I argue that recognizing a human right to adequate food and enforcing it as a legal right is an important way to promote and ensure sustainable food security. I consider objections that have been raised against subsistence rights and socio-economic rights, including the argument that such rights are not feasible, that they are not justiciable, and that they are too amorphous—that it is not clear what is required to fulfill these rights and by whom. I defend the right to adequate (...) food against these objections by considering how this right has been interpreted and applied in international law and how it has been protected in other domestic legal systems. I analyze different dimensions of the right to adequate food and I apply these to recent issues concerning sustainable food security in the United States, such as food deserts. (shrink)

Although Kant argues that a world republic with coercive public law is the only rational way to secure a lawful cosmopolitan condition, he states that it is an unachievable ideal, and he proposes a voluntary, non-coercive federation of states as a substitute. While some scholars have criticized Kant for moving away from this ideal due merely to pragmatic considerations, I argue that his rejection of a coercive world republic is based on his conception of state sovereignty and what is required (...) for a lawful condition. I consider how we can institutionalize a lawful condition between states without a coercive world republic in ways that go beyond Kant’s voluntary federation. I also consider how we can resolve this dilemma in Kant’s account to support a federal world republic. (Published online first on June 16, 2014). (shrink)

Critics of international law argue that it is not really law because it lacks a supranational system of coercive sanctions. International legal scholars and lawyers primarily refute this by demonstrating that international law is in fact enforced, albeit in decentralized and less coercive ways. I will focus instead on the presumption behind this skeptical view—the idea that law must be coercively enforced. First, I argue that coercive enforcement is not conceptually necessary for law or legal obligations. Second, I consider the (...) claim that coercive enforcement is nonetheless necessary for instrumental reasons. I argue that while physical coercion is instrumentally useful for increasing compliance in the domestic case, this is less effective and more problematic in the international case. What then is essential and distinctive about law, and what would increase the effectiveness of international law? First, international law needs to be generally accepted as binding by states, officials, and other agents; and second, international legal rules should be determinatively interpreted and applied by authoritative, adjudicative, and administrative institutions. (shrink)

The reason of faith -- Thought and language -- Truth -- The Monologion arguments for the existence of God -- The Proslogion argument for the existence of God -- The divine attributes -- Thinking and speaking about God -- Creation and the word -- The Trinity -- Modality -- Freedom -- Morality -- Incarnation and atonement -- Original sin, grace, and salvation.

ABSTRACT:This article assesses the proliferation of international accountability standards (IAS) in the recent past. We provide a comprehensive overview about the different types of standards and discuss their role as part of a new institutional infrastructure for corporate responsibility. Based on this, it is argued that IAS can advance corporate responsibility on a global level because they contribute to the closure of some omnipresent governance gaps. IAS also improve the preparedness of an organization to give an explanation and a justification (...) to relevant stakeholders for its judgments, intentions, acts and omissions when appropriately called upon to do so. However, IAS also face a variety of problems impeding their potential to help address social and environmental issues. The contribution of the four articles in this special section is discussed in the context of standards’ problems and opportunities. The article closes by outlining a research agenda to further develop and extend the scholarly debate around IAS. (shrink)

In a rare full-length volume, renowned feminist thinker Sandra Lee Bartky brings together eight essays in one volume, Sympathy and Solidarity. A philosophical work accessible to an educated general audience, the essays reflect the intersection of the author's eye, work, and sometimes her politics. Two motifs connect the works: first, all deal with feminist topics and themes; second, most deal with the reality of oppression, especially in the disguised and subtle ways it can be manifested.

The world is complex, but acknowledging its complexity requires an appreciation for the many roles context plays in shaping natural phenomena. In _Unsimple Truths, _Sandra Mitchell argues that the long-standing scientific and philosophical deference to reductive explanations founded on simple universal laws, linear causal models, and predict-and-act strategies fails to accommodate the kinds of knowledge that many contemporary sciences are providing about the world. She advocates, instead, for a new understanding that represents the rich, variegated, interdependent fabric of many levels (...) and kinds of explanation that are integrated with one another to ground effective prediction and action. Mitchell draws from diverse fields including psychiatry, social insect biology, and studies of climate change to defend “integrative pluralism”—a theory of scientific practices that makes sense of how many natural and social sciences represent the multi-level, multi-component, dynamic structures they study. She explains how we must, in light of the now-acknowledged complexity and contingency of biological and social systems, revise how we conceptualize the world, how we investigate the world, and how we act in the world. Ultimately _Unsimple Truths _argues that the very idea of what should count as legitimate science itself should change. (shrink)

This fine collection of essays by a leading philosopher of science presents a defence of integrative pluralism as the best description for the complexity of scientific inquiry today. The tendency of some scientists to unify science by reducing all theories to a few fundamental laws of the most basic particles that populate our universe is ill-suited to the biological sciences, which study multi-component, multi-level, evolved complex systems. This integrative pluralism is the most efficient way to understand the different and complex (...) processes - historical and interactive - that generate biological phenomena. This book will be of interest to students and professionals in the philosophy of science. (shrink)

Since approval of the EU General Data Protection Regulation (GDPR) in 2016, it has been widely and repeatedly claimed that the GDPR will legally mandate a ‘right to explanation’ of all decisions made by automated or artificially intelligent algorithmic systems. This right to explanation is viewed as an ideal mechanism to enhance the accountability and transparency of automated decision-making. However, there are several reasons to doubt both the legal existence and the feasibility of such a right. In contrast to the (...) right to explanation of specific automated decisions claimed elsewhere, the GDPR only mandates that data subjects receive meaningful, but properly limited, information (Articles 13-15) about the logic involved, as well as the significance and the envisaged consequences of automated decision-making systems, what we term a ‘right to be informed’. Further, the ambiguity and limited scope of the ‘right not to be subject to automated decision-making’ contained in Article 22 (from which the alleged ‘right to explanation’ stems) raises questions over the protection actually afforded to data subjects. These problems show that the GDPR lacks precise language as well as explicit and well-defined rights and safeguards against automated decision-making, and therefore runs the risk of being toothless. We propose a number of legislative and policy steps that, if taken, may improve the transparency and accountability of automated decision-making when the GDPR comes into force in 2018. (shrink)

Moral psychology studies the features of cognition, judgement, perception and emotion that make human beings capable of moral action. Perspectives from feminist and race theory immensely enrich moral psychology. Writers who take these perspectives ask questions about mind, feeling, and action in contexts of social difference and unequal power and opportunity. These essays by a distinguished international cast of philosophers explore moral psychology as it connects to social life, scientific studies, and literature.

To create fair and accountable AI and robotics, we need precise regulation and better methods to certify, explain, and audit inscrutable systems.

Bioethics at the Movies explores the ways in which popular films engage basic bioethical concepts and concerns. Twenty philosophically grounded essays use cinematic tools such as character and plot development, scene-setting, and narrative-framing to demonstrate a range of principles and topics in contemporary medical ethics. The first section plumbs popular and bioethical thought on birth, abortion, genetic selection, and personhood through several films, including The Cider House Rules, Citizen Ruth, Gattaca, and I, Robot. In the second section, the contributors examine (...) medical practice and troubling questions about the quality and commodification of life by way of Dirty Pretty Things, Eternal Sunshine of the Spotless Mind, and other movies. The third section's essays use Million Dollar Baby, Critical Care, Big Fish, and Soylent Green to show how the medical profession and society at large view issues related to aging, death, and dying. A final section makes use of Extreme Measures and select Spanish and Japanese films to discuss two foundational matters in bioethics: the role of theories and principles in medicine and the importance of cultural context in devising care. Structured to mirror bioethics and cinema classes, this innovative work includes end-of-chapter questions for further consideration and contributions from scholars from the United States, Canada, the United Kingdom, Israel, Spain, and Australia. Contributors: Robert Arp, Ph.D., Michael C. Brannigan, Ph.D., Matthew Burstein, Ph.D., Antonio Casado da Rocha, Ph.D., Stephen Coleman, Ph.D., Jason T. Eberl, Ph.D., Paul J. Ford, Ph.D., Helen Frowe, M.A., Colin Gavaghan, Ph.D., Richard Hanley, Ph.D., Nancy Hansen, Ph.D., Al-Yasha Ilhaam, Ph.D., Troy Jollimore, Ph.D., Amy Kind, Ph.D., Zana Marie Lutfiyya, Ph.D., Terrance McConnell, Ph.D., Andy Miah, Ph.D., Nathan Norbis, Ph.D., Kenneth Richman, Ph.D., Karen D. Schwartz, LL.B., M.A., Sandra Shapshay, Ph.D., Daniel Sperling, LL.M., S.J.D., Becky Cox White, R.N., Ph.D., Clark Wolf, Ph.D. (shrink)

Drawing on everyday telephone and video interactions, this book surveys how English speakers use grammar to formulate responses in ordinary conversation. The authors show that speakers build their responses in a variety of ways: the responses can be longer or shorter, repetitive or not, and can be uttered with different intonational 'melodies'. Focusing on four sequence types: responses to questions, responses to informings, responses to assessments, and responses to requests, they argue that an interactional approach holds the key to explaining (...) why some types of utterances in English conversation seem to have something 'missing' and others seem overly wordy. (shrink)

By combining a flanker task and a cuing task into a single paradigm, the authors assessed the effects of orienting and alerting on conflict resolution and explored how normal aging and Alzheimer’s disease (AD) modulate these attentional functions. Orienting failed to enhance conflict resolution; alerting was most beneficial for trials without conflict, as if acting on response criterion rather than on information processing. Alerting cues were most effective in the older groups— healthy aging and AD. Conflict resolution was impaired only (...) in AD. Orienting remained unchanged across groups. These findings provide evidence of different life span developmental and clinical trajectories for each attentional network. (shrink)

Biological knowledge does not fit the image of science that philosophers have developed. Many argue that biology has no laws. Here I criticize standard normative accounts of law and defend an alternative, pragmatic approach. I argue that a multidimensional conceptual framework should replace the standard dichotomous law/ accident distinction in order to display important differences in the kinds of causal structure found in nature and the corresponding scientific representations of those structures. To this end I explore the dimensions of stability, (...) strength, and degree of abstraction that characterize the variety of scientific knowledge claims found in biology and other sciences. (shrink)

ZusammenfassungEntscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (shrink)

Entscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (shrink)

Changing Methods is a collection of original essays by feminist practitioners, scholars, and activists. The authors show why "the method question" has moved to the top of many feminist research and interpretive research strategies, and engage in thinking about how ideas and actions have developed within complex social circumstances. The essays in this book challenge the tradition that has allowed abstracted, formalized versions of the ideas and experiences of privileged white men to set standards for how everyone should conduct themselves. (...) The authors use new-found knowledge to displace the dominant ideology constructed around race, class, gender, and heterosexual privilege, and then propose innovative feminist-informed analyses of subjects as diverse as political change, critical linguistics, child care, religious studies, and violence against women. (shrink)

Sandra Acker; Sex Discrimination in Education: a reply to Shaw, Journal of Philosophy of Education, Volume 15, Issue 1, 30 May 2006, Pages 107–118, https://doi.

This book offers a detailed study of the political philosophies of Thomas Hobbes and Benedict de Spinoza, focussing on their concept of power as potentia, concrete power, rather than power as potestas, authorised power. The focus on power as potentia generates a new conception of popular power. Radical democrats–whether drawing on Hobbes's 'sleeping sovereign' or on Spinoza's 'multitude'–understand popular power as something that transcends ordinary institutional politics, as for instance popular plebsites or mass movements. However, the book argues that these (...) understandings reflect a residual scholasticism which Hobbes and Spinoza ultimately repudiate. Instead, on the book's revisionist conception, a political phenomenon should be said to express popular power when it is both popular (it eliminates oligarchy and encompasses the whole polity), and also powerful (it robustly determines political and social outcomes). Two possible institutional forms that this popular power might take are distinguished: Hobbesian repressive egalitarianism, or Spinozist civic strengthening. But despite divergent institutional proposals, the book argues that both Hobbes and Spinoza share the conviction that there is nothing spontaneously egalitarian or good about human collective existence. From this point of view, the book accuses radical democrats of pernicious romanticism; the slow, meticulous work of organizational design and maintenance is the true centre of popular power. Three minute video summary available via HPBin3. Extended discussion on The Political Theory Review podcast. First chapter open access available via Oxford Scholarship Online. Videos of book talks at National University of Singapore (Centre for Legal Theory) and Universidad de Buenos Aires (Instituto de Investigaciones Gino Germani) available via YouTube. (See links below.). (shrink)

This paper presents a novel analysis of Sluicing, an ellipsis construction first described by Ross (1969) and illustrated by the bracketed portion ofI want to do something, but I'm just not sure [what _]. Starting from the assumption that a sluice consists of a displaced Wh-constituent and an empty IP, we show how simple and general LF operations fill out the empty IP and thereby provide it with an interpretable Logical Form. The LF operations we appeal to rely on the (...) influential theory of indefinites developed by Irene Heim and Hans Kamp, and are in harmony with certain aspects of Chomsky's Minimalist Program for linguistic theory. The analysis accounts directly for the familiar properties of Sluicing, as well as some facts which have not previously been observed. (shrink)

Beatty, Brandon, and Sober agree that biological generalizations, when contingent, do not qualify as laws. Their conclusion follows from a normative definition of law inherited from the Logical Empiricists. I suggest two additional approaches: paradigmatic and pragmatic. Only the pragmatic represents varying kinds and degrees of contingency and exposes the multiple relationships found among scientific generalizations. It emphasizes the function of laws in grounding expectation and promotes the evaluation of generalizations along continua of ontological and representational parameters. Stability of conditions (...) and strength of determination in nature govern projectibility. Accuracy, ontological level, simplicity, and manageability provide additional measures of usefulness. (shrink)

In attempting to improve ethical decision-making in business organizations, researchers have developed models of ethical decision-making processes. Most of these models do not include a role for law in ethical decision-making, or if law is mentioned, it is set as a boundary constraint, exogenous to the decision process. However, many decision models in business ethics are based on cognitive moral development theory, in which the law is thought to be the external referent of individuals at the level of cognitive development (...) that most people have achieved. Other theoretical bases of ethical decision models, social learning, and experientialism, also imply a role for law that is rarely made explicit. Law is a more important aspect of ethical decision-process models than it appears to be in the models. This paper will derive explicit roles for the law from the cognition, experientialism, and social learning theories that are used to build ethical decision-making models for business behavior. (shrink)

Abstract:The new push to move political issue activity from the federal to the state and local levels—a new New Federalism—has implications for the ethical and political legitimacy of business political activity. While business political activity at the federal level may be both less costly and less risky than when action shifts to states or localities, at the state or local level it is likely to be more visible, and individual firms may be perceived to have more power. Increased corporate power (...) raises questions about the legitimacy of firm involvement in the political process at the state and local levels. The issue of legitimacy is viewed in the context of the literature on political subcultures being used to study state economic development. (shrink)

The `fact' of pluralism in science is nosurprise. Yet, if science is representing andexplaining the structure of the oneworld, why is there such a diversity ofrepresentations and explanations in somedomains? In this paper I consider severalphilosophical accounts of scientific pluralismthat explain the persistence of bothcompetitive and compatible alternatives. PaulSherman's `Levels of Analysis' account suggeststhat in biology competition betweenexplanations can be partitioned by the type ofquestion being investigated. I argue that thisaccount does not locate competition andcompatibility correctly. I then defend anintegrative (...) model for understanding pluralism. This view is based on taking seriously both thecomplexity and contingency of biologicalorganization and the idealized character ofbiological models. On this view, explanationbecomes, among other things, the location forthe integration of diverse models. I explicatemy argument by an analysis of explanations ofdivision of labor in social insects. (shrink)

By the start of the twenty-first century, the notion of ‘the sublime’ had come to seem incoherent. In the last ten years or so considerable light has been shed by empirical psychologists on a related notion of ‘awe’, and a fruitful dialogue between aestheticians and empirical psychologists has ensued. It is the aim of this paper to synthesize these advances and to offer what I call a ‘two-tiered’ theory of the sublime that shows it to be a coherent aesthetic category. (...) On this theory, sublime experiences begin in an ‘awe response’ (the ‘thin sublime’) and might, with the additional element of temporally-extended reflection, turn into a ‘thick sublime’ response. Building on accounts of the sublime as a species of ‘aesthetic awe’ (Clewis, 2019a and 2019b; Arcangeli, et al., 2020) I aim to show that this two-tiered theory helps to explain why sublime experiences seem to have a basic, primordial core, but also seem to be historically and culturally quite variable (as Nicolson, 1963 [1959]; Battersby, 2007; and McMahon, 2017 have stressed). On this model, the cultural and historical variability comes in largely at the point of the temporally-extended reflection characteristic of the thick sublime, due to the cognitive stock that the subject brings to the encounter. Thus, sublime experiences really lend themselves to being interpreted quite variously by the subject (as well as by the theorist) of these experiences, as, for example, affording insight into the Divine, our moral vocation, or our metaphysical unity with the entire universe, among other lofty thoughts. (shrink)

Both the organization and recruiter provide signals to candidates that ultimately affect organizational attraction. Ethics is an important area that communicates vital information to candidates. Drawing on social identity theory, signaling theory, and person–organization fit, this study finds that ethical signals during the recruitment process do affect applicant attraction. Additionally, two important moderators, self-importance of moral identity and firm performance were examined. Using a robust laboratory study, this research found results generally consistent with the hypothesized relationships.

Both the organization and recruiter provide signals to candidates that ultimately affect organizational attraction. Ethics is an important area that communicates vital information to candidates. Drawing on social identity theory, signaling theory, and person–organization fit, this study finds that ethical signals during the recruitment process do affect applicant attraction. Additionally, two important moderators, self-importance of moral identity and firm performance were examined. Using a robust laboratory study (n = 665), this research found results generally consistent with the hypothesized relationships.

In Plato's Apology, Socrates says he spent his life examining and questioning people on how best to live, while avowing that he himself knows nothing important. Elsewhere, however, for example in Plato's Republic, Plato's Socrates presents radical and grandiose theses. In this book Sandra Peterson offers a hypothesis which explains the puzzle of Socrates' two contrasting manners. She argues that the apparently confident doctrinal Socrates is in fact conducting the first step of an examination: by eliciting his interlocutors' reactions, (...) his apparently doctrinal lectures reveal what his interlocutors believe is the best way to live. She tests her hypothesis by close reading of passages in the Theaetetus, Republic and Phaedo. Her provocative conclusion, that there is a single Socrates whose conception and practice of philosophy remain the same throughout the dialogues, will be of interest to a wide range of readers in ancient philosophy and classics. (shrink)

ZusammenfassungEntscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (shrink)

The controversy regarding the unit of selection is fundamentally a dispute about what is the correct causal structure of the process of evolution by natural selection and its ontological commitments. By characterizing the process as consisting of two essential steps--interaction and transmission--a singular answer to the unit question becomes ambiguous. With such an account on hand, two recent defenses of competing units of selection are considered. Richard Dawkins maintains that the gene is the appropriate unit of selection and Robert Brandon, (...) in response, argues that the individual organism is better suited to the role. This paper argues that by making explicit the underlying questions that each of these views addresses, the apparent conflict can be resolved. Furthermore, such a resolution allows for a more complete and realistic understanding of the process of evolution by natural selection. (shrink)

We discuss the bearing of Daniel Kahneman and Amos Tversky's Prospect Theory on some central issues in ethics. It has been argued that the theory provides a better explanation of our intuitive responses to some important ethical decision cases—like some famous cases put by Philippa Foot and others—than traditional and widely acknowledged ethical principles do. In this way, Prospect Theory contributes to the new wave of skepticism, emanating from the social sciences, about the role of intuitive judgments in ethical theory (...) and philosophy more generally. We focus on Kahneman and Tversky's famous Asian Disease Problem. We show that the case fails to support Prospect Theory over traditional ethical theory as an explanation of the most common intuitive responses to the case, and, moreover, fails as an account of the most common intuitive responses to Foot's famous trolley case and related cases. We maintain that careful critical attention to all these cases shows that Prospect Theory has not made a successful incursion into ethics, whatever it may have established about non-ethical decision-making. (shrink)

This book articulates and defends an interpretation of Schopenhauer's ethics as an original and credible contribution to the history of ethics. It presents Schopenhauer's ethics of compassion in direct tension with his resignationism and aims to show surprising continuities with Kant's ethics.

Recently adopted health care practices and policies describe themselves as “patient-centered care.” The meaning of the term, however, remains contested and obscure. This paper offers a typology of “patient-centered care” models that aims to contribute to greater clarity about, continuing discussion of, and further advances in patient-centered care. The paper imposes an original analytic framework on extensive material covering mostly US health care and health policy topics over several decades. It finds that four models of patient-centered care emphasize: patients versus (...) their parts; patients versus providers; patients/providers/states versus “the system”; and patients and providers as persons. Each type is distinguishable along three dimensions: epistemological orientations, practical accommodations, and policy tools. Based on this analysis, the paper recommends that four questions be asked of any proposal that claims to provide patient-centered care: Is this care a means to an end or an end in itself? Are patients here subjects or objects? Are patients here individuals or aggregates? How do we know what patients want and need? The typology reveals that models are neither entirely compatible nor entirely incompatible and may be usefully combined in certain practices and policies. In other instances, internal contradictions may jeopardize the realization of coherent patient-centered care. (shrink)