BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Predictable somatosensory feedback leads to a reduction in tactile sensitivity. This phenomenon, called tactile suppression, relies on a mechanism that uses an efference copy of motor commands to help select relevant aspects of incoming sensory signals. We investigated whether tactile suppression is modulated by the task-relevancy of the predicted consequences of movement and the intensity of related somatosensory feedback signals. Participants reached to a target region in the air in front of a screen; visual or tactile feedback indicated the reach (...) was successful. Furthermore, tactile feedback intensity varied across two groups of participants. We measured tactile suppression by comparing detection thresholds for a probing vibration applied to the finger either early or late during reach and at rest. As expected, we found an overall decrease in late-reach suppression, as no touch was involved at the end of the reach. We observed an increase in the degree of tactile suppression when strong tactile feedback was given at the end of the reach, compared to when weak tactile feedback or visual feedback was given. Our results suggest that the extent of tactile suppression can be adapted to different demands of somatosensory processing. Downregulation of this mechanism is invoked only when the consequences of missing a weak movement sequence are severe for the task. The decisive factor for the presence of tactile suppression seems not to be the predicted action effect as such, but the need to detect and process anticipated feedback signals occurring during movement. (shrink)

Research ethics committees—animal ethics committees for animal-based research and institutional research boards for human subjects—have a key role in research governance, but there has been little study of the factors influencing their effectiveness. The objectives of this study were to examine how the effectiveness of a research ethics committee is influenced by committee composition and dynamics, recruitment of members, workload, participation level and member turnover. As a model, 28 members of AECs at four universities in western Canada were interviewed. Committees (...) were selected to represent variation in the number and type of protocols reviewed, and participants were selected to include different types of committee members. We found that a bias towards institutional or scientific interests may result from a preponderance of institutional and scientist members, an intimidating atmosphere for community members and other minority members, recruitment of community members who are affiliated with the institution and members joining for reasons other than to fulfil the committee mandate. Thoroughness of protocol review may be influenced by heavy workloads, type of review process and lack of full committee participation. These results, together with results from the literature on research ethics committees, suggested potential ways to improve the effectiveness of research ethics committees. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

There is the world of ideas and the world of practice; the French are often for sup pressing the one and the English the other; but neither is to be suppressed. -Matthew Arnold The Function of Criticism at the Present Time From its inception, bioethics has confronted the need to reconcile theory and practice. At first the confrontation was purely intellectual, as writers on ethical theory (within phi losophy, theology, or other humanistic disciplines) turned their attention to topics from the (...) world of medical practice. Recently the confrontation has grown more intense. The ap pointment of clinical ethicists in hospitals and other health care settings is an accelerating trend in North America. Concomitantly, those institutions involved in training peo ple in clinical ethics have added organized exposure to the world of practice, in the form of placement requirements, to the normal academic course load. In common with other dis ciplines, bioethics has begun to see clinical training as a con dition of didactic theory and apprenticeship. (shrink)

There is little question that neuroethics can be enriched by closer engagement with Buddhism. One key concern is how to minimize risks of moral imperialism and appropriation while doing so. This co...

An animal confronts numerous challenges when constructing an optimal navigational route. Spatial representations used for path optimization are likely constrained by critical environmental factors that dictate which neural systems control navigation. Multiple coding schemes depend upon their ecological relevance for a particular species, particularly when dealing with the third, or vertical, dimension of space.

Within the field of causal inference, it is desirable to learn the structure of causal relationships holding between a system of variables from the correlations that these variables exhibit; a sub-problem of which is to certify whether or not a given causal hypothesis is compatible with the observed correlations. A particularly challenging setting for assessing causal compatibility is in the presence of partial information; i.e. when some of the variables are hidden/latent. This paper introduces the possible worlds framework as a (...) method for deciding causal compatibility in this difficult setting. We define a graphical object called a possible worlds diagram, which compactly depicts the set of all possible observations. From this construction, we demonstrate explicitly, using several examples, how to prove causal incompatibility. In fact, we use these constructions to prove causal incompatibility where no other techniques have been able to. Moreover, we prove that the possible worlds framework can be adapted to provide a complete solution to the possibilistic causal compatibility problem. Even more, we also discuss how to exploit graphical symmetries and cross-world consistency constraints in order to implement a hierarchy of necessary compatibility tests that we prove converges to sufficiency. (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

The First Conference of the International Society for the Study of Time was held at the Mathematisches Forschungsinstitut at Oberwolfach in the Black Forest, Federal Republic of Germany from Sunday, 31 August to Saturday, 6 September, 1969. The origin of this conference and the formation of the Society goes back to a proposal due to J. T. Fraser that was discussed at a conference on "Interdisciplinary Perspectives of Time" held by the New York Academy of Sciences in January, 1966. (...) It was unanimously agreed than that an international society should be formed on an interdisciplinary basis with the object of stimulating interest in all problems concerning 'time and that this object could best be attained by means of conferences held at regular intervals. J. T. Fraser was elected Secretary, S. Watanabe Treasurer, and I was elected President. It was agreed, at my suggestion, that the organization of the first conference of the newly formed Society be left to a committee of these three officers, on the understanding that they would invite authorities on the role of time in the various special sciences and humanities to form an Advisory Board to assist them. One of the main difficulties in seeking support for an interdisciplinary conference is that most foundations confine their interest exclusively either to the sciences or to the humanities. (shrink)

George Berkeley (1685-1753) is the superstar of Irish Philosophy. He entered Trinity College, Dublin, in 1700 and became a fellow in 1707. In 1724 he resigned his Fellowship to become Dean of Derry, and in 1734 he was made Bishop of Cloyne. He settled in Oxford in 1752 and died the following year. The work of George Berkeley is marked by its diversity and range. His writings take in such topics as mathematics, psychology, politics, health, economics, deism and education, as (...) well as that with which he is most associated - philosophy. Whatever topic he dealt with, his grasp of the subject matter was always impressive and his criticisms of his contemporaries often acute. Among the most noteable of the British Empiricists, he took his starting point from Locke's new 'way of ideas', but he rejected abstract ideas and the possibility of real existence outside perception. It is for this doctrine that he is most known - that there is no such thing as matter, and that things are collections of ideas which can exist only in our minds and only for so long as they are perceived. This philosophy, summed up in his phrase 'to be is to be perceived', he termed 'immaterialism'. A.C. Fraser's collection includes a series of what were previously unpublished notes by Berkeley on all the main topics of his philosophy. This, the 1901 edition, was the first complete edition of his works. (shrink)

Each world faith tradition has its own distinctive relationship with science, and the science-religion dialogue benefits from a greater awareness of what this relationship is. In this book, members of the International Society for Science and Religion (ISSR) offer international and multi-faith perspectives on how new discoveries in science are met with insights regarding spiritual realities.The essays reflect the conviction that “religion and science each proceed best when they’re pursued in dialogue with each other, and also that our fragmented and (...) divided world would benefit more from a stronger dialogue between science and religion.” In Part One, George F. R. Ellis, John C. Polkinghorne, and Holmes Rolston III, each a Templeton Prize winner, discuss their views on why the science and religion dialogue matters. They are joined in Part Two by distinguished theologians Fraser Watts and Philip Clayton, who place the dialogue in an international context; John Polkinghorne’s inaugural address to the ISSR in 2002 is also included. In Part Three, five members of the ISSR look at the distinctive relationships of their faiths to science: •Carl Feit on Judaism •Munawar Anees on Islam •B.V. Subbarayappa on Hinduism •Trinh Xuan Thuan on Buddhism •Heup Young Kim on Asian Christianity George Ellis, the recently elected second president of ISSR, summarizes the contributions of his colleagues. Ronald Cole-Turner then concludes the book with a discussion of the future of the science and religion dialogue. (shrink)

Background. The events of 9/11 and the October 2002 National Intelligence Estimate on Iraq's Continuing Programs for Weapons of Mass Destruction precipitated fundamental changes within the US Intelligence Community. As part of the reform, analytic tradecraft standards were revised and codified into a policy document – Intelligence Community Directive (ICD) 203 – and an analytic ombudsman was appointed in the newly created Office for the Director of National Intelligence to ensure compliance across the intelligence community. In this paper we investigate (...) the untested assumption that the ICD203 criteria can facilitate reliable evaluations of analytic products. Method. Fifteen independent raters used a rubric based on the ICD203 criteria to assess the quality of reasoning of 64 analytical reports generated in response to hypothetical intelligence problems. We calculated the intra-class correlation coefficients for single and group-aggregated assessments. Results. Despite general training and rater calibration, the reliability of individual assessments was poor. However, aggregate ratings showed good to excellent reliability. Conclusions. Given that real problems will be more difficult and complex than our hypothetical case studies, we advise that groups of at least three raters are required to obtain reliable quality control procedures for intelligence products. Our study sets limits on assessment reliability and provides a basis for further evaluation of the predictive validity of intelligence reports generated in compliance with the tradecraft standards. (shrink)

A priori reflection, common sense and intuition have proved unreliable sources of information about the world outside of us. So the justification for a theory of the categories must derive from the empirical support of the scientific theories whose descriptions it unifies and clarifies. We don’t have reliable information about the de re modal profiles of external things either because the overwhelming proportion of our knowledge of the external world is theoretical—knowledge by description rather than knowledge by acquaintance. This undermines (...) the traditional idea that to be an object of category C is to be an object with such- and-such characteristic possibilities of combination. But this is no loss because de re modal thought lacks utility for creatures like us. (shrink)

According to philosophical folklore Ramsey maintained three propositions in his famous 1925 paper “Universals”: (i) there is no subject-predicate distinction; (ii) there is no particular-universal distinction; (iii) there is no particular-universal distinction because there is no subject-predicate distinction. The ‘first generation’ of Ramsey commentators dismissed “Universals” because they held that whereas predicates may be negated, names may not and so there is a subject-predicate distinction after all. The ‘second generation’ of commentators dismissed “Universals because they held that the absence of (...) a merely linguistic distinction between subject and predicate does not provide any kind of reason for doubting that a truly ontological (i.e. non-linguistic) distinction obtains between particulars and universals. But both first and second-generation criticisms miss their marks because Ramsey did not maintain the three identified propositions. The failure of commentators to appreciate the point and purpose of the position Ramsey actually advanced in “Universals” results from (a) failing to consider the range of different arguments advanced there, (b) looking at “Universals” in isolation from Ramsey’s other papers and (c) failing to consider Ramsey’s writings in the context of the views that Russell and Wittgenstein held during the early 1920s. Seen from this wider perspective Ramsey arguments in “Universals” take on an altogether different significance. They not only anticipate important contemporary developments⎯the resurgence of Humeanism and the doctrine that the existence of universals can only be established a posteriori⎯but also point beyond them. (shrink)

I. The present paper was read as one of ‘Three Notes of Doubt and One of Despair’ at the Oxford Philological Society in June 1948. Generally speaking, there is nothing to be said in favour of publishing an article on a text one is admittedly unable to under-stand. But in this case it has seemed advisable to start a discussion. I am therefore grateful to my friend P. Fraser for having consented to communicate his thoughts on the matter in (...) an appendix to my note. We both hope that other scholars will be able to provide the satisfactory solution that has escaped us. Meanwhile we thank P. Maas, C. H. Roberts, and H. M. Last for their great help. (shrink)

La question du langage et de la parole dans les écrits de Merleau-Ponty ne peut se comprendre indépendamment de la phénoménologie du corps-propre et de son corrélat le monde vécu, c'est-à-dire son champ spatial et temporel, avec des horizons, proches ou lointains, dans lequel il se trouve et où il se situe.Rappelons que Merleau-Ponty montre comment le but que se propose la perception par sa propre téléologie est la chose même, et comment, ce but une fois atteint, l'idée d'un monde (...) en soi ou du réel en dérive. Le sujet percevant en tant que corps s'oublie; par rapport au monde en soi ce qui paraît rester du sujet n'est que conscience désincarnée, sujet de la science, sujet qui est partout et nulle part, qui est de tout temps et de nul temps, et qui enfin n'est personne. (shrink)

This note responds to an interpretation of Mohist Canon and Explanation B 671 published by John Makeham some years ago. Makeham’s interpretation makes significant contributions to our understanding of this passage, especially in calling attention to problems with two influential previous interpretations, those of A. C. Graham and Chad Hansen.3 Yet his reading presents difficulties of its own, which I will attempt to rectify here.

Nancy Fraser’s essay ‘From Progressive Neoliberalism to Trump – and Beyond’ is an important intervention in current discussions of Trumpism and how the left, broadly, should understand and respond to it. Fraser’s piece is an admirable effort to situate Trumpism in a broader and deeper political–economic context. At the same time, her argument suffers from a kind of reductionism and takes comfort from a questionable grand narrative of emancipation that is difficult any longer to take seriously. It thus (...) warrants both careful attention and serious criticism. My basic political point: Fraser’s version of ‘socialism or barbarism’ is unconvincing, and the adamant and principled defence of liberal democracy, and its further reform, ought to be a priority for left liberals and leftists more generally who are serious about countering right-wing populist authoritarianism. (shrink)

Mohism was an ancient Chinese philosophical movement founded in the fifth century B.C.E. by the charismatic artisan Mozi, or "Master Mo." The Mohists advanced a consequentialist ethics that anticipated Western utilitarianism by more than two thousand years and developed fascinating logical, epistemological, and political theories that set the terms of philosophical debate in China for generations. They were the earliest thinkers to outline a just war doctrine and to explain the origin of government from a state of nature. Their epistemology (...) and psychology provide intriguing alternatives to contemporary Western mentalism. The Philosophy of the Mozi is an extensive study of Mohism that immerses readers in the Mohist worldview, situates the movement's rise and decline within Chinese history, and highlights its relevance to modern thought. (shrink)

First published by Texte zur Kunst and as part of the Whitney Biennial, we present Fraser's essays together express a something like claustrophobia. As the artworldmarket has become dominated by the speculative economic activities that fueled the current extreme income distribution inequalities globally, can a critique exist that is not already paying into these exploitative practices?

The Mohist Canons are a set of brief statements on a variety of philosophical and other topics by anonymous members of the Mohist school , an influential philosophical, social, and religious movement of China's Warring States period (479-221 B.C.). [1] Written and compiled most likely between the late 4th and mid 3rd century B.C., the Canons are often referred to as the “later Mohist” or “Neo-Mohist” canons, since they seem chronologically later than the bulk of the Mohist writings, most of (...) which are probably from the mid-5th to the late 4th century. The.. (shrink)

Using C. Wright Mills' book The Sociological Imagination as a touchstone for its discussion, this article addresses the relations between the sociological problem, relevance and experience as they are and could potentially be understood within sociology. Beginning with the historical relation between sociology, science and literature — a relation which has been productively but differently complicated by poststructuralist and postconstructivist theories — this article asks: to what extent does the empirical offer a referent for the sociological problem? To what is (...) sociology obliged to be relevant? Arguing for the continued relevance of relevance, particularly in the light of recent reforms in higher education in the UK and the USA, the article explores how the sociological problem might be transformed — and perhaps, more importantly, might be transformative — if the basic commitments of a research project were not to historical social structures but to virtual structures. (shrink)

The “School of Names” ming jia ) is the traditional Chinese label for a diverse group of Warring States (479-221 B.C.) thinkers who shared an interest in language, disputation, and metaphysics. They were notorious for logic-chopping, purportedly idle conceptual puzzles, and paradoxes such as “Today go to Yue but arrive yesterday” and “A white horse is not a horse.” Because reflection on language in ancient China centered on “names”.

Introduction to reprint edition of A. C. Graham, Later Mohist Logic, Ethics and Science.

As bearers of the divine image, all of us are storytellers and artists. However, few people today believe in truth that is not empirically knowable or verifiable, the sort of truth often trafficked through direct forms of communication. Drawing on the works of Soren Kierkegaard, Benson P. Fraser challenges this penchant for direct forms of knowledge by introducing the indirect approach, which he argues conveys more than mere knowledge, but the capability to live out what one takes to be (...) true. Dr. Fraser suggests that stories aimed at the heart are powerful instruments for personal and social change because they are not focused directly on the individual listener; rather, they give the individual room or distance to reconsider old meanings or ways of understanding. Indirect communication fosters human transformation by awaking an individual to attend to images or words that carry deep symbolic force and that modify or replace one's present ways of knowing, and ultimately make one capable of embodying what he or she believes. Through an examination of the indirect approach in Kierkegaard, Jesus, C. S. Lewis, and Flannery O'Connor, Fraser makes a strong case for the recovery of indirect strategies for communicating truth in our time"--Back cover. (shrink)

In Plautus and elsewhere in old Latin there is an imperative suffix -mino of medio-deponential meaning: opperimino, PL True. 188 , progredimino, id. Pseud. 859, arbitramino, id. Epid. 695, praefamino, Cato, RR. 141, 2, famino Paul. Fest. 62, 10, Th., all 2 sg.; in legal documents, antestamino , in the XII Tables, fruimino , CIL. 1, 199, profitemino in Lex Iulia Municipalis, all 3 sg. The generally accepted explanation of the form is that it arose from a contamination of the (...) ordinary 2 pl. medio-passive imperative in -mini and the 2, 3 sg. forms in -to, Lindsay, Latin Language, p. 517, Von Planta, Gramm. d. oskisch-umbr. Dial. II, pp. 310 sqq., Buck, Elementarb. d. oskisch-umbr. Dial. p. 112, Sommer, Hdb. d. lat. Laut- u. Formenlehre, p. 366, Stolz, Lat. Gramm*. p. 158. The Oskan and the Umbrian forms in -mo, -mu, U. spahamu, eturstahmu, persnimu, O. censamur, all of 2 or 3 sg., and U. arsmahamo, caterahamo of 2 or 3 pi., are identified with the Lat. -minō forms on the assumption that the Osk-Umbr. -mu represents an older *-mnō which in turn arose by syncope from -*menō Von Planta, l.c. This explanation is the most satisfactory that has been given, and we may suppose that Latin, Oskan, and Umbrian had an imperative form in *-menō. (shrink)

In Plautus and elsewhere in old Latin there is an imperative suffix -mino of medio-deponential meaning: opperimino, PL True. 188, progredimino, id. Pseud. 859, arbitramino, id. Epid. 695, praefamino, Cato, RR. 141, 2, famino Paul. Fest. 62, 10, Th., all 2 sg.; in legal documents, antestamino, in the XII Tables, fruimino, CIL. 1, 199, profitemino in Lex Iulia Municipalis, all 3 sg. The generally accepted explanation of the form is that it arose from a contamination of the ordinary 2 pl. (...) medio-passive imperative in -mini and the 2, 3 sg. forms in -to, Lindsay, Latin Language, p. 517, Von Planta, Gramm. d. oskisch-umbr. Dial. II, pp. 310 sqq., Buck, Elementarb. d. oskisch-umbr. Dial. p. 112, Sommer, Hdb. d. lat. Laut- u. Formenlehre, p. 366, Stolz, Lat. Gramm*. p. 158. The Oskan and the Umbrian forms in -mo, -mu, U. spahamu, eturstahmu, persnimu, O. censamur, all of 2 or 3 sg., and U. arsmahamo, caterahamo of 2 or 3 pi., are identified with the Lat. -minō forms on the assumption that the Osk-Umbr. -mu represents an older *-mnō which in turn arose by syncope from -*menō Von Planta, l.c. This explanation is the most satisfactory that has been given, and we may suppose that Latin, Oskan, and Umbrian had an imperative form in *-menō. (shrink)

BackgroundAs moral case deliberations (MCDs) have increasingly been implemented in health care institutions as a form of ethics support, it is relevant to know whether and how MCDs actually contribute to positive changes in care. Insight is needed on what actually happens in daily care practice following MCD sessions. This study aimed at investigating the impact of MCD and exploring how ‘impact of MCD’ should be conceptualized for future research.MethodsA multiple-case study was conducted in a care organization for people with (...) intellectual disabilities and/or acquired brain injury, by observing MCD sessions as ‘cases’, followed by interviews with health care professionals concerning the follow-up to these cases, and a focus group with involved MCD facilitators. A conceptual scheme concerning the possible impact formed the basis for analysis: (1) individual moral awareness; (2) the actions of health care professionals; (3) collaboration among health care professionals; (4) the concrete situation of the client; (5) the client’s quality of care and life; (6) the organizational and policy level.ResultsAccording to interviewees, their moral awareness and their collaboration, both among colleagues and with clients’ relatives, improved after MCD. Perceived impact on client situation, quality of care/life and the organizational level varied among interviewees or was difficult to define or link to MCD. Three aspects were added to the conceptual scheme concerning the impact of MCD: (a) preparations and expectations prior to the MCD session; (b) a translational step between the conclusions of the MCD session and practical events in the following period, and (c) collaboration with clients’ relatives. A negative impact of MCD was also found on misunderstandings among participants and disappointment about lack of follow-up.ConclusionsConcretizing and conceptualizing the ‘impact’ of MCD is complicated as many factors play a role either before or during the transition from MCD to practice. It is important to consider ‘impact’ in a broad sense and to relate it to the goals and context of the MCD in question. Future studies in this field should pay additional attention to the preparations, content and process involved in ethics support, including clients’ and relatives’ experiences. (shrink)