The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a virtual reality task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, the Mini Mental State (...) Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a virtual reality task of multiple demands. It was also verified the possibility use of virtual reality for neuropsychological assessment of older adults. (shrink)

Moral philosophers agree that welfare matters. But they disagree about what it is, or how much it matters. In this vital new work, Wayne Sumner presents an original theory of welfare, investigating its nature and discussing its importance. He considers and rejects all notable theories of welfare, both objective and subjective, including hedonism and theories founded on desire or preference. His own theory connects welfare closely with happiness or life satisfaction. Reacting against the value pluralism that currently dominates moral philosophy, (...) he advances welfare as the only basic ethical value. He concludes by discussing the implications of this thesis for ethical and political theory. Written in clear, non-technical language, and including a definitive survey of other work in this area, Sumner's book is essential reading for moral philosophers, political theorists, and welfare economists. (shrink)

Local food systems can have economic and social benefits by providing income for producers and improving community connections. Ongoing global climate change and the acute COVID-19 pandemic crisis have shown the importance of building equity and resilience in local food systems. We interviewed ten stakeholders from organizations and institutions in a U.S. midwestern city exploring views on past, current, and future conditions to address the following two objectives: 1) Assess how local food system equity and resilience were impacted by the (...) COVID-19 pandemic, and 2) Examine how policy and behavior changes could support greater equity and resilience within urban local food systems. We used the Community Capitals Framework to organize interviewees’ responses for qualitative analyses of equity and resilience. Four types of community capital were emphasized by stakeholders: cultural and social, natural, and political capital. Participants stated that the local food system in this city is small; more weaknesses in food access, land access, and governance were described than were strengths in both pre- and post-pandemic conditions. Stakeholder responses also reflected lack of equity and resilience in the local food system, which was most pronounced for cultural and social, natural and political capitals. However, local producers’ resilience during the pandemic, which we categorized as human capital, was a notable strength. An improved future food system could incorporate changes in infrastructure (e.g., food processing), markets (e.g., values-based markets) and cultural values (e.g., valuing local food through connections between local producers and consumers). These insights could inform policy and enhance community initiatives and behavior changes to build more equitable and resilient local food systems in urban areas throughout the U.S. Midwest. (shrink)

Since its inception in 1968, the concept of whole-brain death has been contentious, and four decades on, controversy concerning the validity and coherence of whole-brain death continues unabated. Although whole-brain death is legally recognized and medically entrenched in the United States and elsewhere, there is reasonable disagreement among physicians, philosophers, and the public concerning whether brain death is really equivalent to death as it has been traditionally understood. A handful of states have acknowledged this plurality of viewpoints and enacted “conscience (...) clauses” that require “reasonable accommodation” of religious and moral objections to the determination of death by neurological criteria. This paper argues for the universal adoption of “reasonable accommodation” policies using the New Jersey statute as a model, in light of both the ongoing controversy and the recent case of Jahi McMath, a child whose family raised religious objections to a declaration of brain death. Public policies that accommodate reasonable, divergent viewpoints concerning death provide a practical and compassionate way to resolve those conflicts that are the most urgent, painful, and difficult to reconcile. (shrink)

US Supreme Court rulings concerning sanctions for juvenile offenders have drawn on the science of brain development and concluded that adolescents are inherently less mature than adults in ways that render them less culpable. This conclusion departs from arguments made in cases involving the mature minor doctrine, in which teenagers have been portrayed as comparable to adults in their capacity to make medical decisions. I attempt to reconcile these apparently incompatible views of adolescents’ decision-making competence. Adolescents are indeed less mature (...) than adults when making decisions under conditions that are characterized by emotional arousal and peer pressure, but adolescents aged 15 and older are just as mature as adults when emotional arousal is minimized and when they are not under the influence of peers, conditions that typically characterize medical decision-making. The mature minor doctrine, as applied to individuals 15 and older, is thus consistent with recent research on adolescent development. (shrink)

Clinical decision making is a challenging task that requires practical wisdom—the practised ability to help patients choose wisely among available diagnostic and treatment options. But practical wisdom is not a concept one typically hears mentioned in medical training and practice. Instead, emphasis is placed on clinical judgement. The author draws from Aristotle and Aquinas to describe the virtue of practical wisdom and compare it with clinical judgement. From this comparison, the author suggests that a more complete understanding of clinical judgement (...) requires its explicit integration with goals of care and ethical values. Although clinicians may be justified in assuming that goals of care and ethical values are implicit in routine decision making, it remains important for training purposes to encourage habits of clinical judgement that are consciously goal-directed and ethically informed. By connecting clinical judgement to patients' goals and values, clinical decisions are more likely to stay focused on the particular interests of individual patients. To cultivate wise clinical judgement among trainees, educational efforts should aim at the integration of clinical judgement, communication with patients about goals of care, and ethical reasoning. But ultimately, training in wise clinical judgement will take years of practice in the company of experienced clinicians who are able to demonstrate practical wisdom by example. By helping trainees develop clinical judgement that incorporates patients' goals of care and ethical reasoning, we may help lessen the risk that ‘clinical judgement’ will merely express ‘the clinician's judgement.’. (shrink)

Reporting peers’ counterproductive work behaviors (CWBs) is important for maintaining an ethical organization, but is a significant and potentially risky action. In Bandura’s Theory of Moral Thought and Action (Bandura, 1991) he states that such acts require significant moral agency, which is generated when an individual possesses adequate moral self-regulatory capacities to address the issue and is in a context that activates and reinforces those capacities. Guided by this theory, we assess moral potency (i.e., moral courage, moral efficacy, and moral (...) ownership) as key capacities predicting peer reporting intentions and assess three contextual factors influencing the generation and effects of moral potency: whether a potential informant (1) works for an ethical leader, (2) is embedded in a psychologically safe climate promoting interpersonal risk-taking, and (3) operates in a more normal or extreme context. We assess the proposed model across three field studies entailing both normal and extreme (i.e., firefighting units) contexts. Results show that ethical leaders raise employees’ moral potency, promoting greater willingness to report their peers’ CWBs. In normal work contexts, psychological safety positively moderated both the relationship between ethical leadership and moral potency and between moral potency and peer reporting intentions. However, psychological safety had the opposite effects in more extreme work contexts. Whereas psychological safety strengthens the positive association between moral potency and peer reporting intentions in normal work contexts, in contexts where individuals are more frequently exposed to extreme events, psychological safety weakens this relationship, thus highlighting the unforeseen downsides of psychological safety in extreme contexts. (shrink)

_The Routledge Handbook of Neuroethics_ offers the reader an informed view of how the brain sciences are being used to approach, understand, and reinvigorate traditional philosophical questions, as well as how those questions, with the grounding influence of neuroscience, are being revisited beyond clinical and research domains. It also examines how contemporary neuroscience research might ultimately impact our understanding of relationships, flourishing, and human nature. The _Handbook_ features easy-to-follow chapters that appear here for the first time in print and—written by (...) 61 key scholars and fresh voices—represent the wide range of viewpoints in neuroethics. The volume spotlights new technologies and historical articulations of key problems, issues, and concepts, and includes cross-referencing between chapters to highlight the complex interactions of concepts and ideas within neuroethics. These features enhance the _Handbook_’s utility by providing readers with a contextual map for different approaches to issues, and a guide to further avenues of interest. (shrink)

In _Civilization and Its Discontents_, Freud made abundantly clear what he thought about the biblical injunction, first articulated in Leviticus 19:18 and then elaborated in Christian teachings, to love one's neighbor as oneself. "Let us adopt a naive attitude towards it," he proposed, "as though we were hearing it for the first time; we shall be unable then to suppress a feeling of surprise and bewilderment." After the horrors of World War II, the Holocaust, Stalinism, and Yugoslavia, Leviticus 19:18 seems (...) even less conceivable—but all the more urgent now—than Freud imagined. In _The Neighbor_, three of the most significant intellectuals working in psychoanalysis and critical theory collaborate to show how this problem of neighbor-love opens questions that are fundamental to ethical inquiry and that suggest a new theological configuration of political theory. Their three extended essays explore today's central historical problem: the persistence of the theological in the political. In "Towards a Political Theology of the Neighbor," Kenneth Reinhard supplements Carl Schmitt's political theology of the enemy and friend with a political theology of the neighbor based in psychoanalysis. In "Miracles Happen," Eric L. Santner extends the book's exploration of neighbor-love through a bracing reassessment of Benjamin and Rosenzweig. And in an impassioned plea for ethical violence, Slavoj Žižek's "Neighbors and Other Monsters" reconsiders the idea of excess to rehabilitate a positive sense of the inhuman and challenge the influence of Levinas on contemporary ethical thought. A rich and suggestive account of the interplay between love and hate, self and other, personal and political, _The Neighbor_ will prove to be a touchstone across the humanities and a crucial text for understanding the persistence of political theology in secular modernity. (shrink)

Sexuality education is fundamental in higher and tertiary education institutions (HTEIs). Evidence suggests that its effective education is through translations into the first language of learners. However, in global and multilingual cultural communities such as HTEIs, the foundations for these translations are still a researchable area. Notably, in HTEIs adolescents, young adults and adults co-exist and therefore, any translations must be toned to balance across these groups. The aim of this study was to establish strategies that could enable sexuality educators (...) to effectively transfer information that is steeped in indigenous language, religious and cultural meaning without precipitating stigma and taboo issues. The study setting was the National University of Science and Technology where a cross section of indigenous cultures, languages and religions co-existed with other global cultures. A University Community-based Participatory Research (CBPR) methodology was administered by the researchers using a Delphi research approach to students and staff. Multilingual, multilayered, multireligious, and multicultural nature of the setting presented serious challenges that compromised the prevention of stigma and taboo issues when dealing with sexuality education. We recommend that the strategy to present sexuality education in indigenous languages to the generality of HTEIs population should, in the first instance, involve systematic identification of appropriate interventions that are religious, cultural, and language-specific. Contribution: This research reveals paramount ethical and religious violations that have a potential to precipitate opportunistic sexual relationships that may lead to impediments in capacity building for learners. This research can be utilised by academics on the field of Practical Theology, specifically youth ministry and pastoral care. (shrink)

Confucianism defined benevolence with “feelings” and “love.” “Feelings” in Confucianism can be mainly divided into three categories: feelings in general, love for one’s relatives, and compassion. The seven kinds of feeling in which people respond to things can be summarized as “likes and dislikes.” The mind responds to things through feelings; based on the mind of benevolence and righteousness or feelings of compassion, the expression of feelings can conform to the principle of the mean and reach the integration of self (...) and others, and of self and external things. The “relations between the seven kinds of feelings and the Four Commencements,” however, was not developed into a theoretical idea in Confucianism. After Confucius, the relationship between the universality of natural sympathies and the gradation of love for relatives gradually became an important subject in Confucian ideas of benevolence and love. By “refuting Yang Zhu and Mozi,” Mencius systematically expounded on this issue. Love had two ends: self-love and natural sympathies, between which existed the love for relatives. These two ends were not the two extremes of Yang’s self-interest and Mozi’s universal love. Love for relatives not only implied a gradation, but also contained universality and transcendence that came from self-love. Love for relatives, natural sympathies and self-love had a kind of tension and connectivity between two dynamic ends. The Confucian idea of benevolence and love hence demonstrated differences and interconnectivity. An accurate understanding of such “feelings” and “love” is important for us to grasp Confucian thoughts on benevolence and its realization. (shrink)

This publication features the stories and experiences of pharmacy professionals who identify as members of historically underrepresented groups. This collection of personal essays presents significant events in the lives of those in the pharmacy community whose experiences have been shaped by their race, ethnicity, gender or gender presentation, sexual orientation, ability, language, mental health, or other factors. The perspectives from the narratives highlight the importance of diversity, equity, and inclusion in the healthcare sector. The authors of the narratives also reflect (...) on their experience to consider what they wish would have happened in the experience, to offer advice for others that may be faced with similar situations. Access to these stories will deepen the collective understanding among pharmacy colleagues, patients, and society of the experiences that individuals from historically underrepresented groups within pharmacy have experienced. (shrink)

There is ongoing ethical and legal debate about withdrawing life sup- port for patients with disorders of consciousness (DOCs). Frequently fu- eling the debate are implicit assumptions about the value of life in a state of impaired consciousness, and persistent uncertainty about the quality of life (QoL) of these persons. Yet there are no validated methods for assessing QoL in this population, and a significant obstacle to doing so is their inability to communicate. Recent neuroscientific discoveries might circumvent that problem (...) and help shed light on QoL in DOCs. There is an ethical imperative to prioritize QoL research in this patient population, to provide evidence to inform treatment, research, and end of life decisions. A minimalist and pragmatic model of QoL is proposed, targeting positive and negative affect as domains for which there is po- tential to reach across the communication gap, and restore to these voiceless persons some measure of control. (shrink)

The relationship between the United Kingdom and the United States seems to embody most fully the type of the ‘special relationship’ today. It is a relationship founded ultimately on biological kinship, structured by mutual economic and strategic interests and cemented by a sense of political and ‘spiritual’ affinity. At least the broad contours of such contemporary ‘special relationships’ are sufficiently clear. This is far from being the case with those of the Archaic and Classical Greek world, for two main reasons. (...) First, and more decisively, our sources for the history of that world – literary, epigraphical, archaeological – are normally scrappy, discontinuous and variously slanted. Second, and only in part because of the nature of the evidence, the workings of all ancient Greek interstate relationships, whether ‘special’ or not, are in principle controversial. For in the absence of governments and parties in the modern sense it is frequently impossible to explain confidently a particular foreign policy decision taken by a Greek state. A fortiori it is in principle even more difficult to describe and account for ‘special’ relationships between states that apparently transcended purely immediate, local and narrowly self-interested considerations. (shrink)

In this aricle, I argue that Descartes can be seen as a occupying a distinct middle ground between ancient music theory, which was being revived in the Renaissance, and eighteenth-century aestheticians. Descartes’ approach to music had its roots in humanist thought but, even from the start, it wasn’t simply another humanist theory of music. The views Descartes begins to develop in his early years, in the Compendium musicae (1618), is continuous with the views he articulates near the end of his (...) life in the Passions of the Soul (1649). And the position on the effects of music is an interesting and important one, bridging humanist thought with the new philosophy. Unlike the humanists, Descartes will be unwilling to identify particular musical proportions as intrinsically connected with pleasure or other affects, but he will nevertheless develop an objective account of aesthetic value. (shrink)

The Philosophy of Time Society (PTS) grew out of a National Endowment for the Humanities Summer Seminar on the Philosophy of Time offered by George Schlesinger in 1991. The members of that seminar wanted to promote interest in the philosophy of time and Jon N. Turgerson offered to become the first Director of the PTS with the initial costs underwritten by the Drake University Center for the Humanities. Thus, the PTS was formed in 1993. Its goal is to promote the (...) study of the philosophy of time from a broad analytic perspective, and to provide a forum as an affiliated group with the American Philosophical Association (APA), to discuss the issues in and related to the philosophy of time. The society held its first meeting during the Eastern Division of the APA in Atlanta, GA, in December 1993. In 1997, L. Nathan Oaklander began his tenure as Executive Director of PTS and, with his term ending in 2000, he decided to put together a volume of selected papers read at PTS meetings over the years. The result is the present volume. It contains some of the latest developments in the field, including discussions of books by Michael Tooley (Time, Tense, and Causation), and D. H. Mellor (Real Time II), and much more. The main issue in the philosophy of time is and remains the status of temporal becoming and the passage of time. (shrink)

The federal government is funding a sea change in health care by investing in interventions targeting social determinants of health, which are significant contributors to illness and health inequity. This funding power has encouraged states, professional and accreditation organizations, health care entities, and providers to focus heavily on social determinants. We examine how this shift in focus affects clinical practice in the fields of oncology and emergency medicine, and highlight potential areas of reform.

Concussion and Mild Traumatic Brain Injury affect millions of people worldwide. mTBI has been called the “signature injury” of the recent conflicts in Iraq and Afghanistan, affecting thousands of active duty service men and women, and veterans. Sport-related concussion represents a significant public health problem, with elite and professional athletes, and millions of youth and amateur athletes worldwide suffering concussions annually. These brain injuries have received scant attention from neuroethicists, and the focus of this special issue is on defining the (...) ethical considerations and developing and elucidating the neuroethical contributions to the discussion about concussion and mTBI. (shrink)

Robert Stern has argued that Levinas is a kind of command theorist and that, for this reason, Løgstrup can be understood to have provided an argument against Levinas. In this paper, I discuss Levinas’s use of the vocabulary of demand, order, and command in the light of Jewish philosophical accounts of such notions in the work of Martin Buber, Franz Rosenzweig, and Emil Fackenheim. These accounts revise the traditional Jewish idea of command and I show that Levinas’s use of this (...) vocabulary is also revisionary. I show that in light of this tradition of discussion, Levinas’s use is not susceptible to the interpretation Stern proposes and thus that the Løgstrup-style argument cannot be used against Levinas. (shrink)

Pickering & Garrod's (P&G's) integrated model of production and comprehension includes no explicit role for nonlinguistic cognitive processes. Yet, how domain-general cognitive functions contribute to language processing has become clearer with well-specified theories and supporting data. We therefore believe that their account can benefit by incorporating functions like working memory and cognitive control into a unified model of language processing.

The phenomenon whereby severely disabled persons self-report a higher than expected level of subjective well-being is called the “disability paradox.” One explanation for the paradox among brain injury survivors is “response shift,” an adjustment of one’s values, expectations, and perspective in the aftermath of a life-altering, disabling injury. The high level of subjective well-being appears paradoxical when viewed from the perspective of the non-disabled, who presume that those with severe disabilities experience a quality of life so poor that it might (...) make their lives not worth living. This presumption has profound consequences, for it may inform end-of-life choices made in advance directives, or influence decisions made by surrogates on behalf of persons who are unable to direct their own medical treatment. -/- Peterson et al propose a cautious, well-considered plan to use fMRI-based brain-computer interfaces to assess the decision making capacity of covertly aware, behaviorally non-responsive individuals who retain high levels of preserved cognition. Their plan, if it succeeds, could eventually restore autonomy and empower some severely disabled persons, allowing them to participate in clinical decision making. Peterson et al discuss possible in-principle objections to their proposal, among them the “argument from psychological health,” and the “changing sets of values” objection. These objections both presume that deviations from a pre-injury norm could indicate diminished decision making capacity. This presumption threatens the autonomy of the patient who is capable of making decisions, but whose post-injury decisions appear to diverge from pre-injury preferences or values. In light of the potential for response shift, and the disability paradox, it should not be inferred that changes in values or preferences are unreflective of the true current preferences of a brain-injured person, nor are they conclusive evidence of diminished capacity. Presuming diminished capacity on the basis of unexpected or unconventional preferences has, in the past, been used to disempower patients whose autonomy and capacity would not have been doubted had they made choices that accorded with the expectations or values of others. We must be cautious, and vigilant, to prevent similarly diminishing the autonomy of covertly aware, behaviorally non-responsive individuals on the basis of empirically and ethically questionable inferences about their decision making capacity. (shrink)

Bruno Bernardi ouvre cet imposant recueil en dégageant la difficulté inhérente à son titre : peut-on trouver dans l’œuvre de Rousseau une philosophie? Les actes du colloque sur Rousseau ayant eu lieu en juin 2012 à l’ENS de Lyon manifestent un vrai renouvellement des lectures de l’œuvre du Genevois. Dans une histoire séquencée dont l’utilité pour les jeunes chercheurs justifierait à elle seule l’existence de cet ouvrage, B. Bernardi rappelle les grands jalons de la critique du xxe siècle. Le...

L. Stasyuk «Projection of Humanistic and Reformational reception in Protestant Ortodoxy». There is performed a philosophical and theological reflection of the process in which main subjects of Renaissance and Reformation changes adhere to the principle of getting back to sources such as appeal, thorough rethinking, borrowing of the antique heritage within which a foundation of the Humanism philosophy is laid, as well as to the Holy Scriptures and to the teachings of spiritual and religious leaders of Christianity. There is made (...) a comparative analysis of the attitude to the antique philosophical and medieval scholastic achievements and to the philosophy as a way of thinking generally by representatives of Humanism and Protestant Orthodoxy which typify the spiritual paradigm of European history. (shrink)

A pressing issue in neuroscience is the high rate of misdiagnosis of disorders of consciousness. As new research on patients with disorders of consciousness has revealed surprising and previously unknown cognitive capacities, the need to develop better and more reliable methods of diagnosing these disorders becomes more urgent. So too the need to expand our ethical and social frameworks for thinking about these patients, to accommodate new concerns that will accompany new revelations. A recent study on trace conditioning and learning (...) in vegetative and minimally conscious patients shows promise as a potential diagnostic and prognostic tool, both for differentiating between states of diminished consciousness, and for predicting patient outcomes, but it also generates fresh concerns about quality of life in patients previously thought to be completely unaware. Optimism about progress in diagnosing and treating disorders of consciousness must be tempered by the understanding that not all progress will necessarily be good for all patients. The prognosis for most patients remains bleak, and we must remain vigilant to acute questions and concerns about welfare and quality of life. (shrink)

The aim of this study was to synthesize the concepts from empirical studies and analyze, compare and interrelate them with normative ethics. The International Council of Nurses (ICN) and the Health and Medical Service Act are normative ethics. Five concepts were used in the analysis; three from the grounded theory studies and two from the theoretical framework on normative ethics. A simultaneous concept analysis resulted in five outcomes: interconnectedness, interdependence, corroboratedness, completeness and good care are all related to the empirical (...) perspective of the nurse’s interaction with the older patient, and the normative perspective, i.e. that found in ICN code and SFS law. Empirical ethics and normative ethics are intertwined according to the findings of this study. Normative ethics influence the nurse’s practical performance and could be supporting documents for nurses as professionals. (shrink)

While central to the Christian religion, the act of faith has been notoriously difficult to define. This essay is an attempt to illuminate, with the aid of insights from cognitive science and process philosophy, what it means for a Christian to have faith, specifically in God. In doing so, the apriori and aposteriori aspects of faith are explored, along with its connections to science and empirical evidence, revelation, knowledge, doubt, morality, and additional Christian beliefs.