The paper is written in response to those who fail to recognize the relation between a patient's mental competency and her state of pain. Some clinicians claim that a proper diagnosis can only be made in the absent of analgesia. Rather, the patient's state of pain directly affects her mental competency and thus her ability to give valid consent. Clinicians should rethink their approach to diagnosis when the patient is in pain.

The foundational hypothesis to this study is that congregations which have a healthy perception and a greater understanding of conflict will develop more effective responses to conflict that will translate into more effective conflict resolution and reconciliation. The process and sustainability of the development of a missional church, the context of the study, is pregnant with potential conflict. Untamed conflict has the propensity to retard, jeopardise or even destroy the development of a missional church. When conflict arises, it must be (...) understood and dealt with theologically. The inherent problem is that conflict appears to be neither understood nor appreciated sociologically and theologically. This knowledge and praxis vacuum has the potential for conflict to translate into inappropriate or ineffective responses that do not always make for effective resolution and reconciliation. The research focuses mainly on an empirical study based on the four practical theological questions of Osmer (2008). Participants for this study were randomly selected from specific sectors of Methodist congregations in the wider Pretoria area. The research explores congregants’ perceptions, understanding and views of conflict; their responses to conflict; and some felt and observed outcomes of conflict. The presupposition is that the development of the local missional church would be more effective and efficient when the management and process of conflict resolution and reconciliation are well led and well managed. This study confirmed that conflict, despite its normalcy and necessity, carries a negative undertone and is mostly avoided in congregations. This is compounded by the evidence that there is little, if any, theological or scriptural understanding of conflict. There is also no indication that churches intentionally and purposefully educate their members to appreciate and understand conflict. In so doing, churches are harming their innate calling as the glory and manifestation of God’s divine grace through faith communities for the transformation of all peoples. Yet, the church understands the dangers of unhealthy conflict, and on occasion even expects conflict to arise, although deeming it inappropriate. Practical theological discernment is sought as to why this may be so and remedial action is proposed to address the problem of conflict within congregations. (shrink)

When social reformers blame the current ills of Western culture on the loss of community, they often evoke an ideal past in which societies were characterized by shared values, respect for tradition, commitment to the common good, and similar attributes. Communitarians assert that community was prominent in the past, and argue that reclaiming the role community formerly played is necessary to counter the negative effects of individualism and liberal thinking. Considering the relevance of community for our moral and political life (...) today, Derek Phillips offers the first thorough critique of the historical, often nostalgic, claims that underlie dominant versions of communitarian philosophy. Originally published in 1993. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

This article is an elaboration and extension of an earlier article concerned with guilt and morality in the modern age. The focus is on two general issues arising from what was presented there. First, there is an attempt to explicate the conception of human agency underlying the emphasis on individual responsibility in the original essay. Second, there is a critical examination of the moral relativism position so common in the contemporary world. Both the shrinking conception of human agency and responsibility (...) and the growing acceptance of moral relativism are strongly criticized, and it is concluded that a rationally-based morality must be defended against those many persons today for whom anything goes in the realm of human behavior. (shrink)

Nazarene Theological Seminary, a graduate school in the Wesleyan-Holiness tradition, is undergoing significant self-examination and adjustment in response to changes and challenges in ecclesial and higher education cultures. This article gives readers a glimpse into NTS’s process for the teaching and practice of spiritual formation—something integral to its heritage and history, intentionally engaged curricularly and relationally, yet in need of assessment and revitalization due to increased diversification and fragmentation of learning platforms and contexts. The school’s ecclesial and institutional roots are (...) reviewed, the contextual development of intentional spiritual formation programming described, important shifts and challenges in the educational and formational landscapes prompting new initiatives noted, a preliminary plan for assessment and evaluation of spiritual formation curriculum and programming outlined, and questions raised to focus the horizons for the continuation of the processes. Readers are invited to join the conversation and provide feedback and input for NTS moving forward. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Education in the Virtues: Tragic Emotions and the Artistic ImaginationDerek L. Penwell (bio)IntroductionThe profoundly thoughtful—not to mention extensive—character of the scholarship historically applied to the nature of the difference between Plato and Aristotle on the issue of the tragic emotions raises the obvious question: What new is there left to say? In this article I seek to hold together two separate issues that have occupied much of the scholarship (...) on this topic but that typically have not been considered together: (1) What is the moral value of the tragic emotions? and (2) If the tragic emotions are morally significant, how can we engage tragedy without viewing it instrumentally? By approaching the tragic emotions in this way, I hope to suggest an Aristotelian analysis of tragedy that appreciates tragedy's ability to expand our resources for confronting an often chaotic world, while at the same time avoiding the notion of art as merely useful in the pursuit of larger moral projects.Plato, in Republic X, offers his seminal critique of art and the artist in relationship to the ideal republic. In particular, poetry comes under harsh criticism for encouraging emotions, which, according to Plato, ought to be kept under strict control. In the end, Plato reluctantly declares that poets must be banished as a way of preserving the order and moral integrity of the republic. Poetry, if permitted, will make "pleasure and pain the twin kings in your city in place of established custom and the thing which has always been generally accepted as best—reason."1Aristotle challenges his old teacher, Plato, in his treatise on tragedy in the Poetics. To say that Aristotle challenges Plato, however, is not say that he confronts Plato directly; rather the scope of Aristotle's argument addresses the issue of poetry, which Plato had denounced in the Republic. Specifically, Aristotle calls into question Plato's account of the value of the emotions. [End Page 9] Whereas Plato contends that emotions are a potentially disruptive force, the power of which must always be controlled by reason, Aristotle maintains, as I will argue, that the cultivation of the appropriate emotional response (that is, the correct emotional response at the correct time) is essential to the development of virtue. Moreover, according to Aristotle's view, the cultivation of appropriate emotional response has implications not only for the development of individual virtue but also for the health of the body politic.I must be careful to point out that I am not attempting to elicit Aristotle's endorsement for a view that says reason is not somehow responsible for properly informing the emotions. Aristotle's position with respect to emotions—while different from Plato's in the belief that emotions can be educated—still identifies reason both as the faculty that differentiates us as a species as well as the faculty that occupies the primary place in establishing knowledge and directing action. My goal in the first section of this article is much more modest: I only wish to argue that an Aristotelian critique of Plato on emotions suggests the beginnings of a way of viewing emotions, such that emotions have a significant role to play in moral development.2However, the nature of Aristotle's argument in his implicit response to Plato raises the important question of whether the view of art he advances (in particular, of tragedy) is purely an instrumental one—a question to which I will attend in the second section. Does Aristotle understand art as a tool in the service of some higher good, such as moral education? Art, if this is the case, loses its integrity as an end in itself. Inasmuch as Aristotle believes that art is conducive to moral education, he is in danger of being charged with inhabiting the dubious aesthetic stance that art is always the means to some higher end. That is to say, it could be argued that the theory of art that Aristotle places on offer is what R. W. Beardsmore calls moralism3 and what Berys Gaut calls ethicism.4 Moralism at its most radical is the aesthetic position that finds art as merely a useful tool in dressing... (shrink)

Frequency effects are pervasive in studies of language, with higher frequency words being recognized faster than lower frequency words. However, the exact nature of frequency effects has recently been questioned, with some studies finding that contextual information provides a better fit to lexical decision and naming data than word frequency ( Adelman et al., 2006 ). Recent work has cemented the importance of these results by demonstrating that a measure of the semantic diversity of the contexts that a word occurs (...) in provides a powerful measure to account for variability in word recognition latency ( Johns et al., 2012, 2015 ; Jones et al., 2012 ). The goal of the current study is to extend this measure to examine bilingualism and aging, where multiple theories use frequency of occurrence of linguistic constructs as central to accounting for empirical results ( Gollan et al., 2008 ; Ramscar et al., 2014 ). A lexical decision experiment was conducted with four groups of subjects: younger and older monolinguals and bilinguals. Consistent with past results, a semantic diversity variable accounted for the greatest amount of variance in the latency data. In addition, the pattern of fits of semantic diversity across multiple corpora suggests that bilinguals and older adults are more sensitive to semantic diversity information than younger monolinguals. (shrink)

The words in children's language learning environments are strongly predictive of cognitive development and school achievement. But how do we measure language environments and do so at the scale of the many words that children hear day in, day out? The quantity and quality of words in a child's input are typically measured in terms of total amount of talk and the lexical diversity in that talk. There are disagreements in the literature whether amount or diversity is the more critical (...) measure of the input. Here we analyze the properties of a large corpus of speech to children and simulate learning environments that differ in amount of talk per unit time, lexical diversity, and the contexts of talk. The central conclusion is that what researchers need to theoretically understand, measure, and change is not the total amount of words, or the diversity of words, but the function that relates total words to the diversity of words, and how that function changes across different contexts of talk. (shrink)

We consider the moral and social ingredients in physicians' relationships with patients of diminished capacity by considering certain claims made about friendship and the physician's role. To assess these claims we look at the life context of two patients as elaborated examples provided in two novels: Woman on the Edge of Time (1976) by Marge Piercy, a radical feminist; and It's Hard to Leave While the Music's Playing (1977) by I. S. Cooper, a prominent physician-researcher. At issue is how the (...) doctor-patient relationship should be structured. In question is whether the physician's friendship and professional expertise, together with the diminished capacity of the patient, authorize medical paternalism. From our examination, we find compelling insights against appealing to friendship both in good doctor-patient relationships and in more typical, not-so-good ones. (shrink)

We argue there is a deep conflict in Paul Moser’s work on divine hiddenness. Moser’s treatment of DH adopts a thesis we call SEEK: DH often results from failing to seek God on His terms. One way in which people err, according to Moser, is by trusting arguments of traditional natural theology to lead to filial knowledge of God. We argue that Moser’s SEEK thesis commits him to the counterfactual ACCESS: had the atheist sought after God in harmony with how (...) God reveals himself, she would have had access to filial knowledge of God. By failing to incorporate arguments or propositional evidence for God’s existence, Moser’s account leaves the doubting seeker without any evidential reason to think that either SEEK or ACCESS is true. Without this rational motivation in place, the doubting seeker is unlikely to seek after God in the way ACCESS describes. We argue that natural theology provides an evidential epistemic aid to motivate persons to seek God the way ACCESS describes. Thus, Moser is mistaken. Such arguments can be evidentially helpful in coming to know God. In conclusion, we explain how our reply naturally fits how we form and maintain trusting interpersonal relationships with others. (shrink)

Development of an animal embryo involves the coordination of cell divisions, a variety of inductive interactions and extensive cellular rearrangements. One of the biggest challenges in developmental biology is to explain the relationships between these processes and the mechanisms that regulate them. Teleost embryos provide an ideal subject for the study of these issues. Their optical lucidity combined with modern techniques for the marking and observation of individual living cells allow high resolution investigations of specific morphogenetic movements and the construction (...) of detailed fate maps. In this review we describe the patterns of cell divisions, cellular movements and other morphogenetic events during zebrafish early development and discuss how these events relate to the formation of restricted lineages. (shrink)

Background: Discussions about medical errors facilitate professional learning for physicians and may provide emotional support after an error, but little is known about physicians’ attitudes and practices regarding error discussions with colleagues.Methods: Survey of faculty and resident physicians in generalist specialties in Midwest, Mid-Atlantic and Northeast regions of the US to investigate attitudes and practices regarding error discussions, likelihood of discussing hypothetical errors, experience role-modelling error discussions and demographic variables.Results: Responses were received from 338 participants . In all, 73% of (...) respondents indicated they usually discuss their mistakes with colleagues, 70% believed discussing mistakes strengthens professional relationships and 89% knew at least one colleague who would be a supportive listener. Motivations for error discussions included wanting to learn whether a colleague would have made the same decision , wanting colleagues to learn from the mistake and wanting to receive support . Given hypothetical scenarios, most respondents indicated they would likely discuss an error resulting in no harm , minor harm or major harm . Fifty-seven percent of physicians had tried to serve as a role model by discussing an error and role-modelling was more likely among those who had previously observed an error discussion .Conclusions: Most generalist physicians in teaching hospitals report that they usually discuss their errors with colleagues, and more than half have tried to role-model discussions. However, a significant number of these physicians report that they do not usually discuss their errors and some do not know colleagues who would be supportive listeners. (shrink)

Most books about ethics focus either on the origins of ethics, or on the application of ethical thinking to a single form of therapy. This book sets out to span a range of very different forms of therapy and explores the similarities and the differences between the ethical thinking of the practitioners concerned. By looking at ethical issues in different therapeutic settings the reader is challenged to reconsider the working assumptions which underpin familiar therapeutic practice. Readers of Forms of Ethical (...) Thinking in Therapeutic Practice are offered the unique opportunity to gain insights into the ethical thinking of experienced practitioners offering strikingly different services to their clients and working in contrasting contexts. Essential reading for all practitioners in counselling and the therapies, students, trainers, supervisors and providers of therapeutic services. (shrink)

Philosophers have traditionally assumed that the difference between active and passive movement could be explained by the presence or absence of an intention in the mind of the agent. This assumption has led to the neglect of many interesting active behaviors that do not depend on intentions, including the "mindless" actions of humans and the activities of non-human animals. In this book Jones offers a broad account of agency that unifies these cases. The book addresses a range of questions, (...) including: When are movements properly attributed to whole agents, rather than to their parts? What does it mean for an agent to guide its action? What distinguishes agents from other complex systems? What is the relationship between action and adaptive behavior? And why might the study of living systems be the key to understanding agency? This book makes an important contribution to current philosophical debate on the nature and origins of agency. It defines action as a uniquely biological process and recasts human intentional action as a specialized case of a broader and more common phenomenon than has been previously assumed. Uniting findings from philosophy, cognitive science, psychology, biology, computer science, complexity theory and ethology, this book will be of interest to students and scholars working in these areas. (shrink)

Nanomaterials have the promise of revolutionizing current treatment and diagnosis of diseases, which has led to 33 nanotherapeutics drugs currently on the market and many more in various stages of clinical trials. With an increasing number of products available and in development, along with the unique, emergent properties of the nanoparticle therapeutics themselves, regulatory agencies are now faced with decisions regarding the regulation of such novel technologies. Regulatory guidance, particularly in pre-clinical stages, has the potential to facilitate quick and safe (...) development of these novel materials, but new regulation beyond what is currently in place must be justified in a clear and distinctive toxic response. Herein, we examine literature that compares and correlates in vivo and in vitro nanotoxicity studies to gain a deeper understanding of the modes of nanoparticle toxicity. Additionally, this comparison aims to identify clear and unique toxicity responses caused by nanoparticles, which informs our perspective on pre-clinical nanotherapeutic oversight. (shrink)

Much of the focus of the published 2011 symposium that inspired this work focused on the question, “When have you reduced risk enough to move from bench/animal studies to ‘first in-human’ studies?” Building applied research ethics related to nanotherapeutics requires bench and clinical scientists to have a clear vision about how to test nanotherapeutic safety, and it is clear that there is still much to be considered at the steps before “in-human” assessment. Herein, the perspective of the bench scientist is (...) brought to bear on using in vivo and in vitro models to assess the safety of nanotherapeutics. Much of this work falls under the purview of the field of nanotoxicology that aims to understand the toxicological impact of engineered nanoscale materials. Engineered nanomaterials include a wide variety of materials that are manipulated and controlled on the nanoscale level where, typically, the nanoparticle or nanomaterial has some dimension that is less than 100 nm. (shrink)