This paper presents a qualitative study investigating the application of physiotherapists’ professional ethics in practice with respect to touch, intimacy, and corporeality during therapy, based on the experiences of elderly patients. As the relationship in a physiotherapy session is multidimensional, the study considered three levels: physical contact, verbal contact, and the conditions in which the therapy took place. The aim of this study was to find out what values are of importance to older people during a physiotherapy session, with emphasis (...) on the categories of touch, corporeality, and intimacy. The studied group consisted of sixteen male and female physiotherapy patients aged between sixty-six and ninety-two years. The study was conducted according to the grounded theory methodology. The research material consisted of transcriptions of free targeted interviews, which were subjected to a process of coding and analysis. As a result of data analyses, three superior categories have been identified—safety, anxiety, interpersonal relationship—and three a priori categories stemming from the characteristic features of the study area—touch, corporeality, and intimacy. The a priori categories did not appear independently in statements made by the respondents, but instead seemed to be components of superior categories. The most important values indicated by the respondents concerned the interpersonal relationship with their physiotherapist and the feeling of safety and care. In terms of touch, corporeality, and intimacy, the respondents indicated, among others, the importance of predictability, a sense of security, privacy, and acceptance of the body. (shrink)

The article “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose,” Marshall et al. (2024) highlights the critical issue of care after an opioid overdose. “Revive and Re...

Current philosophical literature is saturated with the debate on biomedical enhancement, where bio-liberals and conservatives alike make compelling arguments for and against the enterprise. However, this literature is yet to consider the impact such enhancement would have on the individual’s actual lived experience. This article seeks to remedy that by situating the bioethics debate within the phenomenology of Maurice Merleau-Ponty, specifically theorising how biomedical enhancement of the physical kind would impact Merleau-Ponty’s notion of the body-subject. The central issue arises when (...) the reciprocal relationship between the physical body and phenomenal world (termed “body/world dynamic”) is shown to be off-balance because of the rapid rate at which human beings continue to “enhance” their environment. In this, we see that the development of the world has outweighed that of the body to the extent that we, as body-subjects, have become maladapted to the place we call home. This article will suggest that we can attempt to resolve this by restoring the balance of the body/world dynamic with “restrictive” enhancement, thereby providing an ethical justification for the pursuit of the enterprise. (shrink)

This contribution seeks to understand the pervasive phenomenon of work compulsion among knowledge workers in our present network society. Knowledge workers not only have to work all the time from anywhere, but they also appear to want to. This study argues that this curious phenomenon may be attributed to the thumotic satisfaction that knowledge work generates. What is more, the neoliberal theory of human capital has found a way to harness thumotic satisfaction to the profit incentive, and has created arguably (...) the most productive working subject to date. The argument is divided into four parts: First, the paper analyses the government(- ality) of control operative in the network society by defining “neoliberalism”. It then focuses on Foucault’s examinations of German and American neoliberalism in the 20th century, treating them as instances of governmentality. The aim is to assess whether employing a governmentality lens is a valid approach for critically analysing present-day neoliberalism. If it proves justifiable, which I argue it does, the study explores the potential valuable insights gained from examining contemporary neoliberalism through this particular analytical framework. Second, the study turns to the “spiritedness” of knowledge workers under the conditions of stealth control that typify the neoliberal network society. Curiously, these highly engaged workers have reportedly experienced increased overall well-being. However, their overinvestment in work appears to be disproportionate to absolute necessity, increased earnings or improved overall quality of life. This paper contends that work compulsion generates and is in turn fuelled by thumotic satisfaction. Third, the study tries to ascertain the connection between neoliberal governmentality and thumos. Neoliberal governmentality appears to have found a way to appropriate thumotic satisfaction to produce and sustain the competitive entrepreneurial spirit. The fourth part of the study considers how the knowledge worker might resist the compulsion to work incessantly. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"And Her Substance Would Be Mine":Envy, Hate, and Ontological Evacuation in Josephine Hart's SinA. Samuel Kimball (bio)Envy involuntarily testifies to a lack of being that puts the envious to shame.—René Girard, A Theatre of EnvySin, offspring of snt-ya, "that which is," in Germanic sun(d)jo, "it is true," "the sin is real," and ultimately from es-, "to be," source of am, is, sooth, soothe; of the Sanskrit roots sat- and (...) sant-, "existing, true, virtuous"; of the Latin, esse, "to be," from which is derived such words as essence, presence, absence, and represent; of the Greek roots einei, "to be" as well as ont-, "being," which provides the name for the philosophical study of being itself, ontology.—Adapted from The American Heritage Dictionaryof Indo-European RootsI: Ruth Garton's Envious NarrationThe etymology of sin suggests that the evil it names reveals something fundamental about being, something ruinous and yet unavoidable, something that endangers or even nullifies being and yet is inseparable from it, even essential to it. In Josephine Hart's second novel, Sin, this something is a species of Girardian desire in the form of a monstrous envy, which impels the first-person narrator, Ruth Garton, to a lifelong hatred of her cousin and stepsister, Elizabeth. The focus of Ruth's confessional narrative, envy, drives Ruth to take covert and increasingly virulent revenge against her quasi-sibling in a self-deluding attempt to appropriate not only the objects of Elizabeth's desire but ultimately Elizabeth's desire itself and the apparent ontological fullness that Ruth attributes to it. Over the course of her life, then, Ruth loses the promise [End Page 239] of her name in her ruthless pursuit of her enemy. As she becomes increasingly frustrated in her efforts to destroy her sister's life, Ruth finally turns her hatred of her nemesis against herself as well as the readers to whom she appeals for understanding. If envy heightens Ruth's consciousness to the point where she can perceive that her desire signals her ontological emptiness, nevertheless, it so captures her, so dominates her emotional and cognitive life, that she is unable to find a way to affirm her own—or anyone else's—being in the world. The result is a spectacular narrative record of the cost of recognizing but being unable to resist the mimeticism of desire.1II. The Girardian Dynamic of SinAs Girard has demonstrated, one of the most difficult existential challenges is to understand that desire is mimetically mediated. The result is that we come into our desire only through someone else's and always want something more and other than we think we want. Behind every move to possess a particular object is a largely unrecognized and in principle unsatisfiable desire for absolute satisfaction in the form of ontological completeness, self-sufficiency, intactness. On the one hand, Girard writes, "by the example of his own desire…the model conveys to the subject the supreme desirability of the object" (1977, 146). On the other hand, since to desire mimetically means to come into desire through the other rather than through oneself, by this same example the model conveys to the subject the contingency, the dependency, the secondariness, hence the emptiness of the subject's desire, even the subject's lack of desire, the lack that, paradoxically, constitutes his or her desire. Therefore, to be subjected to the other's want ultimately has the effect of signaling the seeming priority, fullness, and self-origination of this other person's desire. For this reason Girard asserts that "man... desires being, something he himself lacks and which some other person seems to possess" (146).If at first the other person models the desire that the subject lacks, it is in the logic of mimesis that the other will become a rival and, unless the rivalry is somehow interrupted or abrogated, inevitably an enemy to be destroyed. The subject will become locked into a potentially deadly game of trying to obtain the same object that the model desires, so as to experience the satisfactions—ultimately, the sense of being—that the object in question seems to provide... (shrink)

Despite its successes, to date Artificial Intelligence (AI) is still characterized by a number of shortcomings with regards to different application domains and goals. These limitations are arguably both conceptual (e.g., related to the underlying theoretical models, such as symbolic vs.connectionist), and operational (e.g., related to robustness and ability to generalize). Biologically inspired AI, and more specifically brain-inspired AI, promises to provide further biological aspects beyond those that are already traditionally included in AI, making it possible to assess and possibly (...) overcome some of its present shortcomings. This article examines some conceptual, technical, and ethical issues raised by the development and use of brain-inspired AI. Against this background, the paper asks whether there is anything ethically unique about brain-inspired AI. The aim of the paper is to introduce a method that has a heuristic nature and that can be applied to identify and address the ethical issues arising from brain-inspired AI (and from AI more generally). The conclusion resulting from the application of this method is that, compared to traditional AI, brain-inspired AI raises new foundational ethical issues and some new practical ethical issues, and exacerbates some of the issues raised by traditional AI. (shrink)

Ethical attitudes and behaviour are complex. This complexity extends to the influencers operating at different levels both outside and within the organisation, and in different combinations for different individuals. There is hence a growing need to understand the proximal and distal influencers of ethical attitudes, and how these operate in concert at the individual, organisational, and societal levels. Few studies have attempted to combine these main research streams and systematically examine their combined impact. The minority of studies that have taken (...) a combined approach have often done so using conventional statistical and analytical techniques which imply linearity between variables—a situation that rarely exists in business settings and is likely to lead to simplistic or even erroneous conclusions. Applying a fuzzy-set qualitative comparative analysis approach, this paper reports on the mutual and simultaneous influence of individual demographic factors, as well as proximal and distal factors stemming from within and outside the work environment to understand individuals’ ethical views within the workplace. The multiple configurations that emerged reveal the complex nature of influencers of ethical attitudes, and reinforce the view that “one size does not fit all”. We discuss these implications together with managerial recommendations and future research directions. (shrink)

Over the last 50 years, there has been significant development of qualitative research and related methods in healthcare. Theoretical frameworks support researchers in selecting appropriate research approaches, procedures and analytical tools. However, the implications of the choice of theory are sparsely elucidated. Based on a text excerpt from a public debate article, the study aimed to show how different theory‐inspired analytical perspectives produced varied understandings of the same text. The study presented three subanalyses inspired by Bourdieu's sociological theory, Lazarus and (...) Folkman's psychological theory and utilitarian ethics, respectively. The analyses showed that by using different theoretical analytical perspectives in inductive processes, an immediate interpretation of the text was not obvious. It became possible to spot the underlying meta‐theoretical assumptions, as the interpretations were not taken for granted or indisputable. Our analyses suggest that different theoretical lenses lead to different interpretations of the same empirical material, recognising the existence of multiple truths or realities. Thus, utilising a theoretical perspective in inductive analyses can enhance transparency and rigour because the analytical optics are made explicit to the reader. This allows the reader to follow the analysis processes and comprehend from which theoretical starting point a truth arises. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Background Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture. Methods To identify key ethical considerations (...) arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers. Results After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals. Conclusions The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies. (shrink)

Темпи соціального розвитку на початку ХХІ ст. стали настільки стрімкими і драматичними, що гострі та невідкладні питання, поставлені його зламами і змінами, вимагають не лише науково обґрунтованих теоретичних відповідей, а й відповідних конкретних і вчасних політичних дій. Вивчення історичного досвіду і уроків революцій другої половини ХХ і початку ХХІ ст. дає можливість завчасно прогнозувати подібні процеси. В періоди революційних потрясінь виникають такі стани, коли соціальний рух внаслідок заперечення існуючих порядків стає надзвичайно пластичним. Без наукового розуміння причин виникнення і свідомого запобігання (...) таким наслідкам масові соціально-політичні рухи не мають шансів виконати роль суб’єктів історичного розвитку. (shrink)

International Mindedness (IM) has become an underpinning philosophy of the International Baccalaureate and schools which adopt its programmes. However, the concept of IM is relevant to any school that offers international education given its potential and importance to drive the school’s mindset and mission. The international school market has grown significantly in terms of the number of schools and their diversity. Increasing in popularity are schools that follow the British-based International General Certificate of Secondary Education (IGCSE) and A-level programmes. Moreover, (...) the dgreatest expansion of international schools is now occurring in local markets, in which students are no longer predominantly expatriates but come from the host countries. This study explores the concept of international mindedness in six international schools in Cyprus. Based on data collected from headteachers and teachers, we argue that international mindedness is applicable in various contexts of international schooling and that factors other than the curriculum can affect its development within a school. (shrink)

The conflict in Gaza and Israel that ignited on October 7, 2023 signals a catastrophic breakdown in the possibility of ethical dialogue in the region. The actions on both sides have revealed a dissolution of ethical restraints, with unimaginably cruel attacks on civilians, murder of children, destruction of health facilities, and denial of basic needs such as water, food, and shelter. There is a need both to understand the nature of the ethical singularity represented by this conflict and what, if (...) any, options are available to allow the reconstruction of communication between the warring parties. This article seeks to address these tasks by analysing the conflict as inherently an ethical one, in the sense that it exposes a rupture in the fabric of communicative relationships that has evolved systematically out of the deep cultural structures from which all protagonists have emerged. Drawing on the work of Levinas, Habermas, Arendt, and others, and referring to the specific circumstances in the region, it examines the ethical sources of the crisis and tries to identify conditions for its resolution. The possibility of reconciliation—that is, of refiguring relationships to open up a space for dialogue to create pathways to heal the ruptures—is examined. The dark legacy of the Holocaust is identified as an abiding cultural vulnerability for both societies. It is concluded, however, that the rich history of partnerships and collaborations between Jews and Palestinians provides a robust infrastructure on the basis of which a sustainable peace might be built, providing a much-needed source of hope. (shrink)

In this paper we conduct an analysis of the critical narratives of Stardew Valley and compare them to other relevant videogames in order to develop new possibilities for an ecological critique of capitalist extractive econo­mies. Critical narratives of this game are aimed primarily at the alienating conditions of labour and deeply devastating modes of production under capitalism that impact and severely damage the environment. Analysing these narratives, we superimpose the immediate messages of the game with the procedural rhetoric and material (...) conditions of their existence. Over the course of our analysis, we highlight a material-narrative disso­nance which, in the case of Stardew Valley, fails to function as a commu­nicative strategy of the game and remains its mere external contradiction. Although the game’s critical narrative may seem overly utopian and its political imaginary a bit underdeveloped, the game elaborates on concrete ways to tackle the alienation of labour and resolve the ecological crisis. In addition to this, the paper covers the history of the interplay between the video game industry and the field of global ecological crisis research. We compare the attempts to raise awareness of the videogames’ own material­ity that preceded Stardew Valley. We conclude that Stardew Valley utilises the language of sustainable co-existence and wasteless local production, expanding this logic both to the sphere of labour and the spectrum of en­vironmental problems. In the case of ecological critique, some gameplay decisions in Stardew Valley enable us to come up with new strategies aimed at creating critical narratives about the environment in videogames. Thus supplementing Stardew Valley’s findings with critical tropes derived from other games (mainly, Rain World), we were able to gather a set of theoretical instruments that could facilitate the creation of games about ecosystems. Following Donna Haraway’s emphasis on the crucial role of narrative fram­ing (“it matters which stories tell stories”), we highlight new opportunities for the entire medium of videogames. (shrink)

The present volume focuses on aspects of Islamic thought in Iran and Yemen, and other regions of the Middle East, ninth through fifteenth century CE, through a close study of manuscript materials. The book's sixteen chapters are arranged under five rubrics: Mu'tazilism, Zaydism in Iran and in Yemen, Twelver Shi'ism, Mysticism, and Bibliographical Traditions. The material included in the book has been published previously in a different version. The appearance of these studies together in a single volume makes this book (...) a significant and welcome contribution to the field of classical Islamic Studies. (shrink)

Quelle sorte de contrôle et, par suite, de responsabilité, avons-nous à l'égard de nos croyances? Dans quelle mesure pouvons-nous décider de croire? Cette question agite la philosophie européenne depuis Aristote, les stoïciens, et les sceptiques ; avec les médiévaux, elle croise celle de la responsabilité du chrétien à l'égard de sa foi ; avec les modernes, elle rencontre le problème pratique de la tolérance. Cet ouvrage explore ainsi l'histoire de la controverse sur le rôle de la volonté dans ce que (...) les classiques appellent l'assentiment. Il le fait non dans une perspective d'érudition, mais avec pour objectif de contribuer à une meilleure intelligence d'une question qui connaît aujourd'hui un important regain d'intérêt, dans le domaine de l'épistémologie, de la psychologie, ou de la philosophie de la religion, et dont les enjeux éthiques et politiques sont évidents. Les contributeurs s'aident en retour des outils que la philosophie de l'esprit, durant ces dernières décennies, a développés, pour démêler ce qui, dans la croyance, dépend de l'initiative du croyant, et ce qui ne dépend pas de lui. (shrink)

For many economists, including those who have made the most marked contribution to the development of the discipline, their work has to be understood in the context of the rhetorical strategy they were pursuing – what they wanted to persuade us of and how they wanted to do it. The paper identifies two fundamental rhetorical strategies of laissez-faire resting on entirely distinct ontological foundations. What distinguishes these two strategies is the way they articulate the individual with the general interest, how (...) they relate the micro to the macro. The two strategies discussed in the paper are characterised by the stance they take on a fundamental ontological issue, the way in which the things which appear to us in the world are related to the things or matters which compose them. A reductionist approach suggests that we can understand an entity at one level as a congeries. An entity in this view is just an aggregate of entities at a lower, substrate level – a purely external unity. The properties and behaviour of an entity can then be understood in terms of the properties and behaviour of the constituent lower-level components, taken in isolation. In this approach, phenomena at some level are regarded as having just the qualities enjoyed by its lower-level, substrate elements, writ large. The contrary, holistic, stance is to view the qualities of phenomena at one level as emergent at that level, and to assert that an entity can be understood as a product of the inter-relations between its component parts. We have, then, a pair of contrasted approaches: a polarity which is productive in the study of schools of thought, of competing methodologies, and of rhetorical strategies in economics. The paper applies this approach to the work of Smith, Keynes, Hayek, Lucas and Friedman. (shrink)

This article is a collective writing experiment undertaken by philosophers of education affiliated with the PESGB (Philosophy of Education Society of Great Britain). When asked to reflect on questions concerning the Philosophy of Education in a New Key in May 2020, it was unsurprising that the effects of the coronavirus pandemic on society and on education were foremost in our minds. We wanted to consider important philosophical and educational questions raised by the pandemic, while acknowledging that, first and foremost, it (...) is a human tragedy. With nearly a million deaths reported worldwide to date, and with everyone effected in one way or another by Covid-19, there is a degree of discomfort, and a responsibility to be sensitive, in reflecting and writing about it academically. Members of this ‘Covid Collective’ come from various countries, with perspectives from Great Britain and Ireland well represented, and we see academic practice as a globally connected enterprise, especially since the digital revolution in academic publishing. The concerns raised in this article relate to but move beyond Covid-19, reflecting the impact of neoliberalism [and other political developments] on geopolitics with educational concerns as central to our focus. (shrink)

This book offers fresh perspective on the role of phenomenology in the philosophy of physics which opens new avenues for discussion among physicists, "standard" philosophers of physics and philosophers with phenomenological leanings. Much has been written on the interrelations between philosophy and physics in the late 19th and early 20th century, and on the emergence of philosophy of science as an autonomous philosophical sub-discipline. This book is about the under-explored role of phenomenology in the development and the philosophical interpretation of (...) 20th century physics. Part 1 examines questions about the origins and value of phenomenological approaches to physics. Does the work of classical phenomenologists such as Husserl, Merleau-Ponty or Heidegger contain elements of systematic value to both the practice and our philosophical understanding of physics? How did classical phenomenology influence “standard” philosophy of science in the Anglo-American and other traditions? Part 2 probes questions on the role of phenomenology in the philosophies of physics and science: - Can phenomenology help to solve “Wigner’s puzzle”, the problem of the "unreasonable effectiveness" of mathematics in describing, explaining and predicting empirical phenomena? - Does phenomenology allow better understanding of the principle of gauge invariance at the core of the standard model of contemporary particle physics? - Does the phenomenological notion of “Lifeworld” stand in opposition to the “scientific metaphysics” movement, or is there potential for dialogue? Part 3 examines the measurement problem. Is the solution outlined by Fritz London and Edmond Bauer merely a re-statement of von Neumann’s view, or should it be regarded as a distinctively phenomenological take on the measurement problem? Is phenomenology a serious contender in continuing discussions of foundational questions of quantum mechanics? Can other interpretational frameworks such as quantum Bayesianism benefit from implementing phenomenological notions such as constitution or horizonal intentionality? (shrink)

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

Some individuals facing dementia contemplate hastening their own death: weighing the possibility of living longer with dementia against the alternative of dying sooner but avoiding the later stages of cognitive and functional impairment. This weighing resonates with an ethical and legal consensus in the United States that individuals can voluntarily choose to forgo life‐sustaining interventions and also that medical professionals can support these choices even when they will result in an earlier death. For these reasons, whether and how a terminally (...) ill individual can choose to control the timing of their death is a topic that cannot be avoided when considering the dementia trajectory. With a focus on the U.S. context, this landscape review considers the status of provisions that would legally permit people facing dementia to hasten death with appropriate support from medical professionals. This review can be used to plan and guide clinical and legal practitioner discussion and policy development concerning evolving questions not fully covered by existing medical decision‐making provisions. (shrink)