To consciously bolster behaviour that is disapproved by others (i.e., stigmatised behaviour) people may hold and report a favourable attitude toward the behaviour. However, achieving such bolstering outside awareness may be more difficult. Explicit attitudes were measured with self-report measures, and the Implicit Association Test was used to assess implicit attitudes toward behaviour held by stigmatised actors (smokers) and nonstigmatised actors (vegetarians and omnivores). Smokers' showed greater attitude-behaviour consistency in their explicit attitudes toward smoking that in their implicit attitudes. By (...) contrast, vegetarians and omnivores showed attitude-behaviour-consistency at both implicit and explicit levels. Smokers' implicit negative attitudes toward smoking may reflect its status as a stigmatised behaviour, or its addictive nature. (shrink)

BackgroundHIV cure research involving cell and gene therapy has intensified in recent years. There is a growing need to identify ethical standards and safeguards to ensure cell and gene therapy (CGT) HIV cure research remains valued and acceptable to as many stakeholders as possible as it advances on a global scale.MethodsTo elicit preliminary ethical and practical considerations to guide CGT HIV cure research, we implemented a qualitative, in-depth interview study with three key stakeholder groups in the United States: (1) biomedical (...) HIV cure researchers, (2) bioethicists, and (3) community stakeholders. Interviews permitted evaluation of informants’ perspectives on how CGT HIV cure research should ethically occur, and were transcribed verbatim. We applied conventional content analysis focused on inductive reasoning to analyze the rich qualitative data and derive key ethical and practical considerations related to CGT towards an HIV cure.ResultsWe interviewed 13 biomedical researchers, 5 community members, and 1 bioethicist. Informants generated considerations related to: perceived benefits of CGT towards an HIV cure, perceived risks, considerations necessary to ensure an acceptable benefit/risk balance, CGT strategies considered unacceptable, additional ethical considerations, and considerations for first-in-human CGT HIV cure trials. Informants also proposed important safeguards to developing CGT approaches towards an HIV cure, such as the importance of mitigating off-target effects, mitigating risks associated with long-term duration of CGT interventions, and mitigating risks of immune overreactions.ConclusionOur study identified preliminary considerations for CGT-based HIV cure across three key stakeholder groups. Respondents identified an ideal cure strategy as one which would durably control HIV infection, protect the individual from re-acquisition, and eliminate transmission to others. Known and unknown risks should be anticipated and perceived as learning opportunities to preserve and honor the altruism of participants. Preclinical studies should support these considerations and be transparently reviewed by regulatory experts and peers prior to first-in-human studies. To protect the public trust in CGT HIV cure research, ethical and practical considerations should be periodically revisited and updated as the science continues to evolve. Additional ethics studies are required to expand stakeholder participation to include traditionally marginalized groups and clinical care providers. (shrink)

BackgroundThe expectation of pandemic-induced severe resource shortages has prompted authorities to draft and update frameworks to guide clinical decision-making and patient triage. While these documents differ in scope, they share a utilitarian focus on the maximization of benefit. This utilitarian view necessarily marginalizes certain groups, in particular individuals with increased medical needs.Main bodyHere, we posit that engagement with the disability critique demands that we broaden our understandings of justice and fairness in clinical decision-making and patient triage. We propose the capabilities (...) theory, which recognizes that justice requires a range of positive capabilities/freedoms conducive to the achievement of meaningful life goals, as a means to do so. Informed by a disability rights critique of the clinical response to the pandemic, we offer direction for the construction of future clinical triage protocols which will avoid ableist biases by incorporating a broader apprehension of what it means to be human.ConclusionThe clinical pandemic response, codified across triage protocols, should embrace a form of justice which incorporates a vision of pluralistic human capabilities and a valuing of positive freedoms. (shrink)

Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient’s values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge (...) the information needs of the individual patient. The aim of this paper is to describe ‘core information sets’ which are defined as a minimum set of consensus-derived information about a given procedure to be discussed with all patients. Importantly, they are intended to catalyse discussion of subjective importance to individuals. The model described in this paper applies health services research and Delphi consensus-building methods to an idea orginally proposed 30 years ago. The hypothesis is that, first, large amounts of potentially-important information are distilled down to discrete information domains. These are then, secondly, rated by key stakeholders in multiple iterations, so that core information of agreed importance can be defined. We argue that this scientific approach is key to identifying information important to all stakeholders, which may otherwise be communicated poorly or omitted from discussions entirely. Our methods apply systematic review, qualitative, survey and consensus-building techniques to define this ‘core information’. We propose that such information addresses the ‘reasonable patient’ standard for information disclosure but, more importantly, can serve as a spring board for high-value discussion of importance to the individual patient. The application of established research methods can define information of core importance to informed consent. Further work will establish how best to incorporate this model in routine practice. (shrink)

Research has shown that feelings of self-disgust may have a functional role in the genesis of depression by partially mediating the cross-sectional relationship between dysfunctional thoughts and depressive symptoms. However, there are many outstanding issues regarding these hypothesised associations. First, it is not yet clear whether self-disgust is a temporal antecedent, concomitant, or consequence of depressive experience. Second, it is not known whether the hypothesised mediation sequence is valid over time. Third, the relative contribution of disgust towards different aspects of (...) the self has not yet been examined. In the present longitudinal study, participants completed measures of dysfunctional cognitions, self-disgust and depressive symptoms at baseline, and at six and 12-month follow-ups. Analysis showed that self-disgust is best considered as antecedent to depressive symptoms; the hypothesised mediation model was partially supported, but is too simplistic; and disgust towards physical aspects of the self, rather than behaviour, was more important as a temporal predictor of depressive symptoms. The current results help elucidate the role of self-disgust as an antecedent of depressive experience. (shrink)

While the global threat of Ebola Virus Disease in 2014 was concentrated in several West African countries, its effects have been felt in many developed countries including the United States. Initial, select patients with EVD, largely among American health care workers volunteering in affected regions, were subsequently transported back to the states for isolation and treatment in high-level medical facilities. This included Emory University Hospital, which sits adjacent to the federal Centers for Disease Control and Prevention in Atlanta, Georgia.The first (...) domestic case of EVD occurred in late September in Dallas, Texas. Additional exposures of two HCWs generated an array of legal issues for state and local public health authorities, hospitals, and providers. Consideration of these issues led to extensive discussion among lawyers, public health practitioners, and other attendees at a late-breaking session on EVD and Legal Preparedness at the 2014 National Public Health Law conference. In this commentary, session presenters from CDC and Emory University share their expert perspectives on legal and policy issues underlying state and local powers to quarantine and isolate persons exposed to or infected with Ebola, as well as facets of hospital preparedness underlying the successful treatment of patients with EVD. (shrink)

This paper investigates three morphosyntactic alternations in Estonian – those between the exterior locative cases allative, adessive and ablative and the corresponding postpositionspeale‘onto’,peal‘on’ andpealt‘off’. Based on the Complexity Principle (e.g., Rohdenburg, Günter. 2002. Processing complexity and the variable use of prepositions in English. In Hubert Cuyckens & Günter Radden (eds.),Perspectives on prepositions, 79–100. Tübingen: Niemeyer), we expect cognitively more complex constructions to use more explicit (i.e., morphologically more substantial) marking by means of a postposition. Further, we expect variation to be (...) conditioned similarly in all three semantic categories. For each of the three alternations, a random sample of the two outcomes (case vs. postposition) from the Estonian National Corpus is used, resulting in 3,000 data points. Using properties of the Landmark phrase as independent variables in Bayesian mixed-effects logistic regression models, we predict the choice of postpositions over case-marked realisations. Of the patterns found, only the frequency-related one supports our complexity-related hypothesis. We conclude that the Complexity Principle, in its general form, has little explanatory power for the Estonian constructions at hand and, in particular, that the derived principle of ‘analytic support’ is not generally applicable. We show, however, that the grammatical knowledge of Estonian exterior locative cases and the corresponding postpositions is regulated by our three factors in a relatively uniform way. (shrink)

The remarkable growth in interest in aesthetic gardens in the late Ming period has been recognized in Chinese garden culture studies. The materialist historical approach contributes to revealing the importance of gardens’ economic functions in the shift of garden culture, but is inadequate in explaining the successive burgeoning of small plain gardens in the 17th century. This article integrates the aesthetic and materialist perspectives and situates the cultural transition in the concrete social and cultural context in the late Ming period. (...) Beginning with describing a taste change and an expansion in the number of gardens, this article focuses on the small plain garden phenomenon by exploring the unique role that the arts (e.g., poetry and painting) played. A series of artistic criteria were established in the late Ming period. The application of these aesthetic rules to gardens enabled more people to own gardens. This is process that economic requirements for owning gardens were lowered, giving way to the aesthetic appreciation and exploration of literati individuals’ artistic talents. Gardens thus became more widely accessible and provided enhanced pleasure to the middle and lower class families. The conclusion is that the ‘major shift’ in garden culture was closely associated with the change of garden owners’ aesthetic tastes, in addition to the economic conditions in the Jiangnan area. In the increased popularity of gardens, the arts played a significant role. (shrink)

Often when a new scientific theory is introduced, new terms are introduced along with it. Some of these new terms might be given explicit definitions using only terms that were in currency prior to the introduction of the theory. Some of them might be defined using other new terms introduced with the theory. But it frequently happens that the standard formulations of a theory do not define some of the new terms at all; these terms are adopted as primitives. The (...) audience is expected to come to grasp the meanings of the primitive terms by learning the role they play in the theory and its applications. I shall call such new and undefined terms, as well as new terms that are defined using them, theoretical terms. [1] If T is a theory, the T-terms are the theoretical terms introduced by T. A theoretical term need not be a word new to human language; it might be an old term that is employed in a new and specialized sense, not equivalent to any of its familiar senses; e.g. “color” in quantum chromodynamics. (shrink)

With aims to both increase organ supply and better reflect individual donation preferences, many nations worldwide have shifted from ‘opt‐in’ to ‘opt‐out’ systems for post‐mortem organ donation (PMOD). In such countries, while a prospective donor's willingness to donate their organs/tissues for PMOD was previously ascertained—at least partially—by their having recorded positive donation preferences on an official register prior to death, this willingness is now presumed or inferred—at least partially—from their not having recorded an objection to PMOD—on an official organ donation (...) register. Using evidence regarding the presence and prevalence of selective donation preferences, and via exploration of how appeals to donation preferences are used to both motivate and legitimate shifts to opt‐out frameworks, this paper draws attention to a set of previously unexplored problems for opt‐out organ donation arising in contexts where: (a) individuals demonstrate selective post‐mortem organ/tissue donation preferences, (b) legislation provides prospective donors with the opportunity to selectively permit/refuse the donation of certain organs/tissues in line with these preferences. While selective preferences pose few problems for opt‐in systems where a selective occasion is built into the process of signing the donor register, this is not the case for opt‐out systems. The loss of this selective occasion can cause significant problems where appeals to preferences motivate/legitimate shifts to opt‐out but evidence regarding variable preferences does not feed into determinations regarding organ/tissue exclusions. The nature of these problems depends on how the authorization aspect of ‘opt‐out’ systems is framed (e.g. as presumed consent, deemed consent or, given the role of familial consent in many jurisdictions as consent in name only). (shrink)

Background: Empirical ethics inquiry works from the notion that stakeholder perspectives are necessary for gauging the ethical acceptability of human studies and assuring that research aligns with societal expectations. Although common, studies involving different populations often entail comparisons of trends that problematize the interpretation of results. Using graphical model selection—a technique aimed at transcending limitations of conventional methods—this report presents data on the ethics of clinical research with two objectives: (1) to display the patterns of views held by ill and (...) healthy individuals in clinical research as a test of the study's original hypothesis and (2) to introduce graphical model selection as a key analytic tool for ethics research. Methods: In this institutional review board (IRB)-approved, National Institutes of Health-funded project, data were collected from 60 mentally ill and 43 physically ill clinical research protocol volunteers, 47 healthy protocol-consented participants, and 29 healthy individuals without research protocol experience. Respondents were queried on the ethical acceptability of research involving people with mental and physical illness (i.e., cancer, HIV, depression, schizophrenia, and posttraumatic stress disorder) and non-illness-related sources of vulnerability (e.g., age, class, gender, ethnicity). Using a statistical algorithm, we selected graphical models to display interrelationships among responses to questions. Results: Both mentally and physically ill protocol volunteers revealed a high degree of connectivity among ethically salient perspectives. Healthy participants, irrespective of research protocol experience, revealed patterns of views that were not highly connected. Conclusions: Between ill and healthy protocol participants, the pattern of views was vastly different. Experience with illness was tied to dense connectivity, whereas healthy individuals expressed views with sparse connections. In offering a nuanced perspective on the interrelation of ethically relevant responses, graphical model selection has the potential to bring new insights to the field of ethics. (shrink)

For understanding early Chinese "theories of language" and views about the relation of speech to a nonalphabetic script, a thorough analysis of early Chinese metalinguistic terminology is necessary. This article analyzes the function of ming & (name) in early Chinese texts as a first step in that direction. It argues against the regular treatment of this term in early Chinese texts as the equivalent of "word." It examines ming in light of early Chinese ideas about sense perception, the mythology about (...) the origin or music and writing, and changes occurring in the writing system in the third century B.C.E. This lays the groundwork for a more informed response to Derrida's speculation about Chinese logocentrism. It is explained that, in early Chinese texts, certain concepts associated with logocentrism (e.g., reality/appearance, presence/absence) function in a way that is neither the same as, nor exactly the reverse of, the Western philosophical episteme. Thus, attempts to reconstruct attitudes toward "language" in early China should note the importance of sound in interpreting ming. Moreover, interpretations of apparent denigrations of writing in early Chinese texts should, before diagnosing logocentrism, consider the context of the reliability of the visual. (shrink)

Many recent studies have appealed to the idea that linguistic systems are subject to economy of structure or representation, e.g. Chomsky 1995, Rizzi 1997, Bresnan 2001. The guiding idea of economy of structure is that small structures are preferred over large ones, other things being equal. Other things being equal, projections with fewer elements are preferred over projections with more elements, and structures containing fewer projections are preferred over structures with more projections.

In this paper, the author reflects on an unsuccessful strategy for teaching an introductory philosophy class and charts her transition to a different, successful strategy which strives for intellectual integrity while coming to terms with the “impressive decrease in the level of the average student’s academic preparation.” The author first recalls her attempts to teach an introductory philosophy course with the traditional structure of texts read in chronological order, a midterm and final exam, and two several-page papers throughout the term. (...) This strategy produced panic and incomprehension on the part of both students and professor. Instead, the author recommends a course organized by philosophical theme with stylistically and chronologically mixed readings. Evaluation for this course is based on a series of one-page assignments throughout the term, the topics of which are not strictly academic (e.g. “Explore Marx’ notion of alienation in your own work life”) but which embed course material in a context that is more relevant and comprehensible to students. The author concludes by considering drawbacks to this course structure and arguing that they are outweighed by its benefits. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.1 (2003) 32-39 [Access article in PDF] Aesthetics, Epistemics, and Feminist Theory Jane Duran Recent feminist analysts of aesthetics and analytic aesthetics in particular seem to have come to the conclusion that the redemption of formulated aesthetic theory from the feminist point of view is a difficult and recondite task. 1 If analytic aesthetics now looks problematic, qua fruitful philosophical enterprise, its future (...) appears bleaker still when the intersection of the androcentric nature of analytic philosophy and the larger feminist project, frequently articulated in other than analytic terms, is examined.In this essay I will assume that there is some future for analytic aesthetics, and I will not dispute the basic assumption that any portion of analytic theory is somewhat immiscible with feminist points of view. My concern, rather, will be to try to show what it is specifically in the nature of analytic theory, both aesthetic and otherwise, which renders it of dubious value to the feminist critique (at least on first blush). Although in the past feminist theorists have tried to characterize the androcentric nature of analytic philosophy on the whole in rather striking terms,it is not clear that these terms have been precise enough. 2 Further, it is not clear that analytic modes are obviously unusable for feminist theory or for the development of a still nascent feminist aesthetics, although what one wants to say here is that this task is a terribly danger-fraught one. 3My goal here is twofold: first, to articulate what precisely it is aboutanalytic aesthetics (or any portion of analytic theory, for that matter) thatmakes it a hindrance — at least preliminarily — to the development of feminist views. In order to do this I will need to examine a relatively uncharted area in the literature, that is the parallel between much of analytic aesthetic theory and analytic epistemology. The second portion of my task will runsomewhat contrary to conventional wisdom: having delineated the mostmasculinist parts of analytic endeavors, I inquire if there is, indeed, anypart of rigorously articulated analytic theory that could lend itself to the development of a feminist aesthetic. [End Page 32] Analytic Philosophy and Aesthetics Analytic aesthetics, like analytic philosophy taken as a whole, has often proceeded as if the development of conceptual clarification and theoretical rigor could do much to "solve" or dissolve aesthetic problems. George Dickie's introductory work, for example, presents the student with a number of difficult areas in aesthetics, and then proceeds to address these areas in much the same manner that other contemporary texts employ for the discussion of issues in ethics, epistemology, or metaphysics.In discussing symbolism, Dickie first attempts to clarify the use of theterm, and then notes that there are problematic areas with regard to whether or not a work of art can both contain a symbol and serve itself as a symbol simultaneously. A symbol "stands for" in some establishable way that which it symbolizes. A symbol serves to transfer someone's thought to something other than itself, and the transfer is not a random association. The transfer depends upon certain features of the symbol which give it a place in a certain meaning system. 4I cite this material as exemplary because the flavor of analytic aesthetics is remarkably similar to the flavor of analytic philosophy as a whole. We sometimes need to remind ourselves that the techniques of analysis developed in the earlier part of this century relied on breakthroughs in logic and formal representation which allowed for a certain precision in matching symbol to thing signified. The original hope of philosophers working at the time of Bertrand Russell and G.E. Moore had been to develop something close to a logically perfect language with a one-to-one relationship between signifier and signified. However without merit this somewhat arcane task, its goals infused much of the philosophizing that followed it, and even the ordinary language school was, of course, indirectly an offshoot of this work. Nicholas Wolterstorff, for example, notes that "analytic philosophy was to be 'scientific philosophy'....The goal of the analytic philosopher... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.1 (2003) 32-39 [Access article in PDF] Aesthetics, Epistemics, and Feminist Theory Jane Duran Recent feminist analysts of aesthetics and analytic aesthetics in particular seem to have come to the conclusion that the redemption of formulated aesthetic theory from the feminist point of view is a difficult and recondite task. 1 If analytic aesthetics now looks problematic, qua fruitful philosophical enterprise, its future (...) appears bleaker still when the intersection of the androcentric nature of analytic philosophy and the larger feminist project, frequently articulated in other than analytic terms, is examined.In this essay I will assume that there is some future for analytic aesthetics, and I will not dispute the basic assumption that any portion of analytic theory is somewhat immiscible with feminist points of view. My concern, rather, will be to try to show what it is specifically in the nature of analytic theory, both aesthetic and otherwise, which renders it of dubious value to the feminist critique (at least on first blush). Although in the past feminist theorists have tried to characterize the androcentric nature of analytic philosophy on the whole in rather striking terms,it is not clear that these terms have been precise enough. 2 Further, it is not clear that analytic modes are obviously unusable for feminist theory or for the development of a still nascent feminist aesthetics, although what one wants to say here is that this task is a terribly danger-fraught one. 3My goal here is twofold: first, to articulate what precisely it is aboutanalytic aesthetics (or any portion of analytic theory, for that matter) thatmakes it a hindrance — at least preliminarily — to the development of feminist views. In order to do this I will need to examine a relatively uncharted area in the literature, that is the parallel between much of analytic aesthetic theory and analytic epistemology. The second portion of my task will runsomewhat contrary to conventional wisdom: having delineated the mostmasculinist parts of analytic endeavors, I inquire if there is, indeed, anypart of rigorously articulated analytic theory that could lend itself to the development of a feminist aesthetic. [End Page 32] Analytic Philosophy and Aesthetics Analytic aesthetics, like analytic philosophy taken as a whole, has often proceeded as if the development of conceptual clarification and theoretical rigor could do much to "solve" or dissolve aesthetic problems. George Dickie's introductory work, for example, presents the student with a number of difficult areas in aesthetics, and then proceeds to address these areas in much the same manner that other contemporary texts employ for the discussion of issues in ethics, epistemology, or metaphysics.In discussing symbolism, Dickie first attempts to clarify the use of theterm, and then notes that there are problematic areas with regard to whether or not a work of art can both contain a symbol and serve itself as a symbol simultaneously. A symbol "stands for" in some establishable way that which it symbolizes. A symbol serves to transfer someone's thought to something other than itself, and the transfer is not a random association. The transfer depends upon certain features of the symbol which give it a place in a certain meaning system. 4I cite this material as exemplary because the flavor of analytic aesthetics is remarkably similar to the flavor of analytic philosophy as a whole. We sometimes need to remind ourselves that the techniques of analysis developed in the earlier part of this century relied on breakthroughs in logic and formal representation which allowed for a certain precision in matching symbol to thing signified. The original hope of philosophers working at the time of Bertrand Russell and G.E. Moore had been to develop something close to a logically perfect language with a one-to-one relationship between signifier and signified. However without merit this somewhat arcane task, its goals infused much of the philosophizing that followed it, and even the ordinary language school was, of course, indirectly an offshoot of this work. Nicholas Wolterstorff, for example, notes that "analytic philosophy was to be 'scientific philosophy'....The goal of the analytic philosopher... (shrink)

Research involving minors has been the subject of much ethical debate. The growing number of longitudinal, pediatric studies that involve genetic research present even more complex challenges to ensure appropriate protection of children and families as research participants. Long-term studies with a genetic component involve collection, retention and use of biological samples and personal information over many years. Cohort studies may be established to study specific conditions (e.g. autism, asthma) or may have a broad aim to research a range of (...) factors that influence the health and development of children. Studies are increasingly intended to serve as research platforms by providing access to data and biological samples to researchers over many years. (shrink)