Volume 19, Issue 10, October 2019, Page 68-70.

In this paper, we consider ethical issues related to the treatment of posttraumatic stress disorder (PTSD) in combat zones, via exposure therapy. Exposure-oriented interventions are the most well-researched behavioral treatments for PTSD, and rigorous studies across contexts, populations, and research groups provide robust evidence that exposure therapy for PTSD is effective and can be widely disseminated. Clinical procedures for Prolonged Exposure therapy, a manualized exposure-oriented protocol for PTSD, are reviewed, and we illustrate the potential benefits, as well as the potential (...) difficulties, associated with providing this treatment in combat zones. Several ethical considerations are identified: (1) Assuming successful treatment, is it ethical to send individuals with a known risk of developing PTSD back into combat? (2) If treatment is unsuccessful in theater (perhaps due to the confounding factor of ongoing danger), could that impact treatment effectiveness for soldiers who attempt therapy again post-deployment? (3) If the military finds combat-zone treatment effective and useful in maintaining an efficient work force, will treatment become mandatory for those diagnosed with PTSD? (4) What unintended consequences might be associated with large-scale dissemination of exposure therapy in or near combat, outside of mental health care infrastructures? (5) How would genetic variations known to be associated with PTSD risk influence decisions regarding who receives treatment or returns to combat? We conclude with a review of the personal and societal costs associated with not providing evidence-based PTSD treatments wherever possible. (shrink)

Treatment of military-related posttraumatic stress disorder is a major public health care concern. Since 2001 over 2.5 million troops have been deployed to Iraq or Afghanistan, many of whom have experienced direct combat and sustained threat. Estimates of PTSD rates related to these wars range from 8% to over 20%, or 192,000 to 480,000 individuals. Already, nearly 250,000 service members of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have sought VA health care services for PTSD. This recent increased need (...) for mental health services comes in addition to the ongoing needs of Vietnam-era and other veterans who continue to suffer from PTSD. PTSD is related to high co-morbidities of other mental health difficulties, poorer physical health status, and increased medical care utilization. Such high demand for services is an important contributor to the large cost associated with combat-related PTSD. Accordingly, promoting successful, cost-effective treatment strategies for PTSD is a chief public health care priority. (shrink)

The medical drama and its central character, the doctor-hero have been a mainstay of popular television. House M.D. offers a new (and problematic) iteration of the doctor-hero. House eschews the generic conventions of the “television doctor” by being neither the idealized television doctor of the past, nor the more recent competent but often fallible physicians in entertainment texts. Instead, his character is a fragmented text which privileges the biomedical over the personal or emotional with the ultimate goal of scientifically uncovering (...) and resolving instances of disease. This article examines the implicit and explicit messages in House M.D. and critically analyzes both the show and its lead character in relation to the traditional medical drama genre that highlights the “doctor-hero” as the central character. While at first House seems to completely violate narrative and generic norms, ultimately the program provides a new form that reinforces the presence of the doctor-hero, but highlights House’s character as the central figure who is personally and interpersonally problematic but biomedically effective. (shrink)

Affective variables have been shown to impact working memory and cognitive control. Theoretical arguments suggest that the functional impact of emotion on cognition might be mediated through shifting action dispositions related to changes in motivational orientation. The current study examined the effects of positive and negative affect on performance via direct manipulation of motivational state in tasks with high demands on cognitive control. Experiment 1 examined the effects of monetary reward on task-switching performance, while Experiment 2 examined the effects of (...) both rewards and punishments on working memory, using primary (liquid) reinforcers. In both experiments, dissociable trial-by-trial and contextual (block-related) enhancements of cognitive control during task performance were observed in relationship to motivational incentive value. Performance enhancements were equivalent in the reward and punishment conditions, but were differentially impacted by individual difference measures of trait reward and punishment sensitivity. Together, the results suggest both common and specific mechanisms by which approach and avoidance motivational states influence cognitive control, via activation of reward and punishment processing systems. (shrink)

Clinical ethics consultants face a wide range of ethical dilemmas that require broad knowledge and skills. Although there is considerable overlap with the approach to adult consultation, ethics consultants must be aware of differences when they work with infant, pediatric, and adolescent cases. This article addresses unique considerations in the pediatric setting, reviews foundational theories on parental authority, suggests practical approaches to pediatric consultation, and outlines current available resources for clinical ethics consultants who wish to deepen their skills in this (...) area. (shrink)

Background In February, 2015, the Supreme Court of Canada struck down the ban on medical assistance in dying. In June, 2016, the federal government passed Bill C-14, permitting MAiD. Current medical students will be the first physician cohort to enter a system permissive of MAiD, and may help to ensure equitable access to care. This study assessed medical student views on MAiD, factors influencing these views, and opportunities for medical education. Methods An exploratory cross-sectional survey was developed and distributed to (...) medical students across all years of a three-year Canadian undergraduate medical program. The investigators administered the survey to participants during academic sessions from November to December, 2015. Analysis of the results included summary descriptive statistics, Pearson’s chi-square test of independence to identify differences between participants by year of study, logistic regression to identify factors that influence students’ stances on MAiD, and Wilcoxon signed rank test to measure changes in student support for MAiD and comfort discussing MAiD. Results There were 405 participants for a response rate of 87%. The majority of students supported the Supreme Court’s decision, 61% would provide the means for a patient to end their life, and 38% would personally administer a lethal medication. Students who were more willing to provide the means for MAiD found medical education/clinical experience and patient autonomy to be important contributors to their stances on MAiD. Those students who were less willing to provide the means for MAiD found religious/spiritual beliefs and teachings, as well as concern about potential negative consequences, to be important contributors to their stances on MAiD. Educational training desired by participants included medicolegal, communication skills, technical skills, and religious. Conclusions Medical students generally supported and would provide the means for MAiD to patients. They also indicated a desire for directed medical education on MAiD. (shrink)

The tropical lowlands of southern Mexico and Central America are composed of a complex mosaic of landscapes that presented a variety of possibilities and challenges to the subsistence practices of the ancient Maya. The Yalahau Regional Human Ecology Project has been investigating ancient Maya agricultural practices and use of resources in a unique fresh-water wetland zone located in the northeast corner of the Yucatán Peninsula. While containing only a sparse population today, the Yalahau region once supported numerous Maya communities and (...) civic-ceremonial centers, particularly during the Late Preclassic and Early Classic periods, between approximately 100 B.C. and A.D. 450. Our investigations have developed evidence that the ancient Maya manipulated and cultivated the wetland landscape of the region, used soil or algae from the wetlands to enrich upland garden plots, and cultivated trees within their communities. We suggest that the study of ancient Maya agricultural practices can contribute to sustainable development of the area today and in the future. (shrink)

Few studies have examined how trait emotion dysregulation relates to momentary affective experiences and the emotion regulation strategies people use in daily life. In the current study, 112 c...

Singing and praying in the words of biblical men and women is basic to sacramental mimesis, i.e., Christian imitation of the actions of the saints with the intention of thereby opening themselves to grace. This evidence counters the “voiceless victim” paradigm prevalent in much feminist scholarship. In pre-Christian Jewish liturgy, the song of Miriam after the Crossing of the Red Sea was already important in the annual celebration of the Passover. Jesus emphasized the spiritual equality of the sexes in his (...) teaching and ministry, and this led to increased visibility for women in Christian tradition: Susanna was the first of at least eight women interpreted as types of Christ. She was presented this way even within the synoptic Gospels themselves [see “Aneboesen phone megale: Susanna and the Synoptic Passion Narratives,” forthcoming in Gregorianium]. Moreover, the practice of presenting examples from both sexes in sermons and church decoration was so pervasive as to constitute a pastoral program of the Church. Such balanced representation of the sexes is found in both texts and art. The linguistic range of the evidence for the singing of women’s words includes Greek, Latin, Coptic, Syriac, Slavonic, and German. The artworks depicting women are from throughout the Christian world, including Dura Europos, Jerusalem, Egypt, Ethiopia, Cyprus, Syria, Armenia, Italy, France, Belgium, Germany. More than twenty biblical women are treated in the essay. Women’s words, quoted from the biblical record or imaginatively supplied, became the prayer of the whole congregation. Miriam’s words remain focal universally on Holy Saturday. The acclamations of Elizabeth and of the Virgin Mary became prominent early in both East and West . Both Byzantine and Gregorian chant commemorated them and other women such as Eve, Esther, Judith, Sarah , Susanna, Martha of Bethany, the Samaritan woman, the Canaanite woman, the woman with the ointment, the Samaritan woman, the ten virgins of the parable , and especially the Holy Women at the Tomb . Their proclamation of the Lord’s rising became particularly important in Byzantine resurrection hymns used at Easter and year-round. With four other first-century female saints– Junia, Mariamne, Photina and Thecla– Mary Magdalene was deemed ἰσαπόστολος “equal to the apostles,” because the angel commissioned her to announce the Lord’s Resurrection to the disciples. Martha’s profession of faith is the fullest recorded in the Gospels and became the basis for a Byzantine communion prayer . Repeatedly, one finds that women’s words were sung at important Sunday feasts and during Holy Week. In Gregorian chant their words were sung over the course of several days. Susanna’s words are readily found in fifty Gregorian chant manuscripts from the ninth through fifteenth centuries, used in cathedrals, in monasteries and other religious houses, and in parish churches; an appendix lists these manuscripts. Throughout the continent–in Italy, Austria, Slovenia, Germany, Switzerland, France, The Netherlands, England, Wales–the varied communities of the church sang Susanna’s words. Moreover, her words as mediated through Gregorian chant were quoted by Bernard of Clairvaux in a sermon and by Hermann of Scheda in his account of his conversion from Judaism. These men used Susanna’s words to evoke her as a type of Christ and thereby to seek to be like him themselves. That is, they experienced sacramental mimesis through singing women’s words. (shrink)

Participants recruited for high levels of imaginative absorption were administered a questionnaire based on Calkins' original study that first established a wide continuum of childhood synaesthesias and synaesthetic associations, along with separate questionnaires assessing childhood imaginary companions, positive altered states of consciousness and negative states of nightmares and night terrors. Their inter-relation and relation to measures of adult imaginative absorption helps to establish these states as aspects of an underlying imagistic dimension, while their relative differentiation is explored through different (...) forms of adult absorption, early stressors from childhood, and degree of parental support for creative activities. The connection of this wider continuum of adult recalled childhood synasesthesias, imaginary companions, and altered states of consciousness to adult imaginative absorption is consistent with recent neuro-imaging synaesthetic research supporting its relation to symbolic cognition, metaphor, and creativity. (shrink)

We consider various quotients of the C*-algebra of bounded operators on a nonseparable Hilbert space, and prove in some cases that, assuming some restriction of the Generalized Continuum Hypothesis, there are many outer automorphisms.

In lieu of an abstract, here is a brief excerpt of the content:An Unconscious Dimension of Thinking, Situations, and La Vida:Reflections on Bethany Henning's Dewey and the Aesthetic UnconsciousGregory Pappasthis book is doing different related and valuable things. First, Bethany Henning explores a neglected dimension of Dewey's thought. In particular, the book inquires into the dimension of the unconscious and tries to develop what she considers an "implicit" "theory of the unconsciousness" or of the "aesthetic unconscious" in Dewey's (...) philosophy. Then, based on all of the above, it provides a diagnosis and possible solution to a problem with philosophers and with American culture.The neglected dimension of Dewey's thought that Henning explores highlights the ways in which Dewey foresaw what feminist thinkers have said, and recent scientific accounts of human life and thinking are confirming: What we "feel" (what is "qualitative," "ineffable," and "noncognitive") is key to how to think and how to live (guidance and meaning). It has therefore been puzzling to me (along with John McDermott, Tom Alexander, Mark Johnson, and a few others) why even Dewey scholarship has to a large extent neglected exploring this aspect of his thought. Frustrated with Bertrand Russell, Dewey says that "Mr. Russell has not been able to follow the distinction I make between the immediately had material of non-cognitively experienced situations and the material of cognition—a distinction without which my view cannot be understood" (LW 14:33; emphasis added).More importantly, by neglecting this insight and these aspects of his thought, we have failed to utilize one of the most important resources to diagnose sociopolitical-moral problems today! This is what I have been trying to do in recent years, and I see Dr. Henning as trying to do the same. She is not just providing a theory of the unconscious for the sake of speculation, but she does so with instrumental intent, in the hope that it will help us better approach a concrete social-cultural problem we suffer in our society, a topic to which I will return. [End Page 84]My reading of Dewey and the Aesthetic Unconscious has provoked a few questions:(a). Is there, in Dewey, a conception of aesthetic and religious experience that can be understood as an "implicit theory of the unconscious"?(b). Even if there is one, do we need one? For what purpose?(c). What would we miss if we were to say what needs to be said and explored by Henning by using different terms/concepts and avoiding the possible misunderstanding and dangers of making reference to "the unconscious"?(d). Would Henning agree that the problematic aversion or repression in American culture that concerns us is more than that of the unconscious, the qualitative, body, and nature that form the focus of her book?(e). Henning agrees that we need more than art and "deep" psychology to ameliorate the problems that concern us. What is this "more"? How?In regard to (b), I can think of one good purpose, which Henning develops in Dewey and the Aesthetic Unconscious: to engage in a dialogue with psychoanalysis and contemporary philosophies that draw from psychoanalysis and feminism (e.g., Kristeva) or, in general, other academics concerned with the same problems. I also wondered as I was reading the book why Henning does not put Carl Jung in dialogue with Dewey as well, just as a matter of curiosity. But I wonder, if we need to develop a "theory of the unconsciousness" or of the "aesthetic unconsciousness" to both make a contribution to the "depth" of lived experience (La Vida) and also deal with the social-cultural problems that concern us.There are dangers with talking about or making reference to "the" unconsciousness or "the" aesthetic unconsciousness and theorizing about them. The problem is that it comes across as a noun, and not as way of participating in La Vida or nature, that is continuous in a significant way with what is more conscious and more cognitive: we are at any time more or less conscious. But Henning seems aware of all of this. She is careful enough to make clear that she is acknowledging continuity, but I confess to "feeling" uncomfortable sometimes with her reference to that... (shrink)

Environmental problems often outstrip the abilities of any single scientist to understand, much less address them. As a result, collaborations within, across, and beyond the environmental sciences are an increasingly important part of the environmental science landscape. Here, we explore an insufficiently recognized and particularly challenging barrier to collaborative environmental science: value pluralism, the presence of non-trivial differences in the values that collaborators bring to bear on project decisions. We argue that resolving the obstacles posed by value pluralism to collaborative (...) environmental science requires detecting and coordinating the underlying problematic value differences. We identify five ways that a team might coordinate their problematic value differences and argue that, whichever mode is adopted, it ought to be governed by participatory virtues, pragmatic resolve, and moral concern. Relying on our experiences with the Toolbox Dialogue Initiative, as well as with other dialogical approaches that support team inquiry, we defend the claim that philosophical dialogue among collaborators can go a long way towards helping teams of environmental scientists and fellow travelers detect their problematic value differences. Where dialogical approaches fare less well is in helping teams coordinate these differences. We close by describing several principles for augmenting philosophical dialogue with other methods, and we list several of these methods in an appendix with brief descriptions and links for further learning. Overall, the article makes three main contributions to the research collaboration and values in science literatures: It deepens our understanding of problematic value pluralism in team science; It provides actionable guidance and methods for improving values-oriented philosophical dialogue interventions; and It demonstrates one way of doing engaged philosophy. (shrink)

A request that an ethics committee or consultant analyze the ethical issues in a case, delineate ethical options, or make a recommendation need not automatically but often does elicit legal information. In a recent book in which ethics consultants described cases on which they had worked, almost all cited a legal case or statute that had shaped the consultation process. During a period of just a few months, case consultation done under the auspices of one university hospital ethics committee involved (...) interpretation of statutes on living wills, durable powers of attorney, competency, confidentiality, guardianship, AIDS testing, and disability. At another hospital, 30% of ethics consultations were thought to involve legal issues. Attorneys at a third hospital estimated that virtually every case involves legal issues. The notion that ethics consultation is an “amalgam” of medicine, ethics, interpersonal skills, and law is gaining currency. Ethics consultation has become a channel through which law enters the clinical setting. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Research teams have made considerable progress in treating absolute uterine factor infertility through uterus transplantation, though studies have differed on the choice of either deceased or living donors. While researchers continue to analyze the medical feasibility of both approaches, little attention has been paid to the ethics of using deceased versus living donors as well as the protections that must be in place for each. Both types of uterus donation also pose unique regulatory challenges, including how to allocate donated organs; (...) whether the donor / donor's family has any rights to the uterus and resulting child; how to manage contact between the donor / donor's family, recipient, and resulting child; and how to track outcomes moving forward. (shrink)

Human connection is universally important, particularly in the context of serious illness and at the end of life. The presence of close family and friends has many benefits when death is close. Hospital visitation restrictions during the Coronavirus pandemic therefore warrant careful consideration to ensure equity, proportionality, and the minimization of harm. The Australian and New Zealand Society for Palliative Medicine COVID-19 Special Interest Group utilized the relevant ethical and public health principles, together with the existing disease outbreak literature and (...) evolving COVID-19 knowledge, to generate a practical framework of visiting restrictions for inpatients receiving palliative and end-of-life care. Expert advice from an Infectious Diseases physician ensured relevance to community transmission dynamics. Three graded levels of visitor restrictions for inpatient settings are proposed, defining an appropriate level of minimum access. These depend upon the level of community transmission of COVID-19, the demand on health services, the potential COVID-19 status of the patient and visitors, and the imminence of the patient’s death. This framework represents a cohesive, considered, proportionate, and ethically robust approach to improve equity and consistency for inpatients receiving palliative care during the COVID-19 pandemic and may serve as a template for future disease outbreaks. (shrink)

Do cultural models facilitate particular ways of perceiving interactions in nature? We explore variability in folkecological principles of reasoning about interspecies interactions. In two studies, Indigenous Panamanian Ngöbe and U.S. participants interpreted an illustrated, wordless nonfiction book about the hunting relationship between a coyote and badger. Across both studies, the majority of Ngöbe interpreted the hunting relationship as cooperative and the majority of U.S. participants as competitive. Study 2 showed that this pattern may reflect different beliefs about, and perhaps different (...) awareness of, plausible interspecies interactions. Further probes suggest that these models of ecological interaction correlate with recognition of social agency in nonhuman animals. We interpret our results in terms of cultural models of nature and nonhuman agency. (shrink)

1. Conceptions of the nature of value are of two main types: they are either objective, or realistic, or else subjective, that is, psychological. The immediately following pages are devoted to the critical consideration of the first of these, the realistic conception of value as “an indefinable quality which attaches to things independently of consciousness.” According to this view, things have value as they have form or colour or volume. A rose, for example, has the qualities of redness, of fragrance, (...) and also of beauty; a book has the qualities of rectangularity, of twelve-ounce weight, and also of truth; a negro has the qualities of erectness, of brownness, and also of moral goodness or badness. Beauty, truth, and moral goodness, grouped together as ‘values,’ or ‘worths,’ or ‘goods,’ are from this point of view as indefinable and ‘absolute’ as the primary and secondary qualities: indeed, they are together known as “tertiary qualities.’ In G. E. Moore's words, a value or “ ‘good’ is a simple notion, just as ‘yellow’ is a simple notion”; and “just as you cannot, by any manner of means, explain to anyone who does not already know it what yellow is, so you cannot explain what good is.”. (shrink)

ABSTRACTThis study aimed to investigate the emotional impact of sarcasm. Previous research in this area has mainly required participants to answer questions based on written materials, and results have been mixed. With the aim of instead examining the emotional impact of sarcasm when used in a more conversational setting, the current study utilized animated video clips as stimuli. In each clip, one individual answered general knowledge questions while the other provided feedback that could be delivered either literally or sarcastically, and (...) either complimented or criticized the question answerer’s performance. Participants rated the feedback based on the anticipated emotional impact on the recipient, how the speaker intended the recipient to feel, and whether the speaker intended to be humorous. Results overall supported the Tinge Hypothesis, showing that sarcastic criticism was rated as less negative than literal criticism, and sarcastic compliments were rated as... (shrink)

This paper examines the drive for consensus from the perspective of the good government framework for federal advisory commissions in the United States. Specifically, the paper examines the Federal Advisory Committee Act (FACA) – the statute, its regulations, and case law. It shows that the FACA was intended to be an antidote to abuses in consensus‐making processes, including the failure to fully include competing views on commissions. The index of suspicion in the FACA scheme rises when a group work product (...) – including a consensus report – is to be the basis of recommendations to federal officials. Once FACA's requirements regarding committee composition are satisfied, the index of suspicion drops and FACA is indifferent to consensus‐making; but the conditions for informed, meaningful participation apply to members who dissent from, as well as those who participate in, consensus. In negotiated rulemaking, the push for consensus and closure creates unacceptable tension with the good government goals of openness and accountability. Proponents of consensus‐only bioethics commissions can learn from FACA‐related legislative, agency, and judicial insights that consensus‐seeking is not always desired by government officials; is rarely cost free; and that diversity and dissent enhance openness, accountability, and fairness. The burden of proof is therefore on proponents of a consensus‐only standard for bioethics commissions to demonstrate that a drive for consensus furthers sound decision‐making by government officials more than it sets back openness and accountability to a diverse public. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reply to CriticsBethany Henningplato knew that philosophy is not something we write; it is something we live. As Deweyans, we know philosophy is an ideal that emerges within experience as the highest possibility for dialogue. Insofar as a book appears as an extended monologue, it obscures the qualitative and transactive dimensions of philosophy as it is practiced. But sessions like these reveal that books are moments in a conversation, (...) "perchings" in a dialogue that is forever in media res. I am deeply grateful to Bill Myers for organizing this panel, and for the generosity of Frank Ryan, Gregory Pappas, and Jim Garrison for having taken the time to read and think about this book. Each of them has served as a model for philosophical scholarship, and I am humbled and honored to have the opportunity to engage with them directly. They have challenged me in three distinct ways and have engaged with what I have written on separate plateaus of thought, at times revealing layers of which I was not fully aware. So I will do my best to respond to their concerns and develop our shared inquiry in their light. I will also own that my reading of Dewey is selective, and it is my attempt to work through a problem that materialized, as all problems do, in the course of ordinary lived experience.At Southern Illinois University Carbondale, where I attended graduate school, we offered a course called "The American Mind." The title was a provocation, so I applied to teach it one semester. It was a fantastic challenge to try to curate a selection of texts that would serve as an encounter with an intellectual tradition that eludes me as much as it informs me—after all, prior to college, I only knew that a "philosopher" is what becomes of the loser in the board game called Life. I did not know that there was something called "American philosophy" until I applied to study at SIUC.If philosophy is the way that a culture reflects upon itself, then in this book, I have tried to invite the American mind to lie down on the couch. [End Page 95] Or, it might be more accurate to say that I have asked John Dewey, as the representative of American philosophy, how he might psychoanalyze such a mind. My hypothesis is that Dewey's theory of aesthetic experience, and the art that communicates and preserves such moments of intensified vitality, touches the deepest, but unspoken meanings that human beings encounter. This is where quality, the character of an event as a singular whole, the immediate aspect of an event that we feel rather than know, can be stabilized and communicated. If an interpretation can be made of the deep conflicts that have left philosophy at the margins of American life, I believe we would be wise to begin with our "dreams," with the creations of our imagination, the artistic products that reveal the felt dimension of our shared world.Many readers of Dewey choose to focus on his theory of inquiry, his recasting of the scientific method, and his instrumentalism as forming the core of his thought. This is an understandable approach; his work here is novel and corrects bad intellectual habits. However, for the purposes of this book, I have emphasized aesthetic experience, the role of the qualitative, and pursuit of meaning over the correction of practice in my interpretation. This is a controversial choice since it courts the irrational and the vague, but I believe that our neglect of these portions of experience prevents philosophy from reconnecting with American life.Response to Frank RyanFrank Ryan is concerned about the extent to which I have cast the organism as porous, and that I have identified aesthetic experience as unconscious. I agree with Dr. Ryan's assessment that defining aesthetic experience as wholly unconscious would be a grievous error—and I hope not to have made it. There is a misleading ambiguity in the title of the book that might predispose the reader to suspect that I am claiming an equivalence, but what I intended to argue was not that aesthetic experience itself is unconscious, but rather... (shrink)

Recent ethics literature suggests that issues involved in non-heart-beating organ procurement are both highly charged and rather urgent. Some fear that NHB is a public relations disaster waiting to happen or that it will create a backlash against organ donation. The purpose of the study described below was to assess ethics committees' current level of involvement in and readiness for addressing the difficult issues that NHB organ retrieval raises—either proactively through policy development or concurrently through ethics consultation.

Max Weber, the grandfather of organizational theory, recognized the close association between health care organizations and law. When he introduced the concept of a legallaw-saturated,rational bureaucracies, healthcare organizations have highly formalized rules and procedures. They pay a great deal of attention to legal criteria in decisionmaking, and some have entire departments devoted to legal risk management.

Volume 20, Issue 4, May 2020, Page 59-61.

Introduction to a collection of articles originally presented at a February 2001 conference hosted by the Markkula Center for Applied Ethics, Santa Clara University.

Extending literature on health information to entertainment television, we analyze the prostate cancer narrative presented in the police drama, NYPD Blue. We explain how the physician-patient interaction depicted on the show followed (and sometimes did not follow) the medical dialogue model. Findings reveal that the producers of this show advocate a more dialogic model of medical interaction. Portrayals of incompetent, ineffective physicians are contrasted with the superior, effective efforts of other physicians. The audience learns that a non-dialogic approach characterizes “bad (...) doctors,” while the dialogic method typifies “good doctors.” Likewise, medical professionals can use such texts to enhance physician-patient interaction. (shrink)

We used attractiveness judgements as a proxy to visualize the ideal female and male body for male and female participants and investigated how individual differences in the internalization of cultural ideals influence these representations. In the first of two studies, male and female participants judged the attractiveness of 242 male and female computer-generated bodies which varied independently in muscle and adipose. This allowed us to map changes in attractiveness across the complete body composition space, revealing single peaks for the attractiveness (...) of both men and women. In the second study, we asked our participants to choose the most attractive male and female bodies in a method of adjustment task in which they could independently vary muscle and adipose to create the most attractive body. We asked whether individual differences in internalization of cultural ideals, drive for muscularity, eating disorder symptomatology and depressive symptoms could systematically shift the location of peak attractiveness in body composition space. We found a clear preference by both genders for a male body with high muscle and low adipose, and a toned, low adipose female body. The degree of internalization of cultural ideals predicted large individual differences in the composition of the most attractive bodies. (shrink)

The dubious relation of “subjective” experience to “objective” reality finds its correlate in the opposition we often suppose between culture and nature. Twentieth century theorists, most notably Freud, have claimed various methods for interpreting the illusions of one realm that hide the truths of the other. Ricœur has famously called the psychoanalytic method of dream interpretation a “hermeneutics of suspicion,” which he sees as a threat to the “mytho-poetic core of imagination.” John Dewey regarded the binary opposition between culture/nature as (...) particularly dubious, preferring to see them as reciprocal phases of a continuous process; if cultural life is an interpretation of the biophysical environment, that environment surely has its say. However, in the century since Freud, the tactics of suspicion have proven themselves to be indispensable for developing of critiques that reveal the subtle operations of anti-democratic ideologies, perhaps at the expense of democratic faith. This paper considers if there are less suspicious, more Deweyan possibilities for the interpreting and sharing of dreams, not for the benefit of the psychic health of the individual dreamer, but for the sake of a recovery of democratic life. (shrink)

In response to the Covid‐19 pandemic, health care systems worldwide canceled or delayed elective surgeries, outpatient procedures, and clinic appointments. Although such measures may have been necessary to preserve medical resources and to prevent potential exposures early in the pandemic, moving forward, the indirect effects of such an extensive medical shutdown must not outweigh the direct harms of Covid‐19. In this essay, we argue for the reopening of evidence‐based health care with assurance provided to patients about the safety and necessity (...) of high‐value vaccinations, screenings, therapeutics, and procedures. To ensure that virtually all non‐Covid‐related services do not come to a halt again, health care systems and physician practices must preemptively increase their capacity, secure adequate personal protective equipment to safeguard health care personnel, and develop a measured approach to reclosing such routine health care, should it become necessary in the future. (shrink)