Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

We notice a number of interesting overlaps between the views on personhood of Ifeanyi Menkiti and Marya Schechtman. Both philosophers distance their views from the individualistic ones standard in western thought and foreground the importance of extrinsic or relational features to personhood. For Menkiti, it is ‘the community which defines the person as person’; for Schechtman, being a person is to have a place in person-space, which involves being seen as a person by others. But there are also striking differences. (...) Schechtman sees this aspect as expanding the scope of personhood to infants and those who are severely mentally disabled. Menkiti thinks that there is a line to be drawn at some point between those humans that are persons and those who are not. We consider the cases offered in questioning how the dispute between the two views should be resolved. (shrink)

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical conceptions (...) of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

The discourse on climate politics so far is an expert and elitist discourse in which peoples, societies, citizens, workers, voters and their interests, views and voices are very much neglected. So, in order to turn climate change politics from its head onto its feet you have to take sociology into account. There is an important background assumption which shares in the general ignorance concerning environmental issues and, paradoxically, this is in corporated in the specialism of environmental sociology itself — this (...) is the category of ‘the environment’. If ‘the environment’ only includes everything which is not human, not social, then the concept is sociologically empty. If the concept includes human action and society, then it is scientifically mistaken and politically suicidal. (shrink)

ABSTRACTThe standard view in philosophy of mind is that the way to understand the difference between perception and misperception is in terms of accuracy. On this view, perception is accurate while...

In cases of identity crowding, a subject consciously sees items in a figure, even though they are presented too closely together for her to shift attention to each item. Block uses such cases to challenge the view that attention is necessary for consciousness. I argue that in identity crowding cases, subjects really do attend to the items. Specifically, they attend to the figure as a global object that contains the individual items as parts. To support this view, I provide evidence (...) that attention can be directed to a global object or a local object. My response helps to defend the view that attention is necessary for conscious perception. (shrink)

This article defends a theory of diffuse attention and distinguishes it from focal attention. My view is motivated by evidence from psychology and neuroscience, which suggests that we can deploy visual selective attention in at least two ways: by focusing on a small number of items, or by diffusing attention over a group of items taken as a whole. I argue that diffuse attention is selective and can be object‐based. It enables a subject to select an object to guide behavior, (...) albeit in a different way than focusing does. (shrink)

Put relationship-centered communication at the forefront of care Today, physicians face a hypercompetitive marketplace in which they must meet unique and complex patient needs as efficiently as possible. But in a culture prioritizing clinical outcomes above all, there can be a tendency to lose sight of one of the most critical aspects of providing effective care: the communication skills that build and foster physician-patient relationships. Studies have shown that good communication between doctors and patients and among all caregivers who interface (...) with patients directly results in better clinical outcomes, reduced costs, greater patient satisfaction, and lower rates of physician burnout. In Communication the Cleveland Clinic Way, Dr. Adrienne Boissy and her team tell the story of how Cleveland Clinic created and applied the R.E.D.E. to Communicate: Foundations of Healthcare program, making the world-renowned hospital system a leader in relationship-centered care. They provide a step-by-step guide for healthcare leaders and decision-makers to design, develop, and implement communication skills training in their own institutions. Learn how to: • Craft an effective, colleague-supported communication skills program to include veteran physicians, residents, and medical students • Leverage creative program design and data transparency to engage and facilitate staff physicians and advanced care providers • Identify common misperceptions and myths in healthcare communication and respond to them successfully • Cultivate a true sense of empathy—with patients and fellow caregivers alike—while maintaining professionalism In a field where difficult conversations and stressful relationships are commonplace, clinicians need a structured approach to enable them to deliver the best care possible. Communication the Cleveland Clinic Way is the blueprint for establishing a relationship-centered program that will improve patient experience, reinvigorate doctors’ passion for their work, and elevate any organization. (shrink)

People with disabilities use more medical care and see health professionals more often than do those of the same age, ethnic group, or economic class who do not have impairments. An indisputable medical goal is.

Attention seems to raise a problem for pure representationalism, the view that phenomenal content supervenes on representational content. The problem is that shifts of attention sometimes seem to bring about a change in phenomenal content without a change in representational content. I argue that the representationalist can meet this challenge, but that doing so requires a new view of the representational content of perception. On this new view, the representational content of perception is always relative to a way of attending. (...) I call this the attention-indexed view of perceptual content. (shrink)

Philosophers have traditionally used thought-experiments in their endeavours to find a satisfactory account of the self and personal identity. Yet there are considerations from empirical psychology as well as related ones from philosophy itself that appear to completely undermine the method of thought-experiment. This paper focuses on both sets of considerations and attempts a defence of the method.

When economists perform experiments, they do so typically in one of two traditions: cognitive psychology experiments in the heuristics and biases tradition (H&B-experiments) and experimental economics in the tradition of Vernon Smith. What sets these two traditions apart? In this paper, I offer a novel conceptualization of their pervasive disagreements. Focusing on how each camp approaches preferences, one of the most fundamental concepts in economics, I argue that experimental economics can be reconstructed as holding that the constituents of preferences can (...) be partially located in agents’ environments, while H&B-experiments implicitly assume that the constituents of preferences are entirely located within agents’ bodies. The paper (i) outlines how my reconstruction can account for the disagreement between the two paradigms, (ii) defends the plausibility of this reconstruction, and (iii) highlights its implications for the debate about the nature of preferences in economics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:I Had Never Heard Someone Use That Word BeforeAdrienne Feller NovickThe patient was dying. As the social worker, I had arranged the meeting and sat shoulder to shoulder with the family and the attending physician in the small nondescript room. The family was grief-stricken and asked intelligent questions as they made difficult decisions about end-of-life care for their loved one. The doctor spoke with gentle kindness, acknowledging their difficult (...) decision as he completed the neon pink Medical Orders for Life Sustaining Treatment (MOLST) form and left the room. I was tangled up with emotions; I felt relieved that the meeting had gone smoothly, sad for the patient and family, and in awe of the doctor for his ability to lead the difficult conversation. I stayed behind to ask the family if there was anything I could do to help them. [End Page E4]Before I could speak, the patient's wife turned to me and said, "I am so glad that k--- left the room." (Using a derogatory word for a person of the Jewish faith). My brain began processing the statement. I am a Jewish woman. Did I hear that right? Did she say what I think she said? Should I say something? I froze, and time seemed to stop. She was looking at me expectantly, waiting for a response. Her face reminded me of someone waiting for the other person to return a "high five." I was flooded with emotion. A succession of thoughts ran through my head, everything from being rude in response or getting physical. I did neither. I said nothing. I smiled and left the room feeling like I had been gut-punched.I was in denial. I made excuses for the wife; she was stressed. I kept thinking I must not have heard her correctly and that I was overreacting. I continued to work with the family as though nothing had happened until the patient died five days later. I felt ashamed and never told anyone about what happened. I regretted not saying anything. I replayed the conversation in my mind and felt depressed and angry. Inside I felt complicit for not speaking up, but I had no words. I assumed bias in healthcare was rare. I did nothing.Years later, after I completed a patient visit in the Intensive Care Unit (ICU), I observed a group of surgical residents doing rounds. The attending welcomed me to join this valuable clinical learning experience. As the group approached the next bed, the patient pointed to one resident and loudly said, "I don't want a doctor who looks like that to come near me." I gasped aloud and froze, waiting to see what would happen next. The attending looked directly at the patient and said calmly, "We are all here to help you. That is not an appropriate thing for you to say." Then, he turned to the resident and nodded, directing them to resume their bedside assessment. The patient mumbled something inaudibly and said nothing.To my astonishment, the doctor acknowledged the microaggression (a microaggression is a statement, action, or incident regarded as discrimination), addressed the issue, respectfully supported the resident, created a safe space for everyone on the healthcare team and resumed quality patient care without missing a beat. He modeled a strategy to address patient bias and taught a valuable skill. This was a learning moment for me. It helped me refocus my past experience and provided me with a useful strategy to address bias in the future.As a member of the medical ethics consultation service, I listen, provide support, and aid in challenging communications. I had the opportunity to model the communication strategy I acquired in the ICU. The medical ethics team was consulted for a patient refusing treatment. The patient was disrespectful to healthcare team members, cursing at nurses and residents, using ethnic slurs, and saying he "would rather die than let one of them touch him. I entered the patient's room with the healthcare team, introduced myself, and explained the reason for my visit. The patient defiantly agreed he had used slurs, saying he wanted to go home. I continued, everyone here... (shrink)

Der vorliegende Beitrag nimmt seinen Ausgangspunkt in der Beobachtung zunehmender Verweise auf Menschenbilder oder ein spezielles Menschenbild in öffentlichen und fachwissenschaftlichen Debatten um wissenschaftlichen und technologischen Wandel (1). Zunächst wird ein knapper Überblick über die Bedeutung, Funktion und Herkunft von Menschenbildern gegeben (2), gefolgt von einer Übersicht über die Fragestellungen und Methodik der noch jungen Disziplin einer Ethik der Ernährung (3). Daran anschließend wird der Zusammenhang zwischen lebensweltlichen Menschenbildern und Ernährungsweisen am Beispiel der öffentlichen und wissenschaftlichen Diskurse um Fleischkonsum expliziert (...) (4). Ein knappes Fazit fasst die Ergebnisse zusammen (5). (shrink)

This article addresses an issue overlooked in most of the literature on judicial review: the legitimacy of judicial review of a constitution's federal and structural provisions. Debates about the legitimacy of judicial review—at least as conducted throughout the Commonwealth—are usually focussed on rights. These debates appear to assume that the power of courts like the Australian High Court and the Canadian Supreme Court to interpret and enforce federal and structural provisions is unproblematic. This article tests that assumption and concludes that (...) those who hold democracy-based objections to constitutional rights should seriously reconsider, and perhaps oppose, federal and structural judicial review as well. (shrink)

I argue for adopting a conception of obligation that is broader than the conception commonly adopted by moral philosophers. According to this broader conception, the crucial marks of an obligatory action are, first, that the reasons for the obliged party to perform the action include an exclusionary reason and, second, that the obliged party is the appropriate target of blaming reactive attitudes, if they inexcusably fail to perform the obligatory action. An obligation is directed if the exclusionary reason depends on (...) the relationship between the obliged person and the person to whom they owe the obligatory action, and the latter person is positioned to personally blame the obligated person for inexcusably failing to perform the obligatory action. Some direc- ted obligations are not owed as a matter of right, and the person to whom the obligatory action is owed is the only person positioned to blame nonperformance. Other directed obligations are owed as a matter of right, and people who are not part of the relationship grounding the obligation nevertheless are also positioned to (impersonally) blame non-performance. Only the rights-based form of directed obligation has received signifi- cant attention from moral philosophers, yet the former—which is at the heart of what I call “personal bonds”—is a pervasive and significant theme of our ordinary interpersonal lives. (shrink)

Fact-finding hearings may be held to determine disputed allegations of domestic violence in child contact cases in England and Wales, and can play a vital role for mothers seeking protection and autonomy from violent fathers. Drawing on the author’s empirical study, this article examines the implications for the holding of fact-finding hearings of judges’ and professionals’ understandings of domestic violence and the extent to which they perceive it to be relevant to contact. While more judges and professionals are developing their (...) understanding of domestic violence, the ambit of when and how it is considered relevant to contact has grown increasingly narrow, which suggests that many disputed allegations of domestic violence are disregarded and women and children continue to be put at risk from violent fathers. This bifurcated approach is likely to have significant implications for recent developments in this area of family law which are considered in this article. (shrink)

Eric Olson argues in The Human Animal that thought-experiments involving body-swapping do not in the end offer any support to psychological continuity theories, nor do they pose any threat to his Biological View. I argue that he is mistaken in at least the second claim.

Theodor W. Adornos Jargon der Eigentlichkeit (1963) gehört zu den umstrittensten Texten der Kritischen Theorie. Während der Titel inner- und außerhalb der akademischen Debatte längst zu einem geflügelten Wort mutiert ist, steht diesem die Kenntnis des Inhalts diametral gegenüber. Zumeist wird die Schrift als eine Polemik gegen Martin Heidegger abgehandelt, die zu einer 'philosophischen Kommunikationsverweigerung' Hermann Mörchen) zwischen Frankfurt und Freiburg geführt habe. Plattitüden dieser Art verkennen jedoch den ideologiekritischen Charakter der Streitschrift. Adornos Kritik am neudeutschen Jargon richtet sich keineswegs (...) primär gegen Heidegger, sondern bezieht sich auf ein breites gesellschaftliches Phänomen. Sie hat ihren Ursprung bereits in den 1920er-Jahren in der Kritik Siegfried Kracauers an der Bibel-Übersetzung von Martin Buber und Franz Rosenzweig. Ziel des Sammelbandes ist es, den Jargon der Eigentlichkeit jenseits akademischer Departementalisierungen zu erschließen und auf die Aktualität von Adornos Kritik hinzuweisen. (shrink)

Embryonale Stammzellen, Klonen, Präimplantationsdiagnostik, Gendiagnose, Euthanasie - das sind Stichworte einer Medizin im Umbruch, die mit ihrem Menschenbild und ihrer ethischen Fundierung in eine Sackgasse geraten ist. Wir stehen am Beginn einer Epoche, die dabei ist, den Menschen in seinen frühesten Stadien zum Material zu machen, zum Material für Medikamente für andere Menschen. Mit der Invitro-Fertilisation hat die Herstellung von menschlichem Leben ausserhalb des mütterlichen Organismus begonnen. Es ist frei verfügbar geworden. Wohin führt uns diese Entwicklung der modernen naturwissenschaftlichen Medizin? (...) Beck gibt Denkanstösse, wie die moderne Medizin über ihre Sicht auf die materielle (vielleicht noch psychosomatische) Verfasstheit des Menschen hinaus noch philosophisch-theologische Zugänge zum Menschen und existentiellen Fragen nach dem Dasein einbeziehen kann. (Quelle: www.buch.ch). (shrink)

Phenomenology is a challenging method for many students to understand and apply. Introduction to Phenomenology: Focus on Methodology breaks down the history, methodology, and application so students can more easily write proposals and conduct phenomenological research. Author Cheryl Tatano Beck draws on her depth of experience in applying and teaching phenomenological methods to distill the method into a single guidebook for students and new researchers alike. This introductory book provides a clearer picture of phenomenology as method and its applications (...) to social, behavioral, and health sciences, covering both interpretive and descriptive phenomenology from research design through analysis. (shrink)

This is a fluently written history of ancient Greece seen from the perspective of localism and the origins of the Greek City-State. Much like our own time, from the 8th century BCE until and even beyond its imperial end, the Greek world was constantly expanding and experiencing growing connectivity with the world at large. Conquest, exploration and exchange all grew Greece's global presence and helped develop an expanded world where a need to define and cherish the local would inevitably arise. (...) Beck draws on a breathtaking range of materials: texts, some of them rare, by both well-known and obscure writers; numismatics, visual culture, pottery analysis, landscape and traditional field archaeology. He brings all this together in developing fine-grained case studies about tensions between metropolis and local communities such as Miletus, Ithaca, and rural Attica in relation to Athens and other major centers. (shrink)

By working with underserved communities, anthropologists may play a larger role in democratizing society. The growth of disparities challenges anthropology to be used for social justice. This engaged stance moves the application of anthropological theory, methods, and practice toward action and activism. However, this engagement also moves anthropologists away from traditional roles of observation toward participatory roles that become increasingly involved with those communities or social groupings being studied. The chapters in this book suggest the roles anthropologists are able to (...) play to bring us closer to a public anthropology characterized as engagement. Sam Beck is Senior Lecturer in the College of Human Ecology and Director of the Urban Semester Program of Cornell University. His publications include Ethnicity and Nationalism in Southeastern Europe (1981, ed with John W. Cole) and Manny Almeida's Ringside Lounge: The Cape Verdean Struggle for their Neighborhood (1992). Carl A. Maida is Professor in the Institute of the Environment and Sustainability at the University of California, Los Angeles. His publications include Sustainability and Communities of Place (2007), Pathways through Crisis: Urban Risk and Public Culture (2008), Children and Disasters (1999), and The Crisis of Competence: Transitional Stress and the Displaced Worker (1990). (shrink)

This article examines ancient depictions of the death of Troilus in art and literature and challenges the widespread belief that the Iliad implies an alternative version of the myth in which Troilus dies in battle. In particular, it argues that the death-in-battle interpretation is both insufficiently supported by the internal evidence and incompatible with the external evidence. Given the evident popularity of the story of Achilles’ ambush of Troilus in the Archaic period, it is hard to avoid the conclusion that (...) the poet of the Iliad knew the story of Troilus’ death by ambush. That the poem's only reference to Troilus does not contradict this story, and possibly even alludes to it, should persuade critics of the strong likelihood that the popular story of Troilus’ ambush at the fountain was also the one in the poet's mind. (shrink)

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)