Most sources providing information on infant feeding strongly recommend breastfeeding. The WHO and UNICEF recommend that women breastfeed their babies and that health professionals promote breastfeeding. This creates severe pressure on women to breastfeed, a pressure which is ethically questionable since many women have physical or emotional problems with breastfeeding. In this article, we use insights from the ethics of risk to criticize the current breastfeeding policy. We argue that there are problems related to balancing aggregate wellbeing (...) versus individual wellbeing, that not enough attention is paid to alternatives, that women’s emotions and their need for free choice should be considered and that issues of equity are currently overlooked. We also criticize the way scientific information is presented in the current policy. We conclude that the official sources of information on infant feeding should be revised. Information should be more nuanced and designed to support mothers, and families in making a free choice on what is the best way to feed their babies. (shrink)

Philosophers of science have in recent years become increasingly interested in the notion of interdisciplinarity. One important form interdisciplinarity can take is that of a dynamic exchange of problems and solutions between disciplines—what has recently been called problem-feeding. On this model problems arising within specific disciplines are sometimes solved more effectively by, or in collaboration with, other disciplines. In this paper we explore this model as a framework for thinking about, and actively structuring, interdisciplinary research. We point (...) to the applicability of the problem-feeding model, and to some of the prerequisites of problem-feeding interdisciplinarity, highlighting in particular the harmonisation of goals and the establishment of mutual trust between disciplines. (shrink)

One way to bring order into the often muddled picture we have of interdisciplinarity is to sort interdisciplinary projects or aims by the kinds of element that interact in encounters between researchers of the two or more disciplines involved. This is not the usual approach. Since the early seventies and the publication of Erich Jantsch , at least, the level of integration of the disciplines has been the primary focus. For instance, the level of integration is often treated as the (...) distinguishing boundary between multi‐, inter‐, and trans‐disciplinarity. We identify three kinds of interdisciplinary relation: problem‐feeding, conceptual drift, and methodological migration; we focus, in particular, on the first of these. Drawing on examples from the emerging field of Sustainability Science we show that problem‐feeding is a common and apparently fruitful way of connecting disparate disciplines. We illustrate some of the roles conceptual drift and methodological migration have in problem‐feeding as well as in their own right. Towards the end of the paper we suggest that there is an interesting difference between our approach to interdisciplinarity and the integrative perspective suggested by Jantsch. The interdisciplinarity resulting from problem‐feeding between researchers is typically local and temporary; integration is associated with a longer‐term, global form of interdisciplinarity. (shrink)

Traditionally, interdisciplinarity has been taken to require conceptual or theoretical integration. However, in the emerging field of sustainability science this kind of integration is often lacking. Indeed sometimes it is regarded as an obstacle to interdisciplinarity. Drawing on examples from sustainability science, we show that problem-feeding, i.e. the transfer of problems, is a common and fruitful-looking way of connecting disparate disciplines and establishing interdisciplinarity. We identify two species of problem-feeding: unilateral and bilateral. Which of these is at (...) issue depends on whether solutions to the problem are fed back to the discipline in which the problem originated. We suggest that there is an interesting difference between the problem-feeding approach to interdisciplinarity and the traditional integrative perspective suggested by among others Erich Jantsch and his colleagues. The interdisciplinarity resulting from problem-feeding between researchers can be local and temporary and does not require collaboration between proximate disciplines. By contrast, to make good sense of traditional integrative interdisciplinarity we must arguably associate it with a longer-term, global form of close, interdisciplinary collaboration. (shrink)

"1. A science or study of being: specifically, a branch of metaphysics relating to the nature and relations of being; a particular system according to which problems of the nature of being are investigated; first philosophy. 2. a theory concerning the kinds of entities and specifically the kinds of abstract entities that are to be admitted to a language system.".

Medical Officer of Health reports for London boroughs, 1900–19, are analysed to determine the incidence of neonatal breast-feeding, duration of lactation, reasons for early supplementation and premature weaning, and their relationship with infant mortality. In a sample of 222,989 infants, breast-feeding rates were very high. Over 90% were breast-fed in the first month, almost 80% at 3 months, and over 70% at 6 months. The poorest boroughs had the highest rates of neonatal breast-feeding, but also a higher (...) incidence of early supplementation and premature weaning. There was a significant positive correlation between breast-feeding and infant mortality due to poor maternal diet and health, poor nutritional quality of supplementary and substitute foods, and the use of an unhygienic feeding bottle. Energetic campaigns to counteract these problems probably contributed to the fall of infant mortality in this period. (shrink)

Feeding difficulties in older patients who are suffering from dementia present problems with balancing conflicting ethical principles. They have been considered by several writers in recent years, and the views of nursing and care staff have been studied in different contexts. The present study used focus groups to explore the way in which nursing and care staff in a National Health Service trust deal with conflict between ethical principles in this area. Three focus groups were convened, one each (...) from the staff of three wards caring for patients with dementia. Case histories were discussed and transcripts analysed. It emerged that staff were aware of making fine judgements of utility concerning the spectrum of feeding methods available. Informants gave some weight to the principle of autonomy, but sought to balance that against their commitment to care. In explaining their perspectives, informants gave more weight to personal attitudes and trust culture than to professional ethics. (shrink)

In this paper, I argue that clinically-oriented practical and theoretical approaches to the problem of pain should more carefully heed narrative and phenomenological research. I begin with the work of S. Kay Toombs, contending that her phenomenological account of multiple sclerosis demonstrates how a degenerative condition attendant with pain ultimately effect a constriction of one’s world. Drawing upon two of artist Yosl Bergner’s depictions of the story, I then present a reading of Kafka’s “The Vulture” as a literary account of (...) the constrictive movement of acute, localized pain to chronic, systemic pain. I conclude by discussing the implications of literary and phenomenological accounts of pain for its diagnosis, management, and treatment. (shrink)

Animal lovers who feed meat to other animals are faced with a paradox: perhaps fewer animals would be harmed if they stopped feeding the ones they love. Animal diets do not raise problems merely for individuals. To address environmental crises, health threats, and harm to animals, we must change our food systems and practices. And in these systems, animals, too, are eaters. -/- Looking beyond what humans should eat and whether to count animals as food, Just Fodder answers (...) ethical and political questions arising from thinking about animals as eaters. Josh Milburn begins with practical dilemmas about feeding the animals closest to us, our pets or animal companions. The questions grow more complicated as he considers relationships with more distance - questions about whether and how to feed garden birds, farmland animals who would eat our crops, and wild animals. Milburn evaluates the nature and circumstances of our relationships with animals to generate a novel theory of animal rights. -/- Looking past arguments about what we can and cannot do to other beings, Just Fodder asks what we can, should, and must do for them, laying out a fuller range of our ethical obligations to other animals. (shrink)

According to Jewish law, to make a judgment that a life has no purpose and is not worth saving is contrary to the concept of justiceTraditional medical practice dictates that when patients are unable to eat or drink enough to sustain their basic nutritional requirements, artificial feeding and hydration is indicated. Common clinical examples of this problem are patients with senile dementia and those in a persistent vegetative state . In recent decades, however, the practice of mandating artificial (...) class='Hi'>feeding has been increasingly questioned. A combination of legal, ethical, and clinical considerations has resulted in broad support for withholding and withdrawing artificial nutrition. The guiding ethical principle in the current clinical standards is that patient autonomy must be honoured. In the context of an incompetent adult , advance directives or surrogate decision making are legally binding. Such requests to withhold artificial nutrition are considered appropriate and even encouraged.1 Such a view, however, is not unanimous. For example, Catholic writers have questioned the current consensus. The New Jersey Catholic Conference has written that withholding nutrition and hydration from such patients “ultimately results in starvation, dehydration, and death,” and that withdrawing such basic care from patients who are not dying but in a PVS “is a clear statement that the patient’s life has no moral value”.2 This question is also of great concern in Jewish law . In contrast to secular medical ethics, halachah requires that artificial feeding be given to patients with dementia or in a PVS. The following discussion gives an overview of the pertinent arguments that have led to the consensus in secular ethics that artificial feeding may be withheld from the severely demented and the halachic considerations that argue against this practice.CLINICAL ARGUMENTS IN FAVOUR OF WITHHOLDING ARTIFICIAL FEEDINGThe most obvious …. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral (...) tube feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

In a recent article, Fiona Woollard draws attention to a number of problems, both theoretical and pragmatic, with current discourse around infant feeding. References both to the ‘benefits of breastfeeding’ and ‘harms of formula’ are problematic, since there is no obvious baseline of comparison against which to make these evaluations. Further, she highlights the pragmatic consequences of these linguistic choices. Saying that formula feeding harms babies, for instance, is likely to exacerbate feelings of guilt and shame felt (...) by many mothers who use formula, for various reasons. Since I agree with much that Woollard says, this response is mostly sympathetic, but I wish to draw attention to one point that is largely missing from her analysis. The pragmatic effect of an utterance depends significantly on who is speaking, to whom, and in what context. Thus, we might differentiate between what it is appropriate to say in a professional context, such as an academic journal, from what one might say in a policy document or to a new mother. While we should always be careful about the language that we use, we need not assume that the same language is appropriate in all contexts nor that equal care is always required. (shrink)

The implications of Pope John Paul II's 2004 Allocution on vegetative states remain unclear despite dozens of articles and a recent clarifying statement from the Vatican. Yet few have considered its implications for those with end-stage progressive dementia, such as Alzheimer's disease. Although recent studies suggest tube feeding is burdensome and not beneficial for such patients, the Allocution would nonetheless seem to forbid patients from forgoing it. But this seems to be in tension with the Catholic bioethical tradition as (...) a whole and may therefore be a consequence that the pope did not intend. Because the recent Vatican clarification specifically addresses Alzheimer’s, it is especially important to know what duties it intends to impose on those with dementia. Problems with how it would apply to such patients casts doubt on whether it should be applied to patients in vegetative states at all. (shrink)

Lactation constitutes a major focus for research in international health because of its dramatic impact on child survival; evolutionary biology has investigated lactation as an important aspect of parenting strategy, with implications for understanding parent-offspring conflict. These perspectives are brought together in an attempt to develop integrated models for an issue of key international health concern: the duration of exclusive breast-feeding and the timing of weaning. This analysis highlights the relevance of evolutionary theory for practical problems in public (...) health, and it suggests the utility of public health outcomes for addressing evolutionary questions. (shrink)

In this paper, I propose two theses, and then examine what the consequences of those theses are for discussions of reduction and emergence. The first thesis is that what have traditionally been seen as robust, reductions of one theory or one branch of science by another more fundamental one are a largely a myth. Although there are such reductions in the physical sciences, they are quite rare, and depend on special requirements. In the biological sciences, these prima facie sweeping reductions (...) fade away, like the body of the famous Cheshire cat, leaving only a smile.... The second thesis is that the "smiles" are fragmentary patchy explanations, and though patchy and fragmentary, they are very important, potentially Nobel-prize winning advances. To get the best grasp of these "smiles," I want to argue that, we need to return to the roots of discussions and analyses of scientific explanation more generally, and not focus mainly on reduction models, though three conditions based on earlier reduction models are retained in the present analysis. I briefly review the scientific explanation literature as it relates to reduction, and then offer my account of explanation. The account of scientific explanation I present is one I have discussed before, but in this paper I try to simplify it, and characterize it as involving field elements and a preferred causal model system abbreviated as FE and PCMS. In an important sense, this FE and PCMS analysis locates an "explanation" in a typical scientific research article. This FE and PCMS account is illustrated using a recent set of neurogenetic papers on two kinds of worm foraging behaviors: solitary and social feeding. One of the preferred model systems from a 2002 Nature article in this set is used to exemplify the FE and PCMS analysis, which is shown to have both reductive and nonreductive aspects. The paper closes with a brief discussion of how this FE and PCMS approach differs from and is congruent with Bickle's "ruthless reductionism" and the recently revived mechanistic philosophy of science of Machamer, Darden, and Craver. (shrink)

The problem of cortical integration is described and various proposed solutions, including grandmother cells, cell assemblies, feed-forward structures, RAAM and synchronization, are reviewed. One method, involving complex attractors, that has received little attention in the literature, is explained and developed. I call this binding through annexation. A simulation study is then presented which suggests ways in which complex attractors could underlie our capacity to reason. The paper ends with a discussion of the efficiency and biological plausibility of the proposals as (...) integration mechanisms for different regions and functions of the brain. (shrink)

Academician Gerasimov devoted his presentation to the problem of improvement and protection of the environment. In his opinion, today, when there is a worldwide threat of exhaustion of natural resources, irreversible pollution, poisoning of the environment, and the impossibility of feeding a growing population, questions of environmental protection and rational use of natural resources are becoming not only an important problem for natural science but a serious social and political matter around which an acute ideological struggle is being waged. (...) Certainly it is a real fact that contemporary mankind is encountering a progressive impairment of the world's ecological situation, caused by the ever more intensive utilization of natural resources under the conditions of rapid scientific and technological progress. Therefore, issues of further rational use of natural resources and improvement and protection of the environment are now becoming problems affecting the everyday interests of the entire population of the earth. (shrink)

The present paper will summarise the methodology, the scientific outcomes, and the potential for generalisation of the model of a project that studied cohabitation between human inhabitants and liminal species (in the present case, corvids) in Tartu, Estonia, from October 2021 to July 2023, with a comparative field study in Paris, France. It will present the context and goals of using a semiotic model to map interspecific cohabitation, expose what kind of data can be used to feed the model in (...) a relevant way and how it was done in the case of this project. This paper will present how the model diagnosed issues in cohabitation, both from material nuisances and cultural aspects, insisting on the concept of “hostile minority” that emerged from the study. It will discuss the importance of problem-solving in interspecific cohabitation, what the model suggested regarding this aspect, how this tool can be generalised to a large variety of cases and why it should be used this way. (shrink)

In The Case for Animal Rights, Tom Regan argues that, in addition to the negative duty not to harm nonhuman animals, moral agents have a positive duty to assist nonhuman animals who are victims of injustice. This claim is not unproblematic because, in many cases, assisting a victim of injustice requires that we harm some other nonhuman animal(s). For instance, in order to feed victims of injustice who are obligate carnivores, we must kill some other animal(s). It seems, then, that (...) sometimes the duty to assist nonhuman animals who are victims of injustice conflicts with the prima facie duty not to harm nonhuman animals. In defense of Regan’s theory against this apparent inconsistency, I introduce an additional principle, the “guardianship principle,” which can be used to illustrate how we can be justified, under certain conditions, in overriding our prima facie duty not to harm nonhuman animals in order to fulfill our duty to assist nonhuman animals who are victims of injustice. (shrink)

BackgroundDecision-making in end-stage dementia is a complex process involving medical, social, legal and ethical issues. In ESD, the person suffers from severe cognitive problems leading to a loss of capacity to decide matters regarding health and end-of-life issues. The decisional responsibility is usually passed to clinicians and relatives who can face significant difficulty in making moral decisions, particularly in the presence of life-threatening swallowing problems.AimThis study aimed to understand the decision-making processes of clinical teams and relatives in addressing (...) life-threatening swallowing difficulties in ESD in long-term care in Malta.MethodThe study followed a qualitative approach where six case studies, involving six different teams and relatives of six different patients, were interviewed retrospectively to understand their decision-making in connection with the management of swallowing difficulties in ESD. Data were collected through semistructured interviews with each stakeholder. All data were transcribed and subjected to thematic analysis.ResultsFour themes were identified: the vulnerability of patients in dementia decision-making; the difficult role of relatives in decision-making; the decisional conflict between aggressive care through tube feeding versus oral comfort feeding; a consensus-building decision-making process as ideal to facilitate agreement and respect for patient’s dignity.ConclusionDecision-making to manage swallowing difficulties in ESD is a challenging process, which involves an interpretation of personal values, beliefs, patient preferences, care needs and clinical practice. Better communication between clinicians and relatives in dementia helps promote agreement between stakeholders leading to a care plan that respects the dignity of patients at their end of life. (shrink)

The present study examined the role of father sensitivity and couple coparenting quality in the first 2 years of life in relation to the development of externalizing behavior problems in middle childhood, focusing on the unique role of fathers. In this study, 125 mothers, fathers, and their first-born children were followed from 8 months to age 7 years. Paternal sensitivity was rated when infants were 8 and 24 months old. Fathers were videotaped at home playing, feeding, and changing (...) their 8-month-old infants’ clothes. They also were videotaped in a lab playing with their 24-month-olds and solving a variety of challenging tasks. At 24 months, competitive coparenting was assessed via videotaped triadic family interactions at home in which families participated in a variety of tasks. Teachers rated externalizing behavior problems when the children were age 7. Continuity in paternal sensitivity was documented from 8 to 24 months, and paternal sensitivity at 8 months predicted externalizing behavior in middle childhood through father sensitivity at 24 months. Moreover, paternal sensitivity at 8 months predicted competitive coparenting which, in turn, forecast externalizing behavior problems in middle childhood, even after controlling for maternal sensitivity at 8 and 24 months. These findings highlight the unique role of paternal caregiving quality during the first year of life on couple coparenting and children’s subsequent development of externalizing problems and have implications for creating effective interventions to prevent children from developing externalizing disorders. (shrink)

With aims to both increase organ supply and better reflect individual donation preferences, many nations worldwide have shifted from ‘opt‐in’ to ‘opt‐out’ systems for post‐mortem organ donation (PMOD). In such countries, while a prospective donor's willingness to donate their organs/tissues for PMOD was previously ascertained—at least partially—by their having recorded positive donation preferences on an official register prior to death, this willingness is now presumed or inferred—at least partially—from their not having recorded an objection to PMOD—on an official organ donation (...) register. Using evidence regarding the presence and prevalence of selective donation preferences, and via exploration of how appeals to donation preferences are used to both motivate and legitimate shifts to opt‐out frameworks, this paper draws attention to a set of previously unexplored problems for opt‐out organ donation arising in contexts where: (a) individuals demonstrate selective post‐mortem organ/tissue donation preferences, (b) legislation provides prospective donors with the opportunity to selectively permit/refuse the donation of certain organs/tissues in line with these preferences. While selective preferences pose few problems for opt‐in systems where a selective occasion is built into the process of signing the donor register, this is not the case for opt‐out systems. The loss of this selective occasion can cause significant problems where appeals to preferences motivate/legitimate shifts to opt‐out but evidence regarding variable preferences does not feed into determinations regarding organ/tissue exclusions. The nature of these problems depends on how the authorization aspect of ‘opt‐out’ systems is framed (e.g. as presumed consent, deemed consent or, given the role of familial consent in many jurisdictions as consent in name only). (shrink)

Quantum theory can be regarded as a rationally coherent theory of the interaction of mind and matter and it allows our conscious thoughts to play a causally e cacious and necessary role in brain dynamics It therefore provides a natural basis created by scientists for the science of consciousness As an illustration it is explained how the interaction of brain and consciousness can speed up brain processing and thereby enhance the survival prospects of conscious organisms as compared to similar organisms (...) that lack consciousness As a second illustration it is explained how within the quantum framework the consciously experi enced I directs the actions of a human being It is concluded that contemporary science already has an adequate framework for incorporat ing causally e cacious experiential events into the physical universe in a manner that puts the neural correlates of consciousness into the theory in a well de ned way explains in principle how the e ects of consciousness per se can enhance the survival prospects of organisms that possess it allows this survival e ect to feed into phylogenetic de velopment and explains how the consciously experienced I can direct human behaviour.. (shrink)

This study elaborates on narrative resources emerging in the treatment of longlasting musculoskeletal and psychosomatic disorders in Norwegian psychomotor physiotherapy. Patients’ experiences produced in focus group interviews were analyzed from a narrative perspective, combining common themes across groups with in depth analysis of selected particular stories. NPMP theory expanded by Løgstrup’s and Ricoeur’s philosophy, and Mattingly’s and Frank’s narrative approach provided the theoretical perspective. Patients had discovered meaning imbued in muscular tension. Control shifted from inhibiting discipline and cognitive strategies, towards (...) more contingence with gravity and sensation, and increased freedom to be what and who they were. Trust, time, open speech, and being respectfully listened to were described as therapeutic pre-conditions. The body was experienced as the source of their voice as their own. As tension patterns transformed, novel experience in sensation appeared to feed narrative imagination, reshaping past plots, embodied identity and future prospects. NPMP was disclosed as a treatment integrating detection, battle and repair as narrative subplots, but the core narrative was the journey of transformation. Novel embodied narrative resources nourished the quest for a life and identity in tune with the body as one’s own. (shrink)

This paper examines the debate over the relationship between the public sphere and communication, which has become a focus of attention after the publication of Jürgen Habermas's Structural Transformation of Public Sphere in English in 1989, following the two volumes of his The Theory of Communicative Action in 1984 and 1987. Although the historical account of the public sphere has also received a good deal of attention, I deal mainly with the normative dimension of Habermas's theory as it led to (...) a rethinking and reassessment of public broadcasting, to the end of restructuring it as a site where 'citizens act as a public'. That is to say, a site where people assemble and unite freely, and express and publicize their opinions on matters of general interest without constraint in an age of deregulated communications. Several scholars have provided us with maps for re-organizing the media of communications in this respect, but they have failed to analyze the 'information' which feeds the 'informed citizen'. This paper addresses not only what information means today—whether it is a digit, a signal, or content—but also how it is produced within daily routine practices and how the nature of the means of its dissemination influences its character. Another serious aspect of those assessments, including that of Habermas, is the global character of communications today. Habermas is well aware of the mismatch between the global market and the absence of its corollary in politics. Yet his silence in the economics of information, even as he acknowledges the digitalization of communications and 'a world public sphere', also calls for a critical account of the relations between 'information', democratic politics and the question of scale. (shrink)

Animal feeding operations have come under increased scrutiny as sources of water pollution. Due to the concentration of animals at individual locations and in certain regions, the local environment may not be able to use all of the nutrients contained in the manure. Particularly, problematic are waters being impaired by nitrogen and phosphorus from animal manure. Since federal and state regulations have not been totally successful in precluding water contamination from manure nutrients, scientists and policymakers might seek ways to (...) encourage the use of manure as a resource for crop production. By analyzing diverse state regulations, this paper identifies several strategies that would treat animal waste as a recyclable production input rather than a production byproduct. Citizens and regulators can encourage more sustainable livestock production by proffering regulations that mandate selected production requirements or practices. Agronomic rate regulations, limitations on manure application and timing, lagoon safety requirements, closure mandates, and alternative uses of manure constitute possibilities to remedy some pollution problems. (shrink)