Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool. ECQAT enables raters to assess the (...) quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation, established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT,.. (shrink)

Dispositional forgiveness is positively associated with many facets of wellbeing and has protective implications against depression and anxiety in adolescents. However, little work has been done to examine neurobiological aspects of forgiveness as they relate to clinical symptoms. In order to better understand the neural mechanisms supporting the protective role of forgiveness in adolescents, the current study examined the middle frontal gyrus, which comprises the majority of the dorsolateral prefrontal cortex and is associated with cognitive regulation, and its relationship to (...) forgiveness and clinical symptoms in a sample of healthy adolescents. In this cross-sectional study, larger MFG volume was significantly associated with higher self-reported dispositional forgiveness scores and lower levels of depressive and anxiety symptoms. Forgiveness mediated the relationship between MFG volume and both depressive and anxiety symptom levels. The mediating role of forgiveness in the relationship between MFG volume and clinical symptoms suggests that one way that cognitive regulation strategies supported by this brain region may improve adolescent mental health is via increasing a capacity for forgiveness. The present study highlights the relevance of forgiveness to neurobiology and their relevance to emotional health in adolescents. Future longitudinal studies should focus on the predictive quality of the relationship between forgiveness, brain volume and clinical symptoms and the effects of forgiveness interventions on these relationships. (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 (M age 53.51; SD 7.99) 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: (i) weight, right and left forearm circumference and hip; (ii) 6 min walking, right and left handgrip, sit-to-stand and sit-and-reach; (iii) 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)

In lieu of an abstract, here is a brief excerpt of the content:Sigewiza’s CureJennifer H. Radden (bio)Keywordsbiopsychosocial model, Hildegard of Bingen, associationist presuppositions, causation, power of suggestionSuzanne Phillips and Monique Boivin provide us with a sympathetic and compelling account of how the various elements of Hildegard’s sophisticated amalgam of ritual, magic, religion, dietary and other medical remedies, caring, and community, formed a seamless cure for Sigewiza’s affliction. Whether Hildgard’s approach reflects an early instance of the biopsychosocial “model” is a separate (...) claim, and may be challenged. But that her ministrations somehow effected a cure in this case seems—if not without a doubt, then very likely.Descriptions of Sigewiza’s condition, with its “clumping together of blackness and steam” caused by a “constellation of humors,” echo those of other medieval writers speaking of the humoral disorder of melancholia—at that time an encompassing category for a range of symptoms and syndromes that would today be assigned as different mental disorders. In these descriptions a variety of explanations for mental illness are quite typically introduced, including biological, social, supernatural, dietary and astrological ones. Phillips and Boivin take care to point out that Hildegard was not offering her remedies as alternatives, but rather proposing them as at work jointly and in a range of causal directions, exhibiting mutual influence, and feedback loops. As these authors say, multiple explanations “were often held simultaneously... in reference to a specific case” (Phillips and Boivin 2007, XX). And the factors that might cause the system to move out of balance are many: food, emotions, the soul, the mind, actions, and spiritual forces. So although deeds may cause bodily changes and their psychological accompaniments, “problems in the diet might affect the humors which would then have psychological effects, which demons might... use as opportunities to cause further trouble in the spirit, mind, and body” (Phillips and Boivin 2007, 365).What first struck me about Hildegard’s description of these many distinct causes interacting in complex ways is its compatibility with the multi-causal accounts of depression (and other mental disorder) frequently proffered in our own time. Daily habits (e.g., diet, sleep and exercise regimes), genetic predispositions, including biological states of fragility, external events, experiences of loss, social roles, and cultural beliefs—not to mention spontaneous recovery, and placebo effects—are all regularly implicated in the onset and course of conditions such as depression.Still, the similarity to these modern causal accounts may be somewhat misleading and we must beware of overstating it. In favoring and pressing on Hildegard’s holistic understanding, moreover, Phillips and Boivin perhaps insufficiently emphasize significant dissimilarities between Hildegard’s and our contemporary accounts.It is the interaction between the various elements making up Sigewiza’s cure that is most noteworthy [End Page 373] in this account, as Phillips and Boivin recognize. Yet that relationship itself seems in some ways surprisingly problematic: difficult for us to make sense of, and profoundly unmodern. Granted, we think we see the way these approaches probably influenced how Sigewiza felt and responded; but it is not so clear how Hildegard saw things. Like a lot of thinking in medieval times, Hildegard’s account provides us with glimpses of an understanding of the world that today looks prescientific and in that respect, almost precausal. (So, to the extent that the biopsychosocial model is understood as a causal one, the case of Sigewiza may exemplify it only inexactly.)It is not merely the range and type of causes, including supernatural and astrological ones, in accounts such as Hildegard’s that distinguish it from today’s analyses. It is also the reliance of such accounts on what seems to be a different metaphysics, one of associations or qualities.Associationist presuppositions can be found in accounts of health and illness from before, during, and long after, Hildegard’s time. Three examples of this pervasive, but puzzling thinking serve to illustrate. The melancholiac’s perceived swarthiness and darkened skin color—regularly noted from the time of the Greek physicians and an established part of the medieval iconography in images of melancholy—were not, or not primarily, thought to be a causal result of the darkness of his bile, as one might suppose. Instead, this coloring seems... (shrink)

Ruchkin et al. ascribe a pivotal role to long-term memory representations and binding within working memory. Here we focus on the interaction of working memory and long-term memory in supporting on-line representations of experience available to guide on-going processing, and we distinguish the role of frontal-lobe systems from what the hippocampus contributes to relational long-term memory binding.

Although O'Regan & Noë (O&N) claim that the world may serve as the viewers' external visual memory, findings from the field of memory research have demonstrated the existence of internal visual representations. These representations are stored in the viewer's brain, contain information regarding visual objects and their relations, guide subsequent exploration of the visual world and promote change detection.

IntroductionThose in mental health-related consumer movements have made clear their demands for humane treatment and basic civil rights, an end to stigma and discrimination, and a chance to participate in their own recovery. But theorizing about the politics of recognition, 'recognition rights' and epistemic justice, suggests that they also have a stake in the broad cultural meanings associated with conceptions of mental health and illness.ResultsFirst person accounts of psychiatric diagnosis and mental health care (shown here to represent 'counter stories' to (...) the powerful 'master narrative' of biomedical psychiatry), offer indications about how experiences of mental disorder might be reframed and redefined as part of efforts to acknowledge and honor recognition rights and epistemic justice. However, the task of cultural semantics is one for the entire culture, not merely consumers. These new meanings must be negotiated. When they are not the result of negotiation, group-wrought definitions risk imposing a revision no less constraining than the mis-recognizing one it aims to replace. Contested realities make this a challenging task when it comes to cultural meanings about mental disorder. Examples from mental illness memoirs about two contested realities related to psychosis are examined here: the meaninglessness of symptoms, and the role of insight into illness. They show the magnitude of the challenge involved - for consumers, practitioners, and the general public - in the reconstruction of these new meanings and realities.ConclusionTo honor recognition rights and epistemic justice acknowledgement must be made of the heterogeneity of the effects of, and of responses to, psychiatric diagnosis and care, and the extent of the challenge of the reconstructive cultural semantics involved. (shrink)

In this chapter, I argue that nursing ethics is rightfully viewed as a distinct field of critical inquiry relevant to the nursing profession and its purposes. While there are areas of overlap and mutual interests with bioethics, medical ethics, and the ethics of other disciplines, nursing ethics is concerned with the particular purposes and perspectives of the profession and problems faced in trying to achieve its goals. Nursing ethics, as a field of inquiry, has to do with the purposes of (...) the profession, the scope and limits of practice, expectations of nurse clinicians, educators and scholars, and the future direction of disciplinary knowledge development. Nursing ethics, like other professional ethics, is informed by insights from centuries of moral philosophizing, the conceptualization of nurse scholars and researchers about the distinct nature of the profession, and the experiences of frontline nurses. It is an applied, professional ethics. (shrink)

My thanks to Professors Hawkins and Szmukler for their thoughtful commentaries; I am particularly glad to see these scholars' valuable expertise directed toward what raises pressing issues not only for psychiatry but for contemporary society.Prof. Hawkins reasons that the use of forced feeding with some anorexia is justified, while emphasizing that this will occur rarely. She and I are in agreement that a mere handful of cases may be affected by our debate, since anecdotal evidence from clinical settings as well (...) as the studies Hawkins cites suggest that forced feeding will often be contraindicated. Still, the matter can equally well be cast hypothetically, as I implied in my earlier discussion. If forced feeding... (shrink)

The use of list-learning paradigms to explore false memory has revealed several critical findings about the contributions of similarity and relatedness in memory phenomena more broadly. Characterizing the nature of “similarity and relatedness” can inform researchers about factors contributing to memory distortions and about the underlying associative and semantic networks that support veridical memory. Similarity can be defined in terms of semantic properties (e.g., shared conceptual and taxonomic features), lexical/associative properties (e.g., shared connections in associative networks), or structural properties (e.g., (...) shared orthographic or phonological features). By manipulating the type of list and its relationship to a non-studied critical item, we review the effects of these types of similarity on veridical and false memory. All forms of similarity reviewed here result in reliable error rates and the effects on veridical memory are variable. The results across a variety of paradigms and tests provide partial support for a number of theoretical explanations of false memory phenomena, but none of the theories readily account for all results. (shrink)

This chapter contains sections titled: Why Do We Date? A Brief History of Dating Calculated Relationship Initiation and Maintenance All “Perfect” Dating Relationships Stumble, but Not in the Same Way Dating as a Particular Genre of Friendship Against Unconditional Love Conclusion.

This chapter explores what Kant means by “life”, the “feeling of life”, the “feeling of the promotion of life”, and related notions, such as the idea of a “vital power”, through the contrast between Kant’s account of the beautiful and his account of the sublime. We argue that it is significant that Kant characterizes the feeling of the beautiful as a feeling of the promotion of life but the feeling of the sublime in terms of vital powers. We account for (...) this difference by showing that in experiences of beauty, we are aware of ourselves as rational but embodied human beings, as part of nature. In the feeling of the sublime, by contrast, we are aware of ourselves as pure rational beings. This entails that in the beautiful, we experience nature as deeply life-promoting, while in the sublime, we experience the independence of our supersensible vocation from nature. (shrink)

Background: Dignity, an abstract and complex concept, is an essential part of humanity and an underlying guiding principle in healthcare. Previous literature indicates dignity is compromised in people with dementia (PwD), but those PwD maintain the capacity to live with dignity with appropriate external support. Alzheimer’s disease and related dementias (ADRDs) lead to progressive functional decline and increased vulnerability and dependence, leading to heightened risks of PwD receiving inappropriate or insufficient care that diminishes dignity. Considering the increased disease prevalence and (...) the continuously escalating costs of dementia care, establishing a productive value-based guideline may prevent suffering, maximize dignity, and thus promote quality of life (QoL). Aim: The goal of this project is to identify actionable targets for integrating dignity harmoniously and practically into care planning and management for PwD. Research Design: We conducted a concept analysis using Walker and Avant’s eight-step process. A comprehensive literature search was conducted (PubMed and CINAHL) with the keywords “dignity,” “dementia,” “Alzheimer’s disease,” and “dementia care.” Results: A total of 42 out of 4910 publications were included. The concept of dignity in PwD is operationalized as the promotion of worthiness and the accordance of respect that allows the presence and expression of a person’s sense of self, regardless of physical, mental, or cognitive health. The concept has two subdimensions: absolute dignity which encompasses the inherent self and relative dignity characterized by its dynamic reflective nature. Worthiness and respect are the two main attributes, while autonomy is an underlying component of dignity. Specific antecedents of dignity in PwD are empowerment, non-maleficence, and adaptive environmental scaffolding. As a consequence of facilitating dignity in PwD, QoL may be enhanced. Conclusion: As a foundational and necessary humanistic value, incorporating dignity into dementia care can lead to efficient and effective care that optimizes QoL in PwD throughout their disease progression. (shrink)

Evolutionary developmental biology (evo-devo) has undergone dramatic transformations since its emergence as a distinct discipline. This paper aims to highlight the scope, power, and future promise of evo-devo to transform and unify diverse aspects of biology. We articulate key questions at the core of eleven biological disciplines—from Evolution, Development, Paleontology, and Neurobiology to Cellular and Molecular Biology, Quantitative Genetics, Human Diseases, Ecology, Agriculture and Science Education, and lastly, Evolutionary Developmental Biology itself—and discuss why evo-devo is uniquely situated to substantially improve (...) our ability to find meaningful answers to these fundamental questions. We posit that the tools, concepts, and ways of thinking developed by evo-devo have profound potential to advance, integrate, and unify biological sciences as well as inform policy decisions and illuminate science education. We look to the next generation of evolutionary developmental biologists to help shape this process as we confront the scientific challenges of the 21st century. (shrink)

Volume 25, Issue 3, March 2025, Page 143-145.

This book brings philosophical aesthetics into a broader cultural interest in the fine arts and draws together the classics of the history of aesthetics, the mid-twentieth century or "Analytic" aesthetics, and late-twentieth century or "Continental" post-structuralist "theory.".

Annie Cohen-Solal, Sartre's biographer and author, was one of the keynote speakers at last year's UK Sartre Society Conference at La Maison française in Oxford. The title of her talk echoed that of a key article she published in Le Monde on 12/13 March 2023, ‘Qui a encore peur de Sartre?’, which brilliantly characterises Sartre's position in France and in the world. The article is translated in full below.

The social conservatism of evangelical and fundamentalist groups includes their support for premarital sexual restraint, husband leadership, and father involvement. The authors explore whether religious conservatism affects work–family outcomes of men using the National Survey of Families and Households, 1988 and 1993 waves. The authors hypothesize that men from conservative households will make earlier transitions to adulthood, work fewer hours, and earn less money. Moreover, the belief in strong paternal involvement should lead religiously conservative men to spend more time in (...) housework and child care. Results show that conservative religious affiliation does not hasten the transition to adulthood among men. Current religious conservatism results in lower wages but not reduced work hours, and religious affiliation does not affect housework or child care. (shrink)

Internet-based health research is increasing, and often offers financial incentives but fraudulent behavior by participants can result. Specifically, eligible or ineligible individuals may enter the study multiple times and receive undeserved financial compensation. We review past experiences and approaches to this problem and propose several new strategies. Researchers can detect and prevent Internet research fraud in four broad ways: through the questionnaire/instrument ; through participants' non-questionnaire data and seeking external validation through computer information,, and 4) through study design. These approaches (...) each have pros and cons, and raise ethical, legal, and logistical questions, given that ethical tensions can emerge between preserving the integrity of research vs. protecting the privacy and confidentiality of study respondents. While past discussions concerning the ethics of online research have tended to focus on the participants' ability to trust the researchers, needs now arise to examine researchers' abilities to trust the participants. This analysis has several critical implications for future practice, policy, and research. (shrink)

As scholars integrate empirical approaches to ethical questions in healthcare, relational autonomy theory must inform research design and change practice. Qualitative approaches are well suited to issues where patient values play a central role, and they can be combined with relational autonomy theory to investigate the factors influencing autonomy-rich experiences. This paper draws upon my experience conducting bioethics research related to clinical trial decision-making to develop a systematic method for applying relational autonomy as a theoretical lens to qualitative health research. (...) The resultant practical guide utilizes Susan Sherwin’s theory of relational autonomy and presents an empirical method responsive to autonomy-relevant questions. (shrink)

The ability to judge accurately whether or not an action can be accomplished successfully is critical for selecting appropriate response options that enable adaptive behaviors. Such affordance judgments are thought to rely on the perceived fit between environmental properties and knowledge of one's current physical capabilities. Little, however, is currently known about the ability of individuals to judge their own affordances following a stroke, or about the underlying neural mechanisms involved. To address these issues, we employed a signal detection approach (...) to investigate the impact of left or right hemisphere injuries on judgments of whether a visual object was located within reach while remaining still. Regarding perceptual sensitivity and accuracy in judging reachability, there were no significant group differences between healthy controls, right brain damaged and left brain damaged stroke patients. However, while healthy controls and RBD patients demonstrated a negative response criterion and thus overestimated their reach capability, LBD patients' average response criterion converged to zero, indicating no judgment tendency. Critically, the LBD group's judgment tendency pattern is consistent with previous findings in this same sample on an affordance judgment task that required estimating whether the hand can fit through apertures. Lesion analysis suggests that this loss of judgment tendency may be associated with damage to the left insula, the left parietal and middle temporal lobe. Based on these results, we propose that damage to the left ventro-dorsal stream disrupts the retrieval and processing of a stable criterion, leading to stronger reliance on intact on-line body-perceptive processes computed within the preserved bilateral dorsal network. (shrink)

It is widely held that intuitive dualism—an implicit default mode of thought that takes minds to be separable from bodies and capable of independent existence—is a human universal. Among the findings taken to support universal intuitive dualism is a pattern of evidence in which “psychological” traits (knowledge, desires) are judged more likely to continue after death than bodily or “biological” traits (perceptual, physiological, and bodily states). Here, we present cross-cultural evidence from six study populations, including non-Western societies with diverse belief (...) systems, that shows that while this pattern exists, the overall pattern of responses nonetheless does not support intuitive dualism in afterlife beliefs. Most responses of most participants across all cultures tested were not dualist. While our sample is in no way intended to capture the full range of human societies and afterlife beliefs, it captures a far broader range of cultures than in any prior study, and thus puts the case for afterlife beliefs as evidence for universal intuitive dualism to a strong test. Based on these findings, we suggest that while dualist thinking is a possible mode of thought enabled by evolved human psychology, such thinking does not constitute a default mode of thought. Rather, our data support what we will call intuitive materialism—the view that the underlying intuitive systems for reasoning about minds and death produce as a default judgment that mental states cease to exist with bodily death. (shrink)