Abstract:Vulnerability is an important criterion to assess the ethical justification of the inclusion of participants in research trials. Currently, vulnerability is often understood as an attribute inherent to a participant by nature of a diagnosed condition. Accordingly, a common ethical concern relates to the participant’s decisionmaking capacity and ability to provide free and informed consent. We propose an expanded view of vulnerability that moves beyond a focus on consent and the intrinsic attributes of participants. We offer specific suggestions for how (...) relational aspects and the dynamic features of vulnerability could be more fully captured in current discussions and research practices. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

Medical assistance in dying (MAID) legislation in Canada followed much deliberation after the Supreme Court of Canada’s ruling inCarterv.Canada. Included in this deliberation was the Special Joint Committee on Physician Assisted Dying’s recommendation to extend MAID legislation beyond the inclusion of adults to mature minors. Children's agency is a construct advanced within childhood studies literature which entails eliciting children’s voices in order to recognise children as active participants in constructing their own childhoods. Using this framework, we consider the possible extension (...) of MAID legislation to most minors. We highlight important questions regarding how insights from children’s voices could be mobilised in the life or death context of MAID. We conclude that children’s voices have the potential to help determine their eligibility for MAID; however, incorporating children's voices in the context of MAID requires careful consideration due to the complexity of voice. (shrink)

The goal of our work has been to better understand how Engaged Philosophical Inquiry can be used with young children on topics related to our local forest environment as part our foundation curriculum on sustainability. Theoretically we draw on the work of Matthew Lipman ; Philosophy for Children ; Phillip Cam, ; John Dewey, ; Gunilla Dahlberg and Peter Moss to discuss democratic community building, and ethical pedagogical approaches related to EPI and young children. Working with children of this age (...) holistically on the topic of sustainability has not been systematically researched to date. Our findings therefore contribute to better understandings of EPI and: 1) democratic community building processes; 2) the use of context to focus our discussions; 3) group membership and group size; and 4) turn taking and the role of the moderator. (shrink)

Interference effects from semantically similar items are well-known in studies of single word production, where the presence of semantically similar distractor words slows picture naming. This article examines the consequences of this interference in sentence production and tests the hypothesis that in situations of high similarity-based interference, producers are more likely to omit one of the interfering elements than when there is low semantic similarity and thus low interference. This work investigated language production in Mandarin, which allows subject noun phrases (...) to be omitted in discourse contexts in which the subject entity has been previously mentioned in the discourse. We hypothesize that Mandarin speakers omit the subject more often when the subject and the object entities are conceptually similar. A corpus analysis of simple transitive sentences found higher rates of subject omission when both the subject and object were animate (potentially yielding similarity-based interference) than when the subject was animate and object was inanimate. A second study manipulated subject-object animacy in a picture description task and replicated this result: participants omitted the animate subject more often when the object was also animate than when it was inanimate. These results suggest that similarity-based interference affects sentence forms, particularly when the agent of the action is mentioned in the sentence. Alternatives and mechanisms for this effect are discussed. (shrink)

For some time, the role of culture in language education within schools, universities and professional communication has received increasing attention. This article identifies two aporias in the discourse of intercultural communication : first, that it contains an unstated movement towards a universal consciousness; second, that its claims to truth are grounded in an implicit appeal to a transcendental moral signified.These features constitute IC discourse as ‘totality’, or as ‘metaphysics of presence’.The article draws on the work of Levinas ; and Derrida (...) to propose more considered ethical grounds for intercultural praxis. Contra a Hegelian impetus towards universal consciousness,we posit an irreducible distance and separation between the self and other. In so doing, not only are we able to supersede the field’s implicit appeal to the transcendental as a source of truth but also to counter perceptibly ‘exorbitant’ claims and actions of the intercultural other. In this vein, the article proposes a discourse ethics of responsibility by which it still becomes possible for a critical intercultural praxis to make value judgements and to take potentially transformative action vis-à-vis cultural acts that challenge the limits of intercultural tolerance and hospitality. (shrink)

Gabrielle Suchon’s Treatise on Ethics and Politics offers surprising descriptions of sexual difference for an ostensibly feminist work. Stereotypically feminine traits—such as excessive emotions, chattiness, and deception—are compared to earthquakes, storms, wildfire, and apparitions. Although these descriptions may seem off-putting to modern readers, I argue that in offering these unflattering descriptions of women, Suchon is making a novel intervention in debates about the nature of sexual difference. In the Renaissance and Early Modern period, the salient question about feminine difference was (...) whether it was a preternatural deformity, and specifically a monstrosity. While most pro-woman authors argued that women were not preternatural, Suchon argues the affirmative, claiming that “persons of the sex are true wonders.” In doing so, Suchon presses on a tension at the heart of scholastic conceptions of women while also provoking an emotional response that might encourage men to reconsider whether patriarchal practices are truly to their advantage. (shrink)

Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients’ comfort and dignity were deemed most at stake and therefore commanded nurses’ primary attention. This overarching commitment (...) to comfort and dignity shaped all of nursing practice in this hospice, including practices related to end‐of‐life delirium. The findings of this study elaborate the ways in which hospice nurses interpreted and responded to the discomfort of their patients in delirium, as well as the efforts they made to understand their patients’ subjective experiences and to connect with them in supportive ways. In addition to what is already known about clinical assessment and treatment of delirium in palliative care settings, the findings of this study offer points of reflection for nurses anywhere who are contending with the relational challenges that delirium presents in end‐of‐life care. (shrink)

This research paper shares findings related to our use of Engaged Philosophical Inquiry with a group of young children as a pedagogical method taken up to extend young children’s thinking about human use of forest parkland and to determine the children’s ontological positions related to environmental sustainability. The study was conducted in a forested area adjoining a ‘living building’ childcare centre. Here researchers, along with a core group of 9-13 children, their teachers, and a Philosopher-in-Residence visited the forest environment on (...) a fortnightly basis over a four-month period from January to May 2016 to explore the forested area, play games and discuss issues related to forest use and human habitation. Video records of the EPI sessions were transcribed and analysed to determine the children’s propositions and related ontological stance across sessions. Findings from this study include: evidence that young children’s views on stewardship are situated within socio-material manifestations of belonging, ownership, and entitlement within the forest; and that absurdities, along with other more traditional EPI and P4C strategies, can be used successfully to playfully challenge young children’s thinking about the rigour of their propositions and to provoke deeper thoughts related to belonging and care. (shrink)

Globalization has brought people around the world closer together in ways that have created greater uncertainty in their identity politics. This has sometimes strengthened local identities, despite attempts to create ‘universal’ forms of identity that impose one standard of appropriate conduct in the face of difference. Drawing from Dialogical Self Theory and from cosmopolitanism, we propose that adequately responding to the ethical and identity challenges presented by globalization requires having Global Consciousness: “a knowledge of both the interconnectedness and difference of (...) humankind, and a will to take moral actions in a reflexive manner on its behalf”. We argue that this approach can ground a distinctively normative psychology of globalization. We consider negative and positive aspects of the golden rule in equal and close relationships, and benevolence in unequal power relationships as behaviour guides for global consciousness, and theorize about institutional leadership that supports the provision of public goods. We offer empirical tests of this approach. (shrink)

The purpose of this study was to look beyond the patient as the source of difficulty and to examine the context of care encounters for factors that contributed to the construction of difficulty in the nurse-patient encounter. The study explains the origins of difficulty in the nurse-patient encounter. This explanation broadens the thinking limits previously imposed by locating difficulty within the individual. Key elements of this explanation are: knowing the patient minimizes the likelihood of difficulty in the encounter; and families, (...) availability of supplies and equipment, who is working, and care space changes are contextual factors that contribute to the construction of difficulty in the nurse-patient encounter. Awareness of these findings has implications for the strategies nurses employ in difficult encounters. (shrink)

We agree with Caplan & Waters that there are problems with the single-resource theory of sentence comprehension. However, we challenge their dual-resource alternative on theoretical and empirical grounds and point to a more coherent solution that abandons the notion of working memory resources.

Philosophical theories of perception are generally admitted to be responses to certain problems or puzzles allied to the ancient dichotomy between Appearance and Reality. For they have been mainly provoked by the incompatibility of the common–sense assumption that an external, physical world exists and is revealed to the senses with the well–known facts of perceptual variation and error. If only what is real were perceived just as if only what is right were done it is possible that many of those (...) questions would never have been asked which lead to moral philosophy and a metaphysics of the external world. But sense perceptions of the same object vary so that it appears to have contradictory qualities and are sometimes completely deceptive. Nor do illusory differ internally from veridical perceptions. Moreover, perceptual variation and error can be unmasked only by such procedures as looking more carefully, listening harder, trying to touch, asking others, in short by more sense experience. So the senses are, as it were, both accused and judge in these disputes and why should a venal judge be trusted more than the criminal he tries? Such “correction” of one experience by another of the same kind seems no more reliable than the original “error.” Philosophers have found all this very puzzling. (shrink)

Neuropalliative care developed to address the needs of patients living with life‐limiting neurologic disease. One critical consideration is that disease‐related changes to cognition, communication, and function challenge illness experiences and care practices. We conducted an ethnography to understand neuropalliative care as a phenomenon; how it was experienced, provided, conceptualized. Personhood served as our conceptual framework; with its long philosophical history and important place in nursing theory, we examined the extent to which it captured neuropalliative experiences and concerns. Personhood contextualized complex (...) losses, aligning the impact of functional and relational changes. Cognition, communication, and functional alterations stretched conceptions of personhood, insinuating it can be relational, fluid, adaptive. Although normative conceptions of personhood guided research and decision‐making, ethical considerations suggested personhood could be transformed, remade. We consider the implications of our findings through three themes. First, we examine how literature on illness experience fails to integrate the realities of people living with and dying from neurologic disease; we counter this by interrogating the concept of experience. Second, we turn to Ricoeur's work on recognition to illuminate relational conceptions of personhood to inform care practices. Finally, we reflect on how personhood can bridge the gap left by functional changes, enhance relational engagement, and promote dignity at the end of life. (shrink)

Both Hegel's philosophy and psychoanalytic theory have profoundly influenced contemporary thought, but they are traditionally seen to work in separate rather than intersecting universes. This book offers a new interpretation of Hegel's Phenomenology of Spirit and brings it into conversation the work of two of the best-known contemporary psychoanalysts, Christopher Bollas and André Green. Hegel and Psychoanalysis centers a consideration of the Phenomenology on the figure of the Unhappy Consciousness and the concept of Force, two areas that are often overlooked (...) by studies which focus on the master/slave dialectic. This book offers reasons for why now, more than ever, we need to recognize how concepts of intersubjectivity, Force, the Third, and binding are essential to an understanding of our modern world. Such concepts can allow for an interrogation of what can be seen as the profoundly false and constructed senses of community and friendship created by social networking sites, and further an idea of a "global community," which thrives at the expense of authentic intersubjective relations. (shrink)

In this volume, Simona Goi and Frederick M. Dolan gather stimulating arguments for the indispensability of fiction_including poetry, drama, and film_as irreplaceable sites for wrestling with nature, meaning, shortcomings, and the future of modern politics.