Capitalizing on the hype surrounding stem cell research, numerous clinics around the world offer “stem cell therapies” for a variety of medical conditions. Despite questions about the safety and efficacy of these interventions, anecdotal evidence suggests a relatively large number of patients are traveling to receive these unproven treatments — a practice called “stem cell tourism.” Because these unproven treatments pose risks to individual patients and to legitimate translational stem cell research, stem cell tourism has generated substantial policy concern and (...) inspired attempts to reduce these risks through the development of guidelines for patients and medical practitioners. This paper examines the roles and responsibilities of physicians in patients' home countries with respect to patients' decisions to try unproven stem cell therapies abroad. Specifically, it examines professional guidance from two organizations — the American Medical Association and the International Society for Stem Cell Research — and assesses physicians' professional and legal obligations to patients considering unproven stem cell therapies. Then, drawing on qualitative interviews conducted with patients who traveled abroad for unproven stem cell treatments, it explores the roles that physicians actually play in patients' decisions and compares these actual roles with their professional and legal responsibilities. The paper concludes with a discussion of strategies to help improve the guidance physicians provide to patients considering unproven treatments. (shrink)

Stem cell science, using both embryonic and a variety of tissue-specific stem cells, is advancing rapidly and offers promise to improve medical care in the future. Yet, with the notable exception of hematopoietic stem cell transplantation, a long-established approach to treating certain cancers of the blood system, this promise is long term and most stem cell research focuses on basic scientific questions or the collection of pre-clinical data. Although some clinical trials are underway, most are focused on safety, and novel (...) effective therapy is likely a long way off. Despite the preliminary nature of most stem cell research, however, numerous clinics around the world offer stem cell “therapies” to patients today outside the context of a clinical trial. Although the number of patients who have received these stem cell-based interventions is unknown, anecdotal reports suggest a substantial population of patients is willing to try them, despite unresolved questions about their safety and efficacy. (shrink)

Forty years after his death, Hans Kelsen (1881-1973) remains one of the most discussed and influential legal philosophers of our time. This collection of new essays takes Kelsen's Pure Theory of Law as a stimulus, aiming to move forward the debate on several central issues in contemporary jurisprudence. The essays in Part I address legal validity, the normativity of law, and Kelsen's famous but puzzling idea of a legal system's 'basic norm'. Part II engages with the difficult issues raised by (...) the social realities of law and the actual practices of legal officials. Part III focuses on conceptual features of legal systems and the logical structure of legal norms. All the essays were written for this volume by internationally renowned scholars from seven countries. Also included, in English translation, is an important polemical essay by Kelsen himself. (shrink)

Central to the argument of this article is the sense in which Thomas Hobbes and liberals see freedom as centered around the notion of free movement. Hobbes, in chapter 21 of Leviathan, describes freedom as “the absence of opposition” to motion. This work argues that the Hobbesian view of freedom as motion was taken up by liberalism as its hallmark and flourished most of all in America where emphasis on individualism was greatest. In America, movement coupled with individualism to create (...) a conception of freedom. (shrink)

Central to the argument of this article is the sense in which Thomas Hobbes and liberals see freedom as centered around the notion of free movement. Hobbes, in chapter 21 of Leviathan, describes freedom as “the absence of opposition” to motion. This work argues that the Hobbesian view of freedom as motion was taken up by liberalism as its hallmark and flourished most of all in America where emphasis on individualism was greatest. In America, movement coupled with individualism to create (...) a conception of freedom. (shrink)

Since Freud, clinicians have understood that disturbing memories contribute to psychopathology and that new emotional experiences contribute to therapeutic change. Yet, controversy remains about what is truly essential to bring about psychotherapeutic change. Mounting evidence from empirical studies suggests that emotional arousal is a key ingredient in therapeutic change in many modalities. In addition, memory seems to play an important role but there is a lack of consensus on the role of understanding what happened in the past in bringing about (...) therapeutic change. The core idea of this paper is that therapeutic change in a variety of modalities, including behavioral therapy, cognitive-behavioral therapy, emotion-focused therapy, and psychodynamic psychotherapy, results from the updating of prior emotional memories through a process of reconsolidation that incorporates new emotional experiences. We present an integrated memory model with three interactive components – autobiographical memories, semantic structures, and emotional responses – supported by emerging evidence from cognitive neuroscience on implicit and explicit emotion, implicit and explicit memory, emotion-memory interactions, memory reconsolidation, and the relationship between autobiographical and semantic memory. We propose that the essential ingredients of therapeutic change include: reactivating old memories; engaging in new emotional experiences that are incorporated into these reactivated memories via the process of reconsolidation; and reinforcing the integrated memory structure by practicing a new way of behaving and experiencing the world in a variety of contexts. The implications of this new, neurobiologically grounded synthesis for research, clinical practice, and teaching are discussed. (shrink)

We used a retrospective survey to model the patterns of appraisal, motivation, and coping that uniquely correspond with 12 positive emotions (affection/love, amusement, awe, challenge/det...

Development of the knowledge base for a profession depends on research and scholarship that builds on the insights and work of scholars within the discipline and is disseminated through the literature. The purpose of this study was to examine a unique collection of 79 articles selected by editors as representative of their nursing journals. Articles were assessed for congruence with long‐standing values and conceptual definitions of nursing, and the extent to which they built on prior literature published in nursing. Articles (...) were scored based on whether they reflected four characteristics of nursing as a discipline (holism, social context, goal of health, and consistency with common definitions of nursing); an abstract score on the extent to which the title, abstract, or keywords indicated a general focus on nursing; and a distinction score based on whether the article distinguished nurses or nursing from other providers. Fifty of the articles received an article score of 4, indicating all four disciplinary characteristics were present in the article's content. While the majority of the articles were congruent with fundamental nursing values and perspectives, only 28% of the sources cited were from nursing sources. The lack of citations to nursing literature, coupled with an assessment that reveals gaps in substantive content that builds on nursing knowledge, raises questions about the future of nursing perspectives in the literature. (shrink)

This paper advances the Hunt–Vitell General Theory of Marketing Ethics as a framework for enriching current understanding of both long-term marketing relationships in general, and principal-agent associations specifically. Under economic models of agency theory, manufacturer-distributor relationships are conceptualized as principal-agent associations where both parties are assumed be motivated exclusively by short-term financial self-interest within the logical constraints of zero-sum game conditions. As a general model of ethical decision making and behavior in marketing, the Hunt–Vitell theory illustrates how ethical decisions are (...) predicated not only upon estimations of potential benefits or outcomes (using teleological criteria), but also deontological evaluations which invoke norms and values. Furthermore, the recent ideas advanced in "relationship marketing" perspectives suggest that distribution channel associations premised upon non-zero-sum or symbiotic assumptions may be more effective and more jointly profitable. Based upon the Hunt–Vitell model, propositions are formulated that complement the understanding of agency theory within the context of marketing channel relationships, and thus, may represent a basis for more effective agency selection and interaction in marketing practice. (shrink)

Working within the reader perspective approach to biblical hermeneutics, a recent series of empirical studies has tested the theory that the readers’ psychological type preferences between sensing and intuition (perceiving functions) and between feeling and thinking (judging functions) shape distinctive readings of biblical texts. This study advances the debate by distinguishing between the two orientations within which the functions are expressed (introverted and extraverted). The added clarity offered by this refinement is illustrated by the distinctive voices of introverted intuition and (...) introverted sensing engaging with the Matthean Beatitudes, eight verses rich in materials to engage the perceiving functions. (shrink)

According to appraisal theory, emotions result from an individual's meaning analysis of the implications of his/her circumstances for personal well-being, and individual differences in emotion arise when individuals appraise similar situations differently. Relational models of appraisal attempt to describe the situational and dispositional antecedents of appraisals, and should allow one to predict such individual differences. In this article, we review three examples of our efforts toward developing relational appraisal models. In two, we start with a particular appraisal component, motivational relevance (...) and problem-focused coping potential (Smith & Lazarus, 1990), respectively, and describe and test the relational model proposed for that component. In the third, as a precursor to developing a true relational model, we examine another appraisal component, emotion-focused coping potential, from a more dispositional perspective. We conclude by considering both the potential value of relational appraisal models, and future directions in the development of these models. (shrink)

The pandemic creates unprecedented challenges to society and to health care systems around the world. Like all crises, these provide a unique opportunity to rethink the fundamental limiting assumptions and institutional inertia of our established systems. These inertial assumptions have obscured deeply rooted problems in health care and deflected attempts to address them. As hospitals begin to welcome all patients back, they should resist the temptation to go back to business as usual. Instead, they should retain the more deliberative, explicit, (...) and transparent ways of thinking that have informed the development of crisis standards of care. The key lesson to be learned from those exercises in rational deliberation is that justice must be the ethical foundation of all standards of care. Justice demands that hospitals take a safety‐net approach to providing services that prioritizes the most vulnerable segments of society, continue to expand telemedicine in ways that improve access without exacerbating disparities, invest in community‐based care, and fully staff hospitals and clinics on nights and weekends. (shrink)

In this response to commentaries on our target article, we highlight and clarify a variety of issues and respond to several comments, challenges, and misconceptions. Topics covered include the mechanisms of enduring change, the nature of memory, the conditions in which memories are updated, the role of emotional arousal in change, and current limitations in our understanding of the neural basis of change in psychotherapy. It is our hope that through research stimulated by this exchange the latter may be advanced.

The present study examined a relational model of appraisal that specifies the situational and dispositional antecedents of appraised problem-focused coping potential, itself a hypothesised antecedent of the emotions of hope/challenge and resignation. The hypothesised relational antecedents of this appraisal were tested in a quasi-experiment in which individuals varying in self-perceived and objectively assessed math ability attempted to solve math problems on which difficulty was manipulated. Findings for the critical test problem largely conformed to predictions: Under difficult conditions, but not easy (...) ones, increasing math ability was generally associated with elevated appraisals of problem-focused coping potential, increased hope/challenge, reduced resignation, and increased likelihood of solving the problem. However, problem-focused coping potential, hope/challenge, and the likelihood of solving the problem were all lower, and resignation was higher, for the highest ability participants, than would be predicted from their ability levels. Comparable findings were not observed for appraisals of emotion-focused coping potential or its theoretically associated emotion of anxiety, providing evidence of discriminant validity for the examined model. The results of a mediational analysis supported the hypothesis that the effects of the quasi-experimental design on hope/challenge and resignation were mediated by their effects on appraised problem-focused coping potential, lending support to the proposition that appraisals play a causal role in emotion elicitation. (shrink)

Drawing on philosophical thought from the eighteenth century as well as conceptual frameworks developed in the twenty-first century, the essays in Beyond Sense and Sensibility examine moral formation as represented in or implicitly produced by literary works of late eighteenth-century British authors.

Do our lives have meaning? Should we create more people? Is death bad? Should we commit suicide? Would it be better if we were immortal? Should we be optimistic or pessimistic? Life, Death, and Meaning brings together key readings, primarily by English-speaking philosophers, on such 'big questions.'.

Do our lives have meaning? Should we create more people? Is death bad? Should we commit suicide? Would it be better to be immortal? Should we be optimistic or pessimistic? Since Life, Death, and Meaning: Key Philosophical Readings on the Big Questions first appeared, David Benatar's distinctive anthology designed to introduce students to the key existential questions of philosophy has won a devoted following among users in a variety of upper-level and even introductory courses.

A psychiatrist who has received international recognition for her research on the neural basis of primate social cognition, Leslie Brothers, M.D., offers here a major argument about the social dimension of the human brain, drawing on both her own work and a wealth of information from research laboratories, neurosurgical clinics, and psychiatric wards. Brothers offers the tale of Robinson Crusoe as a metaphor for neuroscience's classic notion of the brain: a starkly isolated figure, working, praying, writing alone. But the (...) famous castaway of literature, she notes, came from society and returned to society. So too with our brains: they have evolved a specialized capacity for exchanging signals with other brains--they are designed to be social. This can be seen in the brain's sensitive attunement to the meanings of facial expressions and physical gestures and the way it assigns mental lives to physical bodies--a feat we too often take for granted. Brothers describes fascinating case studies that show that certain kinds of brain damage can destroy a patient's ability to interpret faces, leaving him or her with the sense that they are surrounded by zombies. She takes us down to the level of the individual neuron, exploring the response of brain cells to social events. Perhaps most important, she connects neuroscience, psychiatry, and sociology as never before, showing how our daily interaction creates an organized social world--a network of brains that generates meaningful behavior and thought. Our emotions and our sense of self have no existence outside of a social context. Brothers conducts her argument with grace and style. By broadening our approach to the brain, this groundbreaking book makes an important contribution to our understanding of the human mind. (shrink)

In this biography of William James, Robert D. Richardson claims that he seeks ". . . to understand his life through his work, not the other way around" (xiii). This he does not do. Rather, where Richardson does excel is in biographical narrative or in his own words, in the aim "to present James' life [rather] than to analyze or explain it" (xiii).Richardson covers fascinating biographical territory familiar to readers of this journal. He provides an excellent narrative description of James's (...) relation to his father Henry James, Sr. He helpfully accounts for the latter's influence on William as well as their intellectual differences. Richardson's descriptions of the warm relationship between William and his brother .. (shrink)

“He's [the Red King's] dreaming now,” said Tweedledee: “and what do you think he's dreaming about?”Alice said, “Nobody can guess that.”“Why, about you!” Tweedledee exclaimed, clapping his hands triumphantly. “And if he left off dreaming about you, where do you suppose you'd be?”“Where I am now, of course,” said Alice.“Not you!” Tweedledee retorted contemptuously. “You'd be nowhere. Why, you're only a sort of thing in his dream!”“If that there King was to wake,” added Tweedledum, “you'd go out—bang!—just like a candle.”“I (...) shouldn't!” Alice exclaimed indignantly. “Besides, if I'm only a sort of thing in his dream, what are you, I should like to know?”“Ditto,” said Tweedledum.“Ditto, ditto!” cried Tweedledee.He shouted this so loud that Alice couldn't help saying “Hush! You'll be waking him, I'm afraid, if you make so much noise.”“Well, it's no use your talking about waking him,” said Tweedledum, “when you're only one of the things in his dream. You know very well you're not real.”“I am real!” said Alice, and began to cry.“You won't make yourself a bit realler by crying,” Tweedledee remarked: “there's nothing to cry about.”“If I wasn't real,” Alice said—half laughing through her tears, it all seemed so ridiculous —“I shouldn't be able to cry.”“I hope you don't suppose those are real tears?” Tweedledum interrupted in a tone of great contempt.—Through the Looking Glass. (shrink)

La pensée conventionnaliste de l’environnement se heurte à un problème central : l’absence d’un ordre de grandeur écologiste qui obéisse à la même grammaire que les six autres. Cet article propose une piste afin de surmonter ce problème. Il s’agit d’envisager l’écologisme, non plus sous le modèle idéal de la cité, mais comme une critique du capitalisme. Dans cette perspective, les fondements théoriques et l’effectivité historique de la critique écologiste du capitalisme sont étudiés. Codes JEL : B5, N5, O13, O440, (...) P10, Q5. (shrink)

La pensée conventionnaliste de l’environnement se heurte à un problème central : l’absence d’un ordre de grandeur écologiste qui obéisse à la même grammaire que les six autres. Cet article propose une piste afin de surmonter ce problème. Il s’agit d’envisager l’écologisme, non plus sous le modèle idéal de la cité, mais comme une critique du capitalisme. Dans cette perspective, les fondements théoriques et l’effectivité historique de la critique écologiste du capitalisme sont étudiés. Codes JEL : B5, N5, O13, O440, (...) P10, Q5. (shrink)