This article describes the situated nature of two intertwined dimensions of the context of medical encounters - expertise and compliance - within the interactional practices of referrals and accounts of referrals. Families who display their expertise and compliance have referral and account sequences with notably different features compared to sequences with families who display a lack of compliance and expertise. The display of expertise significantly affects the course of the interaction, and asymmetrical sequences often occur in interactions when the professionals (...) see families' expertise and compliance as problematic. (shrink)

Interdisciplinary hospital ethics committees have been the most common response to the mandates for ethical review procedures set forth by the Joint Commission for the Accreditation of Health Care Organizations, the American Hospital Association, and within institutions themselves. A 1989 national survey reported that 60% of hospitals had ethics committees. However, little is still known about the current state of these committees in hospitals, their composition, what functions are performed, or what issues are discussed.

Though much has been written about when paternalistic intervention is justified, and about how it is justified, much less has been written about who may do the intervening. This is a substantial lacuna in our understanding of the nature of justified paternalism. By examining the question of who it is that may most appropriately interfere with the course of our decision-making, we can learn something useful both about paternalism and about the nature of friendship.In this essay I will argue that (...) friendship and paternalistic intervention are linked. Friendship of the close, intimate variety that I will be discussing is in part constituted by the fact that one friend is morally justified in interfering with the other’s decisions. Intimate friendship involves a partial meshing of identities. This meshing of identities manifests itself in part by the liberties that one friend takes in guiding the life of the other. Paternalistic intervention between friends can thus be justified because it expresses the union of the friends, and because it preserves that union. (shrink)

The past two decades of psychoanalytic discourse have witnessed a marked transformation in the way we think about women and gender. The assignment of gender carries with it a host of assumptions, yet without it we can feel lost in a void, unmoored from the world of rationality, stability and meaning. The feminist analytic thinkers whose work is collected here confront the meaning established by the assignment of gender and the uncertainty created by its absence. The contributions brought together in (...) _Psychoanalytic Reflections on a Gender-free Case_ address a cross-section of significant issues that have both chronicled and facilitated the changes in feminist psychoanalysis since the mid 1980s. Difficult issues which have previously been ignored are considered first. The book goes on to address family perspectives as they interact and shape the child’s experience of growing up male or female. Other topics covered are the authority of personal agency as influenced by the language and theory of patriarchy, male-centred concepts that consistently define women as inferior, and the concept of gender as being co-constructed within a relationship. The gender-free case presented here will fascinate all psychoanalysts interested in exploring ways of grappling with the elusive nature of gender, as well as those studying gender studies. (shrink)

Friendship alters the moral demands and ideals that we live with. In this dissertation I examine precisely how those ideals must change if they are to accommodate the realities of friendship. I begin by surveying Aristotle, Kant, and Montaigne, and showing that each of those writers had useful insights into the way in which we reconceptualize the self when we become close friends with another person. I suggest that Kant and Montaigne were both right that we tend to merge our (...) identities with our friends. I then argue that if we value this sense of unity with our friends, certain changes must be made to common normative concepts. In particular, I argue that paternalistic intervention is more justified between friends than between strangers, because such intervention presupposes that the two individuals have a kind of shared autonomy. This presupposition is only true for friends, not for strangers. ;I further argue that the concept of respect must be reshaped if it is to be useful between friends. Kant noted that respect is a concept which distances people from one another, and such distance is not always appropriate between friends. I suggest that the notion of respect can be restructured so that it does not require distance and separation. Finally, I suggest that self-respect must also be restructured if the self is shared. (shrink)

This article describes some potential uses of Bayesian estimation for time-series and panel data models by incorporating information from prior probabilities in addition to observed data. Drawing on econometrics and other literatures we illustrate the use of informative “shrinkage” or “small variance” priors while extending prior work on the general cross-lagged panel model. Using a panel dataset of national income and subjective well-being we describe three key benefits of these priors. First, they shrink parameter estimates toward zero or toward each (...) other for time-varying parameters, which lends additional support for an income → SWB effect that is not supported with maximum likelihood. This is useful because, second, these priors increase model parsimony and the stability of estimates and thus improve out-of-sample predictions and interpretability, which means estimated effect should also be more trustworthy than under ML. Third, these priors allow estimating otherwise under-identified models under ML, allowing higher-order lagged effects and time-varying parameters that are otherwise impossible to estimate using observed data alone. In conclusion we note some of the responsibilities that come with the use of priors which, departing from typical commentaries on their scientific applications, we describe as involving reflection on how best to apply modeling tools to address matters of worldly concern. (shrink)

In June 2012, New York City Mayor Michael Bloomberg announced his plans for a ban on the sale of sugary beverages in containers larger than 16 ounces. Shortly thereafter, the Center for Consumer Freedom took out a full-page ad in the New York Times featuring Bloomberg photo-shopped into a matronly dress with the tag line “New Yorkers need a Mayor, not a Nanny.” On television, the CATO Institute's Michael Cannon declared, “This is the most ridiculous sort of nanny state-ism; [i]t’s (...) none of the mayor's business how much soda people are drinking.” And in newspapers around the country, editorial pages featured headlines such as “Gulp! Yet Another Intrusion of the Nanny State.” Just like that, the public debate about this measure became focused on government overreach, while the public health problem of obesity faded into the background. (shrink)

BackgroundStructured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease characteristics or resource limitations mean that high-quality evidence generation is difficult. However, poor reporting of methods used to reach a consensus – for example, not clearly explaining the definition of consensus, or not stating (...) how consensus group panellists were selected – can potentially undermine confidence in this type of research and hinder reproducibility. Our objective is therefore to systematically develop a reporting guideline to help the biomedical research and clinical practice community describe the methods or techniques used to reach consensus in a complete, transparent, and consistent manner.MethodsThe ACCORD project will take place in five stages and follow the EQUATOR Network guidance for the development of reporting guidelines. In Stage 1, a multidisciplinary Steering Committee has been established to lead and coordinate the guideline development process. In Stage 2, a systematic literature review will identify evidence on the quality of the reporting of consensus methodology, to obtain potential items for a reporting checklist. In Stage 3, Delphi methodology will be used to reach consensus regarding the checklist items, first among the Steering Committee, and then among a broader Delphi panel comprising participants with a range of expertise, including patient representatives. In Stage 4, the reporting guideline will be finalised in a consensus meeting, along with the production of an Explanation and Elaboration document. In Stage 5, we plan to publish the reporting guideline and E&E document in open-access journals, supported by presentations at appropriate events. Dissemination of the reporting guideline, including a website linked to social media channels, is crucial for the document to be implemented in practice.DiscussionThe ACCORD reporting guideline will provide a set of minimum items that should be reported about methods used to achieve consensus, including approaches ranging from simple unstructured opinion gatherings to highly structured processes. (shrink)

The American Academy of Pediatrics Task Force on Circumcision published its policy statement and technical report on newborn circumcision in September 2012.1 ,2 Since that time, some individuals and groups have voiced objections to the work of the Task Force, while others have conveyed their support. The AAP task force is pleased that the policy statement and technical reports on circumcision have stimulated debate on this topic and welcomes respectful discussion and dialogue about the scientific and ethical issues that surround (...) neonatal circumcision. We believe this is a complex issue that does not lend itself to simplistic solutions. The Task Force encourages those of all viewpoints to contribute to a vibrant, thoughtful and respectful evidence-based dialogue. We appreciate that the free exchange of competing ideas is a necessary component of scientific discovery. We also recognise that all clinical decisions carry ethical dimensions and that a respectful and thoughtful dialogue about these issues is important. However, the Task Force also feels strongly that this debate and the academic literature are demeaned when those with an ideological agenda disseminate inaccurate information, misapply scientific principles, make accusations that are unsupported, communicate in a vitriolic tone, and attempt to discredit and mischaracterise alternative views and those who hold them. Healthy debate and …. (shrink)

Chapter 9 of Aristotle's 'On Interpretation' deals with determinism, and here the two influential commentaries of Ammonius and Boethius have been published together.

The combination of breeding for increased production and the intensification of housing conditions have resulted in increased occurrence of behavioral, physiological, and immunological disorders. These disorders affect health and welfare of production animals negatively. For future livestock systems, it is important to consider how to manage and breed production animals. In this paper, we will focus on selective breeding of laying hens. Selective breeding should not only be defined in terms of production, but should also include traits related to animal (...) health and welfare. For this we like to introduce the concept of robustness. The concept of robustness includes individual traits of an animal that are relevant for health and welfare. Improving robustness by selective breeding will increase (or restore) the ability of animals to interact successfully with the environment and thereby to make them more able to adapt to an appropriate husbandry system. Application of robustness into a breeding goal will result in animals with improved health and welfare without affecting their integrity. Therefore, in order to be ethically acceptable, selective breeding in animal production should accept robustness as a breeding goal. (shrink)

O presente artigo objetiva apresentar uma compreensão crítica do tempo presente, que se pode chamar de contemporaneidade. Nessa direção, as reflexões sobre esse momento histórico priorizaram os questionamentos filosóficos de Heidegger. Para interpretação mais ampla do pensamento heideggeriano, foi abordada, rapidamente, as concepções existenciais de homem e de mundo trazidas em sua obra “Ser e tempo”. Após essas considerações, a “Era da Técnica”, marcada pelo esquecimento do ser, foi tomada enquanto foco de discussão. Por fim, ressalta-se a inquietação não com (...) relação ao crescimento da técnica planetária, mas sim acerca do fato de o homem não compreender a dimensão e o sentido das transformações empreendidas por esta destinação; rejeitando, com isso, aquilo que tem de mais próprio, a condição de ser o único ser que reflete. (shrink)

David Blank presents a new translation into clear modern English of a key treatise by one of the greatest of ancient philosophers, together with the first ever commentary on this work. Sextus Empiricus' Against the Grammarians is a polemical attack on ancient Greek ideas about grammar, and provides one of the best examples of sustained Sceptical reasoning.

In Aeschines' dialogue Alcibiades, Socrates sees his brilliant young partner's haughty attitude towards the great Themistocles. Thereupon he gives an encomium of Themistocles, a man whose wisdom and arete, great as they were, could not save him from ostracism by his own people. This encomium has an extraordinary effect on Alcibiades: he cries and in his despair places his head upon Socrates' knee, realizing that he is nowhere near as good a man as Themistocles. Aeschines later has Socrates say that (...) he would have been foolish to think he could have helped Alcibiades by virtue of any art or knowledge, but nonetheless by some divine dispensation he has, in virtue of the eros he felt for the youth, been allowed to make him better. (shrink)

This book is the recent addition to the Clarendon Later Ancient Philosophers series, and its greatest significance lies in its being the sole commentary on Against the Grammarians. It also provides the only English alternative to Bury’s 1949 translation in the Loeb edition. As such, it is a clear and readable translation, although, of course, there is no Greek text provided.

The paradigm of work and the formal organizations within which people work are changing. Trends in organizations include less hierarchy, integrated structures, empowered employees, teams and teamwork, labor-management partnerships, and myriad other changes. Underlying all these changes is a new emphasis on values regarding how organizations function. Among the critical organizational functions to which the values framework applies is communication.Most models of internal organizational communication are adaptations of the existing model for communicating externally. These models fall short of what is (...) needed to impact today's employees. (shrink)

Understanding the clinical significance of variants associated with hereditary cancer risk requires access to a pooled data resource or network of resources—a “cancer gene variant commons”—incorporating representative, well-characterized genetic data, metadata, and, for some purposes, pathways to case-level data. Several initiatives have invested significant resources into collecting and sharing cancer gene variant data, but further progress hinges on identifying and addressing unresolved policy issues. This commentary provides insights from a modified policy Delphi process involving experts from a range of stakeholder (...) groups involved in the data-sharing ecosystem. In particular, we describe policy issues and options generated by Delphi participants in five domains critical to the development of an effective cancer gene variant commons: incentives, financial sustainability, privacy and security, equity, and data quality. Our intention is to stimulate wider discussion and lay a foundation for further work evaluating policy options more in-depth and mapping them to those who have the power to bring about change. Addressing issues in these five domains will contribute to a cancer gene variant commons that supports better care for at-risk and affected patients, empowers patient communities, and advances research on hereditary cancers. (shrink)

From its title, which since antiquity has occasioned interpretations of varying ingenuity and implausibility and which the book under review is probably right to judge both inauthentic and inappropriate, to its final chapter, thought to be post-Aristotelian or an exercise by Porphyry and the Greek commentators who followed him, On Interpretation has long been considered one of Aristotle’s most puzzling works. Brief as it is, this treatise was divided into four main parts by Ammonius, dealing with the principles of the (...) assertoric sentence, the proposition consisting of subject and predicate terms only, the proposition which contains an “added predicate”, and modal propositions. Modern commentators tend to find in the work important, but isolated, discussions of general semantic theory, the elements of grammar, and modality and fatalism, but not much else of interest. (shrink)

In Aeschines' dialogue Alcibiades, Socrates sees his brilliant young partner's haughty attitude towards the great Themistocles. Thereupon he gives an encomium of Themistocles, a man whose wisdom and arete, great as they were, could not save him from ostracism by his own people. This encomium has an extraordinary effect on Alcibiades: he cries and in his despair places his head upon Socrates' knee, realizing that he is nowhere near as good a man as Themistocles . Aeschines later has Socrates say (...) that he would have been foolish to think he could have helped Alcibiades by virtue of any art or knowledge, but nonetheless by some divine dispensation he has, in virtue of the eros he felt for the youth, been allowed to make him better. (shrink)

This paper focuses on the 1986 Amendments to the False Claims Act of 1863, which offers whistle-blowers financial rewards for disclosing fraud committed against the U.S. government. This law provides an opportunity to examine underlying assumptions about the morality of whistle-blowing and to consider the merits of increased reliance on whistle-blowing to protect the public interest. The law seems open to a number of moral objections, most notably that it exerts a morally corrupting influence on whistle-blowers. We answer these objections (...) and argue that the law is not objectionable on these grounds. Since there are no compelling moral objections to the law, it is appropriate and acceptable to judge the law in terms of its economic costs and benefits. We assess the most salient of these and conclude that the benefits outweigh the costs. We suggest that a mechanism similar to the Act should be considered for protecting stockholders’ interests in the private sector. We conclude by making several proposals for improving the existing legislation. (shrink)

This paper focuses on the 1986 Amendments to the False Claims Act of 1863, which offers whistle-blowers financial rewards for disclosing fraud committed against the U.S. government. This law provides an opportunity to examine underlying assumptions about the morality of whistle-blowing and to consider the merits of increased reliance on whistle-blowing to protect the public interest. The law seems open to a number of moral objections, most notably that it exerts a morally corrupting influence on whistle-blowers. We answer these objections (...) and argue that the law is not objectionable on these grounds. Since there are no compelling moral objections to the law, it is appropriate and acceptable to judge the law in terms of its economic costs and benefits. We assess the most salient of these and conclude that the benefits outweigh the costs. We suggest that a mechanism similar to the Act should be considered for protecting stockholders' interests in the private sector. We conclude by making several proposals for improving the existing legislation. (shrink)

Introduction - This paper is aimed at gaining more insight into the effects of camera-surveillance on behavior. This study investigates the effects of three different ways of ‘framing’ camera presence on cheating behavior and pro-social behavior. First, we explore the effect of presenting the camera as the medium through which an intimidating authority watches the participant. Second, we test the effect of presenting the camera as being a neutral, non-intimidating viewer. Third, we investigate whether a participant watching themselves via a (...) camera has an effect on their behavior. In contrast to most studies of camera surveillance, we will conduct our experiments in an indoor setting, enabling us to investigate behavior to a much greater detail. We will also explore possible moderating effects of personality traits. Methods - 86 students participated in this experiment, distributed over four conditions: three different ways of framing the camera presence, plus a control condition. Our main dependent variables were various kinds of cheating and pro-social behavior. We established the participant’s relevant personality traits in a separate session. Results - For cheating behavior, findings showed that the ‘authorative’ way of framing camera presence and the situation in which participants viewed themselves, differed significantly from a situation without camera-surveillance. We did not find significant effects of camera surveillance on pro-social behavior during the experiment. Looking at personality traits, we found an indication that people with an internal locus of control are more inclined to cheat when there is no camera present compared to people with an external locus of control. However, the effects of our manipulations were stronger. Conclusion - These results support the idea that the framing of a camera’s presence does indeed influence cheating behavior, adding to the preventive effects of camera-surveillance. Additionally, this study provides some valuable insights into the influence of camera presence on behavior in general. (shrink)

Higher education institutions are mining and analyzing student data to effect educational, political, and managerial outcomes. Done under the banner of “learning analytics,” this work can—and often does—surface sensitive data and information about, inter alia, a student’s demographics, academic performance, offline and online movements, physical fitness, mental wellbeing, and social network. With these data, institutions and third parties are able to describe student life, predict future behaviors, and intervene to address academic or other barriers to student success (however defined). Learning (...) analytics, consequently, raise serious issues concerning student privacy, autonomy, and the appropriate flow of student data. We argue that issues around privacy lead to valid questions about the degree to which students should trust their institution to use learning analytics data and other artifacts (algorithms, predictive scores) with their interests in mind. We argue that higher education institutions are paradigms of information fiduciaries. As such, colleges and universities have a special responsibility to their students. In this article, we use the information fiduciary concept to analyze cases when learning analytics violate an institution’s responsibility to its students. (shrink)

To attain native-like competence, second language (L2) learners must establish mappings between familiar speech sounds and new phoneme categories. For example, Spanish learners of English must learn that [d] and [ð], which are allophones of the same phoneme in Spanish, can distinguish meaning in English (i.e. /deɪ/ ‘day’ and /ðeɪ/ ‘they’). Because adult listeners are less sensitive to allophonic than phonemic contrasts in their native language (L1), novel target language contrasts between L1 allophones may pose special difficulty for L2 learners. (...) We investigate whether advanced Spanish late-learners of English overcome native language mappings to establish new phonological relations between familiar phones. We report behavioral and magnetoencepholographic (MEG) evidence from two experiments that measured the sensitivity and pre-attentive processing of three listener groups (L1 English, L1 Spanish, and advanced Spanish late-learners of English) to differences between three nonword stimulus pairs ([idi]-[iði], [idi]-[iɾi], and [iði]-[iɾi]) which differ in phones that play a different functional role in Spanish and English. Spanish and English listeners demonstrated greater sensitivity (larger d’ scores) for nonword pairs distinguished by phonemic than by allophonic contrasts, mirroring previous findings. Spanish late-learners demonstrated sensitivity (large d’ scores and MMN responses) to all three contrasts, suggesting that these L2 learners may have established a novel [d]-[ð] contrast despite the phonological relatedness of these sounds in the L1. Our results suggest that phonological relatedness influences perceived similarity, as evidenced by the results of the native speaker groups, but may not cause persistent difficulty for advanced L2 learners. Instead, L2 learners are able to use cues that are present in their input to establish new mappings between familiar phones. (shrink)

While cancer rates continue to increase, therapy has dramatically decreased the mortality rates. The increased efficacy of current therapies may unfortunately have profound toxic effects on gamete function in both adolescent and reproductive age groups, with infertility as an expected consequence of cancer therapy. Significant progress in the advancement of fertility preservation therapies provides realistic options for future fertility in cancer survivors. However, a number of challenging issues need to be considered when presenting fertility preservation options. This overview highlights some (...) of these considerations including religious-cultural-ethical values, access to care and cost of services, developmental capacity and consent, and posthumous reproduction. (shrink)