Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predomi- nantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase ‘paradigm shift’ in (...) his groundbreaking book The Structure of Scientific Revolutions. He argued that the arrival of the new and often incompatible idea forms the core of a new paradigm, the birth of an entirely new way of thinking. This article discusses whether Steiner and col- leagues truly brought about a paradigm shift in oncological surgery. By rejecting the principle of en block resection and by replacing it with the belief that not only is it oncologically safe to cut through the substance of the tumour but in doing so one can actually achieve better results, Steiner was able to truly revolutionise the man- agement of laryngeal cancer. Even though within this article the repercussions of his insight are limited to the upper aerodigestive tract oncological surgery, his willingness to question other peoples’ dogma makes his contribution truly a genuine paradigm shift. (shrink)

The term "interest" lacks a precise antonym. In English, we have "disinterested" and "uninteresting," but we want for a term that denotes robust opposition to interest. The same appears to hold true in every other language (as far as we know). Interest's missing antonym reflects not merely a widespread lexical oversight, but a misrecognition of interest's complete and exact meaning. More importantly, the idea that interest has no opposite expresses a certain refusal to acknowledge the power of the impulse to (...) extinguish interest, for the self and for others. Why then do we foreclose interest's possibility, degrade our (and others') capacities to experience interest, and destroy interest's objects? Why do we decline what interest proffers - which includes creative and subjective being, thinking, and relating - in favor of more primitive modes of survival, thoughtlessness, and nonbeing? Why do relationships - with ourselves, with others, with objects - toward which genuine interest draws us seem sometimes, if not often, unbearable? These questions are difficult. Their answers, even more so. Misinterest: Essays, Pensées, and Dreams attempts to approach them in an honest way, without making them fascinating, mysterious, boring, obscurantist, or fascinatingly mysteriously boringly obscurantist. Outwardly, Misinterest is concerned with dreams and forgetting and Eros and soaring dogs and groups and suicidal suburban teenagers and sex and jury duty and Nazis and fathers and hatred and holy parrots and fundamentalists and plagues and other things that may or may not be interesting. Ultimately, however, it seeks, like Jules Renard, "en restant exact" (in remaining true/real), to shed light on the establishment of misinterest, missingness, and mystery where and when they need not be, and, thus, on the psychic, familial, and political forces that compel us not to be when and where we ought. (shrink)

Intent and mitigating circumstances play a central role in moral and legal assessments in large-scale industrialized societies. Al- though these features of moral assessment are widely assumed to be universal, to date, they have only been studied in a narrow range of societies. We show that there is substantial cross-cultural variation among eight traditional small-scale societies (ranging from hunter-gatherer to pastoralist to horticulturalist) and two Western societies (one urban, one rural) in the extent to which intent and mitigating circumstances influence (...) moral judgments. Although participants in all societies took such factors into account to some degree, they did so to very different extents, varying in both the types of considerations taken into account and the types of violations to which such considerations were applied. The particular patterns of assessment characteristic of large-scale industrialized societies may thus reflect relatively recently culturally evolved norms rather than inherent features of human moral judgment. (shrink)

Exploring the darkest side of organizations may have a potential to change our previous assumptions about business life. Scholars both in management and organizational research fields have shown interest in the "bright" side of behavioral life and have looked for the ways to create a positive organizational climate and assumed a positive relation between happiness of employees and productivity. These main assumptions of the Human Relations School have dominated the scientific inquiry on organizational behavior. However, "the dark side of organizational (...) life" may have more explanatory power than "the bright side". Hostility, jealousy, envy, rivalry, gossip, problematic personalities, dislike, revenge, and social exclusion are the realities of business life. A manager may devote most of their time to cope with conflicts, deviant behaviors, ambitious individuals, gossips, and dysfunctional rivalry among employees. It is evident that negative events and interactions among employees cost more time and energy for a manager than the positive side of organizational life. This edited collection specifically focuses on these issues and will be of interest to researchers, academics, and advanced students in the fields of management, organizational studies and behavior, sociology, social psychology, and human resource management. (shrink)

This paper studies general numerical networks with support and attack. Our starting point is argumentation networks with the Caminada labelling of three values 1=in, 0=out and ½=undecided. This is generalised to arbitrary values in [01], which enables us to compare with other numerical networks such as predator?prey ecological networks, flow networks, logical modal networks and more. This new point of view allows us to see the place of argumentation networks in the overall landscape of networks and import and export ideas (...) to and from argumentation networks. We make a special effort to make clear how general concepts in general networks relate to the special case of argumentation networks. We pay special attention to the handling of loops and to the special features of numerical support. We find surprising connections with the Dempster?Shafer rule and with the cross-ratio in projective geometry. This paper is an expansion of our 2005 paper and so we also consider higher level features such as numerical attacks on attacks, and propagation of numerical values.We conclude with a brief view of temporal numerical argumentation and with a detailed comparison with related papers published since 2005. (shrink)

Clinicians' work depends on sincere and complete disclosures from their patients; they honour this candidness by confidentially safeguarding the information received. Breaching confidentiality causes harms that are not commensurable with the possible benefits gained. Limitations or exceptions put on confidentiality would destroy it, for the confider would become suspicious and un-co-operative, the confidant would become untrustworthy and the whole climate of the clinical encounter would suffer irreversible erosion. Excusing breaches of confidence on grounds of superior moral values introduces arbitrariness and (...) ethical unreliability into the medical context. Physicians who breach the agreement of confidentiality are being unfair, thus opening the way for, and becoming vulnerable to, the morally obtuse conduct of others. Confidentiality should not be seen as the cosy but dispensable atmosphere of clinical settings; rather, it constitutes a guarantee of fairness in medical actions. Possible perils that might accrue to society are no greater than those accepted when granting inviolable custody of information to priests, lawyers and bankers. To jeopardize the integrity of confidential medical relationships is too high a price to pay for the hypothetical benefits this might bring to the prevailing social order. (shrink)

The hopes and fears expressed in the debate on human enhancement are not always based on a realistic assessment of the expected possibilities. Discussions about extreme scenarios may at times obscure the ethical and policy issues that are relevant today. This paper aims to contribute to an adequate and ethically sound societal response to actual current developments. After a brief outline of the ethical debate concerning neuro-enhancement, it describes the current state of the art in psychopharmacological science and current uses (...) of psychopharmacological enhancement, as well as the prospects for the near future. It then identifies ethical issues regarding psychopharmacological enhancements that require attention from policymakers, both on the professional and on the governmental level. These concern enhancement research, the gradual expansion of medical categories, off-label prescription and responsibility of doctors, and accessibility of enhancers on the Internet. It is concluded that further discussion on the advantages and drawbacks of enhancers on a collective social level is still needed. (shrink)

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be (...) holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)

Prison work creates ethical challenges for which a training program was initiated for Dutch prison staff to foster their Moral Craftsmanship (MCS). The concept of MCS is not yet defined and operationalized in literature. This explorative study aims to 1) define MCS, 2) identify conceptual elements of MCS, and 3) develop a measurement tool for MCS. A document and literature study provided input for the definition and selection of conceptual elements related within DCIA policy documents, identifying three conceptual levels of (...) MCS: individual (cognition, attitude, and actions), team, and leadership. This first MCSQ consists of seventy-one items distributed across the domains: values and norms, judgment and reasoning, consultation, implementation, looking back, interactions, and leadership. We tested its usability via ‘think-aloud interviews.’ Validation of the current version of the MCS-Questionnaire and consensus among experts about what to include or exclude in the concept of MCS are needed for further development. (shrink)

Objective: To evaluate one ethics rounds model by describing nurses’ and doctors’ experiences of the rounds. Methods: Philosopher-ethicist-led interprofessional team ethics rounds concerning dialysis patient care problems were applied at three Swedish hospitals. The philosophers were instructed to promote mutual understanding and stimulate ethical reflection, without giving any recommendations or solutions. Interviews with seven doctors and 11 nurses were conducted regarding their experiences from the rounds, which were then analysed using content analysis. Findings: The goal of the rounds was partly (...) fulfilled. Participants described both positive and negative experiences. Good rounds included stimulation to broadened thinking, a sense of connecting, strengthened confidence to act, insight into moral responsibility and emotional relief. Negative experiences were associated with a sense of unconcern and alienation, as well as frustration with the lack of solutions and a sense of resignation that change is not possible. The findings suggest that the ethics rounds above all met the need of a forum for crossing over professional boundaries. The philosophers seemed to play an important role in structuring and stimulating reasoned arguments. The nurses’ expectation that solutions to the ethical problems would be sought despite explicit instructions to the contrary was conspicuous. Conclusion: When assisting healthcare professionals to learn a way through ethical problems in patient care, a balance should be found between ethical analyses, conflict resolution and problem solving. A model based on the findings is presented. (shrink)

Although the field of surgical ethics focuses primarily on informed consent, surgical decision‐making, and research ethics, some surgeons have started to consider ethical questions regarding justice and solidarity with poor and minoritized populations. To date, those calling for social justice in surgical care have emphasized increased diversity within the ranks of the surgical profession. This article, in contrast, foregrounds the agency of those most affected by injustice by bringing to bear an ethic of accompaniment. The ethic of accompaniment is born (...) from a theological tradition that has motivated work to improve health outcomes in those at the margins through its emphasis on listening, solidarity against systemic drivers of disease, and proximity to individuals and communities. Through a review of surgical ethics and exploration of a central patient case, we argue for applying an ethic of accompaniment to the care of surgical patients and their communities. (shrink)

Aldous Huxley’s Brave New World is a famous dystopia, frequently called upon in public discussions about new biotechnology. It is less well known that 30 years later Huxley also wrote a utopian novel, called Island. This paper will discuss both novels focussing especially on the role of psychopharmacological substances. If we see fiction as a way of imagining what the world could look like, then what can we learn from Huxley’s novels about psychopharmacology and how does that relate to the (...) discussion in the ethical and philosophical literature on this subject? The paper argues that in the current ethical discussion the dystopian vision on psychopharmacology is dominant, but that a comparison between Brave New World and Island shows that a more utopian view is possible as well. This is illustrated by a discussion of the issue of psychopharmacology and authenticity. The second part of the paper draws some further conclusions for the ethical debate on psychopharmacology and human enhancement, by comparing the novels not only with each other, but also with our present reality. It is claimed that the debate should not get stuck in an opposition of dystopian and utopian views, but should address important issues that demand attention in our real world: those of evaluation and governance of enhancing psychopharmacological substances in democratic, pluralistic societies. (shrink)

That brings me to the crux of my disagreement with Hillis Miller. The central contention is not simply that I am sometimes, or always, wrong in my interpretation, but instead that I—like other traditional historians—can never be right in my interpretation. For Miller assents to Nietzsche's challenge of "the concept of 'rightness' in interpretation," and to Nietzsche's assertion that "the same text authorizes innumerable interpretations : there is no 'correct' interpretation."1 Nietzsche's views of interpretation, as Miller says, are relevant to (...) the recent deconstructive theorists, including Jacques Derrida and himself, who have "reinterpreted Nietzsche" or have written "directly or indirectly under his aegis." He goes on to quote a number of statements from Nietzsche's The Will to Power to the effect, as Miller puts it, "that reading is never the objective identifying of a sense but the importation of meaning into a text which had no meaning 'in itself.'" For example: "Ultimately, man finds in things nothing but what he himself has imported into them." "In fact interpretation is itself a means of becoming master of something."2 On the face of it, such sweeping deconstructive claims might suggest those of Lewis Carroll's linguistic philosopher, who asserted that meaning is imported into a text by the interpreter's will to power: "The question is," said Alice, "whether you can make words mean so many different things.""The question is," said Humpty Dumpty, "which is to be master—that's all." But of course I don't believe that such deconstructive claims are, in Humpty Dumpty fashion, simply dogmatic assertions. Instead, they are conclusions which are derived from particular linguistic premises. I want, in the time remaining, to present what I make out to be the elected linguistic premises, first of Jacques Derrida, then of Hillis Miller, in the confidence that if I misinterpret these theories, my errors will soon be challenged and corrected. Let me eliminate suspense by saying at the beginning that I don't think that their radically skeptical conclusions from these premises are wrong. On the contrary, I believe that their conclusions are right—in fact, they are infallibly right, and that's where the trouble lies. · 1. "Tradition and Difference," Diacritics 2 : 8, 12.· 2. Ibid. M. H. Abrams’s contributions to Critical Inquiry include "Rationality and Imagination in Cultural History: A Reply to Wayne Booth" and "Behaviorism and Deconstruction: A Comment on Morse Peckham's 'The Infinitude of Pluralism'". (shrink)

Let us call an integer part of an ordered field any subring such that every element of the field lies at distance less than 1 from a unique element of the ring. We show that every real closed field has an integer part.

We present PhrasIS, a benchmark dataset composed of natural occurring Phrase pairs with Inference and Similarity annotations for the evaluation of semantic representations. The described dataset fills the gap between word and sentence-level datasets, allowing to evaluate compositional models at a finer granularity than sentences. Contrary to other datasets, the phrase pairs are extracted from naturally occurring text in image captions and news headlines. All the text fragments have been annotated by experts following a rigorous process also described in the (...) manuscript achieving high inter annotator agreement. In this work we analyse the dataset, showing the relation between inference labels and similarity scores. With 10K phrase pairs split in development and test, the dataset is an excellent benchmark for testing meaning representation systems. (shrink)

Clinical and research practices designed by developed countries are often implemented in host nations of the Third World. In recent years, a number of papers have presented a diversity of arguments to justify these practices which include the defence of research with placebos even though best proven treatments exist; the distribution of drugs unapproved in their country of origin; withholding of existing therapy in order to observe the natural course of infection and disease; redefinition of equipoise to a more bland (...) version, and denial of post-trial benefits to research subjects. These practices have all been prohibited in developed, sponsoring countries, even though they invariably have pockets of poverty where conditions comparable to the Third World prevail. Furthermore, the latest update of the Declaration of Helsinki clearly decries double ethical standards in research protocols. Under these circumstances, it does not seem appropriate that First World scholars should propose and defend research and clinical practices with less stringent ethical standards than those mandatory in their own countries. Recent years have witnessed frequent reports of less stringent ethical standards being applied to both clinical and research medical practices, for the most part in the field of drug trials and drug marketing, initiated by developed countries in poorer nations. Still more unsettling, a number of articles have endorsed the policy of employing ethical norms in these host countries, which would be unacceptable to both the legislations and the moral standards of the sponsor nations. Also, these reformulations often contravene the Declaration of Helsinki or one of its updates. This paper is not so much concerned with the actual practices, which have been subjected to frequent scrutiny and publicly decried when gross misconduct occurred. Rather, my concern relates to the approval and support such practices have found in the literature on bioethics from authors who might be expected to use their energy and scholarship to explore and endorse the universalisability of ethics rather than to develop ad hoc arguments that would allow exceptions and variations from accepted moral standards. To this purpose, issue will be taken with arguments in three fields: medical and pharmaceutical practices, research strategies, and local application of research results. (shrink)

A number of recent publications by the philosopher David Seedhouse are discussed. Although medicine is an eminently ethical enterprise, the technical and ethical aspects of health care practices can be distinguished, therefore justifying the existence of medical ethics and its teaching as a specific part of every medical curriculum. The goal of teaching medical ethics is to make health care practitioners aware of the essential ethical aspects of their work. Furthermore, the contention that rational bioethics is a fruitless enterprise because (...) it analyses non-rational social events seems neither theoretically tenable nor to be borne out by actual practice. Medical ethics in particular and bioethics in general, constitute a field of expertise that must make itself understandable and convincing to relevant audiences in health care. (shrink)

Research shows that commitment-based interventions are among the most effective strategies to encourage pro-environmental behaviors, but methods to elicit commitments from a large number of individuals are often costly and unrealistic. Predictions requests—a commitment-type strategy—are an effective mass-communication strategy and have the potential to influence pro-environmental behavior among large audiences. This research is the first to demonstrate that prediction requests in a consumer behavior context influence preference for environmentally friendly products. In addition, this research examines the role of individual and (...) contextual factors in influencing the efficacy of prediction requests. Study 1 shows that exposure to an advertisement with a prediction request leads to increased preferences for environmentally sustainable household cleaning products, compared to a control advertisement, and that this effect is greater when the prediction request is paired with an audience cue . Study 2 indicates that the effect of prediction requests on preference for sustainable products is greater for individuals with interdependent self-construal. Substantive implications and directions for future research are discussed. (shrink)

The concept of natural behavior is a key element in current Dutch policy-making on animal welfare. It emphasizes that animals need positive experiences, in addition to minimized suffering. This paper interprets the concept of natural behavior in the context of the scientific framework for welfare assessment. Natural behavior may be defined as behavior that animals have a tendency to exhibit under natural conditions, because these behaviors are pleasurable and promote biological functioning. Animal welfare is the quality of life as perceived (...) by the animal. Animals have evolved cognitive-emotional systems (“welfare needs”) to deal with a variable environment. Animals do not only have so-called physiological needs such as the need for food, water, and thermal comfort. They also need to exercise certain natural behaviors such as rooting or nest-building in pigs, and scratching or dust-bathing in poultry. All needs must be taken into account in order to assess overall welfare. The degree of need satisfaction and frustration can be assessed from scientific information about the intensity, duration, and incidence of (welfare) performance criteria such as measurements of behavior and/or (patho)physiology. Positive welfare value relates to how animals are inclined to behave under natural conditions, in preference tests, and in consumer-demand studies. Negative welfare value relates to stress, frustration, abnormal behavior, aggression, and reduced fitness. Examples are given to illustrate how the need to perform natural behaviors can be assessed following the general principles for welfare assessment, providing a first approximation of how different natural behaviors affect animal welfare. (shrink)

يقدم المؤلف لنا قانونا اجتماعيًا لعلماء النفس والاجتماع السياسي صاغه كالآتي: (إذا زاد عدد الأفراد الذين يمارسون تصرّفًا يعدّ خزيًا، وتساهل القانون في محاسبة مرتكبيه، وعجز الناس عن إيقافه أو وجدوا له تبريرًا، تحوّل إلى ظاهرة ولم يعد خزيًا كما كان). و من هذه العبارة التقديمية يمكن أن نؤكد أن هذا الكتاب لا يمكن إيفاءه حقه بنبذة موجزة، فهو سفر فكري ممتع، حيث يتناول المؤلف فيه بشكل تحليلي وعلمي مقنع أهم الموضوعات التي تشغل العقل العربي، ما بين شخصيات سياسية كصدام (...) وسليماني، وما بين فكرة الموت والانتحار، والبغاء والجريمة، والالحاد والإيمان، واللاوعي الجمعي العربي وما يحمله من أمراض وانحرافات، والتحرش والكبت، والفساد والسلطة، واللغة العربية والحضارة. (shrink)