Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at exploring rates of body image concerns among breast cancer patients, and identifying dyadic (...) profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics, psychological distress, coping flexibility, dyadic coping, and closeness. Body image and adjustment to cancer measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” reported low rates of body image concerns, anxious preoccupation, negative dyadic coping, and self-oriented stress communication, compared to “worried patients”. “Comfortable partners” reported lower anxiety and depression, self-oriented negative dyadic coping and closeness than “uncomfortable partners”. Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions. (shrink)

ObjectiveMost young adults diagnosed with breast or gynecologic cancers experience adverse reproductive or sexual health outcomes due to cancer and its treatment. However, evidence-based interventions that specifically address the RSH concerns of young adult and/or LGBTQ+ survivor couples are lacking. Our goal is to develop a feasible and acceptable couple-based intervention to reduce reproductive and sexual distress experience by young adult breast and gynecologic cancer survivor couples with diverse backgrounds.MethodsWe systematically adapted an empirically supported, theoretically grounded couple-based intervention to address (...) the RSH concerns of young couples coping with breast or gynecologic cancer through integration of stakeholder perspectives. We interviewed 11 couples with a history of breast or gynecologic cancer to review and pretest intervention materials. Three of these couples were invited to review and comment on intervention modifications. Content experts in RSH and dyadic coping, clinicians, and community advisors participated throughout the adaptation process.ResultsFindings confirmed the need for an online, couple-based intervention to support young couples experiencing RSH concerns after breast or gynecologic cancer. Qualitative themes suggested intervention preferences for: A highly flexible intervention that can be tailored to couples’ specific RSH concerns; Active steps to help members of a dyad “get on the same page” in their relationship and family building plans; A specific focus on raising partners’ awareness about how cancer can affect body image and physical intimacy; and Accessible, evidence-based information about RSH for both partners. These results, along with feedback from stakeholders, informed adaptation and finalization of the intervention content and format. The resulting virtual intervention, Opening the Conversation, includes five weekly sessions offering training to couples in communication and dyadic coping skills for addressing RSH concerns.ConclusionThe systematic adaptation process yielded a theory-informed intervention for young adult couples facing breast and gynecological cancers, which will be evaluated in a randomized controlled trial. The long-term goal is to implement and disseminate Opening the Conversation broadly to reach young adult couples with diverse backgrounds who are experiencing RSH concerns in cancer survivorship. (shrink)

The current situation around COVID-19 portrays a threat to us in several ways: It imposes uncertainty, a lack of control and reminds us of our own mortality. People around the world have reacted to these threats in seemingly unrelated ways: From stockpiling yeast and toilet paper to favoring nationalist ideas or endorsing conspiratorial beliefs. According to the General Process Model of Threat and Defense the confrontation with a threat - a discrepant experience - makes humans react with both proximal and (...) distal threat responses. While the proximal response manifests in behavioral inhibition that leads to heightened anxious arousal and vigilance, distal responses seek to lower behavioral inhibition and the associated state of anxiety and vigilance through engaging in distal defenses. In the present research, we propose that the reactions to COVID-19 may represent distal defense strategies to the pandemic (in the form of environmental or group related worldview defenses) and therefore can be explained and forecasted by the model. Thus we hypothesized increased perceived COVID-19 threat perception to lead to a proximal threat response in the form of heightened behavioral inhibition. This, in return, should enhance the use of distal defenses (i.e.: several ingroup biases, system justification and conspiratorial beliefs) overlapping with the reactions observed as a response to COVID-19. This hypothesized mediated effect of increased perceived COVID-19 threat on distal defenses was tested in two pre-registered studies: In Study 1 (N = 358) results showed perceived COVID-19 threat to be related to behavioral inhibition and in turn to be associated with increased distal defenses (i.e., higher entitativity, control restoration motivation, passive party support). In Study 2 (N = 348) we manipulated COVID-19 threat salience and found results suggesting the distal defenses of system justification and conspiratorial beliefs to be mediated by the proximal threat response. The results of the present research hint towards a common mechanism through which the seemingly unrelated reactions to COVID-19 can be explained. The results might help to predict future behavior during the COVID-19 pandemic and design measures to counteract detrimental effects of the pandemic. (shrink)

§ 219a of the German Penal Code (StGB) – the so-called ban on advertising abortions – has been subject of an increasing legal-political controversy since 2017 and was dropped by legislation in July 2022. This paper examines and reconstructs the extent to which the aforementioned ‘ban on advertising’ was (in–)‌compatible with recognized standards of medical ethics. For this purpose, arguments put forward in public discourse on both sides of the conflict, insofar as they go beyond basic attitudes toward abortion, will (...) be subjected to a plausibility test from the perspective of medical ethics. This will show that (I.) according to the standard understanding of autonomy in medical ethics by Beauchamp and Childress, the provision of information about abortions is not an undue influence, but a necessary precondition for autonomous decisions by pregnant women; that (II.) the feared undesirable social developments after the abolition of § 219a StGB are empirically unfounded and largely implausible; but that on the other hand (iii) a multi-perspective communication landscape with accessible expert information promises to effectively counteract the self- and external stigmatization of unintentionally pregnant women. As a result, this analysis provides two things: a coherent medico-ethical justification for the annulment of § 219a StGB and an argumentative basis for the defense against future efforts to support biopolitical positions by censoring available information. (shrink)

Boredom, in cinema as well as in our everyday experience, is usually associated with a generalised loss of meaning or interest. Accordingly, boredom is often perceived as that which ought to be avo...

Drawing on philosophy, law and political science, and on a wealth of practical experience delivering emergency medical services in conflict-ridden settings, Lepora and Goodin untangle the complexities surrounding compromise and complicity.

After initially emerging in China, the coronavirus outbreak has advanced rapidly. The World Health Organization has recently declared it a pandemic, with Europe becoming its new epicentre. Italy has so far been the most severely hit European country and demand for critical care in the northern region currently exceeds its supply. This raises significant ethical concerns, among which is the allocation of scarce resources. Professionals are considering the prioritisation of patients most likely to survive over those with remote chances, and (...) this news has triggered an intense debate about the right of every individual to access healthcare. The proposed analysis suggests that the national emergency framework in which prioritisation criteria are currently enforced should not lead us to perceive scarce resources allocation as something new. From an ethical perspective, the novelty of the current emergency is not grounded in the devastating effects of scarce resources allocation, which is rife in recent and present clinical practice. Rather, it has to do with the extraordinarily high number of people who find themselves personally affected by the implications of scarce resources allocation and who suddenly realise that the principle of ‘equals should be treated equally’ may no longer be applicable. Along with the need to allocate appropriate additional financial resources to support the healthcare system, and thus to mitigate the scarcity of resources, the analysis insists on the relevance of a medical ethics perspective that does not place the burden of care and choice solely on physicians. (shrink)

In this chapter, I will present an empirical conjecture to the effect that some bodily actions are categorically perceived. These are bodily actions such as grasping or reaching for something, which I am going to call motor actions. My conjecture builds on one recently put forward about how the categorical perception of facial expressions of some emotions works. I shall motivate my own conjecture on the basis of both theoretical and empirical considerations, describe how it could be operationalised and what (...) explanatory gain could be obtained from it. (shrink)

This study offers a new interpretation of the poem of the founder of Western philosophy: Parmenides. It shows that there is more in his poem than the description of Being by means of negative adjectives such as ingenerated and immobile. His words ask his audience to question their habits, to modify their goals, to engage in new enterprises and to look with a critical eye at their previous attempts to get knowledge. It operates as a travel guide that leads the (...) audience on a journey that will educate them and help them to gradually become philosophically mature, to become true themselves, which can also be described as the encouragement to become Being. (shrink)

This paper focuses on a specific aspect of political imaginaries: political myth. What are political myths? What role do they play within today commoditised political imaginaries? What are the conditions for setting up a critique of them? We will address these questions, by putting forward a theory of political myth which situates itself between psychoanalysis and political philosophy, in line with the tradition of critical theory that many still associate with the name of the Frankfurt School. We will first discuss (...) the notion of political myth by illustrating the contribution of both disciplines to its understanding and then, through a discussion of the notion of social unconscious, we will apply this analysis to a contemporary example of political myth, that of a clash of civilisations. (shrink)

The exponential accumulation, processing and accrual of big data in healthcare are only possible through an equally rapidly evolving field of big data analytics. The latter offers the capacity to rationalize, understand and use big data to serve many different purposes, from improved services modelling to prediction of treatment outcomes, to greater patient and disease stratification. In the area of infectious diseases, the application of big data analytics has introduced a number of changes in the information accumulation models. These are (...) discussed by comparing the traditional and new models of data accumulation. Big data analytics is fast becoming a crucial component for the modelling of transmission—aiding infection control measures and policies—emergency response analyses required during local or international outbreaks. However, the application of big data analytics in infectious diseases is coupled with a number of ethical impacts. Four key areas are discussed in this paper: automation and algorithmic reliance impacting freedom of choice, big data analytics complexity impacting informed consent, reliance on profiling impacting individual and group identities and justice/fair access and increased surveillance and population intervention capabilities impacting behavioural norms and practices. Furthermore, the extension of big data analytics to include information derived from personal devices, such as mobile phones and wearables as part of infectious disease frameworks in the near future and their potential ethical impacts are discussed. Considered together, the need for a constructive and transparent inclusion of ethical questioning in this rapidly evolving field becomes an increasing necessity in order to provide a moral foundation for the societal acceptance and responsible development of the technological advancement. (shrink)

Medical complicity in torture is prohibited by international law and codes of professional ethics. But in the many countries in which torture is common, doctors frequently are expected to assist unethical acts that they are unable to prevent. Sometimes these doctors face a dilemma: they are asked to provide diagnoses or treatments that respond to genuine health needs but that also make further torture more likely or more effective. The duty to avoid complicity in torture then comes into conflict with (...) the doctor’s duty to care for patients. Sometimes the right thing for a doctor to do requires complicity in torture. Whether this is the case depends on: the expected consequences of the doctor’s actions; the wishes of the patient; and the extent of the doctor’s complicity with wrongdoing. Medical associations can support physicians who face this dilemma while maintaining a commitment to clear principles denouncing torture. (shrink)

We believe that intellectual humility is an essential intellectual virtue for university students to foster. It enables them to excel as students of philosophy and other disciplines, to navigate the fast-changing world inside and outside academia, and to flourish in interaction with others. In this paper, we analyze this virtue by singling out two distinct but related aspects: the openness-aspect and the care-aspect. The former makes one value a dialogue with those who have different views from one’s own. The latter (...) aspect involves searching for implicit assumptions one brings to encounters with one’s object of inquiry and trying to study this object as unique and irreducible. We discuss four learning activities we developed for the philosophy bachelor course “Who are we? Philosophical views on humans and the gods” at University College Utrecht (the Netherlands). Throughout this paper, we show extracts from the students’ assignments, reflections, and evaluations. These extracts indicate that students developed both aspects of intellectual humility —openness to different views and care for the uniqueness of each object of inquiry— and acknowledged their importance. (shrink)

We develop an account of how mutually inconsistent models of the same target system can provide coherent information about the system. Our account makes use of ideas from the debate surrounding rob...

In the philosophy of science and epistemology literature, robustness analysis has become an umbrella term that refers to a variety of strategies. One of the main purposes of this paper is to argue that different strategies rely on different criteria for justifications. More specifically, I will claim that: i) robustness analysis differs from de-idealization even though the two concepts have often been conflated in the literature; ii) the comparison of different model frameworks requires different justifications than the comparison of models (...) that differ only for the assumption under test; iii) the replacement of specific assumptions with different ones can encounter specific difficulties in scientific practice. These claims will be supported by a case study in population ecology and a case study in geographical economics. (shrink)

This paper is an attempt to think through paranoia’s epistemic and affective features, which pervade both the worldview presented in Senecan tragedy and the inner life of many of its protagonists. Drawing upon recent literary-critical work, I argue that paranoia is temporally and epistemically ambivalent: subjects simultaneously attempt to “get ahead” of a looming cataclysm—looking to the future in an attempt to avert disaster—while inevitably “falling behind,” failing to predict or preempt the future in time to protect themselves. Much of (...) Senecan tragedy plays out paranoia’s future-oriented vigilance on the formal level. Foreshadowing, allusions, and meta-literary flourishes serve to render both readers and characters hyperaware of the earth-shattering horrors to come; however, in doing so, they also reveal that this forward-oriented bracing only serves to dredge up negative affect in advance. By contrast, I argue that Seneca’s Phoenissae thematizes in the character of Oedipus not only paranoia’s future-looking vigilance but also its inherent lagging, the failure to know and act in advance. These elements of slowness, stuckness, and delay open a space for stillness, relief, and intimacy, even within a narrative which hurtles toward cataclysm. (shrink)

Compromise arises in contexts where irreconcilable claims must nonetheless somehow be resolved. Ordinary people in everyday life, politicians and artists, doctors engaging in research, humanitarian workers providing aid in the midst of war – all of them will have faced situations where compromise appeared to be the only reasonable option, and yet will have felt that there was nevertheless something deeply wrong with it. The aim of this paper is to help make sense of that sentiment. The focus of this (...) paper will be on some aspects of the morality of compromise. Its lynchpin will be to construe compromise as a joint action, in particular, a joint wrongdoing – taking part in, and sharing responsibility for, the doing of things that are wrong from the point of view of those who are the parties to the compromise. The question of ‘what is wrong with compromise?’ is thus recast as a question of ‘what is my part in the wrongs being done as part of the compromise?’ It is tempting to suppose that a compromise serves to dilute personal responsibility, parsing it out among parties to the compromise. Viewing a compromise as a joint action, in contrast, will help us to see how a compromise actually increases responsibility among parties to it. They are now jointly collaborating in some action that each of them sees as wrong, at least in part (albeit in differing parts). Discussions of compromise traditionally prioritize the inter-personal aspect – compromise, in the transitive form of ‘compromising with’ someone. But I argue that the intransitive form – ‘compromise of’ – deserves pride of place. The reason for prioritizing the intransitive ‘compromise of’ is simple: that is what is involved in the intra-personal calculation that must, of necessity, go on inside one's own head in the process of deciding whether or not to agree to a 'compromise with' someone else. In this paper I shall concentrate specifically on compromises of principles, or (more precisely) on ‘matters of principled concern to the compromising parties’. Not only is that the most troubling and morally problematic sort of compromise, it is also logically the most central case. I demonstrate that that is so by shifting the focus from inter-personal compromise to the more fundamental intra-personal process underlying it – the compromise we are involved in when adjudicating among our own conflicting values, to decide whether or not to agree to a compromise of the inter-personal sort. This is the subject of the first section of the paper below. Compromise involves resolving conflicts of principles through mutual concessions that are accepted and undertaken by all parties. Doing so may be on-balance desirable, not only from some larger perspective (of social peace, or whatever) but also from each party's own perspective. Nevertheless, from each party's perspective, compromise necessarily involves interacting with, and sometimes contributing to, wrongdoing. Morally, something is lost, even if more is gained on balance. (shrink)

The Sārasaṅgaha is a Pāli text of XIIth–XIIIth century by the Sinhalese monk Siddhattha Thera. Its themes include the aspiration to become a Buddha, shrines, meditation, theories on rain, wind, gender and more. The main body consists of citations from the Nikāyas, the Jātakas, the Visuddhimagga and above all, from commentarial literature. By analysing the way the Sārasaṅgaha refers to and establishes a dialogue with the quoted works, this paper promotes a new assessment of the cultural and textual tendencies that (...) influenced the development of Buddhist literature especially in the Middle Ages. In particular, the analysis of this text and the quotations of which it is composed reveals the importance of commentarial literature, a literary genre that only recently has attracted the attention of Pāli scholars. (shrink)

What are the most detailed descriptions under which subjects intend to perform bodily actions? According to Pacherie (2006), these descriptions may be found by looking into motor representations—action representations in the brain that determine the movements to be performed. Specifically, for any motor representation guiding an action, its subject has an M‐intention representing that action in as much detail. I show that some M‐intentions breach the constraints that intentions should meet. I then identify a set of intentions—motor intentions—that represent actions (...) in as much detail as some motor representations while meeting the constraints that intentions should meet. (shrink)

L’article analyse une forme de migration en vigueur depuis plusieurs décennies dans la population féminine de Lampedusa (Italie) : une migration à court terme mise en œuvre pour bénéficier d’une assistance hospitalière lors de l’accouchement, assistance absente à Lampedusa. Pour cerner les évolutions de cette émigration pour l’enfantement, ce phénomène est étudié sur plusieurs générations. Après avoir examiné les enjeux socio-culturels, socio-économiques et socio-sanitaires de cette mobilité reproductive chez les femmes de Lampedusa, l’article montre comment les accouchements déterritorialisés dialoguent, ou (...) entrent en conflit, avec l’assistance médicale proposée aux immigrées enceintes accueillies de nos jours à Lampedusa. Cette approche permet d’ouvrir la réflexion sur le lien entre migrations féminines nationales et internationales, expériences d’enfantement et droits reproductifs. (shrink)

This study conducted on a sample of 295 Dutch and Italian undergraduate and graduate students aims to investigate how psychopathic personality traits (meanness, boldness and disinhibition) may lead to cheating behavior, and to study whether there are correlations between psychopathic traits, motivation, moral disengagement, the perception of seriousness of academic dishonesty and frequency of academic dishonesty to try to better understand what causes students to cheat and engage in dishonest conduct. Results confirmed the key role of psychopathic traits, particularly the (...) disinhibition aspect in predicting academic dishonesty. In addition, it was shown that students’ perceptions of what constitutes academic dishonesty and what does not are also important in predicting the frequency of dishonest behavior. Furthermore, the role of motivation and moral disengagement in predicting and mediating the relationship between traits of psychopathy and academic dishonesty were analyzed through mediation and regression analysis. (shrink)

Life sciences research is increasingly international and data-intensive. Researchers work in multi-jurisdictional teams or formally established research consortia to exchange data and conduct research using computation of multiple sources and volumes of data at multiple sites and through multiple pathways. Despite the internationalization and data intensification of research, the same ethics review process as applies to single-site studies in one country tends to apply to multi-site studies in multiple countries. Because of the standard requirement for multi-jurisdictional or multi-site ethics review, (...) international research projects are subjected to multiple ethics reviews of the same research protocol. Consequently, the reviews may be redundant and resource-consuming, whilst the opinions delivered by ethics committees may be inconsistent both within and across jurisdictions. In this article, we present findings based on interviews conducted with international experts in research ethics on the topic of et... (shrink)

Torture is unethical and usually counterproductive. It is prohibited by international and national laws. Yet it persists: according to Amnesty International, torture is widespread in more than a third of countries. Physicians and other medical professionals are frequently asked to assist with torture. -/- Medical complicity in torture, like other forms of involvement, is prohibited both by international law and by codes of professional ethics. However, when the victims of torture are also patients in need of treatment, doctors can find (...) themselves torn. To accede to the requests of the torturers may entail assisting or condoning terrible acts. But to refuse care to someone in medical need may seem like abandoning a patient and thereby fail to exhibit the beneficence expected of physicians. -/- In this paper, we argue that this dilemma is real and that sometimes the right thing for a doctor to do, overall, is to be complicit in torture. Though complicity in a wrongful act is itself prima facie wrongful, this judgment may be outweighed by other factors. We propose three criteria for analyzing how those factors apply to particular cases of medical complicity in torture. (shrink)

This study analyses for the first time whether and when moral distress may be related to work-family conflict and burnout. Additionally, this study examines whether resilience and positive refocusing might protect healthcare professionals from the negative effects of moral distress. A total of 153 Italian healthcare professionals completed self-report questionnaires. Simple and moderated mediation models revealed that moral distress was positively related to burnout, directly and indirectly, as mediated by work-family conflict. Highly resilient professionals experienced low work-family conflict, regardless of (...) moral distress levels. Moreover, professionals who frequently used positive refocusing were less vulnerable to burnout following moral distress. (shrink)