Evaluating the Knowledge and Practice of Limitation of Therapeutic Effort in Health Workers at a Health Care Institution for Cancer Patients in Medellín, 2018Avaliação do conhecimento e da prática da limitação de esforço terapêutico em equipe de atendimento de uma instituição prestadora de serviços de saúde para pacientes oncológicos de Medellín, 2018Limitation of therapeutic effort is any action that involves suspending or not initiating medical treatment or therapeutic measures in patients who will not receive any clinical benefit. In Latin America, (...) some research has proven a lack of familiarization and disagreement with the subject and its practices. The present study tried to objectify the knowledge of LTE of healthcare personnel at an institute in Medellín using a self-administered survey that allowed conducting a cross-sectional descriptive study with non-probabilistic sampling. Within the results, 56.5 % of respondents understood the concept of LTE, and 90 % applied it actively. However, there were discrepancies regarding the core concepts of the definition and practice.Para citar este artículo / To reference this article / Para citar este artigoVallejo LI, Palacio AM, Marulanda V, Restrepo A, Yepes LA, Valencia NL, Cruz MA. Evaluación del conocimiento y práctica de la limitación del esfuerzo terapéutico en personal asistencial de una institución prestadora de servicios de salud para pacientes oncológicos de Medellín, 2018. 2020;24:177-87. DOI: https://doi.org/10.5294/pebi.2020.24.2.5Recibido: 19/07/2019Aceptado: 08/08/2020Publicado: 27/11/2020. (shrink)

Justo antes de la pandemia por COVID-19, la Organización Mundial de la Salud definió unas prioridades de trabajo para la década 2020-2030. Un grupo interdisciplinario de profesionales de la salud reflexiona sobre estas prioridades, determinando unas categorías de análisis y, desde una perspectiva bioética, analiza cada una de ellas, ve su pertinencia, algunos eventos causales, las implicaciones que pueden tener si no son enfrentadas adecuadamente y hace sugerencias sobre la forma de llevarlas a cabo. En esta primera entrega se analiza (...) el primer grupo de prioridades estratégicas: “poblaciones más sanas”. En las conclusiones se destaca la conveniencia de acometer cada una de ellas de una manera colaborativa, gubernamental y privada; de reestructurar el sector salud con base en estas prioridades, aprovechando la experiencia obtenida en la lucha contra el COVID-19. La relación del ser humano con el medio ambiente también debe cambiar, apelando a la responsabilidad humana por el cuidado del planeta. (shrink)

Scientists typically use a variety of representations, including different kinds of figures, to present and defend hypotheses. In order to understand the justification of scientific hypotheses, it is essential to understand how visual representations contribute to scientific arguments. Since the logical understanding of arguments involves the truth or falsity of the representations involved, visual representations must have the capacity to bear truth in order to be genuine components of arguments. By drawing on Goodman's analysis of symbol systems, and on Tarski's (...) work on truth, I show that the figures used in science meet this criterion. (shrink)

Philosophers of perception have a notoriously difficult time trying to account for hallucinatory experiences. One surprisingly quite popular move, and one that cross-cuts the representationalism/relationalism divide, is to say that hallucinations involve an awareness of uninstantiated properties. In this paper, I provide a new argument against this view. Not only are its proponents forced to classify many hallucinations as veridical, such experiences turn out to be necessarily veridical. In addition, I show that representationalists who endorse the uninstantiated property view must (...) reject the common fundamental kind claim and adopt disjunctivism, and naïve realists/relationalists must radically modify their disjunctivism: The distinction between ‘veridical’ and ‘hallucinatory’ will no longer track a metaphysical distinction between the relevant experiences. (shrink)

Religion within the Boundaries of Mere Reason remains one of the most opaque of Kant's published writings. Though this opacity belongs, partly, to the text itself, a key claim of this article is that this opacity stems also from the narrow lenses through which his readers view this text. Often read as part of Kant's moral philosophy or his universal history, the literature has thus far neglected a different vantage point on the Religion, one that does not refute the utility (...) of these lenses but complements them. This paper places the Religion alongside parts of Kant's corpus that it is less typically paired with, namely his natural history writings—in particular, his writings on the concept of race and the development of the human races. I argue that by doing so, we can shed much light on Kant's infamous claim that there is a radical evil in the human species. More precisely, we will come to appreciate that this evil is not, as it is usually understood, a static property or fixed characteristic of human beings. Instead, radical evil concerns a dynamic, changing defect in human nature that increasingly threatens our aspirations to collective moral perfection. (shrink)

The Fold is a book of practical philosophy that takes a radical new approach to aesthetics. Laura U. Marks calls this philosophy "enfolding-unfolding aesthetics," based in ideas derived from Gilles Deleuze and others (G.F.W. Leibniz, David Bohm, and Édouard Glissant) that the universe is folded in on itself. She proposes a theory of mediation as contact and connection across the folds and a set of embodied methods for detecting such cosmic connections. In drawing out this aesthetics, Marks considers the (...) embodied and sensuous dimensions of engaging with audiovisual works and works of art-dimensions that Marks suggests are composed of the very folds that compose everything and everyone: all living beings, from humans to particles, sandwiches to stars, technologies, thoughts and images, in the present, the past, and the future. Making use of art and film, with a focus on African diaspora and Arab cinema, Marks opens ways to strengthen connections to the cosmos and to better trace processes of becoming that are immanent within the fold. (shrink)

Laura Nader is a towering figure as anthropologist, teacher, and public intellectual. Her letters give a glimpse of academic life mostly unseen by academics and by the general public. The collection includes letters from academic colleagues, but it also contains correspondence from lawyers, politicians, citizens, people on death row, Peace Corps workers, members of the military, scientists, and more.

Insights into the intelligence throughout the natural and technical environment, in the fabric of our devices and dwellings, in our clothes, and under our skin. Is there a way to understand the materials that surround us not as passive objects, but as other intelligences interacting with our own? In Parallel Minds, expert in materials science and nanotechnology Laura Tripaldi delivers not only detailed insights into the properties and emergent behaviors of matter as revealed by state-of-the-art chemistry, synthetic biology, and (...) nanotech, but also a rich philosophical reflection that crosses the frontier between nature and culture, where the most cutting-edge scientific syntheses resonate with ancient myth. The result is a technomaterial bestiary full of unexpected encounters with “strange minds”—from cobwebs to kevlar and carbon fibre, from centaurs to amoebas to arachnids, from polycephalic slime to resonating plasmons, from viruses to golems. Parallel Minds reveals the intelligence at large throughout the natural and technical environment, in the fabric of our devices and dwellings, in our clothes, and even under our skin. Full of lateral ideas and unexpected images, Tripaldi’s book imbues the study and synthesis of materials with a new urgency. For not only do the materials that surround us participate actively in the construction of the world in which we live, but harnessing their ability to interact intelligently with their environment could be the key to the future of our species. (shrink)

La voz humana es un fenómeno ampliamente estudiado desde una gran variedad de disciplinas, desde las especialidades de la medicina hasta las artes. Aunque esta situación resulta enriquecedora, la multiplicidad de perspectivas ha conspirado contra la formulación de una concepción única de la voz y de un sistema lógico que pueda ayudar a entender los fenómenos asociados con ella en términos más generales, enfatizando continuidades y relaciones en lugar de requerir cada vez una definición del objeto de estudio de acuerdo (...) con las herramientas conceptuales y las metodologías de cada disciplina. La semeiotica de Peirce ofrece una alternativa a esta fragmentación de los estudios de la voz, especialmente a través de su taxonomía de signos relacionada con las categorías faneroscópicas. El nonágono semiótico es un modelo operativo que, adoptando la forma de un ícono diagramático, ayuda a aplicar las categorías peirceanas al análisis de conceptos, objetos o disciplinas en general. Con el nonágono semiótico como herramienta metodológica, este artículo ofrece una forma de analizar, describir y categorizar de acuerdo con criterios lógicos los múltiples usos de la voz humana. Se espera que las relaciones que revela entre usos radicalmente diferentes de la voz ayuden a reducir la redundancia entre disciplinas y a proveer nuevas direcciones para la investigación en otras áreas, así también como para cubrir potenciales necesidades pedagógicas y analíticas en las artes y otras disciplinas. (shrink)

This article addresses the general ethical issues of accessing online personal data for research purposes. The authors discuss the practical aspects of online research with a specific case study that illustrates the ethical challenges encountered when accessing data from Kooth, an online youth web-counselling service. This paper firstly highlights the relevance of a process-based approach to ethics when accessing highly sensitive data and then discusses the ethical considerations and potential challenges regarding the accessing of public data from Digital Mental Health (...) services. It presents solutions that aim to protect young DMH service users as well as the DMH providers and researchers mining such data. Special consideration is given to service users’ expectations of what their data might be used for, as well as their perceptions of whether the data they post is public, private or open. We provide recommendations for planning and designing online research in an ethical manner that includes vulnerable young people as research participants. We emphasise the distinction between public, private and open data, which is crucial to comprehend the ethical challenges in accessing DMH data. Among our key recommendations, we foreground the need to consider a collaborative approach with the DMH providers while respecting service users’ control over personal data, and we propose the implementation of digital solutions embedded within the platform for explicit opt-out/opt-in recruitment strategies and ‘read more’ options. (shrink)

We began writing the first edition of this textbook in 2006, soon after a wave of major corporate scandals had shaken the financial world. Headlines made the companies involved in these ethical scandals household names: Enron, WorldCom, Arthur Andersen, KPMG, J.P. Morgan, Merrill Lynch, Morgan Stanley, Citigroup, Salomon Smith Barney. At that time, we suggested that, in light of such significant cases of financial fraud, mismanagement, criminality, and deceit, the relevance of business ethics could no longer be questioned.

This paper offers a novel solution to the Wrong Kind of Reason problem that afflicts Fitting-Attitude analyses of value. I argue that we can distinguish reasons of the right kind from reasons of the wrong kind by being clear about what our reasons are for. In Wrong Kind of Reason cases, our reason to have a certain affective attitude is a reason for an action, and it is this category-mistake that is the source of the problem.

This chapter contains sections titled: Notes.

The price for morality as the meaning of existence is the entrance of another kind of absurdity, a moral absurdity. Clearly, there is something absurd about life on The Good Place. Moral worth, both on The Good Place and in our real‐life existence, comes in degrees. Deontological views, most famously associated with Immanuel Kant, hold that the morality of an action is determined based on whether or not it adheres to a moral rule. Care requires being flexible in different situations (...) so as to best foster caring relationships with others. A care ethics approach would give some support to Eleanor's claims in The Good Place, insofar as a caring home life is essential to the development of the child in a variety of ways. The power of caring relationships is perhaps nowhere more salient than in the show's final few episodes. (shrink)

Language and thought share a unitary cognitive activity, addressed by an interpretative function. This interpretative effort reveals the assonance between the attribution of meaning to an utterance and the discovery of a solution via restructuring in insight problem solving. We suggest a view of complex integrated analytical thinking, which assumes that thinking processes information in different ways, depending on the characteristics of the tasks the subject has to solve, so that reasoning results in a stepwise, rule-based process or in a (...) widespread activity of search where implicit parallel processes are also involved. We investigated the interrelationship between language and thought in insight problem solving, in both its positive (Experiments 1 and 3) and its negative effects (Experiment 2). Our results are discussed in the light of the debate on dual processing theories. (shrink)

This chapter contains sections titled: Conception Gestation Labor and Delivery Home Note.

Le blockbuster, c'est de l'explosif. A l'origine du mot, une bombe utilisée pendant la Seconde Guerre mondiale, capable de détruire tout un pâté de maisons. Et il n'y a sans doute pas d'image plus typique du blockbuster que celle d'une gigantesque explosion. Les déflagrations dont il s'agit dans ce livre ne sont pas uniquement celles que racontent les films. Produit grand public, confectionné grâce à d'immenses investissements financiers, le blockbuster s'apparente à une bombe à fragmentation, pulvérisant l'objet filmique dans des (...) contextes de consommation qui n'ont plus rien à voir avec le cinéma, se diffractant sur le marché mondial sous forme de produits dérivés, T-shirts, figurines et autres gadgets. Sept auteurs, philosophes et critiques, se sont penchés sur quelques blockbusters de leur choix. A chaque fois, les films dynamitent la pensée et l'entraînent dans des directions inattendues : les gremlins sabotent les écrans et contaminent les images, Godzilla et King Kong se font machines à échanger les regards, Batman devient le théâtre d'une déconstruction du politique, Alien met en scène les métamorphoses d'un récit qui ne change jamais, et Titanic coule comme cette industrie lourde qu'est le cinéma lui-même... (shrink)

Despite the centrality of the term within the title, the meaning of ?care? in residential child care remains largely unexplored. Shifting discourses of residential child care have taken it from the private into the public domain. Using a care ethics perspective, we argue that public care needs to move beyond its current instrumental focus to articulate a broader ontological purpose, informed by what is required to promote children's growth and flourishing. This depends upon the establishment of caring relationships enacted within (...) the lifespaces shared by children and those caring for them. We explore some of the central features of caring in the lifespace and conclude that residential child care is best considered to be a practical/moral endeavour rather than the technical/rational one it has become. It requires morally active, reflexive practitioners and containing environments. (shrink)

Neoliberal Techniques of Social Suffering: Political Resistance and Critical Theory from Latin America and Spain is the result of the critical and political commitment of various Latin American and Spanish philosophers who share a critical approach to the global “stealth revolution” in recent decades, where neoliberalism has forced the well-being and reproduction of life to adapt to a system devastating for both humans and non-humans. The authors voice the shared concern of contemporary Spanish and Latin American societies to build new (...) conceptions of the public and the common through mobilizing affects usually disavowed in political theory. If, in Ancient Greece, the idea of strengthening the most vulnerable and weakest was deplored as the art of sophists, this collection edited by Laura Quintana and Nuria Sánchez Madrid explores the other side of our social world to revive grassroots strategies of resistance and emancipation, which are able to bring about new distributions of power, welfare, and discursive legitimation and to extend our goal of creating a radically democratic world. (shrink)

One of the foundational problems of biochemistry concerns the conceptualisation of the relationship between the composition, structure and function of macromolecules like proteins. Part of the recent philosophical literature displays a reductionist bias, that is, the endorsement of a form of microstructuralism mirroring an out-dated biochemical conceptualisation. We shall argue that such microstructuralist approaches are ultimately committed to a potentialist form of micro-predeterminism whereby the macrostructure and function of proteins is accounted for solely in terms of the intrinsic properties and (...) potentialities of the components of the primary structure as if they were self-contained or essentially immutable entities. We shall instead suggest that a conceptualisation of the relationship between proteins’ composition, structure and function consistent with contemporary biochemical practice should account also for the causal role of the cellular, organismal and environmental relations in protein development. The analysis of the folding process we propose suggests that microstructure-laden reductionist approaches are ontologically indefensible. Rather than a potentialist form of micro-predeterminism, our analysis ultimately supports a relational-construction-based view of protein development and potentialities formation, which requires an indispensable analysis of the dynamical interplay between the micro-level of the parts and the macro-level of the relational structures of their systems. (shrink)

Dr. Laura dives into the controversial topics and thorniest problems that face today's parents and grandparents, husbands and wives, men and women, and everyone seeking love, fulfillment, success -- or simply anyone who wants to be a decent and productive human being. With her trademark provocative, firm, but always thought-provoking and values-centered advice, Dr. Laura provides guidance that will inspire readers to be the very best they can be. Based on the tough-love advice from the calls and letters (...) Dr. Laura receives. (shrink)

In the 1970s, Alvin Plantinga made use of the Anselmian concept of God to develop a modal version of Anselm's ontological argument for God's existence. His definition describes the God of perfect-being theology as one that exists necessarily and is essentially omnipotent, omniscient, and morally perfect, and this definition has become standard in discussions about the nature and existence of the God of western theism. Hence, these discussions operate with a relatively thin conception of God, since many of the key (...) terms in the definition, including essential moral perfection, remain undefined. Philosophers find this attractive in some ways, since it permits an a priori approach to explicating the divine perfections. One drawback for the minimalist approach, however, is that it can impede the effort to connect philosophical theology with religious faith. This article discusses three major ways of modelling divine moral perfection and considers some of the major objections to the claim that God is necessarily morally perfect. (shrink)

While various definitions of moral distress have been proposed, some agreement exists that it results from illegitimate constraints in clinical practice affecting healthcare professionals’ moral agency. If we are to reduce moral distress, instruments measuring it should provide relevant information about such illegitimate constraints. Unfortunately, existing instruments fail to do so. We discuss here several shortcomings of major instruments in use: their inability to determine whether reports of moral distress involve an accurate assessment of the requisite clinical and logistical facts (...) in play, whether the distress in question is aptly characterized as moral, and whether the moral distress reported is an appropriate target of elimination. Such failures seriously limit the ability of empirical work on moral distress to foster appropriate change. (shrink)