BackgroundThe aim of this survey was to determine the level of awareness and understanding of peer review and peer review models amongst junior hospital doctors and whether this influences clinical decision-making.MethodsA 30-question online anonymous survey was developed aimed at determining awareness of peer review models and the purpose of peer review, perceived trustworthiness of different peer review models and the role of peer review in clinical decision-making. It was sent to 800 trainee doctors in medical specialties on the University College (...) London Partners trainee database.ResultsThe response rate was (178/800) 22%. Most respondents were specialist registrars. Checking that research is conducted correctly (152/178, 85%) and the data interpreted correctly (148/178, 83%) were viewed as the most important purposes of peer review. Most respondents were aware of open (133/178, 75%), double-blind (125/178, 70%) and single-blind peer review (121/178, 68%). 101/178 (57%) had heard of collaborative, 87/178 (49%) of post publication and 29/178 (16%) of decoupled peer review. Of those who were aware of double-blind, single-blind open and collaborative peer review, 85 (68%), 82 (68%), 74 (56%) and 24 (24%), respectively, understood how they worked. The NEJM, Lancet and The BMJ were deemed to have most trustworthy peer review, 137/178 (77%), 129/178 (72%) and 115/178 (65%), respectively. That peer review had taken place was important for a journal content to be used for clinical decision-making 152/178 (85%), but the ability to see peer review reports was not as important 22/178 (12%). Most felt there was a need for peer review training and that this should be at the specialist registrar stage of training.ConclusionsJunior hospital doctors view peer review to be important as a means of quality control, but do not value the ability to scrutinize peer review themselves. The unquestioning acceptance of peer review as final validation in the field of medicine emphasises not only the responsibility held by medical journals to ensure peer review is done well but also the need to raise awareness amongst the medical community of the limitations of the current peer review process. (shrink)

Harvey and Gurvir’s Law is a bill proposed to the Legislative Assembly of Ontario (Canada) to reduce stigma and bias associated with Down syndrome, by developing and disseminating quality information about Down syndrome in the context of prenatal testing.

ZusammenfassungDie Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

Jeffery Aubin ,Marie Chantal ,Dianne Cole ,Julio Chaves ,Cathelyne Duchesne ,Christel Freu ,Steve Johnston ,Brice Jones ,Amaury Levillayer ,Stéphanie Machabée ,Paul-Hubert Poirier ,Philippe Therrien ,Jonathan von Kodar ,Martin Voyer ,Jennifer Wees ,Eric Crégheur.

Die Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

BackgroundIn the early phase of the COVID-19 pandemic, many restrictions hit people in ways never seen before. Mental wellbeing was affected and burden was high, especially for high-risk groups such as parents. However, to our knowledge no research has yet examined whether being a parent was not only a risk for psychological burden but also a way to cope with the COVID-19 pandemic.MethodsAn online survey was used to collect data from 1,121 participants from April to June 2020. In addition to (...) demographic variables, risk factors and protective factors were collected. The dataset was divided into three groups: parents whose children lived at home, parents whose children did not live at home, and people who were not parents.ResultsA linear mixed effect model showed that parents had no higher burden than non-parents, and even less when children did not live at home. Expected risk factors were generally less important, and there were no differences between parents and non-parents. In contrast, parents had advantages in protective factors.ConclusionIn the early phase of the COVID-19 pandemic, it was shown that parents were not necessarily at risk due to additional burden, but also had prospects of coping better with the situation than people without children. (shrink)

The primary goal of this article is point out certain close parallels between some ideas of the radical feminist theorist Mary Daly and those of the French philosopher Henri Bergson. These similarities are particularly striking regarding distinctions made by both authors between two fundamentally contrasting types of cognitive faculty, of time and temporal experience, and of self and emotion. Daly departs from Bergson inasmuch as she employs these distinctions in her own way. She does not—like Bergson—employ them to depict the (...) result of a natural process of consciousness or life, and the dangers for human freedom and thought of not properly respecting these differences. Rather, she locates these differences within a more liberatory, ethical perspective to ground a sharp, inimical contrast between feminist creative movement on the one hand, and static, fixing, and “fixating” patriarchy, with its “technocratic” pretensions, on the other. My hope is that highlighting the similarities between Daly and Bergson will open new paths of appreciation and critique of Daly’s work. (shrink)

Photographic representations of women living with or beyond breast cancer have gained prominence in recent decades. Postmillennial visual narratives are both documentary projects and dialogic sites of self-construction and reader-viewer witness. After a brief overview of 30 years of breast cancer photography, this essay analyzes a collaborative photo-documentary by Stephanie Byram and Charlee Brodsky, Knowing Stephanie , and a memorial photographic essay by Brodsky written ten years after Byram’s death, “Remembering Stephanie” . The ethics of representing women’s postsurgical bodies and (...) opportunities for reader-viewers to engage in “productive looking” are the focal issues under consideration. (shrink)

Dans le cadre de notre thèse, nous avons confronté les Lais de Marie de France datant du xiie siècle qui présentent la particularité alors inédite d’avoir pour auteur une femme et le Genji Monogatari de Murasaki Shikibu (une femme également), écrit au xie siècle au Japon, qui fait aussi figure d’exception dans un paysage scriptural majoritairement masculin, a fortiori pour une œuvre d’une telle ampleur. Le rapprochement entre les deux œuvres était avant tout motivé par une thématique de fond, (...) l’imaginaire féminin, déployé dans deux cultures géographiquement et sociologiquement éloignées, cependant immergées dans un milieu élitiste, celui de la Cour. Ce choix s’inscrivait surtout dans la perspective d’une approche mythocritique plutôt que strictement littéraire, dont l’intérêt se situait en deçà du cadre du texte, puisqu’il puisait dans la mythologie fondatrice des deux cultures, source de l’émergence d’un imaginaire féminin à des époques chiches de féminité. Or, cette analyse, que nous avons qualifiée de contrastive, a permis l’ouverture de la réflexion sur d’autres perspectives que seul autorisait un tel rapprochement ; elle a également cherché à distinguer, parmi les motifs communs aux deux textes, ceux qui relevaient d’une universalité (contextuelle) de ceux qui relevaient d’une commune origine eurasiatique. La réflexion était axée sur la notion d’altérité selon une acception très large mais concentrée sur la représentation par l’imaginaire féminin de l’Autre sexe et d’un Ailleurs avant tout textuel et narratif. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Toward Mindful Music Education:A Response To Bennett ReimerSandra L. StaufferIn her book Composing a Life, Mary Catherine Bateson reminds us to acknowledge our antecedents—those who have gone before in whatever way or whatever path.1 I believe we should also acknowledge our co-conspirators—those who have listened to us and wrestled with our ideas. Following Bateson, I wish to recognize the contributions of my teachers and my colleagues, particularly the members (...) of the doctoral seminar at Arizona State University. I am grateful for your contributions to the life of my mind and the words of this morning. For the record, I also want to say that Bennett Reimer is both antecedent and co-conspirator for everyone in this room, and we are indebted to him."The first task of philosophy involves learning to ask a good question," says Walter Feinberg in his essay on the philosophical scholar.2 Reimer asks us, "Who is philosophy of music education for?"—a provocative question indeed. He also gives us an answer: K-12 students.I agree, but not really. How can that be? Imagine this. A music teacher I know, Stephanie, was engaged with some first-grade children in singing songs and moving and reading rhythms. She turned to write on the white board. When she turned back to the children, one boy, Alex, was standing, perfectly still, on his head. What happened next? I will tell you in few minutes. Reimer says, "Philosophical issues are not disconnected to or incidental to musical experience. [End Page 135] They are foundational for musical experience, because one's values, beliefs, desires, preferences, and so forth, directly affect how one engages with music and what one gets from doing it." Abridging those two sentences at my own peril, Reimer appears to be saying that philosophical issues are foundational to musical experience.That idea works for me only if I am standing, figuratively and metaphorically, not literally, on my head. It seems to me that experience is the foundation of philosophy or, put another way, that one's philosophy derives from one's experiences; the richer the experiences, the richer the philosophy. A philosophy based on limited or weak experience is a limited or weak philosophy. This, however, is only surface-level logic for a deeper epistemological question—where does one's philosophy come from? If I take the Deweyan perspective that philosophy derives from experience, then surely I am obligated, in this forum, to define my terms—particularly "experience." It would be easy to say that experience means making music and listening to music, and surely it does. By experience, however, I mean not only these actions—the doing of music—but also thinking, or what Ellen Langer calls mindfulness.3 Langer describes mindful learning as having three characteristics: "the continuous creation of new categories; openness to new information; and an implicit awareness of more than one perspective."4 I like how Robert Duke articulates the same idea: "Teach things that are intellectually interesting and functionally valuable."5 Engage students not just in doing, but also in thinking—in mindful learning. Rich experience makes for rich philosophy. If we are talking about music education at all levels that is not only participatory, but also mindful, then I am all for it.Reimer asks a second question: how are we to accomplish the teaching of philosophy to K-12 students? I want to know what we are trying to accomplish. Are we trying to teach the content of philosophy or are we trying to help students develop their own abilities to think about their experiences as musicians, whether as listeners or as music makers, in whatever contexts they find themselves? The former seems to be a reification of philosophy in which I am not eager to engage most K-12 students. I hope we are aiming for the latter. If so, then our task is to provide rich and mindful experiences in every music setting. Our task is to model the disposition of a philosopher—one who asks questions, is curious, and is engaged in the life of the mind.This seems so obvious. Why aren't we doing it already? There... (shrink)

by Charlee BrodskyStephanie Byram was my friend. She died of breast cancer at age thirty-eight on June 9, 2001. She lived eight years after the disease was discovered.With her cancer diagnosis at age thirty, Stephanie’s life changed. She became more known to others than she would have otherwise. She always had a close circle of friends who were drawn to her because of her candor, her intellect, her impish humor, her steadiness, her sensitivity. But after her diagnosis, many more people (...) knew of Stephanie Byram because of her willingness to share. Stephanie went public with breast cancer.Stephanie called the work that we produced our “art project.” The work consisted of my photographs and her words, and it took many forms. We exhibited in galleries; published pieces in newspapers, magazines, and journals; produced a thirty-minute video with filmmaker Mary Rawson; and the Univeristy of Pittsburgh published the work as a book. The project garnered recognition and many awards.Recently, I d .. (shrink)

“Remembering Stephanie” by Charlee Brodsky is part of the symposium “Disease, Communication, and the Ethics of Visibility” published in the 11 issue of the Journal of Bioethical Inquiry and guest edited by Martha Stoddard Holmes and Monika Pietrzak-Franger. Although this article was included in the print version of the journal, in error it was not published online or included in the table of contents for the symposium. We republish it in the 12 issue of the Journal of Bioethical Inquiry for (...) these reasons.Additionally, the article “Documenting Women’s Postoperative Bodies: Knowing Stephanie and ‘Remembering Stephanie’ as Collaborative Cancer Narratives” by Mary K. DeShazer, which was published in the 11 symposium and is available at DOI 10.1007/s11673-014-9582-8, comments on and makes direct reference to “Remembering Stephanie” by Charlee Brodsky. (shrink)

Moral duties are regularly attributed to groups. Does this make conceptual sense or is this merely political rhetoric? And what are the implications for these individuals within groups? Collins outlines a Tripartite Model of group duties that can target political demands at the right entities, in the right way and for the right reasons.

Argues that positive changes in perspective and deeper spiritual connections to things greater than oneself can influence the world for the better.

A comprehensive collection of classic texts, contemporary interpretations, guidelines for activists, issue-specific information, and materials for environmentally-oriented religious practice. Sources and contributors include Basho, the Dalai Lama, Thich Nhat Hanh, Gary Snyder, Chogyam Trungpa, Gretel Ehrlich, Peter Mathiessen, Helen Tworkov (editor of Tricycle ), and Philip Glass.

The ethics of care has flourished in recent decades yet we remain without a succinct statement of its core theoretical commitment. This book uses the methods of analytic philosophy to argue for a simple care ethical slogan: dependency relationships generate responsibilities. It uses this slogan to unify, specify and justify the wide range of views found within the care ethical literature.

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

Young children learn about the power of God's love and creation through simple text and illustrations.

When making decisions on behalf of someone, is asking what they would have wanted a good way to respect their autonomy? Against prevalent assumptions, I argue that in decisions about the care and treatment of those with advanced dementia, the notion of ‘what one would have wanted’ is conceptually, epistemically, and practically problematic. The problem stems from the disparity between the first-person subjectivity of the past person and that of the present person. The transformative nature of dementia renders the very (...) meaning of ‘what the patient would have wanted’ problematic. When applied to those with advanced dementia, the subjunctive notion is either (i) incoherent, (ii) fundamentally indeterminate, or (iii) normatively irrelevant. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

Organizations do moral wrong. States pursue unjust wars, businesses avoid tax, charities misdirect funds. Our social, political, and legal responses require guidance. We need to know what we’re responding to and how we should respond to it. We need a metaphysical and moral theory of wrongful organizations. This book provides a new such theory, paying particular attention to questions that have been underexplored in existing debates. These questions include: where are organizations located as material objects in the natural world? What’s (...) the metaphysical relation between organizations and their members? Can organizations be blameworthy for attitudes and character traits, as well as for actions? What about feelings of guilt, remorse, and shame—can organizations feel these emotions and why does this matter? How and why are members implicated in organizations’ wrongs? How should organizations’ reparative costs be apportioned among members? The book answers these questions. It argues that organizations are material objects with humans as material parts—much like how a pizza is a material object with slices as material parts. This picture helps us make sense of organizations’ blameworthiness, including blame for organization-level actions, attitudes, and character traits. The book argues that organizations can experience moral self-awareness—a crucial component of guilt, remorse, and shame. Members can be implicated in organizations’ actions in numerous ways—and, it is argued, members’ level of implication should determine their share of organizations’ reparative burdens. (shrink)

On a Humean account, a person's reasons for action are determined by her desires---in the broadest sense of 'desires', that is, noncognitive pro-attitudes. In four essays, I defend this account against several prominent objections. The first essay addresses the concern that the Humean cannot account for rationalizing reasons . The next three essays concern justifying reasons : reasons for action that are more fully normative than those that merely make action intelligible. Instrumental reasons, prudential reasons, and intrinsic reasons are three (...) different sorts of reasons to which an agent can appeal in justifying her action. ;Each essay focuses on a specific attack against the Humean account. In the second essay I argue that the normatively of instrumental reasons is brute ; and that, contrary to the received view, this is compatible with Humeanism. In the third essay I consider prudential reasons and defend the Humean claim that all and only present concerns provide normative reasons for action. In the final essay I address the fundamental question considerations of deliberative relevance: what makes certain desires and considerations relevant to a specific decision-making context, that is, what puts them among a person's present active reasons. ;In addition to defending a broadly Humean account of practical reasons, I am concerned to expand the components of a plausible form of Humeanism. Specifically, I argue that desires alone are not always sufficient to ground an agent's reasons, and that affective states are sometimes also necessary. I call this view "thick Humeanism". In essays one and four especially, I urge that a central place be given to affective states in determining practical reasons. I also invoke recent studies in cognitive psychology to support my claims about the role of the emotions in practical deliberation. (shrink)

In this collected volume, the authors analyze the deficiencies of existing theory and present alternate explanations of Third World foreign policy behavior. The essays show how examining Third World experience can broaden our understanding of how and why states and non-state actors interact in the international system.