Although medical providers rely on similar tools to “treat” intersex and trans individuals, their enactment of medicalization practices varies. To deconstruct these complexities, we employ a comparative analysis of providers who specialize in intersex and trans medicine. While both sets of providers tend to hold essentialist ideologies about sex, gender, and sexuality, we argue they medicalize intersex and trans embodiments in different ways. Providers for intersex people are inclined to approach intersex as an emergency that necessitates medical attention, whereas providers (...) for trans people attempt to slow down their patients’ urgent requests for transitioning services. Building on conceptualizations of “giving gender,” we contend both sets of providers “give gender” by “giving sex.” In both cases too, providers shift their own responsibility for their medicalization practices onto others: parents in the case of intersex, or adult recipients of care in the case of trans. According to the accounts of most providers, successful medical interventions are achieved when a person adheres to heteronormative gender practices. (shrink)

BackgroundReturning neuroimaging incidental findings may create a challenge to research participants’ health literacy skills as they must interpret and make appropriate healthcare decisions based on complex radiology jargon. Disclosing IF can therefore present difficulties for participants, research institutions and the healthcare system. The purpose of this study was to identify the extent of the health literacy challenges encountered when returning neuroimaging IF. We report on findings from a retrospective survey and focus group sessions with major stakeholders involved in disclosing IF.MethodsWe (...) surveyed participants who had received a radiology report from a research study and conducted focus groups with participants, parents of child participants, Institutional Review Board members, investigators and physicians. Qualitative thematic analyses were conducted using standard group-coding procedures and descriptive summaries of health literacy scores and radiology report outcomes are examined.ResultsAlthough participants reported high health literacy skills, 67 % did not seek medical care when recommended to do so; and many participants in the focus groups disclosed they could not understand the findings described in their report. Despite their lack of understanding, participants desire to have information about their radiology results, and the investigators feel ethically inclined to return findings.ConclusionsThe language in clinically useful radiology reports can create a challenge for participants’ health literacy skills and has the potential to negatively impact the healthcare system and investigators conducting imaging research. Radiology reports need accompanying resources that explain findings in lay language, which can help reduce the challenge caused by the need to communicate incidental findings. (shrink)

Philosophy has much to offer psychiatry, not least regarding ethical issues, but also issues regarding the mind, identity, values, and volition. This has become only more important as we have witnessed the growth and power of the pharmaceutical industry, accompanied by developments in the neurosciences. However, too few practising psychiatrists are familiar with the literature in this area. -/- The Oxford Handbook of Philosophy and Psychiatry offers the most comprehensive reference resource for this area ever published. It assembles challenging and (...) insightful contributions from key philosophers and others to the interactive fields of philosophy and psychiatry. Each contributions is original, stimulating, thorough, and clearly and engagingly written - with no potentially significant philosophical stone left unturned. Broad in scope, the book includes coverage of several areas of philosophy, including philosophy of mind, science, and ethics. For philosophers and psychiatrists, The Oxford Handbook of Philosophy and Psychiatry is a landmark publication in the field - one that will be of value to both students and researchers in this rapidly growing area. (shrink)

Action research is increasingly used as a means for teachers to improve their instruction, yet for many the idea of doing "research" can be somewhat intimidating. _Using Action Research to Improve Instruction_ offers a comprehensive, easy-to-understand approach to action research in classroom settings. This engaging and accessible guide is grounded in sources of data readily available to teachers, such as classroom observations, student writing, surveys, interviews, and tests. Organized to mirror the action research process, the highly interactive format prompts readers (...) to discover a focus, create research questions, address design and methodology, collect information, conduct data analysis, communicate the results, and to generate evidence-based teaching strategies. Engaging in these decision-making processes builds the skills essential to action research and promotes a deeper understanding of teaching practice. Special Features Include: -An Interactive Text -Reflection Questions and Activity Prompts -A Sample Action Research Report -Numerous Examples and Practice Examples -Numbered Sections for Cross Referencing This original text is a must-read for teachers interested in how they can use their current knowledge of instruction and assessment to meaningfully engage in action research. (shrink)

Modified Theistic Activism is the view that abstract objects not essentially possessed by God fall under God’s creative activity in one way or another. Michelle Panchuk has argued that this position succumbs to the bootstrapping problem such that God is and is not logically prior to his properties—an incoherent and necessarily false state of affairs. In this essay we respond to Panchuk by arguing that our neo-Aristotelian account of substance and property possession successfully avoids the bootstrapping problem. Moreover, her own (...) neo-Augustinian account of universals contains many conceptual deficiencies and ultimately succumbs to an epistemic iteration of the bootstrapping problem. Finally, we argue that the reasons provided for thinking only created beings need universals to ground character is unmotivated. In clarifying and defending our position, our hope is to bury once and for all the familiar claim that traditional theists cannot be realists with respect to abstract objects because of divine bootstrapping. (shrink)

Obtaining informed consent, an ethical obligation of nurses and other health care providers, occurs routinely when patients make health care decisions. The values underlying informed consent (promotion of patients’ well-being and respect for their self-determination) are embedded in the dominant American culture. Nurses who apply the USA’s cultural values of informed consent when caring for patients who come from other cultures encounter some ethical dilemmas. This descriptive study, conducted with Latino, Chinese and Anglo-American cancer patients in a large, public, west-coast (...) clinic, describes constraints on the informed consent process in a multicultural setting, including language barriers, the clinical environment, control in decision making, and conflicting desired health outcomes for health care providers and patients, and suggests some implications for nursing practice. (shrink)

How far does a researcher’s responsibility extend when an incidental finding is identified? Balancing pertinent ethical principles such as beneficence, respect for persons, and duty to rescue is not always straightforward, particularly in neuroimaging research where empirical data that might help guide decision making are lacking. We conducted a systematic survey of perceptions and preferences of 396 investigators, research participants, and Institutional Review Board members at our institution. Using the partial entrustment model as described by Richardson, we argue that our (...) data supports universal reading by a neuroradiologist of all research MRI scans for incidental findings and providing full disclosure to all participants. (shrink)

Although women are severely under-represented in national politics in Europe, in the European Parliament they are better represented than they are in the national parliaments of the EEC member states. This book examines why this is so. Based largely on their detailed interviews with women MEPs, the authors describe the latter's backgrounds, attitudes and political experience. They also explain the history, structure and organisation of the European Parliament and outline the complexities of the European legal system. A particular concern of (...) the book is the contribution that women MEPs have made to legislation and policy, expecially in the context of recent Community legislation on sex equality, and what impact their presence has had on issues relating to women's interests. (shrink)

Recent magnetic resonance imaging and pathological studies have indicated that axonal loss is a major contributor to disease progression in multiple sclerosis. 1 H magnetic resonance spectroscopy, through measurement of N -acetyl aspartate, a neuronal marker, provides a unique tool to investigate this. Patients with primary progressive multiple sclerosis have few lesions on conventional MRI, suggesting that changes in normal appearing white matter, such as axonal loss, may be particularly relevant to disease progression in this group. To test this hypothesis (...) NAWM was studied with MRS, measuring the concentration of N -acetyl derived groups. Single-voxel MRS using a water-suppressed PRESS sequence was carried out in 24 patients with primary progressive multiple sclerosis and in 16 age-matched controls. Ratios of metabolite to creatine concentration were calculated in all subjects, and absolute concentrations were measured in 18 patients and all controls. NA/Cr was significantly lower in NAWM in patients than in controls, as was the absolute concentration of NA. There was no significant difference in the absolute concentration of creatine between the groups. This study supports the hypothesis that axonal loss occurs in NAWM in primary progressive multiple sclerosis and may well be a mechanism for disease progression in this group. (shrink)

In this introduction to Part 1 of the Common Knowledge symposium, “Fuzzy Studies,” the journal's editor discusses four essays from the 1980s by Richard Rorty, in which Rorty chose to associate himself with various neopragmatists, Continental thinkers, and “left-wing Kuhnians” under the rubric of the “new fuzziness.” The term had been introduced as an insult by a philosopher of science with positivist leanings, but Rorty took it up as an “endearing” compliment, arguing that “to be less fuzzy” was also to (...) be “less genial, tolerant, open-minded, and fallibilist.” He defined the “new fuzziness” as “an attempt to blur just those distinctions between the objective and subjective and between fact and value which the critical conception of rationality has developed.” This introduction also examines W. V. Quine's essay “Speaking of Objects” (1957), which describes objects as fuzzy “half-entities”; Clifford Geertz's essay “Blurred Genres” (1980), which advises social scientists that being “taxonomically upstanding” is futile; and Lofti Zadeh's article “The Concept of a Linguistic Variable and Its Application to Approximate Reasoning” (1975), which abandons “Aristotelian, bivalent logic” in favor of a “fuzzy logic” based on Zadeh's “fuzzy set theory.” This introductory piece relates these theoretical works of the past half-century to the sorites paradox and to classical issues of vagueness raised and still unresolved in Western philosophy. Returning then to Rorty, the author questions how Rorty expected his endorsement of the “new fuzziness” to be applied, as proposed, to theology and politics. Suggesting that such applications are the natural work of historians, the author, having asked the historian Natalie Zemon Davis for comment, then quotes her response—which associates fuzzy studies, “common knowledge,” and peacemaking—at length. (shrink)

In this introduction to Part 1 of the Common Knowledge symposium, “Fuzzy Studies,” the journal's editor discusses four essays from the 1980s by Richard Rorty, in which Rorty chose to associate himself with various neopragmatists, Continental thinkers, and “left-wing Kuhnians” under the rubric of the “new fuzziness.” The term had been introduced as an insult by a philosopher of science with positivist leanings, but Rorty took it up as an “endearing” compliment, arguing that “to be less fuzzy” was also to (...) be “less genial, tolerant, open-minded, and fallibilist.” He defined the “new fuzziness” as “an attempt to blur just those distinctions between the objective and subjective and between fact and value which the critical conception of rationality has developed.” This introduction also examines W. V. Quine's essay “Speaking of Objects”, which describes objects as fuzzy “half-entities”; Clifford Geertz's essay “Blurred Genres”, which advises social scientists that being “taxonomically upstanding” is futile; and Lofti Zadeh's article “The Concept of a Linguistic Variable and Its Application to Approximate Reasoning”, which abandons “Aristotelian, bivalent logic” in favor of a “fuzzy logic” based on Zadeh's “fuzzy set theory.” This introductory piece relates these theoretical works of the past half-century to the sorites paradox and to classical issues of vagueness raised and still unresolved in Western philosophy. Returning then to Rorty, the author questions how Rorty expected his endorsement of the “new fuzziness” to be applied, as proposed, to theology and politics. Suggesting that such applications are the natural work of historians, the author, having asked the historian Natalie Zemon Davis for comment, then quotes her response—which associates fuzzy studies, “common knowledge,” and peacemaking—at length. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:News from the President’s Council on BioethicsDiane M. Gianelli (bio) and F. Daniel Davis (bio)Although the President's Council has moved into several new areas of interest during the past year, it also has devoted considerable effort to finalizing several upcoming reports and white papers. In early 2008, the Council will publish a collection of essays on human dignity and bioethics, a report on organ transplantation, and a white paper (...) on "brain death."The Council's report on organ transplantation—now near the end of the drafting and editing phases—has the public as its main audience and, as such, seeks to promote greater understanding of the ethical issues in organ procurement, allocation, and transplantation. The report situates these issues within the contexts of the history of transplantation, the clinical realities of this therapeutic modality, and the current policy framework of state and federal law and regulation.The Council is aware that other bodies—such as the Institute of Medicine—have, in recent years, produced excellent reports on transplantation. The Council's report, however, has a different focus. It explores such foundational issues as the meaning and experience of human embodiment, the philosophy of giving and receiving, and transplantation in relation to the ends and aims of medicine.The report also analyzes the ethics of deceased organ donation, living organ donation, organ allocation, and various proposals for increasing the supply of organs, with a focus on those that call for the replacement of the organ-as-gift philosophy with a market-oriented ethic of selling and buying.In another upcoming publication, the Council revisits the notion of "brain death." The Council did not plan to take on this issue when it began its organ transplantation project. But when researching material for that report, it became clear that—in recent years—some serious criticisms of the neurological standard for declaring death have arisen. Since the vast majority of organs procured from the dead come from "brain dead" patients—that is, those declared dead by the neurological standard—this presented an issue ripe for exploration.The last time a national bioethics body looked at the criteria for determining death was in 1981, when The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research issued "Defining Death," its seminal report that articulated and defended the neurological standard for declaring death. It also proposed a uniform statute for states to adopt based [End Page 397] on that standard. After its publication, states that had not already rewritten their laws to recognize the new neurological standard did so. The Council's white paper on the topic takes a new look at "brain death" in light of the recent evidence and arguments on both sides of the issue.In the Council's last report to the Kennedy Institute of Ethics Journal (December 2006), its upcoming volume on "Dignity" was described. Scholars from a variety of disciplines—and opinions—have written essays on "dignity and bioethics." The volume is ready to go to press.In addition to these documents, the Council, after devoting a number of sessions to the topic over the past couple of years, is considering publication of a white paper on newborn screening, with a probable focus on the benefits, harms, and burdens of mandated screening, and a look at the broader human significance of genetic information. The paper probably also will address the moral precepts that should guide such testing, as well as the precepts that should guide the acquisition and use of the genetic information gained through this process.Venturing into new territory this year, the Council heard from several speakers on "the healing professions" and "the ethical foundations of health care." Both of these topics are the subject of considerable attention and debate in the ethics literature. There is some concern, for example, that medicine and the other healing professions have lost—or are in danger of losing—their moral bearings. And in the controversies surrounding health care reform policies, what is at stake ethically often is obscured, confused, or lacking altogether.Under the rubric of "the professions," the Council heard various dimensions of the issue: the "crisis" in the ethics... (shrink)

Over the past twenty-five years, no one has done more than J. P. Moreland to equip Christians to love God with their minds. In his work as a Christian philosopher, scholar, and apologist, he has influenced thousands of students, written groundbreaking books, and taught multitudes of Christians to defend their faith. -/- In honor of Moreland's ministry, general editors Paul M. Gould and Richard Brian Davis have assembled a team of friends and colleagues to celebrate his work. In three major (...) parts devoted to philosophy, apologetics, and spiritual formation, scholars such as Stewart Goetz, Paul Copan, Douglas Groothuis, Scott Rae, and Klaus Issler interact with Moreland's thought and make their own contributions to these important subjects. Moreland concludes the volume with his own essay, "Reflections on the Journey Ahead.". (shrink)

Recent public hearings on misconduct charges belie the conjecture that due process will perforce defeat informed scientific reasoning. One notable case that reviewed an obtuse description of experimental methods displays some of the subtleties of differentiating carelessness from intent to deceive. There the decision of a studious nonscientist panel managed to reach sensible conclusions despite conflicting expert testimony. The significance of such a result may be to suggest that to curtail due process would be both objectionable and unproductive.

After introducing the new field of cultural evolution, we review a growing body of empirical evidence suggesting that culture shapes what people attend to, perceive and remember as well as how they think, feel and reason. Focusing on perception, spatial navigation, mentalizing, thinking styles, reasoning (epistemic norms) and language, we discuss not only important variation in these domains, but emphasize that most researchers (including philosophers) and research participants are psychologically peculiar within a global and historical context. This rising tide of (...) evidence recommends caution in relying on one’s intuitions or even in generalizing from reliable psychological findings to the species, Homo sapiens. Our evolutionary approach suggests that humans have evolved a suite of reliably developing cognitive abilities that adapt our minds, information-processing abilities and emotions ontogenetically to the diverse culturally-constructed worlds we confront. (shrink)

Advances in genomics have led to calls for developing population-based preventive genomic sequencing programs with the goal of identifying genetic health risks in adults without known risk factors. One critical issue for minimizing the harms and maximizing the benefits of PGS is determining the kind and degree of control individuals should have over the generation, use, and handling of their genomic information. In this article we examine whether PGS programs should offer individuals the opportunity to selectively opt out of the (...) sequencing or analysis of specific genomic conditions or whether PGS should be implemented using an all-or-nothing panel approach. We conclude that any responsible scale-up of PGS will require a menu approach that may seem impractical to some, but that draws its justification from a rich mix of normative, legal, and practical considerations. (shrink)

This article, reporting on selected data from a larger study, discusses some responses to end-of-life questions that elderly Japanese people who were living in small towns gave in a questionnaire survey. Japan is now the country with the largest number of elderly people in the world and confronts numerous social and economic questions concerning how best to cope with its older population. Although it is a highly urbanized society, Japan also has large semirural areas. The focus here is on the (...) questions in the survey that sought responses to ethical dimensions of end-of-life issues. The findings demonstrate the strength of traditional values that still exist throughout small towns in Japan. (shrink)

A simple experimental paradigm creates the powerful illusion that one is touching one’s own hand even when the two hands are separated by 15 cm. The participant uses her right hand to administer stimulation to a prosthetic hand while the Examiner provides identical stimulation to the participant’s receptive left hand. Change in felt position of the receptive hand toward the prosthetic hand has previously led to the interpretation that the participant experiences self-touch at the location of the prosthetic hand, and (...) experiences a sense of ownership of the prosthetic hand. Our results argue against this interpretation. We assessed change in felt position of the participant’s receptive hand but we also assessed change in felt position of the participant’s administering hand. Change in felt position of the administering hand was significantly greater than change in felt position of the receptive hand. Implications for theories of ownership are discussed. (shrink)

The typical Cartesian collection contains papers which treat the problems arising out of Descartes's philosophy as though they and it appeared for the first time in a recent journal. The approach of this collection is quite different. The eight contributors concentrate on problems faced by Cartesianism which are of historical significance. Without denigrating the importance of the technique of exploiting the texts in a manner that appeals to contemporary philosophical interests, the contributors show how Cartesianism was shaped over time by (...) the criticism it received. This criticism took place in many areas - politics, theology, natural science, and metaphysics - and its scope is reflected in this collection of papers. The efforts of advocates of Cartesianism to produce a biography of Descartes, and the political difficulties they faced, are no less a part of the problems of Cartesianism than are the difficulties alleged against the Cartesian ontology of thought and extension in accounting for transubstatiation. Seventeenth- and eighteenth-century theories of the formation of the earth, for example, were historically part of the same set of problems as the difficulties in Bible criticism. These significant issues and many others are discussed in this volume. (shrink)

This article, reporting on selected data from a larger study, discusses some responses to end-of-life questions that elderly Japanese people who were living in small towns gave in a questionnaire survey. Japan is now the country with the largest number of elderly people in the world and confronts numerous social and economic questions concerning how best to cope with its older population. Although it is a highly urbanized society, Japan also has large semirural areas. The focus here is on the (...) questions in the survey that sought responses to ethical dimensions of end-of-life issues. The findings demonstrate the strength of traditional values that still exist throughout small towns in Japan. (shrink)

The growing practice of returning individual results to research participants has revealed a variety of interpretations of the multiple and sometimes conflicting duties that researchers may owe to participants. One particularly difficult question is the nature and extent of a researcher’s duty to facilitate a participant’s follow-up clinical care by placing research results in the participant’s medical record. The question is especially difficult in the context of genomic research. Some recent genomic research studies — enrolling patients as participants — boldly (...) address the question with protocols dictating that researchers place research results directly into study participants’ existing medical records, without participant consent. Such privileging of researcher judgment over participant choice may be motivated by a desire to discharge a duty that researchers perceive themselves as owing to participants. However, the underlying ethical, professional, legal, and regulatory duties that would compel or justify this action have not been fully explored. (shrink)

The generalized second law of thermodynamics states that entropy always increases when all event horizons are attributed with an entropy proportional to their area. We test the generalized second law by investigating the change in entropy when dust, radiation and black holes cross a cosmological event horizon. We generalize for flat, open and closed Friedmann–Robertson–Walker universes by using numerical calculations to determine the cosmological horizon evolution. In most cases, the loss of entropy from within the cosmological horizon is more than (...) balanced by an increase in cosmological event horizon entropy, maintaining the validity of the generalized second law of thermodynamics. However, an intriguing set of open universe models shows an apparent entropy decrease when black holes disappear over the cosmological event horizon. We anticipate that this apparent violation of the generalized second law will disappear when solutions are available for black holes embedded in arbitrary backgrounds. (shrink)