The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...) the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions. (shrink)

In debates about the proper analysis of demonstrative expressions, ostensive gestures and speaker intentions are often seen as competing for primary importance in securing reference. Underlying some of these debates is the mistaken assumption that ostensive gestures always make the demonstrated object maximally salient to interlocutors. When we abandon this assumption and focus on an object’s mutually-recognized salience itself, rather than on how the object came to be salient, we can work towards a more promising analysis with a uniform treatment (...) of demonstrative reference whether or not there is an ostensive gesture, and whether reference is ordinary or deferred. (shrink)

Fashion design is a feminized occupation, but there is a widespread perception that gay male designers are advantaged in receiving awards, publicity, and praise. This article develops the notion of a “glass runway” to explain this inequality. First, using design canons and lists of award recipients, I show that men, especially gay men, receive more consecration than women. Second, I show how men and women are consecrated differently by analyzing the content of 157 entries in Voguepedia’s design canon and 96 (...) fashion media articles. Attributions of value and legitimacy construct a gendered image of the ideal fashion designer through discourses of art and culture that reinforce essentialist ideas about gender difference. Because cultural value is ambiguous, processes of valorization are shaped by gender essentialism, pushing male cultural producers down the glass runway and into the spotlight of fame, consecration, and legitimation. Finally, the case of fashion design offers insights into how intersecting inequalities can shape the glass runway. Gay designers experience both valorization and discrimination from intersections of gender and sexuality. (shrink)

Within the class of indexicals, a distinction is often made between “pure” or “automatic” indexicals on one hand, and demonstratives or “discretionary” indexicals on the other. The idea is supposed to be that certain indexicals refer automatically and invariably to a particular feature of the utterance context: ‘I’ refers to the speaker, ‘now’ to the time of utterance, ‘here’ to the place of utterance, etc. Against this view, I present cases where reference shifts from the speaker, time, or place of (...) utterance to some other object, time, or place. I consider and reject the claim that these counterexamples to the automatic indexical theory all involve non-literal uses of indexicals and argue that they cannot be explained away on the grounds that they involve conversational implicature or pretense. (shrink)

There is an expectation that all researchers will act ethically and responsibly in the conduct of research involving humans and animals. While research ethics is mentioned in quality indicators and codes of responsible researcher conduct, it appears to have little profile in doctoral assessment. There seems to be an implicit assumption that ethical competence has been achieved by the end of doctoral candidacy and that there is no need for candidates to report on the ethical dimensions of their study nor (...) for examiners to assess this integral aspect of researcher development. In the context of ensuring that institutions are fulfilling their responsibility of producing ethically sensitive and competent researchers, it is salient to investigate whether doctoral thesis examiners make comment about ethical issues in their reports. This study analysed an archive of examiner reports to identify the frequency, magnitude and nature of examiner comment about ethics. Although comment was rare examiners provided: prescriptive instruction on ethical review processes; formative instruction on the design, conduct, and reporting of research projects; and positive or negative judgments about a candidate's ethical competence, the latter often aligned with meeting, or not meeting, 'doctoral standards'. The scarcity of ethics in examination criteria and examiner reports implies a silence that needs to be addressed to ensure graduating candidates are prepared to conduct ethical and responsible research. (shrink)

DIVBased on a series of lectures delivered in 1840, Thomas Carlyle’s On Heroes, Hero-Worship, and the Heroic in History considers the creation of heroes and the ways they exert heroic leadership. From the divine and prophetic to the poetic to the religious to the political, Carlyle investigates the mysterious qualities that elevate humans to cultural significance. By situating the text in the context of six essays by distinguished scholars that reevaluate both Carlyle’s work and his ideas, David (...) Sorensen and Brent Kinser argue that Carlyle's concept of heroism stresses the hero’s spiritual dimension. In Carlyle’s engagement with various heroic personalities, he dislodges religiosity from religion, myth from history, and truth from “quackery” as he describes the wondrous ways in which these “flowing light-fountains” unlock the heroic potential of ordinary human beings. /div. (shrink)

This essay examines the symbolic significance of blood in the twentieth century and its role in determining the composition of a national community along racial lines. By drawing parallels between Nazi notions of blood and racial purity and historically contemporaneous U.S. policies regarding blood and blood products, Polsky reveals a disturbing proximity in discourse and policy. While the Nazis attempted to locate Jewish racial essence and inferiority in blood and instituted eugenic measures and laws forbidding racial admixture, similar policies existed (...) in the U.S. based on the so-called one drop rule that systematically discriminated against African Americans. (shrink)

Denunciations of child sexual abuse in the sport context have been increasing in the last decades. Studies estimate that between 14 and 29% of athletes have been victim of at least one form of sexual violence in sport before the age of 18. However, studies suggest that many do not disclose their experience of CSA during childhood. This finding is alarming since studies have shown that the healing process usually starts with disclosure. Moreover, little is known about the healing process (...) of CSA experienced in the sport context. The aim of the study is to present a single case study of a CSA in sport to better understand the global experience over time from the perspective of the athlete. A narrative inquiry approach was adopted. Three non-structured interviews were conducted with the participant. Three pathways in the survivor journey have been identified through inductive thematic analysis: pathway to understanding, pathway to disclosure, and pathway to healing. These pathways represent distinct processes but are intertwined as they are dynamic and iterative. Indeed, the survivor explained how she had been, and is still, going back and forth between them. Results are consistent with those found in the literature on CSA in the general population. It suggests that theoretical models of CSA in the general population could be applied to CSA in sport. Practical implications include a need for education and clearer boundaries in the coach-athlete relationship. Sport stakeholders also need to be better equipped to recognize the signs of sexual violence in sport. Our results indicate that qualitative research could be a potential avenue to help victims heal from CSA. It gives them the chance to talk about and make sense of their abuse in a safe space. Finally, our results demonstrate the importance of reviewing the current justice system for victims. It should be based on a trauma-informed approach that places the victim at the center of the judicial process. (shrink)

Empathy is widely touted as a springboard for social change. Within the academy, ‘identification’ is often used to promote the social value of literary and cultural studies. But to what degree have scholars, in seeking to defend the value of literary and cultural studies, conceived the act of reading in problematic ways? ‘An Ethics of Reading’ argues that adopting a Lacanian paradigm of self (reader) and text (other) to discuss the act of textual interpretation reduces a complex event involving multiple (...) actors to a simple dualism, while ineluctably consigning any act of interpretation to simple projection. Turning instead to psychoanalyst Jean Laplanche’s concept of the enigmatic signifier, this article rethinks the relation between reader and cultural text – reconceiving the act of interpretation by situating it within a dynamic of transference, as opposed to projection. When conceived via this Laplanchian framework, reading becomes not only an effective path to cognition and knowledge, but a radical means of subjective transformation. (shrink)

Core indexicals like ‘I’, ‘here’, and ‘now’ sometimes appear to refer to an object, place, or time other than the speaker, location, or time of utterance. This presents well-known problems for Kaplan's view, which treats reference shifting as a violation of the character rules that give the meaning of indexicals. I propose a view according to which indexical reference is essentially a matter of the mutually-accepted perspective of interlocutors. It follows that contexts need not be ‘proper’ in Kaplan's sense, and (...) a successful convergence of perspectives is needed for indexical reference to succeed. I provide reasons for embracing these conclusions. (shrink)

The COVID-19 pandemic introduced significant disruptions and challenges to the learning environment for many post-secondary students with many shifting entirely to remote online learning. Barriers to academic success already experienced in traditional face-to-face classes may be compounded in the online environment and exacerbated by stressors related to the pandemic. In 2020–2021, post-secondary institutions were faced with the reality of rolling out fully online instruction with limited access to resources for assisting students in this transition. Instructional interventions that target students’ ability (...) to self-regulate their learning have been shown to improve academic performance and self-regulated learning competencies have also been found to mediate the effect of SRL interventions on higher education. However, few studies have examined the efficacy of fully online SRL intervention on mitigating the impact of psychological distress and academic challenges on academic success. This study examined the moderating roles of self-regulatory practices and SRL intervention in buffering the influence of COVID-related psychological distress and academic challenges on academic outcomes and academic challenges) in a Canadian sample of undergraduate students. We found levels of metacognitive and motivational challenges fully mediated the impact of COVID distress on GPA, SRL adapting practices moderated the impact of metacognitive challenges on GPA, and semester-long SRL intervention buffered the impact of COVID distress on academic challenges and resulted in lower levels of social-emotional, cognitive, and metacognitive challenges for first year undergraduate students. (shrink)

In the clinical setting, not enough attention is paid to the role that emotion plays. It is at worst ignored or avoided, isolating those who are suffering, at best treated as something to help another to endure. This is the result, in part, of an impoverished idea that views emotion as mere feelings. However, emotions are not just feelings, they are cognitive. If we look beneath the surface, emotions can provide information about values and beliefs, some of which may be (...) false or unreasonable. When they are motivating decisions that seriously affect the lives of others, there is a moral obligation to ferret them out and correct or deal with them. Attention needs to be paid to the emotions of healthcare providers as well as to the emotions of patients and their loved ones, and more done to train healthcare providers to deal effectively and productively with emotion – their own and others’. A son tearfully requests everything be done for his dying father. He fears limiting treatment means his father will be ignored. A physician orders another course of chemotherapy because she cannot bear for this patient to die. The patient, fearing he will painfully suffocate to death, agrees. Paying attention to emotions and bringing to light the beliefs and values behind them can only enhance the care and consideration of all involved. (shrink)

A definitive theory for ethical decision making in nursing is still only conjecture. The literature confirms that there have been numerous examinations of ethical decision making in nursing, with most proposing either the justice or the care orientation, or a combination of both. In the absence of a definitive theory, this exploratory work sets out, via grounded theory, to shed some light on the methods used every day by nurses to make ethical decisions in the clinical area. The data show (...) that some factors, such as doctors, colleagues and the organization, profoundly influence ethical decision making. The informants used both care and justice to formulate decisions, which is known as the combined approach. As a result of these findings, this article concludes with tentative suggestions and recommendations for practice. (shrink)

The number of admissions to hospitals of patients without a proxy decision maker is rising. Very often these patients need fairly immediate medical intervention for which informed consent—or informed refusal—is required. Many have recommended that there be a process in place to make these decisions, and that it include a variety of perspectives. People are particularly wary of relying solely on medical staff to make these decisions. The University Hospitals Case Medical Center recruits community members from its Ethics Committee to (...) serve on a subcommittee, the Patients Without Proxies (PWP) Committee, which works with medical staff during the decision-making process for these patients. Generally, the community members go to the bedside to observe patients. This article looks at how those unused to observing hospitalized patients who are sick and/or dying are affected, comparing them to mock jurors in a research study who are exposed to graphic photographs related to a fabricated crime scene. Judgments made by the mock jurors are affected by viewing such images. The personal experience of witnessing unfamiliar and shocking scenes affects their subsequent judgments. While it may be difficult to tease out whether observing patients causes PWP members to be benefited or harmed, they are affected by what they see. If a variety of perspectives is desirable to reduce possible bias or error, this article argues that at least one community member should refrain from seeing the patient in order to add a different and valuable voice to the decision-making process. Members of the subcommittee base their judgments on the various kinds of information available. Sometimes the things they see, hear, or feel may affect them particularly deeply, and affect their judgments as well. In this article I explore the idea that something like this may be happening in a particular kind of clinical ethics case consultation. (shrink)

The function of REM, or any other stage of sleep, can currently only be conjectured. A rational evaluation of the role of REM in memory processing requires systematic testing of hypotheses that are optimally derived from a complete synthesis of existing knowledge. Our view is that the large number of studies supporting a relationship between REM-related brain activity and memory is not easily explained away. [Vertes & Eastman].

This study focuses on the concept of a 'model organism' in the biomedical sciences through an historical and philosophical examination of research with the nematode Caenorhabditis elegans. I explore the choice of C. elegans in the mid-1960s, showing a rich context existed within which the organism was selected as the focus for a molecular biological research program, including an experimental life prior to Sydney Brenner's work. I argue that this choice can be seen as an obvious outcome of what was (...) a complex search procedure, and that the success of the 'worm project' depended not only on organismal choice but also on the conceptual and institutional framework at the Laboratory of Molecular Biology in Cambridge within which it was pursued. Examination of C. elegans work in the late 1960s through the early 1980s illuminates several additional theses. Although development and behavior were the general areas of interest for the project, the original goals and proposed methodology were extremely vague. As the project evolved, which investigations proved to be tractable using the worm depended not only on which methodologies were fruitful but also on the interests and skills of early workers. Much of the power of C. elegans as a model organism can be traced historically to the investment of resources which resulted in an unprecedented, complete description of the organism, and represented a return to a more naturalistic biological tradition. In light of the historical study, I develop a philosophical analysis of C. elegans as a model organism through exploration of the three kinds of modeling with the worm: modeling of structures, processes, and information. I expand the notion of a descriptive model, arguing that C. elegans is best understood as a prototype of the metazoa, and that C. elegans as a model organism has been not only heuristically valuable, but also essential to this research project particularly in its pre-explanatory stages. I conclude by suggesting that more investigation of descriptive prototypes such as those in the worm project must be done to capture important aspects of the biomedical sciences that will be neglected if explanatory models are the sole focus in the philosophy of science. (shrink)

Why should we seek and tell the truth? Does anyone know what truth is? Many are skeptical about the relevance of truth. Truth Matters endeavours to show why truth is important in a world where the very idea of truth is contested. Putting philosophers in conversation with educators, literary scholars, physicists, political theorists, and theologians, Truth Matters ranges across both analytic and continental philosophy and draws on the ideas of thinkers such as Aquinas, Balthasar, Brandom, Davidson, Dooyeweerd, Gadamer, Habermas, Kierkegaard, (...) Plantinga, Ricoeur, and Wolterstorff. Some essays attempt to provide a systematic account of truth, while others wrestle with the question of how truth is told and what it means to live truthfully. Contributors address debates between realists and anti-realists, explore issues surrounding relativism and constructivism in education and the social sciences, examine the politics of truth telling and the ethics of authenticity, and consider various religious perspectives on truth. Most scholars agree that truth is propositional, being expressed in statements that are subject to proof or disproof. This book goes a step farther: yes, propositional truth is important, but truth is more than propositional. To recognize how it is more than propositional is crucial for understanding why truth truly matters. Contributors include Doug Blomberg (ICS), Allyson Carr (ICS), Jeffrey Dudiak (King’s University College), Olaf Ellefson (York University), Gerrit Glas (VU University Amsterdam), Gill K. Goulding (Regis College), Jay Gupta (Mills College), Clarence Joldersma (Calvin College), Matthew J. Klaassen (ICS), John Jung Park (Duke University), Pamela J. Reeve (St. Augustine’s Seminary), Amy Richards (World Affairs Council of Western Michigan), Calvin Seerveld (ICS), Ronnie Shuker (ICS), Adam Smith (Brandeis University), John Van Rys (Redeemer University College), Darren Walhof (Grand Valley State University), Matthew Walhout (Calvin College), and Lambert Zuidervaart (ICS). (shrink)

The Walker model raises a number of questions, particularly about the nature of the sleep states involved in consolidation enhancement. While REM sleep, Stage 2 sleep, and Stage 3/4 sleep have been implicated in procedural learning, we still do not understand which types of learning are involved with specific sleep states. Several possible ideas for future research are suggested.

In this article, I foreground the role of relationality in Husserl’s later reflections on ethics and self-constitution, with a particular interest in Husserl’s account of sacrifice. I exposit how Husserl’s account of self-constitution and the conflict of absolute values between competing vocations offers a solution to Brentano’s rendering of the obligation to “choose the best among the ends attainable.” I explore the numerous instances in which Husserl uses the parent-child relation to illustrate the absolute value of our relation to an (...) individual and how this absolute value triumphs over other seemingly rational maxims. Although problematic in several ways, Husserl’s account of motherhood grounds his notion of self-constitution in particular relations with others, rather than in a general category of nation or humanity. I conclude by considering how his emphasis on phenomenological constitution and his approach to value and sacrifice may inform future projects in phenomenological relational ethics. (shrink)

In this article, I foreground the role of relationality in Husserl’s later reflections on ethics and self-constitution, with a particular interest in Husserl’s account of sacrifice. I exposit how Husserl’s account of self-constitution and the conflict of absolute values between competing vocations offers a solution to Brentano’s rendering of the obligation to “choose the best among the ends attainable.” I explore the numerous instances in which Husserl uses the parent-child relation to illustrate the absolute value of our relation to an (...) individual and how this absolute value triumphs over other seemingly rational maxims. Although problematic in several ways, Husserl’s account of motherhood grounds his notion of self-constitution in particular relations with others, rather than in a general category of nation or humanity. I conclude by considering how his emphasis on phenomenological constitution and his approach to value and sacrifice may inform future projects in phenomenological relational ethics. (shrink)

In a promising working note to the Visible and Invisible, Merleau-Ponty proposes that we understand Being according to topological space – relations of proximity, distance, and envelopment – and move away from an image of Being based on homogeneous, inert Euclidean space. With reference to treatments of cross-sensory perception, color-blindness, and the concept of quale or qualia, I seek to rehearse this shift from Euclidean to topological Being by illustrating how modern science confines color itself to a Euclidean model of (...) color space. I discuss “being as Object” in Merleau-Ponty’s later work before showing how color, and indeed all perception, is reduced to being as Object in the form of “quale”. Next, I address discussions in Merleau-Ponty’s work and contemporary research to illustrate how synesthesia and so-called color-blindness are rendered abnormal by this objectified being of color. Merleau-Ponty’s reading of synesthesia follows directly from his rejection of quale, and his use of color perception serves as a rejection of solipsism. With appeal to his proposed topological model of Being, I conclude by recognizing the problematic nature of synesthesia and color-blindness as being ontological, not psychological.Dans une note de travail, à mon sens décisive, du Visible et l’Invisible, Merleau-Ponty propose que l’on comprenne l’Être à partir de l’espace topologique – relations de proximité, distance et enveloppement – allant à l’encontre d’une l’image de l’Être fondée sur un espace euclidien homogène et inerte. En faisant référence aux traitements de la perception synesthésique, au daltonisme et au concept de quale ou qualia, j’essayerai de décrire ce passage de l’Être euclidien à l’Être topologique en montrant que la science moderne finit par confiner la couleur dans un modèle euclidien d’espace-couleur. J’examinerai « l’Être-objet » dans les derniers écrits de Merleau-Ponty avant de montrer comment la couleur, et plus en général la perception, est réduite à être comme un Objet dans la forme d’un « quale ». Ensuite, en examinant les analyses merleau-pontiennes et les recherches contemporaines, je montrerai comment la synesthésie et le daltonisme sont donc considérés comme anormaux à partir de cette objectivation de la couleur. La lecture que Merleau-Ponty donne de la synesthésie est la conséquence directe de son refus du quale, et l’utilisation qu’il fait de la perception des couleurs sert comme un refus du solipsisme. En faisant appel au modèle topologique de l’Être qu’il propose, je conclurai en constatant que la nature problématique de la synesthésie et du daltonisme est ontologique et non pas psychologique.In una nota di lavoro al Visibile e l’invisibile, Merleau-Ponty propone di comprendere l’Essere a partire da uno spazio topologico – secondo le relazioni di prossimità, distanza e avvolgimento – e abbandona l’immagine di un Essere fondato su uno spazio omogeneo, inerte, euclideo. Facendo riferimento ai trattamenti per le percezioni sinestetiche, al daltonismo e al concetto di quale o qualia, si cercherà di provare questo passaggio da un Essere euclideo a uno topologico, illustrando quanto la scienza moderna tenda a ridurre il concetto stesso di colore a un modello euclideo di spazio-colore. Si esaminerà l’“Essere-oggetto” degli ultimi lavori di Merleau-Ponty, mostrando come il colore, e in realtà la percezione tout court, vengano ridotti a oggetto nella forma di “quale”. Infine, si esaminerà l’opera merleau-pontiana e la ricerca contemporanea al fine di illustrare quanto la sinestesia e il daltonismo siano resi anormali da questa oggettivazione dell’essere del colore. L’interpretazione merleau-pontiana della sinestesia deriva proprio dal suo rifiuto del quale, e il suo uso della percezione del colore funge da rifiuto del solipsismo. Ricorrendo al modello topologico di Essere elaborato da Merleau-Ponty, si conclude riconoscendo che il problema della sinestesia e del daltonismo è, a tutti gli effetti, ontologico e non psicologico. (shrink)

Medical Assistance in Dying (MAiD) in Canada has had a tumultuous social and legal history. In the 6 years since assisted dying was decriminalized by the Canadian Parliament in June 2016, the introduction of this practice into the Canadian healthcare system has been fraught with ethical challenges, practical hurdles and grass-roots innovation. In 2021, MAiD accounted for approximately 3.3% of all Canadian deaths annually, and more patients are seeking MAiD year over year as this option becomes more widely know. Unfortunately, (...) some patients who want MAiD are unable to access it in a timely manner because of a lack of willing MAiD providers. This introduction describes statistics about the uptake of MAiD in Canada and the challenges presented by Canadians’ rapid acceptance of this end of life care option. In this special edition of HEC Forum about the implementation of MAiD in Canada, authors depict a range of ethical challenges and strategies to address issues related to MAiD access and quality, organizational engagement, clinician recruitment and retention, and support for a morally diverse workforce. In each article, the authors reflect on the question: What are the practical ethics involved in introducing assisted dying into a new healthcare context, and how can ethicists and ethics resources collaborate with stakeholders to ensure the integration of ethical considerations as this practice continues to evolve? (shrink)

For the last fifty years, the United States healthcare system has done an extremely poor job of delivering healthcare in a just and fair manner. The United States holds the dubious distinction of being the only industrialized nation in the world lacking provisions to ensure universal coverage. We attempt to provide some of the reasons this dysfunctional system has persisted and show that healthcare should not be a commodity. We begin with a brief historical overview of healthcare delivery in the (...) United States since WWII. This is followed by a critical analysis of the for-profit model including reasons to support the view that healthcare should not be a free market commodity. We also demonstrate how special interest groups have been able to win support for their practices based on propaganda rather than fact. A brief analysis of the Affordable Care Act is offered along with critical comments regarding its ineffectiveness. We conclude with a brief overview of international approaches that have resulted in universal coverage and suggest the United States ought to adopt an approach similar to those outlined so that it no longer stands as the only industrialized nation to ignore the glaring problems that exist. (shrink)