Engaging a broad range of Platonic dialogues, this collection of essays by distinguished scholars in political theory and philosophy explores the relation of Socratic philosophizing to those activities with which it is typically opposed—such as tyranny, sophistry, poetry, and rhetoric. The essays show that the harder one tries to disentangle Socrates’ own activity from that of its apparent opposite, the more entangled they become; yet, it is only by taking this entanglement seriously that the distinctive character of Socratic philosophy emerges. (...) The collection sheds new light on the ways in which Plato not only represents philosophy in relation to what it is not, but also makes it “strange” to itself. (shrink)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based (...) on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed "medically inappropriate" will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

The paper introduces what is deemed as the general epistemological problem of measurement: what characterizes measurement with respect to generic evaluation? It also analyzes the fundamental positions that have been maintained about this issue, thus presenting some sketches for a conceptual history of measurement. This characterization, in which three distinct standpoints are recognized, corresponding to a metaphysical, an anti-metaphysical, and relativistic period, allows us to introduce and briefly discuss some general issues on the current epistemological status of measurement science.

Despite growing interest in emotions, organizational scholars have largely ignored the moral emotion of schadenfreude, which refers to pleasure felt in response to another’s misfortune. As a socially undesirable emotion, it might be assumed that individuals would be hesitant to share their schadenfreude. In two experimental studies involving emotional responses to unethical behaviors, we find evidence to the contrary. Study 1 revealed that subjects experiencing schadenfreude were willing to share their feelings, especially if the misfortune was perceived to be deserved. (...) Study 2 extends this work by incorporating schadenfreude targets of different status. Consistent with the “tall poppy syndrome,” subjects were more willing to share schadenfreude concerning high status targets than low status targets when the perceived severity of the target’s misconduct was low. This status effect disappeared at higher levels of perceived deservingness, however. Reported willingness to share schadenfreude was strongest at these levels but did not differ significantly between high and low status targets. These findings build on the social functional account of emotions, suggesting that sharing schadenfreude may signal normative cues to others regarding workplace behaviors that are deemed to be unethical. (shrink)

: Elizabeth Spelman has famously argued against gender realism. By and large, feminist philosophers have embraced Spelman's arguments and deemed gender realist positions counterproductive. To the contrary, Mikkola shows that Spelman's arguments do not in actual fact give good reason to reject gender realism in general. She then suggests a way to understand gender realism that does not have the adverse consequences feminist philosophers commonly think gender realist positions have.

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based on the well-documented (...) tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed “medically inappropriate” will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wonder, Imagination, and the Matter of Theatre in The TempestMary MooreAriel occurs. Recounting his performance of "the tempest" in Act I, scene 1 of The Tempest, he presents himself as being and action, fracturing grammar, spatial and temporal logic in ways that amaze and confound:I boarded the King's ship; now on the beak, Now in the waist, the deck, in every cabin, I flamed amazement. Sometime I'd divide, And (...) burn in many places; on the topmast, The yards, and bowsprit would I flame distinctly, Then meet and join...(1.2.195–201) 1"I flamed" means that Ariel emits or is flames, which in the normal order of things would consume him. His very narration, however, proves his survival, evoking wonder through the utterance itself. Forceful and compacted syntax, a recognized source of wonder in Classical and Renaissance accounts of style (Biester, pp. 14; 35–40), magnifies this effect. 2 Shakespeare's transitive use of the usually intransitive verb flame reflects a not uncommon practice, as E. A. Abbott shows; 3 but this syntactic device also reflects The Tempest's own logic. Ariel crosses boundaries between [End Page 496] deed and being, verb and noun, subject and object, matter and spirit: he both is and does flames. What could be more jarring to syntax and semantics than a singular subject whose utterance claims that he can flame, divide, meet and join? Just as "a" fire consists of many flames yet functions grammatically as a singular substance in English, just as the Christian Trinity is both singular and multiple, Ariel burns in many places at once. Meanwhile, this extraordinary language seems belied by the actor's very embodiment. Ariel cannot have done what he claims; yet the prior scene has represented the very storm in which Ariel flamed. In that sense, the actor's embodiment represents what we imagine to be matter's intractability, while Ariel's claims, coupled with the storm we have just witnessed, reveal matter's fluidity and permeability to imagination. Fluidity and intractability co-exist, another source of wonder. Sound mimics these paradoxes: the assonance and consonance in flame and amazement create a near rhyme that echoes the near identity of fire and human amazement. If, as Gurr and Ichikawa observe, a Renaissance audience expected to hear more than see a play, this echo calls attention to Ariel's marvelous powers. 4 Lest the noises and pleasures of the Renaissance theatre, which recent scholarship deems to be considerable, distract audience members from this bit of language, similar moments reinforce Ariel's play in and with language and matter throughout the play. Marvelous poetic language is of a piece with a "fever" that is of "the mind," with music that "creeps," actors who vanish, new found goddesses who speak the discoverers' own language.Amazement provides our cue: it and its cognates name the appropriate response to Ariel, his language, and to The Tempest itself. Attention to Ariel's poetic language reveals that it, like the plot, conforms to the marvels of the play and to the period's well documented love for marvels in several ways. Wonder, an aesthetic "'object of desire'" in itself, and a response to the inexplicable in classical and early modern views, may be evoked by the unexpected in style (and through other strategies that the era's handbooks taught). 5 The clause "I flamed amazement" epitomizes the unexpected in syntax as well as differing from one of the few sources found for The Tempest, William Strachey's 1610 letter, which describes just such a storm. 6 While St. Elmo's fire itself may elicit wonder, Shakespeare's syntax and diction reinforce that marvel. And no wonder: rhetoric and theatre alike depend upon audience attention, and wonders naturally evoke it. Jarring language also harmonizes with The Tempest's structural marvels—loose ends, disrupted actions, unforeseen futures—issues several critics explore. 7 [End Page 497]The wonders of The Tempest, however, also involve imagination—in early modern psychology, the human faculty that permits perception of the world and invention of images. 8 Wonder responds to how the perceived differs from the expected, how the imagined supplants the usual, how an... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wonder, Imagination, and the Matter of Theatre in The TempestMary MooreAriel occurs. Recounting his performance of "the tempest" in Act I, scene 1 of The Tempest, he presents himself as being and action, fracturing grammar, spatial and temporal logic in ways that amaze and confound:I boarded the King's ship; now on the beak, Now in the waist, the deck, in every cabin, I flamed amazement. Sometime I'd divide, And (...) burn in many places; on the topmast, The yards, and bowsprit would I flame distinctly, Then meet and join...(1.2.195–201) 1"I flamed" means that Ariel emits or is flames, which in the normal order of things would consume him. His very narration, however, proves his survival, evoking wonder through the utterance itself. Forceful and compacted syntax, a recognized source of wonder in Classical and Renaissance accounts of style (Biester, pp. 14; 35–40), magnifies this effect. 2 Shakespeare's transitive use of the usually intransitive verb flame reflects a not uncommon practice, as E. A. Abbott shows; 3 but this syntactic device also reflects The Tempest's own logic. Ariel crosses boundaries between [End Page 496] deed and being, verb and noun, subject and object, matter and spirit: he both is and does flames. What could be more jarring to syntax and semantics than a singular subject whose utterance claims that he can flame, divide, meet and join? Just as "a" fire consists of many flames yet functions grammatically as a singular substance in English, just as the Christian Trinity is both singular and multiple, Ariel burns in many places at once. Meanwhile, this extraordinary language seems belied by the actor's very embodiment. Ariel cannot have done what he claims; yet the prior scene has represented the very storm in which Ariel flamed. In that sense, the actor's embodiment represents what we imagine to be matter's intractability, while Ariel's claims, coupled with the storm we have just witnessed, reveal matter's fluidity and permeability to imagination. Fluidity and intractability co-exist, another source of wonder. Sound mimics these paradoxes: the assonance and consonance in flame and amazement create a near rhyme that echoes the near identity of fire and human amazement. If, as Gurr and Ichikawa observe, a Renaissance audience expected to hear more than see a play, this echo calls attention to Ariel's marvelous powers. 4 Lest the noises and pleasures of the Renaissance theatre, which recent scholarship deems to be considerable, distract audience members from this bit of language, similar moments reinforce Ariel's play in and with language and matter throughout the play. Marvelous poetic language is of a piece with a "fever" that is of "the mind," with music that "creeps," actors who vanish, new found goddesses who speak the discoverers' own language.Amazement provides our cue: it and its cognates name the appropriate response to Ariel, his language, and to The Tempest itself. Attention to Ariel's poetic language reveals that it, like the plot, conforms to the marvels of the play and to the period's well documented love for marvels in several ways. Wonder, an aesthetic "'object of desire'" in itself, and a response to the inexplicable in classical and early modern views, may be evoked by the unexpected in style (and through other strategies that the era's handbooks taught). 5 The clause "I flamed amazement" epitomizes the unexpected in syntax as well as differing from one of the few sources found for The Tempest, William Strachey's 1610 letter, which describes just such a storm. 6 While St. Elmo's fire itself may elicit wonder, Shakespeare's syntax and diction reinforce that marvel. And no wonder: rhetoric and theatre alike depend upon audience attention, and wonders naturally evoke it. Jarring language also harmonizes with The Tempest's structural marvels—loose ends, disrupted actions, unforeseen futures—issues several critics explore. 7 [End Page 497]The wonders of The Tempest, however, also involve imagination—in early modern psychology, the human faculty that permits perception of the world and invention of images. 8 Wonder responds to how the perceived differs from the expected, how the imagined supplants the usual, how an... (shrink)

Operational statistics is an operational theory of probability and statistics which generalizes classical probability and statistics and provides a formalism particularly suited to the needs of quantum mechanics. Within this formalism, statistical inference can be accomplished using the Bayesian inference strategy. In a hierarchical Bayesian approach, a second-order probability measure, or credibility, represents degrees of belief in statistical hypotheses. A credibility determines an assignment of simple and conditioned betting rates to events in a natural way. In the setting of operational (...) statistics, we show that a credibility is completely determined by the assignment of the betting rates it induces. This result suggests a certain unity between the Bayesian philosophy which deems that betting rates are central and the one which advocates the hierarchical approach. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Incorporating Religion into Psychiatry:Evidenced–Based Practice, Not a Bioethical DilemmaMary D. MollerFor over sixteen years I was the owner and clinical director of an advanced practice nurse–managed outpatient rural psychiatric clinic staffed by APNs, a social worker, a licensed counselor and several graduate students. Many of our patients were victims of severe and often brutal trauma and abuse suffered at the hands of family, friends, and various professionals including spiritual (...) leaders. We also uncovered sources of abuse suffered from those involved in occult practices ranging from seemingly innocent white witchcraft (Wicca, Paganism, New Age) that includes such activities as astral projection and remote viewing to the darkest possible black witchcraft (perpetrating evil, incanting evil spirits, casting spells and hexes, creating dissociative identities) such as occurs in ritual abuse and satanic rites. Both types of witchcraft also typically involved family, friends, various professionals, and spiritual leaders. Recognizing the controversy surrounding the reality of witchcraft I am sharing a story that I hope will help break down the barriers that prevent many patients from receiving the treatment that would provide the most benefit to recovery.Seeking services for these patients led me on an intense personal and professional journey that included a profound Christian born–again experience at almost 50 years of age. My professional career grew in nearly indescribable terms as a result of the incorporation of prayer and deliverance ministry as part of the services we selectively provided. Today I always include assessment of spiritual experiences a patient has as well as spiritual supports that are available with every new patient intake. For patients who indicate that prayer is one of their supports, I ask if they would like prayer at the conclusion of the session. The gratitude that is expressed by individuals who appreciate being able to pray with a psychiatric provider is often profound.In the field of psychiatry there has been a long–standing and distinct taboo regarding incorporating religious and spiritual aspects of life experience into treatment unless it is to frame most of these discussions within the context of psychosis. This stems from the advent of psychoanalysis in which religion was deemed a neurosis and atheism became the goal. Some still hold to that belief and there certainly remains controversy regarding the incorporation of prayer into routine outpatient or inpatient care. The essential starting point is the determination of accurate differential diagnosis, which can often be a lengthy process. The clinician must be careful about distinguishing between religious experiences and religious delusions, and often this takes time to sort out. The determination of the etiology of hearing the voice of God or the devil or demons must be carefully parsed and framed within the context of the situation and culture the patient describes. If the clinician denies the existence of God or the devil or demons or the practice of witchcraft, the patient’s descriptions of such experiences will be quickly [End Page 206] labeled psychotic. The patient may then experience a lengthy hospitalization and treatment with psychotropic medications that can have an extremely negative effect on the possibility of recovery. Once I witnessed the level of healing that occurs with carefully administered spiritual interventions that are related to specific spiritual experiences that are based on the patient’s belief system, there was no going back to using only allopathic medication and non–spiritual psychosocial interventions, even in spite of the criticisms from others. The key is to understand and respect the patient’s belief system, if this is not congruent with the practitioner’s belief system, then practitioner must refer out.In the United States, an increasing persecution of Christianity and a devaluing of the Judeo–Christian heritage of our Constitution are creating a climate of intolerance to the expression of religious values resulting in an expectation that Christians should compromise their beliefs for the sake of political correctness. As a doctorally prepared psychiatric–mental health advanced practice nurse I experienced a profound born–again Christian experience that ultimately led to study of the Hebrew roots of Christianity and I now worship in a Messianic Jewish synagogue. It is impossible for me to not include the concept of spirituality into... (shrink)

Complete determinism is, as Karl Popper said, “a daydream of omniscience.” Determinism is usually conceived as linked with a particular science whose explanations are deemed fundamental. As Rose rightly points out, biological enquiry includes many different kinds of question. Genetic determinism, making genes central to biology, is therefore biased and misguided. The crucial unit must be the whole organism. Correspondence:c1 IA Collingwood Terrace, Newcastle on Tyne NE2 2JP, United Kingdom [email protected].

Drawing on managerial discretion and conflicting institutional logics literature, this study investigates the relation between the personal sustainability behaviors of owner–managers and the corporate sustainability practices of SMEs. The research proposes a contingency model that assesses the moderating effects of perceived economic advantages and environmental hostility on this relationship. Based on linear hierarchical multiple regression analyses of a cross-sectoral sample of French SMEs, the results suggest a positive influence of the manager's PSB on the SME's CS practices that appears to (...) be differently moderated depending on the type of practice considered. The influence on environmental practices is fostered through the perception of economic advantages. The influence on workplace practices is only effective when the business environment is deemed benign and the influence on community practices is dampened by the perception of environmental hostility. Highlighting the trade-off between the manager's personal values and the SME's economic constraints, these findings contribute to a better understanding of the critical antecedents of sustainability in small businesses. (shrink)

BackgroundThe proper and ethical inclusion of PWLHIV and their young children in research is paramount to ensure valid evidence is generated to optimize treatment and care. Little empirical data exists to inform ethical considerations deemed most critical to these populations. Our study aimed to systematically review the empiric literature regarding ethical considerations for research participation of PWLHIV and their young children.MethodsWe conducted this systematic review in partnership with a medical librarian. A search strategy was designed and performed within the following (...) electronic databases: Ovid MEDLINE, Embase and CINAHL. We screened titles and abstracts using the following inclusion criteria: (1) a study population of PWLHIV or children under 5 years of age; and (2) collection of qualitative or quantitative data regarding ethics of research participation. Excluded were reviews, commentaries, policy statements, clinical care-related ethics concerns, abstracts, case studies, or studies unrelated to HIV research. Studies were appraised for quality, data were extracted, and studies were qualitatively analyzed using a principle-based ethical framework within the Belmont Report.ResultsOf the 7470 titles identified, 538 full-text articles were reviewed for eligibility and only three articles met full criteria for inclusion within this review. While we allowed for inclusion of studies involving young children born to mothers with HIV, only articles focused on PWLHIV were identified. Within the results of these studies, four themes emerged: (1) adequacy of informed consent; (2) consideration of paternal involvement; (3) balancing risks; and (4) access to research and treatment. A strength of this review is that it included perspectives of international research investigators, community leaders, and male partners. However, only two studies collected empiric data from PWLHIV regarding their experiences participating in researchConclusionResearchers and funding agencies should be aware of these considerations and appreciate the value of and critical need for formative research to ensure clinical trials involving PWLHIV promote ethical, well-informed research participation and, ultimately, improve care outcomes. More research is needed to create a comprehensive ethical framework for researchers when conducting studies with PWLHIV. (shrink)

The right to conceive and bear children has been protected both in law and in policy. Human society has from its earliest time valued children and defended procreation as a basic right.Modern health technology offers the possibility of conception to the estimated 2.5 million infertile couples who may wish to have children. For these persons, infertility treatment offers the hope of having children, an activity deemed basic and essential in human society.In general, the state has been reluctant to directly interfere (...) in the reproductive decisions of individuals. However, the state may act to increase or reduce access to reproductive services in a variety of ways. For example, recent legislation regulating fertility clinics affects the distribution of assisted reproductive technology in the United States. The purpose of this paper is to describe this legislation, project its probable effects on the distribution of ART services, and analyze these effects based on distributive theories of justice. (shrink)

Protecting the Vulnerable explores the reality of patient control and choice in health care and analyzes how decisions should be made on behalf of those deemed incapable of making decisions. The contributors, distinguished experts from the disciplines of medicine, ethics, theology, and law, look at the complex problem of autonomy and consent in health care and clinical research today from an illuminating perspective--its impact on the vulnerable members of society. The essays move from the exploration of lingering paternalism in health (...) care to the acute dilemma of treatment of and research on newborn babies. In covering both general and specific problems the collection reveals how exploitation can occur when the right of autonomy is eroded and where informed consent is illusory. Particularly vulnerable groups, such as children and people with mental handicaps, are discussed alongside cases where the vulnerability is itself an issue. Other areas covered include: `gesture' suicides, the practical problems of doctors in dealing with dependent patients, and the limits of proxy consent. All health care professionals, ethicists, policy makers, and lawyers currently engaged in the study or practice of health care ethics will find Protecting the Vulnerable to be a vital source of information for many years to come. (shrink)

This essay uses the philosophy and theology of John Paul II to argue that re-enchanting the world requires various modes depending on whether disenchantment is due to religious beliefs being deemed false or irrelevant. The former is countered through philosophical arguments for God's existence and the plausibility of religious belief, the latter through accepting the human condition and the connection between self-fulfillment and adherence to the laws of life, reason, other-centered love, and God-centered spirituality. These laws, especially as embodied in (...) Christianity, facilitate the familial love of God that is so necessary for re-enchanting the world. (shrink)

Le sacramentalisme qu’on s’accorde, depuis longtemps déjà, à reconnaître comme excessif à la fin du Moyen Âge devait conduire Luther puis les autres Réformateurs à dénoncer la « captivité babylonienne » de l’Eglise, notamment sous l’espèce d’une sorte d’emprisonnement de la « Parole de Dieu » dans l’institution sacramentelle, emprisonnement qui fut analogiquement dénoncé, à l’époque moderne, dans l’institution magistérielle de l’Eglise. Cette opposition entre Parole et Sacrement a en outre connu au XXe siècle une sorte de redoublement avec la (...) dichotomie entre la « foi » et la « religion », dichotomie qui a d’ailleurs traversé aussi bien le camp « catholique » que le camp « protestant », la foi étant mise du côté de la Parole, censée être nécessairement plus « pure » que les sacrements, lesquels relèveraient plutôt de la « religion » avec toutes les ambiguïtés que prend alors le terme devenu proche de la « magie ». La donne ayant aujourd’hui considérablement changé, il semble clair que l’on peut, dans la fidélité à la régulation dogmatique de la foi catholique, penser théologiquement les sacrements dans le sillage direct de la Parole.For a long time an agreement to recognize sacramentalism as excessive at the end of the Middle Ages would lead Luther and the other Reformers to denounce the “Babylonian captivity” of the Church, notably as a kind of imprisonment of the “Word of God” in the sacramental institution, imprisonment that was denounced analogically, in modern times, in the magisterial institution of the Church. This opposition between Word and Sacrament has moreover resurfaced in the 20th century, as a dichotomy between “faith” and “religion.” This dichotomy passed through both the “Catholic” and the “Protestant” camps. Faith was allied with the Word, because it was deemed to be necessarily “purer” than the sacraments, which were more a product of “religion” with all its ambiguities, which then takes on a connotation close to “magic.” Perspectives have considerably changed today, so it seems clear that it is possible to remain faithful to the dogmas of the Catholic faith and theologically view the sacraments as flowing directly from the Word. (shrink)

Spiritual life and community engagement animation services have existed since 2001. These services replaced pastoral animation in schools and are intended to promote the spiritual development and community engagement of all students, whether or not they are affiliated with a religion. This article presents the historical background that led to development of this service, as well as the professional concerns of its stakeholders. The concerns raised are based on awareness of great diversity among those who provide this service - diversity (...) in both their training and their understanding of the meanings of the terms that define their work. Presently working towards the professionalization that they deem essential to their very survival, they are using professional strategies that are largely not aligned with their reality nor their abilities. This article hopes to demonstrate the relevance of changing perspectives so that this profession would not be understood through functionalist or conflictualist paradigms, nor limited only to community engagement, but would rather adopt an interactionist point of view, focused on the spiritual aspect of this role. (shrink)

The fact that Internet companies may record our personal data and track our online behavior for commercial or political purpose has emphasized aspects related to online privacy. This has also led to the development of search engines that promise no tracking and privacy. Search engines also have a major role in spreading low-quality health information such as that of anti-vaccine websites. This study investigates the relationship between search engines’ approach to privacy and the scientific quality of the information they return. (...) We analyzed the first 30 webpages returned searching “vaccines autism” in English, Spanish, Italian, and French. The results show that not only “alternative” search engines but also other commercial engines often return more anti-vaccine pages (10–53%) than Google (0%). Some localized versions of Google, however, returned more anti-vaccine webpages (up to 10%) than Google. Health information returned by search engines has an impact on public health and, specifically, in the acceptance of vaccines. The issue of information quality when seeking information for making health-related decisions also impact the ethical aspect represented by the right to an informed consent. Our study suggests that designing a search engine that is privacy savvy and avoids issues with filter bubbles that can result from user-tracking is necessary but insufficient; instead, mechanisms should be developed to test search engines from the perspective of information quality (particularly for health-related webpages) before they can be deemed trustworthy providers of public health information. (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)

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 completed surveys and 54 partially completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

BackgroundThe advent of learning healthcare systems (LHSs) raises an important implementation challenge concerning how to request and manage consent to support secondary use of data in learning cycles, particularly research activities. Current consent models in Quebec were not established with the context of LHSs in mind and do not support the agility and transparency required to obtain consent from all involved, especially the citizens. Therefore, a new approach to consent is needed. Previous work identified the meta-consent model as a promising (...) alternative to fulfill the requirements of LHSs, particularly large-scale deployments. We elicited the public’s attitude toward the meta-consent model to evaluate if the model could be understood by the citizens and would be deemed acceptable to prepare for its possible implementation in Quebec.MethodsEight focus groups, with a total of 63 members of the general public from various backgrounds were conducted in Quebec, Canada, in 2019. Explicit attention was given to literacy levels, language spoken at home and rural vs urban settings. We assessed attitudes, concerns and facilitators regarding key components of the meta-consent model: predefined categories to personalized consent requests, a dynamic web-based infrastructure to record meta-consent, and default settings. To analyse the discussions, a thematic content analysis was performed using a qualitative software.ResultsOur findings showed that participants were supportive of this new approach of consent as it promotes transparency and offers autonomy for the management of their health data. Key facilitators were identified to be considered in the implementation of a meta-consent model in the Quebec LHSs: information and transparency, awareness campaigns, development of educational tools, collaboration of front-line healthcare professionals, default settings deemed acceptable by the society as well as close partnerships with recognized and trusted institutions.ConclusionsThis qualitative study reveals the openness of a sample of the Quebec population regarding the meta-consent model for secondary use of health data for research. This first exploratory study conducted with the public is an important step in guiding decision-makers in the next phases of implementing the various strategies to support access and use of health data in Quebec. (shrink)

REIMER‐KIRKHAM S, SHARMA S, PESUT B, SAWATZKY R, MEYERHOFF H and COCHRANE M. Nursing Inquiry 2012; 19: 202–212 Sacred spaces in public places: religious and spiritual plurality in health careSeveral intriguing developments mark the role and expression of religion and spirituality in society in recent years. In what were deemed secular societies, flows of increased sacralization (variously referred to as ‘new’, ‘alternative’, ‘emergent’ and ‘progressive’ spiritualities) and resurgent globalizing religions (sometimes with fundamentalist expressions) are resulting in unprecedented plurality. These shifts (...) are occurring in conjunction with increasing ethnic diversity associated with global migration, as well as other axes of difference within contemporary society. Democratic secular nations such as Canada are challenged to achieve social cohesion in the face of growing religious, spiritual and ethnic diversity. These challenges are evident in the high‐paced, demanding arena of Health care. Here, religious and spiritual plurality enter in, sometimes resulting in conflict between medical services and patients’ beliefs, other times provoking uncertainties on the part of healthcare professionals about what to do with their own religiously or spiritually grounded values and beliefs. In this paper, we present selected findings from a 3‐year study that examined the negotiation of religious and spiritual pluralism in Health care. Our focus is on the themes of ‘sacred’ and ‘place’, exploring how the sacred – that which is attributed as special and set apart as it pertains to the divine, transcendence, God or higher power – takes form in social and material spaces in hospitals. (shrink)

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)

French end-of-life law aims at protecting patients from unreasonable treatments, but has been used to force caregivers to prolong treatments deemed unreasonable. We describe six cases (five intensi...

Is the possession of taste relevant to the practice of moral and political judgement? For Mary Wollstonecraft and many of her contemporaries, the formation of taste was increasingly significant for both ethics and politics. In fact, some of the key contributors to the debate, which I have termed the ‘politics of taste’, believed that fostering existing standards of taste promised a palliative to modern democratic ills that they diagnosed. Wollstonecraft is an immanent critic of such positions. Although she shares (...) some of Edmund Burke’s and David Hume’s assumptions, she proposes dramatic revision of the extant model of refined taste driven by the spread of rational education. In this way, she attempts to rescue ‘true taste’ from its sentimental context – one permeated by false assumptions about femininity and class. For Wollstonecraft, ‘true taste’ must be the product of refined understanding. Only then can it be deemed a support rather than a hindrance to the practice of moral and political judgement. Although recent Wollstonecraft scholarship has emphasised the depth of her engagement with Scottish Enlightenment thought, using Hume as a primary interlocutor with Wollstonecraft, especially on the question of taste, is yet unprecedented. This approach, Wollstonecraft’s immanent critique of taste, yields arguments about taste that are especially complex and philosophically interesting, both in her time and ours. (shrink)

Many commentators have contrasted the way that sociability is theorized in the writings of Mary Astell and Damaris Masham, emphasizing the extent to which Masham is more interested in embodied, worldly existence. I argue, by contrast, that Astell's own interest in imagining a constitutively relational individual emerges once we pay attention to her use of religious texts and tropes. To explore the relevance of Astell's Christianity, I emphasize both how Astell's Christianity shapes her view of the individual's relation to (...) society and how Masham's contrasting views can be analyzed through the lens of her charge that Astell is an “enthusiast.” In late seventeenth-century England, “enthusiasm” was a term of abuse that, commentators have recently argued, could function polemically to dismiss those deemed either excessively social or antisocial. By accusing Astell of enthusiasm, I claim, Masham seeks to marginalize the relational self that Astell imagines and to promote a more instrumental view of social ties. I suggest some aspects of Astell's thought that may have struck contemporaries as “enthusiastic” and contrast her vision of the self with Masham's more hedonistic subject. I conclude that, although each woman differently configures the relation between self and society, they share a desire to imagine autonomy within a relational framework. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Last Man by Mary ShelleyJennifer A. Wagner-LawlorMary Shelley. The Last Man. 1826. Edited by Chris Washington. Norton Critical Editions. New York: W. W. Norton, 2023. xxiv + 571 pp. Paperback, ISBN 9780393887822.New critical editions of well-known literary works serve several important functions, and those designed specifically for students serve two of the most important: to introduce readers to texts that were overlooked during and since the (...) author’s time, but that might find greater favor today; and to re-introduce to a new generation of students classic texts that have lost critical favor or been neglected. Mary Shelley’s The Last Man (1826) is a novel long overshadowed by brilliance and resilient legacy of her first novel, Frankenstein (1818), written at a mere eighteen years of age. As so often happened to nineteenth-century women who published under their own names, both Frankenstein and The Last Man were hammered critically by male reviewers (and often by the few female ones) unable to believe any woman, and certainly no “good” woman, could compose these stories. And by 1826, Mary Shelley had already gained notoriety thanks to her association with the radical politics and “free-loving” Shelley-Byron circle). No wonder then that contemporaneous reviewers—even as they brought themselves to compliment the narratological and formal accomplishment the novel represents—could not countenance either its content or its author, as the novel “violated” certain forms of literary and gender propriety: indeed, the novel was deemed the product of a “diseased imagination” (The Monthly Review).Modern assessments of the novel are far more admiring of Shelley’s sophisticated examination of national and cultural mythic structuralizations, and receptive to the boldness of Shelley’s profoundly ironical assessments of them. In this new Norton Critical Edition of The Last Man, Chris Washington comes to the text with a refreshingly undeferential approach to Shelley’s Romantic forebears and immediate companions. Not because they [End Page 582] deserve being knocked off their pedestals, but because—granting all that—Shelley’s text has a lot more to give to us. This is the first time the Norton Critical Edition series has produced an annotated critical edition of The Last Man (Broadview’s appeared in 1996), and it is therefore both welcome and well overdue. For this reader, The Last Man is in some ways arguably superior to Frankenstein, certainly better written and developed. Frankenstein packs the greater punch, but The Last Man picks up and reweaves, on a much larger loom, the same thematic threads: justice and judgment; hospitality and generosity; family love and ethical obligation to community and nation; “civilized” and “wild” spaces. These themes are figured not only in terms of landscape but also in terms of geopolitical organization (i.e., the West vs. “the East,” presumed source of the virus); the bounded- vs. unbound-ness of the creative imagination (also tied to cultural notions of civilization and wilderness); solitude and loneliness; alienness and otherness; alienation and self-alienation and/as dehumanization; the human and the posthuman. While part of Frankenstein’s greatness is its narrative concision and stylistic spareness, the greatness of The Last Man, written by the more mature writer, intellectually and technically (and without the interference of Percy Shelley), is how fully Shelley “fleshes out” those entanglements in this later novel.Setting aside therefore the inclusion of “the usual suspects” (xx) of earlier editions, Washington gives space to critical approaches that are not focused so intensely on the influences of Shelley’s biography. In an excellent introduction Washington emphasizes the various ways in which this novel opens up to (still) intractable political and human rights issues: slavery, imperialism, nonheteronormative genders and sexualities, and precarious lives.Washington addresses particularly what Shelley’s text has to offer—and does offer—to today’s students. He shares his own experience of teaching this novel during COVID times, finding the students, used to speed of communication and multimedia delivery, resistant initially to the narrative’s pacing, and reintroducing them to the pleasures of the slow build-up of plot and setting, as well as the excruciating tension of watching a slow-burn approach to seemingly unavoidable catastrophe. But Washington rejects... (shrink)

Mary Kate McGowan’s Just Words offers an interesting account of exercitives. On McGowan’s view, one of the things we do with words is change what’s permitted, and we do this ubiquitously, without any special authority or specific intention. McGowan’s account of exercitives is meant to identify a mechanism by which ordinary speech is harmful, and which justifies the regulation of such speech. It is here that I part ways. I make three main arguments. First, McGowan’s focus on harm is (...) misguided; that ordinary speech is harmful is harder to support, and in turn does not less to support conclusions about whether it is wrong and warrants regulation, than Just Words suggests. Second, if the speech is harmful, McGowan’s account of exercitives is ill-suited to explain why; the relevant instances of ordinary speech seem to express speakers’ views about moral norms, not change social norms. Third, McGowan’s argument for why ordinary speech should be regulated because it is a form of discrimination presupposes a great deal that is controversial about what makes discrimination wrong and legally actionable, and even if it is right it may license the regulation of more speech than many, including McGowan, would deem acceptable. (shrink)

Plato famously promised to complement the Sophist and the Statesman with another work on a third sort of expert, the philosopher--but we do not have this final dialogue. Mary Louise Gill argues that Plato promised the Philosopher, but did not write it, in order to stimulate his audience and encourage his readers to work out, for themselves, the portrait it would have contained. The Sophist and Statesman are themselves members of a larger series starting with the Theaetetus, Plato's investigation (...) of knowledge, and the whole series relies on the Parmenides, the second part of which presents a philosophical exercise, introduced as the first step in a larger philosophical program. Gill contends that the dialogues leading up to the missing Philosopher, though they reach some substantive conclusions, are philosophical exercises of various sorts designed to train students in dialectic, the philosopher's method; and that a second version of the Parmenides exercise, closely patterned on it, spans parts of the Theaetetus and Sophist and brings the philosopher into view. This is the exercise about being, the subject-matter studied by Plato's philosopher. Plato hides the pieces of the puzzle and its solution in plain sight, forcing his students (and modern readers) to dig out the pieces and reconstruct the project. Gill reveals how, in finding the philosopher through the exercise, the student becomes a philosopher by mastering his methods. She shows that the target of Plato's exercise is internally related to its pedagogical purpose. (shrink)

This 1997 book was the first English translation of all of Kant's writings on moral and political philosophy collected in a single volume. No other collection competes with the comprehensiveness of this one. As well as Kant's most famous moral and political writings, the Groundwork of the Metaphysics of Morals, the Critique of Practical Reason, the Metaphysics of Morals, and Toward Perpetual Peace, the volume includes shorter essays and reviews, some of which have never been translated before. The volume has (...) been furnished with a substantial editorial apparatus including translator's introductions and explanatory notes to each text by Mary Gregor, and a general introduction to Kant's moral and political philosophy by Allen Wood. There is also an English-German and German-English glossary of key terms. (shrink)

This book explores a fundamental tension in Aristotle's metaphysics: how can an entity such as a living organisma composite generated through the imposition of form on preexisting matterhave the conceptual unity that Aristotle demands of primary substances? Mary Louise Gill bases her treatment of the problem of unity, and of Aristotle's solution, on a fresh interpretation of the relation between matter and form. Challenging the traditional understanding of Aristotelian matter, she argues that material substances are subverted by matter and (...) maintained by form that controls the matter to serve a positive end. The unity of material substances thus involves a dynamic relation between resistant materials and directive ends. Aristotle on Substance offers both a general account of matter, form, and substantial unity and a specific assessment of particular Aristotelian arguments. At every point, Gill engages Aristotle on his own philosophical ground through the detailed analysis of central, and often controversial, texts from the Metaphysics, Physics, On Generation and Corruption, De Anima, De Caelo, and the biological works. The result is a coherent, firmly grounded rethinking of Aristotle's central metaphysical concepts and of his struggle toward a fully consistent theory of material substances. (shrink)

Philosophers have traditionally concentrated on the qualities that make human beings different from other species. In _Beast and Man_ Mary Midgley, one of our foremost intellectuals, stresses continuities. What makes people tick? Largely, she asserts, the same things as animals. She tells us humans are rather more like other animals than we previously allowed ourselves to believe, and reminds us just how primitive we are in comparison to the sophistication of many animals. A veritable classic for our age, _Beast (...) and Man_ has helped change the way we think about ourselves and the world in which we live. (shrink)

In _Michael Polanyi and His Generation_, Mary Jo Nye investigates the role that Michael Polanyi and several of his contemporaries played in the emergence of the social turn in the philosophy of science. This turn involved seeing science as a socially based enterprise that does not rely on empiricism and reason alone but on social communities, behavioral norms, and personal commitments. Nye argues that the roots of the social turn are to be found in the scientific culture and political (...) events of Europe in the 1930s, when scientific intellectuals struggled to defend the universal status of scientific knowledge and to justify public support for science in an era of economic catastrophe, Stalinism and Fascism, and increased demands for applications of science to industry and social welfare. At the center of this struggle was Polanyi, who Nye contends was one of the first advocates of this new conception of science. Nye reconstructs Polanyi’s scientific and political milieus in Budapest, Berlin, and Manchester from the 1910s to the 1950s and explains how he and other natural scientists and social scientists of his generation—including J. D. Bernal, Ludwik Fleck, Karl Mannheim, and Robert K. Merton—and the next, such as Thomas Kuhn, forged a politically charged philosophy of science, one that newly emphasized the social construction of science. (shrink)

This book explores a fundamental tension in Aristotle's metaphysics: how can an entity such as a living organisma composite generated through the imposition of form on preexisting matterhave the conceptual unity that Aristotle demands of ...

Published in 1982, Carol Gilligan's _In a Different Voice_ proposed a new model of moral reasoning based on care, arguing that it better described the moral life of women. ____An Ethic of Care__ is the first volume to bring together key contributions to the extensive debate engaging Gilligan's work. It provides the highlights of the often impassioned discussion of the ethic of care, drawing on the literature of the wide range of disciplines that have entered into the debate. _Contributors:_ Annette (...) Baier, Diana Baumrind, Lawrence A. Blum, Mary Brabeck, John Broughton, Owen Flanagan, Marilyn Friedman, Carol Gilligan, Catherine G. Greeno, Catherine Jackson, Linda K. Kerber, Mary Jeanne Larrabee, Zella Luria, Eleanor E. Maccoby, Linda Nicholson, Bill Puka, Carol B. Stack, Joan C. Tronto, Lawrence Walker, Gertrud Nunner-Winkler. (shrink)

This article presents a detailed reconsideration of the well-established and canonized theory of “Sasanian iconoclasm” postulated by Mary Boyce in 1975. The Sasanians did not develop any prohibition against anthropomorphic representations of the gods, and in the surviving Zoroastrian literature and inscriptions there is no evidence of either theological disputes over idols or of a deliberate eradication of them by the Persian kings. Sasanian cult was aniconic, but the historical and archaeological evidence clearly demonstrates that Sasanian visual culture was (...) anything but iconoclastic. It seems that the Persian iconoclastic identity was constructed in the early Sasanian period as a response to the challenges posed by Christianity. By joining the common monotheistic discourse against idolatry, the Zoroastrian clergy adopted the conventions of the world in which they lived. Attacks against “idols” and “idolatry” should be understood in the context of internal and external polemical discourse against beliefs deemed to be erroneous by the Zoroastrian priesthood. (shrink)

Plato's Republic lurks in cybernetics, a word popularly attributed to US American mathematician Norbert Wiener (1894–1964). In his accounts of how he came up with it, however, Wiener never mentions Plato, though he does note it was formed from the ancient Greek word kubernētēs (navigator). Among the earliest popular books about the cybernetics craze are three published in France, and their authors show a special interest in the origin of cybernetics. In something like learned rebukes to Wiener, all three books (...) credit Plato with significant use of kubernē-based terms. This article presents evidence, one, that Wiener knows well he has chosen a word with a Platonic history and, two, that Wiener deems the technical and social climate of ancient Athens (and of the Republic) instructive only as an anti-model for the mid-20th-century United States and so does not feel compelled to associate cybernetics with Plato. Instead, Wiener focuses on the challenges cybernetics and automation pose for his own engineering-oriented, capitalist, multiracial, democratic republic. Wiener's decisions not to use Plato as an authorizing force and not to put ancient Athens on a pedestal merit recognition, since subsequent writers link ancient Athens with cybernation via a presumption that cybernation will enable and fully democratize the sort of leisure activities, including thinking and participation in public life, deemed by some to be emblematic of ancient Athens. (shrink)

Contradicting the long-held belief that Aristotle was the first to discuss individuation systematically, Mary Margaret McCabe argues that Plato was concerned with what makes something a something and that he solved the problem in a ...

InWisdom, Information and Wonder, Mary Midgley tackles the question at the root of our civilization: What is knowledge for?

Background:Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives, setting, and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced (...) by nurses in traditional patient-care settings.Research objectives:The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice.Research design:The study utilized a qualitative descriptive design with individual interviews.Participants and research context:Participating nurses self-identified as having experienced ethical challenges during screening. The majority were Caucasian, female, and worked in outpatient settings. Approximately 50% had > 10 years of research experience.Ethical considerations:The human subjects review board approved the study. Written informed consent was obtained.Findings:Predominant themes were revealed: the inability to provide a probable good, or/do no harm, and dual obligations. The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship.Discussion:Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science.Conclusion:Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

Confucianism conceives of persons as being necessarily interdependent, defining personhood in terms of the various roles one embodies and that are established by the relationships basic to one's life. By way of contrast, the Western philosophical tradition has predominantly defined persons in terms of intrinsic characteristics not thought to depend on others. This more strictly and explicitly individualistic concept of personhood contrasts with the Confucian idea that one becomes a person because of others; where one is never a person independently (...) or in and of oneself but develops into one only in community. This article surveys some differences between Confucian and Western ideas of self and their connection to ethics mainly in light of the relational self of the Confucian Analects and Mencius . A Philosophy Compass article called Confucianism and Ethics in the Western Philosophical Tradition II: A Comparative Analysis of Personhood will follow, that examines how the more individualistic way of conceiving of personhood in the West has had moral and political implications that differ, and even conflict, with those of Confucianism. (shrink)