic example of a phenomenal kind with a phenomenal quality common and unique to its instantiations. Philosophers have intensely discussed the relation between the subjective feeling, which unites pains and distinguishes them from other experiences, and the phenomenal properties of sensory, affective, and evaluative character along which pains typically vary. At the center of this discussion is the question whether the phenomenal properties prove necessary and/or sufficient for pain. In the empirical literature, sensory, affective, (...) and evaluative properties have played a decisive role in the investigation of psychophysical correspondence and clinical diagnostics. This paper addresses the outlined philosophical and empirical issues from a new perspective by constructing amultidimensional phenomenal spacefor pain. First, the paper will construe the phenomenal properties of pains in terms of a property space whosestructurereflects phenomenal similarities and dissimilarities by means of spatial distance. Second, philosophical debates on necessary and sufficient properties are reconsidered in terms of whether there is a phenomenal space formed of dimensions along which all and only pains vary. It is concluded that there is no space of this kind and, thus, that pain constitutes aprimitivephenomenal kind that cannot be analyzed entirely in terms of its varying phenomenal properties. Third, the paper addresses theutilityof continued reference to pain and its phenomenal properties in philosophical and scientific discourses. It is argued that numerous insights into the phenomenal structure of pain can be gained that have thus far received insufficient attention. (shrink)

According to pure imperativism, pain experiences are experiences of a specific phenomenal type that are entirely constituted by imperative content. As their primary argument, proponents of imperativism rely on the biological role that pain experiences fulfill, namely, the motivation of actions whose execution ensures the normal functioning of the body. In the paper, I investigate which specific types of action are of relevance for an imperative interpretation and how close their link to pain experiences actually is. I argue that, although (...) imperative theories constitute an apparently promising version of strong intentionalism, they cannot provide an imperative content that meets their own criteria of both sufficiency and necessity. I further argue that this issue cannot be solved by impure imperative theories either. (shrink)

The pattern of ups and downs in a sequence with varying pitch can be heard as a melodic contour. Contrary to single pitch, the neural representation of melodic contour information in the auditory cortex is rarely investigated, and it is not clear whether the processing entails a hemispheric asymmetry. The present magnetoencephalography study assessed the neuromagnetic responses of N = 18 normal-hearing adults to four-note sequences with fixed vs. varying pitch that were presented either monaurally or diotically; data were analyzed (...) using minimum-norm reconstructions. The first note of the sequences elicited prominent transient activity in posterior auditory regions (Planum temporale), especially contralateral to the ear of entry. In contrast, the response to the subsequent notes originated from more anterior areas (Planum polare) and was larger for melodic contours than for fixed pitch sequences, independent from the ear of entry and without hemispheric asymmetry. Together, the results point to a gradient in the early cortical processing of melodic contours, both in spatial and functional terms, where posterior auditory activity reflects the onset of a pitch sequence and anterior activity reflects its subsequent notes, including the difference between sequences with fixed pitch and melodic contours. (shrink)