Clinical Ethics Committees (CECs), as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases (PubMed, Ovid (...) MEDLINE, Scopus, Philosopher’s Index, Embase and Web of Science), following PRISMA guidelines. We included only articles specifically addressing CECs and providing any form of CECs performance assessment. Twenty-nine articles were included. Ethics consultation was the most evaluated of CECs’ functions. We did not find standardized tools for measuring CECs’ efficacy, but 33% of studies considered “user satisfaction” as an indicator, with 94% of them reporting an average positive perception of CECs’ impact. Changes in patient treatment and a decrease of moral distress in health personnel were reported as additional outcomes of ethics consultation. The highly diverse ways by which CECs carry out their activities make CECs’ evaluation difficult. The adoption of shared criteria would be desirable to provide a reliable answer to the question about their effectiveness. Nonetheless, in general both users and providers consider CECs as helpful, relevant to their work, able to improve the quality of care. Their main function is ethics consultation, while less attention seems to be devoted to bioethics education and policy formation. (shrink)

International criminal law (ICL) has traditionally overlooked sexual and gender-based violence (SGBV) and struggles to understand it. Prosecutions have been largely inefficient and not reflective of gender harms. The Rome Statute requires interpreting SGBV as a social construction (article 7(3)), in consistency with international human rights law (IHRL) and without discrimination (article 21(3)). There is, however, little guidance to implement these approaches. This article argues that intersectionality, an IHRL-based approach that reveals compounded discrimination, is an efficient tool to interpret SGBV (...) and, therefore, should be integrated in ICL. The article traces the origins of intersectionality in feminism and its recognition by IHRL dealing with violence against women. It establishes the applicability of intersectionality in ICL that it demonstrates with a comparative analysis of the Lubanga and Ntaganda cases. The findings show that intersectionality suits ICL’s specific needs which allows labelling and explaining some of those contributions throughout the judicial process. (shrink)

In this article we show that, even though the classification and diagnosis of Psychiatric Disorders are performed according to essentialist terms, the psychiatric diagnoses currently employed, do not actually meet these criteria. Diagnosis is performed operationally. In this paper, we suggest a change of perspective. We reject essentialism relating to PDs and argue for the Homeostatic Property Cluster model, which allows a greater insight into the ontology of PDs than the operational perspective. More specifically, we argue that the HPC model (...) allows for a synthesis of continuous and discrete methods of understanding the boundaries between PDs. Finally, we specify in a more general manner, the kind of ontology we deal with when adopting the HPC model, arguing that this model can be viewed as a mirror device, reflecting the ontological features of PDs. (shrink)

Fundado em 14 de janeiro de 1933 como remanescente das associações culturais criadas pelo movimento anarquista e anarco-sindicalista nas primeiras décadas do século XX, o Centro de Cultura Social de São Paulo tem por objetivo o aprimoramento intelectual, a prática pedagógica e os debates públicos. Nesse intuito, organiza palestras, cursos, seminários, filmes, peças teatrais, entre outros, além de manter um acervo de arquivo e biblioteca voltada principalmente para os estudos. Desenvolve formas de ação e formação de militantes e de livres (...) pensadores, tendo sido comum a formação de diversos centros de cultura ou congêneres em meados do século XX. A obra Pedagogia, sujeitos e resistências é resultado de um seminário promovido pelo Centro de Cultura Social de São Paulo em Junho de 2009 com o propósito de discutir o funcionamento das verdades do poder e dos poderes da verdade que circundam as várias práticas políticas e pedagógicas na contemporaneidade. Nesse sentido, a obra em questão, como bem apresenta Silvio Gallo, é resultado do esforço intelectual de jovens pesquisadores que transformaram um encontro de estudos em matéria concreta e viva de resistência ao instituído em prol da liberdade de expressão e de criação de novos modos de vida. Esta coletânea de textos apresenta-se extremamente inovadora no que concerne a educação e a pedagogia porque apresenta o funcionamento de micropolíticas cotidianas capazes de mobilização-transformação do mesmo e da mesmidade político,pedagógica e educacional tão correntes nos dias de hoje. (shrink)

This book focuses on the role of philosophy across disciples. It gives several examples of how philosophical theories or particular concepts or lines of arguments, can be used in other (non-philosophical) disciplines, such as politics, business, psychology, art, and film studies.

BackgroundClinical Ethics Support Services have been established to support healthcare professionals in addressing ethically sensitive issues in clinical practice and, in many countries, they are under development. In the context of growing CESS, exploring how healthcare professionals experience and address clinical ethics issues in their daily practice represents a fundamental step to understand their potential needs. This is even more relevant in the context of extremely sensitive diseases, such as cancer. On this basis, we carried out a qualitative study conducting (...) in-depth semi-structured interviews with stakeholders of a major comprehensive cancer centre in Italy, with the twofold aim of investigating what ethical issues arise in the context of clinical oncology and how they are addressed, as well as stakeholders’ expectations about a potential CESS to be implemented within the Institution.MethodsThe study was conducted within the theoretical framework of Grounded Theory. Participants were healthcare professionals and other key stakeholders working within the cancer centre. The semi-structured interview aimed at exploring common ethical aspects of oncology, investigating stakeholders’ professional experience in dealing with clinical ethics issues, their expectations and requests regarding ethics support services. Transcripts of the interviews were coded and analysed according to the principles of Grounded Theory.ResultsTwenty-one stakeholders were interviewed. Our analysis showed a wide consensus on the identification of ethically relevant issues, above all those concerning communication, end-of-life, and resource allocation. The absence of institutional tools or strategies to address and manage ethical issues at the patient bedside emerged, and this is reflected in the widespread request for their development in the future. The ideal support service should be fast and flexible in order to adapt to different needs and clinical cases.ConclusionsThe interviewees showed a limited degree of ‘ethical awareness’: despite having reported many issues in clinical practice, they could hardly identify and describe the ethical aspects, while complaining about a lack of ethical resources in their management. To build a truly effective support service, it therefore seems appropriate to take such context into consideration and address the emerged needs. Ethical sensitivity seems to be key and it becomes even more relevant in critical clinical areas, such as the therapeutic pathways of terminally ill patients. (shrink)

In their contribution, Kok et al raise a relevant, though often underestimated, issue: clinical ethics support services are often assumed to lead to an improvement of quality of care at the organisational level, but evidence in support of this claim is weak, if not completely lacking.1 Therefore, the authors propose a complex theoretical model connecting a specific kind of CESS, moral case deliberation, with mechanisms for quality of care improvement at the individual and the organisational level. The proposal is original, (...) and the topic discussed of great interest not only to practitioners and researchers dealing with CESS, but also to health policy-makers and managers of healthcare system, for all of whom it is indeed crucial to understand whether and how ethics support can positively impact quality of care. However, despite its undoubtful merits, we feel that some claims and model’s underlying assumptions might require in-depth scrutiny and more solid justification. i. First, the authors discuss two different approaches to understanding quality of care: the first approach, which they define as reductionist, interprets quality as an outcome-oriented, quantitative, and therefore, measurable function. The second approach defines quality …. (shrink)

Despite its potential implications for the objectivity of scientific knowledge, the claim that “scientific instruments are perspectival” has received little critical attention. I show that this claim is best understood as highlighting the dependence of instruments on different perspectives. When closely analyzed, instead of constituting a novel epistemic challenge, this dependence can be exploited to mount novel strategies for resolving two old epistemic problems: conceptual relativism and theory-ladeness. The novel content of this article consists in articulating and developing these strategies (...) by introducing two fine-grained notions of perspectives as the key units of analysis: “broad perspectives” and “narrow perspectives.”. (shrink)

Croatia is a transitional society in that it is a country emerging from a socialist command economy toward a market-based economy with ensuing structural changes of a social and political nature—some extending into the healthcare system. A legacy from our past is that, until now, Croatian healthcare institutions have had no real experience with clinical ethics support services. When clinical cases arise presenting complex ethical dilemmas in treatment options, the challenges presented to the medical team are substantial. The case described (...) below recently occurred on a ward in a university hospital in Croatia. An unexpected request from the patient’s parents created a number of issues that needed to be addressed by the medical team, which was made more difficult by the lack of clinical ethics support services. Such cases press the question currently being debated as to what type of ethics support services would be suitable for Croatia and why. (shrink)

Fencing for the blind and visually impaired is an emerging sub-discipline of fencing that creates unusual conditions for meaning-making through interaction between embodied endowments and worldly affordances. With the rules of fencing slightly adjusted to the needs of the blindfolded participants – regardless of their sightedness – the discipline requires the fencers to engage in a duel by relying on other than visual cues. This article explores what an autoethnographic account of experiences of participation in fencing for the blind and (...) visually impaired brings to debates on the embodied, and specifically sensory difference. The discussion of these experiences intersects with debates on affect, affordance, and habit, with all three having important roles in related semiotic processes. Presented vignettes draw upon the author’s lived experiences of participation in fencing for the blind and visually impaired and are analyzed as part of a mixed-method autoethnographic study, accompanied by sensory methodologies, with a focus on an inquiry beyond the visual. The vignettes elucidate how we make sense of our surroundings through a complex engagement with the ecology of sensory and affective processes. In addition to exploring the role of affective and pre-conceptual aspects of our experiences, the article seeks to understand how semiosis occurs through both exposure to as well as the active pursuit of specific environmental signs available to us. The article also derives from biosemiotics to examine the complex relationship between meaning-making processes and habits. Finally, the autoethnographic account provides an insight into how we habituate the world and our embodied differences and thus enable meaning-making processes. (shrink)

On development of professionalism of teachers in Indonesia; collected articles.

This book provides insights on how emerging technosciences come together with new forms of governance and ethical questioning. Combining science and technologies and ethics approaches, it looks at the emergence of three key technoscientific domains - body enhancement technologies, biometrics and technologies for the production of space -exploring how human bodies and minds, the movement of citizens and space become matters of technoscientific governance. The emergence of new and digital technologies pose new challenges for representative democracy and existing forms of (...) citizenship. As citizens encounter and have to adapt to technological change in their everyday life, new forms of conviviality and contestation emerge. This book is a key reference for scholars interested in the governance of emerging technosciences in the fields of science and technology studies and ethics. (shrink)

We adopt the largest consistent set defined by Chwe (1994; J. Econ. Theory 63: 299–325) to predict which coalition structures are possibly stable when players are farsighted. We also introduce a refinement, the largest cautious consistent set, based on the assumption that players are cautious. For games with positive spillovers, many coalition structures may belong to the largest consistent set. The grand coalition, which is the efficient coalition structure, always belongs to the largest consistent set and is the unique one (...) to belong to the largest cautious consistent set. (shrink)

Publicada en 1979, Violence se desarrolla en la ciudad nigeriana de Benín, durante el boom petrolífero de la década de 1970. La narrativa se centra en dos matrimonios que representan ambos extremos del espectro social, cuyos caminos se cruzan mientras sortean diversos obstáculos. La novela de Iyayi constituye una crítica marxista de la violencia ejercida por la pobreza y la desigualdad extrema. Violence muestra cómo ciertos cuerpos humanos se cosifican y explotan de manera sistemática, a la vez que aquellos que (...) no generan ganancias son descartados sin el menor rastro de humanidad. Desde la perspectiva de la ecocrítica urbana, este artículo examina instancias de cosificación corporal en la novela y, específicamente, de comoditización de energía y materia humanas entendidas como recursos naturales. El estudio propone que Iyayi no solo critica esta comoditización al presentarla como una consecuencia del proyecto capitalista, sino que también la cuestiona mediante actos de cuidado resistente que devuelven a los cuerpos cosificados su calidad de sujeto. Estos actos de cuidado constituyen una forma de refutar la separación artificial de Naturaleza y Sociedad, contenida en el dualismo de cuerpo y mente, que históricamente ha justificado la explotación y expropiación capitalista (neo)colonial. El presente artículo contribuye entonces tanto al campo de los estudios poscoloniales como a los de ecocrítica urbana y literaturas africanas, centrándose en una obra relativamente poco analizada y en problemáticas sumamente relevantes para la Nigeria contemporánea. (shrink)

Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the TB community (...) to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TB elimination. We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new TB technologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action. (shrink)

The present collection brings together a number of studies interested in highlighting the role of reflexivity and sentiment in Kant's philosophy. If philosophy is by definition a reflective endeavor, Kant's writings document a particularly powerful philosophical enterprise; not only because he constitutes reflexivity itself into the cornerstone of philosophical method, but also because, in doing so, he unveils fundamental structures of human subjectivity. Authors in this volume have succeeded in highlighting how Kant's commitment to reflexivity represents a privileged gateway of (...) exploring the complexity and richness of human experience. Aesthetic and moral experiences are particularly eloquent in this regard: aesthetic and moral sentiments represent for Kant a particular site of human reflexivity, which bring to light a specifically human world, marked by different kinds of normativity, in the midst of which humans actually live. (shrink)

Desigualdade, pobreza e diferença: precariedade na vida escolar Resumo: O presente artigo tem como objetivo analisar a desigualdade, a pobreza e as diferenciações inferiorizadoras – discriminações e segregações – e seus efeitos de precarização sobre a vida escolar: reprovação e abandono escolar. O centro crítico da análise encontra-se na circularidade viciosa pela qual, num sentido, a desigualdade e a pobreza determinam diferenciações inferiorizadoras que resultam em fracasso escolar e, no sentido inverso, o fracasso escolar resulta em mais pobreza e mais (...) desigualdade. Tal processo selaria a impossibilidade de cumprimento do direito universal à educação, inscrito como promessa nos ideais da democracia liberal. O estudo pode ser caracterizado como bibliográfico, embasado em autores do campo da economia, sociologia, direito e filosofia, com especial apoio em documentos da ONU, UNESCO, OCDE e Constituição Federal brasileira. Os resultados do estudo apontam para as graves responsabilidades das políticas públicas, dos sistemas de ensino e dos projetos pedagógicos das unidades escolares em interromper a circularidade dessa precarização. Palavras-chave: Desigualdade. Pobreza. Diferença. Precariedade. Fracasso escolar. Desigualdad, Pobreza y Diferencia: Precariedad en la Vida Escolar Resumen: El artículo analiza la desigualdad, la pobreza y las diferenciaciones inferiorizadoras - discriminaciones y segregaciones - y sus efectos de precarización sobre la vida escolar: reprobación y abandono escolar. El centro crítico del análisis se ubica en la circularidad viciosa por la cual, en un sentido, la desigualdad y la pobreza determinan diferenciaciones inferiorizadoras que resultan en fracaso escolar y, al inverso, el fracaso escolar resulta en más pobreza y más desigualdad. Esa circularidad sellaria la imposibilidad de cumplimiento del derecho universal a la educación - promesa de la democracia liberal. El estudio es bibliográfico, desde autores en la economía, sociología, derecho y filosofía, con especial apoyo en documentos de la ONU, UNESCO, OCDE y la Constitución Federal brasileña. Se apunta a las graves responsabilidades de las políticas públicas, de los sistemas de enseñanza y de los proyectos pedagógicos de las unidades escolares en interrumpir la circularidad de esa precarización. Palabras-clave: Desigualdad. Pobreza. Diferencia. Precariedad. Fracaso escolar. Inequality, Poverty and Difference: Precariousness in School Life: This article aims to analyze inequality, poverty and specific social differences - discrimination and segregation - and their impacts on precariousness of school life: failure and school dropout. The center of analysis lies in the vicious circularity by which, in a direction, inequality and poverty determine the differentiation of people that result in school failure, and on the way round, school failure results in more poverty and more inequality. Such circularity is an impossibility of compliance with the universal right of education - a promise of liberal democracy. It’s about a bibliographic study of a wide range of authors on economics, sociology, law and philosophy, with references to UN, UNESCO, OECD documents and the brazilian Federal Constitution. The results of the study point out to the responsibilities of public policies, educational systems and the pedagogical projects of the school units, to interrupt the circularity of this precariousness. Keywords: Inequality. Poverty. Precariousness. Difference. School Failure. Data de registro:08/07/2019 Data de aceite: 27/05/2020. (shrink)

In this essay I present some of my thoughts on the issue of boundaries in the professional relationship between service users and social workers. As a graduate student of social work, I had an opportunity to discuss ethical dilemmas in an international perspective in one of my courses. A guest professor, who provided international perspectives, was Prof. Kim Strom from UNC at Chapel Hill in North Carolina, USA. The lectures offered a fresh perspective that raised many questions about thick and (...) thin boundaries in social work – especially when approaching social work by following prevailing guidelines for social work in Slovenia requiring us to co-create solutions through dialogue with service users, keeping in mind that service users are actually the ones who are the experts from experience. In this way, the working relationship seeks to foster a sense of partnership between social workers and service users. In this essay I would like to challenge the idea of rigid boundaries in social work and explore the possibility of fluid boundaries, keeping in mind that boundaries should reflect their main purpose, which I believe is to protect human dignity. (shrink)

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt (...) calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)

Online education has become an essential component of education. Thus, several factors, such as the student’s learning strategy and motivation, generally contribute to their academic success. This study investigates the relationship between learning strategies, motivation, and online learning environment among 150 first-year college students. Employing correlational design, the statistical findings of the study reveal that the r coefficient of 0.59 indicates a moderate positive correlation between the variables. The p-value of 0.00, which is less than 0.05, leads to the decision (...) to reject the null hypothesis. Hence, a significant relationship exists between learning strategies, motivation, and the online learning environment. (shrink)

The somatic mutation theory (SMT) of cancer has been and remains the prevalent theory attempting to explain how neoplasms arise and progress. This theory proposes that cancer is a clonal, cell‐based disease, and implicitly assumes that quiescence is the default state of cells in multicellular organisms. The SMT has not been rigorously tested, and several lines of evidence raise questions that are not addressed by this theory. Herein, we propose experimental strategies that may validate the SMT. We also call attention (...) to an alternative theory of carcinogenesis, the tissue organization field theory (TOFT), which posits that cancer is a tissue‐based disease and that proliferation is the default state of all cells. Based on epistemological and experimental evidence, we argue that the TOFT compellingly explains carcinogenesis, while placing it within an evolutionarily relevant context.magnified imagemagnified imageAna Soto and Carlos Sonnenschein are at Tufts University School of Medicine, Boston, MA, USA. (shrink)

Flexibility in conceptual projection constitutes one of the most challenging issues in the embodiment and conceptual metaphor literatures. We sketch a theoretical proposal that places the burden of the explanation on attentional dynamics in interaction with mental models in working memory that are constrained to be maximally coherent. A test of this theory is provided in the context of the conceptual projection of time onto the domain of space. Participants categorized words presented at different spatial locations (back–front, left–right) as referring (...) to the past or to the future. Responses were faster when the irrelevant word location was congruent with the back–past, front–future metaphoric mapping. Moreover, when a new highly task-relevant spatial frame of reference was introduced, it changed the projection of past and future onto space in a way that was congruent with the new frame (past was now projected to left space and future to right space), as predicted by the theory. This study shows that there is substantial flexibility in conceptual projection and opens a venue to study metaphoric variation across tasks, individuals, and cultures as the result of attentional dynamics. (shrink)

How can we feel at home in this world without clinging to false certainties? This book offers a humanist re-reading of philosophical pragmatism and explores its potentials for a worldview that relies only on human resources. Thinking along with authors like William James and F.C.S. Schiller, it highlights a fundamentally humanist strand of pragmatism aimed at fostering human creativity and transformative action. It is grounded in everyday experience and underlines our responsibility to strive for the better. Ana Honnacker traces perspectives (...) on science, religion, and ethics in the light of a pragmatic understanding of humanism. Furthermore, she suggests how to address the existential challenges we face today. Thus, pragmatic humanism is explored not only as a philosophy for critical minds, but also as a way of life. (shrink)

The theory of mental models postulates that meaning and knowledge can modulate the interpretation of conditionals. The theory's computer implementation implied that certain conditionals should be true or false without the need for evidence. Three experiments corroborated this prediction. In Experiment 1, nearly 500 participants evaluated 24 conditionals as true or false, and they justified their judgments by completing sentences of the form, It is impossible that A and ___ appropriately. In Experiment 2, participants evaluated 16 conditionals and provided their (...) own justifications, which tended to be explanations rather than logical justifications. In Experiment 3, the participants also evaluated as possible or impossible each of the four cases in the partitions of 16 conditionals: A and C, A and not-C, not-A and C, not-A and not-C. These evaluations corroborated the model theory. We consider the implications of these results for theories of reasoning based on logic, probabilistic logic, and suppositions. (shrink)

Humanism is charged with fostering a harmful anthropocentrism that has led to the exploitation of non-human beings and the environment. Posthumanist and transhumanist ideas prominently aim at rethinking our self-understanding and human-nature relations. Yet these approaches turn out to be flawed when it comes to addressing the challenges of the “age of the humanity”, the Anthropocene. Whereas posthumanism fails in acknowledging the exceptional role of human beings with regard to political agency and responsibility, transhumanism overemphasizes human capabilities of controlling nature (...) and only deepens the human-nature dualism. Therefore, a critical and humble version of humanism is suggested as a viable alternative. Drawing on pragmatist thinkers William James and F.C.S. Schiller, a resource for de-centering the human being is provided that critically reflects our role in the larger ecosystem and underlines human potentials as well as human responsibilities. (shrink)