The authors consider the legal and ethical considerations of offering a time-limited trial of a potentially non-beneficial intervention in the setting of patient or surrogate requests to pursue aggressive treatment. The likelihood of an intervention’s success is rarely a zero-sum game, and an intervention’s risk-to-benefit ratio may be indiscernible without further information (often, a matter of time).

Background: The law and literature about children’s consent generally assume that patients aged under-18 cannot consent until around 12 years, and cannot refuse recommended surgery. Children deemed pre-competent do not have automatic rights to information or to protection from unwanted interventions. However, the observed practitioners tend to inform young children s, respect their consent or refusal, and help them to “want” to have the surgery. Refusal of heart transplantation by 6-year-olds is accepted. Research question: What are possible reasons to explain (...) the differences between theories and practices about the ages when children begin to be informed about elective heart surgery, and when their consent or refusal begins to be respected? Research design, participants and context: Research methods included reviews of related healthcare, law and ethics literature; observations and conversations with staff and families in two London hospitals; audio-recorded semi-structured interviews with a purposive sample of 45 healthcare professionals and related experts; interviews and a survey with parents and children aged 6- to 15-years having elective surgery (not reported in this paper); meetings with an interdisciplinary advisory group; thematic analysis of qualitative data and co-authorship of papers with participants. Ethical considerations: Approval was granted by four research ethics committees/authorities. All interviewees gave their informed written consent. Findings: Interviewees explained their views and experiences about children’s ages of competence to understand and consent or refuse, analysed by their differing emphases on informed, signified or voluntary consent. Discussion: Differing views about children’s competence to understand and consent are associated with emphases on consent as an intellectual, practical and/or emotional process. Conclusion: Greater respect for children’s practical signified, emotional voluntary and intellectual informed consent can increase respectful understanding of children’s consent. Nurses play a vital part in children's practitioner-patient relationships and physical care and therefore in all three elements of consent. (shrink)

Since the 1980s, there has been an increasing acknowledgement of the importance of recognising the ethical dimension of clinical decision-making. Medical professional regulatory authorities in some countries now include ethical knowledge and practice in their required competencies for undergraduate and post graduate medical training. Educational interventions and clinical ethics support services have been developed to support and improve ethical decision making in clinical practice, but research evaluating the effectiveness of these interventions has been limited. We undertook a systematic review of (...) the published literature on measures or models of evaluation used to assess the impact of interventions to improve ethical decision making in clinical care. We identified a range of measures to evaluate educational interventions, and one tool used to evaluate a clinical ethics support intervention. Most measures did not evaluate the key impact of interest, that is the quality of ethical decision making in real-world clinical practice. We describe the results of our review and reflect on the challenges of assessing ethical decision making in clinical practice that face both developers of educational and support interventions and the regulatory organisations that set and assess competency standards. (shrink)

The 1960s was a decade dedicated to experimentation within the Kennedy and Johnson administrations. Americans witnessed many significant changes and advancements in those ten short years, including the first man on the moon, a war in Vietnam, and successes in the automobile industry. Probably the most important of these changes was the War on Poverty, introduced by John Fitzgerald Kennedy and continued by Lyndon Baines Johnson and subsequent administrations. This paper examines the creation of a new class of (...) reliance on government handouts, as well as a misallocation of resources.Poverty was a well-known tragedy in third world countries. It was hard to believe that the United States, a leading nation of the world, was hit just as badly as those other countries. In fact, many Americans denied the problem for fear of the reaction from the rest of the world. In reality, though, many American families were struggling every day to provide food, shelter, and education for their children. Once this devastating misfortune was acknowledged, Kennedy dedicated his 1960 campaign to the New Frontier, which would encourage Americans to regain faith in their country by implementing programs to eradicate poverty. To succeed, Kennedy knew that the key to recovery centered on education. Improved education would provide the youth with better job opportunities, which would increase productivity, and therefore decrease poverty. Unfortunately, Kennedy was unable to follow through with his plans. After he was assassinated, Johnson took office ready to expand on Kennedy’s drafted plan. He wanted to look at poverty in a more positive way, as an opportunity to effectively change society. Continuing with Kennedy’s ideas, Johnson felt this change would best be accomplished through publics works programs. In his State of the Union Address, Johnson declared a “war on poverty” in which he would provide Americans with the tools needed to escape the world of poverty and make a living for themselves.Under the provision of the Office of Economic Opportunity, created specifically to abolish poverty, programs were created to begin the process of recovery. Community action programs, the Jobs Corps, and Head Start are just three programs put into action to improve the status of the poor. Job training and education were the main functions of these programs, but the effectiveness is heavily debated amongst historians.Though many claim that the War on Poverty was indeed successful, evidence shows otherwise. In viewing statistics from Congressional Records and other government documents, it is clear that the short-term effects were not worth the long-term consequences, and had the problem of poverty been left to the natural market, the issue would have been solved much more sufficiently. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 44, no. 3. © 2018 by Feminist Studies, Inc. 699 Jennifer C. Nash The Political Life of Black Motherhood In 1976, Adrienne Rich wrote, “We know more about the air we breathe, the seas we travel, than about the nature and meaning of motherhood.”1 In the four decades since the publication of Rich’s now-canonical Of Woman Born, Andrea O’Reilly has argued for the advent of “maternal theory” (...) as an academic discipline, the maternal memoir has become a highly popular (and profitable) literary genre, and there has been sustained attention to maternal activism with scholarly analyses of such organizations as Mothers Against Drunk Driving and Mothers of the Movement.2 If Mamie Till Bradley boldly “let the world see” her son’s mutilated body in a 1955 public plea to make visible black suffering and antiblack violence, Valerie Castile’s statement after a jury found a police officer not guilty in the death of her son continued in the tradition of 1. Adrienne Rich, Of Woman Born: Motherhood as Experience and Institution (New York: W. W. Norton, 1995), 11. 2. See Andrea O’Reilly, ed., Maternal Theory: A Reader (New York: Demeter Press, 2007); Ann Hulbert, “The Real Myth of Motherhood,” Slate, March 8, 2005; Jennifer C. Nash and Samantha Pinto, “Strange Intimacies: Reading Black Mothering Memoirs,” Public Culture (forthcoming); Danielle Poe, Maternal Activism: Mothers Confronting Injustice (Albany: SUNY Press, 2016); and Ruth Feldstein, Motherhood in Black and White: Race and Sex in American Liberalism, 1930–1965 (Ithaca, NY: Cornell University Press, 2000). 700 Jennifer C. Nash Books Discussed in This Essay Revolutionary Mothering: Love on the Front Lines. Edited by Alexis Pauline Gumbs, China Martens, and Mai’a Williams. Oakland, CA: PM Press, 2016. Laboring Positions: Black Women, Mothering and the Academy. Edited by Sekile Nzinga-Johnson. Bradford, ON: Demeter Press, 2013. How All Politics Became Reproductive Politics: From Welfare Reform to Foreclosure to Trump. By Laura Briggs. Oakland: University of California Press, 2017. Birthing Justice: Black Women, Pregnancy, and Childbirth. Edited by Julia Oparah and Alicia Bonaparte. New York: Routledge, 2016. making black (male) pain visible through grief-stricken black motherhood. Castile said, My son loved this state. He had one tattoo on his body and it was of the twin cities, the state of Minnesota with “TC” on it. My son loved this city, and this city killed my son and the murderer gets away.... We’re not evolving as a civilization, we’re devolving, we have taken steps forward, people have died for us to have these rights and now we’re devolving, we’re going back to 1969.3 Her emotional plea reveals the political currency of black maternal suffering, one of the few spaces in which black pain is readily culturally visible. Indeed, there has been intensified scholarly and popular interest in representing black motherhood as both a site constituted by grief and expected loss and as a political position made visible (only) because of its proximity to death. It is certainly the case that a cultural inattention to motherhood has been replaced by an intense investment in representing at least some aspects of “the nature and meaning of motherhood” and 3. “Philando Castile’s Mother Reacts to Verdict,” Washington Post video on YouTube, posted on June 16, 2017, https://www.youtube.com/watch?v=RJsD4cCpUA. Jennifer C. Nash 701 in representing certain mothers—particularly black mothers—as symbols of trauma and injury, of pain that can be mobilized for “legitimate” political ends and social change. If, as O’Reilly suggests, maternal theory is now a distinct field, it has been fundamentally shaped by the intellectual and political labor of black feminists—Dorothy Roberts, bell hooks, Alice Walker, Patricia Hill Collins, Hortense Spillers, and Audre Lorde—who have captured the myriad ways that black maternity is cast as pathological, excessive, and marked by aberrant performances of gender and heterosexuality that threaten both the nuclear family and the heterosexual state. Drawing on a varied archive from the Moynihan Report to cultural panics about “kids having kids,” from ongoing representations of black women’s “failure” to breastfeed as a public health crisis to the racialized underpinnings of birth control, black feminist theory... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:preface This issue of Feminist Studies includes a cluster of essays that demonstrates new approaches to life writing, with special attention to unconventional women’s autobiographies. Lara Vapnek describes the historical inhibitions that shaped the self-presentation of pioneering American labor activist Elizabeth Gurley Flynn in the early twentieth century such that she omitted her sexual relationships with both women and men from her autobiographical writings. Overlapping with Vapnek’s historical focus, (...) Nora Doyle’s essay takes a new look at Gertrude Stein’s bestknown and most accessible work, The Autobiography of Alice B. Toklas, seeing it as Stein’s clever reworking of the women’s genre of domestic fiction in its pairing of a domesticated wife with a “genius” husband. In her examination of Kamala Das’s Balyakala Smaranakal (Memories of childhood), Sharmila Sreekumar discusses how the memoir’s depiction of self-deferral rather than self-realization unsettles autobiographical conventions through its troubling of the relationship between “self,” “life,” and “writing” that is constitutive of the genre. In Olga Zilberbourg’s short story, two women are baffled as they contemplate a friend’s suicide: what does it say about their own accomplishments and losses? Attention to the visual aspects of women’s lives and to their embodiment is highlighted in Estelle Carol’s memoir about her time spent as a member of the Graphic Collective of the Chicago Women’s Liberation Union in the 1970s. Corey Hickner-Johnson’s lyrical essay describes the first-person I of the poem as pushing herself to a physical extreme. Her autobiographical crisis-moment, depicted in acutely visceral and visual terms, wills into relief life’s underlying colors against a backdrop of otherwise drab monotony and disappointment. Feminist graphic artwork is discussed in Hillary Chute’s review essay on the newly popular genre of graphic novels by women. Alexandra Ketchum’s “‘The Place We’ve Always Wanted to Go But Never Could Find’: Finding Woman Space in Feminist Restaurants and Cafés in Ontario 1974–1982” and Samantha Pergadia’s “Geologies of 8 Sex and Gender: Excavating the Materialism of Gayle Rubin and Judith Butler” shift our attention away from individual life trajectories to broader sweeps of space and time. Ketchum’s history of feminist restaurants and cafes in Ontario, Canada, in the mid 1970s to early 1980s encourages us to consider the importance of space to the formation of feminist solidarities and political organizing, while Pergadia’s analysis of the geological understandings that undergird the work of both Gayle Rubin and Judith Butler invites us to rethink the temporalities through which gendered and sexed subjects, as well as academic disciplines, are formed. In closing, Ashwini Tambe reflects on the #MeToo movement and how we might fashion a more responsive public reckoning with sexual coercion. The issue leads off with Vapnek’s essay, “The Rebel Girl Revisited: Rereading Elizabeth Gurley Flynn’s Life Story.” As Vapnek details, Flynn, an activist in the Industrial Workers of the World, chronicled her life only as far as 1926. Although she envisioned women’s emancipation as an integral component of the socialist revolution, her self-censorship reveals “how communism as well as anticommunism has limited our knowledge of the feminist past.” Flynn remained committed to socialism and women’s rights and continued to agitate for social change, but her efforts to narrate her later life were stymied by internal inhibitions and external forces. For a decade she lived with another woman at a time when leftists were not open about same-sex relationships. Nor did she wish to reveal her sexual relationships with a number of men or the psychological breakdown she suffered in 1926. Joining the US Communist Party in 1936 re-energized her career as a labor organizer and resulted in her being sent to prison from 1955 to 1957 during the period of the Red Scare in the United States. By her middle age, she had experienced not only nonconventional personal relationships but also a dramatic change in her appearance: rather than the slim girl pictured on the cover of songs designed to encourage the labor movement, she was a stout, matronly woman. Inhibited from revising her autobiography to account for her later life... (shrink)

This gives Montessori teachers the knowledge, skills, and confidence to get their children independently reading, writing, playing, researching, and composing music.

Early in my college career, I was perusing the science section of my favorite bookstore in Albuquerque —the Living Batch, where the really smart hippies hung out—when my eye was caught by the spine of a little paperback called The Universe and Dr. Einstein. Priced at ninetyfive cents, it promised to be “the clearest, most readable book on Einstein’s theories ever published.” On the cover was a tantalizing portrait of a well-tanned Einstein, his wild shock of hair blowing in the (...) cosmic wind. Behind him loomed the night sky, shining with constellations and mathematics. This was clearly the man who knew the answers and they would be imparted to me, a mere humanities major, in a book that was only 118 pages long. I bought it on the spot. (shrink)

Contrary to what many philosophers believe, Calvinism neither makes the problem of evil worse nor is it obviously refuted by the presence of evil and suffering in our world. Or so most of the authors in this book claim. While Calvinism has enjoyed a resurgence in recent years amongst theologians and laypersons, many philosophers have yet to follow suit. The reason seems fairly clear: Calvinism, many think, cannot handle the problem of evil with the same kind of plausibility as other (...) more popular views of the nature of God and the nature of God's relationship with His creation. This book seeks to challenge that untested assumption. With clarity and rigor, this collection of essays seeks to fill a significant hole in the literature on the problem of evil. (shrink)

SummaryThe Gainj of highland Papua New Guinea do not use contraception but have a total fertility rate of only 4·3 live births per woman, one of the lowest ever recorded in a natural fertility setting. From an analysis of cross-sectional demographic and endocrinological data, the causes of low reproductive output have been identified in women of this population as: late menarche and marriage, a long interval between marriage and first birth, a high probability of widowhood at later reproductive ages, low (...) effective fecundability and prolonged lactational amenorrhoea. These are combined with near-universal marriage, a low prevalence of primary sterility and a pattern of onset of secondary sterility similar to that found in other populations. Of all the factors limiting fertility, by far the most important are those involved in birth spacing, especially lactational amenorrhoea. (shrink)

Under the impressive editorship of Warren Samuels et al, this book addresses the state of the history of economic thought today. An important contribution to the study of the history of economics, this eagerly-awaited book will develop an unsurprisingly large following.

What holds together the various fields that are supposed to consititute the general intellectual discipline that people now call cognitive science? In this book, Erneling and Johnson identify two problems with defining this discipline. First, some theorists identify the common subject matter as the mind, but scientists and philosophers have not been able to agree on any single, satisfactory answer to the question of what the mind is. Second, those who speculate about the general characteristics that belong to cognitive (...) science tend to assume that all the particular fields falling under the rubric--psychology, linguistics, biology, and son on--are of roughly equal value in their ability to shed light on the nature of mind. This book argues that all the cognitive science disciplines are not equally able to provide answers to ontological questions about the mind, but rather that only neurophysiology and cultural psychology are suited to answer these questions. However, since the cultural account of mind has long been ignored in favor of the neurophysiological account, Erneling and Johnson bring together contributions that focus especially on different versions of the cultural account of the mind. (shrink)

With most states now making sex offender registration information available to the public, journalists must balance their obligation to inform the public about potential dangers with respect for individuals' rights. This article examines the problems journalists face in truth telling and minimizing harm and offers suggestions for covering community notification. At minimum, we suggest journalists verify the accuracy of information received from police, make independent judgments about whether or not publication of sex offender registration information is warranted, and provide background (...) information on the scope and effectiveness of community notification in their areas. (shrink)

This chapter presents a synopsis of the historical evidence concerning the expansion of slavery and the trade in ivory during the Turco-Egyptian era in the Sudan between 1820 and 1881, and a description of the results of recent and very preliminary archaeological investigations at three sites associated with this trade around the town of Rumbek in Lakes State, South Sudan. The chapter begins with a brief review of the establishment of Ottoman rule in Egypt, before moving on to consider the (...) broader geopolitical forces that gave rise to the decision by the Egyptian Khedive, Mehmed Ali, to invade Sinnar, Kordofan and adjacent areas of northern Sudan. It then discusses the economic consequences and legal changes following the establishment of Turco-Egyptian rule that helped create the conditions for the expansion of slaving expeditions into southern Sudan and the establishment of a series of fortified camps or zaribas in these areas. (shrink)

This is the Second Edition of a well-received book that reflects a fresh, integrated coverage of the concepts and scientific measurement of stress and welfare of animals including humans. This book explains the basic biological principles of coping with many forms of adversity. The major part of this work is devoted to explaining scientifically usable concepts in stress and welfare. A wide range of welfare indicators are highlighted in detail with examples being drawn from man and other species. The necessity (...) for combining information from disciplines is emphasized with a one-health, one-welfare approach. This information forms the basis for a synthesis of new ideas. Among the issues covered are: - How brain and body systems regulate using feelings, physiological responses, behaviour and responses to pathology - Limits to adaptation - Assessing positive and negative welfare during both short-term and long-term situations - Ethical problems and suggested solutions A proper assessment of animal welfare is essential to take informed decisions about what is morally acceptable in terms of practice and in the development of a more effective legislation. This work encapsulates a very wide body of literature on scientific aspects of animal welfare and will thus prove a valuable asset for animal welfare scientists, psychologists, students and teachers of all forms of biology, behaviour, medicine, veterinary medicine and animal usage. (shrink)

Theories of a new phase of earth history, the Anthropocene, position human world-making activity as a bio-geological force. Social interventions into earth systems have been extensive and malignant, altering the earth’s surface, atmosphere, oceans, and systems of nutrient cycling. To adapt and respond to emerging planetary dangers requires the collaboration of scholars from many different disciplines. In this paper, I argue that a coalition of the arts and sciences might draw upon György Márkus’s extensive studies of the topography of ‘high’ (...) culture. I reconstruct Márkus’s conceptual map of the arts and sciences as regions of ‘high’ cultural activity, each with their own criteria of value yet subject to an integral unity and shared ambition. Both regions of ‘high’ culture aim to create original works of significance for an engaged public. I then examine the implications of Márkus’s claim that the classical vocation of robust, public-oriented culture has run aground. The field of problems that this paper traverses are not the ecological crises of the Anthropocene per se. I attend rather to Márkus’s account of the neoliberal erosion of cultural infrastructure where democratic publics might engage with such problems. (shrink)