Cultural narratives shape how we think about the world, including how we decide when the end of life begins. Hospice care has become an integral part of the end‐of‐life care in the United States, but as it has grown, its policies and practices have also imposed cultural narratives, like those associated with the “six‐month rule” that the majority of the end of life takes place in the final six months of life. This idea is embedded in policies for a range (...) of care practices and reimbursement processes, even though six months is not always a meaningful marker. In the case of people living with advanced dementia, six months is both too early in the trajectory to facilitate conversations and too late in the trajectory to ensure decision‐making capacity. This essay encourages scholars and policy‐makers to consider how cultural narratives may limit what they think is possible in care for people living with dementia. (shrink)

Marshall et al. (2024) raise questions regarding patient refusals of care. In this commentary we address refusals of care from the lens of patient autonomy and provide suggestions for patient cente...

This essay critically examines three theories of moral rights, theBenefit, the Interest, and the Choice theories. The Interest andChoice theories attempt to explain how rights can be more robustthan seems possible on the Benefit theory. In particular, moralrights are supposed to be resistant to trade-offs to supportprincipled anti-paternalism, to constitute a distinct dimensionof morality, and to provide right holders with a range ofdiscretionary choice. I argue that these and other featuresare better yet provided by a fourth theory of moral rights, (...) theJurisdiction theory. (shrink)

It has come to be widely accepted that jus post bellum includes responsibilities to rebuild. Consequently, duties to establish a sustainable peace are increasingly defined in terms of duties to protect and promote international human rights, including duties to effectively investigate human rights violations, to ensure access to effective remedy, and to transform institutional and legal contexts that have facilitated or sustained human abuse. But what are investigations by transitional bodies seeking when they take on these tasks? Often, investigators present (...) themselves as seeking the truth and claim value for their findings based on having produced a better description or explanation than was antecedently available. But is truth worth pursuing for its own sake in transitions from conflict or must it contribute to some other goal to be valuable? In what follows I argue that the value of truth in transitions from conflict lies in the role of truth in ascribing knowledge. The connection between truth and knowledge makes it important to preserve distinctively epistemological grounds for accepting and rejecting claims and narratives. These distinctively epistemological grounds explain how, if it is conceived of as adequate responsiveness to experience, truth is a legitimate and important goal in transitions from violence that is worth pursuing for its own sake. In particular, I argue that there is value in insisting that adequate responsiveness to experience serve as an arbiter in the reception of claims and narratives because when responsiveness to experience plays an arbitral role it becomes possible for bodies such as truth commissions to serve as vehicles by which groups may attain or ascribe knowledge. (shrink)

I. Die Differenz von Gut und (Ge- )recht - Eine ethische Grundunterscheidung -- II. Konsequenzen für die moderne Ethik -- III. Vier philosophische Lösungsversuche zur Klärung der Differenz -- IV. Der Umgang christlicher Ethik mit dem Zusammenhang von Gut und Gerecht -- V. Paradigmatische Impulse für die christliche Ethik -- VI. Politische Gerechtigkeit und eine umfassende christliche Theorie des Guten.

Over the past decade AIDS research has turned toward the use of pharmacology in HIV prevention, including pre-exposure prophylaxis (PrEP): the use of HIV medication as a means of preventing HIV acquisition in those who do not have it. This paper explores the contradictory reasons offered in support of PrEP—to empower women, to provide another risk-reduction option for gay men—as the context for understanding the social meaning of the experimental trials that appear to show that PrEP works in gay men (...) and heterosexual couples but not single women. The PrEP debates reveal the different ideas about “demedicalization” in the earlier gay health and women’s health movements and highlight the relationship between health activism and critique of research ethics in the context of a global pharmaceutical market. (shrink)

This chapter contains sections titled: Character of Claus Christmas Crowd Civic Claus Symbol of Supremacy? Common Claus.

Zaller's model of public-opinion formation portrays the average citizen as an automaton who responds unthinkingly to elite cues. That is, once people have received information from political elites, they tend to abide by whatever their respective cue-givers dictate, since rejecting information is more cognitively costly than simply accepting it. Empirical research in psychology on priming supports this view of the citizen as a passive receiver of information. For example, people are likely to be unconsciously influenced by subtle cues and they (...) tend to base their opinions on the accessibility of information in memory. However, some citizens, under certain conditions, may be ?active processors? of information: actively interpreting it, elaborating on its implications, and negotiating its meaning. Whether or not Zaller's model is an accurate representation of the process of public-opinion formation depends substantially upon the inclusiveness of the researcher's views about what constitutes public opinion and how to study its determinants. (shrink)

La conceptualización del saber artesanal es compleja y requiere del reconocimiento epistemológico dentro del contexto sociocultural y económico en el que opera lo artesanal, donde es necesario resaltar el valor ancestral, pues, dentro del aprendizaje hay una transferencia de conocimiento tradicional cuando no hay una ruptura en la producción de sentido que se constituye.Por ello, esta investigación busca, por medio de un documental, visibilizar la labor que cumplen los artesanos y cesteros del municipio de Tocaima, Cundinamarca, logrando construir un espacio (...) de integración y capacitación donde sean los cesteros quienes se beneficien y logren transmitir los saberes de la cestería. (shrink)

Most political philosophers are reluctant to treat cultural rights as basic. Instead, the predominant view is that cultural interests are only important derivatively, in virtue of their contribution to some other interest. In this chapter I argue that political philosophers ought to follow international human rights norms regarding the importance of culture. Not only do international human rights courts and committees come to the right conclusion about the significance of culture, but, as importantly, they come to this conclusion because they (...) think about what cultural rights protect inthe right way. Contemporary political philosophers prefer to treat cultural rights as derivative in part because they tend to treat culture as a “resource” or a “good,” but this is a mistake. Cultural rights are better understood as protecting and promoting an activity. Respecting and promoting cultural participation is a constitutive element of showing respect for human dignity because, like free expression, political participation, and freedom of conscience, cultural participation is something persons do as part of making a life for themselves. (shrink)

Robert Card argues that although Susan Okin’s analysis in Justice, Gender and the Family leads to the conclusion that justice within the family requires elimination of gendered roles within marriage, this conclusion is not compatible with a conception of justice in which neutrality between reasonable conceptions of the good, and protection of individuals’ contractual capabilities are taken to be fundamental values. Although Card is right that there is tension in Okin’s work between where the analysis of injustice within the gender-structured (...) family leads and where, as a reformer, Okin is willing to go, and he is right to locate the source of that tension in Okin’s attempt to remain within Rawlsian liberalism, Okin’s view has more resources to respond to this critique than Card acknowledges. In the end, these additional resources may not be sufficient to address the problems that Card notes, but they do suggest a more complex relationship between Okin’s view and the liberal tradition than Card allows.. (shrink)

Background Current requirements for ethical research in Canada, specifically the standard of active or signed parental consent, can leave Indigenous children and youth with inequitable access to research opportunities or health screening. Our objective was to examine the literature to identify culturally safe research consent processes that respect the rights of Indigenous children, the rights and responsibilities of parents or caregivers, and community protocols. Methods We followed PRISMA guidelines and Arksey and O’Malley’s approach for charting and synthesizing evidence. We searched (...) MEDLINE, PsycINFO, ERIC, CINAHL, Google Scholar, Web of Science, Informit Indigenous Collection, Bibliography of Native North Americans, and Sociological Abstracts. We included peer-reviewed primary and theoretical research articles written in English from January 1, 2000, to March 31, 2022, examining Indigenous approaches for obtaining informed consent from parents, families, children, or youth. Eligible records were uploaded to Covidence for title and abstract screening. We appraised the findings using a Two-Eyed Seeing approach. These findings were inductively coded using NVivo 12 and analyzed thematically. Results We identified 2,984 records and 11 eligible studies were included after screening. Three key recommendations emerged: addressing tensions in the ethics of consent, embracing wise practices, and using relational approaches to consent. Tensions in consent concerned Research Ethics Board consent requirements that fall short of protecting Indigenous children and communities when culturally incongruent. Wise practices included allowing parents and children to consent together, land-based consenting, and involving communities in decision-making. Using relational approaches to consent embodied community engagement and relationship building while acknowledging consent for Indigenous children cannot be obtained in isolation from family and community. Conclusions Very few studies discussed obtaining child consent in Indigenous communities. While Indigenous communities are not a monolith, the literature identified a need for community-driven, decolonized consent processes prioritizing Indigenous values and protocols. Further research is needed to examine nuances of Indigenized consent processes and determine how to operationalize them, enabling culturally appropriate, equitable access to research and services for all Indigenous children. (shrink)

Breastfeeding remains an understudied topic in research and theorizing about reproductive experience and women's bodies. This article reports on women's experiences of breastfeeding in public as revealed through in-depth interviews with 51 women. The current construction of the good maternal body requires women to carefully manage the performance of breastfeeding in specific ways and with particular attention to the dominant notion of a sexualized rather than nurturing breast. Women accommodate to, and resist, the perceived boundaries of the good maternal body (...) through their breastfeeding behaviors. (shrink)

The child protection system in France has gradually changed along the lines of the laws enacted in 2002 and 2007 that reasserted the importance of the role played by the parents. Far from condemning the family, it henceforth seeks to provide it with accompaniment so as to ensure the child’s future reintegration. Grounded in psychoanalytical group and family theories, the article investigates the psychic function of the institution and (with case studies to support it) discusses what has to be done (...) to make arrangements within the therapeutic framework for families to make progress and maintain ties despite the absence of direct relations. For it is only after a real period of separation that work on the young person’s psychic group experience will enable the family to move forward. (shrink)

Fodor and Lepore, in their recent book "Holism," maintain that if an inference from semantic anatomism to semantic holism is allowed, certain fairly deleterious consequences follow. In Section 1 Fodor and Lepore's terminology is construed and amended where necessary with the result that the aforementioned deleterious consequences are neither so apparent nor straightforward as they had suggested. In Section 2 their "Argument A" is considered in some detail. In Section 3 their "argument attributed to Quine" is examined at length and (...) a shorter and more perspicacious argument suggested which avoids their charge that the Quinean argument is guilty of an equivocation on the word 'statement'. (shrink)

A dominant belief in political philosophy is that states must be entitled to authorize the use of coercion in order to justifiably coerce its subjects. Call this view the entitlement view. On this view, for a state to justifiably coerce its subjects, a necessary condition is that it is entitled to authorize the use of coercion. Sceptics hold the entitlement view. However, they deny that states are entitled to authorize the use of coercion. This denial informs their views regarding the (...) permissible use of political power. Skeptics believe that nearly all uses of political power is impermissible. In this paper, I present a challenge to the skeptical view that nearly all uses of political power is impermissible. I also present a view on the justification of certain uses of political power that is an alternate to the entitlement view. My alternate view allows me to demonstrate that a state can engage in permissible uses of political power over a broad range of domains without possessing any entitlements. (shrink)

By examining an exemplar sample of mental health nursing educational policies and related legislation, in this article, we trace the discursive production of madness as an “othered” identity category. We engage in a critical discourse analysis of mental health nursing education in Canada, drawing on provincial and federal policies and legislation as the main sources of data. Theoretically framed by critical posthumanism and mad studies, this article outlines how the mad subjectivity becomes decontextualized out of its identity‐based understanding and recontextualized (...) as an inferior category of “the human,” circulating within discourses of pedagogy, economics, law, and psychiatry. The article maps the intertextual nexus of the discourse of mental health nursing education, making visible the complex, the arbitrary, and the sometimes‐contradictory nature of the discipline's grappling with identity‐based mental health concepts. We close with several implications for nursing policy, education, and practice. (shrink)

Several commentators have expressed concern that the Durban Platform does not include more specific language about the need for equitable mitigation efforts. Meanwhile, other commentators have argued that the differentiated approach adopted by the Kyoto Protocol set up an opposition between the developed and developing nations; resulting in an impasse which has prevented the achievement of adequately ambitious, agreeable and binding mitigation commitments. In this commentary I propose that the political impasse is not due to the equity track per se, (...) but rather to the territorial and production-based accounting system upon which it was built. Under the UNFCCC, parties are required to provide inventories of GHG emissions within their national borders. There are several problems with this method, but most important given the argument here, is that the production-approach has resulted in a significant misrepresentation of the total climate impact of developed nations. Because GHG emissions are not confined by geopolitical borders, it is important to understand the climate impact of contemporary consumption and trade, regardless of where emissions are produced. I argue that supplementing production-based accounting with a consideration of the emissions embedded in trade has the potential to provide a more agreeable and politically viable path for closing the ambition gap and ensuring equity. (shrink)

Maintaining academic integrity is a growing concern for higher education, increasingly so due to the pivot to remote learning in 2020 caused by the COVID-19 pandemic. We canvassed students, faculty, and tutors at an online Canadian university about their perspectives on academic integrity and misconduct. The survey asked how the university could improve policies concerning issues of academic integrity, how faculty and tutors handled cases of misconduct, about satisfaction with how academic violations were treated, and about the role of students, (...) faculty, and tutors in encouraging academic integrity. As well, we collected suggestions from respondents for reducing cheating, addressing academic misconduct, and general ideas about academic integrity. The distinction between misconduct and integrity was not always clear in their comments. We received responses from 228 students and 73 faculty and tutors, generating hundreds of comments. In this paper we focus only on the answers to open-ended questions. Using content analysis, we categorized the replies into similar threads. After multiple iterations of analysis, we extracted three general recommendation groupings: Policy and Procedures, Compliance and Commitment, and Resources. Based on respondents’ views, we propose a balanced approach to supporting academic integrity. Although we conducted the study pre-COVID-19, the recommendations apply to current and future academic integrity practices in our context and beyond. (shrink)

Este estudio buscó describir e interpretar las teorías subjetivas sobre la identidad profesional docente que se construyen y difunden noticiosamente durante la educación de emergencia por la pandemia de COVID 19. Se utilizó un estudio de análisis documental, metodología cualitativa y un diseño de estudio de casos. El muestreo intencionado y por conveniencia corresponde a 40 noticias de prensa escrita en español, sobre el profesor(a) en pandemia y publicadas en diferentes medios que fueron recolectadas a través de Google Noticias desde (...) el 11 de marzo de 2020 y hasta el 01 de noviembre de 2020. A partir de una codificación temática, los resultados evidenciaron teorías subjetivas asociadas a las exigentes características, roles, funciones y valores con los que se identifica al profesorado durante la pandemia. El análisis mostró los distintos sentidos del ejercicio profesional y las competencias asociadas a su desempeño en la prensa. En la discusión, se utilizaron estudios relativos a la práctica docente para interpretar estos resultados. (shrink)

Throughout the 1980s, the American right wing attempted to control the field of social politics and social policy through a rhetoric of `family'. In response, the left, including much of the lesbian and gay movement, abandoned an early, theorized antipathy to family, attempting to recapture the political field with ideas like `alternative families' and `families we chose'. These moves do not sufficiently account for the hidden glue that binds bodies to politics, national or anti-national. The glue, or, as Benedict Anderson (...) calls it, `political love' is no longer an affect to be rejected but a `feeling' to be embraced. Examining the case of sexual abstinence in early right-wing AIDS discourse and in current websites, this article suggests that micro-politics of love are inextricable from macro-politics of nationalism. (shrink)

ObjectivesThe end of life is an ethically challenging time requiring complex decision-making. This study describes ethical frameworks among physician trainees, explores how these frameworks manifest and relates these frameworks to experiences delivering end-of-life care.DesignWe conducted semistructured in-depth exploratory qualitative interviews with physician trainees about experiences of end-of-life care and moral distress. We analysed the interviews using thematic analysis.SettingAcademic teaching hospitals in the United States and United Kingdom.ParticipantsWe interviewed 30 physician trainees. We purposefully sampled across three domains we expected to be (...) associated with individual ethics in order to elicit a diversity of ethical and experiential perspectives.ResultsSome trainees subscribed to a best interest ethical framework, characterised by offering recommendations consistent with the patient’s goals and values, presenting only medically appropriate choices and supporting shared decision-making between the patient/family and medical team. Others endorsed an autonomy framework, characterised by presenting all technologically feasible choices, refraining from offering recommendations and prioritising the voice of patient/family as the decision-maker.ConclusionsThis study describes how physician trainees conceptualise their roles as being rooted in an autonomy or best interest framework. Physician trainees have limited clinical experience and decision-making autonomy and may have ethical frameworks that are dynamic and potentially highly influenced by experiences providing end-of-life care. A better understanding of how individual physicians’ ethical frameworks influences the care they give provides opportunities to improve patient communication and advance the role of shared decision-making to ensure goal-aligned end-of-life care. (shrink)