A democratic premise is that expert influence should not extend into the political domain of environmental policymaking. This article analyses the relationship between experts and policymakers in the historical development of the National Flood Insurance Program as a flood governance strategy in the United States. The article draws three conclusions. First, while experts asserted great influence on the development of this policy program, underlying values were evaluated and judged by policymakers. Second, as socio-political values changed, new types of experts were (...) involved in the policymaking process. Third, these different types of experts had different implications for how value conflicts were addressed. (shrink)

Background: Nurses encounter complex ethical dilemmas in everyday nursing care. It is important for nurses to have moral courage to act in these situations which threaten patients’ safety or their good care. However, there is lack of research of moral courage. Purpose: This study describes nurses’ experiences of care situations demanding moral courage and their actions in these situations. Method: A qualitative descriptive research design was applied. The data were collected with an open-ended question in the questionnaire used in validation (...) of the Nurses’ Moral Courage Scale. The sample consisted of 286 nurses from four different clinical fields in a major university hospital in Finland, providing a total of 611 answers. Data were analyzed using inductive content analysis. Ethical considerations: The study followed the commonly recognized principles of good scientific practice. The use of data was authorized by the developer of the instrument, the data collector, and the participating hospital. Ethical approval was obtained from the university ethics committee. Findings: Nurses acted morally courageously in most situations but sometimes they failed to do so. Although situations demanding moral courage varied, they could be categorized into seven main domains relating to colleagues, physicians, patients, relatives, nurses themselves, managers, and organizations. Nurses acted in the situations in different ways. The main acts in solving the situations were verbal communication or immediate action, such as interrupting of action. Conclusion: Care situations demanding moral courage focus on good and safe patient care and the patient’s good is at the center of attention. The situations are mostly related to the activities of other healthcare professionals. Findings may be applied in developing ethical nursing care through basic and continuing nursing education. Research is needed on the moral courage of physicians and managers, as well as on patients’ and their relatives’ experiences of care situations demanding moral courage. (shrink)

This book is the result of a long-standing clinical and educational cooperation between a medical psychologist (Bergsma) and a medical ethicist/philosopher (Thomasma). It is thoroughly interdisciplinary in its examination of the difficulties of honoring the patient's and the physician's autonomy, especially in light of the changes in health care worldwide today. Although autonomy has become the primary standard of bioethics, little has been done to link it to the ways people actually behave, nor to its roots in the healing (...) relationship. Combining as it does the disciplines of psychology and philosophy, this book is a step in that direction. (shrink)

As China and the United States strive to be the primary global leader in AI, their visions are coming into conflict. This is frequently painted as a fundamental clash of civilisations, with evidence based primarily around each country’s current political system and present geopolitical tensions. However, such a narrow view claims to extrapolate into the future from an analysis of a momentary situation, ignoring a wealth of historical factors that influence each country’s prevailing philosophy of technology and thus their overarching (...) AI strategies. In this article, we build a philosophy-of-technology-grounded framework to analyse what differences in Chinese and American AI policies exist and, on a fundamental level, why they exist. We support this with Natural Language Processing methods to provide an evidentiary basis for our analysis of policy differences. By looking at documents from three different American presidential administrations––Barack Obama, Donald Trump, and Joe Biden––as well as both national and local policy documents (many available only in Chinese) from China, we provide a thorough comparative analysis of policy differences. This article fills a gap in US–China AI policy comparison and constructs a framework for understanding the origin and trajectory of policy differences. By investigating what factors are informing each country’s philosophy of technology and thus their overall approach to AI policy, we argue that while significant obstacles to cooperation remain, there is room for dialogue and mutual growth. (shrink)

La didáctica de las ciencias es cada vez más activa, por lo que una metodología ampliamente utilizada es el Aprendizaje Basado en Problemas (ABP). Este método implica la resolución de un problema, la que se recoge en un informe denominado Informe de resolución de problemas (IRP). Para los estudiantes esta tarea representa un gran desafío, ya que implica actuar y expresarse del modo en que lo harían los expertos en el área. Es debido a esta dificultad que se hace imprescindible (...) la orientación de los tutores a través de la retroalimentación. Existen distintos tipos y modos de retroalimentar, lo que generará un impacto en el desempeño de los estudiantes. Analizamos los comentarios evaluativos que entregan las especialistas a los estudiantes que elaboran un IRP, tanto en un borrador como en la versión final del escrito. A partir de la clasificación de comentarios escritos de Arancibia, Tapia-Ladino & Correa (2019), realizamos un análisis de los tipos y modos de comentarios evaluativos y cómo el objeto influencia el modo. Los resultados indican que, a la hora de retroalimentar, en el primer borrador las docentes centran su atención en la superficie más que en el contenido y el modo predominante es a través de órdenes. En la versión final, la retroalimentación se dirige más bien al contenido y las evaluaciones positivas y negativas aumentan. Se infiere que en la medida que los comentarios evaluativos promuevan la adecuación al género, los estudiantes se insertarán más fácilmente en la comunidad a la que han ingresado. (shrink)

This paper advances an interpretation of Deleuze's Chronos–Aion distinction in The Logic of Sense as a development of Freud's thesis concerning the timelessness of the unconscious. If Chronos forms a unidirectional sequence along the arrow of a living present, the Aion as the eternal truth of events represents a form of time that is transcendentally distinct. While Chronos belongs to consciousness through the functions of good and common sense, the paradoxical insistence of the Aion represents for Deleuze the force of (...) the unconscious. By identifying the Aion with the death drive, Deleuze positions timelessness as the transcendental condition of the living, corporeal ego. (shrink)

This investigation develops in three steps. First, we seek to complexify the opioid crisis in a way that helps us to see how the issues of misguided desire and misplaced attachments are fundamentally important for a theological account of opioid addiction.1 Second, acknowledging the connections between pain and opioid addiction, we explore some of the ways in which our understanding of pain can influence our understanding of and responses to opioid use. Finally, we offer some tentative reflections on the theological (...) and ecclesial dimensions of the opioid crisis which hold the potential to influence the nature of a Christian response to the issues. Having laid out these steps, we argue for the church’s calling, where she complexifies the narratives about the opioid crisis and provides individuals suffering from opioid use “homeful” encounters with God and the community. (shrink)

This paper analyzes ethnographic and historical data to emphasize the importance of framing health as collective wellbeing. Exploring missionary medical campaigns during the colonial period in East Africa, I connect the institutional legacy of Euro-American Protestant missions on the contemporary frameworks of US global public health provisions at my research site, Mwana Mwema Program. At this network of faith-based, USAID clinics in Kenya that provide treatment for children living with HIV, practitioners care for the wider community within a global health (...) system that bases donor funding on epidemiological criteria. This narrow framing conflicts with practitioners’ notions of healing as collective wellbeing and can exacerbate communal divisions. I argue that Mwana Mwema’s notion of collective wellbeing offers a healthcare framework that faith-based providers can embrace. It yields more holistic care for entire communities and offers an opportunity for those of us in the United States to rethink our notions of health. (shrink)

This paper analyzes ethnographic and historical data to emphasize the importance of framing health as collective wellbeing. Exploring missionary medical campaigns during the colonial period in East Africa, I connect the institutional legacy of Euro-American Protestant missions on the contemporary frameworks of US global public health provisions at my research site, Mwana Mwema Program. At this network of faith-based, USAID clinics in Kenya that provide treatment for children living with HIV, practitioners care for the wider community within a global health (...) system that bases donor funding on epidemiological criteria. This narrow framing conflicts with practitioners’ notions of healing as collective wellbeing and can exacerbate communal divisions. I argue that Mwana Mwema’s notion of collective wellbeing offers a healthcare framework that faith-based providers can embrace. It yields more holistic care for entire communities and offers an opportunity for those of us in the United States to rethink our notions of health. (shrink)

The US is promoting a new vision of a “Good AI Society” through its recent AI Bill of Rights. This offers a promising vision of community-oriented equity unique amongst peer countries. However, it leaves the door open for potential rights violations. Furthermore, it may have some federal impact, but it is non-binding, and without concrete legislation, the private sector is likely to ignore it.

This commentary examines the challenges faced by metaverse platforms in cross-border content moderation, focusing on the implications for freedom of expression and nondiscrimination. It highlights the difficulties in determining what to remove for which users as well as how to do so, which has serious implications for freedom of expression and our shared sense of reality. Proto-metaverse platforms such as Roblox and Minecraft face similar questions, but have not yet encountered major cross-jurisdictional issues because, as looking at traditional social media (...) platforms reveals, content moderation is not merely a question of law and policy, but also of geopolitics and government priorities. To avoid a “lowest common denominator effect” where freedom of expression is infringed upon worldwide and discrimination is entrenched, this commentary argues that metaverse platforms must clarify their moderation policies, assess their entry into specific markets based on local laws and their own values, and be prepared to exit overly restrictive markets. (shrink)

The exportation of Western biomedicine throughout the world has not resulted in a systematic homogenization of scientific ideology but rather in the proliferation of many forms and practices of biomedicine. Similarly, in the last decade, bioethics has become increasingly an international enterprise. Although there may be consensus regarding the inherent value of ethical discourse as it relates to health and medical care, there are disagreements about the nature and parameters of medical morality. This lack of consensus exists because our beliefs (...) about morality are culturally constituted, embedded in social, religious, and political ideologies that influence particular individuals and communities at specific historical moments. (shrink)

The SARS-CoV-2 (COVID-19) pandemic has caused social and economic devastation. As the milestone of two years of ‘living with the virus’ approaches, governments and businesses are attempting to develop means of reopening society whilst still protecting public health. However, developing interventions – particularly technological interventions – that find a safe, socially acceptable, and ethically justifiable balance between these two seemingly opposing demands is extremely challenging. There is no one right solution, but the current most popular ‘solution’ is the so-called ‘COVID-19 (...) Vaccine Passport’ (also known as COVID-19 passes or certificates), the use of which may be supported by both human rights and international public health law if they are designed and implemented appropriately. (We use the term ‘Vaccine Passport’ because it has been adopted by the popular press. Though it has been used in many ways, here we use it generically to refer to a document that certifies that an individual has been vaccinated against COVID-19 and on that basis grants the bearer more liberties than to those who have not been vaccinated. Later, we will discuss why it is necessary to move beyond considering only vaccinations, which informs our preferred term of ‘COVID-19 Status Pass’.) We set out to answer the following questions: how should governments and businesses assess the risks in light of human rights, public health ethics, and digital ethics concerns which emerge from developing and deploying COVID-19 Vaccine Passports? What design decisions should businesses make when developing COVID-19 Vaccine Passports to help ensure they respect human rights, and both public health and digital ethics? Do the implications for human rights, public health, and digital ethics vary depending on where and when COVID-19 Vaccine Passports are used? What are the rights and powers of the individual to object to or seek remedy for the use of COVID-19 Vaccine Passports? How can the risks of inequalities and social division derived from the deployment of COVID-19 Vaccine Passports be avoided or mitigated? We conducted a literature review and documentary analysis, supplementing our findings with news articles where appropriate. The following pages report our results, concluding with a series of actionable recommendations for businesses, national governments, and supranational organisations. (shrink)

In recent years, policymakers, academics, and practitioners have increasingly called for the development of global governance mechanisms for artificial intelligence (AI). This paper considers the prospects for these calls in light of two other geopolitical trends: digital sovereignty and digital expansionism. While calls for global AI governance promote the surrender of some state sovereignty over AI, digital sovereignty and expansionism seek to secure greater state control over digital technologies. To demystify the tensions between these trends and their potential consequences, we (...) undertake a case analysis of digital sovereignty and digital expansionism in China, the European Union, and the United States. We argue that the extraterritoriality embedded in these three actors’ policies and escalatory competitive narratives, particularly those from the US, will likely undermine substantive global AI governance cooperation. However, nascent areas of alignment or compromise, notably in data governance and technical standards, could prove fruitful starting points for building trust in multilateral fora, such as the G20 or United Nations. (shrink)

A plethora of studies stress students’ self-regulated learning skills to be conditional for successful learning in school and beyond. In general, self-regulated learners are actively engaged in constructing their own understanding also including the regulation of contextual features in the environment. Within the contextual features, the regulation of peer interaction is necessary, because college courses increasingly require peer learning. This goes along with the increasing interest for online learning settings, due in no small part to the recent COVID-19 pandemic. In (...) the present study we explore how social presence, social space and sociability are essential elements in the regulation of online peer interaction. To shed light in this matter, higher education students were qualitatively followed for 1 year in an online academic writing course by using retrospective interviews and reflective questions. Additionally, for social presence, students’ perceptions were quantitatively measured with a validated questionnaire. The results show that the planning phase is the most important phase for supporting students’ social presence because that is where the regulation of peer interaction becomes important. The sociability has an important role here as well becoming less prominent further on in the self-regulation process. In the SRL follow-up phases, students look for other ways to increase their social presence and social space in order to shape the regulation of peer interaction from a position of trust. In the evaluation phase, students are aware of the importance of social presence but less of social space for the regulation of peer interaction. We conclude with some design principles to facilitate students’ regulation of peer interaction in online settings. (shrink)

Calling on the methodology of psychology, the authors explore the way illness alters the self-image of the sick person, and the way the experience changes the person who is ill. The reader is taken through the psychological impacts of the first clinical moment when the patient realizes he or she is in the altered state of illness, as well as the subsequent effects of pain, hospitalization, being bed-ridden, fatigued or disabled. The central thesis is that an integral picture of medicine (...) must include social-cultural aspects, the institutionalization of health care, and an attempt to provide patient-centered care. The approach taken is the empirically based psychosocial reflection of the disturbances to a person's self-image caused by various kinds of illness. Focusing on the world of the patient, the authors relate to problems concerning self-image, pain, exhaustion, isolation, handicaps, aging, dying and death. The relationships between patients and medical personnel are also examined. Concluding the work is an excellent bibliography keyed to the chapters of the text. (shrink)

Although many Catholics are familiar with the four Gospels and other writings of the New Testament, for most, reading the Old Testament is like walking into a foreign land. Who wrote these forty-six books? When were they written? Why were they written? What are we to make of their laws, stories, histories, and prophecies? Should the Old Testament be read by itself or in light of the New Testament? John Bergsma and Brant Pitre offer readable in-depth answers to these (...) questions as they introduce each book of the Old Testament. They not only examine the literature from a historical and cultural perspective but also interpret it theologically, drawing on the New Testament and the faith of the Catholic Church. Unique among introductions, this volume places the Old Testament in its liturgical context, showing how its passages are employed in the current Lectionary used at Mass. Accessible to nonexperts, this thorough and up-to-date introduction to the Old Testament can serve as an idea textbook for biblical studies. Its unique approach, along with its maps, illustrations, and other reference materials, makes it a valuable resource for seminarians, priests, Scripture scholars, theologians, and catechists, as well as anyone seeking a deeper understanding of the Bible. (shrink)

How many times have you wanted to convey to someone the joy and excitement of the basic gospel messagebut stumbled in the process? Here is a book that explains the kerygmathe proclamation of the gospelin a simple way. Dr. Bergsma, a professor at Franciscan University and noted biblical scholar, uses both words and illustrations to tell the story of the Bible. In this short book, he brings the gospel to life for believers and nonbelievers alike. Readers will want to (...) buy multiple copies of this book to give away to friends and family so that they can truly understand the amazing good news of what God has done for us in Christ Jesus." -- Amazon.com. (shrink)

In the process of individual psychotherapy, the client and the therapist work together towards clarifying the client's problems, unlocking vicious circles, opening new perspectives and creating a new narrative congruent with the client's experiencing. The real and undeniable situation in individual psychotherapy across different therapeutic systems is that therapists enter the therapeutic encounter equipped with their own vision of humanity and their own particular theory and methods of psychotherapy. Through the differences in power between therapists and clients and the powerful (...) role of language, clients in their dependent position are apt to assimilate the percepts and the ideas of their therapists. Consequently therapists tend to exert a dominant and influential force in their client's lives. This raises a main ethical concern: to what extent do therapists from different therapeutic systems really help clients to recover their freedom to live their lives congruent to their own authentic perceptions and experiences? (shrink)

From the sixties on it has become clear how the human physical condition could be influenced by human behavior. Although hypothesis were lacking to understand these connections, nursing research especially proved how systematically introduced patient behavior during illness and hospitalization could induce better recovery results and better prognosis for the patient.Information andattitude proved to be crucial elements in these processes of improved patient expectations. It took less than two decades to get to the insights we have in 1994. Recent research (...) shows the interlocking mechanisms of nervous and endocrine systems with the immune system as significantly being influenced by behavior and especially psychic and or psychosocial stress.This special issue of Theoretical Medicine briefly describes the historical development with contributions on the most recent state of the scientific art. These developments are emphasized by discussion on the clinical reality of the (breast) cancer patient and recent findings on the complexity of the prevalence of cancer in epidemiology. An attempt is made to consider practical consequences of the actual knowledge if applied to patient care. (shrink)

Recent research supports the hypothesis that more active engagement of the patient in occurring illnesses improves quality of life and probably even life expectancy.In this study experience and theoretical knowledge from psychotherapy is transplanted to clinical practice in order to improve the physician''s engagement in the patient-disease relationship. By defining severe and long-term illnesses as a psychotrauma, the transfer of the psychotherapeutical model leads to the creation of a new triangular relationship: patient-illness-doctor. Practical examples are used as illustrations for the (...) conceptual differences between psychotherapy and clinical medicine. Options for dialogue show the difference between adaptation (learning to live with) and adjustment (active coping strategies and controlling). The hypothesis is that a better dialogue will reduce illness-related stress, giving the patient better and more effective access to personal psychic and physical support systems. (shrink)

In this book, Emmy van Deurzen addresses the taboo subject of the moral role of psychotherapists and counselors.

The aim of this study was to explore the note-taking experiences of university students using paper-based and paperless resources. By means of a hermeneutic phenomenological approach, the note-taking experiences of 18 students from an international program at a university in Belgium were examined throughout a semester. In order to document these students’ practices with paper-based and paperless resources, four data collection methods were used: in-depth interviews observations focus group discussions and document analysis of students’ lecture notes. The results showed that (...) students experience note-taking as a complex phenomenon in which lived body, lived human relations, lived space and lived time come into play, and in which they try to find a balance between multiple engagements, between autonomy and authority, between attention and distraction, and between being original and mirroring others. This struggle for balance occurs irrespective of which medium they choose to use. These results provide an in-depth view of the phenomenon, and also highlight the complexity of the note-taking experience. (shrink)

BackgroundInvolvement of adolescent girls in biomedical HIV research is essential to better understand efficacy and safety of new prevention interventions in this key population at high risk of HIV infection. However, there are many ethical issues to consider prior to engaging them in pivotal biomedical research. In Uganda, 16–17-year-old adolescents can access sexual and reproductive health services including for HIV or other sexually transmitted infections, contraception, and antenatal care without parental consent. In contrast, participation in HIV prevention research involving investigational (...) new drugs requires adolescents to have parental or guardian consent. Thus, privacy and confidentiality concerns may deter adolescent participation. We describe community perspectives on ethical considerations for involving adolescent girls in the MTN 034 study in Uganda.MethodsFrom August 2017 to March 2018, we held five stakeholder engagement meetings in preparation for the MTN 034 study in Kampala, Uganda (NCT03593655): two with 140 community representatives, two with 125 adolescents, and one with 50 adolescents and parents. Discussions were moderated by the study team. Proceedings were documented by notetakers. Summary notes described community perspectives of adolescent participation in HIV research including convergent, divergent or minority views, challenges, and proposed solutions.ResultsMost community members perceived parental or guardian consent as a principal barrier to study participation due to concerns about adolescent disclosure of pre-marital sex, which is a cultural taboo. Of 125 adolescent participants, 119 (95%) feared inadvertent disclosure of sexual activity to their parents. Community stakeholders identified the following critical considerations for ethical involvement of adolescents in HIV biomedical research: (1) involving key stakeholders in recruitment, (2) ensuring confidentiality of sensitive information about adolescent sexual activity, (3) informing adolescents about information to be disclosed to parents or guardians, (4) offering youth friendly services by appropriately trained staff, and (5) partnering with community youth organizations to maximize recruitment and retention.ConclusionsStakeholder engagement with diverse community representatives prior to conducting adolescent HIV prevention research is critical to collectively shaping the research agenda, successfully recruiting and retaining adolescents in HIV clinical trials and identifying practical strategies to ensure high ethical standards during trial implementation. (shrink)

Over the past few years, there has been a proliferation of artificial intelligence strategies, released by governments around the world, that seek to maximise the benefits of AI and minimise potential harms. This article provides a comparative analysis of the European Union and the United States’ AI strategies and considers the visions of a ‘Good AI Society’ that are forwarded in key policy documents and their opportunity costs, the extent to which the implementation of each vision is living up to (...) stated aims and the consequences that these differing visions of a ‘Good AI Society’ have for transatlantic cooperation. The article concludes by comparing the ethical desirability of each vision and identifies areas where the EU, and especially the US, need to improve in order to achieve ethical outcomes and deepen cooperation. (shrink)

The exportation of Western biomedicine throughout the world has not resulted in a systematic homogenization of scientific ideology but rather in the proliferation of many forms and practices of biomedicine. Similarly, in the last decade, bioethics has become increasingly an international enterprise. Although there may be consensus regarding the inherent value of ethical discourse as it relates to health and medical care, there are disagreements about the nature and parameters of medical morality. This lack of consensus exists because our beliefs (...) about morality are culturally constituted, embedded in social, religious, and political ideologies that influence particular individuals and communities at specific historical moments. (shrink)

In recent decades, the governance of food safety, food quality, on-farm environmental management and animal welfare has been shifting from the realm of ‘the government’ to that of the private sector. Corporate entities, especially the large supermarkets, have responded to neoliberal forms of governance and the resultant ‘hollowed-out’ state by instituting private standards for food, backed by processes of certification and policed through systems of third party auditing. Today’s food regime is one in which supermarkets impose ‘private standards’ along the (...) food supply chain to ensure compliance with a range of food safety goals—often above and beyond those prescribed by government. By examining regulatory governance in Australia, Norway and the United Kingdom we highlight emerging trajectories of food governance. We argue that the imposition of the new private forms of monitoring and compliance continue the project of agricultural restructuring that began with government support for structural adjustment schemes in agriculture and that these are most evident in the UK and Australia where neoliberalism is an entrenched philosophy. However, despite Norway’s identity as a social democracy, we also identify neoliberal ‘creep’ into the system of food governance. Small-scale producers in all three nations are finding themselves increasingly subject to governance through private, market-based mechanisms that, to varying degrees, are dominated by major supermarket chains. The result is agricultural restructuring not through the traditional avenues of elected governments, but via non-elected market operatives. (shrink)

Randomised clinical trials involve procedures such as randomisation, blinding, and placebo use, which are not part of standard medical care. Patients asked to participate in RCTs often experience difficulties in understanding the meaning of these and their justification.