As in other societies, medical professionalism in the Peoples’ Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, “Medical Professionalism in the New Millennium: A Physician Charter,” by the Chinese Medical Doctor Association (hereafter, the Charter). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians’ attitudes toward the fundamental principles and core commitments put forward in the Charter. Based (...) on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients’ autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically—recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism—a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine crosscultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

The repercussions of unconscious priming on the neural correlates subsequent cognition have been explored previously. However, the neural dynamics during the unconscious processing remains largely uncharted. To assess both the complexity and temporal dynamics of unconscious cognition the present study contrasts the evoked response from classes of masked stimuli with three different levels of complexity; words, consonant strings, and blanks. The evoked response to masked word stimuli differed from both consonant strings and blanks, which did not differ from each other. (...) This response was qualitatively different to any evoked potential observed when stimuli were consciously visible and peaked at 140 ms, earlier than is usually associated with differences between words and strings and 100 ms earlier than word-consonant string differences in the visible condition. The evoked response demonstrates a qualitatively distinct signature of unconscious cognition and directly demonstrates the extraction of abstract information under subliminal conditions. (shrink)

Evidence shows that changes in the architecture, design, and decor of health care facilities can improve patient care and in the long run reduce expenses. These essays detail the state of the research, look inside two hospitals that put some of these innovations into practice, and consider how design fits into the moral mission ofhealth care.

Prior to the initiation of spontaneous movement, evoked potentials can be seen to precede awareness of the impending movement by several hundreds of milliseconds, meaning that this recorded neural activity is the result of unconscious processing. This study investigates the neural representations of impending movement with and without awareness. Specifically, the relationship between awareness and ‘idling’ cortical oscillations in the beta range was assessed. It was found that, in situations where there was awareness of the impending movement, pre-movement evoked potentials (...) were associated with a decrease in beta range oscillations. In contrast, when awareness of the impending movement was not present, the onset of the pre-movement potential was associated with tonic levels of beta range oscillations. A model is considered where by distributed neural activity remains outside of conscious awareness through the persistence of tonic slow wave cortical oscillations. (shrink)

Herein, I clarify my concern regarding Raelin’s Leadership-as-Practice and argue that inconsistent moral philosophies undermine the veracity of leadership theory, especially more recent democratic, shared, collective, and practice oriented theories; that this problem seems to be proliferating in the social sciences, and that this is especially concerning in socio-psychologically oriented theories. I contend that the moral foundations of L-A-P remain philosophically disquieting, unless it is understood as excluding moral agents other than those of a genealogical tradition, and that such exclusionary (...) consequences in practice may lead to moral disengagement, which might then lead to cognitive dissonance and even self-harm. (shrink)

In Alain Badiou’s most recent work, L’immanence des vérités ( The Immanence of Truths), psychoanalyst Jacques Lacan once again figures peripherally but saliently. What is their specific relation in this text, however? We argue that Badiou responds here to the problem raised precisely by the Lacanian subject, situated as it is between the radical subjectivity of the symptom and the possibility of formalization. In L’immanence, he introduces the term ‘absoluteness’ to secure truths against both relativism and transcendental construction. We show (...) that in drawing on Lacan to establish an understanding of the absolute, Badiou highlights the implicit tension between psychoanalysis and philosophy. We treat central cross-currents – truths, knowledge, the event and love – to help reveal the specific character of their confluence in this third book of Badiou’s trilogy. Although he stresses the unity of his and Lacan’s efforts, the impossible Real marking their divisions also invariably emerges the closer one investigates. (shrink)

This paper defends the autonomy thesis, which holds that one can intend to do something even though one believes it to be impossible, against attacks by Fred Adams. Adams denies the autonomy thesis on the grounds that it cannot, but must, explain what makes a particular trying, a trying for the aim it has in view. If the autonomy thesis were true, it seems that I could try to fly across the Atlantic ocean merely by typing out this abstract, a (...) palpable absurdity. If we deny the autonomy thesis, we have an easy explanation: one simply cannot try to do something which one believes to be impossible. In response, I argue, first, by means of examples, that one clearly can try and intend to do what one believes to be impossible; and then l show how we can provide an answer to Adams’s challenge even so. (shrink)

ObjectiveOverweight and obesity [body mass index ≥ 25 kg/m2] are associated with poorer prognosis among women with breast cancer, and weight gain is common during treatment. Symptoms of depression and anxiety are also highly prevalent in women with breast cancer and may be exacerbated by post-diagnosis weight gain. Altered brain function may underlie psychological distress. Thus, this secondary analysis examined the relationship between BMI, psychological health, and resting state functional connectivity among women with breast cancer.MethodsThe sample included 34 post-menopausal women (...) newly diagnosed with Stage 0-IIa breast cancer who were enrolled in a 6-month randomized controlled trial of aerobic exercise vs. usual care. At baseline prior to randomization, whole-brain analyses were conducted to evaluate the relationship between BMI and seed-to-voxel rsFC of the hippocampus and amygdala. Connectivity values from significant clusters were then extracted and examined as predictors of self-reported depression and anxiety.ResultsMean BMI was in the obese range. For both seeds examined, higher BMI was associated with lower rsFC with regions of prefrontal cortex, including ventrolateral PFC, dorsolateral PFC, and superior frontal gyrus. Hippocampal connectivity with the vlPFC was negatively correlated with self-reported anxiety.ConclusionHigher BMI was associated with lower hippocampal and amygdala connectivity to regions of PFC implicated in cognitive control and emotion regulation. BMI-related differences in hippocampal and amygdala connectivity following a recent breast cancer diagnosis may relate to future worsening of psychological functioning during treatment and remission. Additional longitudinal research exploring this hypothesis is warranted. (shrink)

In the epistemology of disagreement literature an underdeveloped argument defending the claim that an agent need not conciliate when she becomes aware of epistemic peer disagreement is based on the idea that there are epistemic benefits to be gained from disagreement. Such benefits are unobtainable if an agent conciliates in the face of peer disagreement. I argue that there are good reasons to embrace this line of argument at least in inquiry-related contexts. In argumentation theory a deep disagreement occurs when (...) there is a disagreement between fundamental frameworks. According to Robert J. Fogelin disagreements between fundamental frameworks are not susceptible to rational resolution. Instead of evaluating this claim I argue that deep disagreements can lead to epistemic benefits, at least when inquiry is in view. Whether rational resolution is possible in cases of deep disagreements, their existence turns out to be epistemically beneficial. I conclude by examining whether this line of argument can be taken beyond research-related contexts.Dans la littérature sur l'épistémologie du désaccord, un argument sous-développé pour une approche non conciliatoire se fonde sur l'idée qu'il y a des bénéfices épistémiques à tirer du désaccord. De tels bénéfices sont impossibles à obtenir si un agent se concilie face au désaccord avec ses pairs, du moins dans les contextes liés à la recherche. Dans la théorie de l'argumentation, un désaccord profond se produit lorsqu'il y a un désaccord entre des propositions cadres. Je soutiens que des désaccords profonds peuvent mener à des avantages épistémiques, du moins dans le contexte de la recherche. Que la résolution rationnelle soit ou non possible en cas de désaccord profond, leur existence s'avère être bénéfique sur le plan épistémologique. (shrink)

This paper articulates and defends a conception of logical form as semantic form revealed by a compositional meaning theory. On this conception, the logical form of a sentence is determined by the semantic types of its primitive terms and their mode of combination as it relates to determining under what conditions it is true. We develop this idea in the framework of truth-theoretic semantics. We argue that the semantic form of a declarative sentence in a language L is revealed by (...) a (canonical) proof of its T- sentence in an interpretive truth theory for L. We give a precise characterization of sameness of logical form between any two declarative sentences in any two languages in terms of the notion of corresponding proofs in interpretive truth theories for the languages. We illustrate the utility of this approach with a number of examples. We then extend the characterization to non-declaratives in a generalization of truth-theoretic semantics that appeals to fulfillment conditions, of which truth conditions are one variety. On this approach, logical forms are not reified, and the notion of sameness of logical form is treated as conceptually basic. We discuss the relation of this conception of logical form to the project of identifying logical constants, reviewing two approaches, one of which takes topic neutrality as central, the other recursion. We argue that the project of identifying logical constants for the purposes of classifying together valid arguments is largely independent of that identifying logical form of sentences, and urge an ecumenical approach to extending talk of logical constants beyond where it is currently well-grounded. (shrink)

The axiological question in the philosophy of religion is the question of what impact, if any, God’s existence does make to the axiological value of our world. It has recently been argued that we should prefer a theistic world where God is hidden to an atheistic world or a theistic world where God isn’t hidden. This is because in a hidden theistic world all of the theistic goods obtain in addition to the experience of atheistic goods. I complete this line (...) of argument by showing that theistic goods do indeed obtain in a world where God hides. In doing so I indirectly argue against proponents of divine hiddenness arguments such as J.L. Schellenberg. The correct answer to the axiological question turns out to be a solution to the problem of divine hiddenness. (shrink)

Increasing behavioural evidence suggests that expert video game players (VGPs) show enhanced visual attention and visuospatial abilities, but what underlies these enhancements remains unclear. We administered the Poffenberger paradigm with concurrent electroencephalogram (EEG) recording to assess occipital N1 latencies and interhemispheric transfer time (IHTT) in expert VGPs. Participants comprised 15 right-handed male expert VGPs and 16 non-VGP controls matched for age, handedness, IQ and years of education. Expert VGPs began playing before age 10, had a minimum 8 years experience, and (...) maintained playtime of at least 20 hours per week over the last 6 months. Non-VGPs had little-to-no game play experience (maximum 1.5 years). Participants responded to checkerboard stimuli presented to the left and right visual fields while 128-channel EEG was recorded. Expert VGPs responded significantly more quickly than non-VGPs. Expert VGPs also had significantly earlier occipital N1s in direct visual pathways (the hemisphere contralateral to the visual field in which the stimulus was presented). IHTT was calculated by comparing the latencies of occipital N1 components between hemispheres. No significant between-group differences in electrophysiological estimates of IHTT were found. Shorter N1 latencies may enable expert VGPs to discriminate attended visual stimuli significantly earlier than non-VGPs and contribute to faster responding in visual tasks. As successful video-game play requires precise, time pressured, bimanual motor movements in response to complex visual stimuli, which in this sample began during early childhood, these differences may reflect the experience and training involved during the development of video-game expertise, but training studies are needed to test this prediction. (shrink)

Carl-Johan Palmqvist recently examines a well-known form of non-doxastic religiosity called ultimism, which comes to us from J. L Schellenberg. He contends that traditional forms of religion are better candidates for non-doxastic religion for two reasons. First, their specificity makes them more likely to put one into contact with transcendental reality than ultimism. Second, religious experience can only be on traditional forms of religion, not on ultimism. I argue that Palmqvist’s rejection of ultimism is wrong. It’s false that ultimism isn’t (...) specific enough to put one into contact with transcendental reality. It’s also false that there aren’t religious experiences consistent with ultimism, but not with traditional forms of religion. There might be reasons for preferring traditional forms of religion to ultimism; however, Palmqvist fails to demonstrate that this is the case. (shrink)

Considérons deux mondes épistémiquement possibles qui sont aussi similaires que possible, sauf que l’athéisme est vrai dans un monde et que le théisme est vrai dans l’autre monde. Quel monde est-il rationnel de préférer? J’examine la défense la plus forte de l’affirmation quelque peu contre-intuitive selon laquelle il est rationnel de préférer le monde athée. Je discute également de la conclusion opposée, à savoir qu’il est rationnel de préférer le monde théiste. Étonnamment, ma conclusion est qu’il est difficile de dire (...) s’il faut préférer le théisme ou l’athéisme en général. (shrink)

Education, by B. H. Streeter.--Marriage, by K. E. Kirk.-- Patriotism, by J. P. R. Maud.--Social inequalities, by C. R. Morris.--Earning and spending, by R. L. Hall.--Gambling, by R. C. Mortimer.--Ethics and religion, by J. S. Bezzant.

It seems very commonly agreed that Sappho's wedding-songs display none of the ritual obscenity so frequent in the genre. Thus D. L. Page wrote of fr. i ioa that ‘There is no trace here or elsewhere in Sappho of that ribaldry which was characteristic of the songs recited at this and other stages of Greek wedding-ceremonies’. Similarly Sir Maurice Bowra asserted of fr. 111 that it is ‘neither bawdy nor exalted, but playful. If the humour is a bit primitive, that (...) is due to tradition, which expected jokes at this level’. On the next page he writes of the songs sung outside the bridal chamber, as distinct from those sung in the procession thither, that ‘Here too Sappho seems to avoid bawdry but is not averse from rather elementary jokes’. (shrink)

It seems very commonly agreed that Sappho's wedding-songs display none of the ritual obscenity so frequent in the genre. Thus D. L. Page wrote of fr. i ioa that ‘There is no trace here or elsewhere in Sappho of that ribaldry which was characteristic of the songs recited at this and other stages of Greek wedding-ceremonies’. Similarly Sir Maurice Bowra asserted of fr. 111 that it is ‘neither bawdy nor exalted, but playful. If the humour is a bit primitive, that (...) is due to tradition, which expected jokes at this level’. On the next page he writes of the songs sung outside the bridal chamber, as distinct from those sung in the procession thither, that ‘Here too Sappho seems to avoid bawdry but is not averse from rather elementary jokes’. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Cycle of Violence and Feminist Constructions of Selfhood Jennifer L. Rike University ofDetroit Mercy Violence is the heart and secret soul ofthe sacred" (Girard 1977, 31). René Girard reaches this shocking conclusion by tracing the dynamics ofthe generation ofviolence in history, and the ingenious ways in which humanity has learned to funnel violence into ritual sacrifice to avoid apocalypse. His argument pivots upon his understanding ofhumanity as inherently (...) flawed, as fated to conflict in the struggle to survive. Ifthe sacred mechanism of ritual sacrifice is not deployed, violence takes on a power and personality all its own: "If left unappeased, violence will accumulate until it overflows its confines and floods the surrounding area. The role ofsacrifice is to stem this rising tide... and redirect violence into 'proper' channels" (10). Girard's theory about the violent origins ofthe sacred institutions of ritual sacrifice, law, and myth highlights perhaps the chief paradox of religion: it has been used to promote as much as to oppose violence. Today, as feminists explore how women in particular have been the objects ofsuch violence, they too have turned to Girard to understand this paradox, and yet most have ended up criticizing Girard for falsely universalizing typically Eurocentric and androcentric conceptions of humanity, violence, and religion (Shea, Kirk-Duggan, Nowak 24-6).' While they may be right on certain points, it is also possible that the rush offeminist scholars to charge 1 Nancy Jay has also criticized Girard for androcentrism, in particular because "he still grounds all community and culture on male control of male violence" (130). 22Jennifer L. Rike Girard with androcentrism reflects their own refusals to confront how the dark face of violence appears in women as well as in men. Rather than evaluating specific feminist criticisms ofGirard in this regard, I propose a more global approach—to delineate in greater detail how feminist constructions of selfhood need to be informed by Girard's theory of the violent origins ofthe sacred in order for feminism to achieve its own goals. In Girard's view, the ritual ofsacrifice and the law are generated out ofthe socio-psychological mechanisms ofacquisitive mimesis and scapegoating as the sacred's way of controlling violence. In ways he leaves largely implicit, these mechanisms reflect the devastating cyclical effects of violence upon its victims. Girard stops short of reflecting on the roles gender plays in the cyclical processes of violence, and yet, as my subsequent analyses shall demonstrate, there can be little doubt that women participate in these processes in ways both like and unlike men. Women have been scapegoated throughout history, but not all women end up as victims ofviolence and the rituals constructed to appease it. Nor do many women remain simply victims of the tides of violence: many repeat the cycle of victimization and themselves become perpetrators. Moreover, some escape the cycle ofviolence by a variety ofmeans whose patterns are well worth scrutinizing. My point is that women's modes of participation in the processes through which violence makes and remakes itself are far more complex than has been recognized, and merit our full attention. From the perspective of feminist constructions of selfhood, the question then becomes, how does gender affect one's experience of acquisitive mimesis and scapegoating, victimage and perpetration? To claim that only women are victims and only men—and the women they have co-opted—are perpetrators may be politically correct, but that claim ignores some hard but ultimately helpful truths about what women must do to bring about the changes necessary for revolutionizing our society by transforming its violent ways into peaceful ones. My plan, then, is to suggest how Girard might be used to advance the theory and praxis of feminism further by delving into the psychological mechanisms underlying acquisitive mimesis and scapegoating. I shall argue that using object relations theory to understand the ways in which violence splits the human psyche complements Girard's conception of acquisitive mimesis and scapegoating to disclose the complete dynamics ofthe cycle ofviolence. Such understanding is essential to feminist reconstructions of selfhood, because it makes the defeat of sexism and violence possible by exposing them at their roots. Feminist Constructions ofSelfhood23 My project has four steps... (shrink)

Selon Kirk Lougheed, favoriser une version objective de l’argument du sens de la vie établit une sorte d’antithéisme, c’est-à-dire une perspective qui maintient que l’existence d’un Dieu théiste aggraverait les choses et qu’il est donc plus rationnel de préférer que Dieu n’existe pas. Cette version objective est présentée par Lougheed comme une amélioration par rapport à ma version subjective de l’argument du sens de la vie. Je soutiens que la version de Lougheed ne réussit pas mieux que la version (...) subjective que j’ai développée, puis rejetée. (shrink)

RÉSUMÉEn réponse à Paul Hurley, je soutiens que l'argument de la triangulation de Donald Davidson ne peut s'appliquer aux croyances normatives que si ces croyances correspondent à des propriétés à la fois normatives et causales. L'argument engage donc Davidson à une forme de naturalisme non-réductif et étonnamment non-révisionniste. En réponse à Kirk Ludwig, je soutiens que Davidson avait de bonnes raisons d'abandonner les théories humiennes des pro-attitudes, parce qu'il avait de bonnes raisons d'accepter la forme de naturalisme non-réductive et (...) non-révisionniste qui émerge une fois que l'argument de la triangulation est appliqué aux croyances normatives. (shrink)

RÉSUMÉCet article est une réponse aux commentaires de Kirk Ludwig et d'Alexander Miller sur la première partie de Donald Davidson's Triangulation Argument: A Philosophical Inquiry. Il répond aux objections de Ludwig selon lesquelles l'argument de la triangulation ne réussit pas à établir le caractère social du langage et de la pensée. Il répond à l'invitation de Miller à comparer le non-réductionnisme de Davidson avec celui de Crispin Wright, ainsi que l'aspect social de la thèse de Davidson avec celui de (...) la thèse de Saul Kripke. Il répond enfin aux questions de Miller concernant mes affirmations sur la normativité de la signification. (shrink)