By registering different health benefits on a common scale, CEA allows us to assess the relative social importance of different health care interventions and opens the way for the allocation decisions of health care policy. If it is really to be effective, however, CEA must be recalibrated so that it better reflects some of our widely held beliefs about the merits of different kinds of treatment.

By registering different health benefits on a common scale, CEA allows us to assess the relative social importance of different health care interventions and opens the way for the allocation decisions of health care policy. If it is really to be effective, however, CEA must be recalibrated so that it better reflects some of our widely held beliefs about the merits of different kinds of treatment.

Why do people read novels, go to the theater, or listen to beautiful music? Do we seek out aesthetic experiences simply because we enjoy them--or is there another, deeper, reason we spend our leisure time viewing or experiencing works of art? Aesthetics, the first short introduction to the contemporary philosophy of aesthetics, examines not just the nature of the aesthetic experience, but the definition of art, and its moral and intrinsic value in our lives. Anne Sheppard divides her work (...) into two parts: In the first, she summarizes the major theories defining art and beauty; in the second, she explores the nature of aesthetic evaluation and appreciation. As Sheppard explains, there are three main approaches to defining art, all focused on what art objects share. One proposes that all art imitates something in life, another that it expresses something (such as anger or ecstasy), still another suggests that all art has formal qualities. There is also a fourth which offers that all art shares the quality of beauty. In the second part, which concentrates on literary art, Sheppard explores such philosophic topics as critical judgment, meaning and truth in literature, and the relationship between art and morals. She raises such questions as whether there is one correct interpretation of a work of art and whether art has a moral effect on its audience and, citing specific examples, explores the views that have been put forth. A wide-ranging, intriguing book, which assumes no formal knowledge on the part of its readers, Aesthetics opens the door to a greater understanding and appreciation of art. (shrink)

Introduction: Aristotle's phantasia and the ancient concept of imagination -- Visualization, vividness (enargeia) and realism -- Mathematical projection, copying and analogy -- Prophecy, inspiration and allegory -- Conclusion: ancient and modern imagination.

This anthology of philosophical texts by Greek and Roman authors brings together works from the late fifth century BC to the sixth century AD that comment on major aesthetic issues such as the perception of beauty and harmony in music and the visual arts, structure and style in literature, and aesthetic judgement. It includes important texts by Plato and Aristotle on the status and the role of the arts in society and in education, and Longinus' reflections on the sublime in (...) literature, in addition to less well-known writings by Philodemus, Cicero, Seneca, Plotinus, Augustine and Proclus. Most of the texts have been newly translated for this volume, and some are available in English for the first time. A detailed introduction traces the development of classical aesthetics from its roots in Platonism and Aristotelianism to its ultimate form in late Antiquity. (shrink)

Perceived behavioral integrity involves the employee’s perception of the alignment of the manager’s words and deeds. This meta-analysis examined the relationship between perceived behavioral integrity of managers and the employee attitudes of job satisfaction, organizational commitment, satisfaction with the leader and affect toward the organization. Results indicate a strong positive relationship overall (average r = 0.48, p<0.01). With only 12 studies included, exploration of moderators was limited, but preliminary analysis suggested that the gender of the employees and the number of (...) levels between the employee and the manager are potential moderators of the relationship. In the current sample of studies, country where the research was conducted did not seem to have any moderating effects. In addition to suggesting further investigation of potential moderators, we call for research that examines the relationship between behavioral integrity and outcomes that include individual behavior and organizational performance. (shrink)

Our objective was to better understand the values and ethical dilemmas surrounding advance care planning through stories told by registered nurses and licensed social workers, who were employed as care managers within Area Agencies on Aging. We conducted eight focus groups in which care managers were invited to tell their stories and answer open-ended questions focusing on their interactions with consumers receiving home-based long-term care. Using narrative analysis to understand how our participants thought through particular experiences and what they valued, (...) we identified seven themes representative of their work with consumers and families: humility, respect, responsibilities, boundaries, empowerment, courage, and veracity. (shrink)

Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopment advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.In a letter sent out to 2600 hospitals across the country they [Public Citizen] demand that healthcare facilities “immediately discontinue the distribution of commercial infant formula manufacturer discharge bags,” claiming it undermines women’s success at breastfeeding. What they failed to explain is (...) why a woman’s decision regarding her own tits is anyone’s fucking business but her own.Clearly, policies to promote breast-feeding.. (shrink)

Bishop is a professor of nursing; Scudder is a professor of philosophy.

Sally Gadow influenced our work when we first began exploring the meaning of nursing philosophically. In this article, we discuss two major themes of Gadow's work that have influenced us: existential advocacy and treating the body objectively without reducing the patient to the moral status of an object. Our treatment of these issues is appreciative but not uncritical. We argue that existential advocacy makes an important contribution to the meaning of nursing but that it cannot be its essential meaning. We (...) contend that Gadow, by making self‐direction the essence of care, tends to diminish the intersubjective nature of care. Then we show how Gadow recovers the intersubjective nature of care by disclosing how nurses and patients both become subjects in personal relationships, even when tending to the body objectively. We show how hermeneutic phenomenology, which we favour, can contribute to Gadow's existential phenomenology by using examples from nursing practice to disclose the meaning of nursing. Gadow's major contribution to our work has been in the ways her work has evoked creative thought from us concerning the meaning of nursing. (shrink)

BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...) objective of this review was to identify and map the outcomes reported in primary studies of CEC. The secondary objective was to provide a comprehensive overview of CEC structures, processes, and roles to enhance understanding and to inform standardization.MethodsWe searched electronic databases to identify primary studies of CEC involving patients, substitute decision-makers and/or family members, clinicians, healthcare staff and leaders. Outcomes were mapped across five conceptual domains as identified a priori based on our clinical ethics experience and preliminary literature searches and revised based on our emerging interpretation of the data. These domains included personal factors, process factors, clinical factors, quality, and resource factors. ResultsForty-eight studies were included in the review. Studies were highly heterogeneous and varied considerably regarding format and process of ethical intervention, credentials of interventionist, population of study, outcomes reported, and measures employed. In addition, few studies used validated measurement tools. The top three outcome domains that studies reported on were quality, process factors, and clinical factors. The majority of studies examined multiple outcome domains. All five outcome domains were multidimensional and included a variety of subthemes.ConclusionsThis scoping review represents the initial phase of mapping the outcomes reported in primary studies of CEC and identifying gaps in the evidence. The confirmed lack of standardization represents a hindrance to the provision of high quality intervention and CEC scientific progress. Insights gained can inform the development of a core outcome set to standardize outcome measures in CEC evaluation research and enable scientifically rigorous efficacy trials of CEC. (shrink)

Paul Grobstein, Eleanor A. Bliss Professor of Biology at Bryn Mawr College, Pennsylvania, USA passed away Tuesday, June 28, 2011. Since Paul came to Bryn Mawr in 1986, he taught courses ranging from "Introductory Biology" and "Philosophy of Science" to "Evolution of Stories" and "The Brain and Education." Paul founded the Summer Institutes for K-12 Teachers, which brought hundreds of local educators to campus to consider new ways of teaching science and math. He served as chair of the Biology Department (...) and was instrumental in the establishment and success of the Center for Science in Society at Bryn Mawr College. (shrink)

Three female physicians were interviewed as part of a comprehensive investigation into the narratives of female and male physicians and nurses, concerning their experience of being in ethically difficult care situations in the care of elderly people. The interviewees expressed great concern for the low status of care for elderly people, and the need to fight for the specialty and for the care and rights of their patients. All the interviewees’ narratives concerned problems relating to perspectives of both action ethics (...) and relational ethics. The main focus was on problems concerning the latter perspective, expressed as profound concern and respect for the individual patient. Secondary emphasis was placed on relationships with relatives and other professionals. The most common themes in an action ethics perspective were too little treatment and the lack of health services for older patients, together with overtreatment and death with dignity. These results were discussed in the light of Løgstrup’s ethics, which emphasize that human life means expressing oneself, in the expectation of being met by others. Both Ricoeur’s concept of an ethics of memory and Aristotle’s virtue ethics are presented in the discussion of too little and too much treatment. (shrink)

The main objective of this essay is to validate some of the principal, currently competing, mammalian consciousness-brain theories by comparing these theories with data on both cognitive abilities and brain organization in birds. Our argument is that, given that multiple complex cognitive functions are correlated with presumed consciousness in mammals, this correlation holds for birds as well. Thus, the neuroanatomical features of the forebrain common to both birds and mammals may be those that are crucial to the generation of both (...) complex cognition and consciousness. The general conclusion is that most of the consciousness-brain theories appear to be valid for the avian brain. Even though some specific homologies are unresolved, most of the critical structures presumed necessary for consciousness in mammalian brains have clear homologues in avian brains. Furthermore, considering the fact that the reptile-bird brain transition shows more structural continuity than the stem amniote-mammalian transition, the line drawn at the origin of mammals for consciousness by several of the theorists seems questionable. An equally important point is that consciousness cannot be ruled out in the absence of complex cognition; it may in fact be the case that consciousness is a necessary prerequisite for complex cognition. (shrink)

Research on emotion perception in schizophrenia has focused primarily on the perception of static faces displaying different emotion signals or expressions. However, perception of emotion in daily life relies on much more than just the face. In this article, we review the role of context in emotion perception among people with and without schizophrenia. We argue that not only is context central to the perception of emotion, it in fact helps to construct the perception. Implications for future research on emotion (...) perception are discussed. (shrink)

Recent buzzes around big data, data science and artificial intelligence portray a data-driven future for healthcare. As a response, Europe's key players have stimulated the use of big data technologies to make healthcare more efficient and effective. Critical Data Studies and Science and Technology Studies have developed many concepts to reflect on such overly positive narratives and conduct critical policy evaluations. In this study, we argue that there is also much to be learned from studying how professionals in the healthcare (...) field affectively engage with this strong European narrative in concrete big data projects. We followed twelve hospital-based big data pilots in eight European countries and interviewed 145 professionals between 2018 and 2020. In this study, we introduce the metaphor of dreams to describe how professionals link the big data promises to their own frustrations, ideas, values and experiences with healthcare. Our research answers the question: how do professionals in concrete data-driven initiatives affectively engage with European Union's data hopes in their ‘dreams’ – and with what consequences? We describe the dreams of being seen, of timeliness, of connectedness and of being in control. Each of these dreams emphasizes certain aspects of the grand narrative of big data in Europe, makes particular assumptions and has different consequences. We argue that including attention to these dreams in our work could help shine an additional critical light on the big data developments and stimulate the development of responsible data-driven healthcare. (shrink)

Feminist bioethicists have long shed light on the indignities and injustice of reproductive intrusions, be they coerced gestation or forced interventions during pregnancy and birth. Writing about t...

ABSTRACTThe Norwegian government implemented a comprehensive welfare reform in 2012 to better manage an increasingly care-demanding patient demography while meeting budgetary constraints. This article discusses interdiscursive relationships between policy strategies and language use among rehabilitation professionals. It is based on a synthesis of textual analyses of policy documents and of transcribed interviews to produce complex insights into current rehabilitation discourse. The synthetic product is expressed in the form of two nodal discourses which subsume and articulate in particular ways the constituent (...) discourses of the policies and interviews. One nodal discourse approaches rehabilitation as a clinical practice; the other concerns rehabilitation as a management practice. These discourses serve different purposes. One is based in traditional medical science as a means for political action and relates to the body as an object of government policies and practices. The other relies on the individual... (shrink)

I explore in this essay an ethically grounded method for structuring a program of study. Rather than attempt to delimit a discipline or to reinforce disciplinarity, I suggest a means of creatively narrowing the scope of research, namely by focusing on inner necessity and conscience. The art of rhetoric as self-discipline is an extension of inner necessity and a framework in which scholars may come to integrate the more rational and more artistic, more public and more private elements of their (...) personalities by exploring the influence of symbols on their lives. By conceptualizing the art of rhetoric as a "self-discipline," I affirm the significance of all these elements and suggest that their harmonious blending will enhance the pleasures and utilities of discourse. (shrink)