Acting for the good of the patient is the most fundamental and universally acknowledged principle of medical ethics. However, given the complexity of modern medicine as well as the moral fragmentation of contemporary society, determining the good is far from simple. In his philosophy of medicine, Edmund Pellegrino develops a conception of the good that is derived from the internal morality of medicine via the physician-patient relationship. It is through this healing relationship that rights, duties, and privileges are defined for (...) both physicians and patients. Moreover, this relationship determines the characteristics or virtues that are necessary to engage in the medical telos. This paper addresses the role of the moral virtues in clinical medicine and the physician-patient relationship. First, it provides a brief background of the Aristotelian foundations of virtue-ethics. Second, it delves into Pellegrino’s philosophy of medicine understood as a practice oriented towards a teleological goal. Third, it relates the telos of medicine to the notion of the medical community as a fundamentally moral community. Finally, it concludes with a section that creates a dialogue between virtue ethics and principlism. (shrink)

ABSTRACTTheodor Haecker’s translation and reception of Kierkegaard exerted a strong influence on interwar German readings of Kierkegaard. Recent scholarship has drawn renewed attention to Haecker’s World War I Kierkegaardian polemics and the dampening of his enthusiasm for Kierkegaard after his conversion to Catholicism in 1921. This article offers a twofold refinement of current accounts of Haecker’s Kierkegaard reception. First, it shows that Haecker’s attempt to describe a Catholic theological anthropology after 1931 was less a turn away from Kierkegaard and more (...) a turning of Kierkegaard toward the Catholic intellectual tradition. Second, the article shows how this anthropological project collided with the ideology and censorship of the Third Reich, where Haecker became a key voice in the Catholic ‘inner emigration.’ Revisionist methodologies in German studies have modelled how to retrieve the resonance of inner-emigration texts – literary, philosophical, theological, etc. – that were written against the grain of dictatorship. As inner emigrant, Haecker draws instinctively on Kierkegaard’s authorship, life, and thought as a paradigm for his own regime-critical writing and existence. With the claim that Haecker’s inner-emigration writings depend on his ongoing encounter with Kierkegaard, this article offers new access to Haecker’s late thought for philosophers, theologians, and literary scholars alike. (shrink)

Businesses and the social sciences are increasingly facing calls to further scholarship dedicated to understand sustainability. Furthermore, multinationals are also facing similar calls given their high profile and their role in environmental degradation. However, a literature review shows that there is very limited understanding of sustainability at a cross-national level. Given the above gaps, we contribute to the literature by examining how selected GLOBE [House et al., Culture, leadership and organizations: The GOBE study of 62 societies. Sage Publications, Thousand Oaks, (...) 2004 ] cultural dimensions are related to individuals’ propensity to support sustainability initiatives in 33 countries. We use data from the World Values Survey [World Values Study Group, World Values Surveys and European Value Surveys, 1999–2001. Inter-University Consortium for Political and Social Research, Ann Arbor, 2004 ] and test our hypotheses using Hierarchical Linear Modeling (HLM). Results support all but one hypothesis. Specifically, uncertainty avoidance is not related to propensity to support sustainability initiatives. In contrast, performance orientation and assertiveness have the desired negative relationship with our dependent variable while collectivism, future orientation, and human orientation have the desired positive relationship. We discuss the conceptual and practical implications of this study. (shrink)

Dual process accounts of affective learning state that the learning of likes and dislikes reflects a learning mechanism that is distinct from the one reflected in expectancy learning, the learning of signal relationships, and has different empirical characteristics. Affective learning, for example, is said not to be affected by: (a) extinction training; (b) occasion setting; (c) cue competition; and (d) awareness of the CS-US contingencies. These predictions were tested in a series of experiments that employed simple Pavlovian conditioning procedures. Neutral (...) visual pictures of geometric shapes, or tactile conditional stimuli (CS) were paired with aversive electrotactile unconditional stimuli (US). Dependent measures were physiological (skin conductance, blink startle modulation) or verbal (US expectancy, on-line and off-line ratings of CS pleasantness). Different combinations of these dependent measures were employed across different experiments in an attempt to assess affective and expectancy learning simultaneously. Changes in CS pleasantness as indexed by ratings or blink startle modulation were readily observed. However, contrary to the predictions from dual-process accounts, results indicated that acquired CS unpleasantness is subject to extinction, occasion setting, cue competition, and not found in absence of CS-US contingency awareness. (shrink)

It has been consistently demonstrated that fear-relevant images capture attention preferentially over fear-irrelevant images. Current theory suggests that this faster processing could be mediated by an evolved module that allows certain stimulus features to attract attention automatically, prior to the detailed processing of the image. The present research investigated whether simplified images of fear-relevant stimuli would produce interference with target detection in a visual search task. In Experiment 1, silhouettes and degraded silhouettes of fear-relevant animals produced more interference than did (...) the fear-irrelevant images. Experiment 2, compared the effects of fear-relevant and fear-irrelevant distracters and confirmed that the interference produced by fear-relevant distracters was not an effect of novelty. Experiment 3 suggested that fear-relevant stimuli produced interference regardless of whether participants were instructed as to the content of the images. The three experiments indicate that even very simplistic images of fear-relevant animals can divert attention. (shrink)

From an early age, exposure to a spoken language has allowed us to implicitly capture the structure underlying the succession of speech sounds in that language and to segment it into meaningful units. Statistical learning, the ability to pick up patterns in the sensory environment without intention or reinforcement, is thus assumed to play a central role in the acquisition of the rule-governed aspects of language, including the discovery of word boundaries in the continuous acoustic stream. Although extensive evidence has (...) been gathered from artificial languages experiments showing that children and adults are able to track the regularities embedded in the auditory input, as the probability of one syllable to follow another syllable in the speech stream, the developmental trajectory of this ability remains controversial. In this work, we have collected Event-Related Potentials while 5-year-old children and young adults were exposed to a speech stream made of the repetition of eight three-syllable nonsense words presenting different levels of predictability to mimic closely what occurs in natural languages and to get new insights into the changes that the mechanisms underlying auditory statistical learning might undergo through the development. The participants performed the aSL task first under implicit and, subsequently, under explicit conditions to further analyze if children take advantage of previous knowledge of the to-be-learned regularities to enhance SL, as observed with the adult participants. These findings would also contribute to extend our knowledge of the mechanisms available to assist SL at each developmental stage. Although behavioral signs of learning, even under explicit conditions, were only observed for the adult participants, ERP data showed evidence of online segmentation in the brain in both groups, as indexed by modulations in the N100 and N400 components. A detailed analysis of the neural data suggests, however, that adults and children rely on different mechanisms to assist the extraction of word-like units from the continuous speech stream, hence supporting the view that SL with auditory linguistic materials changes through development. (shrink)

BackgroundRandomized controlled trials are often complex and expensive to perform. Less than one third achieve planned recruitment targets, follow-up can be labor-intensive, and many have limited real-world generalizability. Designs for RCTs conducted using cohorts and routinely collected health data, including registries, electronic health records, and administrative databases, have been proposed to address these challenges and are being rapidly adopted. These designs, however, are relatively recent innovations, and published RCT reports often do not describe important aspects of their methodology in a (...) standardized way. Our objective is to extend the Consolidated Standards of Reporting Trials statement with a consensus-driven reporting guideline for RCTs using cohorts and routinely collected health data.MethodsThe development of this CONSORT extension will consist of five phases. Phase 1 consisted of the project launch, including fundraising, the establishment of a research team, and development of a conceptual framework. In phase 2, a systematic review will be performed to identify publications that describe methods or reporting considerations for RCTs conducted using cohorts and routinely collected health data or that are protocols or report results from such RCTs. An initial “long list” of possible modifications to CONSORT checklist items and possible new items for the reporting guideline will be generated based on the Strengthening the Reporting of Observational Studies in Epidemiology and The REporting of studies Conducted using Observational Routinely-collected health Data statements. Additional possible modifications and new items will be identified based on the results of the systematic review. Phase 3 will consist of a three-round Delphi exercise with methods and content experts to evaluate the “long list” and generate a “short list” of key items. In phase 4, these items will serve as the basis for an in-person consensus meeting to finalize a core set of items to be included in the reporting guideline and checklist. Phase 5 will involve drafting the checklist and elaboration-explanation documents, and dissemination and implementation of the guideline.DiscussionDevelopment of this CONSORT extension will contribute to more transparent reporting of RCTs conducted using cohorts and routinely collected health data. (shrink)

Background: Women's health has received renewed attention in the last few years including health rehabilitation options for women affected by breast cancer. Dancing has often been regarded as one attractive option for supporting women's well-being and health, but research with women recovering from breast cancer is still in its infancy. Dancing with Health is multi-site pilot study that aimed to evaluate a dance programme for women in recovery from breast cancer across five European countries.Methods: A standardized 32 h dance protocol (...) introduced a range of Latin American dances presented within a sports and exercise framework with influences from dance movement therapy. Fifty-four women participated in the study who had a breast cancer diagnosis 6 weeks, no indication of metastasis, or scheduled surgery/chemotherapy/radiation treatment for the duration of the intervention. Primary outcome data was collected for anthropometric and fitness measures next to cancer-related quality of life. T-tests and Wilcoxon signed ranked tests were used to establish differences pre and post intervention. Cohen's d was also calculated to determine the effect size of the intervention.Results: Statistically significant changes were found for: weight, right and left forearm circumference and hip; 6 min walking, right and left handgrip, sit-to-stand and sit-and-reach; the EORTC-QLQ C30 summary score as well as the subscales of emotional and social functioning and symptoms. In all cases the direction of change was positive, while Cohen's d calculated showed that the effect of the intervention for these parameters ranged from intermediate to large.Conclusion: Changes on the above anthropometric, fitness and quality of life measures suggest that the intervention was of value to the participating women recovering from breast cancer. Results also advocate collaborative efforts across countries to further research. (shrink)

Very little research has attempted to describe normal human variation in female genitalia, and no studies have compared the visual images that women might use in constructing their ideas of average and acceptable genital morphology to see if there are any systematic differences. The objective of the present work was to determine if visual depictions of the vulva differed according to their source so as to alert medical professionals and their patients to how these depictions might capture variation and thus (...) influence perceptions of ‘normality’. A comparative analysis was conducted by measuring (a) published visual materials from human anatomy textbooks in a university library, (b) feminist publications (print and online) depicting vulval morphology and (c) online pornography, focusing on the most visited and freely accessible sites in the UK. Post hoc tests showed that labial protuberance was significantly less (p<0.001, equivalent to approximately 7 mm) in images from online pornography compared to feminist publications. All five measures taken of vulval features were significantly correlated (p<0.001) in the online pornography sample, indicating a less varied range of differences in organ proportions than the other sources where not all measures were correlated. Women and health professionals should be aware that specific sources of imagery may depict different types of genital morphology and may not accurately reflect true variation in the population, and consultations for genital surgeries should include discussion about the actual and perceived range of variation in female genital morphology. (shrink)

This is a jubilant and rewarding collection of Winterson scholarship--a superb group of essays from a host of fine authors.

This survey set out to explore occupational health professionals' courses of action with respect to privacy in a situation of dual loyalty between employees and employers. A postal questionnaire was sent to randomly selected potential respondents. The overall response rate was 64%: 140 nurses and 94 physicians returned the questionnaire. Eight imaginary cases involving an ethical dilemma of privacy were presented to the respondents. Six different courses of action were constructed within the set alternatives proposed. The study indicated that privacy (...) as an absolute value is not in the interest of either employees or employers. It also showed that, where dual loyalty is concerned, the most valid course of action in dealing with sensitive subjects such as drug and work community problems, sexual harassment and sick leave is to rely on tripartite co-operation. If they maintain their professional independence and impartiality, health professionals are well placed to succeed in this challenging task; if not, there are bound to be severe violations of privacy. (shrink)