Background Policies to use financial incentives to encourage healthy behaviour are controversial. Much of this controversy is played out in the mass media, both reflecting and shaping public opinion. Objective To describe UK mass media coverage of incentive schemes, comparing schemes targeted at different client groups and assessing the relative prominence of the views of different interest groups. Design Thematic content analysis. Subjects National and local news coverage in newspapers, news media targeted at health-care providers and popular websites between January (...) 2005 and February 2010. Setting UK mass media. Results The study included 210 articles. Fifteen separate arguments favourable towards schemes, and 19 unfavourable, were identified. Overall, coverage was more favourable than unfavourable, although most articles reported a mix of views. Arguments about the prevalence and seriousness of the health problems targeted by incentive schemes were uncontested. Moral and ethical objections to such schemes were common, focused in particular on recipients such as drug users or the overweight who were already stereotyped as morally deficient, and these arguments were largely uncontested. Arguments about the effectiveness of schemes and their potential for benefit or harm were areas of greater contestation. Government, public health and other health-care provider interests dominated favourable coverage; oppo- sition came from rival politicians, taxpayersÕ representatives, certain charities and from some journalists themselves. Conclusions Those promoting incentive schemes for people who might be regarded as ÔundeservingÕ should plan a media strategy that anticipates their public reception. (shrink)

The purpose of this paper is to present the findings of an investigation into missionary-refugee relationships in Europe. The main research question guiding this study was: How do missionaries understand and describe their relationship with the refugees they serve? The data for this study were collected at an international consultation on ministry with refugees held in the fall of 2017 from 21 missionaries using semi-structured interview protocols. Findings demonstrate that missionaries shared a liminal identity with the refugees in their ministry, (...) viewed hospitality as a Christian lifestyle, perceived Christianity to be an inclusive faith, and discussed the challenges and opportunities in their ministry with refugees. Based on the findings we offer implications for mission theorizing and practice in the 21st century church. (shrink)

Microbial model systems have a long history of fruitful use in fields that include evolution and ecology. In order to develop further insight into modelling practice, we examine how the competitive exclusion and coexistence of competing species have been modelled mathematically and materially over the course of a long research history. In particular, we investigate how microbial models of these dynamics interact with mathematical or computational models of the same phenomena. Our cases illuminate the ways in which microbial systems and (...) equations work as models, and what happens when they generate inconsistent findings about shared targets. We reveal an iterative strategy of comparative modelling in different media, and suggest reasons why microbial models have a special degree of epistemic tractability in multimodel inquiry. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

The global pandemic needs to mark a turning point for the peoples of Aotearoa New Zealand. How can we make sure that our culturally diverse nation charts an equitable and sustainable path through and beyond this new world? In a less affluent future, how can we ensure that all New Zealanders have fair access to opportunities? One challenge is to preserve the sense of common purpose so critical to protecting each other in the face of Covid-19. How can we centre (...) what we have learnt about resilience within Māori and wider Pacific communities in our reforms? How can public understanding of Covid-19 science create a platform for the future social valuing of expertise? How can we ensure that the impact of Covid-19 in New Zealand results in a more sustainable, and inclusive workforce–for instance by expanding our perceptions of the value of our workers through promoting digital inclusion? To meet these challenges, we must reimagine our existing traditions of thought, breathing new life into perennial concepts and debates. Our paper indicates some of the ways that Philosophy is central to this collective reimagining, highlighting solutions to be found across our rich philosophical traditions. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

Background:In Ontario, Canada, patients who lack decision-making capacity and have no family or friends to act as substitute decision-makers currently rely on the Office of the Public Guardian and Trustee to consent to long-term care (nursing home) placement, but they have no legal representative for other placement decisions.Objectives:We highlight the current gap in legislation for difficult transition cases involving unrepresented patients and provide a novel framework for who ought to assist with making these decisions and how these decisions ought to (...) be made.Research design:This paper considers models advanced by Volpe and Steinman with regard to who ought to make placement decisions for unrepresented patients, as well as current ethical models for analyzing how these decisions should be made.Participants and research context:We describe an anonymized healthcare transition case to illustrate the fact that there is no legally recognized decision-maker for placement destinations other than long-term care facilities and to show how this impacts all stakeholders.Ethical considerations:The case provided is an anonymized vignette representing a typical transition case involving an unrepresented patient.Findings:As a result of a gap in provincial legislation, healthcare providers usually determine the appropriate placement destination without a clear framework to guide the process and this can cause significant moral distress.Discussion:We argue for a team decision-making approach in the short term, and a legislative change in the long-term, to respect the patient voice, evaluate benefit and risk, enhance collaboration between healthcare providers and patients, and promote social justice. We believe that our approach, which draws upon the strengths of interprofessional teams, will be of interest to all who are concerned with the welfare and ethical treatment of the patients for whom they care.Conclusions:One of the main strengths of our recommendation is that it provides all members of the healthcare team (including nurses, social workers, therapists, and others) an increased opportunity to advocate on behalf of unrepresented patients. (shrink)

The idea that social and political institutions can be designed in order to achieve specific human ends goes back, at least, to Plato’s presentation of the appropriate form of the just city-state i...

Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap (...) by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy. (shrink)

Volume 24, Issue 4, August 2019, Page 1-2.

In response to concern over the numeracy skills deficit displayed by student nurses, an online computer programme, ?Authentic World??, which aims to simulate a real-life clinical environment and improve the medication dosage calculation skills of users, was developed (Founded in 2004 Authentic World Ltd is a spin out company of Glarmorgan and Cardiff Universities, Cardiff, Wales UK.). Two randomised controlled trials were conducted, each at a UK University, in order to investigate the impact of Authentic World? on student nurses? general (...) numeracy abilities. All first year nursing students who gave consent were randomised equally into an intervention or control group. The intervention group were given access to Authentic World?. The primary outcome measure was the students? scores on a general numeracy test. The Intention to Treat (ITT) analysis in both trials revealed a small negative effect of Authentic World? on general numeracy, which was statistically significant in one trial. However, compliance with the intervention was very low in both trials, with only 24 and 12% of students allocated to the intervention groups spending more than 15 minutes using the programme. Providing nursing students with access to Authentic World? is not an effective use of resources since use of the programme appears to be very low. (shrink)

For individuals pursuing medically assisted gender transition, gender-affirming surgical treatments, such as oophorectomy (removal of the ovaries) and orchiectomy (removal of the testicles), cause sterility, and gender-affirming hormone treatment with medications (i.e., testosterone and estrogen) may negatively impact infertility. The major United States (US) medical associations already endorse fertility preservation (FP) through cryopreservation (i.e., “freezing” egg and sperm) for transgender individuals. Despite these endorsements from the relevant medical societies, medical insurance coverage for FP remains very limited in the US. Given (...) the high out-of-pocket costs for FP services, fertility preservation remains financially out of reach for many transgender individuals who may desire it. We present an ethical justification for universal FP coverage for all transgender and gender diverse (TGD) individuals who request this option during medically assisted gender transition. First, we argue that gender-affirming medical care is analogous to other medical interventions and treatment regimens that compromise fertility, such as cancer care, and that both types of interventions need to be afforded the same medical benefits and assistance in pursuing fertility goals. Second, we argue that the lack of FP for transgender individuals contributes to the ongoing and profound transphobia and anti-trans bias that has been exacerbated in the past several years across the healthcare landscape in the United States. We argue that the provision of FP coverage for transgender individuals is necessary for clinicians and third-party payers to state their unequivocal support for TGD patients and their healthcare needs. (shrink)

While anger can derail argumentation, it can also help arguers and audiences to reason together in argumentation. Anger can provide information about premises, biases, goals, discussants, and depth of disagreement that people might otherwise fail to recognize or prematurely dismiss. Anger can also enhance the salience of certain premises and underscore the importance of related inferences. For these reasons, we claim that anger can serve as an epistemic resource in argumentation.

Clarke, Moira On the East coast of America, every 13 or 17 years, billions of red-eyed magicicadas emerge from underground. For the next few weeks every tree resounds with a near-deafening symphony, a courting ritual that has been measured at 94 decibels. Finally, the resulting offspring burrow back into the earth, there to remain inactive for the exact same duration, 13 or 17 years.

Moira Gatens investigates the ways in which differently sexed bodies can occupy the same social or political space. Representations of sexual difference have unacknowledged philosophical roots which cannot be dismissed as a superficial bias on the part of the philosopher, nor removed without destroying the coherence of the philosophical system concerned. The deep structural bias against women extends beyond metaphysics and its effects are felt in epistemology, moral, social and political theory. The idea of sexual difference is contextualised in (...) _Imaginary Bodies_ and traced through the history of philosophy. Using her work on Spinoza, Gatens develops alternative conceptions of power, new ways of conceiving women's embodiment and their legal, political and ethical status. (shrink)

Aristotle's Conception of Freedom MOIRA M. WALSH That human being is free, we say, who exists for his own sake and not for another's. ' 1. INTRODUCTION THERE IS NO PLACE in the Nicomachean Ethics, or the Politics, where Aristotle provides us with an explicit definition of freedom. Nevertheless, it is possible to glean Aristotle's notion of freedom from a series of passages in the Politics, in which Aristotle discusses such matters as the existence of the natural slave, and (...) the understanding of freedom underlying certain forms of democracy. This effort is useful insofar as it not only helps us to understand Aristotle, but also presents us with a conception of freedom interestingly different from many contemporary versions and perhaps worth our consideration. ~ The reader will notice that I deliberately retain, for the most part, the generic use of 'man' and of masculine pronouns in translating and commenting on Aristotle, a practice which cannot go without explanation in this day and age. Such terms in English convey just the same ambiguity as Aristode's Greek does when, for instance, he uses the masculine adjectives eleutheros or agathos as generic terms -- that is, they leave the reader uncertain as to whether women are considered capable of freedom or goodness in the same way that men are, with the suspicion that they are not. I do not share the opinion, apparently held by Aristotle, that members of my gender are.. (shrink)

It describes and explains the patient-centered model examining and evaluating qualitative and quantitative research. It comprehensively covers the evolution and the six interactive components of the patient-centered clinical method, taking the reader through the relationships between the patient and doctor and the patient and clinician. All the editors are professors in the Department of Family Medicine at the University of Western Ontario, London, Canada.

We compared the punitiveness of two groups following a manipulation in which participants were either able to cheat on a simple number-matching task, by taking more money then they rightfully earned, or prevented from doing so on the same task. After completing the task, participants read a number of small vignettes of politicians who had acted questionably, and then were asked to rate the scenarios on both how wrong the behavior was and how much punishment it deserved. Participants given the (...) opportunity to cheat with impunity were significantly less punitive when judging questionable behavior on the part of elected officials. (shrink)

Moira Howes and Catherine Hundleby ABSTRACT: While anger can derail argumentation, it can also help arguers and audiences to reason together in argumentation. Anger can provide information about premises, biases, goals, discussants, and depth of disagreement that people might otherwise fail to recognize or prematurely dismiss. Anger can also enhance the salience of certain premises...

Why would the work of the 17th century philosopher Benedict de Spinoza concern us today? How can Spinoza shed any light on contemporary thought? In this intriguing book, Moira Gatens and Genevieve Lloyd show us that in spite of or rather because of Spinoza's apparent strangeness, his philosophy can be a rich resource for cultural self-understanding in the present. _Collective Imaginings_ draws on recent re-assessments of the philosophy of Spinoza to develop new ways of conceptualising issues of freedom and (...) difference. This ground-breaking study will be invaluable reading to anyone wishing to gain a fresh perspective on Spinoza's thought. (shrink)

Debates about female genital mutilation/cutting have polarized opinion between those who see it as an abuse of women’s health and human rights, to be ‘eradicated’, and those who may or may not oppose the practice, but see a double standard on the part of western campaigners who fail to challenge other unnecessary surgical interventions — such as male circumcision or cosmetic surgery — in their own communities and cultures. This article interrogates these debates about FGM/c in the context of measures (...) to reduce it in the UK over recent decades. It does not suggest that FGM/c is a legitimate practice, seeing it, rather, as an abuse of women’s and children’s rights that should be combated using a combination of measures. However, it argues that reduction strategies are undermined by inconsistencies in the law and the failure to back up the law with research and education. (shrink)

Summarizes author’s contextual empiricism and uses it to analyze the difference between neuro-endocrinological accounts of presumed behavioral sex differences and neuro-selectionist accounts. Contextual empiricism is a philosophical approach that both shows how feminist critique works in the sciences and makes a contribution to general philosophy of science.

It has typically been assumed that affective and social components of disagreement, such as trust and fair treatment, can be handled separately from substantive components, such as beliefs and logical principles. This has freed us to count as “deep” disagreements only those which persist even between people who have no animosity towards each other, feel equal to one another, and are willing to argue indefinitely in search of truth. A reliance on such ideal participants diverts us from the question of (...) whether we have swept away the opportunity for some real arguers to have their voices heard, and for those voices to determine the real substance of the disagreement. If affective and social issues need to be assessed side by side with belief differences and reasoning paradigms, investigating trust may assist us to understand and make progress on the affective and social components that are involved in disagreement. (shrink)

This paper reads Deleuze through a Spinozist lens to conceive of the human being as a dynamic and complex whole in constant interchange with its environment. The author thus moves beyond philosophical dualisms, and challenges the assumption that a hierarchical normative organization is the only possible world. Using the example of rape, she argues that micropolitical strategies might disrupt and “pass” the juridical order and open up alternative, more equitable, forms of sociability.

This book concentrates on Nietzsche's major legacy as a philosopher.

Different sectors have expressed the need to address the different notions of pluralism that characterize modern society, as well as their difficulties. The article provides a critical reading of three significantly different approaches to the issue: Chantal Mouffe's On the Political, John Rawls' Political Liberalism, and William E. Connolly's Pluralism. It discusses their strengths and weaknesses, as well as the possibilities they provide to understand pluralism and take their theoretical contributions to the field of practice.

Desde diversos ámbitos se ha señalado la necesidad de abordar las nociones y difi-cultades del pluralismo que caracteriza a la sociedad actual. Se busca aportar una lectura crítica de tres abordajes considerablemente diferentes del tema: En torno a lo político (2005) de Chantal Mouffe, Political Liberalism (1996) de John Rawls y Pluralism (2005) de William E. Connolly. Se sopesan sus fortalezas y debilidades, así como las posibilidades que brindan para comprender el pluralismo y llevar los aportes teóricos a la esfera (...) práctica. (shrink)

The paper applies the theoretical frameworks of epistemic injustice and narrativist philosophy of history to read the process of re-signification of an event that took place in a prison in the city of Buenos Aires, Argentina, in 1978, called “Massacre in the Seventh Ward” or “Mutiny of the Mattresses”. By looking into this case, we explore the exercise of epistemic resistance through category expansion, drawing on the most recent developments on hermeneutical injustice as a deficiency in the application (and not (...) only in the content) of the available concepts. This allows us to identify the selected case as an example of hermeneutical injustice, and to highlight some characteristics of such injustice that remain under-analysed in the specialised literature, linked to agency, temporality, and the concrete forms adopted by resistance. Among the latter, we highlight the role that can be played by the exercise of what in philosophy of history has been called the “practical past”: an intervention in the dispute of meanings about the past, born out of an explicit commitment to the present. Finally, the conclusions present some caveats to be considered in the study of epistemic injustice in the context of institutions such as prisons. (shrink)

This book may be taken as a plea for a return to a teleological moral philosophy. Mrs Roberts examines responsibility and freedom in terms of human interests and purposes and seeks to establish the autonomy of the personal decision. F. H. Bradley's criteria for moral responsibility serves as a starting point, but Mrs Roberts finds these theoretical and remote. She builds up an account of the social context in which we learn to use words like 'responsibility', 'freedom' and 'action'. Ambiguities (...) in the use of 'action' and 'perception' are dealt with at length. (shrink)