Termination of pregnancy (TOP) is offered in many countries, for foetuses prenatally diagnosed with congenital malformations that are deemed incompatible with life or that are associated with a high morbidity. In Lebanon, a middle income country where religion plays a focal role, the law prohibits any form of TOP unless it is the only means to save the mother's life. It is the contention of the authors of this article that even if the foetus is a person, if it were (...) medically revealed that there is a substantial risk that the newborn will suffer severe physical abnormalities that will cause it to be seriously handicapped; it is morally acceptable to terminate the pregnancy. Hence, TOP carried out for these indications is justified in the interest of the foetus and the child. Whatever the status of the foetus is, once born, it will become a full-fledged sentient being with all that this entails. When given the option of starting an existence, this person-to-be has the right to a minimum that allows him/her to enjoy a relatively good quality of life. Today, Lebanese obstetricians are confronted with the burden placed on them under the law to refuse TOP, or, when performing them, to forge records or deny having done them. This is why we strongly believe that the Lebanese policy on abortion should be amended. (shrink)

Over the last 80 years, a major goal of medical educators has been to improve the quality of applicants to medical school and, hence, the resulting doctors. To do this, academic standards have been progressively strengthened. The Medical College Admission Test (MCAT) in the United States and the undergraduate science grade point average (GPA) have long been correlated with success in medical school, and graduation rates have been close to 100 percent for many years. Recent studies have noted that some (...) doctors having difficulties in practice were found to have had similar problems while in school. In this essay, we present a brief historical account of attitudes and approaches to admissions requirements, then discuss basic broad areas of accomplishment in clinical practice: academic mastery, clinical acumen, and professionalism. We then review data that suggest that lack of competency can often be detected very early in a student’s career and may or may not be immune to remediation efforts. We end with a recommendation for a course of action that upholds and fulfills the profession’s social responsibility. This will be a moral argument, defending an aggressive but equitable approach to maintaining both public accountability and trust. (shrink)

A physician's lack of humanity is a general complaint in public surveys. The physician-patient relationship is viewed by the public as being reduced to a business relationship where the patient feels that she is merely a 'client' and the physician a healthcare 'practitioner' instead of a 'care giver'. This public perception is not a phenomenon that is peculiar to Lebanon. Yet, the problem has been increasing over the years to the extent that patients feel that physicians are becoming inhumane and (...) business oriented. While this might not characterize all physicians of the 21 st century, this might be true of at least some. Responses were collected from a study that was undertaken based on a questionnaire distributed to a pool of 650 participants from different geographical areas and different social and educational backgrounds in Lebanon. Participants were all older than18 years and mentally competent. None were physicians. The questionnaire was open-ended and initially piloted among a random sample. The physician traits most desired by the public were found to be: moral traits (41%), interpersonal traits (36%), scientific traits (19%) and other (4%). The most unwanted traits/behaviours were a lack of interpersonal traits (57%), a lack of moral traits (40%) and a lack of scientific skills (3%). The physician-patient relationship was perceived, in general, as being a flawed one. What can be done to remedy the image of the Lebanese physician that has been projected in the minds of the patients and the public at large? Nine major recommendations are presented. (shrink)

Bioethics is a relatively new addition to bedside medical care in Arab world which is characterized by a special culture that often makes blind adaptation of western ethics codes and principles; a challenge that has to be faced. To date, the American University of Beirut Medical Center is the only hospital that offers bedside ethics consultations in the Arab Region aiming towards better patient-centered care. This article tackles the role of the bedside clinical ethics consultant as an active member of (...) the medical team and the impact of such consultations on decision-making and patient-centered care. Using the case of a child with multiple medical problems and a futile medical condition, we describe how the collaboration of the medical team and the clinical ethics consultant took a comprehensive approach to accompany and lead the parents and the medical team in their decision-making process and how the consultations allowed several salient issues to be addressed. This approach proved to be effective in the Arab cultural setting and indeed did lead to better patientcentered care. (shrink)

This symposium includes twelve narratives from individuals or groups who have worked to help the sick and injured receive healthcare during armed conflict. Four commentaries on these narratives are also included, authored by experts and scholars in the fields of bioethics, human rights, sexual violence in armed conflict, the forced displacement of civilians, and policy development for resource constrained healthcare. The goal of this symposium is to call attention to the the difficulties and ethical dilemmas of providing healthcare during violent (...) armed conflict. (shrink)

Opportunities for practical, hospital-based training in those skills demanded by clinical ethics consultation (CEC) have been limited. Given the number of individuals who provide part-time CEC, greater access to condensed, practical training such as the clinical ethics immersion course offered by the Washington Hospital Center, is necessary.Two participants in the initial cohort evaluate their CE training at a busy, urban referral center, exploring prior expectations, perceptions of its utility and suggestions for improvement. Such training will prove valuable not only for (...) bioethicists who lack practical CEC experience “at the bedside” but also for ethics consultants whose ethics services have a low consult volume who wish to sharpen their skills. (shrink)

The field of reproductive medicine witnessed a breakthrough in September 2014 with the first successful live birth post uterine transplantation. This success represents the culmination of decades' worth of research on infertility and reproductive medicine. This subject of infertility gathers special attention in the Middle East, as childbearing is given paramount importance in the family unit. And as with any new medical advancement, Middle Eastern people look to their religious authorities for guidance. This paper describes the various ethical quandaries related (...) to uterine transplantation, from a perspective of the religious and societal factors that are unique to the Middle East, and embeds them within the conversation of its alternative solutions. (shrink)

Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or ‘preapproval’, access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms (...) enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients’ best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee. Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice. (shrink)

BackgroundBetween the need for transparency in healthcare, widely promoted by patient’s safety campaigns, and the fear of negative consequences and malpractice threats, physicians face challenging decisions on whether or not disclosing medical errors to patients and families is a valid option.We aim to assess the knowledge, attitudes and practices (KAP) of physicians in our center regarding medical error disclosure.MethodsThis is a cross-sectional self-administered questionnaire study. The questionnaire was piloted and no major modifications were made.A day-long training workshop consisting of didactic (...) lectures, short and long case scenarios with role playing and feedback from the instructors, were conducted. Physicians who attended these training workshops were invited to complete the questionnaire at the end of the training, and physicians who did not attend any training were sent a copy of the questionnaire to their offices to complete. To assure anonymity and transparency of responses, we did not query names or departments.Descriptive statistics were used to present demographics and KAP. The differences between response\s of physicians who received the training and those who did not were analyzed with t-test and descriptive statistics. The 0.05 level of significance was used as a cutoff measure for statistical significance.ResultsEighty-eight physicians completed the questionnaire (55 attended training (62.50%), and 33 did not (37.50%)). Sixty Five percent of physicians were males and the mean number of years of experience was 16.5 years. Eighty-Seven percent (n = 73) of physicians were more likely to report major harm, compared to minor harm or no harm. Physicians who attended the workshop were more knowledgeable of articles of Jordan’s Law on Medical and Health Liability (66.7% vs 45.5%,p-value = 0.017) and the Law was more likely to affect their decision on error disclosure (61.8% vs 36.4%,p-value = 0.024).ConclusionFormal training workshops on disclosing medical errors have the power to positively influence physicians’ KAP toward disclosing medical errors to patients and possibly promoting a culture of transparency in the health care system. (shrink)

Cognitive Science, Volume 46, Issue 7, July 2022.

This book provides a comprehensive overview of critical approaches to questions in qualitative research. Written using examples from actual research and course work, this volume helps students and researchers learn to interrogate and inquire against the grain. For use by anyone doing qualitative research in Education, _Critical Approaches to Questions in Qualitative Research_ teaches that questions are tools for decision making in the research process. With exercises, sample questions, and outlines for planning research, this volume teaches readers to ask questions (...) that confront prevailing assumptions leading to an analysis, dismantling and uncovering of omissions and invisiblities. (shrink)

Every day, students from marginalized communities disproportionately face adversity and trauma. It is well documented that exposure to adverse childhood experiences can impact children's ability to focus, learn, and even regulate their emotions. Many schools, rather than providing multi-tiered systems of support to address the root causes of behavior, place these students at greater risk of experiencing health disparities through the use of exclusionary school discipline practices. ESDs not only deny students important educational opportunities, but also can compound existing social, (...) economic, and health inequities. Thus, ESD practices must be understood as more than simply impacting what happens in the classroom. Instead, they should be conceptualized as public health policies with far-reaching impacts on a child's lifelong health and well-being. Even though school discipline has largely been overlooked by the public health community, current reform efforts are one aspect of a holistic health justice framework.This article seeks to begin to bridge current gaps in the literature and public discourse by identifying key linkages between ESD practices and health. It then presents evidence-based design principles to ensure education policy is aligned with a health justice framework. And finally, it explores a specific school-based intervention, restorative justice. (shrink)

This article argues that criminal justice and health institutions under settler colonialism collude to create and sustain “truths” about First Nations lives that often render them as “bare life,” to use the term of Giorgio Agamben. First Nations peoples’ existence is stripped to its sheer biological fact of life and their humanity denied rights and dignity. First Nations people remain in a “state of exception” to the legal order and its standards of care. Zones of exception place First Nations people (...) in a separate and diminished legal order. Medical and health agencies have been instrumental in shaping colonial “biopower,” both in and beyond carceral settings to ensure that First Nations lives are managed in accordance with the colonial settler state project. This project is able both to threaten First Nations rights to live and to maintain settler self-perceptions of decency and care. We illustrate this discussion with reference to the tragic and unnecessary deaths in custody of twenty-two-year-old Yamatji woman Ms Dhu in 2014 in South Hedland Police Station, Western Australia, and twenty-six-year-old Dunghutti man David Dungay Jnr in Long Bay jail in Sydney, NSW, in 2015. Health professionals and police demonstrated callous disregard to Ms Dhu and Mr Dungay—treating them as “bare life.”. (shrink)

Negative self-referential processing has fruitfully been studied in unipolar depressed patients, but remarkably less in patients with bipolar disorder (BD). This exploratory study examines the relation between task-based self-referential processing and depressive symptoms in BD and their possible importance to the working mechanism of mindfulness-based cognitive therapy (MBCT) for BD. The study population consisted of a subsample of patients with BD (n = 49) participating in an RCT of MBCT for BD, who were assigned to MBCT + TAU (n = (...) 23) or treatment as usual (TAU) (n = 26). Patients performed the self-referential encoding task (SRET), which measures (1) positive and (2) negative attributions to oneself as well as (3) negative self-referential memory bias, before and after MBCT + TAU or TAU. At baseline, all three SRET measures were significantly related to depressive symptoms in patients with BD. Moreover, repeated measures analyses of variance revealed that negative self-referential memory bias diminished over time in the MBCT + TAU group, compared with the TAU group. Given the preliminary nature of our findings, future research should explore the possibly mediating role of reducing negative self-referential memory bias in preventing and treating depressive symptoms in BD through MBCT. (shrink)

Acting classes and theatre education have long been framed as activities during which children can learn skills that transfer outside the acting classroom. A growing empirical literature provides evidence for acting classes’ efficacy in teaching vocabulary, narrative, empathy, theory of mind, and emotional control. Yet these studies have not been based in what is actually happening in the acting classroom, nor on what acting teachers report as their pedagogical strategies. Instead, previous work has been unsystematic and fragmented in its measured (...) transfer outcomes, and absent mechanistic explanation. Expanding research on this topic requires more grounding in teachers’ beliefs about the acting classes they teach, as well as observation of the classes themselves. As a first step, we surveyed 173 acting teachers online, asking them about the activities within acting classes they believed caused change in their students, as well as which outcomes they believed were changed as a result of acting classes. Teachers taught across educational levels (elementary to professional) and had a variety of training in teaching acting. Overall, teachers rated almost every activity within classes as important for and causing impact on students, and almost every outcome as being positively influenced as a result of acting class. When forced to rank order outcomes, teachers focused on collaboration, communication, creativity, confidence, and empathy as most likely to change. Teachers rated importance of class activities and outcomes differently depending on what level they taught. This study shows the difficulty of surveying highly motivated teachers, given the globally high rankings, but also proposes candidate psychological skills likely to change as a result of acting classes, and the mechanistic behaviors that may cause change. (shrink)

Distancing and then embracing constitutes a useful way of thinking about the paradox of aesthetic pleasure. However, the model does not account for live theatre. When live actors perform behaviors perceptually close to real life and possibly really experienced by the actors, audiences may experience autonomic reactions, with less distance, or may have to distance post-experiencing/embracing their emotions.

With growing public health and health equity challenges brought to the forefront — following racialized health inequities resulting from COVID-19 and a national reckoning around the deaths of unarmed Black victims at the hands of police — an antiracist health equity agenda has emerged naming racism a public health crisis.

An overview of the latest interdisciplinary research on human morality, capturing moral sensibility as a sophisticated integration of cognitive, emotional, and motivational mechanisms. Over the past decade, an explosion of empirical research in a variety of fields has allowed us to understand human moral sensibility as a sophisticated integration of cognitive, emotional, and motivational mechanisms shaped through evolution, development, and culture. Evolutionary biologists have shown that moral cognition evolved to aid cooperation; developmental psychologists have demonstrated that the elements that underpin (...) morality are in place much earlier than we thought; and social neuroscientists have begun to map brain circuits implicated in moral decision making. This volume offers an overview of current research on the moral brain, examining the topic from disciplinary perspectives that range from anthropology and neurophilosophy to justice and law. The contributors address the evolution of morality, considering precursors of human morality in other species as well as uniquely human adaptations. They examine motivations for morality, exploring the roles of passion, extreme sacrifice, and cooperation. They go on to consider the development of morality, from infancy to adolescence; findings on neurobiological mechanisms of moral cognition; psychopathic immorality; and the implications for justice and law of a more biological understanding of morality. These new findings may challenge our intuitions about society and justice, but they may also lead to more a humane and flexible legal system. Contributors Scott Atran, Abigail A. Baird, Nicolas Baumard, Sarah Brosnan, Jason M. Cowell, Molly J. Crockett, Ricardo de Oliveira-Souza, Andrew W. Delton, Mark R. Dadds, Jean Decety, Jeremy Ginges, Andrea L. Glenn, Joshua D. Greene, J. Kiley Hamlin, David J. Hawes, Jillian Jordan, Max M. Krasnow, Ayelet Lahat, Jorge Moll, Caroline Moul, Thomas Nadelhoffer, Alexander Peysakhovich, Laurent Prétôt, Jesse Prinz, David G. Rand, Rheanna J. Remmel, Emma Roellke, Regina A. Rini, Joshua Rottman, Mark Sheskin, Thalia Wheatley, Liane Young, Roland Zahn. (shrink)

Philosophy can enhance communication among new forms of knowledge, existing ones, and those that will arise in light of the heuristic possibilities of the revolutions in science, technology, and thought; it can turn to a reevaluation of all of the culture that humanity has produced for its own welfare and can prevent the loss of the differentiating essences of diverse social groups. In the conjugation of the forms of knowledge, I am interested in the relationship that has emerged between specialized (...) scientific knowledge and ordinary knowledge, between the tradition, religion, art, and the evaluation of all that has previously been treated by philosophy. But if there is one discipline that I regard as privileged because of its effect on human actions, it is political science: public policy can provide a basis for planetary consciousness, a concern for mankind and for its potential destruction. The role of political philosophy is to serve as an ideological guide for a political science that would comprehend political behavior in relation to its consequences for individual human beings and would thus support actions favorable to humanity. (shrink)

BackgroundMany discretionary foods contribute both to individual health risks and to global issues, in particular through high carbon footprints and water scarcity. Snacking is influenced by the presence of snacking cues such as food availability, observing others eating, and negative affect. However, less is known about the mechanisms underlying the effects of negative affect. This study examines whether the individual odds of consuming high-calorie snacks as a consequence to being exposed to known snacking cues were moderated by experiencing higher or (...) lower total negative affect per day or higher or lower negative affect variability per day.MethodsSecondary analysis of an ecological momentary assessment study of 60 participants over 14 days with food logs and randomly timed assessments of known snacking cues. High total daily negative affect levels and negative affect variability were examined as moderators to predict high-calorie snacking in three-level hierarchical random effects logistic regressions.ResultsConsistent with previous studies, the odds of snacking increased when food was available, when others were eating, and when participants experienced more negative affect. Associations for food availability and others eating were significantly moderated by negative affect variability such that associations between cues and high-calorie snacking were weaker on days with higher negative affect variability, but not negative affect levels.ConclusionThe relationship between cues to high-calorie snacking and snacking behavior varies with variability in negative affect, suggesting a complex relationship between affect and high-calorie snacking. Clearer conceptualizations on the relation between affect and eating are needed. (shrink)

al-juzʼ 1. al-Alfāẓ wa-madhāhib -- al-juzʼ 2. al-Mafāhīm wa-al-uṣūl.

Faith and reason; Islam; Islamic philosophy.

In this paper, we argue that in order for the study of arts education to continue to advance, we must delineate the effects of particular forms of arts education, offered in certain contexts, on specific domains of children’s socioemotional development. We explain why formulating precise hypotheses about the effects of arts education on children’s socioemotional development requires a differentiated definition of each arts education program or activity in question, as well as a consideration of both the immediate and broader contexts (...) in which that program or activity occurs. We then offer the New Victory Theater’s Schools with Performing Arts Reach Kids program as an illustrative example of how these considerations allow for the refinement of hypotheses about the impact of arts education on children’s socioemotional development. (shrink)

This paper provides critical insights into the inclusion of sexual minorities in Flemish fictional TV shows aimed at children. Narratives including LGBT+ characters and non-normative gender performances have gained presence, and especially Nordic and Dutch productions have been acknowledged for their inclusive storytelling. Following up on this premise, our study analyzes five Flemish programs aimed at children aged six to twelve, which all include at least one character who identifies as LGBT+. Our analysis concludes that Flemish children’s productions show a (...) visible willingness to include diversified and inclusive storytelling. However, the assimilationist venture of minimizing the ‘otherness’ of non-heterosexual characters has led to a rather homogenous and normative portrayal of these characters. More stereotypical representations like frivolous singing hairdressers have now been replaced by rather heteronormative and gender-conforming characters. Not confining representations to either end of the spectrum are a necessity if Flemish children’s television wants its audience to understand the diversified range of sexual and gender identities. (shrink)

While Dubourg and Baumard argue that predisposition toward exploration draws us to fictional environments, they fail to answer their titular question: “Why Imaginary Worlds?” Research in pretend play, psychological distancing, and theatre shows that being “imaginary” (i.e., any type of unreal, rather than only fantastically unreal) makes exploration of any fictional world profoundly different than that of real-life unfamiliar environments.

That facial expressions are universal emotion signals has been supported by observers agreeing on the emotion mimed by actors. We show that actors can mime a diverse range of states: emotions, cognitions, physical states, and actions. English, Hindi, and Malayalam speakers viewed 25 video clips and indicated the state conveyed. Within each language, at least 23 of the 25 clips were recognised above chance and base rate. Facial expressions of emotions are not special in their recognisability, and it is miming (...) that may be the universal human ability. (shrink)

Each target article contributes important proto-musical building blocks that constrain music as-we-know-it. However, neither the credible signaling nor social bonding accounts elucidate the central mystery of why music sounds the way it does. Getting there requires working out how proto-musical building blocks combine and interact to create the complex, rich, and affecting music humans create and enjoy.

Conscious will is an experience like the sensation of the color red, the percepfion of a friend's voice, or the enjoyment of a fine spring day. David Hume (1739/1888) appreciated the will in just this way, defining it as "nothing but the internal..

Much recent research has sought to uncover the neural basis of moral judgment. However, it has remained unclear whether "moral judgments" are sufficiently homogenous to be studied scientifically as a unified category. We tested this assumption by using fMRI to examine the neural correlates of moral judgments within three moral areas: (physical) harm, dishonesty, and (sexual) disgust. We found that the judgment ofmoral wrongness was subserved by distinct neural systems for each of the different moral areas and that these differences (...) were much more robust than differences in wrongness judgments within a moral area. Dishonest, disgusting, and harmful moral transgression recruited networks of brain regions associated with mentalizing, affective processing, and action understanding, respectively. Dorsal medial pFC was the only region activated by all scenarios judged to be morally wrong in comparison with neutral scenarios. However, this region was also activated by dishonest and harmful scenarios judged not to be morally wrong, suggestive of a domain-general role that is neither peculiar to nor predictive of moral decisions. These results suggest that moral judgment is not a wholly unified faculty in the human brain, but rather, instantiated in dissociable neural systems that are engaged differentially depending on the type of transgression being judged. (shrink)

My purpose in this article is twofold. I wish to discuss the rift between Jewish feminists and Christian feminists and their Goddess peers, aiming to grapple with points of dispute, alienation and disparity. I equally aspire to find shared grounds; even where agreement is impossible, to raise a greater insight into Judaism beyond irreducible divides, and enhance mutual understanding and respect. By mutual respect I mean that not only shared grounds should build bridges; bridges should be built where homologous identity (...) is missing. While leaving a space for disagreements, irreducible edges and differences; it is when divides are irreducible that mutual respect is most needed, though most difficult to find. Bridges over both shared and unshared grounds are the future of relations, as awareness of differences and open contention can widen reciprocal understanding of our separate worlds. (shrink)

While life thrives on all that is particular, private and personal, arbitrary atrocity conspires to establish itself on the power to destroy it. Conversely, art of atrocity finds its vocation in concentrating on the particular, by magnifying minute details. Individualizing the anonymous victim, ‘art of atrocity' 1 protests the conspiracy of dehumanization that lies with destruction of life.

The Ultimatum Game is commonly interpreted as a two-person bargaining game. The third person who donates and may withdraw the money is not included in the theoretical equations, but treated like a neutral measurement instrument. Yet in a cross-cultural analysis it seems necessary to consider the possibility that the thoughts of a player – strategic, altruistic, selfish, or concerned about reputation – are influenced by both an anonymous second player and the non-anonymous experimenter.