This article critically examines the relations between epistemics in conversation analysis and linguistic and cognitivist conceptions of communicative interaction that emphasize information and information transfer. The epistemic program adheres to the focus on recorded instances of talk-in-interaction that is characteristic of CA, explicitly identifies its theoretical origins with ethnomethodology, and points to implications of its research for the social distribution of knowledge. However, despite such affiliations with CA and ethnomethodology, the EP is cognitivist in the way it emphasizes information exchange (...) as an underlying, extrasituational ‘driver’ in social interaction. To document how the EP draws upon cognitivist conceptions of information and knowledge, we review examples from the corpus of transcripts analyzed in key publications on epistemics. Our re-analysis casts doubt upon the way EP analysis invokes an underlying order that supposedly drives the evident sequential organization of those transcripts. (shrink)

After a 50-page outline of the principles of clinical reasoning, over 60 actual cases are detailed that illustrate (and are keyed to) the principles, presenting case records, analysis, and references to literature. For medical students and interns, and their instructors. Annotation copyright Book Ne.

This article offers a comprehensive review of the major theoretical issues and findings of the epistemic approaches to deliberative democracy. Section 2 surveys the norms and ideals of deliberative democracy in relation to deliberation's ability to “track the truth.” Section 3 examines the conditions under which deliberative mini‐publics can “track the truth.” Section 4 discusses how “truth‐tracking” deliberative democracy is possible through the division of epistemic labor in a deliberative system.

Several prominent voices have called for a democratization of science through deliberative processes that include a diverse range of perspectives and values. We bring these scholars into conversation with extant research on democratic deliberation in political theory and the social sciences. In doing so, we identify systematic barriers to the effectiveness of inclusive deliberation in both scientific and political settings. We are particularly interested in what we call misidentified dissent, where deliberations are starkly framed at the outset in terms of (...) dissenting positions without properly distinguishing the kinds of difference and disagreement motivating dissent. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Most healthcare providers work from ethical principles based on a Western model of practice that may not adhere to the cultural values intrinsic to Indigenous peoples. Breaking bad news is an important topic of ethical concern in health research. While much has been documented on BBN globally, the ethical implications of receiving bad news, from an Indigenous patient perspective in particular, is an area that requires further inquiry. This article discusses the experiences of Māori lung cancer patients and their families, (...) in order to investigate the ethical implications of receiving bad news. Data collection occurred through 23 semistructured interviews and nine focus groups with Māori lung cancer patients and their families in four districts in the Midland Region of New Zealand: Waikato, Bay of Plenty, Lakes and Tairāwhiti. The findings of this study were categorised into two key themes: communication and context. Avenues for best practice include understanding the centrality of the HCP–patient relationship and family ties in the healthcare journey, and providing patients with the full range of viable treatment options including hope, clear advice and guidance when the situation calls for it. Overall, the findings of this study hold implications for providing culturally safe and humanistic cancer care when BBN to Māori and Indigenous patients. (shrink)

The practice of covertly administering medication is controversial. Although condemned by some as overly paternalistic, others have suggested that it may be acceptable if patients have permanent mental incapacity and refuse needed treatment. Ethical, legal, and clinical considerations become more complex when the mental incapacity is temporary and when the medication actually serves to restore autonomy. We discuss these issues in the context of a young man with schizophrenia. His mother had been giving him antipsychotic medication covertly in his soup. (...) Should the doctor continue to provide a prescription, thus allowing this to continue? We discuss this case based on the “four principles” ethical framework, addressing the conflict between autonomy and beneficence/non-maleficence, the role of antipsychotics as an autonomy restoring agent, truth telling and the balance between individual versus family autonomy. (shrink)

With advances in genetic technology, there are increasing concerns about the way in which genetic information may be abused, particularly in people at increased genetic risk of developing certain disorders. In a recent case in Hong Kong, the court ruled that it was unlawful for the civil service to discriminate in employment, for the sake of public safety, against people with a family history of mental illness. The plaintiffs showed no signs of any mental health problems and no genetic testing (...) was performed. This was the first case concerning genetic discrimination in common law jurisdictions, therefore the court's judgment has implications for how genetic discrimination cases may be considered in the future. The court considered it inappropriate to apply population statistics or lifetime risks to individuals while examining fitness for work. It recommended an individualised assessment of specific risks within the job, relative to other risks posed by that workplace. (shrink)

Amphibian metamorphosis is a post‐embryonic process that systematically transforms different tissues in a tadpole. Thyroid hormone plays a causative role in this complex process by inducing a cascade of gene regulation. While natural metamorphosis does not occur until endogenous thyroid hormone has been synthesized, tadpoles are competent to respond to exogenous thyroid hormone shortly after hatching. In addition, even though the metamorphic transitions of individual organs are all controlled by thyroid hormone, each occurs at distinct developmental stages. Recent molecular studies (...) suggest that this competence of premetamorphic tadpoles to respond to the hormone and the developmental stage‐dependent regulation of tissue‐specific transformations are determined in part by the levels of thyroid hormone receptors and the concentrations of cellular free thyroid hormone. In addition, at least two genes, encoding a cytosolic thyroid hormone binding protein and a 5‐deiodinase, respectively, are likely to be critical players in regulating cellular free thyroid hormone concentrations. This review discusses how all of these molecuar components coordinate to induce amphibian metamorphosis in a correct spatial and temporal manner. These studies provde us with general clues as to how and why tissues become competent to respond to hormonal signals. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Many researchers have identified a process they call ‘deskilling’, which they use to describe the daily experience of teachers who have been gradually losing control of their own labour within ‘low‐trust’ workplaces. Conversely, other scholars have found that under similar conditions, some teachers have their own ways of dealing with it which leads them towards a process of ‘reskilling’. This study is an attempt to explore the actual teachers’ perceptions towards their daily practice within the context of educational decentralization, a (...) neglected area of research which needs to be further discussed and explored. This paper uses data gathered from seven schools in Guangdong Province, China as a case study to show that educational decentralization in China not only results in teachers being deskilled because indirect control is still being maintained, but also provides a small number of teachers with a competitive working environment to reskill their pedagogical techniques and educational knowledge, and to pursue good practices in teaching under the pressure of competition. All in all, educational decentralization provides a context in which teachers can experience either deprofessionalization or reprofessionalization. (shrink)

The expression ‘Oh’ in natural conversation is a signal topic in the development of the Epistemic Program. This article attempts to bring into view a sense of place for this simple expression in the early literature, beginning with ‘Oh’ as a ‘change-of-state token’ and through its subsequent treatments in the production of assessments. It reviews them with an interest in two allied developments. One is the rendering of ‘Oh’ as an expression that ‘indexes’ epistemic structure. The other, pursued in the (...) detail of transcript in Part 2, is how, as of this rendering, the literature manages its tasks of ‘animating transcript’, or how we portray ordinary talk as social action. We think these two moves are closely connected within the EP. And we think they yield a very different ‘vocabulary of motives’, different from the natural language studies of conversation analysis. Our discussions address in turn the central phrases of our title. (shrink)

In conversation analysis, through Sacks, Schegloff, Jefferson, and others, the conceptual architecture is joined at the hip to a technical architecture of transcripts, sequence, and turn productions. That the conceptual was to be found and demonstrated in the material detail of temporal productions was central to CA’s extraordinary innovations. As with CA, an Epistemic CA has the task of giving evidence of its conceptual order in actual materials, and thus animating the materials to show them. The task and relationship are (...) emblematically reflexive: we shall find the expression ‘Oh’ indexing ‘changes of state’ or ‘inapposite inquiries’, for example, as of the account-able animations of turns and sequences of turns. Our shared attachments to sequential analysis deliver the expectation that we shall see how Epistemic order is achieved on actual occasions, through actual materials, rendered as transcript. The discussion turns to how the Epistemic Program engages and acquits this analytic expectation. (shrink)

Today, long before a child is born, its growth is monitored and measured against norms of foetal development. At birth, each child is weighed, measured and tested to assess its development. We have a wealth of scientific knowledge which tells us precisely what each child should typically achieve by a prescribed age. The ideas of development and normalcy form the overarching principle by which we now think about children. Why? Because it is the truth about children that they are developing (...) beings. ;That the child is a developing being might seem to be a timeless truth, because, to put it starkly, have children not always been children? Yet I argue that the idea of the child as a developing being is surprisingly recent, barely 150 years old, a product of momentous social transformations in the nineteenth century. In this short period, developmental thinking, with its idea of appropriate norms, has come to determine innumerable practices concerning children in Western culture. Through these practices, we mould the very being of children according to the 'natural' laws of development. ;This essay traces developmental thinking about children. It attempts a philosophical analysis of the present way of reasoning about, interacting with and bringing up children by using a structural account of the historical events that produce our present ways of thinking and doing. My investigation raises philosophical issues about the relationship between epistemology and ontology, ones not usually examined in mainstream Anglo-American philosophy. I argue that the knowledge we have about children as developing creatures not only moulds the being of children but also that of their parents, especially their mothers. Such knowledge determines what is permissible, what mothers can or cannot do; such knowledge constitutes them as mothers. The interrelation between knowledge about ourselves and the kinds of being we are--between epistemology and ontology--demands critical reflection, theoretically and concretely, because of its tremendous effects upon people's lives. A better understanding of the specific ways in which epistemology and ontology intersect may enable us to imagine other possibilities of being for ourselves. (shrink)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

I will do two things in this paper. First, I examine the issue of construction in the social sciences by using “teenage pregnancy” as an example. Following Michel Foucault's genealogical studies, I show that new categories were constructed to study teenage pregnancies, but that the construction involved does not support an extreme theory of construction—a theory which allows of nothing like “reality”. Second, I study the interaction between the categories used in investigations of teenage pregnancies and those to whom such (...) categories are applied, namely the young mothers themselves. The interaction illustrates what Ian Hacking has described as a “looping effect” characteristic of categories used to study people and their behaviour. I claim that with teenage pregnancy, the looping effect is much more complex than Hacking suggests. (shrink)

The authors of this essay challenge the notion that “philosophy” is irredeemably Eurocentric by providing a series of personal, professional, and pedagogical reflections on their experience in a new graduate seminar on “Indigenous philosophy.” The authors—a graduate student, professor, and Indigenous course-facilitator—share in the fashion of “Indigenous storywork,” as outlined by Stó:lō pedagogue Jo-Ann Archibald. We begin with the instructor and how he was personally challenged to re-evaluate his roots and philosophical praxis in spite of his experience teaching over several (...) decades. The second section describes a student experience and how they measured the exigencies of decolonization against the esteem that their family holds for Canada’s brand of multiculturalism. Finally, we turn to the Indigenous seminar facilitator and his skepticism over whether the course truly constituted decolonized, or “landed,” pedagogy. Throughout, the authors ask about the demands of decolonization and how philosophical pedagogy may center Indigenous futurity. (shrink)

The authors take up Amy Allen's suggestion that while Foucault's work may be able to support a certain type of self-critique and self-development, it does not permit the kind of interpersonal relations that are necessary for the development of intersubjective meaning in struggles against imposed identities. The authors contend that for Foucault, relations of ‘truth’ play an important constitutive role in subjectivities, and that understanding the ‘politics of ourselves’ in the context of this truth shows not only an openness to (...) meaningful interpersonal relations, but also that these relations are capable of generating the conceptual and normative resources necessary for resisting socially imposed subjectivities. The authors present such an account of intersubjective relations based on Foucault's discussion of parrhesia, and develop a model of collaborative political action that addresses the criticisms raised. (shrink)

A central characteristic of people with Prader-Willi Syndrome (PWS) is an apparent insatiable appetite leading to severe overeating and the potential for marked obesity and associated serious health problems and premature death. This behaviour may be due to the effects of the genetic defect resulting from the chromosome 15 abnormalities associated with the syndrome. We examine the ethical and legal dilemmas that can arise in the care of people with PWS. A tension exists between a genetic deterministic perspective and that (...) of individual choice. We conclude that the determination of the capacity of a person with PWS to make decisions about his/her eating behaviour and to control that behaviour is of particular importance in resolving this dilemma. If the person is found to lack capacity, the common law principles of acting in a person's "best interests" using the "least restrictive alternative" may be helpful. Allowing serious weight gain in the absence of careful consideration of these issues is an abdication of responsibility. (shrink)

IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential for pregnancy.MethodsA literature (...) review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

This study investigates a few Anglo English and Singapore English tags. The focus is on their meaning and the ways of thinking they reflect, rather than their forms and functions. The study contrasts the so-called Anglo English tag questions and the Singapore English tag is it? and tries to show that their semantic and pragmatic differences relate to differences in ways of thinking in the two cultures. For the purposes of this research, meaning is articulated in a paraphrase couched in (...) natural semantic metalanguage (NSM), which comprises a set of empirically established semantic primes and a universal grammar. (shrink)

Family migration often disadvantages women’s careers. Yet, we know little about the decision-making processes that lead to such outcomes. To address this gap, I conducted a longitudinal interview study of 21 heterosexual young adult couples who were deciding whether to move for early career opportunities. Analyzing 118 interviews, I detail how partners negotiate their desired work and family arrangements given structural and cultural constraints. On one negotiation trajectory, partners maintained their egalitarian desires by performing practical labor to make equal work–family (...) arrangements. On another pathway, couples changed their desires by doing emotion work to justify neotraditional roles. On the last pathway, men deferred to women’s desires, unintentionally leaving women the emotional and practical work of coordinating two careers and the couple’s life. These pathways show how couples contest and reproduce gendered work and family roles during the stalled gender revolution. (shrink)

This paper discusses why speech regulations are logically necessary for any account of a moral right to free speech. My argument for limiting the right to free speech (and more widely any right to freedom) will be grounded in compossibility. Rights to freedom, formally speaking, are claims by an agent that other people not interfere with them; a compossible set of rights is one where the domains of permissible actions–permitted by each claim (and its correlative duty) within the set–do not (...) contradict one another across claims. I will argue that in order for claims to be coherent, they cannot generate contradictory domains, and that for a claim to non-interference to not generate contradictory domains across multiple people with the same claim, the claim must be restricted. This account as it currently stands can at least generate conclusions on the permissibility of incitement. (shrink)

In this stimulating work, Dr. Wong propounds Christian Wholism as a path to peace and joy as well as healing for our 'brokeness' and 'lostness' in the postmodern world. Wong discusses what it means to be whole in our spiritual, intellectual, physical, ethical, psychological, and other domains of our multidimensional personhood. Some practical suggestions are offered. He voices a hope in God's promise of a resurrected body as the gift of ultimate wholeness.