:Empirical work has shown that patients and physicians have markedly divergent understandings of treatability statements in the context of serious illness. Patients often understand treatability statements as conveying good news for prognosis and quality of life. In contrast, physicians often do not intend treatability statements to convey improvement in prognosis or quality of life, but merely that a treatment is available. Similarly, patients often understand treatability statements as conveying encouragement to hope and pursue further treatment, though this may not be (...) intended by physicians. This radical divergence in understandings may lead to severe miscommunication. This paper seeks to better understand this divergence through linguistic theory—in particular, H.P. Grice’s notion of conversational implicature. This theoretical approach reveals three levels of meaning of treatability statements: the literal meaning, the physician’s intended meaning, and the patient’s received meaning. The divergence between the physician’s intended meaning and the patient’s received meaning can be understood to arise from the lack of shared experience between physicians and patients, and the differing assumptions that each party makes about conversations. This divergence in meaning raises new and largely unidentified challenges to informed consent and shared decision making in the context of serious illness, which indicates a need for further empirical research in this area. (shrink)

To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

In their target article, Millum and Bromwich situate their article against a backdrop of well-documented empirical research demonstrating that many participants have variable and often poor...

Perhaps the central focus of American bioethics has been to push against medical paternalism on the grounds that it impedes the autonomy of patients—that is, their ability to make choices of their...

In summary, the creation and maintenance of the Wistar Rats as standardized animals can be attributed to the breeding work of Helen Dean King, coupled with the management and husbandry methods of Milton Greenman and Louise Duhring, and with supporting documentation provided by Henry Donaldson. The widespread use of the Wistar Rats, however, is a function of the ingenuity of Milton Greenman who saw in them a way for a small institution to provide service to science. Greenman's rhetoric, as captured (...) in his Director's Reports, prepared annually from 1905 until his death in 1937, shows that he was unusually sensitive to his times and to the economics of science and of society. In the era when biology was being defined, he recognized in the rat the potential to be a living analog to the pure chemicals that legitimated experimental science. From management literature he extracted the ideals of uniformity of product, standards of quality, and efficiency of production, applying them to scientific practice to generate an animal model that thrives as standard equipment in laboratories throughout the world today.I will close with a quote from Frederick W. Taylor that is a cogent statement of the contribution to science and scientific progress made by standardized tools and their creators. Equating the surgeon and the workman, Taylor wrote: [He is given] the finest implements, each one of which has been the subject of special study and development ... [and] the very best knowledge of his predecessors; and, provided with standard implements and methods which represent the best knowledge of the world up to date, he is able to use his own originality and ingenuity to make real additions to the world's knowledge, instead of reinventing things which are old.Standardized tools, whether surgeons' implements or laboratory-bred rats, are one of the vehicles for carrying scientific knowledge forward from generation to generation. In this sense, Greenman's Wistar Rats have done their job, in his words, of “providing service to science.”. (shrink)

In this book, David B. Wong defends an ambitious and important new version of moral relativism. He does not espouse the type of relativism that says anything goes, but he does start with a relativist stance against alternative theories such that there need not be only one universal truth. Wong proposes that there can be a plurality of true moralities existing across different traditions and cultures, all with one core human question as to how we can all live (...) together. (shrink)

The view defended is one sense externalist on the relation between moral reasons and motivation: A's having a moral reason to do X does not necessarily imply that A has a motivation that would support A's doing X via some appropriate deliberative route. However, it is in another sense externalist in holding that there are the kind of moral reasons there are only if the relevant motivational capacities are "generally present" in human beings, if not in all individuals. The process (...) of socialization is an attempt to embed the recognition of what we have moral reason to do in the intentional content of one's feelings. E.g., learning that about others' suffering embeds their suffering as a reason to help in the intentional content of incipient compassionate feelings. This endows the reason with motivational efficacy while conferring further direction to the feelings in ways that shape us for social cooperation. (shrink)

The use of cochlear implants, especially for prelingually deafened children, has aroused heated debate. Members and proponents of Deaf culture vigorously oppose implants both as a seriously invasive treatment of dubious efficacy and as a threat to Deaf culture. Some find these arguments persuasive; others do not. And in this context arise questions about the extent to which individuals with disabilities may decline treatments to ameliorate disabling conditions. When they do so, to what extent may they call upon society to (...) provide supportive services and accommodations? (shrink)

The present study investigates the dynamics of emotional processing and awareness using an affective facial priming paradigm in conjunction with a multimodal assessment of awareness. Key facial primes are visually masked, and are presented for brief and extended durations. Using a preference measure, we examine whether the effects of the primes differ qualitatively . We show that: unconscious affective priming with faces emerges strongly in initial presentations and diminishes rapidly with repetition; conscious affective priming also emerges strongly in initial presentations, (...) however it persists in strength with repetition; and in contrast to other reports on the salience of negative stimuli, happy faces appear more salient than sad faces when presented outside awareness. We discuss the limits and extensions of unconscious affective priming with faces, and consider several methodological and conceptual questions concerning emotional processing out of awareness. (shrink)

CHAPTER ONK Negotiating Positions: The Politics of Virtue and Virtu [Virtu] rouses enmity toward order, toward the lies that are concealed in every order, ...

This paper is to inform the recent situations of work by the foreign domestic workers (FDWs) in Hong Kong through the lens of Covid-19. Through the interviews with seven informants — two employers and five FDWs, stories describing the changes in their working conditions, rights and entitlement, and the contextual environment related to the impacts of Covid-19 were collected. They were analysed through three theoretical tools — visibility/invisibility, mobility/immobility, and work boundary. The findings show that under the Covid-19 crisis, the (...) FDWs experienced more hardships and struggles in both the home country and host country. The paradoxes of visibility/invisibility and mobility/immobility together with blurred work boundary were found in their experience of work, rights and entitlement, and the contextual environment. On one hand, the employers’ power of controlling FDWs has increased, but the agency to resist by the FDWs has decreased making them to turn to more passive means of resistance which could harm the FDWs’ physical and mental health and wellbeing. (shrink)

This research ethics article focuses on an unexpected finding from my Master’s thesis examining bereaved participants’ experiences of taking part in sensitive qualitative research: some participants wanted their real names used in my written dissertation and any subsequent empirical publications. While conducting interviews for my thesis and explaining the consent process, early responses highlighted the problematic notion of anonymity for participants engaged in qualitative research. Several participants asserted the significance of immortalizing their deceased loved ones in the pages of my (...) thesis, retaining ownership over their words and maintaining a public attachment to their personal identity. The preliminary responses also resonate with concerns regarding the ethics of assigning pseudonyms and anonymity to participants in qualitative research. Themes in the extant literature tend to centre on issues of researchers’ accountability and transparency towards participants or respect. The present article contributes to the debates surrounding anonymity and confidentiality within qualitative research, and also expands on specific issues pertaining to bereavement research ethics. (shrink)

Most of us believe that we are entitled to treat members of other species in ways which would be considered wrong if inflicted on members of our own species. We kill them for food, keep them confined, use them in painful experiments. The moral philosopher has to ask what relevant difference justifies this difference in treatment. A look at this question will lead us to re-examine the distinctions which we have assumed make a moral difference.

In light of the recent emergence of predictive techniques in law enforcement to forecast crimes before they occur, this paper examines the temporal operation of power exercised by predictive policing algorithms. I argue that predictive policing exercises power through a paranoid style that constitutes a form of temporal governmentality. Temporality is especially pertinent to understanding what is ethically at stake in predictive policing as it is continuous with a historical racialized practice of organizing, managing, controlling, and stealing time. After first (...) clarifying the concept of temporal governmentality, I apply this lens to Chicago Police Department’s Strategic Subject List. This predictive algorithm operates, I argue, through a paranoid logic that aims to preempt future possibilities of crime on the basis of a criminal past codified in historical crime data. (shrink)

This is a critical discussion of Paul Humphreys's fusion view of emergence, focusing on the basal loss feature of his ontology. The discussion yields some general morals for special science ontology.

This article argues that the meaning of the word ‘autism’ experienced a radical shift in the early 1960s in Britain which was contemporaneous with a growth in epidemiological and statistical studies in child psychiatry. The first part of the article explores how ‘autism’ was used as a category to describe hallucinations and unconscious fantasy life in infants through the work of significant child psychologists and psychoanalysts such as Jean Piaget, Lauretta Bender, Leo Kanner and Elwyn James Anthony. Theories of autism (...) were then associated both with schizophrenia in adults and with psychoanalytic styles of reasoning. The closure of institutions for ‘mental defectives’ and the growth in speech therapy services in the 1960s and 1970s encouraged new models for understanding autism in infants and children. The second half of the article explores how researchers such as Victor Lotter and Michael Rutter used the category of autism to reconceptualize psychological development in infants and children via epidemiological studies. These historical changes have influenced the form and function of later research into autism and related conditions. (shrink)

Sophocles' Antigone is a touchstone in democratic, feminist and legal theory, and possibly the most commented upon play in the history of philosophy and political theory. Bonnie Honig's rereading of it therefore involves intervening in a host of literatures and unsettling many of their governing assumptions. Exploring the power of Antigone in a variety of political, cultural, and theoretical settings, Honig identifies the 'Antigone-effect' - which moves those who enlist Antigone for their politics from activism into lamentation. She argues (...) that Antigone's own lamentations can be seen not just as signs of dissidence but rather as markers of a rival world view with its own sovereignty and vitality. Honig argues that the play does not offer simply a model for resistance politics or 'equal dignity in death', but a more positive politics of counter-sovereignty and solidarity which emphasizes equality in life. (shrink)

An interpretative history of human rights in Africa, exploring indigenous rights traditions, anti-slavery, anti-colonialism, post-colonial violations and pro-democracy movements.

I argue that it is a main theme of Davidson's theory of interpretation that interpretive charity implies the impossibility of massive disagreement. There is clear textual support for that. I then argue that from the first-person point of view of a full-blooded interpreter, the theme must be accepted; and that is precisely why Davidson accepts it. If massive disagreement between speaker and interpreter seems to us easy to imagine, it is only because the imagination involved is third-personal and not full-blooded.

En esta era digital contemporánea, la constante creación y consumo de arte e imágenes visuales se ha vuelto predominante. Sin embargo, sigue existiendo la necesidad imperante de alfabetización visual. Esta investigación explora el impacto positivo de la educación artística en la vida de los estudiantes y aborda las desigualdades en la oferta de clases de arte en España y Estados Unidos. También enfatiza el rol fundamental de la integración de las artes de manera interdisciplinaria y transversal, instando a los encargados (...) de formular políticas educativas a priorizar la educación artística mejorando la legislación educativa y la asignación de recursos. El artículo examina las dificultades para garantizar el acceso equitativo a la educación artística y señala las oportunidades que se pierden cuando las habilidades de alfabetización visual no se desarrollan. Los resultados indican la necesidad de incorporar el arte en el plan de estudios de todas las asignaturas y así promover las habilidades de alfabetización visual. El artículo concluye ofreciendo sugerencias para integrar el arte en las clases obligatorias y promoviendo una educación artística equitativa en las escuelas. Esta investigación contribuye al discurso vigente sobre el potencial transformador de la educación artística en el panorama digital actual. (shrink)

Many explanations in molecular biology, neuroscience, and other fields of experimental biology describe mechanisms underlying phenomena of interest. These mechanistic explanations account for higher-level phenomena in terms of causally active parts and their spatiotemporal organization. What makes such a mechanistic description explanatory? The best-developed answer, Craver's causal-mechanical account, has several weaknesses. It does not fully explicate the target of explanation, interlevel relation, or interactive nonmodular character of many biological mechanisms as we understand them. An alternative account of MEx, emphasizing interdependence (...) among a mechanism's components, remedies these difficulties. (shrink)

This book intervenes in contemporary debates about the threat posed to democratic life by political emergencies. Must emergency necessarily enhance and centralize top-down forms of sovereignty? Those who oppose executive branch enhancement often turn instead to law, insisting on the sovereignty of the rule of law or demanding that law rather than force be used to resolve conflicts with enemies. But are these the only options? Or are there more democratic ways to respond to invocations of emergency politics? Looking at (...) how emergencies in the past and present have shaped the development of democracy, Bonnie Honig argues that democracies must resist emergency's pull to focus on life's necessities because these tend to privatize and isolate citizens rather than bring us together on behalf of hopeful futures. Emphasizing the connections between mere life and more life, emergence and emergency, Honig argues that emergencies call us to attend anew to a neglected paradox of democratic politics: that we need good citizens with aspirational ideals to make good politics while we need good politics to infuse citizens with idealism.Honig takes a broad approach to emergency, considering immigration politics, new rights claims, contemporary food politics and the infrastructure of consumption, and the limits of law during the Red Scare of the early twentieth century. Taking its bearings from Moses Mendelssohn, Franz Rosenzweig, and other Jewish thinkers, this is a major contribution to modern thought about the challenges and risks of democratic orientation and action in response to emergency. (shrink)

Hospital ethics committees are common, but not universal, in small hospitals. A needs assessment was completed at a 155-bed community hospital in order to adapt an academic tertiary center model for a clinical ethics committee to fit the needs of the small hospital community. Of 678 questionnaires distributed, 209 were completed. Data suggested that clinical staff frequently experienced ethical dilemmas. Significantly more nonphysicians indicated that they would utilize a consultation service, if available, compared to physicians (p = 0.0067). The data (...) also indicated that the majority of staff (>80 percent) desired more education in clinical ethics. Physicians preferred annual or bi-annual hospital-wide grand rounds, compared to nonphysicians, who preferred more frequent department-based teaching (p < 0.001). The data presented in this article were used to subsequently develop a clinical ethics support committee, the process of which is also described. (shrink)

CRISPR/Cas9 is quickly becoming one of the most influential biotechnologies of the last five years. Clinical trials will soon be underway to test whether CRISPR/Cas9 can edit away the genetic mutations that cause sickle cell disease (SCD). This article will present the background of CRISPR/Cas9 gene editing and SCD, highlighting research that supports the application of CRISPR/Cas9 to SCD. While much has been written on why SCD is a good biological candidate for CRISPR/Cas9, less has been written on the ethical (...) implications of including SCD in CRISPR/Cas9 research. This article will argue that there is a strong case in favor of including SCD. Three benefits are achieving distributive justice in research, continuing to repair the negative relationship between patients with SCD and the health‐care system, and benefit‐sharing for those who do not directly participate in CRISPR/Cas9 research. Opponents will argue that SCD is a risky candidate, that researchers will not find willing participants, and that the burden of SCD is low. Of this set of arguments, the first gives pause. However, on balance, the case in favor of including SCD in CRISPR/Cas9 research is stronger than the case against. Ultimately, this article will show that the historic and sociopolitical injustices that impede progress in treating and curing SCD can be alleviated through biotechnology. (shrink)

This book intervenes in contemporary debates about the threat posed to democratic life by political emergencies. Must emergency necessarily enhance and centralize top-down forms of sovereignty? Those who oppose executive branch enhancement often turn instead to law, insisting on the sovereignty of the rule of law or demanding that law rather than force be used to resolve conflicts with enemies. But are these the only options? Or are there more democratic ways to respond to invocations of emergency politics? Looking at (...) how emergencies in the past and present have shaped the development of democracy, Bonnie Honig argues that democracies must resist emergency's pull to focus on life's necessities because these tend to privatize and isolate citizens rather than bring us together on behalf of hopeful futures. Emphasizing the connections between mere life and more life, emergence and emergency, Honig argues that emergencies call us to attend anew to a neglected paradox of democratic politics: that we need good citizens with aspirational ideals to make good politics while we need good politics to infuse citizens with idealism.Honig takes a broad approach to emergency, considering immigration politics, new rights claims, contemporary food politics and the infrastructure of consumption, and the limits of law during the Red Scare of the early twentieth century. Taking its bearings from Moses Mendelssohn, Franz Rosenzweig, and other Jewish thinkers, this is a major contribution to modern thought about the challenges and risks of democratic orientation and action in response to emergency. (shrink)

The Art of War application to education is about solving problems to improve student and school success. The Art of War describes the significance of a leader and his knowledge and prudent application of the strategies. At the core of theses strategies is the non-negotiable moral purpose of the leader to be reinforced by other fine qualities as wisdom, commitment, discipline, and courage.

As staggering inequality continues to be an urgent political topic, this book, illustrated with nearly seventy of Riis ’s photographs, will serve as a stunning reminder of what has changed, and what has not.

We argue in this article that many common adverbial phrases generally taken to signal a discourse relation between syntactically connected units within discourse structure instead work anaphor- ically to contribute relational meaning, with only indirect dependence on discourse structure. This allows a simpler discourse structure to provide scaffolding for compositional semantics and reveals multiple ways in which the relational meaning conveyed by adverbial connectives can interact with that associated with discourse structure. We conclude by sketching out a lexicalized grammar for (...) discourse that facilitates discourse interpretation as a product of compositional rules, anaphor resolution, and inference. (shrink)

What does it mean to know another person, and how is such knowledge different from other kinds of knowledge? These questions constitute an important part of what I call ‘second-person epistemology’ – the study of how we know other people. I claim that knowledge of other people is not only central to our everyday lives, but it is a kind of knowledge that is unlike other kinds of knowledge. In general, I will argue that second-person knowledge arises from repeated interactions (...) with another person, and that it also requires employment of certain cognitive abilities and a unique kind of second-order knowledge. This paper provides the framework for a second-person epistemology by examining some of our ordinary claims about what it means to know another person. I describe four conditions that typically characterize knowing another person. Then I describe the psychological grounds of knowing a person. Finally, I conclude with some thoughts about the unique symmetries of second person knowledge and the role of such knowledge in our broader epistemological endeavours. (shrink)