Are new democracies with divided government and volatile parties politically ill fated? The literature suggests so, but cases of emergent democracies such as Taiwan and Brazil that face both conditions defy the prediction. This paper explains why: party volatility follows from pursuing distinct executive and legislature agendas under divided government; the political ambition that underlies these conditions sustains democratic and even political performance. We evaluate the argument through government spending in Taiwan. The results corroborate our expectations: they show more parties (...) composing the legislature as government spending favors an executive agenda and neglects a legislative welfare-spending agenda. The findings make three contributions to the literature: first, they reveal a political divide between executive and legislature rather than ideological parties to undercut concerns regarding performance. Second, they demonstrate that the strategic use of government spending to institutionalize party development along an executive agenda fuels party fragmentation. Third, they show that legislators split, switch, or create alternative routes to office in reaction to strategic spending to underscore that ambition underlies party volatility and divided government. (shrink)

IntroductionHead and neck cancer diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth, which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumatic experience. Intrusive rumination, by contrast, is linked to poorer outcomes. This study explored HNC survivors’ experiences of rumination.MethodsTwenty HNC survivors between 9 months and 5 years post-diagnosis were recruited. They had a range (...) of HNC sub-types and cancer treatments. Participants underwent a semi-structured interview about their cancer diagnosis and treatment. Reflexive thematic analysis identified themes and sub-themes around rumination.ResultsFour themes with linked subthemes on the content and process of rumination were identified. Theme 1 was rumination and worry related to diagnosis. Here, survivors discussed how the HNC diagnosis and plans for treatment had dominated their initial thoughts. Theme 2 was processing the trauma of HNC. This theme reflected rumination on the traumatic experience of diagnosis and treatment and how the participant was reacting to it. Theme 3 was considering the impact. This theme encompassed retrospective thinking and comparisons between the participant now versus the early days after diagnosis. Theme 4 was continued rumination. This theme included ongoing intrusive and distressing rumination about the trauma and impact of cancer. Those who expressed ongoing rumination revisited fears or returned to negative experiences.ConclusionThis study uniquely describes the nature and content of rumination following HNC. Early intrusive rumination is common and may reflect perceptions of cancer as an existential threat. Over time, rumination can become more reflective and move towards deliberate meaning-making. Some HNC survivors may benefit from interventions to reduce barriers to this transition. The content of distressing and difficult to control rumination helps to identify those who may benefit from more directed psychological support. (shrink)

For medical schools, the COVID-19 pandemic necessitated examination and curricular restructuring as well as significant changes to clinical attachments. With the available evidence suggesting that medical students’ mental health status is already poorer than that of the general population, with academic stress being a chief predictor, such changes are likely to have a significant effect on these students. This online, cross-sectional study aimed to determine the impact of COVID-19 on perceived stress levels of medical students, investigate possible contributing and alleviating (...) factors, and produce recommendations for medical schools to implement during future healthcare emergencies. The majority of respondents reported levels of stress ranging from moderate to extreme. Higher levels of stress were significantly associated with female gender and international status. A significant association was also noted between reported stress and the transition to online learning and online assessment formatting, concerns for personal health and for the health of family members. Students who reported higher stress levels were less confident in their government’s management of the crisis. Additionally, students who reported lower stress agreed highly that their medical school had an appropriate response to the crisis, had provided sufficient information regarding the crisis, that they trust their school in handling the continuing of their education and that their school had appropriate plans in place to support the continuing of education. (shrink)

The last 10 years has seen the development and deployment of new biotechnologies not just as potential treatments but also as potential enhancements. The definition and differentiation of treatment from enhancement is an ongoing clinical, ethical and social debate that ranges across a proliferating number of convergent technologies. Many of these innovations will ‘come-on-line’ as present generations of young people will be reaching adulthood and considering parenthood. This paper reports on a project that explored the possibilities for human enhancement with (...) young people in order to gather their attitudes towards enhancement and the types of arguments/reasoning they employ when thinking about the possibilities and the techniques. The project focused on if/how distinctions are made between treatment and enhancement, between the different techniques that might be used for enhancement and perceptions of risks and benefits. The young people’s viewpoints, their methods of reasoning and underlying values are compared with those of bioethicists writing on the topic. (shrink)

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services. Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic review (...) was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. (shrink)

In this model consciousness is a form of memory. We are essentially “living in the past” as our experience, the qualia, is always of past events. Consciousness represents the storage of past events for use in future situations and it is altered by external experience of the organism. Psychological frameworks of conditioning and learning theory are used to explain this model along with recent neuropsychological research on synaesthesia and phantom limb pain. Consciousness results from the gradual evolutionary development of the (...) human information processing function. Language is hypothesised to have evolved at a pre-conscious stage of human development as a function of the need for ‘within-organism’ data storage. Communication with others may not have been the initial evolutionary advantage conferred by language. The later incidental use of language as a communication tool, which results in the reflecting back of one’s experience through others, is what has triggered a conscious experience. (shrink)

This paper seeks to evaluate the concept of mainstreaming against a range of feminist critiques of laws and legal systems and to examine the case for the pursuit of feminist politics through mainstreaming strategies. It begins, in section two, by identifying theme sin existing mainstreaming literature, and then in section three considers the potential of mainstreaming to tackle the causes o fine quality. In particular it questions whether mainstreaming can address the patriarchal nature of laws and legal systems and the (...) essentialising tendencies of law, and whether mainstreaming can effectively tackle market-driven inequality. A final section considers the conditions under which feminists might consider engagement with mainstreaming and the limits of such strategies. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and Clarke’s (...) thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

How would you feel about your husband, wife, or partner masturbating using pornography or erotica? For many, this would be a betrayal – a kind of cheating. I explore whether monogamous relationships should forbid solo masturbation using erotica and pornography, considering two possible objections: (1) the objection that such activity is a kind of infidelity; (2) the objection that such activity involves attitudes, usually attitudes towards women that are incompatible with an equal, loving relationship. I argue that the use of (...) erotic material in solo masturbation should not count as cheating. Solo use of pornography differs significantly from interpersonal sexual activity. Thus, unlike causal interpersonal sex, it does not undermine the role of sex within the relationship. Additionally, freedom to explore sexual fantasy through masturbation is an important element of sexual autonomy. Objection (2) holds against some but not all erotic material. Sexual enjoyment of pornography that depicts, or is produced by, suffering or degradation involves a way of seeing others that has implications for the user’s relationships with others, particularly sexual relationships. However, not all erotic material involves objectionable attitudes towards others. Thus partners should allow moderate use of some types of erotica in solo-masturbation. (shrink)

This paper explores the meaning of environmental ethics in the small firm domain. A distinction is made between two approaches: conventional ethical discourse based on shallow ecological principles and a new ethical discourse based on deep ecology principles. Using the literature in this multi‐disciplinary field of inquiry a link is made between small firms, ethics and the environment. Empirical research data based on the author’s doctoral work with firms in Leeds is discussed. The research results indicate that small firms from (...) the study are predominantly operating a conventional ethic discourse and are framing their response to the environmental challenge using a shallow ecology ethic. (shrink)

There are many good reasons to learn about the lives of people who have less social privilege than we do. We might want to understand their circumstances in order to have informed opinions on social policy, or to make our institutions more inclusive. We might also want to cultivate empathy for its own sake. Much of this knowledge is gained through social scientific or humanistic research into others' lives. The entitlement to theorize about or study the lives of marginalized others (...) is often granted under the presumption of academic freedom. This paper will not question whether academic freedom licenses us to do so in the first place ; instead, I will... (shrink)

Which objects and properties are represented in perceptual experience, and how are we able to determine this? The papers in this collection address these questions together with other fundamental questions about the nature of perceptual content. The book draws together papers by leading international philosophers of mind, including Alex Byrne (MIT), Alva Noë (University of California, Berkeley), Tim Bayne (St Catherine’s College, Oxford), Michael Tye (University of Texas, Austin), Richard Price (All Souls College, Oxford) and Susanna Siegel (Harvard University) Essays (...) address the central questions surrounding the content of perceptual experience Investigates how are we able to determine the admissible contents of experience Published in association with the journal Philosophical Quarterly . (shrink)

This powerfully iconoclastic book reconsiders the influential nativist position toward the mind. Nativists assert that some concepts, beliefs, or capacities are innate or inborn: "native" to the mind rather than acquired. Fiona Cowie argues that this view is mistaken, demonstrating that nativism is an unstable amalgam of two quite different--and probably inconsistent--theses about the mind. Unlike empiricists, who postulate domain-neutral learning strategies, nativists insist that some learning tasks require special kinds of skills, and that these skills are hard-wired into (...) our brains at birth. This "faculties hypothesis" finds its modern expression in the views of Noam Chomsky. Cowie, marshaling recent empirical evidence from developmental psychology, psycholinguistics, computer science, and linguistics, provides a crisp and timely critique of Chomsky's nativism and defends in its place a moderately nativist approach to language acquisition. Also in contrast to empiricists, who view the mind as simply another natural phenomenon susceptible of scientific explanation, nativists suspect that the mental is inelectably mysterious. Cowie addresses this second strand in nativist thought, taking on the view articulated by Jerry Fodor and other nativists that learning, particularly concept acquisition, is a fundamentally inexplicable process. Cowie challenges this explanatory pessimism, and argues convincingly that concept acquisition is psychologically explicable. What's Within? is a clear and provocative achievement in the study of the human mind. (shrink)

Scientific and philosophical perspectives on hallucination: essays that draw on empirical evidence from psychology, neuroscience, and cutting-edge philosophical theory.

Introduction -- The ethics of care and global politics -- Rethinking human security -- 'Women's work' : the global care and sex economies -- Humanitarian intervention and global security governance -- Peacebuilding and paternalism : reading care through postcolonialism -- Health and human security : gender, care and HIV/AIDS -- Gender, care, and the ethics of environmental security -- Conclusion. Security through care.

Merleau-Ponty identifies an intertwined affective state of anxiety and courage, claiming that these are one and the same thing, as a fundamental characteristic of human existence. I argue that trust, understood as phenomenologically basic, is the unity, or the something beyond, the singularly conceived states of anxiety and courage, and that trust itself cannot be conceived apart from these states. Merleau-Ponty says little, directly, about trust in his work, yet his focus on the fundamental precariousness of existence demands such an (...) exploration. I explore how our ordinary day-to-day experience of existence is related to an intertwined affective state of anxiety and courage and how trust is operative in affective depth, in order to understand how it is we come to speak of trust not only in terms of proximity and distance, emotional depth and extension across time, but most markedly, in terms of how we see someone and what it is like to be in relation to them. (shrink)

Can the phenomenal character of perceptual experience be altered by the states of one's cognitive system, for example, one's thoughts or beliefs? If one thinks that this can happen then one thinks that there can be cognitive penetration of perceptual experience; otherwise, one thinks that perceptual experience is cognitively impenetrable. I claim that there is one alleged case of cognitive penetration that cannot be explained away by the standard strategies one can typically use to explain away alleged cases. The case (...) is one in which it seems subjects' beliefs about the typical colour of objects affects their colour experience. I propose a two-step mechanism of indirect cognitive penetration that explains how cognitive penetration may occur. I show that there is independent evidence that each step in this process can occur. I suspect that people who are opposed to the idea that perceptual experience is cognitively penetrable will be less opposed to the idea when they come to consider this indirect mechanism and that those who are generally sympathetic to the idea of cognitive penetrability will welcome the elucidation of this plausible mechanism. (shrink)

This book challenges readers to rethink rural health ethics. Traditional approaches to health ethics are often urban-centric, making implicit assumptions about how values and norms apply in health care practice, and as such may fail to take into account the complexity, depth, richness, and diversity of the rural context. There are ethically relevant differences between rural health practice and rural health services delivery and urban practice and delivery that go beyond the stereotypes associated with rural life and rural health services. (...) This book examines key values in the rural context that have not been fully explored or taken into account when we examine health ethics issues, including the values of community and place, and a need to “revalue” relationships. It also advocates for a greater attention to meso and macro level analysis in rural health ethics as being critical to ethical analysis of rural health care. This book is essential reading for those involved in health ethics, rural health policy and governance, and for rural health providers. (shrink)

It is a philosophy of patient care, and is therefore open to critique and evaluation.Using the Oxford Textbook of Palliative Medicine Third Edition as their ...

Although the focus of "Globalizing Democracy and Human Rights" is practical, Gould does not shy away from hard theoretical questions, such as the relentless debate over cultural relativism, and the relationship between terrorism and democracy.

In this paper we trace the historical exclusion of women from the legal profession in Canada. We examine women’s efforts to gain entry to law practice and their progress through the last century. The battle to gain entry to this exclusive profession took place on many fronts: in the courts, government legislature, public debate and media, and behind the closed doors of the law societies. After formal barriers to entry were dismantled, women continued to confront formidable barriers through overt and (...) subtler forms of discrimination and exclusion. Today’s legal profession in Canada is a contested one. Women have succeeded with large enrolments in law schools and growing representation in the profession. However, women remain on the margins of power and privilege in law practice. Our analysis of contemporary official data on the Canadian legal profession demonstrates that women are under-represented in private practice, have reduced chances for promotion, and are excluded from higher echelons of authority, remuneration, and status in the profession. Yet, the contemporary picture of the legal profession also reveals that women are having an important impact on the profession of law in Canada by introducing policy reforms aimed at creating a more humane legal profession. (shrink)

Research ethicists have recently declared a new ethical imperative: that researchers should communicate the results of research to participants. For some analysts, the obligation is restricted to the communication of the general findings or conclusions of the study. However, other analysts extend the obligation to the disclosure of individual research results, especially where these results are perceived to have clinical relevance. Several scholars have advanced cogent critiques of the putative obligation to disclose individual research results. They question whether ethical goals (...) are served by disclosure or violated by non-disclosure, and whether the communication of research results respects ethically salient differences between research practices and clinical care. Empirical data on these questions are limited. Available evidence suggests, on the one hand, growing support for disclosure, and on the other, the potential for significant harm. (shrink)

ABSTRACT This paper reveals David Hilbert’s position in the philosophy of mathematics, circa 1900, to be a form of non-eliminative structuralism, predating his formalism. I argue that Hilbert withstands the pressing objections put to him by Frege in the course of the Frege-Hilbert controversy in virtue of this early structuralist approach. To demonstrate that this historical position deserves contemporary attention I show that Hilbertian structuralism avoids a recent wave of objections against non-eliminative structuralists to the effect that they cannot distinguish (...) between structurally identical but importantly distinct mathematical objects, such as the complex roots of $-1$. (shrink)

In the late 1940s, a microanatomist from London Ontario, Murray Barr, discovered a mark of sex chromosome status in bodily tissues, what came to be known as the ‘Barr body’. This discovery offered an important diagnostic technology to the burgeoning clinical science community engaged with the medical interpretation and management of sexual anomalies. It seemed to offer a way to identify the true, underlying sex in those whose bodies or lives were sexually anomalous . The hypothesis that allowed the Barr (...) body to stand in for ‘chromosomal’ or ‘genetic’ sex was provisional, but it supported the expectation that genetic information established one’s primary identity, and the conviction that the animal world could be neatly divided into two, and only two, sexes. Ultimately, this provisional hypothesis, and its status as an unambiguous arbiter of true sex, was overturned. But during much of the 1950s, Barr’s thesis about the identity of the Barr body was consistent with a coherent set of theories and evidence explaining sexual development and sexual pathology. Though provisional, the scientific status of the sex chromatin within this system of knowledge was good enough to support a flourishing research enterprise in the clinical sciences. (shrink)

The correct positioning of organs during embryonic development requires multiple cues. The Xenopus cement gland is a mucus‐secreting epithelium that is a simple model for organogenesis, allowing detailed analysis of this complex process. The cement gland forms at a conserved anterior position, where embryonic ectoderm and endoderm touch. In all deuterostomes, this region will form the stomodeum (primitive mouth) and, in some aquatic larva, will also form a cement gland. In recent years, a model has been put forward suggesting that (...) an intermediate level of BMP signaling in the ectoderm leads to cement gland formation. We propose an alternative model whereby, during gastrulation, the cement gland (CG) is positioned by the overlap of three domains, corresponding to anterodorsal identity (AD), ventrolateral identity (VL), and ectodermal outer layer identity (EO), defining the equation (AD + VL + EO = CG). Anterodorsal identity requires a contribution by the transcription factor Otx2 while ventrolateral identity requires the BMP4 signaling pathway. These postional cues are integrated to activate cement gland differentiation. This integration appears to require intermediate steps, including expression of pitx genes, and members of the ATF/CREB and Ets transcription factor families. BioEssays 25:717–726, 2003. © 2003 Wiley Periodicals, Inc. (shrink)

Fiona Woollard presents an original defence of the Doctrine of Doing and Allowing, according to which doing harm seems much harder to justify than merely allowing harm. She argues that the Doctrine is best understood as a principle that protects us from harmful imposition, and offers a moderate account of our obligations to offer aid to others.

Ethical perspectives on regional, rural, and remote healthcare often, understandably and importantly, focus on inequities in access to services. In this commentary, we take the opportunity to examine the implications of normalizing metrocentric views, values, knowledge, and orientations, evidenced by the recent (2022) New South Wales inquiry into health outcomes and access to hospital and health services in regional, rural and remote New South Wales, for contemporary rural governance and justice debates. To do this, we draw on the feminist inspired (...) approach to rural health ethics involving analysis of power relationships developed by Simpson and McDonald and related ideas from critical health sociology. In presenting this analysis, we extend contemporary thought about spatial health inequities and structural violence. (shrink)

The biomedicalist conceptualization of disablement as a personal medical tragedy has been criticized by disability studies scholars for discounting the difference between disability and impairment and the ways disability is produced by socio-environmental factors. This paper discusses prospects for partnerships between disability studies teaching/research and medical education; addresses some of the themes around the necessity of critical disability studies training for medical students; and examines a selection of issues and themes that have arisen from disability education courses within medical schools (...) globally. The paper concludes that providing there is a commitment from senior management, universities are well positioned to apply both vertical and horizontal approaches to teaching disability studies to medical students. (shrink)