Evolution in Four Dimensions claims that epigenetic, behavioral, and symbolic inheritance systems should be considered equal partners to genetics in evolutionary biology. The evidence for, and applicable scope of, these additional inheritance systems is limited, particularly with regard to areas involving learning. It is unclear how including these extra dimensions in mainstream evolutionary thinking translates into testable hypotheses for a productive research program.

To the woman, God said, “I will greatly multiply your pain in child bearing; in pain you shall bring forth children, yet your desire shall be for your husband, and he shall rule over you.”Genesis 3:16There is now a well-established body of literature documenting the pervasive inadequate treatment of pain in this country. There have also been allegations, and some data, supporting the notion that women are more likely than men to be undertreated or inappropriately diagnosed and treated for their (...) pain.One particularly troublesome study indicated that women are more likely to be given sedatives for their pain and men to be given pain medication. Speculation as to why this difference might exist has included the following: Women complain more than men; women are not accurate reporters of their pain; men are more stoic so that when they do complain of pain, “it's real”; and women are better able to tolerate pain or have better coping skills than men. (shrink)

Volume 19, Issue 10, October 2019, Page 52-54.

Trust is central to the therapeutic relationship, but the epistemic asymmetries between the expert healthcare provider and the patient make the patient, the trustor, vulnerable to the provider, the trustee. The narratives of pain sufferers provide helpful insights into the experience of pain at the juncture of trust, expert knowledge, and the therapeutic relationship. While stories of pain sufferers having their testimonies dismissed are well documented, pain sufferers continue to experience their testimonies as being epistemically downgraded. This kind of epistemic (...) injustice has received limited treatment in bioethics. In this paper, we examine how a climate of distrust in pain management may facilitate what Fricker calls epistemic injustice. We critically interrogate the processes through which pain sufferers are vulnerable to specific kinds of epistemic injustice, such as testimonial injustice. We also examine how healthcare institutions and practices privilege some kinds of evidence and ways of knowing while excluding certain patient testimonies from epistemic consideration. We argue that providers ought to avoid epistemic injustice in pain management by striving toward epistemic humility. Epistemic humility, as a form of epistemic justice, may be the kind disposition required to correct the harmful prejudices that may arise through testimonial exchange in chronic pain management. (shrink)

A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...) a consult. As one bioethicist commented:if you approach any endeavor as an amateur activity, you will get, in the end, an amateurish version of the activity. Without a sufficient commitment of personnel, time, support, and financial resources, a healthcare organization will get the ‘ethics’ program … it set out to create: an inept, unskilled, inefficient, and highly risky ‘program’ in healthcare ethics and bioethics. (shrink)

BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs (HCEPs) that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online survey, 97% (...) of hospitals have HCEPs. Their scope includes clinical ethics functions in virtually all hospitals, but includes other functions in far fewer hospitals: ethical leadership (35.7%), regulatory compliance (29.0%), business ethics (26.2%), and research ethics (12.6%). HCEPs are responsible for providing ongoing ethics education to various target audiences including all staff (77.0%), nurses (59.9%), staff physicians (49.0%), hospital leadership (44.2%), medical residents (20.3%) and the community/general public (18.4%). HCEPs staff are most commonly involved in policy work through review of existing policies but are less often involved in development of new policies. HCEPs have an ethics representative in executive leadership in 80.5% of hospitals, have representation on other hospital committees in 40.7%, are actively engaged in community outreach in 22.6%, and lead large-scale ethics quality improvement initiatives in 17.7%. In general, major teaching hospitals and urban hospitals have the most highly integrated ethics programs with the broadest scope and greatest number of activities. Larger hospitals, academically affiliated hospitals, and urban hospitals have significantly more individuals performing HCEP work and significantly more individuals receiving financial compensation specifically for that work. Overall, the most common greatest challenge facing HCEPs is resource shortages, whereas underutilization is the most common greatest challenge for hospitals with fewer than 100 beds. Respondents’ strategies for managing challenges include staff training and additional funds.ConclusionsWhile this study must be cautiously interpreted due to its limitations, the findings may be useful for understanding the characteristics of HCEPs in US hospitals and the factors associated with these characteristics. This information may contribute to exploring ways to strengthen HCEPs. (shrink)

Background Previous research mainly focuses on how to support nursing students in caring for the patient and on educators’ views of students’ development as professional caring nurses. Against this background, it is important to further investigate nursing students’ perspectives on what it means to become a professional caring nurse. Research aim This qualitative systematic review study aims to identify and synthesize nursing students’ perceptions on the meaning of becoming a caring nurse. Research design and data sources Systematic data searches were (...) conducted by using the electronic databases MEDLINE (Ovid), CINAHL (EBSCO), Academic Search Premiere (EBSCO), and Philosopher`s Index. In total, 13 studies met the inclusion and quality criteria. The articles were analyzed by a systematic review and a thematic synthesis according to Thomas and Harden. Ethical consideration The study followed good ethical practice guidelines outlined in the Northern Nurses’ Federation. Findings The analysis resulted in eight descriptive themes and finally in three analytical themes: Becoming is to get in touch with one’s inner ethic or ethos, Becoming is a movement between courage, understanding, and being touched, and Becoming is strengthened through caring role models and a learning culture. Conclusions Becoming a professional caring nurse is seen as an ongoing movement toward a deeper understanding of oneself and one’s being and bearing. This movement is enabled when nursing students have a sense of self-awareness, courage to stand in their vulnerability, and reflect on their responsibility, caring attitude, and inner values and ethics. The force of becoming is that the attention is directed beyond self to care for and feel empathy for others in a caring manner. Becoming is released through a caring relationship, external confirmation, and good role models. A lack of external support in the movement can potentially prevent the students from becoming a professional caring nurse. (shrink)

A significant amount of discussion in the bioethics community has been devoted to the question of whether individuals performing ethics consultations in healthcare institutions have any special expertise. In addition, articles in the lay press have questioned the “added value” that bioethicists bring to ethical dilemmas. Those at the forefront of the bioethics community have argued repeatedly that those doing ethics consults cannot simply be well-intentioned individuals, that some training in bioethics, group process, and facilitation is necessary to competently execute (...) a consult. As one bioethicist commented:if you approach any endeavor as an amateur activity, you will get, in the end, an amateurish version of the activity. Without a sufficient commitment of personnel, time, support, and financial resources, a healthcare organization will get the ‘ethics’ program … it set out to create: an inept, unskilled, inefficient, and highly risky ‘program’ in healthcare ethics and bioethics. (shrink)

Mobile technologies such as tablets, iPads, laptops, netbooks as well as mobile phones with internet connectivity and recording features present new challenges to the academy. In the age of convergence and with the encoding of several features into mobile telephony, private spaces of the classroom can be reconfigured through the mediation of technologies. In most cases, existing rules and regulations of higher education institutions do not comprehensively address these challenges. The introduction of new technologies into the classroom has been often (...) framed historically as vital and relevant for a progressive academic society or as part of a national imperative to transform the ways in which the authors access and engage with knowledge. This paper surveys British universities to examine how they govern the phenomenon of recording content through mobile technologies. The results reveal a pervasive use of mobile devices in UK universities and clear divergences in approaches to enacting mobile device-specific policies to govern the usage of these technologies. (shrink)

In this anthology of new and classic articles, fifteen noted feminist philosophers explore contemporary ethical issues that uniquely affect the lives of women. These issues in applied ethics include autonomy, responsibility, sexual harassment, women in the military, new technologies for reproduction, surrogate motherhood, pornography, abortion, nonfeminist women and others. Whether generated by old social standards or intensified by recent technology, these dilemmas all pose persistent, 'nagging,' questions that cry out for answers.

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

State medical boards are beginning to take a more balanced approach to monitoring and disciplining for prescribing of pain medications, according to this survey of state medical boards across the country. Overall, respondents indicated that they are becoming more educated and more sophisticated in their approach to complaints of opioid overprescribing. In addition, their responses reflect a heightened awareness of the appropriateness of treating chronic pain with controlled substances.Yet, despite these inroads, boards generally demonstrate a continued tolerance of pain undertreatment, (...) the survey found. There is a discrepancy in the weight given to violation of standard of care, patient harm, and gross negligence for opioid overprescribing versus undertreatment of pain. Boards appear to have a higher threshold for patient harm in cases involving pain undertreatment — particularly for chronic nonmalignant pain. (shrink)

Uncertainty regarding potential disciplinary action may give physicians pause when considering whether to accept a chronic pain patient or how to treat a patient who may require long-term or high doses of opioids. Surveys have shown that physicians fear potential disciplinary acrion for prescribing controlled substances and that physicians will, in some cases, inadequately prescribe opioids due to fear of regulatory scrutiny. Prescribing opioids for long-term pain management, particularly noncancer pain management, has been controversial; and boards have investigated and, in (...) some cases, disciplined physicians for such prescribing. While in virtually all of these cases the disciplinary actions were successfully appealed, news of the success was not often as well-publicized as news of the disciplinary actions, leaving some physicians confused about their potential liability when prescribing opioids for pain. The confusion has perhaps increased as a result of two relatively recent cases, one where a physician was successfully disciplined by a state medical board for undertreatment of his patients’ pain, and another where the physician was successfully sued for inadequate pain treatment. (shrink)

The article introduces readers to the study of disability, both with respect to the interdisciplinary field of disability studies and the field of philosophy of disability. We then offer an overview of three central areas of philosophical inquiry where feminist work in philosophy and disability has made significant contributions: (1) metaphysics and ontology, (2) epistemology and phenomenology, and (3) ethical, social, and political philosophy.

The paper defends the thesis that institutional virtue is properly modeled as a ‘‘consensual’’ property, along the lines of the Lehrer–Wagner model of consensus (LWC). In a first step, I argue that institutional virtue is not exhausted by duty-fulfilling, since institutions, contrary to natural individuals, are designed to fulfill duties. To avoid the charge of vacuity, virtue, if attributed to institutions, must be able to motivate supererogatory action. In a second step, I argue against dis- continuity of institutional virtue with (...) individual virtue. Two main arguments for discontinuity of collective properties display serious shortcomings when applied to virtues of institutions. Given that motivation for supererogatory action is neither inferred from statutory duties nor accommodates a right of reprobation, modeling institutional virtue on collective rationality or explaining it in terms of joint com-mitment both prove problematic. In a third step, I argue that LWC has the explanatory potential to account for institutional virtue. Due to its main features,iteration and evaluation, it provides a non-trivial analysis of continuity and thereby satisfies basic constraints on the notion of genuine institutional virtue. (shrink)

Management has tended to be established as science (Episteme) by using scientific methodologies and techniques. Although the era of Grand Theories has passed some time ago in social sciences, management has been still indicating the tendencies to develop ‘Grand Theories’. However, economic developments associated with globalization and the ‘Lehman brothers’ big bang in financial sector has shaken some assumptions about the nature of management as science and also about the methodologies by which management and entrepreneurship can or could be studied. (...) Specific shift to the future developments through Aristoteles’s intellectual virtue Phronesis has been traced in the work of theorists, such as Flyvbjerg, and others. They indicate new approach to organization studies, called phronetic organization research. In this paper, our exploration of research methodologies builds on Phronesis. Based on results of empirical study of business models in small and medium size companies in Slovenia, and extensive literature review we inductively build theoretical foundations for phronetic studies in the field of management and entrepreneurship and introduce the concept, called ‘phronetic bricolage’. It is based on understanding of management as ‘practical activity’ of ‘wise managers’ and bricolage—the research design (or approach) that builds knowledge from pieces of research from different fields, with different methods and various sources of data. We argue that phronetic bricolage is approach in management studies that links wisdom with complexity and variety of methods and sources of data. (shrink)

Recent findings indicate that frontal brain asymmetry may be a marker of for depression. However, the psychological predispositions that account linkage between frontal brain asymmetry and depression are unclear. approach-withdrawal hypothesis is the primary framework that has been to account for the linkages between frontal brain asymmetry and or emotional disorders. We review evidence consistent with this and suggest several directions for its extension. One such direction is to constrain the approach-withdrawal hypothesis by linking frontal asymmetry to the known functions (...) of the prefrontal cortex. On this we propose that frontal brain asymmetry may be preferentially linked processes that promote the temporal continuity and shifting of or emotional priorities and the suppression of interference by sources of motivation or emotion. We review evidence from and neurobiological studies of depression that is broadly consistent with these predictions. We emphasise the need for future studies testing our hypotheses. (shrink)

CAN WE BUILD THEORIES OF UNDERSTANDING ON THE BASIS OF MIRROR NEURONS? The discovery of mirror neurons and the characterization of their response properties is certainly an important achievement in neurophysiology and cognitive neuroscience. The reference to the role of mirror neurons in ‘reading’ the intentions of other creatures and in the learning process fulfils an explanatory function in understanding many cognitive phenomena beginning from imitating, towards understanding, and finishing with complex social interactions. The focus of this paper is to (...) review selected approaches to the role of mirror neurons in mental activity as understanding, and to conclude with some possible implications for researches on mirror neurons for philosophical theories of understanding. (shrink)

Les remarques de Bolzano sur les couleurs n’ont pas fait l’objet de recherches jusqu’à présent. Le but de cet article est de montrer que ses investigations sur les couleurs constituent une contribution intéressante à la théorie de la connaissance du XIXe siècle. Selon Bolzano, les couleurs sont des qualités secondes ainsi que des propriétés physiques et, par conséquent, elles sont des quantités mesurables. Il soutient que la perception des couleurs est réglée par des lois empiriques et il argumente que les (...) couleurs que nous voyons sont déterminables par des concepts de grandeur. (shrink)

Ma is a curriculum. The Japanese concept of ma refers to the interval between two markers. In a dialectic exploration, the spaces between--private/public, teacher/student, old/new, self/other, among others are probed in ways that contribute to the significant research in teaching and learning that has been undertaken in the last decades.

The contributions gathered in this volume present the state of the art in key areas of current social ontology. They focus on the role of collective intentional states in creating social facts, and on the nature of intentional properties of groups that allow characterizing them as responsible agents, or perhaps even as persons. Many of the essays are inspired by contemporary action theory, emotion theory, and theories of collective intentionality. Another group of essays revisits early phenomenological approaches to social ontology (...) and accounts of sociality that draw on the Hegelian idea of recognition. This volume is organized into three parts. First, the volume discusses themes highlighted in John Searle's work and addresses questions concerning the relation between intentions and the deontic powers of institutions, the role of disagreement, and the nature of collective intentionality. Next, the book focuses on joint and collective emotions and mutual recognition, and then goes on to explore the scope and limits of group agency, or group personhood, especially the capacity for responsible agency. The variety of philosophical traditions mirrored in this collection provides readers with a rich and multifaceted survey of present research in social ontology. It will help readers deepen their understanding of three interrelated and core topics in social ontology: the constitution and structure of institutions, the role of shared evaluative attitudes, and the nature and role of group agents. (shrink)

The research paper elaborates on the main concepts and terminology of strategic planning in education, including all the steps of building a strategic plan with mission and vision statements. Furthermore, it analyses and compares some successful strategic planning case studies in education by identifying the strengths and some weaknesses. The final results of this inquiry serve as recommendations for positive changes and reforms in North Macedonian education. Furthermore, this research paper emphasizes the importance of the SMART strategic goals for improving (...) education, articulated via the mission and vision statements. It is quite interesting that internationally accredited educational organizations like NOVA IS of Skopje have more successful improvement plans based on shared values and goals via their mission and vision. The implementation of their strategic plans is closely monitored and evaluated. Moreover, some successful educational reforms happened in Finland, Singapore, and Victoria, Australia, and their ministries of education are dedicated and accountable to aligning their mission and vision with all public schools in these countries. On the contrary, although the Ministry of Education of North Macedonia has clearly published the mission and vision statements, there is still a huge gap in the reality of implementation of those in all public schools, and rarely any school has a shared mission and vision on their web page. Browsing around, one primary school in North Macedonia, “Jan Amos Komenski” has recently started sharing their school’s mission and vision, values, and goals with the community which is a positive change toward SMART reforms. Strategic planning affects the improvement of learning and teaching; therefore it needs to be built inclusively and wisely. (shrink)

In this paper I try to consider the question of understanding as a special mental capacity in the light of the neuroscientific approach and the philosophical tradition. I assert that it is not sufficient to explain the process of understanding on the subpersonal level. The understanding has several dimensions that are revealed only in the aspect of interpretation, communication and social interaction. This kind of understanding implies the meta-representational knowledge, which we wanted to present on the example of rational and (...) hermeneutic thinking. It should be clear that in these cases, the reduction of holistic higher mental states gathered in the form of the mind theory to the neuronal level is not possible. (shrink)

Głównym celem niniejszej książki jest filozoficzno-kognitywistyczna analiza trzech zdolności poznawczych, intencjonalności, rozumienia i samowiedzy, które odgrywają kluczową rolę w ludzkim poznaniu. Analiza odbywać się będzie w odwołaniu do wybranych koncepcji, głoszonych na gruncie epistemologii i kognitywistyki. Poznanie będzie tu ujmowane jako efekt połączenia owych zdolności, jakimi są intencjonalne odniesienie podmiotu do świata zewnętrznego i własnych stanów mentalnych, rozumienie siebie i innych podmiotów oraz samowiedza, definiowana jako wiedza (prawdziwe, uzasadnione przekonanie) o własnych stanach mentalnych."--Fragment of Introduction, p.9.

Celem niniejszego artykułu jest przedstawienie psychologicznego portretu kobiety końca dziewiętnastego wieku, mistrzowsko uchwyconego w opowiadaniach Arthura Schnitzlera: Die Braut, Fräulein Else i Die griechische Tänzerin. Artykuł odwołuje się do interpretacji filozoficznych, w których dominuje dualistyczny opis nawiązujący do problemu umysłu i ciała rozważanego na gruncie Freudowskiej psychoanalizy. Z jednej strony kobieta jest tu charakteryzowana jako indywiduum determinowane napięciem między psyche a somą, z drugiej zaś strony jako jednostka funkcjonująca w społeczeństwie zdominowanym przez mężczyzn.

The question of subject's cognitive access to his own mental states contains an assumption, that this cognition is direct and authoritative, what is also a condition of subject's self-knowledge. The directness means, that this kind of cognition is not burdened by the intermediaries as Fregean senses or representations. Now arises the problem, how the self-knowledge, which has a propositional character can be direct, hence nonrepresentational. In this paper I considered the three kinds of representations, which are present in self-knowledge and (...) I have tried to answer the question, whether it is possible to preserve the directness of self-knowledge, despite of its representational constituents. First I have asked about the representation of self, then I assumed that to have self-knowledge a subject has to conceptualise his state as a belief or other experience of a certain kind and he has to think about himself as a subject of this state. Then I considered the representation of the modality of the state. Finally I analysed the representational character of the content of mental states. The conclusion of these investigations was that even if the self-knowledge in its epistemological aspect is representational (for example because of its propositional structure) it preserves its directness in its essential form, i.e. psychological aspect. (shrink)

Since the sharing economy is a rather new phenomenon, there is still no official definition of it in the legal framework of Croatia. The continuous development of sharing economy started a few years after the 1998 global and domestic economic crisis stroked Croatia. Namely, a total of eight platforms in the sectors of transportation, accommodation, finance, and online skills could be identified. The total market share of these platforms amounts to estimated market revenue of roughly 106 million EUR. When compared (...) to the other EU Member States, it could be noticed that Croatia falls within the group of countries with a below-average performance by a number of platforms per 1 million population, as well as in the level of revenues compared to national GDP. Figures that are more promising can be detected regarding the collaborative economy’s contribution to national employment, which positions Croatia within the EU average. Future studies should explain in greater depth how the sharing economy poses several new challenges for regulators in Croatia and countries across the EU. In particular, policymakers must comprehend the big picture and provide regulatory guidelines to manage the long-term changes in job markets, public safety, competition, and digital trust. (shrink)

Better memory, greater motivation and concentration lead to greater productivity, efficiency and performance, all of which are features that are highly valued in a modern society focused on productivity. In the effort for better cognitive abilities, otherwise healthy individuals use cognitive enhancers, medicines for the treatment of cognitive deficits of patients with various disorders and health problems, such as Alzheimer’s disease, schizophrenia, stroke, Attention Deficit Hyperactivity Disorder or ageing. The use of these is more common in professions with emphasised cognitive (...) abilities, or in occupations that require more attention, focus and alertness. Their use is also associated with the general working population, in that they are supposed to use them to alleviate the effects of sleep deprivation and to cope with increasing workloads. In the paper, we are addressing the ethical issue and the dilemmas of the use of pharmaceutical enhancements by healthy people who have no medical reason for taking such substances, in the context of improving their cognitive functions. (shrink)