Når man går i gang med et forskningsprojekt, vil der typisk være nogle forskningsetiske problemstillinger, man skal forholde sig til. Det kan fx være, at man skal have indhentet informeret samtykkeerklæringer fra de deltagere, der skal være med, eller man skal have indhentet forskningsetiske tilladelser og godkendelser fra uafhængige instanser. Det er altså overvejelser, som typisk dukker op ved begyndelsen af et forskningsprojekt. Der kan efterfølgende være en risiko for, at man forsømmer refleksioner over emergerende etiske problemstillinger, og at forskningsetik (...) således reduceres til, at man som forsker har underskrevet og overholdt nogle prædefinerede retningslinjer for god forskningspraksis. Sådanne retningslinjer er naturligvis særdeles vigtige. Men det er pointen i denne artikel, at de ikke kan stå alene. Forskningsetiske dilemmaer er et epistemologisk vilkår gennem hele forskningsprocessen, og de må således overvejes og genovervejes, forhandles og genforhandles gennem hele forskningsprocessen. Den form for forskningsetik, der følger bestemte på forhånd fastlagte retningslinjer, som typisk er formuleret i standardiserede, kontekstuafhængige principper for god etisk adfærd, benævnes i artiklen procedural forskningsetik, mens en forskningsetik, der foretager en konkret og kontekstafhængig vurdering af de specifikke etiske problemstillinger og dilemmaer, som de viser sig i praksis gennem hele forskningsprocessen, benævnes kasuistisk forskningsetik. Distinktionen mellem disse to typer forskningsetik er udtryk for en teoretisk konstruktion, og de skal ikke betragtes som modsatrettede alternativer, men derimod som supplerende sider ved god forskningsetisk praksis. I artiklen diskuteres forholdet mellem dem for ad den vej at fremhæve enhver forskers pågående og kontinuerlige ansvar gennem hele forskningsprocessen. Nøgleord: forskningsetik, procedural, kasuistisk, Leibniz English summary: Dic cur hic – a casuistic research ethic When embarking on a research project, researchers must customarily confront some ethical issues. To begin with, they may need informed consent from the participants, or research ethics permission and approval from an independent Research Ethics Committee. However, there is more involved than these legal requirements alone, for just complying with some pre-defined guidelines for good research practice is by no means enough. In fact, a number of ethical issues demanding thorough reflection may emerge during the research project. Far from being neglected, such questions deserve careful attention. Research ethical dilemmas are an epistemological condition throughout the whole research process, and must therefore be constantly considered and reviewed, negotiated and renegotiated. This article purports to categorize the ethical issues likely to arise during the course of an investigation into two main types, namely procedural and casuistic. The kind of research ethics following certain pre-established guidelines, which are typically expressed in standardized, context-independent principles of good ethical behavior, will be labeled as procedural research ethics, while the type of research ethics ensuing from the analysis and contextual assessment of the specific dilemmas arising in practice in the particular situation studied, will be named casuistic research ethics. A distinction between these two types of research ethics reflects a theoretical construct. Both types should not be regarded as opposing alternatives, but as complementary aspects of good ethical research practices. This article discusses the relationship between the two types in order to highlight the researcher’s ongoing and continuous responsibility throughout the research process. (shrink)

In order to attain a deeper understanding of Aristotelian philosophy in the Renaissance, it is necessary to consider the theological implications of given facts. This article discusses a basic problem centring on the reception of Aristotle's Ethics. The Nicomachean Ethics was widely regarded as the basis for a virtuous ethical life, yet how could a pagan philosophy, with its concepts of happiness, virtue, justice, etc., be the basis of a Christian society? The aim of the present article is to show (...) how Lutheran scholars solved this problem in confrontation with Catholic and Calvinist scholars of the time. The first part deals with the two basic components of Aristotle's Ethics, namely the doctrines of happiness and virtue , and attempts to show that Aristotle's Ethics should not be understood as a system of rules, but rather as a handbook for the cultivation of practical habits in the free human being who strives to live a good life. The second part examines two key ideological confrontations in relation to Aristotle's philosophy: between Lutherans and Calvinists in respect of definition of theology and philosophical and theological virtues on the one hand, and between Lutherans and »the Enthusiasts« in respect of the concept of virtues on the other. (shrink)

In order to attain a deeper understanding of Aristotelian philosophy in the Renaissance, it is necessary to consider the theological implications of given facts. This article discusses a basic problem centring on the reception of Aristotle’s Ethics. The Nicomachean Ethics was widely regarded as the basis for a virtuous ethical life, yet how could a pagan philosophy, with its concepts of happiness, virtue, justice, etc., be the basis of a Christian society? The aim of the present article is to show (...) how Lutheran scholars solved this problem in confrontation with Catholic and Calvinist scholars of the time. The first part deals with the two basic components of Aristotle’s Ethics, namely the doctrines of happiness and virtue, and attempts to show that Aristotle’s Ethics should not be understood as a system of rules, but rather as a handbook for the cultivation of practical habits in the free human being who strives to live a good life. The second part examines two key ideological confrontations in relation to Aristotle’s philosophy: between Lutherans and Calvinists in respect of definition of theology and philosophical and theological virtues on the one hand, and between Lutherans and ›the Enthusiasts‹ in respect of the concept of virtues on the other. (shrink)

In order to attain a deeper understanding of Aristotelian philosophy in the Renaissance, it is necessary to consider the theological implications of given facts. This article discusses a basic problem centring on the reception of Aristotle’s Ethics. The Nicomachean Ethics was widely regarded as the basis for a virtuous ethical life, yet how could a pagan philosophy, with its concepts of happiness, virtue, justice, etc., be the basis of a Christian society? The aim of the present article is to show (...) how Lutheran scholars solved this problem in confrontation with Catholic and Calvinist scholars of the time. The first part deals with the two basic components of Aristotle’s Ethics, namely the doctrines of happiness and virtue, and attempts to show that Aristotle’s Ethics should not be understood as a system of rules, but rather as a handbook for the cultivation of practical habits in the free human being who strives to live a good life. The second part examines two key ideological confrontations in relation to Aristotle’s philosophy: between Lutherans and Calvinists in respect of definition of theology and philosophical and theological virtues on the one hand, and between Lutherans and ›the Enthusiasts‹ in respect of the concept of virtues on the other. (shrink)

This extended abstract critically exams the use of the terms "rigorous" and "soft" in the context of engineering modeling. Common usage of the terms is contrasted with Toulmin's notion of "reasonableness" and Schoen's notion of "reflective practice." The abstract continues by considering an economic model of models in engineering, suggesting that overly "rigorous" engineering practice may box itself into being unable to afford the models it values, thereby presenting a conundrum for the practice and teaching engineering that demands relaxation.

Abstract:This article discusses the ways in which the practical benefit of poetry, as a source of healing power to reduce distress, is enhanced through incorporating a detailed analysis of literary texts and their sources that relate to the author’s depiction of the human predicament and suggestions for liberation from it. This article focuses on two Romantic poems as case studies, Percy Bysshe Shelley’s “Mutability” (1816) and John Keats’s “Ode on Melancholy” (1820), to highlight an effective way of inspiring students to (...) recognize the poets’ representations of anxiety and their poems’ therapeutic effects. By pointing out the limitations of recent studies promoting the curative power of poetry, the article examines precise literary aspects of the two works, which facilitate the relief from inner affliction for readers as they discuss in detail the concept of affliction in its association with the realities of instability and depression. It suggests a method of providing poetry education that reveals the paradox of suffering and self-remedy and thereby reinforces comprehension. (shrink)

Novel cellular therapy techniques promise to cure many haematology patients refractory to other treatment modalities. These therapies are intensive and require referral to and care from specialised providers. In the USA, this pool of providers is not expanding at a rate necessary to meet expected demand; therefore, access scarcity appears forthcoming and is likely to be widespread. To maintain fair access to these scarce and curative therapies, we must prospectively create a just and practical system to distribute care. In (...) this article, we first review previously implemented medical product and personnel allocation systems, examining their applicability to cellular therapy provider shortages to demonstrate that this problem requires a novel approach. We then present an innovative system for allocating cellular therapy access, which accounts for the constraints of distribution during real-world oncology practice by using a combination of the following principles: maximising life-years per personnel time, youngest and robust first, sickest first, first come/first served and instrumental value. We conclude with justifications for the incorporation of these principles and the omission of others, discuss how access can be distributed using this combination, consider cost and review fundamental factors necessary for the practical implementation and maintenance of this system. (shrink)

This article discusses the ways in which the practical benefit of poetry, as a source of healing power to reduce distress, is enhanced through incorporating a detailed analysis of literary texts and their sources that relate to the author's depiction of the human predicament and suggestions for liberation from it. This article focuses on two Romantic poems as case studies, Percy Bysshe Shelley's “Mutability” (1816) and John Keats's “Ode on Melancholy” (1820), to highlight an effective way of inspiring students to (...) recognize the poets’ representations of anxiety and their poems’ therapeutic effects. By pointing out the limitations of recent studies promoting the curative power of poetry, the article examines precise literary aspects of the two works, which facilitate the relief from inner affliction for readers as they discuss in detail the concept of affliction in its association with the realities of instability and depression. It suggests a method of providing poetry education that reveals the paradox of suffering and self-remedy and thereby reinforces comprehension. (shrink)

Proposed educational outcomes for the health humanities in medical education range from empathy to visual thinking skills to social accountability. This lack of widely agreed-upon high-level curricular goals limits humanities educators’ ability to design purposeful curricula toward clear, common ends and threatens justifications for scarce curricular time. We propose a novel approach to the hoped-for outcomes of health humanities training in medical schools, which has the potential to encompass traditional health humanities knowledge, skills, and behaviors while also being concrete and (...) measurable: humanistic practice. Humanistic practice, adapted from the concept of ethical sensitivity, is an intentional process of applying humanities knowledge and skills to a clinical scenario by 1) noticing that the scenario requires humanities knowledge or skills, 2) informing one’s clinical and interpersonal strategy and behavior with humanities knowledge or skills, 3) reflecting on the effectiveness of the strategy and behavior, and 4) reorienting to develop new approaches for future practice. The construct of humanistic practice may help address some of the foundational problems in health humanities outcomes research since it transcends the traditional diverse content domains in the health humanities, can link patient and provider experiences, and may bridge the divide among the additive, curative, and intrinsic epistemic positions of humanities to medical education. (shrink)

This article explores the Foucauldian notions of practices of the self and care of the self, read via Deleuze, in the context of Iyengar yoga (one of the most popular forms of yoga currently). Using ethnographic and interview research data the article outlines the Iyengar yoga techniques which enable a focus upon the self to be developed, and the resources offered by the practice for the creation of ways of knowing, experiencing and forming the self. In particular, the article (...) asks whether Iyengar yoga offers possibilities for freedom and liberation, or whether it is just another practice of control and management. Assessing Iyengar yoga via a ‘critical function’, a function of ‘struggle’ and a ‘curative and therapeutic function’, the article analyses whether the practice might constitute a mode of care of the self, and what it might offer in the context of the contemporary need to live better, as well as longer. (shrink)

In this paper we argue that the responsibility for systematic community-based preventive medicine should not be made part of the role of the general practitioner (GP). Preventive medicine cannot be shown to be more effective than curative or supportive medicine. Therefore, the allocation of the large amount of general practice staff time and resources required for systematic preventive medicine should not come at the expense of the care of the sick and the suffering. The traditional healing role of the (...) GP requires a cooperative patient-centred approach, whereas systematic preventive medicine is driven by rigid pre-set protocols and is intrinsically paternalistic. Trying to merge the two approaches is detrimental to the doctor-patient relationship. Furthermore, a number of potential pitfalls are identified that may be encountered in the implementation of preventive medicine programmes in general practice: interference with the course of the consultation; inadequate explanation and consent; distortion of practice priorities as reflected in quality indicators; temptation to record inaccurate data; conflict of interests where the doctor is rewarded for performance; patient blaming; exacerbation of the health gap. We suggest that a more justifiable strategy would be for GPs to identify patients at high risk and offer them specific preventive advice when the opportunity presents itself and at a time when the patient is likely to be most amenable to cooperate. Opportunistic health promotion offers higher expectations of benefit, as well as a more equitable allocation of the risks associated with preventive medicine, than a systematic community-based approach. (shrink)

This article discusses ethnoveterinary medical pluralism in Western Kenya. Qualitative methods of data collection such as key informant interviews, open-ended in-depth interviews, focus group discussions (FGDs), narratives, and participant and direct observations were applied. The study shows that farmers in Nyang’oma seek both curative and preventive medical services for their animals from the broad range of health care providers available to them within a pluralistic medical system. Kleinman’s model of medical pluralism, which describes the professional, folk, and popular sectors, (...) informs this discussion because of its relevance and appropriateness to the study. It is, however, important to note the overlap in the three sectors and to point out that livestock farmers engage in multiple “consultations” based on a combination of their own characteristics and the cost, availability and specialization of health care providers. The study concludes by recognizing the complexity of ethnoveterinary medical pluralism and calls for the integration of a pluralistic perspective into the planning and implementation of animal health care interventions and services. (shrink)

In his article "How Certain Boundaries and Ethics Diminish Therapeutic Effectiveness", Lazarus asserts that many clinicians are adhering to strict therapeutic boundaries and ethics in a fear-driven effort to avoid unwarranted malpractice claims. Although I agree that maintenance of conventional therapeutic boundaries is apt to minimize malpractice claims in most cases, I believe that is because such boundaries are critical to protect patients' welfare and thereby promote effective treatment. My reasoning, discussed next, revolves around the following premises: 1. For many, (...) if not most, types of patient problems and patient populations, boundaries and the personal meaning of the therapeutic boundaries are an arena in which critical emotional issues are manifested and worked through. 2. Clear, consistent boundaries provide a structure and safety for many patients that is a curative factor in itself. 3. Patients' reactions to alterations in usual therapeutic boundaries are often unpredictable ahead of time (even if requested by the patient) and typically complex, ambivalent, and heavily colored by transferential meaning. 4. Because alterations in therapeutic boundaries typically add a new therapist role or activity that involves potential gratification of personal needs of the therapist, objectivity in evaluating such a change may be compromised by the inherent self-interest. 5. Consistent, clear boundaries need have no impact on therapist warmth and empathy. (shrink)

Adoption of integrated pest management(IPM) practices in the Guatemalan highlands has beenlimited by the failure of researchers andextensionists to promote genuine farmer participationin their efforts. Some attempts have been made toredress this failure in the diffusion-adoptionprocess, but farmers are still largely excluded fromthe research process. Understanding farmers'agricultural knowledge must be an early step toward amore participatory research process. With this inmind, we conducted a semi-structured survey of 75Cakchiquel Maya farmers in Patzún, Guatemala, tobegin documenting their pest control practices. (...) Theirresponses revealed that their understanding ofbiological and curative pest control is limited.However, their broad knowledge of cultural preventivepest control practices could explain why they hadfaced few pest problems in their traditionalmilpa (intercrop of corn, beans, and other edibleplants). The majority of these preventive practicesare probably efficient and environmentallyinnocuous. (shrink)

It is a popular view thatpractical deliberation excludes foreknowledge of one's choice. Wolfgang Spohn and Isaac Levi have argued that not even a purely probabilistic self-predictionis available to thedeliberator, if one takes subjective probabilities to be conceptually linked to betting rates. It makes no sense to have a betting rate for an option, for one's willingness to bet on the option depends on the net gain from the bet, in combination with the option's antecedent utility, rather than on the offered (...) odds. And even apart from this consideration, assigning probabilities to the options among which one is choosing is futile since such probabilities could be of no possible use in choice. The paper subjects these arguments to critical examination and suggests that, appearances notwithstanding, practical deliberation need not crowd outself-prediction. (shrink)

This volume presents a collection of refereed papers reflecting the state of the art in the area of over-constrained systems. Besides 11 revised full papers, selected from the 24 submissions to the OCS workshop held in conjunction with the First International Conference on Principles and Practice of Constraint Programming, CP '95, held in Marseilles in September 1995, the book includes three comprehensive background papers of central importance for the workshop papers and the whole field. Also included is an introduction by (...) one of the volume editors together with a bibliography listing 243 entries. All in all this is a very useful reference book relevant for all researchers and practitioners interested in hierarchical, partial, and over-constrained systems. (shrink)

What is medicine? One obvious answer in the context of the contemporary clinical tradition is that medicine is the process of curing sick people. However, this “curative thesis” is not satisfactory, even when “cure” is defined generously and even when exceptions such as cosmetic surgery are set aside. Historian of medicine Roy Porter argues that the position of medicine in society has had, and still has, little to do with its ability to make people better. Moreover, the efficacy of (...) medicine for improving population health has been famously doubted by historians and epidemiologists. The curative thesis demands that we have mostly been stupid, duped, or staggeringly hopeful, given that medicine has not until recently offered more than a handful of effective cures. I suggest, in this article, that the core medical competence is neither to cure, nor to prevent, disease, but to understand and to predict it. I argue that this approach does a better job than the curative thesis at explaining why not all medicine is concerned with curative efforts and that it enjoys historical support from the ancient entanglement of prophecy and medicine and from the fact that medicine thrived for centuries with almost no effective cures and continues to thrive today in various forms that are mostly without curative efficacy. I suggest that this approach grounds a fairer approach to alternative, traditional, and other medical practices, as well as some fresh lessons for the development of mainstream medicine. (shrink)

In “Prediction, Understanding, and Medicine,” Alex Broadbent rejects the curative thesis, the view that the core medical competence is to cure, in favor of his predictive thesis that the main intellectual medical competence is to explain and the main practical medical competence is to predict. Broadbent thinks his account explains the phenomenon of multiple consultation, which is the fact that people persist in consulting alternative medical traditions despite having access to mainstream medicine. I argue that Broadbent’s explanation of multiple (...) consultation makes sense only from the perspective of patients who migrate from mainstream to alternative consultation. His explanation is not as convincing when we consider alternative-to-mainstream migration. I also provide an argument against Broadbent’s view that prediction is medicine’s main practical competence and argue that, when it comes to explaining most cases of multiple consultation, the curative thesis provides a more convincing explanation than the predictive thesis. (shrink)

As self-conscious curators and critics of moral history, the early Confucians are relevant to the contemporary debate over the fate of memorials dedicated to morally flawed individuals. They provide us with a pragmatic justification that is distinct from those utilized in the current debate, and in many respects superior to the alternatives. In addition to supplying this curative philosophic resource, the early Confucian practices of ancestral memorialization suggest preventative measures we might adopt to minimize the chances of establishing (...) divisive and oppressive memorials in the future. (shrink)

The world literature shows that empirical research regarding the process of decision-making when cancer in adolescents is no longer curable has been conducted in High-income, English speaking countries. The objective of the current study was to explore in-depth and to explain the decision-making process from the perspective of Mexican oncologists, parents, and affected adolescents and to identify the ethical principles that guide such decision-making. Purposive, qualitative design based on individual, fact-to-face, semi-structured, in-depth interviews. The participants were thirteen paediatric oncologists, 13 (...) parents or primary carers, and six adolescents with incurable cancer. The participants were recruited from the paediatric oncology services of three national tertiary-care medical centres in Mexico City. The oncologists stated that they broach the subject of palliative management when they have determined that curative treatment has failed. Respect for autonomy was understood as the assent of the parent/adolescent to what the oncologist determined to be in the best interest of the adolescent. The oncologists thought that the adolescent should be involved in the decision-making. They also identified the ability to count on a palliative care clinic or service as an urgent need. For the parents, it was essential that the oncologist be truly interested in their adolescent child. The parents did not consider it necessary to inform the child about impending death. The adolescents stated that the honesty of their oncologists was important; however, several of them opted for a passive role in the decision-making process. The findings of this study evidence that to achieve good medical practice in low-middle income countries, like Mexico, it is urgent to begin effective implementation of palliative care, together with appropriate training and continuing education in the ethics of clinical practice. (shrink)

Background The world literature shows that empirical research regarding the process of decision-making when cancer in adolescents is no longer curable has been conducted in High-income, English speaking countries. The objective of the current study was to explore in-depth and to explain the decision-making process from the perspective of Mexican oncologists, parents, and affected adolescents and to identify the ethical principles that guide such decision-making. Methods Purposive, qualitative design based on individual, fact-to-face, semi-structured, in-depth interviews. The participants were thirteen paediatric (...) oncologists, 13 parents or primary carers, and six adolescents with incurable cancer. The participants were recruited from the paediatric oncology services of three national tertiary-care medical centres in Mexico City. Results The oncologists stated that they broach the subject of palliative management when they have determined that curative treatment has failed. Respect for autonomy was understood as the assent of the parent/adolescent to what the oncologist determined to be in the best interest of the adolescent. The oncologists thought that the adolescent should be involved in the decision-making. They also identified the ability to count on a palliative care clinic or service as an urgent need. For the parents, it was essential that the oncologist be truly interested in their adolescent child. The parents did not consider it necessary to inform the child about impending death. The adolescents stated that the honesty of their oncologists was important; however, several of them opted for a passive role in the decision-making process. Conclusion The findings of this study evidence that to achieve good medical practice in low-middle income countries, like Mexico, it is urgent to begin effective implementation of palliative care, together with appropriate training and continuing education in the ethics of clinical practice. (shrink)

Human enhancement technologies raise serious ethical questions about health practices no longer content simply to treat disease, but which now also propose to “optimize” human beings’ physical, cognitive and psychological abilities. These technologies call for a reassessment of our relationship to health, the human body and the body's organic, identity and social functions. In nursing, such considerations are in their infancy. In this paper, we argue for the relevance of critical phenomenology as a way to better understand the ethical (...) issues related to human enhancement technologies (HET). In so doing, we seek to problematize HET and assess their influence on the future development of nursing science and practice. It is difficult to anticipate the concrete effects of HET, we suggest, because these practices reconfigure the meaning of normativity and disorient our conventional ethical landscape. In this context, we argue that the later work of Martin Heidegger and Michel Foucault invites a critical perspective into how techno‐scientific discourses modify our relationship to care, to health and to our own social and corporeal identities. Despite the traditional philosophical opposition between phenomenology and critical theory, we maintain that a hybrid critical phenomenological approach opens new ways to assess the integration of technology and practice. Our analysis understands HET as a process of “hybridization” between technological objects and human subjects. Critical phenomenology thus effectively questions anthropocentric definitions of technology, challenges the dichotomy between curative treatment and enhancement and, finally, prompts valuable reflection on the implications of HET for nursing theory and practice. (shrink)

This article examines the current state of end-of-life care in internal medicine wards in Israel, through an analysis of medical practice and the existing legal framework. The authors demonstrate the processes that lead chronically ill, elderly patients to perceive death as an unexpected phenomenon that is to be avoided at all costs. This perception stems, among other things, from the lack of public debate on questions relating to the end of life and the dominant cultural expectation that physicians provide (...) class='Hi'>curative interventions. This results in a dearth of palliative care for the elderly along with a growing number of medical interventions that are of questionable value. The authors propose an alternative approach that highlights individual well-being and that demonstrates the potential areas of intervention by which death can be transformed into an expected and acceptable occurrence for the old and infirm. This approach allows patients to avoid unnecessary interventions and to reduce the burden of responsibility on family members and physicians, who are currently being called on to make end-of-life choices under exigent circumstances. We present these dilemmas by focusing on typical cases of incompetent elderly patients when there is no clear documentation of their wishes regarding treatment, and when their families do not have a coherent perception of what they may have wanted or of the care that would be most appropriate for them. We conclude with a call to action that highlights the need for greater awareness—through public discourse and private discussions—of end-of-life medical choices before the onset of ill-health and incompetence. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Human Genome Project and BioethicsEric T. Juengst, Ph.D. (bio)The fifteen-year "human genome project" at the National Institutes of Health and the Department of Energy officially began on October 1, 1990. With it began a new dimension in federally supported scientific research: concurrent funding for work to anticipate the social consequences of the project's research and to develop policies to guide the use of the knowledge it produces. As (...) a result, the National Center for Human Genome Research (NCHGR) at NIH will support the largest public investment in bioethical analysis to date.NCHGR was established to work with other federal, private, and international organizations on the scientific effort to characterize the form and content of the human genome. The research will yield information—high-resolution genetic linkage and physical maps of all the human chromosomes as well as human DNA sequence data—that will be a resource for studies of gene structure and function. It will greatly increase our understanding of the genetic aspects of human health and disease. That increased understanding will eventually provide insights into the prevention and treatment of the 3,000 known inherited disorders, and of conditions caused by our (gene-governed) physiological reactions to pathogens, toxins, and mutagens of external origin.It has been clear since the conception of the human genome project, however, that professional and public deliberations concerning the responsible use of genetic information must be a part of the process. The most immediate consequence of genome research will be the development of new diagnostic and predictive tests, well in advance of corresponding therapeutic or curative advances. The implications of acquiring and using that knowledge about individuals raise policy questions at many levels within society. The primary purpose of the Ethical, Legal and Social Implications Program at the NCHGR is to anticipate and address these questions early in the life of the scientific project, to help optimize the [End Page 71] benefits to human welfare and opportunity from the new knowledge, and to guard against its misuses.The program has identified three sets of questions as particularly important to pursue as the genome initiative proceeds:1.Issues involved in the integration of new genetic tests into medical practice. Human genome research is expected to increase greatly the number of gene-based diagnostic and prognostic tests available to health professionals. The bioethical policy problems involved in integrating those tests effectively into medical practice include developing standards for:— accuracy and quality control of genetic tests;— medical indications for testing and design of testing protocols;— professional responsibilities of clinicians who perform tests;— confidentiality of information obtained from testing;— access to and use of test results by third parties, such as health insurers; and— reimbursement for testing and test-related counseling.These are problems for both those charged with regulating the use of new genetic tests and for those establishing the standards of practice within the health professions. Thus, in addition to soliciting and funding scholarly research proposals on both the factual and normative questions raised by these problems, the program is commissioning a major new study by the National Academy of Sciences/Institute of Medicine aimed at providing professional guidelines for the integration of genetic services into mainstream medical practice.2. Issues involved in educating and counseling individuals about genetic test results. The primary risk that health professionals will face in using genetic tests is the misinterpretation of their findings and the resulting potential for psychological trauma, stigmatization, and discrimination. Sometimes, out of ignorance, patients, families, and social institutions already stigmatize genetic disorders and treat those with them unfairly. This risk broadens as the genetic elements of more health problems are uncovered and gene-based tests for susceptibilities and carrier states are developed.To protect against these risks, NCHGR is soliciting and supporting projects aimed at improving professional and public understanding of these tests and their implications. For example, a philosopher is leading a team of geneticists and physicians in a scholarly effort to clarify [End Page 72] concepts of genetic susceptibility and draw out the social meaning of their different interpretations. Other projects involve social scientific studies of genetic risk perceptions, stigmatization, and discrimination. The conclusions of these studies, and... (shrink)

With the start of teaching the sect-based Islamic religion lesson in public schools within the scope of a pilot project in Germany, the development and efforts are continuing to ensure that the course can be given both as a lesson in accordance with the constitution and in accordance with the wishes and expecta-tions of Muslims. Since the Islamic religion lesson is still in the process of formation, one of the most curious points is what the expectations of Muslim families from (...) the lessom are. For this reason, in this study, the state of Baden-Württemberg, one of the states of Germany, in the 2018/2019 academic year, 1-4th grades in public schools. It is aimed to determine the opinions and expectations of the parents of Tur-kish Muslim students who take this lesson from the Islamic religion lesson, which is given as a pilot pro-ject at grade levels, on the issues related to the operation and application of the lesson in the light of cur-rent practices. The study is important in terms of revealing the current status of the lesson and shed light on the future development of the lesson in accordance with the wishes and expectations of Muslim fami-lies. Qualitative research method was used in the research. Research data were collected by semi-structured interview technique consisting of open-ended questions. The research sample consists of 11 Turkish students' parents. In the research, the views and expectations of the parents were expressed with the help of the analysis categories in the form of lower and upper categories. Thus, evaluations were made about at which points the Islamic religion lesson is suitable for the expectations of the parents and at which points it should be made appropriate. (shrink)

This article provides an Anselmian interpretation of the theme of the congress, Pleasures of Knowledge. First, it shows the practical character of Anselm’s epistemology, according to his dialogue De veritate: cognition is conceived as a process characterised by an internal normative claim – called rectitudo – on the one hand, and practical acts supposed to meet this claim on the other hand. Secondly, the same structure is analysed in Anselm’s ethics especially in his soteriological work Cur deus homo, which serves (...) as a link to connect the emotional mood of the Orationes sive Meditationes with the former considerations on epistemology. Thus, it is shown that emotions play a significant systematic role in Anselmian thought. (shrink)

Neglected diseases are severe conditions that mainly affect the world's poorest people. Those suffering from neglected diseases are mostly suffering from tropical infections that have failed to receive priority in pharmaceutical research and development programs, as well as in public health policies aimed at improving availability and access to preventive, diagnostic and curative medicine. The World Health Organization has issued a number of documents directing attention to the plight affecting one third of the world's population, assisted by active support (...) from private organizations, notably the Bill and Melissa Gates Foundation, but the overall situation remains dismal. In the wake of major socioeconomic processes including globalization, steadily growing economic disparity, healthcare inequality, the instability created by rogue states and terrorism, as well as massive migration, and epidemic outbreaks, the features of neglected diseases have been changing. Neglected populations affected by tropical diseases are suffering increasingly from non-infectious degenerative conditions and disabilities due to untreated chronic maladies. Pockets of poverty and neglect can also be detected in high-income countries, contributing to the emergence of new diseases and the reemergence of infections believed to be disappearing such as tuberculosis and the measles. Included in the issues of neglect are rare diseases, mostly of genetic origin, affecting a small number of patients that suffer from multiple life-shortening functional impairment and organ defects. Effective medicines are extremely expensive, allegedly because research and development of appropriate drugs is resources and time consuming, requiring exorbitant prices to recoup investment from a small number of consumers. Bioethics has been tardy in addressing the suffering and destitution of neglected and rare diseases. Convinced that permanently repeated denunciations blunt the sensitivity towards suffering, whereas statistics are bloodless and unable to elicit commitment, this book attempts to explore a different strategy. In an upstream approach, bioethics needs to engage in ethnographic fieldwork that confronts and shares the context in which people suffer, vividly presenting what epidemiological research has blunted into statistical data. Additionally, a downstream approach is suggested, requiring bioethics to vigorously and openly denounce unethical biomedical and pharmaceutical research, misdeeds in registration and marketing of drugs, and misalignment of policies with the unmet healthcare needs of the destitute. More than being critical observers, bioethicists ought to shed lurking conflicts of interests and seek active participation in planning research and public healthcare practices aimed at improving the lives of medically neglected populations. (shrink)

Music in the Flesh reimagines the lived experiences of music-making subjects (composers, musicians, listeners) in the long European seventeenth century. There are countless historical testimonies of the powerful effects of music upon early-modern bodies, described as moving, ravishing, painful, dangerous, curative, miraculous, and encompassing "the circulation of the humors, purification of the blood, dilation of the vessels and pores. In asking what this all meant at the time, the author considers musical scores and their surrounding texts as "somatic scripts" (...) that afford a range of somatic actions and reactions and can give us a glimpse into the historical embodied experience of organized sound. Starting from the Lutheran hymns and their accompanying intellectual traditions and ritual practices in German-speaking lands, the book moves with ease across repertories and regions, sacred and vernacular musics, domestic and public settings in order to sketch a "physiology of music" that is as historically illuminating as it is relevant for present-day performing practices and that sheds unprecedented light on how subjectivity was embodied through sound in early-modern Europe. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Power of PersuasionG. Bennett HumphreyA long white coat, the title of doctor, a practiced professional persona and an appointment to the staff of a prestigious university medical center allows the physician to be a persuader of clinical decisions affecting patient management. When this power of persuasion is used to encourage patient compliance with a therapeutic regimen that might be curative for a fatal disease, there is justification (...) for trying to influence the patient to make choices resulting in a positive outcome. But when a physician is asking permission to enter the patient into a research protocol where the primary goal of the study is the hope of advancing knowledge, then much thought needs to be given to the potential abuse of this power of persuasion.In the 1960s, I found myself having to think about recruiting children into research protocols. I had just finished two years of residency in internal medicine and wanted to pursue a career in academic medicine. My primary interest was in laboratory research. To strengthen my training in research, I had competed for a position as clinical fellow in a western university. The fellowship program was designed to expose young physicians to both clinical and laboratory research. The first year was spent on one of the clinical research wards and the second year in a research laboratory. The program was open to residents from surgery, medicine and pediatrics but because there was a shortage of pediatricians in the program, I was required to work on the children’s leukemia ward for one year.The learning curve was steep during the first few months. Naturally, the faculty in pediatrics and the medical literature gave me a technical education in the use of protocols for therapeutic treatment of leukemia. For example, the first protocol used was designated as Phase III, and the goal was to try to cure the patient. A remission could be achieved in over 90 percent of children but the disease recurred. The median duration of these remissions in the mid–1960s was one year. A relapse was followed by progressive disease and death in a matter of weeks, but a new drug of unknown efficacy could be administered. This was a Phase II protocol, and while there was a chance of prolonging life for a month or so, the primary goal was the identification of drugs anti–leukemic activity.The pediatric leukemia ward experience for me as a fellow was unusual. There was more to learn than the treatment of leukemia. To my surprise, the children and their mothers gave me insight into the care of pediatric patients. Each month, the patients were admitted for five days of intravenous chemotherapy. The first day was traumatic with venipunctures, bone marrow aspirations and the establishment of an IV for the daily infusion of drugs. The remaining four days were for social rounds: listening to the children who liked to talk; talking with the ones who liked to listen; putting puzzles together with some toddlers; responding to a request to listen to the heart of a much loved teddy bear; exchanging jokes and riddles; stories about school, the family dog, or a favorite friend; enjoying the banter of the adolescents; and not invading the privacy of a few who didn’t like me, the ward or the therapy. These children were sharing their childhood with me and it took couple of months for me to recognize I was bonding with these little patients. I observed and listened to the mothers caring for their children and stood in awe of the resources that they brought to bear on having children with a fatal disease. A feeling of mutual respect and trust developed between these mothers and me. For an internist, these experiences were profound and very different from my experience treating adults.A professor, an internationally known researcher in the field of leukemia, was in charge of the ward. Formal rounds were conducted on Tuesday mornings when the result of the bone marrow aspirates and the toxicity of the chemotherapy were reviewed. The day–to–day responsibility for [End Page 101] treatment and informing the mothers on the remission status on Mondays was my responsibility... (shrink)

Dreaming is a communicative activity between the most sensitive archive of the enregistered experience of life on the earth, the brain, and the most plastic medium for the discovery and practice of meaning, the mind or culture. Both love and war have been made on the basis of dreams, not to mention scientific discoveries. In ancient Greece dreams were medicinal parts of curative sleeping or "incubation" rites in the temple of Aesculapius, and many psychoanalytic physicians today still consider dreams (...) as possessing therapeutic potential. The ethnographic literature gives ample testimony to the great significance accorded to dreams by all of the world cultures. Dreams form a rich store of ethnographic evidence, and their indigenous interpretations can often illuminate the central issues and conflicts of a people otherwise hidden from obvious view. Given these facts, plus the physiological facts that the dream process itself involves deeply-rooted material brain functions, and that rapid eye movement, or REM, sleep, which is the key indicator of human dreaming, is shared by all mammals, it remains strange how little attention is given to dreaming as a formative aspect of human evolution and culture. -/- This essay addresses dreaming as a formative aspect of human evolution and culture by viewing dreaming as a borderland between biology and culture, a thoroughly social, yet private experience. Dreaming not only highlights the "cultic" roots of culture—the spontaneous impulse to meaning—but also illustrates one of the ways in which the technics of the biosocial human body itself form the primary source of culture. I show why dreaming, although private, is a thoroughly cultural, biological, communicative activity. -/- Culture and biology are often treated by social scientists as though they were oil and water, not to be mixed. I should inform the culture theorist at the start that I am fully aware of the assumed nature-culture dichotomy, and that I reject it. I do so not because I am a sociobiologist, quite the contrary, rather because I am a semiotician, and my studies of signs have led me toward a critical reconstruction of the concepts of nature and culture. In what follows I beg the reader's patience, since I will draw from diverse materials and project some speculative hypotheses in places in order to make my argument. -/- . (shrink)

A patient suffering from a severe illness that is entering its terminal stage is forced to develop a coping process. Of all the coping patterns, the religious one stands out as being a psychological resource available to all patients regardless of culture, learning, and any age. Religious coping interacts with other values or practices of society, for example the model of a society that takes care of it's elder members among family or in an institutionalized environment or the way (...) the health system offers or not psychological support for a terminally ill patient. Health care providers should have at least some psychological coping patterns training because not all patterns of religious coping are equally effective, and some have been described as increasing the level of stress or producing other negative psychological effects on the patient. This article aims to review the complex models of religious coping that are unanimously accepted in psychooncology, arguments in favor of religious coping, the types of patients that use this model, ethical dilemmas that could be reinterpreted using religious arguments. Finally, we will also discuss the need of Romanian patients to embrace a religious coping in case of an incurable illness, and also the support that they can receive from both curative and palliative health care providers.  . (shrink)

A persistent problem in the dominant agricultural development model is the imposition of technologies without regard to local processes and cultures. Even with the recent shift towards sustainability and agroecology, initiatives continue to overlook local knowledge. In this article we provide analysis of agroecological soil management in the Maya-Achi territory of Guatemala. The Achí, subject to five decades of interventions and development, present an interesting case study for assessing the complementarities and tensions between traditional, generally preventative practices and external (...) initiatives which tend to be curative. Our findings reveal a complex farming system that continues to rely on ancestral knowledge and practices, many of which display a high potential for sustainability and are deeply embedded in local culture. While some new practices have been incorporated into the traditional system, abandonment rates are high, and some extension methods have been paternalistic. The Achí are thirsty for new ideas to help them confront their current, unprecedented challenges. However, future collaborations should be built on existing local knowledge, which has contributed to the development of preventative and restorative practices still in use. Introduced technologies must coincide with local needs and socioecological context in a manner that encourages beneficial synergies, as well as horizontal learning/teaching processes. (shrink)