Efforts to professionalize the field of bioethics have led to the development of the Healthcare Ethics Consultant-Certified (HEC-C) Program intended to credential practicing healthcare ethics consultants (HCECs). Our team of professional ethicists participated in the inaugural process to support the professionalization efforts and inform our views on the value of this credential from the perspective of ethics consultants. In this paper, we explore the history that has led to this certification process, and evaluate the ability of the HEC-C Program to (...) meet the goals it has set forth for HCECs. We describe the benefits and weaknesses of the program and offer constructive feedback on how the process might be strengthened, as well as share our team’s experience in preparing for the exam. (shrink)

The objective of the study was to explore parental experiences of being offered participation in a previous neonatal research study involving venepuncture. The method employed was a questionnaire-based exploration of parents' attitudes in those approached to participate in a study of term and preterm immunization responses (Preterm Immunisation Study [PREMIS]). We explored experience of the initial approach, knowledge of study, venepuncture and views on research ‘in general’. In all, 59% of families responded. Highest response rates were for those participating in (...) PREMIS (87% term/69% preterm) and lowest in decliners (34% and 35%). Responding parents participating in PREMIS were well informed, positive about research and did not find the venepuncture problematic. Sixty percent of responding parents who declined PREMIS attributed their declining to the need for venepuncture. In conclusion, parents participating or declining a neonatal study involving venepuncture are different, but participating parents were well informed and seemed able to judge that participation was right for them such that in consenting families venepuncture itself is not problematic. (shrink)

Evolving Clinical Ethics: A Working UnConference, held 5 through 7 February 2020 in Houston, Texas, brought together 91 participants from a variety of institutions, many of whom are engaged in clinical ethics work. The event followed the success of the first Clinical Ethics UnConference hosted by the Cleveland Clinic Center for Bioethics in 2018, and offered an opportunity for ethicists to share both their challenges and their solutions to clinical ethics issues. In this article we explore the emerging themes of (...) the second UnConference and identify the top 10 questions currently faced by the field. We address both unresolved issues and areas of agreement and highlight new collaborations that have been developed to work toward greater standardization in our field. (shrink)

Biographical essays explore the careers of two major early photographers, Joseph-Philibert Girault de Prangey and William James Stillman. in addition, portfolios with works by Maxime Du Camp, John Beasley Greene, Francis Frith, Robert Macpherson, Adolphe Braun and others testify to the strength and consistency of other early photographers who captured the antique worlds around the Mediterranean."--BOOK JACKET.

I will not dwell overlong on the “meaning” of this story. But let me make two essential points. Plato tells us this story as though it were true: it is “a tale which, though passing strange, is yet wholly true.” Those words were to be translated into every language in the world and used to justify the most realistic fantasies. That is quite understandable, for Plato’s story started something new. With a perversity that was to ensure him great success, Plato (...) had laid the foundations for the historical novel, that is to say, the novel set in a particular place and a particular time. We are now quite accustomed to historical novels, and we also know that in every detective story there comes a moment when the detective declares that real life is not much like what happens in detective stories; it is far more complicated. But that was not the case in the fourth century B.C. Plat’s words were taken seriously, not by everyone, but by many, down through the centuries. And it is not too hard to see that some people continue to take them seriously today.As for the “meaning,” following others and together with others, I have tried elsewhere to show that essentially it is quite clear: the Athens and Atlantis of ancient lore represent the two faces of Plato’s own Athens. The former, the old primordial Athens, is what Plato would have liked the city of which he was a citizen to be; the latter is what Athens was in the age of Pericles and Cleon, an imperialistic power whose very existence constituted a threat to other Greek cities. Pierre Vidal-Naquet is director of the Centre Louis Gernet de Recherches Comparées sure les Sociétés Anciennes at the École des Hautes Études en Sciences Sociales in Paris. His most recent publications are the second volume of Les Juifs, la mémoire et le present , La Grèce ancienne 1: Du mythe à la raison, with Jean-Pierre Vernant , and La Démocratie grecque vue d’ailleurs . Among his works to have appeared in English are Myth and Tragedy in Ancient Greece, with Jean-Pierre Vernant , and The Black Hunter: Forms of Thought and Forms of Society in the Greek World . Janet Lloyd is a supervisor for a number of colleges in Cambridge University, where she gives classes in French language and literature. Among her more recent translations are Yves Mény’s Government and Politics in Western Europe: Britain, France, Italy, West Germany and Marie-Claire Bergère’s Golden Age of the Chinese Bourgeoisie, 1911-1937 . In progress are translations of works on Shakespeare, Pericles’ Athens, and a historical geography of France. (shrink)

This paper proposes communities of practice (CoP) as a process to build moral resilience in healthcare settings. We introduce the starting point of moral distress that arises from ethical challenges when actions of the healthcare professional are constrained. We examine how situations such as the current COVID-19 pandemic can exponentially increase moral distress in healthcare professionals. Then, we explore how moral resilience can help cope with moral distress. We propose the term collective moral resilience to capture the shared capacity arising (...) from mutual engagement and dialogue in group settings, towards responding to individual moral distress and towards building an ethical practice environment. Finally, we look at CoPs in healthcare and explore how these group experiences can be used to build collective moral resilience. (shrink)

In this paper, I discuss Whiting’s (2021) account of rational belief and discuss some unresolved issues arising from its reliance on epistemic possibility and, by extension, perspective-relative aprioricity.

The well-known experiments of Nisbett and Wilson lead to the conclusion that we have no introspective access to our decision-making processes. Johansson et al. have recently developed an original protocol consisting in manipulating covertly the relationship between the subjects’ intended choice and the outcome they were presented with: in 79.6% of cases, they do not detect the manipulation and provide an explanation of the choice they did not make, confirming the findings of Nisbett and Wilson. We have reproduced this protocol, (...) while introducing for some choices an expert guidance to the description of this choice. The subjects who were assisted detected the manipulation in 80% of cases. Our experiment confirms Nisbett and Wilson’s findings that we are usually unaware of our decision processes, but goes further by showing that we can access them through specific mental acts. (shrink)

In this article, I deal with the notion of ‘academic identity’ holistically, seeking to bring together the teacher and researcher roles of academics in the neoliberal university. The article begins from the perspective of early-career academics who occupy the majority of fixed-term, teaching-only contracts in Higher Education, arguing that such casualisation of academic labour entrenches the role of the academic asHomo economicus. Drawing on the work of Foucault, I demonstrate how a neoliberal governmentality is now not only exerted upon academics (...) from without, but increasingly they are subjecting themselves to the logic of efficiency and effectiveness too. The neoliberal governmentality of the university thus influences and shapes academic subjectivities, such that what it means tobean academic is confined to this marketised logic. Despite the pressures placed on academics to ‘produce’ measurable outputs and demonstrate their impact, I argue that moving beyondHomo economicusis possible, arguing instead for a re-claiming of ‘the academic’ asHomo academicus. The idea ofHomo academicuscan only be supported when three conditions are present: collegiality is afforded greater importance than competition; the discourses of ‘productivity’ and performativity are balanced against simply ‘doing good work well’ (Pirrie in Virtue and the quiet art of scholarship, Routledge, London, 2019), and; academics are mindful to practice the ‘quieter’ intellectual virtues, including the virtue of ‘unknowing’ (Smith in J Philos Educ 50:272–284, 2016). (shrink)

Background The ethical principle of justice demands that resources be distributed equally and based on evidence. Guidelines regarding forgoing of CPR are unavailable and there is large variance in the reported rates of attempted CPR in in-hospital cardiac arrest. The main objective of this work was to study whether local culture and physician preferences may affect spur-of-the-moment decisions in unexpected in-hospital cardiac arrest. Methods Cross sectional questionnaire survey conducted among a convenience sample of physicians that likely comprise code team members (...) in their country. The questionnaire included details regarding respondent demographics and training, personal value judgments and preferences as well as professional experience regarding CPR and forgoing of resuscitation. Results Of the 675 questionnaires distributed, 617 were completed and returned. Country of practice and level of knowledge about resuscitation were strongly associated with avoiding CPR performance. Mexican physicians were almost twicemore likely to forgo CPR than their Israeli and Indonesian/Malaysian counterparts [OR1.84, p = 0.038]. Mexican responders also placed greater emphasison personal and patient quality of life. In multivariate analysis, degree of religiosity was most strongly associated with willingness to forgo CPR; orthodox respondents were more than twice more likely to report having forgone CPR for apatient they do not know than secular and observant respondents, regardless of the country of practice [OR 2.12, p = 0.003]. Conclusions In unexpected in-hospital cardiac arrest the decision to perform or withhold CPR may be affected by physician knowledge and local culture as well as personal preferences. Physician CPR training should include information regarding predictors of patient outcome at as well as emphasis on differentiating between patient and personal preferences in an emergency. (shrink)

The purpose of this paper is to show through the concrete example of epileptic seizure anticipation how neuro-dynamic analysis and “pheno-dynamic” analysis may guide and determine each other. We will show that this dynamic approach to epileptic seizure makes it possible to consolidate the foundations of a cognitive non pharmacological therapy of epilepsy. We will also show through this example how the neuro-phenomenological co-determination could shed new light on the difficult problem of the “gap” which separates subjective experience from neurophysiological (...) activity. (shrink)

The critical realist and Bourdieusian conceptions of action fundamentally disagree on a number of fronts: the synthetic versus dualistic relationship between structure and agency; the social nature of the self/body; the link between morphogenesis and reflexivity. Despite these differences, this article argues that re-reading Bourdieu’s theories with attention to some of the core tenets of critical realism (emergence, the stratification of reality, and conjunctural causality) can provide insights into how the habitus is capable of reflexivity and social change. In particular, (...) this article reworks Bourdieu’s theory of habitus by suggesting that social selves are always situated at the intersection of multiple and competing social locations (or field positions) and that the habitus itself is always layered. Reflexivity arises from horizontal disjunctures (between field positions) and vertical disjunctures (across temporal sedimentation). (shrink)

Most people encounter art images as digital reproductions on a computer screen instead of as originals in a museum or gallery. With the development of digital technologies, high-resolution artworks can be accessed anywhere and anytime by a large number of viewers. Since these digital images depict the same content and are attributed to the same artist as the original, it is often implicitly assumed that their aesthetic evaluation will be similar. When it comes to the digital reproductions of art, however, (...) it is also obvious that reproductions do differ from the originals in various aspects. Besides image quality, resolution, and format, the most obvious change is in the representation of color. The effects of subjectively varying surface-level image features on art evaluation have not been clearly assessed. To address this gap, we compare the evaluation of digital reproductions of 16 expressionist and impressionist paintings manipulated to have a high color saturation vs. a saturation similar to the original. We also investigate the impact of viewing time and expertise, two other aspects that may impact the perception of art in online contexts. Moreover, we link these dimensions to a recent model of aesthetic experience [the Vienna Integrated Model of Top-Down and Bottom-Up Processes in Art Perception ]. Results suggest that color saturation does not exert a major influence on liking. Cognitive and emotional aspects, however, are affected – to different extents for experts and laypersons. For laypersons, the increase in color saturation led to more positive assessments of an artwork, whereas it resulted in increased confusion for art experts. This insight is particularly important when it comes to reproducing artworks digitally. Depending on the intended use, increasing or decreasing the color saturation of the digitally reproduced image might be most appropriate. We conclude with a discussion of these findings and address the question of why empirical aesthetics requires more precise dimensions to better understand the subtle processes that take place in the perception of today’s digitally reproduced art environment. (shrink)

‘Patient satisfaction’: Knowledge for ruling hospital reform — An institutional ethnography Driven by funding restraint, Canadian health‐care has undergone over a decade of significant reform. Hospitals are being restructured, as text‐based practices of accountability bring a new business‐orientation into hospital and clinical management. New forms of knowledge, generated through records of various sorts, are a necessary resource for managing care in the new environment. This paper's research uses Canadian sociologist Dorothy E. Smith's institutional ethnographic methodology to critically analyse one instance (...) of text‐based management. I analyse information about ‘patient satisfaction’ as it is generated through a patient survey (in which I was implicated through my involvement with a hospitalized family member). Subsequently, I have studied the management environment into which that information would be entered. I argue that in the instance analysed, the information becomes part of a dominant consumer oriented healthcare discourse that subordinates concerns about ‘what actually happened’ as a professional caregiver would have known it. On this basis, I contend that this sort of taken‐for‐granted approach to making decisions about quality care in hospitals may be seriously, even dangerously, flawed. (shrink)

The objective of this article is to study a deeply pre- reflective dimension of our subjective experience. This dimension is gestural and rhythmic, has precise transmodal sensorial submodalities, and seems to play an essential role in the process of emergence of all thought and understanding. In the first part of the article, using examples, we try to draw the attention of the reader to this dimension in his subjective experience. In the second part, we attempt to explain the difficulties and (...) describe the interior process of becoming aware of it. Then we describe the structural characteristics of this dimension, and the different types of 'interior gestures' which enable us to connect ourselves with it. Finally, we formulate a genetic hypothesis about the role of this dimension in cognition, on the basis of which we suggest some research paths in the neuroscientific, educational and existential domains. (shrink)

Context: The pandemic we are going through is an unprecedented situation from which tragic consequences loom. Disturbing and painful though it is, we should, however, remember that it is but a ….

This book attempts to understand regret, an emotion that bridges the actual and the possible, the past and present. Through a wealth of sources it takes up questions of the meaning of regret and how it differs from similar experiences such as remorse and guilt; what sorts of things people most often regret; and the roots of regret in circumstances and in who we are. It takes issue with the view common both in this culture and in leading theories of (...) decision that regret is irrational and dysfunctional - specifying the surprising benefits of regret, its great and good sense. (shrink)

In this paper, we show that Higher{Order Coloured Uni cation { a form of uni cation developed for automated theorem proving { provides a general theory for modeling the interface between the interpretation process and other sources of linguistic, non semantic information. In particular, it provides the general theory for the Primary Occurrence Restriction which (Dalrymple et al., 1991)'s analysis called for.

Les trajectoires d’entrée dans la vie adulte sont parsemées d’événements, de périodes de crise, de carrefours biographiques devant lesquels les jeunes sont amenés à réagir, à faire des choix et à opérer parfois un changement brutal dans leur parcours. Dans ces moments de crise, de basculement et de réalisation de l’improbable, se révèlent des enjeux et des logiques de choix qui resteraient invisibles dans le cours tranquille des choses.À partir d’une enquête qualitative longitudinale auprès d’un panel de jeunes, je propose (...) ici une tentative d’exploration de la notion de bifurcation. Les récits et les argumentaires développés permettent d’identifier les « ingrédients » mobilisés dans la prise de décision. Sont parcourus là divers registres structurels, contextuels, relationnels et individuels, ainsi que des temporalités diverses en interaction. C’est peut-être justement leur conjonction qui autorise cette « rupture » de l’ordre social attendu.The trajectories of entry into adulthood are cluttered with events, periods of crisis, life crossroads to which young people have to face up, to make choices and sometimes operate radical changes in the course of their lives. In these moments of crisis, upheavals and unexpected turning points, new stakes and logics of orientation appear, which would have remained unseen in a quieter course of things.Working from a qualitative longitudinal survey of a panel of young people, this paper offers an attempt to explore the notion of bifurcation. The life stories and the arguments these young people developed allow to identify the components of choice-making. Various structural, topical, relational and individual registers have been identified, along with various interacting temporalities. It is their conjunction that is likely to make possible a breaking up of the expected social order. (shrink)

Although Levinas talks about ethics as a response to the other, most scholars assume that this "response" is not something tangible—it is not an actual giving of food or providing of shelter and clothing. But there is evidence in Levinas's own writings that indicate he does intend for a positive response to the Other. In any event, while he acknowledges that the other is the sole person I wish to kill, killing the other, within an ethical framework would be a (...) violation of that response. The failure to respond to the other ethically requires us to ask if Levinas's project needs an educational philosophy or a model of moral cultivation to supplement it. This essay explores this question by putting into conversation Levinas's ethical project and his interest in Jewish education with John Dewey's philosophy of education and its relationship to the political community. This exploration will help us see what this field of research might offer in promoting the cultivation of ethical response as Levinas envisions it and what its limits are. (shrink)

Background:The ability to save the life of an extremely premature baby has increased substantially over the last decade. This survival, however, can be associated with unfavourable outcomes for both baby and family. Questions are now being asked about quality of life for survivors of extreme prematurity. Quality of life is rightly deemed to be an important consideration in high technology neonatal care; yet, it is notoriously difficult to determine or predict. How does one define and operationalise what is considered to (...) be in the best interest of a surviving extremely premature baby, especially when the full extent of the outcomes might not be known for several years?Research question:The research investigates the caregiving dilemmas often faced by neonatal nurses when caring for extremely premature babies. This article explores the issues arising for neonatal nurses when they considered the philosophical and ethical questions about quality of life in babies ≤24 weeks gestation.Participants:Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia.Ethical considerations:Ethical processes and procedures have been adhered to by the researchers.Findings:A qualitative approach was used to analyse the data. The theme ‘difficult choices’ was generated which comprised three sub-themes: ‘damaged through survival’, ‘the importance of the brain’ and ‘families are important’. The results show that neonatal nurses believed that quality of life was an important consideration; yet they experienced significant inner conflict and uncertainty when asked to define or suggest specific elements of quality of life, or to suggest how it might be determined. It was even more difficult for the nurses to say when an extremely premature baby’s life possessed quality. Their previous clinical and personal experiences led the nurses to believe that the quality of the family’s life was important, and possibly more so than the quality of life of the surviving baby. This finding contrasts markedly with much of the existing literature in this field.Conclusion:Quality of life for extremely premature babies was an important consideration for neonatal nurses; however, they experienced difficulty deciding how to operationalise such considerations in their everyday clinical practice. (shrink)

This response contributes to Feldman and Turner's interesting discussion in two ways: firstly, it provides some clarity on the definition of the term ‘NIMBY’; and, secondly, it incorporates some of...

In several places, Levinas identifies the problem that concerns him as a “ crisis of humanism.” This problem finds its seeds in modernity but comes to fruition in the inhumanities of the 20 th century. Like his philosophical predecessors, Levinas offers an educational model as a solution to a problem he has identified. But this model--Jewish education—is uniquely different from those offered by those who came before him. This essay examines Levinas‘s interest in Jewish education as a solution to this (...) crisis in humanism and considers what the implications of this solution are for his project as a whole. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:217 HUME'S IDEAS ABOUT NECESSARY CONNECTION 1. Introduction Hume asks, "What is our idea of necessity, when we say that two objects are necessarily connected together"? He later says that he has answered this question, but it is difficult to see what his answer is, or even to see precisely what the question was. Currently there are two main ways of understanding Hume's views about our idea of necessary (...) connection. These interpretations divide on the question whether Hume allows that we can speak meaningfully of an objective and necessary connection between two events. The one interpretation, which I will call epistemological, says that Hume does allow meaning to that phrase. On this view, justification is the only topic of Hume's negative message about necessary connection. We can mean what we say when we talk about necessary connection, but we cannot justify what we (meaningfully) say. That, according to this interpretation, is the negative outcome toward which Hume aims his investigation of the origin of our idea of necessary connection. He isn't denying we have that very idea; he is denying that its origin allows us to justify applying it to anything. The other interpretation, which I will call psychological, says that Hume does not allow meaning to the phrase, "an objective and necessary connection between two events." According to this interpretation, once we see the origin of our idea of necessary connection, we realize that we cannot mean by "necessary connection" what we thought we meant. Those words allow us to speak only of a certain 218 feeling in our minds, not of an objective feature of the world. Of course, the psychological interpretation partly resembles the epistemological one: it, too, denies that we can justify saying objective necessary connections exist. But on the psychological interpretation this follows a fortiori from the central negative claim, a claim which itself concerns meaning, not justification. In what follows, I will present these two interpretations more carefully and critically, and then I will advance my own. I think Hume was trying to express a view very different in kind from either of the two I've just mentioned. I think we can get a good idea of the kind of view Hume had by looking at Newton's treatment of gravitational force. Roughly, Newton thought that while there certainly are gravitational forces in objects, we can say nothing about them except that they are whatever it is that accounts for a specific set of observable regularities. Hume's views about necessary connection, or causal power, are roughly parallel. He does not doubt that we may speak meaningfully of objective necessary connections — rE we mean just some unknown quality in objects that underlies the constant conjunction of their sensible qualities. Inevitably we try to mean something more than this, but any such attempt is doomed to failure. Showing that we cannot mean something more is the point of investigating the origin of the "idea." I will be arguing that with this interpretation we can handle the sets of texts and problems that undercut the prevailing two interpretations, and reconcile those sets of texts with one another, despite their apparent inconsistency. This interpretation also has the advantage of attributing to Hume a view closely connected with a 219 distinctively eighteenth-century way of setting up these problems. Finally, I think the interpretation brings out nicely an instructive and central failing of Hume's views about necessary connection. 2. The Epistemological View Although there are hints of this kind of interpretation in other books, it is really articulated and defended only in Barry Stroud's book, 2 Hume. In what follows here, I mean to be sketching out and commenting on that interpretation. Hume wants to find out what our idea of necessary connection is. He conducts his investigation according to the dictum, "as we have no idea, that is not deriv'd from an impression, we must find some impression, that gives rise to this idea of necessity, if we assert we have really such an idea." (T 155) He argues, of course, that among our experiences of causes and effects, there are no impressions of necessary connection. Our experiences of... (shrink)

Originally presented as the author's thesis, University of Birmingham, 1972. Bibliography: p. 139-146. Includes index.

The living mycelium networks are capable of efficient sensorial fusion over very large areas and distributed decision making. The information processing in the mycelium networks is implemented via propagation of electrical and chemical signals en pair with morphological changes in the mycelium structure. These information processing mechanisms are manifested in experimental laboratory findings that show that the mycelium networks exhibit rich dynamics of neuron-like spiking behaviour and a wide range of non-linear electrical properties. On an example of a single real (...) colony of _Aspergillus niger_, we demonstrate that the non-linear transformation of electrical signals and trains of extracellular voltage spikes can be used to implement logical gates and circuits. The approaches adopted include numerical modelling of excitation propagation on the mycelium network, representation of the mycelium network as a resistive and capacitive network and an experimental laboratory study on mining logical circuits in mycelium bound composites. (shrink)

So why is it so difficult to figure out how to take what is in the Bible and apply it to the tough issues we encounter in daily life?" "Claire Disbrey presents the ancient concept of virtue ethics as a way to work through this difficulty.

Cette recension a déjà paru dans la Revue de l'Institut français d'histoire en Allemagne, le 1er janvier 2011. Janina Wellmann, Die Form des Werdens. Eine Kulturgeschichte der Embryologie 1760-1830, Göttingen, Wallstein, 2010, 429 p. Dans cet ouvrage tiré d'une thèse, Janina Wellmann s'attache à une période-clef, les années 1760 à 1830, au cours desquelles la biologie fut définie comme science du vivant. Dorénavant, les savants ne s'attachèrent plus tant à collectionner, dresser des inventaires et - Recensions.

Belgian data from the PIDOP project show that boys are more involved than girls in illegal political actions, namely the production of graffiti and other acts of “incivility”. These activities must be considered in both groups as complementary to conventional political and social participation and not as their opposite. The main explanatory factor is the level of the perceived efficaciousness of such actions. The lack of trust in institutions and the level of awareness of societal discrimination play no significant explanatory (...) role. In males, the involvement level in these activities depends on feelings of personal discrimination and on the lack of freedom concerning individual choice, confirming the theory of societal vulnerability and Honneth’s theory of recognition. This level also increases along with increasing opportunities to make acquaintances and have fun in the neighbourhood. In females, this involvement is explained by the distance with regard to pro-sociality level. (shrink)