A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) community engagement. Despite the importance of research to improve emergency (...) care in low-income and middle-income countries (LMICs) and the widely acknowledged ethical challenges, very little has been written on the ethics of emergency care research in LMICs. This paper examines the ethical and regulatory challenges to conducting emergency care research with human participants in LMICs. We outline key challenges, present potential solutions or frameworks for addressing these challenges, and identify gaps. Despite the ethical and regulatory challenges, conducting high-quality, ethical emergency care research in LMICs is possible and it is essential for global health. (shrink)

Literature on racism, anti‐racism, whiteness, nursing education and nurse educators was reviewed and analysed for the development of race consciousness and application of anti‐racist pedagogy. The literature describes an oppressive educational climate for non‐white identifying people, a curriculum that does not attend to the social construction of difference, and a nursing culture that is not consciously situated in a broader sociopolitical context. A particular focus on studies of nurse educators demonstrates a stark need for personal and professional development towards effectively (...) delivering anti‐racist pedagogy and a deconstruction of white normativity and dominance amongst white faculty. The protection and reproduction of white privilege is identified through the scholarship itself through a lack of racial analysis, an externalization of the root of oppression and non‐specific study measures and outcomes. The persistence and pervasiveness of white dominance in nursing and the lack of anti‐racist competence in white educators, particularly, merits a shift in anti‐racist efforts away from short‐term skill acquisition initiatives towards the deconstruction of socialized white supremacy and enactments of white privilege in nurse educators themselves. (shrink)

Healthcare environments continue to prove discriminatory and marginalizing towards patients and healthcare workers themselves, which contributes to inequitable health outcomes across lines of socially constructed difference. This content and discourse analysis of nursing identity scholarship asks whether there is a connection between nursing identity and oppressive behaviour by examining the construction of nursing identity and the foundational discourses, sometimes in absentia, that support such a construction. Bourdieu's concepts of social fields and Audre Lorde's concept of the master's house are applied (...) as a framework towards understanding the constructs of power and status in healthcare. The analysis identifies a gap in nursing identity literature where social constructs of difference are not considered. In the reviewed literature, nursing identity has been co‐opted by the professionalization project in effort to stabilize a conceptualization of nursing's contribution to healthcare towards gaining professional and societal status. This leads to a monolithic, apolitical representation of nursing identity that erases difference, denies historical influence, universalizes nursing work and further marginalizes marginalized identities. The oppressive and hegemonic nature of a universal nursing identity may contribute to a lack of disciplinary reflexivity about the ongoing influences of foundational discursive constructs of gender, epistemology, power and professional status. (shrink)

In this essay on epistemological development in college students, I argue that “subjectivism” (a.k.a. “multiplism;” often identified in female undergraduates) should be understood and treated not as amanifestation of a primitive, irrational notion of knowing that must be exterminated and replaced by the more impersonal, detached, objective procedures embodied in scientific method and critical thinking. Rather, it should be regarded as a point of departure for moving into more reflective modes of thought when approached via, and encouraged into, the more (...) personal, empathic procedure made known in Women’s Ways of Knowing as “connected knowing.” Along the way, I develop further the difference between “connected knowing” and “separate knowing” (the latter being the dominant academic paradigm of knowing), bringing out how connected knowing is an important and at times indispensable complement to separate knowing in achieving an objectivity integrated with subjectivity. (shrink)

This essay is a short response to comments made by Cannon, Meeks, and Yu to my articles “Beyond Subjectivism,” published in this special edition of Tradition and Discovery (34:1), and “Connected andSeparate Knowing: A Marriage of Two Minds,” published in Knowledge, Difference, and Power, edited by Nancy Goldberger, et al., focusing on convergences between my work and the ideas of Michael Polanyi.

In the present essay, I explore some ways in which Polanyi’s concepts can be applied to enrich our understanding of epistemological development and the educational practices that seem to facilitate orsuppress it. Among the concepts discussed are Polanyi’s notion of uncertainty, combined with confidence as driving intellectual activity; the role of conviviality in the collaborative construction of knowledge,· the act of discovery as beginning with a problem that obsesses the thinker and proceeding through the integration of (often tacit) fragments into (...) a coherent whole; the notion of personal knowledge and commitment as transcending the disjunction between subjective and objective; apprenticeship as a personal relationship between a learner and a more sophisticated master, and most important, the assertion that beliefis prior to doubt. Thus, in terms ofthe concepts my colleagues and I have developed, “connected knowing” (a personal approach) is not simply equal to “separate knowing” (a detached, impersonal mode) as a procedure for arriving at knowledge, but is prior to it, “making meaning” being a necessary prerequisite to testing the validity ofa position. Drawing on interview data and memoirs of academic experiences, I argue that because these priorities are often reversed in educational practice, students learn to delete their personal responses from their essays in order to meet what they perceive as the utterly objective standards of the academy. When educators “endorse” uncertainty, students are encouraged to engage in the collaborative making of meaning and the pursuit of problems of personal importance. (shrink)

Three ethical conflicts in particular are paradigmatic of what we define as “clerkship ethics.” First, a distinction that differentiates the clerkship student from the practicing physician involves the student’s principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student (...) is left with a more ambiguous set of choices. Second, evaluative scrutiny during clinical clerkships often forces medical students to balance doing what is morally fitting against the perceived expectations of the medical teams in which they work. Third and finally, a deeply entrenched culture of medical hierarchy presents a particular challenge to innovation and improvement in ethics education during the clerkship years. Students regard faculty as exemplars, but are not provided with the tools to assess when technical medical competence is not matched by moral competence; moreover, these faculty are unlikely to have experienced the ethics education in which students are asked to demonstrate mastery. (shrink)

In their target article, Millum and Bromwich situate their article against a backdrop of well-documented empirical research demonstrating that many participants have variable and often poor...

Selected as a Financial Times Best Book of 2013Governments today in both Europe and the United States have succeeded in casting government spending as reckless wastefulness that has made the economy worse. In contrast, they have advanced a policy of draconian budget cuts--austerity--to solve the financial crisis. We are told that we have all lived beyond our means and now need to tighten our belts. This view conveniently forgets where all that debt came from. Not from an orgy of government (...) spending, but as the direct result of bailing out, recapitalizing, and adding liquidity to the broken banking system. Through these actions private debt was rechristened as government debt while those responsible for generating it walked away scot free, placing the blame on the state, and the burden on the taxpayer. That burden now takes the form of a global turn to austerity, the policy of reducing domestic wages and prices to restore competitiveness and balance the budget. The problem, according to political economist Mark Blyth, is that austerity is a very dangerous idea. First of all, it doesn't work. As the past four years and countless historical examples from the last 100 years show, while it makes sense for any one state to try and cut its way to growth, it simply cannot work when all states try it simultaneously: all we do is shrink the economy. In the worst case, austerity policies worsened the Great Depression and created the conditions for seizures of power by the forces responsible for the Second World War: the Nazis and the Japanese military establishment. As Blyth amply demonstrates, the arguments for austerity are tenuous and the evidence thin. Rather than expanding growth and opportunity, the repeated revival of this dead economic idea has almost always led to low growth along with increases in wealth and income inequality. Austerity demolishes the conventional wisdom, marshaling an army of facts to demand that we austerity for what it is, and what it costs us. (shrink)

There are substantial numbers of frozen embryos in storage that will not be used by those who produced them for their own fertility treatment. One option for such embryos is to donate them to others to use in their fertility treatment. There has been considerable debate about how this process should be organized. In the US, there are embryo adoption programmes that mediate between those relinquishing embryos and potential recipients. This is a form of conditional embryo donation, where the relinquishing (...) couple can choose the recipient of their embryo. This article examines the ethical debate over conditional embryo donation for family building and explores the question of whether those who have unused frozen embryos should be able to determine who receives their embryos. The main objections to conditional embryo donation are examined: first, the embryo is not a person and therefore such concern over the placement of an embryo is unwarranted; secondly, potential donors might impose morally problematic conditions on who should receive their embryo; and thirdly, there are practical difficulties regarding organizational arrangements and the associated costs involved. It will be concluded that these objections can be countered and that if people wish to donate and receive embryos in this way there is no ethical objection to them doing so. (shrink)

This article discusses when it is ethically acceptable to withdraw consent for the storage and use of embryos and gametes. Currently, the law in the UK states that consent to use of a gamete or embryo can be withdrawn up to the point of the embryo's transfer to the recipient's uterus or when the gamete is used in providing treatment services; that is, the ‘point of no return’. In this article, we will consider other points of no return and argue (...) that having a single point of no return, a one size fits all form of consent can, in some cases, lead to restrictions on individuals’ autonomy and cause particular types of harm. Therefore, having different points of no return that fit different circumstances could extend autonomy and allow people to enter into agreements that are tailored more to their own particular needs and circumstances. (shrink)

In this commentary we concur with Frost's view of the centrality of universal principles in models of word identification. However, we argue that other processes in sentence comprehension also fundamentally constrain the nature of written word identification. Furthermore, these processes appear to be universal. We, therefore, argue that universality in word identification should not be considered in isolation, but instead in the context of other linguistic processes that occur during normal reading.

Notre enquête porte sur la réception à la fois philosophique et théologique de la pensée de saint Thomas d’Aquin dans la culture roumaine à l’âge moderne.Nous avons essayé de marquer les étapes principales d’une histoire qui reflète dans une culture religieuse d’origine byzantine les tribulations de la réception dela philosophie médiévale en Occident. Formés dans les universités françaises ou allemandes, les philosophes et les théologiens orthodoxes roumains sont redevables aussi bien aux traditions philosophiques des XVIIIᵉ-XIXᵉ siècles qu’à la découverte gilsonienne (...) de la pensée médiévale. Entre polémique confessionnelle et approche scientifique, saint Thomas d’Aquin devient au XXᵉ siècle une présence significative dans les discours philosophiques et théologiques roumains (notamment dans le débat concernant la possibilité d’une philosophie chrétienne), en dépit d’une préférence traditionnelle accordée à saint Augustin. Il importe de remarquer aussi le fait que la spécificité des approches des philosophes roumains de la pensée de saint Thomas d’Aquin consiste dans l’effort de transgresser un thomisme «historique» vers des possibles enjeux modernes. (shrink)

Colexification refers to the phenomenon of multiple meanings sharing one word in a language. Cross‐linguistic lexification patterns have been shown to be largely predictable, as similar concepts are often colexified. We test a recent claim that, beyond this general tendency, communicative needs play an important role in shaping colexification patterns. We approach this question by means of a series of human experiments, using an artificial language communication game paradigm. Our results across four experiments match the previous cross‐linguistic findings: all other (...) things being equal, speakers do prefer to colexify similar concepts. However, we also find evidence supporting the communicative need hypothesis: when faced with a frequent need to distinguish similar pairs of meanings, speakadjust their colexification preferences to maintain communicative efficiency and avoid colexifying those similar meanings which need to be distinguished in communication. This research provides further evidence to support the argument that languages are shaped by the needs and preferences of their speakers. (shrink)

This text is based on an image that, in some ways, can be understood only in terms of sound. In the lonely darkness of a movie theatre, the audience spends ninety minutes gazing at a single image: that of a rubber dinghy drifting aimlessly on a vast expanse of water.This is the rare challenge posed by German filmmaker Philip Scheffner with his documentary Havarie: viewers are asked to focus on a single image while listening to a variety of sounds – (...) especially the voices of many nameless individuals discussing their own drifting journeys.A few years ago, Scheffner happened “totally by accident” to come across a cellphone video on YouTube lasting three minutes and thirty-six seconds; it was titled simply “refugees”... (shrink)

Cross-situational learning is a mechanism for learning the meaning of words across multiple exposures, despite exposure-by-exposure uncertainty as to the word's true meaning. We present experimental evidence showing that humans learn words effectively using cross-situational learning, even at high levels of referential uncertainty. Both overall success rates and the time taken to learn words are affected by the degree of referential uncertainty, with greater referential uncertainty leading to less reliable, slower learning. Words are also learned less successfully and more slowly (...) if they are presented interleaved with occurrences of other words, although this effect is relatively weak. We present additional analyses of participants’ trial-by-trial behavior showing that participants make use of various cross-situational learning strategies, depending on the difficulty of the word-learning task. When referential uncertainty is low, participants generally apply a rigorous eliminative approach to cross-situational learning. When referential uncertainty is high, or exposures to different words are interleaved, participants apply a frequentist approximation to this eliminative approach. We further suggest that these two ways of exploiting cross-situational information reside on a continuum of learning strategies, underpinned by a single simple associative learning mechanism. (shrink)

ABSTRACT This article explores the history of the bedwetting alarm, invented in 1938 by two psychologists to cure enuresis, or bedwetting, using the principles of classical conditioning. Infused with the optimism of behaviorism, the bedwetting alarm unexpectedly proved difficult to implement in practice, bearing a multitude of unanticipated complications that hindered its widespread acceptance. Introduced as a medical and psychological technology, in practice the alarm was also a child‐rearing device, encouraging the kind of behavioristic attitudes that had prompted its initial (...) development, while simultaneously promoting the child‐centered approach that would become dominant in the early 1950s. The life story of the bedwetting alarm muddies the traditional account of how child‐rearing theories progressed in tidy succession, suggesting both that behavioristic approaches did not die out in the 1930s and that elements of permissive child‐rearing were being considered earlier than we traditionally assume. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

In _Aristotle’s Ever-turning World in _Physics _8_ Blyth analyses the reasoning in Aristotle’s explanation of cosmic movement, with detailed evaluation of ancient and modern commentary on this central text in the history of ancient and medieval philosophy and science.

Journal Name: Apeiron Issue: Ahead of print.

This study adjudicates between two opposing accounts of morphological productivity, using English past-tense as its test case. The single-route model posits that both regular and irregular past-tense forms are generated by analogy across stored exemplars in associative memory. In contrast, the dual-route model posits that regular inflection requires use of a formal “add -ed” rule that does not require analogy across regular past-tense forms. Children saw animations of an animal performing a novel action described with a novel verb. Past-tense forms (...) of novel verbs were elicited by prompting the child to describe what the animal “did yesterday.” Collapsing across age group, the likelihood of a verb being produced in regular past-tense form was positively associated with the verb's similarity to existing regular verbs, consistent with the single-route model only. Results indicate that children's acquisition of the English past-tense is best explained by a single-route analogical mechanism that does not incorporate a role for formal rules. (shrink)