España es el país europeo donde más carne se consume. El consumo de carne y sus efectos es objeto de discusión en distintos ámbitos por su impacto negativo en el medioambiente así como en la salud humana. Por ello, se persigue concienciar a la sociedad para reconsiderar su consumo. En este estudio se explora la actitud de los jóvenes españoles ante el consumo de carne. Los resultados muestran su preocupación por el impacto negativo de la carne pero subrayan barreras como (...) la falta de información por las cuales no están dispuestos a cambiar de hábito en el consumo de carne. (shrink)

In this paper, we examined how companies are employing new media to engage in dialogue with their stakeholders about corporate social responsibility -related matters. Through a qualitative theory-building study conducted in three stages over a period of 2 years, we discovered that corporations with reputations for CSR have built virtual spaces for dialogue about CSR, but that these spaces remain empty of dialogue. Our theory-building model highlights how the mix of four dialogue processes may allow companies to create open dialogue (...) about CSR initiatives and avoid leaving these spaces empty. Contributions for CSR studies are discussed. (shrink)

El trabajo desarrollado en este artículo muestra una experiencia docente basada en la Metodología Activa del Aprendizaje Basado en Proyectos en la asignatura de Instalaciones II de la titulación del Grado en Arquitectura Técnica de la Universidad de Burgos. Para alcanzar la excelencia del proceso de enseñanza y aprendizaje, se ha diseñado una metodología de trabajo basada en el desarrollo progresivo de un Proyecto de Ejecución mediante subproyectos, con el objetivo de conseguir mejores resultados en el proceso de aprendizaje mediante (...) el desempeño personal, la retroalimentación de procesos y el trabajo cooperativo, todo ello orientado a la excelencia académica y profesional de los estudiantes. Los resultados obtenidos muestran que el ABP es una excelente metodología para el proceso de enseñanza-aprendizaje de la asignatura de Instalaciones II y para el futuro desempeño profesional de los estudiantes. (shrink)

ABSTRACT Empathy is relevant to sociomoral development, especially in relation to prosociality and the penalization of acts as faults and crimes. The objective of this research was to test whether empathy is a predictor of prosociality and of perceptions of seriousness of delinquent acts among research participants in Argentina and Spain. The Argentinian sample comprised 215 high school and university students. The Spanish sample comprised 199 university students. The proposed theoretical model showed good fit in both countries. Although empathy was (...) found to predict prosocial conduct more than the perception of the seriousness acts as offenses and crimes, empathy was a significant of both prosocial conduct and perception of the seriousness acts as faults and crimes. Thus, the importance of empathy in morality was supported for both countries, supporting the influence of in different cultural context. (shrink)

Uno de los componentes más importantes del proceso de enseñanza-aprendizaje de los estudios de Arquitectura Técnica es la realización de un proyecto final que aglutina todos los conocimientos y competencias desarrollados en las diferentes disciplinas que configuran el Plan de Estudios. El objetivo de esta propuesta es visualizar la evolución del proceso de enseñanza y aprendizaje en el Proyecto Fin de Grado en los estudios de Arquitectura Técnica e Ingeniería de Edificación de la Universidad de Burgos, mostrando las diferentes adaptaciones (...) de los contenidos y la tipología elegida para su desarrollo. (shrink)

BackgroundThis study analyzed the difference in psychological distress of the healthcare workers in three different periods of the coronavirus disease 2019 (COVID-19) pandemic in Argentina. Specifically, from the third week of the mandatory quarantine through the two following weeks.MethodsAnalysis of the responses of 1,458 members of the health personnel was done on a questionnaire on healthcare workers concerns regarding the care of patients with coronavirus, indicators of depression, anxiety, intolerance of uncertainty, and coping.ResultsThe psychological indicators that were considered presented differences (...) between the evaluated periods. Perceived concerns about the possibility of infecting loved ones and infecting themselves were greatest in the periods after the onset of the pandemic. In addition, the perception of how the work environment worsened and how lack of sleep interfered with their work was also higher in periods 2 and 3. The same results were found in the indicators of depression, anxiety, and intolerance of uncertainty. Finally, the indicators of high tension and concurrent lack of emotional control, which was greater in the last periods evaluated, were also expressed in the coping strategies (showing emotional lability, only contained by hypercontrol).ConclusionThe differences found in the psychological indicators between the evaluated periods support the need for early psychological care of health personnel which should be a priority of public health and a fundamental fact to increase its immediate effectiveness in the care of infected patients. (shrink)

Blanca Rodríguez López, Nuria Sánchez Madrid and Adriana Zaharijević, 2021, Rethinking Vulnerability and Exclusion. Historical and Critical Essays, Palgrave Macmillan, 232 pp.

Transhumanism is a challenging movement that invites us to rethink what defines humanity, including what we value and regret the most about our existence. Vulnerability is a key concept that require thorough philosophical scrutiny concerning transhumanist proposals. Vulnerability can refer to a universal condition of human life or, rather, to the specific exposure to certain harms due to particular situations. Even if we are all vulnerable in the first sense, there are also different sources and levels of vulnerability depending on (...) concrete social circumstances. Recently, Michael Hauskeller argued about a fundamental incompatibility between transhumanism and vulnerability. He understands vulnerability as an existential category, linked to woundability and mortality. This idea is akin to ontological vulnerability, but it does not notice some important features of social vulnerability. On the other side, transhumanism is a complex and non-homogeneous movement. Here we distinguish between a strong and a weak version of transhumanism. We will propose that the salience of vulnerability is only diminished in the radical one, while a moderate version can reconcile vulnerability with human enhancement. Thus, vulnerability, a concept that has recently gained much importance as an anthropological category in contemporary ethics, is not necessarily at odds with any transhumanist project. (shrink)

This paper is concerned with moral experimentalism, which I describe as the stance according to which moral inquiry is grounded not in objective foundations nor in our subjective inclinations but in our active encounter with things and events and in our communicative interactions with others. The notion of moral inquiry as grounded in objective foundations and that as based on subjective inclinations have traditionally been conceived of not as two independent possibilities but as the two poles of a dramatic Either/Or (...) that has profoundly conditioned, and still does, our perception of and approach to disagreements and conflicts. When the pragmatists, particularly Dewey, advanced the idea of an experimental approach to moral issues, they put it forward as an alternative to these extreme positions and, therefore, as a way out of what they perceived, I think correctly, as a false and pernicious dichotomy. The paper is divided into three parts: In the first section, I set the theoretical foundation of experimentalism as conceived of by the American pragmatists, in particular Peirce and Dewey. In the second part, and drawing mainly on Dewey’s Logic, I explore the procedural implications derived from the application of experimentalism to practice. In the third section, I consider the particularities of the application of experimentalism to the realm of ethics. As I argue, experimentalism is not only a promising approach to moral problems but perhaps the only effective remedy for the increasingly irrational attitudes with which they are today addressed. (shrink)

We analyze conceptual patterns shared by Michael Ende’s novel about time, Momo , and examples of time conceptualization from psychology, sociology, economics, conventional language, and real social practices. We study three major mappings in the materialization of time: time as money in relation with time banking, time units as objects produced by an internal clock, and time as a substance that flows. We show that binary projections between experiential domains are not enough to model the complexity of meaning construction in (...) these widely successful examples. To account for the intricacies of time materialization in context, we use generic integration templates , models for conceptual templates based on Fauconnier and Turner’s Blending Theory. The interplay of such detailed patterns with pragmatic and cultural factors, including diachronic aspects, is crucial to identify the cognitive models at work, and the factors that guide their instantiations as a variety of surface products. The blending model for the spatialized time can be refined and extended to the materialization of time. (shrink)

We analyze conceptual patterns shared by Michael Ende’s novel about time, Momo, and examples of time conceptualization from psychology, sociology, economics, conventional language, and real social practices. We study three major mappings in the materialization of time: time as money in relation with time banking, time units as objects produced by an internal clock, and time as a substance that flows. We show that binary projections between experiential domains are not enough to model the complexity of meaning construction in these (...) widely successful examples. To account for the intricacies of time materialization in context, we use generic integration templates, models for conceptual templates based on Fauconnier and Turner’s Blending Theory. The interplay of such detailed patterns with pragmatic and cultural factors, including diachronic aspects, is crucial to identify the cognitive models at work, and the factors that guide their instantiations as a variety of surface products. The blending model for the spatialized time can be refined and extended to the materialization of time. (shrink)

This study investigates the effects on organization’s financial performances of, first, the extent to which the organizations are involved in controversial business activities, and second, their level of social performance. These companies can be considered non-socially responsible given the harmful nature of the activities they are involved in. Managers of these companies may still have incentives to pursue socially responsible actions if they believe that engaging on those actions will help them to achieve legitimacy and improve investors’ perception about them. (...) We develop a comprehensive methodology to investigate these corporate social performance (CSP)-related effects in a complex but specific setting. To this end, we analyze a sample of 202 US firms for the period 2005–2008 using a novel method in this area: partial least squares. Our results indicate that, contrary to the general findings in prior literature, companies involved in controversial business activities which engage in CSP do not directly reduce the negative perception that stakeholders have about them. Instead, we found evidence of a positive mediation effect of CSP on financial market-based performance through innovation. (shrink)

Este artículo pretende abrir una línea de trabajo en la que confluye el área de la restauración y la didáctica. Se muestra un proceso de restauración basado en la mínima intervención, en cuanto a pérdidas de policromía se refiere, pero se ofrece como una herramienta medio para la enseñanza. El proyecto posibilita que la tabla se exhiba como pieza modelo en una sala del Museo Arte Sacro de Teruel, que el público visualice y conozca el mecanismo técnico de creación de (...) una tabla del siglo XV y que, mediante la recreación virtual y la utilización de imágenes de la misma temática de otras obras de relevancia, se proponga cómo pudo ser la tabla de Olalla en origen. En definitiva, se plantea realizar una prueba piloto que pueda servir para otras obras con circunstancias similares. Palabras clave: pintura gótica, Aragón, siglo XV, restauración y conservación, nuevas tecnologías, educación patrimonial, didáctica de la pintura, musealización.. This project aims to be a new line of work where restoration and didactics fields converge. It shows a process of restoration based on the minimum intervention in terms of loss of polychromy. However, it is offered as a tool for teaching. In this specific case, this table is shown as a model piece through its exhibition in a room at Sacred Art Museum of Teruel. Following this project, it will be possible to visualize and learn the technical mechanism of creation of a 15th century panel reinforced with a virtual recreation using digital media to show how it could have been in origin, as well as using images of the same subject matter of other relevant works. The main focus of this project is to serve as a pilot test for other works with similar circumstances. Key words: gothic painting, Aragon, 15th century, restauration and conservation, new technologies, heritage education, painting education, musealization. (shrink)

En cada época y en cada civilización existen problemas socialmente importantes que son objeto de especial atención. Son hechos que, por su ámbito de extensión o por su gravedad, tienen una gran resonancia. Es lo que en las últimas décadas ocurre con las adicciones, que constituyen uno de los trastornos emblemáticos de nuestra sociedad.

DNA methylation can be considered a component of epigenetic memory with a critical role during embryo development, and which undergoes dramatic reprogramming after fertilization. Though it has been a focus of research for many years, the reprogramming mechanism is still not fully understood. Recent results suggest that absence of maintenance at DNA replication is a major factor, and that there is an unexpected role for TET3-mediated oxidation of 5mC to 5hmC in guarding against de novo methylation. Base-resolution and genome-wide profiling (...) methods are enabling more comprehensive assessments of the extent to which ART might impair DNA methylation reprogramming, and which sequence elements are most vulnerable. Indeed, as we also review here, studies showing the effect of culture media, ovarian stimulation or embryo transfer on the methylation pattern of embryos emphasize the need to face ART-associated defects and search for strategies to mitigate adverse effects on the health of ART-derived children. DNA methylation, critical for embryo development, suffers significant changes after fertilization, including demethylation, remethylation and TET3-mediated oxidation of 5 mC to 5 hmC. In addition to infertility and environmental insults, ART could impact DNA methylation and ART related consequences in the offspring have been reported. (shrink)

The subject of this paper is to deep in the way that Guzmán planned to make effective social participation in an authoritarian context like Pinochet's Chile (1973-1990). We will see how Guzmán considered civil participation as an essential requirement in order to get a modern democracy which would be opened in Chile after the military dictatorship. He supported this idea through the concepts of subsidiarity State and liberal economy policy.

La Asamblea General de las Naciones Unidas aprobó la Declaración Universal de los Derechos Humanos el 10 de diciembre de 1948, su artículo 26 reconocía el derecho a la educación de todas las personas, la gratuidad y obligatoriedad en los niveles elementales. La igualdad de oportunidades en el acceso a los estudios superiores, el derecho de los padres a escoger el tipo de educación de sus hijos y concretaba el objetivo de la misma como el pleno desarrollo de la personalidad (...) humana y el fortalecimiento del respeto a los derechos humanos y a las libertades fundamentales. Esta Declaración fue el punto de partida de la Comisión constitucional del Congreso de los Diputados encargada de elaborar la Constitución de 1978, para desarrollar el artículo sobre el derecho a la educación. (shrink)

Ensayo sobre la contraposición rostro/máscara, donde por 'rostro' se entiende aquello que singulariza a cada ser humano, aquello que hace visible su ser único y valioso, mientras que por 'máscara' se hace alusión a aquello que oculta esa singularidad, aquello que lo remite a una categoría, a un este..

This essay works on the opposition between face and mask, where ‘face’ is understood as that which makes every human being singular, and makes visible her or his unique worth, while ‘mask’ is understood as whatever hides that singularity, and refers to a category, stereotype or cliché. The etymological history that relates face and mask to the concept of person, and the history of modern portrait painting, which alternates representations of face and mask, both lead to a discussion with authors (...) who diagnose a contemporary “defeat of the face” as a result of the crisis of humanism and of ethical individualism, which give meaning and dignity to that face. (shrink)

Para algunos la empatía es “el centro del universo moral”, mientras que para otros juega un papel secundario o, en todo caso, éticamente poco fiable. Acudiendo tanto a sus precursores filosóficos –como Hume y Smith–, como a sus investigadores contemporáneos en el campo de la psicología – como Hoffman y Batson–, este artículo elabora una defensa ponderada del papel de la empatía en la motivación, el desarrollo y el juicio morales, reconociendo sus limitaciones.

Research on salesperson creativity remains as one of the most under-researched topics in the sales literature despite the evidence that encouraging creativity in the sales domain is a source of competitive advantage. This paper aims to fill this research gap by exploring the influence of perceived ethical climate on salesperson creative performance, paying special attention to the role that emotions play in this process. Data provided by 176 supervisor–salesperson dyads confirm that the trust/responsibility dimension of an ethical climate is positively (...) related to salesperson creative selling by increasing salespeople's organizational pride. Similarly, the perception of unethical selling practices negatively affects salesperson organizational pride, reducing the expression of creative behaviors. Moreover, the negative effect of unethical selling practices on creative performance is stronger (more negative) when salespeople's identification with an organization increases. Managerial implications and future research directions are also addressed. (shrink)

En este artículo pretendemos dar cuenta del desenvolvimiento que tuvo la filosofía moderno-contemporánea y el llamado pensamiento postmetafísico, a partir de Edmund Husserl. Alrededor las categorías fenomenológicas de método y de sentido enunciamos un gesto de apertura a la filosofía contemporánea la cual asume distintos matices que pretenden que la actividad filosófica vaya más allá de sí misma.

RESUMENEl tratamiento que el arte más vanguardista ha dado a la relación con lo cotidiano, rompiendo las fronteras entre arte y vida, ha tenido una influencia palpable en nuestros comportamientos actuales a la luz de los medios, especialmente televisión e internet. Hoy, nuestra relación con lo cotidiano en gran medida se teje en el mundo internet, que constituye un espacio de socialización y configuración de la identidad. Los valores presentes en la forma de relacionarnos con lo cotidiano han ido experimentando (...) cambios que hoy se dirían ambivalentes: gesto vital-artístico y parte del dispositivo neoliberal de la transparencia. El recorrido por esta relación, poniendo en un mismo escenario voces de procedencias diversas, nos conduce hasta el planteamiento no exento de controversias de nuestra identidad y nuestra vida como una creación artística.PALABRAS CLAVESOCIALIZACIÓN, MEDIOS, ARTISTAS DE LA VIDA, AUTODETERMINACIÓN, BÚSQUEDA-CONTROLABSTRACTThe way in which the most vanguardist art has approached the relation with everyday life, breaking the barriers between art and life, has had a tangible influence on our current behaviour in lights of Mass Media, especially television and Internet. Nowadays, our relationship with day-to-day life develops, to a great extent, in the Internet world, which constitutes a space for socialization and profiling our identity. The values that accompany the way in which we establish the link with everyday life have been undergoing changes that nowadays could be considered as ambivalent: vital artistic gesture and a part of neoliberal mechanism of transparency. The overview of this relation, including voices from various sources, leads us to a conclusion, not at all devoid of controversies, regarding our identity and our life as an artistic creationKEYWORDSSOCIALIZATION, MEDIA, ARTISTS OF LIFE, SELF-DETERNINATION, A SEARCH-CONTROL. (shrink)

The Turing Machine presents itself as the very landmark and initial design of digital automata present in all modern general-purpose digital computers and whose design on computable numbers implies deeply ontological as well as epistemological foundations for today’s computers. These lines of work attempt to briefly analyze the fundamental epistemological problem that rose in the late 19th and early 20th century whereby “machine cognition” emerges. The epistemological roots addressed in the TM and notably in its “Halting Problem” uncovers the tension (...) between determinism and uncertainty, regarded here as the primal and inherent features of machine cognition. Resumen La Máquina de Turing se presenta como el hito y el diseño inicial de un autómata digital presente en todas las computadoras digitales modernas de propósito general y cuyo diseño en números computables establece bases profundamente ontológicas y epistemológicas para las computadoras de hoy. Estas líneas de trabajo intentan analizar brevemente el problema epistemológico fundamental que surgió a finales del siglo XIX y principios del XX mediante el cual emerge la “cognición de la máquina”. Las raíces epistemológicas que se abordan en la TM y, en particular, en su “Problema de detención” ponen al descubierto la tensión entre el determinismo y la incertidumbre, consideradas aquí, como las características primordiales e inherentes de la cognición de la máquina. (shrink)

El presente artículo estudiará la utilidad de la Carta Europea de Turismo Sostenible de Sierra Nevada como herramienta para promover el turismo sostenible en espacios protegidos. Se pretende mostrar cómo la adopción de la CETS ha supuesto una implicación real de las empresas con el territorio incrementado el sentimiento de pertenencia y el asociacionismo activo, así como a la puesta en marcha de actuaciones colectivas e individuales que contribuyen a mejorar la sostenibilidad ambiental, económica y social en los territorios, a (...) atraer turistas responsables motivados por el ecoturismo y a la mitigación y adaptación del territorio al Cambio Climático. (shrink)

Transparency is a quality of corporate social responsibility communication that enhances the relationship between the investors and the company. The objective of this paper is to analyze if the transparency of the sustainability reports is affected by the relationship of companies in different industries with their stakeholders. If this were the case, it would indicate that the pressure of significant stakeholders determines the required level of transparency of the reports. We find that the pressure of some groups of stakeholders improves (...) the quality of transparency of the reports. We extend previous research by studying the effect of stakeholder group pressure on transparency when reporting sustainability. Our results show that transparency is affected by ownership, along with size and global region. (shrink)

Not only is writing about ethics and politics, but there is an ethics and a policy of language and thought. Writing and style are a philosophical problems that in this text are guided by three questions: why is written, to whom and what kind of philosophy is chosen. They are timely questions both in the academic environment and in the network world, where writing has become a sort of assumption that is rarely questioned. The heart of the article focuses on (...) addressing writing as a matter of desire taking as reference the work of Deleuze and Guattari. (shrink)

La novela ha sido consagrada como una de las “técnicas de experiencia vicaria” fundamentales, que adiestran nuestra habilidad para ponernos en la piel de otras personas. No han sido pocos los que han visto un claro efecto moral en esa permanente exploración de la alteridad. El artículo repasa los argumentos de los entusiastas de esa idea, los que creen que leer novelas nos hace más empáticos y solidarios; de los moderados, quienes consideran que ayuda ante todo a ejercitar nuestro juicio (...) moral, y de los escépticos, que apenas encuentran ningún fin moral en ese hábito. Revisa a continuación algunas complejidades del desarrollo moral, que hacen improbable una fácil conexión, y termina distinguiendo los modos en que la lectura de novelas sí puede contribuir a cultivar la humanidad que hay en nosotros y a ahondar en el humanitarismo. (shrink)

In the digital age, the use of advanced technology is becoming a new paradigm in police work, criminal justice, and the penal system. Algorithms promise to predict delinquent behaviour, identify potentially dangerous persons, and support crime investigation. Algorithm-based applications are often deployed in this context, laying the groundwork for a ‘smart criminal justice’. In this qualitative study based on 32 interviews with criminal justice and police officials, we explore the reasons why and extent to which such a smart criminal justice (...) system has already been established in Switzerland, and the benefits perceived by users. Drawing upon this research, we address the spread, application, technical background, institutional implementation, and psychological aspects of the use of algorithms in the criminal justice system. We find that the Swiss criminal justice system is already significantly shaped by algorithms, a change motivated by political expectations and demands for efficiency. Until now, algorithms have only been used at a low level of automation and technical complexity and the levels of benefit perceived vary. This study also identifies the need for critical evaluation and research-based optimization of the implementation of advanced technology. Societal implications, as well as the legal foundations of the use of algorithms, are often insufficiently taken into account. By discussing the main challenges to and issues with algorithm use in this field, this work lays the foundation for further research and debate regarding how to guarantee that ‘smart’ criminal justice is actually carried out smartly. (shrink)

El feedback correctivo escrito ha demostrado ser efectivo para el tratamiento de ciertas estructuras gramaticales ; sin embargo, persisten factores que dificultan realizar conclusiones categóricas al respecto. Algunos de estos corresponden al tipo de las formas que se benefician de un tratamiento como este, a los distintos contextos de aprendizaje investigados, a los diversos niveles de competencia lingüística de los participantes, entre otros. La presente investigación estudia dos estrategias de FCE indirecto; a saber, indirecto con indicación y localización e indirecto (...) con indicación, localización y explicación metalingüística, en el tratamiento de la forma comparativa de adjetivos en inglés a nivel escolar. Los objetivos son examinar la efectividad del FCE y robustecer la evidencia empírica en contextos de aprendizaje que han sido insuficientemente indagados. Este primer acercamiento constituye una aproximación inédita que contribuye al fortalecimiento y al aumento de la evidencia empírica existente en el ámbito del FCE. La muestra del estudio correspondió a 24 estudiantes de 8° año de enseñanza primaria con un nivel básico de competencia lingüística en el idioma inglés como lengua extranjera. Los resultados muestran que ambos tipos de feeback promueven el uso preciso de la forma estudiada pero el FCE indirecto con indicación y localización del error es el que consigue mayores logros que se mantienen en el tiempo. Estos antecedentes sugieren una acción facilitadora del FCE en el tratamiento de la forma gramatical apuntada. (shrink)

The first issue this essay examines is the articulation of the cinema of the body, the feminine gestus, and the ‘political cinema’, which begins with the philosophical shout, ‘Give me a body, then!’ and ends with the ‘Third World Cinema’ as a cinema of memory. How is this Deleuzian concept in tension with the one proposed here of ‘missing body’? The second issue concerns the importance of the body for theory and practice within feminist film theory and queer theory. The (...) question of the body is introduced in-between these two lines in the context of a series of Latin American documentaries. The final problem is then how to see and show a body that is missing, like an outside of the body image, and of a certain regime of the visible and the audible that tends to be fixed in topics by the production of technologies of memory. (shrink)

Background and objectives: Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few. Patients were allowed to discuss their concerns about end-of-life care, so that their ideas about treatment futility or utility could be extrapolated by us.Methods: In this cross-sectional study, in-depth, semistructured interviews were conducted with 30 elderly people who were receiving outpatient care in a large, (...) urban Veterans Affairs medical centre in the US. Each of their healthcare providers was also interviewed. Participants were asked to consider four terms commonly used in advance directive forms and to discuss what these terms meant to them. Audiotapes of the open-ended interviews were transcribed and responses were coded and categorised by constant comparison, a commonly used qualitative method.Results: The following four factors were taken into account by the participants when discussing end-of-life interventions and outcomes: expected quality of life; emotional and financial costs of treatment; likelihood of treatment success; and expected effect on longevity.Conclusions: Although the terms “utility” or “futility” were not generally used by the participants, segments of speech indicating their perceptions of these terms were identified. Treatment was not always discussed in the same way by patients and providers, but seemed to reflect the same four concerns. Therefore, it may be fruitful for providers to focus on these concerns when discussing end-of-life treatment options with their patients. (shrink)