BackgroundJunior medical doctors have a key role in discussions and decisions about treatment and end-of-life care for people with dementia in hospital. Little is known about junior doctors’ decision-making processes when treating people with dementia who have advance care directives, or the factors that influence their decisions. To describe among junior doctors in relation to two hypothetical vignettes involving patients with dementia: their legal compliance and decision-making process related to treatment decisions; the factors influencing their clinical decision-making; and the factors (...) associated with accurate responses to one hypothetical vignette. MethodA cross-sectional survey of junior doctors, including trainees, interns, registrars and residents, on clinical rotation in five public hospitals located in one Australian state. The anonymous, investigator-developed survey was conducted between August 2018 and June 2019. Two hypothetical vignettes describing patients with dementia presenting to hospital with an ACD and either: bacterial pneumonia; or suspected stroke were presented in the survey. Participants were asked to indicate whether they would commence treatment, given the ACD instructions described in each vignette.ResultsOverall, 116 junior doctors responded. In Vignette 1, 58% of respondents selected the legally compliant option. Participants who chose the legally compliant option perceived ‘following patient wishes’ and ‘legal requirements to follow ACDs’ as equally important reasons for complying with the ACD. The most common reason for not selecting the legally compliant option in Vignette 1 was the ‘ACD is relevant in my decision-making process, but other factors are more relevant’. In Vignette 2, 72% of respondents indicated they would commence treatment and 18% selected they would not commence treatment.. Similar reasons influenced participant decision-making in Vignette 2, a less legally certain scenario.ConclusionsThere are critical gaps in junior doctors’ compliance with the law as it relates to the implementation of ACDs. Despite there being differences in relation to the legal answer and its certainty, clinical and ethical factors guided decision-making over and above the law in both vignettes. More education and training to guide junior doctors’ clinical decision-making and ensure compliance with the law is required. (shrink)

Mary Anne Warren investigates a theoretical question that is at the centre of practical and professional ethics: what are the criteria for having moral status? That is: what does it take to be an entity towards which people have moral considerations? Warren argues that no single property will do as a sole criterion, and puts forward seven basic principles which establish moral status. She then applies these principles to three controversial moral issues: voluntary euthanasia, abortion, and the status of (...) non-human animals. (shrink)

Current advances in connectivity, sensor technology, computing power and the development of complex algorithms for processing health-related data are paving the way for the delivery of innovative long-term health care services in the future. Such technological developments will, in particular, assist the elderly and infirm to live independently, at home, for much longer periods. The home is, in fact, becoming a locus for health care innovation that may in the future compete with the hospital. However, along with these advances come (...) valid privacy and security questions arising from the fact that the data collected and transmitted through these technologies could also allow for individual monitoring as well as unauthorized access to critical diagnostic and other health data. (shrink)

By a potential person I shall mean an entity which is not now a person but which is capable of developing into a person, given certain biologically and/or technologically possible conditions. This is admittedly a narrower sense than some would attach to the term ‘potential'. After all, people of the twenty-fifth century, if such there will be, are in some sense potential people now, even though the specific biological entities from which they will develop, i.e. the particular gametes or concepti, (...) do not yet exist. For there do exist, in the reproductive capacities of people now living and in the earth's resources, conditions adequate to produce these future people eventually, provided of course that various possible catastrophes are avoided. Indeed, in some sense of ‘potential’ there have been countless billions of potential people from the beginning of time. But I am concerned not with such remote potentialities but with currently existing entities that are capable of developing into people. (shrink)

Does birth make a difference to the moral rights of the fetus/infant? Should it make a difference to its legal rights? Most contemporary philosophers believe that birth cannot make a difference to moral rights. If this is true, then it becomes difficult to justify either a moral or a legal distinction between late abortion and infanticide. I argue that the view that birth is irrelevant to moral rights rests upon two highly questionable assumptions about the theoretical foundations of moral rights. (...) If we reject these assumptions, then we are free to take account of the contrasting biological and social relationships that make even relatively late abortion morally different from infanticide. (shrink)

"Readers interested in feminist studies, applied ethics, or social and political philosophy should find Gendercide especially interesting and informative. Highly recommended."-CHOICE.

Mary Anne Perkins re-examines Coleridge's claim to have developed a "logosophic" system which attempted "to reduce all knowledges into harmony." She pays particular attention to his later writings, some of which are still unpublished. She suggests that the accusations of plagiarism and of muddled, abstruse metaphysics which have been levelled at him may be challenged by a thorough reading of his work in which its unifying principle is revealed. She explores the various meanings of the term "logos," a recurrent (...) theme in every area of Coleridge's thought--philosophy, religion, natural science, history, political and social criticism, literary theory, and psychology. Coleridge was responding to the concerns of his own time, a revolutionary age in which increasing intellectual and moral fragmentation and confusion seemed to him to threaten both individuals and society. Drawing on the whole of Western intellectual history, he offered a ground for philosophy which was relational rather than mechanistic. He is one of those few thinkers whose work appears to become more interesting and his perceptions more acute as the historical gulf widens. This book is a contribution to the reassessment that he deserves. (shrink)

Il ne faut pas chercher à suivre l’ordre chronologique en parcourant ce livre qui s’inscrit dans quelques thématiques (le couple, la femme, les solidarités familiales) abordées à partir de différents dossiers européens d’un large Moyen Âge. Ce sont les doctorants du CIHAM qui ont contribué à ce volume, dans lequel ils analysent des documents de première main, souvent peu connus, ou bien relisent des documents bien connus mais sous des angles nouveaux. Après une brève préface des éditeurs du v...

This chapter contains sections titled: What is Moral Status? The Moral Agency Theory The Genetic Humanity Theory The Sentience Theory The Organic Life Theory Two Relationship‐based Theories Combining these Criteria Principles of Moral Status Human Zygotes, Embryos, and Fetuses Are All Animals Equal? Machines and Artificial Life‐forms Conclusion.

When deciding what disorders to screen newborns for, we should be guided by evidence of real effectiveness, take opportunity cost into account, distribute costs and benefits fairly, and respect human rights. Current newborn screening policy does not meet these requirements.

Dans le cadre des visual studies, Mitchell a montré que l’image organise de plus en plus notre perception sémiotique, en réarticulant la production du sens dans une perspective iconique. L’hypothèse d’un « devenir-image » du texte, du discours et de l’interaction n’est donc pas nouvelle mais semble confirmée par la communication numérique, où l’image joue un rôle important, réorganisant les contenus de sens et prenant parfois le pas sur l’expression verbale au sein du technographisme, défini comme une production multimédiatique numérique (...) native articulant image, texte et éventuellement son. Dans cet article, je propose de mettre en œuvre cette hypothèse à partir de l’exemple de la photographie de texte imprimé ou sur écran, qui est de plus en plus intégrée dans les discours numériques natifs, en particulier sur les réseaux sociaux comme Twitter ou Facebook. Je montrerai qu’elle relève d’une iconisation du texte, témoignant d’une conversion numérique de la scripturalité et posant la question d’un pilotage contemporain du sens par l’image. (shrink)

This paper analyzes the struggle for women’s suffrage in Kuwait to determine how and why it was successful. The research highlights two paradoxical findings: first, democratic progress occurred despite the pacifying and hindering effects of modernization; second, it was supported more strongly and effectively by Kuwait's autocratic executive than the democratically elected Kuwaiti parliament. We delineate two psychological factors that were connected to the climax of the struggle as they were experienced and acted upon by a relatively small number of (...) Kuwaiti middle- and upper-class women: transformative events and the tying of struggle goals to self-esteem. We examine these factors in the context of interaction between chaotic political circumstances and the new strategy and tactics that suffragists employed in the last phase of their struggle. The analytic approach involves process tracing, field research, interviews, and longitudinal analysis of primary and secondary sources. (shrink)

The Commission on the Accreditation of Law Enforcement employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group (...) or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum. (shrink)

The Forum and the Tower tackles a fascinating and perennial topic: the relationship between the academy and the world of politics. The accomplished Harvard law professor Mary Ann Glendon traces this crucial relationship from Classical Greece taking readers through the Roman Empire, Renaissance Italy, the English revolution, the Federalist era in the US, the French Revolution, the Napoleonic wars, the Concert of Europe, the progressive era, and the New Deal/World War II era.

This paper uses the controversy over the denial of care on futility grounds as a window into the broader issue of the role of cost in decisions about treatment near the end of life. The focus is on a topic that has not received the attention it deserves: the difference between refusing medical treatment and demanding it. The author discusses health care reform and the ethics of cost control, arguing that we cannot achieve universal access to quality care at affordable (...) care without better public understanding of the moral legitimacy of taking cost into account in health care decisions, even decisions at the end of life. (shrink)

In 1989, Helga Wanglie, 86 years old, broke her hip. This began a medical downhill course that a year later caused her health care providers to conclude that she would not benefit from continued medical treatment. It would be futile, and therefore, should not be provided. Her husband disagreed, and the conflict eventually led to a lawsuit. The Wanglie case touched off an extended debate in the medical and bioethical literature about medical futility: what it means and how useful the (...) concept is in making ethical decisions about starting or stopping treatment. (shrink)

In an age where digital images are omnipresent, the use of participant photography in qualitative research has become accessible and commonplace. Yet, scant attention is paid to the social justice impact of photovoice amongst studies that have used this innovative method as a way to promote social justice. There is a need to review this method to understand its contributions and possibilities. This literature review of photovoice research studies (i) explores whether authors implicitly or explicitly related the methodologies to their (...) aims of promoting social justice (methodology–method fit) and (ii) outlines the social justice research impact of photovoice findings using the framework of social justice awareness, amelioration and transformation. PubMed, Scopus, PsycINFO and Web of Science databases were searched from the years 2008–13 using the following keywords: photovoice; photonovella; photovoice and social justice; and photovoice and participatory action research. Of the 30 research studies reviewed, only thirteen identified an underlying methodology guiding the photovoice method. The social justice impacts emphasized were more related to social justice awareness (n = 30) than amelioration (n = 11) or transformation (n = 3). Future researchers using photovoice as a way to promote social justice are encouraged to assess and plan for the social justice impact desired. (shrink)

La renommée nationale et internationale de Pierre Bourdieu lui est venue de la sociologie, une sociologie un peu particulière, dite " des élites ", ou plus communément, " de la domination ", au fil de laquelle il ne se fit pas faute de fustiger les représentants de celle qu'il appelait " La discipline du couronnement ", la philosophie. C'était là pourtant son terroir d'origine, sa formation première, et la seule dans laquelle il possédât un diplôme. Mais il ne voyait dans (...) ses anciens " collègues " que des lectors figés dans une position scolastique qui les éloignait des urgences du monde et du " sens pratique ". Pourtant, c'est à l'aide de La philosophie qu'il critique la philosophie, et vise à l'éduquer, qu'il forge les concepts majeurs de sa sociologie, comme l'habitus, la violence symbolique. Et l'enjeu de ses recherches est encore un enjeu philosophique, qui le rapproche de ceux qui ont voulu transformer le monde, au lieu de se borner à le penser. (shrink)

The past 25 years have seen an upsurge of interest in the figure of Mary Magdalene, whose image has been transformed through feminist scholarship from penitent prostitute to prominent disciple of Jesus. This article documents another, non-academic, interpretation of Mary Magdalene – the image of Mary as goddess or embodiment of the female divine. The most influential proponent of this view is Margaret Starbird, who hypothesizes that Mary was both Jesus’ wife and his divine feminine counterpart. (...) The author suggests that feminist theologians/thealogians should be aware of this popular understanding of Mary; and consider what it is about Mary Magdalene as the sacred feminine/bride of Jesus/sophia that captures the public imagination in a way that other feminist christologies do not. (shrink)

The Commission on the Accreditation of Law Enforcement employs rigorous evaluation techniques. Objective accreditation, such as made possible by CALEA, is important from the public’s perspective and in the national community of law enforcement.To counteract a general distrust of law enforcement agencies, the Law Enforcement Assistance Administration developed a grant to develop standards by which the quality and performance of law enforcement could be measured. LEAA developed 107 standards and, though well received by the law enforcement community, no single group (...) or agency took the initiative to begin a program to evaluate and implement the standards. In 1979, the Department of Justice established an additional grant that effectively organized the four major law enforcement groups: the International Association of Chiefs of Police, the National Sheriff’s Association, the National Organization of Black Law Enforcement Executives, and the Police Executive Research Forum. (shrink)