Background Cancer patients are at risk of developing blood clots in their veins - venous thromboembolism - which often takes the form of a pulmonary embolism or deep vein thrombosis. The risk increases with advanced disease. Evidence based treatment is low molecular weight heparin by daily subcutaneous injection. The aim of this research is to explore the barriers for doctors in the UK when diagnosing and treating advanced cancer patients with VTE. Method Qualitative, in-depth interview study with 45 doctors. Doctors (...) were from three specialties: oncology, palliative medicine and general practice, with a mixture of senior and junior staff. Framework analysis was used. Results Doctors opinions as to whether LMWH treatment was ethically appropriate for patients who were symptomatic from VTE but at end of life existed on a shifting continuum, largely influenced by patient prognosis. A lack of immediate benefit coupled with the discomfort of a daily injection had influenced some doctors not to prescribe LMWH. The point at which LMWH injections should be stopped in patients at the end of life was ambiguous_._ Some perceived ‘overcaution’ in their own and other clinicians’ treatment of patients_._ Viewpoints were divergent on whether dying of a PE was considered a “good way to go”. The interventionalism and ethos of palliative medicine was discussed. Conclusions Decisions are difficult for doctors to make regarding LMWH treatment for advanced cancer patients with VTE. Treatment for this patient group is bounded to the doctors own moral and ethical frameworks. (shrink)

Background: Cancer patients are at risk of developing blood clots in their veins - venous thromboembolism(VTE) - which often takes the form of a pulmonary embolism or deep vein thrombosis. Therisk increases with advanced disease. Evidence based treatment is low molecular weightheparin (LMWH) by daily subcutaneous injection. The aim of this research is to explore thebarriers for doctors in the UK when diagnosing and treating advanced cancer patients withVTE.MethodQualitative, in-depth interview study with 45 doctors (30 across Yorkshire, England and 15across (...) South Wales). Doctors were from three specialties: oncology, palliative medicine andgeneral practice, with a mixture of senior and junior staff. Framework analysis was used. Results: Doctors opinions as to whether LMWH treatment was ethically appropriate for patients whowere symptomatic from VTE but at end of life existed on a shifting continuum, largelyinfluenced by patient prognosis. A lack of immediate benefit coupled with the discomfort of adaily injection had influenced some doctors not to prescribe LMWH. The point at whichLMWH injections should be stopped in patients at the end of life was ambiguous. Someperceived overcaution in their own and other clinicians treatment of patients. Viewpointswere divergent on whether dying of a PE was considered a "good way to go". Theinterventionalism and ethos of palliative medicine was discussed. Conclusions: Decisions are difficult for doctors to make regarding LMWH treatment for advanced cancerpatients with VTE. Treatment for this patient group is bounded to the doctors own moral andethical frameworks. (shrink)

This book deals with the need to rethink the aims and methods of contemporary linguistics. Orthodox linguists' discussions of linguistic form fail to exemplify how language users become language makers. Integrationist theory is used here as a solution to this basic problem within general linguistics. The book is aimed at an interdisciplinary readership, comprising those engaged in study, teaching and research in the humanities and social sciences, including linguistics, philosophy, sociology and psychology.

Technologies for mitigating and adapting to climate change are inherently political. Their development, diffusion and deployment will have uneven impacts within and across national borders. Bringing the governance of climate technologies under democratic control is imperative but impeded by the global scale of governance and its polycentric nature. This article draws on innovative theorising in the deliberative democracy tradition to map possibilities for global democratic governance of climate technologies. It is argued that this domain is not beyond the reach of (...) democracy. Civil society has a unique and expanded role to play in generating democratic legitimacy by fostering public deliberation; translating and transmitting concepts, ideas and messages; and promoting and facilitating deliberative accountability. (shrink)

Task shifting is increasingly used to address human resource shortages impacting HIV service delivery in low- and middle-income countries. By shifting basic tasks from higher- to lower-trained cadres, such as Community Health Workers, task shifting can reduce overhead costs, improve community outreach, and provide efficient scale-up of essential treatments like antiretroviral therapies. Although there is rich evidence outlining positive outcomes that CHWs bring into HIV programs, important questions remain over their place in service delivery. These challenges often reflect concerns over (...) whether CHWs can mitigate HIV through a means that does not overlook the ethical and practical constraints that undergird their work. Ethical and practical guidance thus needs to become the cornerstone of CHW deployment. This paper analyzes such challenges through the lens of Ethical Principlism. We examined papers identifying substantive and ethical challenges impacting CHWs as they provide HIV services in low- and middle-income contexts. To do this, we analyzed papers written in English and published from year 2000 or later. These articles were identified using MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar databases. In total, 465 articles were identified, 78 of which met our inclusion criteria. Article reference lists and grey literature were also examined. CHWs experience specific challenges while carrying out their duties, such as conducting emotionally- and physically-demanding tasks with often inadequate training, supervision and compensation. CHWs have also been poorly integrated into health systems, which not only impacts quality of care, but can hinder their prospects for promotion and lead to CHW disempowerment. As we argue, these challenges can be addressed if a set of ethical principles is prioritized, which specifically entail the principles of respect for persons, justice, beneficence, proportionality and cultural humility. CHWs play a crucial role in HIV service delivery, yet the ethical challenges that can accompany their work cannot be overlooked. By prioritizing ethical principles, policymakers and program implementers can better ensure that CHWs are combatting HIV through a means that does not exploit or take their critical role within service delivery for granted. (shrink)

This paper demonstrates how British Quakers, between 1870 and 1914, attempted to understand and debate the issue of vivisection through the lens of the Quaker peace testimony. Drawing on primary source materials, the article argues that these Friends were able to agitate for radical legislative and social change using virtue ethics as their framework. The paper further suggests that the moral parameters of the Quaker testimony for peace expanded briefly in this period to include interspecies as well as intraspecies engagement. (...) Friends accomplished this by arguing that humans could not engage in vivisection—a “moral disease” just like slavery and war—without risking individual and social virtue. Friends were able to call for radical change in society without arguing for ethical egalitarianism. Hierarchy was implicit in their virtue ethic, but this did not hinder their creation of a forward-thinking stance on human-animal relations. (shrink)

Children diagnosed with type 1 diabetes mellitus (T1DM) are at risk for neurocognitive sequelae, including impaired attention functioning. The specific nature of the cognitive deficit varies; current literature underscores early age of diabetes diagnosis and increased disease duration as primary risk factors for this neurocognitive decline. Forty-three children with T1DM were evaluated for Attention Deficit/Hyperactivity Disorder (ADHD) symptomatology using the MOXO continuous performance test (MOXO-CPT) performed during a routine outpatient evaluation. The study cohort demonstrated a significant decline in all four (...) domains of attention functioning. The effect was most pronounced with early age at T1DM diagnosis, a longer disease duration and with poorer glycemic control (represented by higher HbA1c values). With increased disease duration (of 5 plus years), acute hyperglycemia was associated with inattention in the real-time setting. These findings highlight the need for routine screening of neurocognitive function in children with T1DM so that early intervention can be employed during this crucial period of cognitive development. (shrink)

The profession of psychology is one of many entities affected by the current economic recession. The question of what to do when clients cannot pay agreed-upon charges will need to be answered. Ethical issues related to setting the fee for psychotherapy, insurance coverage, abandonment, pro bono psychotherapy, and lack of resources are addressed in light of the 2002 American Psychological Association's Ethical Principles of Psychologists and Code of Conduct and other relevant literature. The impact of the Mental Health Parity Act (...) on the financial complexities that professionals in psychology now face is also discussed. Several recommendations are made for psychologists, calling them to be proactive in their communities, to be advocates for their clients, and to critically evaluate their financial practices. (shrink)

This paper discusses health policy and systems research in complex and rapidly changing contexts. It focuses on ethical issues at stake for researchers working with government policy makers to provide evidence to inform major health systems change at scale, particularly when the dynamic nature of the context and ongoing challenges to the health system can result in unpredictable outcomes. We focus on situations where ‘country ownership’ of HSR is relatively well established and where there is significant involvement of local researchers (...) and close ties and relationships with policy makers are often present. We frame our discussion around two country case studies with which we are familiar, namely China and South Africa and discuss the implications for conducting ‘embedded’ research. We suggest that reflexivity is an important concept for health system researchers who need to think carefully about positionality and their normative stance and to use such reflection to ensure that they can negotiate to retain autonomy, whilst also contributing evidence for health system change. A research process informed by the notion of reflexive practice and iterative learning will require a longitudinal review at key points in the research timeline. Such review should include the convening of a deliberative process and should involve a range of stakeholders, including those most likely to be affected by the intended and unintended consequences of change. (shrink)

Charles Darwin and C. Lloyd Morgan forward two influential principles of cognitive ethological inference that yield conflicting results about the extent of continuity in the cognitive traits of humans and other animals. While these principles have been interpreted as reflecting commitments to different senses of parsimony, in fact, both principles result from the same vera causa inferential strategy, according to which “We ought to admit no more causes of natural things, than such as are both true and sufficient to explain (...) their appearances”. Instead, the conflict stems from Darwin’s and Morgan’s views about the true causes of human psychology. Darwin holds a thoroughly Humean philosophy of the human mind, from which he infers significant continuity between human and animal minds. In contrast, Morgan argues that Humean cognitive mechanisms cannot account for a class of uniquely human behaviors, and therefore, he concludes that there is a significant discontinuity between human and animal cognition. This historical debate is informative for current controversies in comparative psychology. (shrink)

Several major breakthroughs in the history of physics have been prompted not by new empirical data but by thought experiments. James Robert Brown and John Norton have developed accounts of how thought experiments can yield such advances. Brown argues that knowledge gained via thought experiments demands a Platonic explanation; thought experiments for Brown are a window into the Platonic realm of the laws of nature. Norton argues that thought experiments are just cleverly disguised inductive or deductive arguments, so no new (...) account of their epistemology is needed. In this paper, I argue that although we do not need to invoke any Platonic insight to explain thought experimentation, Norton’s eliminativist account fails to capture the unique epistemological importance of thought experiments qua thought experiments. I then present my own account, according to which thought experiments are a particular type of inductive inference that is uniquely suited to generate new breakthroughs. (shrink)

In South Africa, disability grant allocation has been under review and tensions are evident in government rhetoric stressing welfare provision on the one hand, and encouraging on the other. This ambiguity is traced down to the level of grant negotiations between doctors and in a psychiatry clinic in Khayelitsha. Here embodies the distress associated with harsh circumstances and is deemed by supplicants as sufficient to secure a grant. The paper illustrates how national discourses influence the presentation and experience of suffering (...) and the way in which doctors mediate diagnoses. The implications of local understandings of for expectations of the post-apartheid state are explored. (shrink)

I analyze two recent parsimony arguments that have been offered to break the current impasse in the chimpanzee mindreading controversy, the ‘logical problem’ argument from Povinelli, Penn, and Vonk, and Sober's attempt to apply model selection criteria in support of the mindreading hypothesis. I argue that Sober's approach fails to adequately rebut the ‘logical problem’. However, applying model selection criteria to chimpanzees' own mental models of behavior does yield a response to the ‘logical problem’ and reveals an adaptive advantage of (...) mindreading models and a potential solution to a paradox raised by Whiten. (shrink)

The probability that the fitter of two alleles will increase in frequency in a population goes up as the product of N (the effective population size) and s (the selection coefficient) increases. Discovering the distribution of values for this product across different alleles in different populations is a very important biological task. However, biologists often use the product Ns to define a different concept; they say that drift “dominates” selection or that drift is “stronger than” selection when Ns is much (...) smaller than some threshold quantity (e.g., ½) and that the reverse is true when Ns is much larger than that threshold. We argue that the question of whether drift dominates selection for a single allele in a single population makes no sense. Selection and drift are causes of evolution, but there is no fact of the matter as to which cause is stronger in the evolution of any given allele. (shrink)

_Manual of Regulation-Focused Psychotherapy for Children with Externalizing Behaviors: A Psychodynamic Approach_ offers a new, short term psychotherapeutic approach to working dynamically with children who suffer from irritability, oppositional defiance and disruptiveness. _RFP-C_ enables clinicians to help by addressing and detailing how the child’s externalizing behaviors have meaning which they can convey to the child. Using clinical examples throughout, Hoffman, Rice and Prout demonstrate that in many dysregulated children, _RFP-C_ can: Achieve symptomatic improvement and developmental maturation as a result (...) of gains in the ability to tolerate and metabolize painful emotions, by addressing the crucial underlying emotional component. Diminish the child’s use of aggression as the main coping device by allowing painful emotions to be mastered more effectively. Help to systematically address avoidance mechanisms, talking to the child about how their disruptive behavior helps them avoid painful emotions. Facilitate development of an awareness that painful emotions do not have to be so vigorously warded off, allowing the child to reach this implicit awareness within the relationship with the clinician, which can then be expanded to life situations at home and at school. This handbook is the first to provide a manualized, short-term dynamic approach to the externalizing behaviors of childhood, offering organizing framework and detailed descriptions of the processes involved in _RFP-C_. Supplying clinicians with a systematic individual psychotherapy as an alternative or complement to PMT, CBT and psychotropic medication, it also shifts focus away from simply helping parents manage their children’s misbehaviors. Significantly, the approach shows that clinical work with these children is compatible with understanding the children’s brain functioning, and posits that contemporary affect-oriented conceptualizations of defense mechanisms are theoretically similar to the neuroscience construct of implicit emotion regulation, promoting an interface between psychodynamics and contemporary academic psychiatry and psychology. Manual of Regulation-Focused Psychotherapy for Children with Externalizing Behaviors: A Psychodynamic Approach is a comprehensive tool capable of application at all levels of professional training, offering a new approach for psychoanalysts, child and adolescent counselors, psychotherapists and mental health clinicians in fields including social work, psychology and psychiatry. (shrink)

The theory-theory of human uniqueness posits that the capacity to theorize, in a way strongly analogous to theorizing in scientific practice, was a key innovation in the hominid lineage and was responsible for many of our unique cognitive traits. One of the central arguments that its proponents have used to support the claim that animals are not theorists, the logical problem, bears strong similarities to Hempel's theoretician's dilemma, which purports to show that theories are unnecessary. This similarity threatens to undermine (...) both the claim that theorizing serves a unique, adaptive role in human cognition and our ability to test for the presence of theories. I examine two historical responses to the theoretician's dilemma and argue that they open up strategies for experimentally testing for theoretical ability in other animals. (shrink)

Several recent arguments by philosophers of biology have challenged the traditional view that evolutionary factors, such as drift and selection, are genuine causes of evolutionary outcomes. In the case of drift, advocates of the statistical theory argue that drift is merely the sampling error inherent in the other stochastic processes of evolution and thus denotes a mathematical, rather than causal, feature of populations. This debate has largely centered around one particular model of drift, the Wright–Fisher model, and this has contributed (...) to the plausibility of the statisticalists’ arguments. However, an examination of alternative, predictively inequivalent models shows that drift is a genuine cause that can be manipulated to change population outcomes. This case study illustrates the influence of methodological assumptions on ontological judgments, particularly the pernicious effect of focusing on a particular model at the expense of others and confusing its assumptions and idealizations for true claims about the phenomena being modeled. (shrink)

In their 2010 book, Biology’s First Law, D. McShea and R. Brandon present a principle that they call ‘‘ZFEL,’’ the zero force evolutionary law. ZFEL says (roughly) that when there are no evolutionary forces acting on a population, the population’s complexity (i.e., how diverse its member organisms are) will increase. Here we develop criticisms of ZFEL and describe a different law of evolution; it says that diversity and complexity do not change when there are no evolutionary causes.

I evaluate the plausibility of explanatory elitism, the view that a good scientific explanation of an outcome will show that it was highly probable. I consider an argument from Michael Strevens that elitism is the only view that can account for the historical acceptance of probabilistic theories in physics. I argue that biology provides better test cases for evaluating elitism and conclude that theories in that domain were favored in virtue of conferring correct, and not necessarily high, probabilities on outcomes.

In the Origin, Darwin forwards two incompatible lines of attack on special creationism. First, he argues that imperfect or functionless traits are evidence against design. Second, he argues that since special creationism can be made compatible with any observation, it is unscientific and explanatorily vacuous. In later works, Darwin shifts to an argument that he finds much more persuasive and which would undermine theistic evolutionism as well. He argues that variation is random with respect to selection and that this demonstrates (...) that there is no design in the biological world. I examine why Darwin found the argument from independence of variation and selection more compelling than the argument from imperfection. I argue that Darwin utilized general principles of causal inference, akin to those used in modern causal modeling, to rule out any unified cause behind the evolutionary process. (shrink)

In this article we critically reflect on ‘feminist research methods’ and ‘methodology’, from the perspective of a feminist research unit at a South African university, that explicitly aims to improve gender-based violence service provision and policy through evidence-based advocacy. Despite working within a complex and inequitable developing country context, where our feminist praxis is frequently pitted against seemingly intractable structural realities, it is a praxis that remains grounded in documenting the stories of vulnerable individuals and within a broader political project (...) of working towards improving the systems that these individuals must navigate under challenging social and structural conditions. We primarily do this by working with non-governmental organisations (NGOs) providing gender-based violence services in research conceptualisation, design and implementation. This raises unique and complex questions for feminist participatory research, which we illustrate through a case study of collaborative, participatory research with NGOs to improve health and criminal justice outcomes for survivors of sexual violence. Issues include the possibility of good intentions/good research designs failing; the suitability of participatory research in sensitive service provision contexts; the degree(s) of engagement between researchers, service providers (collaborators/participants) and research participants; as well as our ethical duties to do no harm and to promote positive, progressive change through personal narratives and other forms of evidence. Given the demands of our context and these core issues, we not only argue that there are no ‘feminist methods’, but also caution against the notion of a universal ‘feminist methodology’. Whilst we may all be in agreement about the centrality of gender to our research and analysis, the fundamental aims and assumptions of mainstream (Western) feminist approaches do not hold true in all contexts, nor are they without variance in mode, ideal degrees of participation and importance to social context. (shrink)

A number of influential biologists are currently pursuing efforts to restore previously extinct species. But for decades, philosophers of biology have regarded “de-extinction” as conceptually incoherent. Once a species is gone, it is gone forever. We argue that a range of metaphysical, biological, and ethical grounds for opposing de-extinction are at best inconclusive and that a pragmatic stance that allows for its possibility is more appealing.

The constructs of motivation (or needs, motives, etc.) to explain higher-order behavior have burgeoned in psychology. In this article, we critically evaluate such high-level motivation constructs that many researchers define as causal determinants of behavior. We identify a fundamental issue with this predominant view of motivation, which we called the black-box problem. Specifically, high-level motivation constructs have been considered as causally instigating a wide range of higher-order behavior, but this does not explain what they actually are or how behavioral tendencies (...) are generated. The black box problem inevitably makes the construct ill-defined and jeopardizes its theoretical status. To address the problem, we discuss the importance of mental computational processes underlying motivated behavior. Critically, from this perspective, motivation is not a unitary construct that causes a wide range of higher-order behavior --- it is an emergent property that people construe through the regularities of subjective experiences and behavior. The proposed perspective opens new avenues for future theoretical development, i.e., the examination of how motivated behavior is realized through mental computational processes. (shrink)

The sport of wheelchair rugby is the subject of a recent film Murderball, which tells the story of the apparently intense rivalry between the Canadian and United States men's teams. In part, the story is told through the lives of some of the game's leading players and coaches. Murderball deals with a series of ethical and political questions concerned with conceptions of disability, articulations of sporting bodies, and the value attached to sporting performance. In this paper we offer a critique (...) of Murderball and explore a number of themes including: (1) What can disabled bodies do?; (2) This is not the Special Olympics; and (3) ?Hot? and disabled. We conclude that these themes offer us new intellectual challenges for thinking about the physical education experiences of young disabled people and progression in disability sport. Indeed, we argue that Murderball moves disability issues into new intellectual terrain, thus increasing the ways in which people who work with young people and sport might need to take account of disability. (shrink)

This paper proposes the development of a new model of treatment for survivors of sexual abuse suffering from Posttraumatic Stress Disorder. Foa, Rothbaum, Riggs, and Murdock and Foa, Rothbaum, and Furr support Prolonged Exposure as a highly effective treatment for PTSD. However, PE can be intimidating to survivors, contributing to hesitancy to participate in the treatment. This paper posits that animal-assisted therapy will decrease anxiety, lower physiological arousal, enhance the therapeutic alliance, and promote social lubrication. The paper also posits that (...) AAT will enhance the value of PE by making it more accessible to survivors, increasing social interaction, and perhaps decreasing the number of sessions required for habituation to the traumatic memories. (shrink)

Hierarchical cognitive mechanisms underlie sophisticated behaviors, including language, music, mathematics, tool-use, and theory of mind. The origins of hierarchical logical reasoning have long been, and continue to be, an important puzzle for cognitive science. Prior approaches to hierarchical logical reasoning have often failed to distinguish between observable hierarchical behavior and unobservable hierarchical cognitive mechanisms. Furthermore, past research has been largely methodologically restricted to passive recognition tasks as compared to active generation tasks that are stronger tests of hierarchical rules. We argue (...) that it is necessary to implement learning studies in humans, non-human species, and machines that are analyzed with formal models comparing the contribution of different cognitive mechanisms implicated in the generation of hierarchical behavior. These studies are critical to advance theories in the domains of recursion, rule-learning, symbolic reasoning, and the potentially uniquely human cognitive origins of hierarchical logical reasoning. (shrink)