BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

This paper concentrates on a particular sort of case where it’s plausible that epistemic requirements can conflict: cases where an agent’s higher-order evidence supports doubting her reliability in reacting to her ordinary evidence. Conflicting epistemic requirements can be seen as generating epistemic dilemmas. The paper examines two ways that people have sought to recognize conflicting requirements without allowing them to generate epistemic dilemmas: separating epistemic norms into two different varieties, and positing rational indeterminacy in cases where principles conflict. It argues (...) that these views incur costs, and that the sense in which they avoid dilemmas does not gain them an advantage over a view that simply recognizes dilemmas as a natural outgrowth of agents’ rational reflection on their own thinking. (shrink)

Within the past ten years, the discussion of the nature of folk psychology and its role in explaining behavior and thought has become central to the philosophy of mind. However, no comprehensive account of the contemporary debate or collection of the works that make up this debate has yet been available. Intending to fill this gap, this volume begins with the crucial background for the contemporary debate and proceeds with a broad range of responses to and developments of these works (...) -- from those who argue that "folk theory" is a misnomer to those who regard folk theory as legitimately explanatory and necessary for any adequate account of human behavior. Intended for courses in the philosophy of mind, psychology, and science, as well as anthropology and social psychology, this anthology is also of great value in courses focusing on folk models, eliminative materialism, explanation, psychological theory, and -- in particular -- intentional psychology. It is accessible to both graduate students and upper-division undergraduate students of philosophy and psychology as well as researchers. As an aid to students, a thorough discussion of the field and the articles in the anthology is provided in the introduction; as an aid to researchers, a complete bibliography is also provided. (shrink)

In this chapter I will present, in a general way, Millikan's biosemantic theory of the phenomenon of intentionality. For this purpose, the text will take the following path. First, I will present the problem of intentionality and an overview of the dominant theories of intentional content during the twentieth century and part of the twenty-first century. Then, I will present a general version of Millikan's biosemantic theory, appearing in 1984, which will allow us to see what the relevance and originality (...) of his proposal consists in. Finally, in keeping with one of the central purposes of Las filósofas que nos formaron, I will share a brief interview that Millikan very kindly agreed to give for this publication, in which she tells us some non-theoretical aspects of her history as a philosopher. (shrink)

In Philosophy, it is well known that of the total faculty population, the proportion of women is significantly lower than men. This disproportion is odd for a discipline within the humanities; these numbers seem more compatible with what is found in STEM (Science, Technology, Engineering, Mathematics) careers. These proportions are in turn a product of the low female presence that exists from the previous levels of academic training in philosophy. What happens in the case of the philosophy student body? For (...) example, the report presented by BeeBee and Saul (2011), on women in philosophy in the United Kingdom, in the period 2008 and 2009, points out that in the first degrees of academic training, in the bachelor's degree, women occupy 45% of the student population, in the master's degree 38% and in the doctorate 35%. Thus, "it is notable that there is a reduction in the proportion of women from the bachelor's degree to the doctorate [...]. This has as a consequence that at the professional level women holding positions as professors represent only 19%" (BeeBee & Saul, 2011, p. 11). Recently, Torres González (2018), based on European Union studies, points out that in Spain, with respect to gender disparity in students, "the data yield as a result masculinized studies, where, contrary to what happens in the branch of the humanities to which it [philosophy] belongs, males outnumber females by 28 percentage points" (2018, p. 328). This disparity is reflected in philosophy at the professional level, "the indicators of vertical segregation show a reinforced glass ceiling, which presents one of the worst data of hierarchical discrimination in the university: the percentage of female professors in philosophy is 12% compared to 21% of female professors in higher education" (Idem). Although it is a fact that there are fewer women than men studying philosophy and, therefore, fewer women than men working professionally in this discipline, we do not yet have possible explanations for this phenomenon of gender disparity in the student body in philosophy. In some cases, even if the number of women entering the philosophy degree program is already low, the number of women graduating is even lower, which indicates that there is attrition along the way; the initial numbers of women entering the program tend to decrease by the time they graduate. Thus we come to the question that is the subject of this paper: What causes female students to drop out of the philosophy program? In this article we answer this question from the philosophy of science and supported by local empirical data, so we do not give a complete or even less exhaustive answer. We review two explanatory models that purport to answer the question of why there are fewer women in philosophy, both formatively and professionally. These are the Different Voices Model (DVM) and the Perfect Storm Model (PSM); we opt for the latter and give reasons for it. Regarding the empirical aspect of our research, our source of statistical data belongs to the undergraduate program in philosophy at the Facultad de Estudios Superiores Acatlán-UNAM, Mexico (FES Acatlán), obtained in the framework of the SWIP-Analytic Mexico workshops. Our analysis of these data shows that even when female students have better GPAs than male students and take fewer subjects while enrolled, female students graduate less than male students in the FES Acatlan degree program. (shrink)

This paper focuses on Confucian formulations of personhood and the implications they may have for bioethics and medical practice. We discuss how an appreciation of the Confucian concept of personhood can provide insights into the practice of informed consent and, in particular, the role of family members and physicians in medical decision-making in societies influenced by Confucian culture. We suggest that Western notions of informed consent appear ethically misguided when viewed from a Confucian perspective.

Previous research has established that the success of strikes, and social movements more broadly, depends on their ability to garner support from the public. However, there is scant published research investigating the response of the public to strike action by healthcare workers. In this study, we address this gap through a study of public responses to UK nursing strikes in 2022–2023, using a data set drawn from Twitter of more than 2300 publicly available tweets. We focus on negative tweets, investigating (...) which societal discourses social media users draw on to oppose strike action by nurses. Using a combination of corpus‐based approaches and discourse analysis, we identified five categories of opposition: (i) discourse discrediting nurses; (ii) discourse discrediting strikes by nurses; (iii) discourse on the National Health System; (iv) discourse about the fairness of strikers' demands and (v) discourse about potential harmful impact. Our findings show how social media users operationalise wider societal discourses about the nursing profession (e.g., associations with care, gender, vocation and sacrifice) as well as recent crises such as the Covid‐19 pandemic to justify their opposition. The results also provide valuable insights into misconceptions about nursing, strike action and patient harm, which can inform strategies for public communication. (shrink)

Women and men are biologically and reproductively dissimilar. This sexual distinctiveness gives rise to a “sexual asymmetry”—the fundamental reality that the potential consequences of sexual intercourse are far more immediate and serious for women than for men. Advocates of contraception and abortion sought to cure sexual asymmetry by decoupling sex from procreation, relieving women from the consequences of sex, and thus equalizing the sexual experiences of men and women. But efforts to suppress or reject biological difference have not relieved women (...) of the consequences of sex and the vulnerabilities of pregnancy, even as they have further relieved men. Although secular feminist responses to biological difference have served to exacerbate sexual asymmetry, Catholic teaching on abortion, sex, and marriage—even contraception—provides an authentically pro-woman cultural response. (shrink)

Oregon is the only state in the United States where a physician may legally prescribe a lethal dose of barbiturate for a patient intending suicide. The Oregon Death with Dignity Act was passed by voters in 1994 and came into effect after much legal wrangling in October of 1997. At the same time, a cabinetmaker named Pat Matheny was struggling with progressive weakness from amyotrophic lateral sclerosis, or ALS. I met with Pat and his family for a lengthy interview in (...) October 1998 in Coos Bay, Oregon, for a television news report on his decision to get a lethal prescription. Below is an extract from that interview. On the day this introduction was written, 10 March 1999, Pat took the prescribed lethal overdose of barbiturates and died at home. His illness was taking his voice, he could not move his hands or legs, and breathing was becoming very difficult. His mother told me he knew that was for him. (shrink)

In Ludwig Wittgenstein's writings, ethics takes a central place in his thinking. This element investigates his engagement with ethics in both early and later thinking. Starting from the remarks on ethics in the Tractatus Logico-Philosophicus and the framing of these remarks, it presents two influential approaches to Tractarian ethics, before it develops a coherent reading of ethics in the early thinking, focusing on ethical silence and the relationship notions of world and the philosophical 'I'. The reading of 'A Lecture on (...) Ethics' focuses on the critique of ethical theory and the personal dimension of ethics, two themes also running through Wittgenstein's later thinking. It considers Wittgenstein's later ethical investigations, of ethical examples, ethically relevant language uses of language and the connections between reflections on ethics and living. It also considers the role of the other in Wittgenstein's later thinking. (shrink)

En Infancia e historia Giorgio Agamben afirma que en la contemporaneidad asistimos a la “destrucción” de la capacidad para transmitir la experiencia. Ante esto, propone la idea de “infancia” entendida como una “experiencia originaria” en la que residiría la pura potencia del lenguaje. Esta idea presenta una serie de dificultades en tanto posibilidad concreta de volver a transmitir la experiencia ante su destrucción. Por lo tanto, el presente escrito indaga en otros conceptos de Agamben tales como el “montaje de temporalidades”, (...) el “paradigma” y el “testimonio”, conjeturando que allí se encuentran posibles claves para efectivamente volver a transmitir la experiencia. (shrink)

As innovations in the field of vascular composite allotransplantation (VCA) progress, whole-eye transplantation (WET) is poised to transition from non-human mammalian models to living human recipients. Present treatment options for vision loss are generally considered suboptimal, and attendant concerns ranging from aesthetics and prosthesis maintenance to social stigma may be mitigated by WET. Potential benefits to WET recipients may also include partial vision restoration, psychosocial benefits related to identity and social integration, improvements in physical comfort and function, and reduced surgical (...) risk associated with a biologic eye compared to a prosthesis. Perioperative and postoperative risks of WET are expected to be comparable to those of facial transplantation (FT), and may be similarly mitigated by immunosuppressive protocols, adequate psychosocial support, and a thorough selection process for both the recipient and donor. To minimize the risks associated with immunosuppressive medications, the first attempts in human recipients will likely be performed in conjunction with a FT. If first-in-human attempts at combined FT-WET prove successful and the biologic eye survives, this opens the door for further advancement in the field of vision restoration by means of a viable surgical option. This analysis integrates recent innovations in WET research with the existing discourse on the ethics of surgical innovation and offers preliminary guidance to VCA programs considering undertaking WET in human recipients. (shrink)

This study reflects on the ways in which children, during pandemic times, expressed themselves and came into contact with their teachers and classmates through Image-Letters, ways of saying and saying themselves to the world through audiovisual media. Sensible sharing of their daily lives were revealed by these media and made us think about the diverse childhood of this time. The theoretical framework that supported this work had the contribution of De Certeau regarding studies on everyday life, Walter Benjamin with his (...) writings on childhood experience, Sandra Corazza and Walter Kohan with their contributions to studies on contemporary childhoods and Virgínia Kastrup who supported us on to the cartography method, a methodological approach that allowed us to follow the research process. The objective of this work was to observe the ways in which children communicate through verbal-visual media and what type of content and everyday fragments they choose to share their experiences during the pandemic period.with the school institution. It is important to highlight that the dissemination of the images was authorized by the children and their guardians through a free and informed consent term, in compliance with the ethical principles of research with images of children. Furthermore, the images are available through QRcode and can be accessed through a smartphone camera. (shrink)

Due to the ongoing advancements in technology, socio-technical collaboration has become increasingly prevalent. This poses challenges in terms of governance and accountability, as well as issues in various other fields. Therefore, it is crucial to familiarize decision-makers and researchers with the core of human–machine collaboration. This study introduces a taxonomy that enables identification of the very nature of human–machine interaction. A literature review has revealed that automation and technical autonomy are main parameters for describing and understanding such interaction. Both aspects (...) must be carefully evaluated, as their increase has potentially far-reaching consequences. Hence, these two concepts comprise the taxonomy’s axes. Five levels of automation and five levels of technical autonomy are introduced below, based on the assumption that both automation and autonomy are gradual. The levels of automation were developed from existing approaches; those of autonomy were carefully derived from a review of the literature. The taxonomy’s use is also explained, as are its limitations and avenues for further research. (shrink)

An absolute decline in US life expectancy in low education whites has alarmed policy makers and attracted media attention. Depending on which studies are correct, low education white women have lost between 3 and 5 years of lifespan; men, between 6 months and 3 years. Although absolute declines in life expectancy are relatively rare, some commentators see the public alarm as reflecting a racist concern for white lives over black ones. How ought we ethically to evaluate this lifespan contraction in (...) low education whites? Should we care, or is it racist to care? Does it constitute an injustice or reflect justice being done? I argue that the lifespan contraction in low education whites violates key normative criteria used to make determinations of health justice, and that these judgments do not vitiate concerns about racism. I conclude with reflections on US population health policy and building an inclusive health equity movement. (shrink)

Berichte zur Wissenschaftsgeschichte, Volume 45, Issue 1-2, Page 164-188, June 2022.

Due to the variety of research ethics and integrity training formats it may be challenging to use a common instrument to monitor and evaluate the development of competencies and learning progress as well as determine the effectiveness of the training. The present study scrutinises the use of learning diaries as one possible measure to evaluate the development of ethics competencies. The aim of the study was to increase understanding about how learning diaries capture development of research ethics and integrity competencies (...) of participants and explore the use of diaries as a measure of training effectiveness. In the evaluative case study, a micro-credential programme was used as the context of the study and data was analysed using deductive content analysis. As a result, we outline criteria for analysis to be used in ethics training programmes for learning diaries. Results indicated that learning diaries submitted in the forum format (compared to individual submissions) provide peer support, so learners display more content knowledge on high levels of reflection and understanding. Submitting learning diaries over a longer period and making submissions repeatedly can improve writing and reflection competencies. The quality of learning diary entries may also depend on learner characteristics, such as commitment and motivation. Keeping a learning diary can help retain obtained competencies over a longer period. The article ends with a set of recommendations for implementing learning diaries as one measure of evaluation. (shrink)

: The main contribution of this paper to current philosophical and sociological studies on modeling is to analyze modeling as an object-oriented interdisciplinary activity and thus to bring new insights into the wide, heterogeneous discourse on tools, forms and organization of interdisciplinary research. A detailed analysis of interdisciplinarity in the making of models is presented, focusing on long-standing interdisciplinary collaboration between specialists in infectious diseases, mathematicians and computer scientists. The analysis introduces a novel way of studying the elements of the (...) models as carriers of interdisciplinarity. These elements, being functionally interdependent building blocks, evolve during the modeling work and carry the disciplinary tensions in the process. This shows how the long and challenging process of defining and reformulating the object of research is crucial for understanding the dynamics of interdisciplinarity in the making. (shrink)

This paper is going to explore the adverse effects of exposure to combat death on medics’ holistic well-being, which, if ignored could decrease individual readiness and negatively impact the mission. We rely on the experience of United States Air Force Special Operation Surgical Teams (AF SOST) whose exposure to mass casualty scenarios in austere environments could serve as approximations of conditions of future battlefields. Over the past two decades, the ability to deliver advanced medical care on and off the battlefield (...) along with a rapid casualty evacuation platform has allowed for unprecedented survival rates exceeding 90%. While laudable, these medical achievements have also set up a casualty management paradigm in which medical decision-making singularly focuses on life-saving care. Confronting peer-peer adversaries in large scale combat operations (LSCO) on a multi-domain battlefield will make casualty management frighteningly more complex by introducing major infrastructural, personnel, and resource constraints. When considering the high number of casualties expected in LSCO alongside enormous limitations in medical resource and resupply capability, the current casualty management paradigm will not be sustainable. The resource constrained environment in LSCO will shift medical decision-making away from a singular focus on life-saving care to triage, which hinges on the ability to determine futile medical interventions—a skill that has been lost in the past two generation of combat medics. As such, a broad ethical challenge that arises in preparation for LSCO is the need to set new expectations concerning dying and death. However, medical decision-making focused on death and dying has not been explicitly addressed in military medical training, research, or policy. Relying on a body of literature known as terror management theory (TMT) and ethnographic data from our study with AF SOST medics, we are going to argue that it is important to expose medics to death in mass casualty and triage training. (shrink)

Existing whistle-blowing models rely on “cold” economic calculations and cost-benefit analyses to explain the judgments and actions of potential whistle-blowers. I argue that “hot” cognitions – value conflict and emotions – should be added to these models. I propose a model of the whistle-blowing decision process that highlights the reciprocal influence of “hot” and “cold” cognitions and advocate research that explores how value conflict and emotions inform reporting decisions. I draw on the cognitive appraisal approach to emotions and on the (...) social-functional value pluralism model to generate propositions. (shrink)

The study of religious practices in the Cyclades, particularly during the Iron Age and Archaic period, has traditionally concentrated on Delos. This situation has changed dramatically over the past decade, however, thanks to archaeological discoveries of important sanctuaries unmentioned in the literary sources or inscriptions. The most important sites for the study of Cyclades in these early periods, at Despotiko, Tenos, and Kythnos, are, again, known chiefly through the material evidence. T...

Once common, therapeutic privilege—the practice whereby a physician withholds diagnostic or prognostic information from a patient intending to protect the patient—is now generally seen as unethical. However, instances of therapeutic privilege are common in some areas of clinical psychiatry. We describe therapeutic privilege in the context of borderline personality disorder, discuss the implications of diagnostic non-disclosure on integrated care and offer recommendations to promote diagnostic disclosure for this patient population. There are no data in this work.

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In recent decades, the Organisation for Economic Co-operation and Development has become a powerful forum for trade liberalization and regulatory harmonization. OECD members have worked to reconcile divergent national regulatory approaches, applying a single framework across sovereign states, in effect determining whose knowledge-making practices would guide regulatory action throughout the industrialized world. Focusing on US regulators, industry associations, and environmental groups, this article explores the participatory politics of OECD chemical regulation harmonization in the late 1970s to early 1980s. These efforts (...) were conditioned by differential institutional access and resources among stakeholders who sought to shape regulatory knowledge rules. Facing competing European and US approaches to chemical data—a minimum “base set” of test data versus case-by-case determinations—OECD members chose the European approach in 1980. However, US regulatory politics shifted with the election of President Reagan, prompting industry associations to lobby the US government to block the agreement. Examining the micropolitics of these standards in the making, I demonstrate that while long-term structures advantaged industrial actors, ideological alignment with the US government precipitated their decisive influence. The case illustrates the importance of attending to the distinctive politics of international harmonization and the effects on transnational knowledge-making and regulatory intervention. (shrink)