Respect for patients’ autonomy has taken a central place in the practice of medicine. Received wisdom holds that respect for autonomy allows overriding a patient’s treatment preferences only if the patient has been found to lack capacity. This understanding of respect for autonomy requires a dichotomous approach to assessing capacity, whereby a patient must be found either to have full capacity to make some particular treatment decision or must be found to lack capacity to make that decision. However, clinical reality (...) is more complicated, and, in borderline cases, different physicians may arrive at disparate judgments of capacity. In such cases, when capacity-determination protocols fail to achieve consensus, physicians would benefit from guidance regarding the clinical decision-making process necessary to elucidate the most ethically sound course of action. This article considers one such case and argues that, in a limited number of cases, respect for autonomy may require overriding a patient’s stated treatment preference when a capacity determination is equivocal, even though the patient has not clearly demonstrated a lack of capacity. (shrink)

Article de Michael Burawoy « The Future of Sociology » publié dans Brym R. (ed.), New Society, 7th Edition, Scarborough, Nelson Education, 2014, traduit par Carolyne Grimard et Marc-Henry Soulet. Cette traduction a déjà paru dans SociologieS, accompagnée d'une introduction par Marc-Henry Soulet accessible ici. Nous remercions Michael Burawoy et la revue SociologieS de nous avoir autorisé à la reproduire ici. La marchandisation du monde Une vague de marchandisation déferle sur le monde. Des (...) - Sociologie – Nouvel article.

Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – the family of a very elderly non-English speaking Asian lady did not want her to be informed that she had incurable lymphoma. The case study summarises the reflections of the Committee and focusses on: the role of cultural norms in healthcare decision making; the extent to which the views of the family about what is best for the patient should (...) be respected, whether the patient should have been informed of her terminal diagnosis and the role of the clinician in navigating complex family dynamics. (shrink)

ABSTRACTFew would argue against the importance of ethics in early childhood teacher preparation and practice. However, arguing for something in principle does not always lead to action. The purpose of this paper is to bring attention to the need for a sharper applied focus on ethics in early childhood education than that which currently exists. A context for professional ethics in early childhood education is outlined, a case highlighting specific ethical considerations is presented, and, finally, concerns and insights are discussed. (...) The discussion is anchored in professional ethical codes and the literature on teacher preparation and ethics education. (shrink)

Members of the Student Clinical Ethics Committee discussed the ethical issues arising in a case referred for consideration – a homeless man presenting to the emergency department of a busy London hospital with recent self-reported suicide attempts. Should he be admitted overnight in order to address a short-term shelter problem? The case study summarises the reflections of the Committee and focusses on the doctor’s duty of care and patient responsibility, benefits of admission and resource considerations.

Members of the Student Clinical Ethics Committee discussed whether tube feeding should be instigated for a man who had indicated through his actions that he may be refusing it, although his family stated that he would have wanted to be kept alive in such a situation. The Committee considered the key issues of capacity and best interests, which in this case were confounded by lack of clarity about whether the patient’s actions amounted to a valid refusal of life sustaining treatment, (...) and if his previous views still pertained to his current, yet unforeseen, circumstances. As the discussion progressed, it became apparent that some members were reluctant to accept that non-insertion of clinically assisted feeding could ever be in a patient’s best interests. (shrink)

Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – a female patient in her mid-60s, who had a very long history of multiple sclerosis, withdrew her previous consent to treatment following discussion with her son. The case study summarises the reflections of the Committee and focusses on: the meaning and practical application of respect for patient autonomy; whether a refusal of clinically indicated treatment may challenge the notion of (...) capacity; the role of others in the process of decision-making; if the current decision to refuse treatment was the patient’s own and whether, in the circumstances, it should be respected. (shrink)

If the opening sequence of a film is a microscopic 'event' that achieves far more than setting the tone and whetting the appetite for what we are about to see, then Todd Haynes' I'm Not There is exemplary. This paper works its way through the conceptually dense and intricately woven textual layers of the film's opening to stage a three-way dialogue between Haynes, Bob Dylan and Jacques Derrida: three mavericks who defy simple categorisation, by transgressing the boundaries of their respective (...) fields (song writing, cinema and philosophy). By introducing Derrida's deconstructive logic of hauntology as a strategy for reading Haynes' biopic on Dylan, the figure of the ghost is called upon to situate the quest for an identity's authenticity as a perennial, irresolvable problem in song, cinema and philosophy. Belonging to a time that is neither past nor present, a place that is neither here nor there, the ghost offers the perfect medium to join Haynes, Dylan and Derrida in (re)thinking identity in terms that respond to a call (in the name of art, justice and truth, among other things) that is not based on an unyielding conception of authenticity. (shrink)

Doctoral graduates in philosophy are an excellent source of information about the discipline: they are at the cutting edge of research trends, have an inside view of researchfocused departments, and their employment prospects provide early insights on the future health of the discipline. We report on the results of a survey sent to recent PhD graduates and current students, as well as data gathering efforts by Academic Placement Data and Analysis that have taken place over the past ten years. In (...) this report we especially focus on demographic representation, program ratings, academic job placement, and non-academic careers. (shrink)

Critically significant parental effects in behavioral genetics may be partly understood as a consequence of maternal brain structure and function of caregiving systems recently studied in humans as well as rodents. Key parental brain areas regulate emotions, motivation/reward, and decision making, as well as more complex social-cognitive circuits. Additional key environmental factors must include socioeconomic status and paternal brain physiology. These have implications for developmental and evolutionary biology as well as public policy.

Farmer participatory approaches were used to identify problems and needs as perceived by local people and to develop strategies to achieve fodder security in south Indian villages. Indigenous knowledge systems as they relate to agroforestry were explored. The farmer participatory approaches have laid the foundations for selecting appropriate agroforestry technologies and developing suitable fodder security policy options. Potential benefits and risks as a result of implementing agroforestry projects were also discussed.

Magnetic resonance imaging (MRI) can provide a number of measurements relevant to sport-related concussion (SRC) symptoms; however, most studies to date have used a single MRI modality and whole-brain exploratory analyses in attempts to localize concussion injury. This has resulted in highly variable findings across studies due to wide ranging symptomology, severity and nature of injury within studies. A multimodal MRI, symptom-guided region-of-interest (ROI) approach is likely to yield more consistent results. The functions of the cerebellum and basal ganglia transcend (...) many common concussion symptoms, and thus these regions, plus the white matter tracts that connect or project from them, constitute plausible ROIs for MRI analysis. We performed diffusion tensor imaging (DTI), resting-state functional MRI, quantitative susceptibility mapping (QSM), and cerebral blood flow (CBF) imaging using arterial spin labeling (ASL), in youth aged 12-18 years following SRC, with a focus on the cerebellum, basal ganglia and white matter tracts. Compared to controls similar in age, sex and sport (N = 20), recent SRC youth (N = 29; MRI at 8 ± 3 days post injury) exhibited increased susceptibility in the cerebellum (p = 0.032), decreased functional connectivity between the caudate and each of the pallidum (p = 0.035) and thalamus (p = 0.021), and decreased diffusivity in the mid-posterior corpus callosum (p < 0.038); no changes were observed in recovered asymptomatic youth (N = 16; 41 ± 16 days post injury). For recent symptomatic-only SRC youth (N = 24), symptom severity was associated with increased susceptibility in the superior cerebellar peduncles (p = 0.011) and reduced activity in the cerebellum (p = 0.013). Fewer days between injury and MRI were associated with reduced cerebellar-parietal functional connectivity (p < 0.014), reduced activity of the pallidum (p = 0.002), increased CBF in the caudate (p = 0.005), and reduced diffusivity in the central corpus callosum (p < 0.05). Youth SRC is associated with acute cerebellar inflammation accompanied by reduced cerebellar activity and cerebellar-parietal connectivity, as well as structural changes of the middle regions of the corpus callosum accompanied by functional changes of the caudate, all of which resolve with recovery. Early MRI post-injury is important to establish objective MRI-based indicators for concussion diagnosis, recovery assessment and prediction of outcome. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 34.2 (2001) 179-181 [Access article in PDF] Book Review Rethinking the Rhetorical Tradition: From Plato to Postmodernism Rethinking the Rhetorical Tradition: From Plato to Postmodernism. James L. Kastely. New Haven, CT: Yale University Press, 1997. Pp. viii + 293. $30.00. In Rethinking the Rhetorical Tradition, James Kastely presents an alternative to the "standard" rhetorical tradition; he calls this alternative skeptical rhetoric, describes its characteristic activity as (...) refutation, and claims for it special relevance in negotiating postmodern challenges to rhetoric, specifically, that it can serve as a "refutation of postmodernism" (23). This alternative tradition inheres in a canon of works somewhat different from the standard canon, and an examination of key works organizes most of the chapters in this book. To establish and articulate this tradition in the classical era, Kastely examines Plato's Gorgias and Meno, Sophocles' Philoctetes, and Euripides' Hecuba; he then moves to the modern era, and to two works that address themes central to ancient rhetorical skepticism: Jane Austen's Persuasion (1818) and Jean-Paul Sartre's What Is Literature? (1949). Finally, Kastely turns to the two prongs of the postmodern reappropriation of traditional rhetoric, the tropological formalism of Paul de Man and the ideological approaches of Marxist critics such as Terry Eagleton, challenging both of them with the comic skepticism of Kenneth Burke.The skeptical tradition begins with Socrates, of course. It takes as its central problem, not the impossibility or contingency of knowledge, but the existence of injustice. In a political community, the unavoidability of doing inadvertent injury both requires rhetoric and at the same time makes it party to continued injustice: "[D]oing injury is an inescapable aspect of a being who is born into a world that is shaped by a language and by conventional practices that embody a particular set of values" (42). It is these prior commitments and conventional practices that, Kastely argues, lead us to cause injury. Thus, the positive task of rhetoric is not to persuade others away from injustice or to promote remedies; it is to keep us constantly open to refutation, to the possibility of seeing an alternative to the inadvertent wrong we commit. The inherency of injustice is what makes rhetoric a philosophical problem, but refutation is what rhetoric can offer to philosophy (a claim that might surprise philosophers). And in his reading of the Meno, Kastely argues explicitly for a rhetorical, rather than philosophical or logical, understanding of refutation.Overall, Kastely offers us a Plato who is not the enemy of rhetoric, but rather "the most sophisticated and profound rhetorical theorist" (30), who dramatizes in dialogue the philosophical dilemma of rhetoric. In [End Page 179] Sophocles and Euripides, he finds dramatists who illustrate practical forms the dilemma can take, specifically the problem of the unavailable audience. In the Philoctetes, the problem is how to regain the trust and confidence of the marginalized and disenfranchised, how to restore the status of rhetorical audience to one who no longer believes that justice is possible. In the Hecuba, the problem is how a disempowered rhetor can speak to the powerful. In both plays, but especially in Hecuba, the proximity of rhetoric to violence is a practical consequence of the unsolved philosophical problem.Kastely admits that the skeptical legacy from classical rhetoric has had little effect since antiquity. His argument that this alternate tradition deserves recognition is made primarily by his chapters on Austen and Sartre. He sees the works he examines here as raising a question central to rhetorical skepticism: "Can there be a way of speaking and writing that can effectively challenge the marginalization and dehumanization of people in a world in which traditional structures of authority that made discourse coherent have vanished or, at least, are seriously and irretrievably eroded?" (139-40). Both question Enlightenment assumptions about universality and at the same time confront the vacuum left by the erosion of local communal and authority structures. Austen's "active exploration" of a "crisis in discursive practice" (141) and Sartre's concern with the "social responsibility of the writer" and the loss of a public... (shrink)

The Ethics of Bioethics: Mapping the Moral Landscape is a compelling, thoughtful, sobering examination of the moral practice of bioethics. Jonathan D. Moreno sets the tone in the foreword by unsettling the reader with questions from critics about the intellectual legitimacy of bioethics (e.g., the frequent tensions of political ideology with normative expertise in the public debate) and the practices of some in bioethics (e.g., the controversial roles in for-profit industry or health care). Twenty-five essays follow, addressing issues and activities (...) that mark the relatively brief history and much of the scope of bioethics practice. Each essay turns bioethics practice inward to lay bare, explore, and possibly .. (shrink)

For ten years, between 1903 and 1913, Gertrude Stein saw human relationships as painful mathematical puzzles in need of solutions. Again and again, she converted the predicaments of her personal life into literary material, the better to solve and to exorcise them. The revelation that relationships had a structural quality came to her during the composition of Q.E.D. , when she grasped the almost mathematical nature of her characters' emotional impasse. Stein's persona in the novel comments on their triangular affair, (...) "Why it's like a piece of mathematics. Suddenly it does itself and you begin to see."1 The theory encouraged her to examine such situations as if they were case histories: she continued to study the same piece of mathematics from different angles in Fernhurst , Three Lives , and The Making of Americans . But whatever the sexual arrangements in these triangles, the powerful generally managed to impose their wills upon the less powerful, and the triangles resolved themselves into oppositional structures, pitting two against one. Gradually, when the couple began to replace the triangle as her structural model, Stein composed numerous verbal portraits of couples and their relationships. In two of these, "Ada" and "Two Women," Stein applied her general theory of relationships to the particular puzzle of female friendships because, I think, she felt that women's characters were most intensely molded in same-sex involvements. Although she attempted to "prove" these theories in distanced, deliberately depersonalized prose, we as readers must examine "the complex interplay of self-discovery and writing" from which her portraits emerged.2Stein's portraits of women entangled in familial and erotic bonds seem to invite us into "the process whereby the self creates itself in the experience of creating art"; to read them, we must "join the narrator in reconstructing the other woman by whom we know ourselves."3 This task of reconstruction implies that we must also rethink the place of biography—generally dismissed by New Criticism and its subsequent post-structuralist permutations as "mere" biography—in feminist critical projects. If it is true that "in reading as in writing, it is ourselves that we remake," then feminist critics have a special stake in understanding the biographical, and autobiographical, impulses at work in these activities.4 Stein's portraits, which hover between fiction and biography, raise important questions about the ways in which biographical information can justify our suspicion that female writers may be "closer to their fictional creations than male writers are."5 Recently, feminist critics have adapted psychoanalytic theory to examine the particular closeness of female characters in women's writing or to suggest a related closeness between the female author and her characters. We find it useful to speak of the pre-Oedipal structures and permeable ego boundaries that seem to shape women's relationships. Although Stein used very different psychological paradigms, she approached these same issues in her own studies of female friendships. Realizing that she preferred to write about women, she observed, "It is clearer…I know it better, a little, not very much better."6 In spite of her qualifications, she knew that she could see the structuring principles of relationships with greater clarity when writing from her own perspective.1. Stein, "Fernhurst," "Q.E.D.," and Other Early Writings, ed. Leon Katz , p. 67.2. Elizabeth Abel, "Reply to Gardiner," Signs 6 : 444. For a very useful critical discussion of this complex issue, see Abel, "Merging Identities: The Dynamics of Female Friendship in Contemporary Fiction by Women," and Judith Kegan Gardiner, "The es of dentity: a Response to Abel on 'Merging Identities,'" in the same issue of Signs .3. Gardiner, "The es of dentity," p. 442.4. Jonathan Morse, "Memory, Desire, and the Need for Biography: The Case of Emily Dickinson," The Georgia Review 35 : 271. See also J. Gerald Kennedy's suggestive remarks on the "tension between personal confession and implacable theory" in Barthes' later work .5. Abel, "Reply to Gardiner," p. 444.6. Stein, The Making of Americans, cited in Richard Bridgeman, Gertrude Stein in Pieces , p. 78.Carolyn Burke, an Affiliated Scholar at the Center for Research on Women, Stanford University, has published articles on French feminist writing and on Mina Loy, whose biography she is now completing. The theoretical implications of this essay will be explored in her related study in progress on feminist biography. (shrink)

Skin is one of the most thoroughly studied epithelia and can be used as a model for transcriptional control of epithelial differentiation. In particular, the stages of epidermal development and differentiation from a simple epithelium are well characterized. Temporal gene expression during development can be used to assign roles for transcription factors in epidermal differentiation. Approaches to understanding transcriptional regulation in epidermis include extensive promoter analysis and expression studies, in some cases coupled to functional studies. This work has not produced (...) any consensus about the importance of any particular factor or class of factors in epidermal specification. There is, as yet, nothing similar to the myo D family of tissue‐specific and cell‐type determining factors in epidermis. These studies, however, have revealed much about control of the differentiation process in epidermis. Most recently, there has been a suggestion that epithelial transcription can be influenced directly by the status of the adhesion complexes at the cell surface, providing a direct link between one of the distinguishing features of the epithelial state and gene transcription. (shrink)

The release of genetically engineered organisms into the shared environment raises scientific, ethical, and societal issues. Using some form of democratic deliberation to provide the public with a voice on the policies that govern these technologies is important, but there has not been enough attention to how we should connect public deliberation to the existing regulatory process. Drawing on lessons from previous public deliberative efforts by U.S. federal agencies, we identify several practical issues that will need to be addressed if (...) relevant federal agencies are to undertake public deliberative activities to inform decision‐making about gene editing in the wild. We argue that, while agencies may have institutional capacity to undertake public deliberative activities, there may not be sufficient political support for them to do so. Advocates of public deliberation need to make a stronger case to Congress about why federal agencies should be encouraged and supported to conduct public deliberations. (shrink)

Low mean fundamental frequency (F 0) in men’s voices has been found to positively influence perceptions of dominance by men and attractiveness by women using standardized speech. Using natural speech obtained during an ecologically valid social interaction, we examined relationships between multiple vocal parameters and dominance and attractiveness judgments. Male voices from an unscripted dating game were judged by men for physical and social dominance and by women in fertile and non-fertile menstrual cycle phases for desirability in short-term and long-term (...) relationships. Five vocal parameters were analyzed: mean F 0 (an acoustic correlate of vocal fold size), F 0 variation, intensity (loudness), utterance duration, and formant dispersion (D f , an acoustic correlate of vocal tract length). Parallel but separate ratings of speech transcripts served as controls for content. Multiple regression analyses were used to examine the independent contributions of each of the predictors. Physical dominance was predicted by low F 0 variation and physically dominant word content. Social dominance was predicted only by socially dominant word content. Ratings of attractiveness by women were predicted by low mean F 0, low D f , high intensity, and attractive word content across cycle phase and mating context. Low D f was perceived as attractive by fertile-phase women only. We hypothesize that competitors and potential mates may attend more strongly to different components of men’s voices because of the different types of information these vocal parameters provide. (shrink)

We discuss our surgical philosophy concerning the subtle interplay between the size of the surgical margin taken and the resultant morbidity from ablative oncological. procedures, which is ever more evident in the treatment of head and neck malignancy. The extent of tissue resection is determined by the "trade off" between cancer control and the perioperative, functional and aesthetic morbidity and mortality of the surgery. We also discuss our dilemmas concerning recent minimally invasive endoscopic microsurgical. techniques for the trans-oral laser removal. (...) or co-ablation of aero-digestive tract tumours, which result in a minimal. surgical margin of oncological clearance. By a process of inductive argument as to the nature of the surgical margin, we consider whether the risks of taking a lesser margin with adjuvant therapy is justified by the attendant gain in reduced surgical morbidity and the possible costs in tumour control. (c) 2006 Elsevier Ltd. All rights reserved. (shrink)

This book includes a selection of contributions to the Iowa State University Symposium on agricultural bioethics in november 1987. The papers are grouped in the sections "Safety and regulatory issues", "Impact on scientific and industrial communities", "Public perceptions", "Economic prospects", "Social considerations" and "Ethical dilemmas".

Rationale, aims and objectives This randomized controlled trial was designed to evaluate the 2-year costs and effects of a proactive, public health nursing case management approach compared with a self-directed approach for 129 single parents (98% were mothers) on social assistance in a Canadian setting. A total of 43% of these parents had a major depressive disorder and 38% had two or three other health conditions at baseline. Methods Study participants were recruited over a 12 month period and randomized into (...) two groups: one receiving proactive public health nursing and one which did not. Results At 2 years, 69 single parents with 123 children receiving proactive public health nursing (compared with 60 parents with 91 children who did not receive public health nursing services) showed a slightly greater reduction in dysthymia and slightly higher social adjustment. There was no difference between the public health and control groups in total per parent annual cost of health and support services. However, costs were averted due to a 12% difference in non-use of social assistance in the previous 12 months for parents in the public health nursing group. This translates into an annual cost saving of $240 000 (Canadian) of costs averted within 1 year for every 100 parents. Conclusions In the context of a system of national health and social insurance, this study supports the fact that it is no more costly to proactively service this population of parents on social assistance. (shrink)

This carefully designed, multi-authored textbook covers a broad range of theoretical issues in cognitive science, psychology, and neuroscience. With accessible language, a uniform structure, and many pedagogical features, Mind, Cognition, and Neuroscience: A Philosophical Introduction is the best high-level overview of this area for an interdisciplinary readership of students. Written specifically for this volume by experts in their fields who are also experienced teachers, the book’s thirty chapters are organized into the following parts: I. Background Knowledge, II. Classical Debates, III. (...) Consciousness, IV. Crossing Boundaries. -/- Each chapter starts with relevant key words and definitions and a chapter overview, then presents historical coverage of the topic, explains and analyzes contemporary debates, and ends with a sketch of cutting edge research. A list of suggested readings and helpful discussion topics conclude each chapter. This uniform, student-friendly design makes it possible to teach a cohort of both philosophy and interdisciplinary students without assuming prior understanding of philosophical concepts, cognitive science, or neuroscience. -/- Key Features: -/- Synthesizes the now decades-long explosion of scientifically informed philosophical research in the study of mind. Expands on the offerings of other textbooks by including chapters on language, concepts and non-conceptual content, and animal cognition. Offers the same structure in each chapter, moving the reader through an overview, historical coverage, contemporary debates, and finally cutting-edge research. Packed with pedagogical features, like defined Key Terms, Suggested Readings, and Discussion Questions for each chapter, as well as a General Glossary. Provides readers with clear, chapter-long introductions to Cognitive Neuroscience, Molecular and Cellular Cognition, Experimental Methods in Cognitive Neuroscience, Philosophy of Mind, Philosophy of Science, Metaphysical Issues, and Epistemic Issues. (shrink)

This comment responds to Maul’s (2012) article evaluating the validity evidence and argument for the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) as a measure of emotional intelligence (EI). We suggest that Maul’s standards for establishing validity evidence are unrealistically high, and may not be met by other established psychometric tests. As an example, we show that evidence for the validity of Raven’s Progressive Matrices (RPM) is of a similar standard to the MSCEIT.

Volume 19, Issue 6, June 2019, Page 22-25.

Bishop and Trout here present a unique and provocative new approach to epistemology. Their approach aims to liberate epistemology from the scholastic debates of standard analytic epistemology, and treat it as a branch of the philosophy of science. The approach is novel in its use of cost-benefit analysis to guide people facing real reasoning problems and in its framework for resolving normative disputes in psychology. Based on empirical data, Bishop and Trout show how people can improve their reasoning by relying (...) on Statistical Prediction Rules. They then develop and articulate the positive core of the book. Their view, Strategic Reliabilism, claims that epistemic excellence consists in the efficient allocation of cognitive resources to reliable reasoning strategies, applied to significant problems. The last third of the book develops the implications of this view for standard analytic epistemology; for resolving normative disputes in psychology; and for offering practical, concrete advice on how this theory can improve real people's reasoning. This is a truly distinctive and controversial work that spans many disciplines and will speak to an unusually diverse group, including people in epistemology, philosophy of science, decision theory, cognitive and clinical psychology, and ethics and public policy. (shrink)