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)

This volume considers formalisations of love in the 21st century. Engaging with the Slovenian School of Philosophy, the book contends that psychoanalysis is the one line of thought that exposes the role that love plays in all knowledge, emphasising the importance of love in these unsettled times.

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)

[P]layers line up in a long line and hold hands. The player at the front of the line is the ‘head’ and the player at the end of the line is the ‘tail’.… The game begins when the head begins to run wildly in any direction, making sharp turns and quick double-backs.… The force created by the twists and turns will often send the tail of the whip flying.… It may be best for the tail to hold on with both (...) hands to keep from flying off the end. Sometimes, however, the tail will go flying no matter how hard they hold on... Be prepared to get dirty if you play this game!--"Crack the Whip: Party Game CentralIf the evolution of American health policy is compared to the children’s game of Crack the Whip, then there is no question that the Medicaid program is the tail of the line. When those at the head of the line start to move. Medicaid receives whatever shocks and unintended consequences result, and when the line “begins to run wildly in any direction,” it receives them faster and harder than the players at the center.Shocks also come from other sources. When the economy slumps, an epidemic arises, or a path in another part of the system becomes a cul-de-sac, new twists and turns occur, with Medicaid absorbing much of the change. (shrink)

In a recent paper, Michael Levin argues that both statements reporting causal relations and causal explanatory statements are extensional. We show that his argument for the extensionality of causal explanatory statements fails to establish that conclusion. His claim that certain 'because' statements are elliptical for statements of what he terms the 'causal explanatory' form is unsubstantiated. The argument for the referential transparency of the allegedly explanatory form, regardless of whether it is a distinct explanatory form, fails because of scope problems. (...) Finally, we argue that the apparent referential opacity of explanations, the attribution of certain kinds of properties to explanations, and our satisfaction with explanations in what appear to be disparate forms are best accounted for, not by the assumption of ellipticality of statements in various forms for statements in some inherently explanatory form, but rather by an account of explanation as a speech act, the success or failure of which may be affected by which of several co-referring expressions is employed. (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)

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)

[P]layers line up in a long line and hold hands. The player at the front of the line is the ‘head’ and the player at the end of the line is the ‘tail’.… The game begins when the head begins to run wildly in any direction, making sharp turns and quick double-backs.… The force created by the twists and turns will often send the tail of the whip flying.… It may be best for the tail to hold on with both (...) hands to keep from flying off the end. Sometimes, however, the tail will go flying no matter how hard they hold on... Be prepared to get dirty if you play this game!--"Crack the Whip: Party Game CentralIf the evolution of American health policy is compared to the children’s game of Crack the Whip, then there is no question that the Medicaid program is the tail of the line. When those at the head of the line start to move. Medicaid receives whatever shocks and unintended consequences result, and when the line “begins to run wildly in any direction,” it receives them faster and harder than the players at the center.Shocks also come from other sources. When the economy slumps, an epidemic arises, or a path in another part of the system becomes a cul-de-sac, new twists and turns occur, with Medicaid absorbing much of the change. (shrink)

Chronic poverty comes in a variety of forms. It is multi-dimensional in its causes and multi-dimensional in its impacts . Although poverty "has an irreducible economic connotation," this connotation "does not necessarily imply the primacy of economic factors" . For example, violent conflict, access to land, and social relations of power are among the most important factors in food security . Integration into global economic markets is as likely to be a source of immiseration and impoverishment as it is a (...) solution . Access to safe drinking water and basic sanitation are significantly impacted by displacement and violent conflict and its aftermath; displacement and violent conflict often have an ethnic dimension. (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)

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

Although some psychoanalysts in the clinical field have criticised Žižek for corrupting Lacan’s teachings, through playing down the importance of the clinical, there is no doubt that Žižek’s scholarship and contribution to psychoanalysis displays mastery of Lacanian theory. Moreover, Žižek has applied this mastery to push theoretical ideas about the subject and social worlds, into public and intellectual debate. For Žižek, Lacan is a master from whom social knowledge as well as knowledge of the social is developed and critiqued. In (...) keeping with Žižek’s ontology, an examination of the intersection of belief with desire reveals the importance of a critical return to ideology that cannot be overlooked, particularly when examining how present social conditions structure an intersection of desire and belief. For Žižek, the contemporary subject believes now more than ever. Žižek positions modern social conditions together with the practices and organisations which maintain ideologies, as structuring the contours of belief. Capitalism, the supposed master of the 20th century, has presented as not so reliable. Might belief be the 21st century master, stepping in to support those ideological forces which intensify the scaffolding of a failing capitalist system? (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)

A shift in emphasis can change the truth-value of a singular causal sentence. This poses a challenge to the view that singular sentences predicate a relation. I argue that emphasized causal sentences conjoin predication of a causal relation between events with predication of a relation of causal relevance between states of affairs (or perhaps facts). This is superior to the treatments of such sentences offered by Achinstein, Dretske, Kim, Sanford, Bennett, and Levin. My proposal affords clarity regarding logical structure, at (...) least at a certain level of detail. It makes the relation between the content of an emphasized causal sentence and the unemphasized version clear. It answers some questions about the ontological requirements of the truth of emphasized causal sentences, without introducing new entities (as do some other accounts) or unacceptable consequences for identity and individuation of events. (shrink)

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)

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)

Neal Berlin, Ann Arbor City Administrator, Tom Blessing, Assistant City Attorney, plus some Cable Communications Commission (CCC) members are trying to put free speech restrictions into Community Television Network�s policies and remove City Council from the debate. CTN, Ann Arbor�s community access cable TV station, is run by the city but not paid for by tax dollars. It is one of the first public access cable stations in the U.S., founded in 1973.

The present study shows that the Internet functions as a gratifying context for the exchange of knowledge and values related to religious matters among youngsters in the Netherlands; they are in the midst of constructing a religious identity. Systematic content analysis complemented by qualitative research was carried out on Maroc.nl, a discussion forum primarily aimed at Moroccan youth. Inspired by Kemper's definitions of experiencing Islam, the recurrence of six dimensions of religious experience was looked into in 1,354 online messages. The (...) purpose of this study is to gain insight into the nature and the relative visibility of each of these dimensions in the online discussions under study. In addition, a number of context-bound and issue-related characteristics of the message were assessed through qualitative analysis, in an effort to find out what key issues were mainly dealt with, what normative statements were made, and how the informants related to one another. (shrink)

The practice of placing men and women in the same hospital room (mixed gender rooms) has been prohibited in the UK National Health Service for over a decade. However, recent research demonstrates that the practice is common and increasing in a major New Zealand public hospital. Reports and complaints show that the practice also occurs in Australia. We argue that mixed gender rooms violate the fundamental human rights of personal security and dignity. The high rates of cognitive impairment, sensory impairment (...) and frailty in hospital wards exacerbates the risk for these violations and subsequent harm. We argue for the adoption of specific national policies prohibiting mixed gender rooms and public reporting of breaches. Importantly, these guidelines can be adopted without compromising the rights of gender minorities. In the long term, hospitals should be built with single occupancy rooms. (shrink)

Recent events concerning Žižek at the Left Forum in New York have revealed much about the state of the Left. It appears that the Left is weaker than ever before and Žižek’s appeal to return to radical roots, yet also break some Leftist taboos, situates the liberal Left as anxious, insecure and reactionary. It also appears that Žižek is deliberately and steadily undertaking what many have accused him of failing to attain – of not going far enough. Here, Žižek is (...) breaking away from being the poster boy for the liberal Left and refining his commitment to communism through critiquing postmodern representations concerning tolerance, hyper-relativism and culturation. (shrink)

It is the praxis of being a subject in the world which enables psychoanalysis to theorise subjectivity. Freud theorised subjectivity from the perspective of desires, those repressed unconscious forces which conflict with the subjects’ need to live in the world. The upshot of this conflict for the subject is trauma and for psychoanalysis such trauma provides a way into a remedy, a cure, the presumption of psychoanalysis being that through its method of transference, it does indeed possess the knowledge to (...) pursue a remedy. Lacan offers a new interpretation of Freud by considering the subject as an ongoing ontological enigma in so far as subjective unconscious desire is not only (potentially) traumatic but necessarily (always) linguistic. How is this an ontological enigma? For Lacan the subject is first and foremost a speaking being engaged in an ongoing struggle to articulate unconscious desire. This is because, claims Lacan, we are born into language which not only pre-exists us but continues after death. In this way subjectivity is inescapably oriented to language as simultaneously intrinsic external to it. The unconscious is therefore a mixture of inside and outside, an enigmatic (pre)ontological space which Lacan calls extimacy. This essay seeks to explore Lacan’s orientation of the subject towards extimacy as the site of subjective conflict where, in its quest for the subject’s desire to know and handle the symptom, transference engages a new ontological dimension in which we can say that the extimate is structured like a sensation. (shrink)

We live in a world of states: a world in which the dominant form of “persisting structure” for the wielding of political power is characterized by territorially concentrated power exercised through political institutions that exert sovereign control in the sense of being able to exclusively command compliance. Within such a world, calls for reorganization of the way these institutions are organized so as to devolve power to groups oppressed or marginalized within existing structures are inevitable. However, for proponents of liberal (...) states, such calls for devolving power pose a problem. When substate groups call for a reorganization in which power is devolved rather than reformed, they imply that within some portions of the state’s territory, or for certain of the state’s inhabitants, state-level political institutions cannot rightfully command compliance, or at least, cannot do so exclusively. Proponents of liberal states might respond to this problem by letting go of the need for exclusive command. However, for many proponents of liberal states, the prospect of a competing source of rightful command that may assert priority over decision making that applies to the entire territory is impractical, and conceptually difficult to sustain. An alternative response, one that preserves the pre-eminent position of institutions that encompass the state’s entire territory and population, is to insist that such institutions have a vital role in ensuring that the decision making of sub-state groups meets minimal conditions of moral equality and respect for human rights. Emphasizing the role of institutions that encompass the entire territory in guaranteeing minimal conditions of moral equality and respect for human rights seems promising, but it cannot provide a satisfactory account of the desirability of empowering state officials to exercise powers of oversight, and so it cannot justify reserving such powers in the face of calls for power to be devolved. This is most obvious in relation to oppressed an marginalized groups, as state officials recognize cannot reasonably expect members of such groups to accept officials as credible guarantors of moral equality or human rights. This problem aside, there is a basic problem with the way decision making is conceived of in arguments for the importance of reserving powers of oversight as groups calling for devolution of power are not susceptible to the kind of characterization that state officials would have to engage in to effectively gauge whether to intervene to secure moral equality and human rights. (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)

This paper involves a case study of physicians working in an urban Midwestern region. It raises questions surrounding how physicians adapted to, encouraged and resisted the increasing presence of managed care in their work lives. The patterning of physician accommodation to managed care and the failure of physicians to mount any effective organized resistance in Metro has some important implications for theories about professional dominance and decline.