The concept of the sick role entered sociology in 1951 when Talcott Parsons creatively separated the sick person out of the doctor–patient dyad. The idea became fundamental in the subdiscipline of medical sociology. By the 1990s, the concept had almost disappeared from the research literature. Beyond the generational and theoretical changes that explain how the sick role idea could become irrelevant or unnecessary to sociologists, there were two immediate factors: the negative politicization of the concept (...) and the shift of medical sociologists to a focus on applied health behavior. In the later, fragmented discipline of sociology, final, total abandonment was still uncertain. (shrink)

Parsons’ sick role concept has become problematic in the face of the increased significance of chronic illnesses and the growing emphasis on lifestylecentred health promotion. Both developments de-limit the medical system so that it extends into the world of health, fundamentally changing the doctor-patient relationship. But as the sick role is firmly based on the reciprocities of a resiliently capitalist achievement society it still informs normative expectations in the field of health and illness. The precarious social (...) position of chronic patients between being governed by and being consumers of medicine, I will argue, can only be adequately understood if one involves, as Parsons did, the moral economy surrounding health and illness. (shrink)

Recovery from a range of common medical conditions requires patients to have the will to change their behaviour. The authors argue that the proper recognition of the role of willpower in recovery is necessary for effective treatment.

This article examines factors related to husbands' contribution to housework when their wives become newly impaired. Data are from a sample of 319 married couples who participated in the National Survey of Families and Households, and in which wives developed physical limitations between baseline and five-year follow-up interviews. Using ordinary least squares regression, we found that husbands who have egalitarian attitudes toward marital roles and are happy in their marriage at baseline do more housework at follow-up than husbands who are (...) traditional and/or are less happy. Given the slow rate of change in household division of labor, the lack of public policies to support people with impairment and family caregiving disproportionately burdens women. (shrink)

This study examined the challenges for supervisors and managers of managing sick leave within a New Zealand university. We used a qualitative research design, interviewing 20 university staff across the academic and service divisions who had managerial roles. We applied Habermas’ distinctions of technical instrumental, practical relational, and emancipatory critical transformative interests, and his twofold distinction of system and lifeworld to our analysis. The primary findings suggest that while the technical instrumental discourses were dominant within the university bureaucracy, managers (...) drew upon practical relational and emancipatory critical transformative discourses to justify the considerable discretion they exercised in managing sick leave. Far from being incidental, these humanistic elements are as much a part of the bureaucracy as the rational elements and are fundamental to the system’s equilibrium. (shrink)

This paper argues that new light may be shed on mathematical reasoning in its non-pathological forms by careful observation of its pathologies. The first section explores the application to mathematics of recent work on fallacy theory, specifically the concept of an ‘argumentation scheme’: a characteristic pattern under which many similar inferential steps may be subsumed. Fallacies may then be understood as argumentation schemes used inappropriately. The next section demonstrates how some specific mathematical fallacies may be characterized in terms of argumentation (...) schemes. The third section considers the phenomenon of correct answers which result from incorrect methods. This turns out to pose some deep questions concerning the nature of mathematical knowledge. In particular, it is argued that a satisfactory epistemology for mathematical practice must address the role of luck. (shrink)

Due to the confinement imposed by the COVID-19 pandemic situation, companies adopted remote work more than ever. The rapid rise of remote work also affected local life and many employers introduced or extended their telework activities because of the associated advantages. However, despite the evident positive benefits, some employees were pressured to work remotely while ill. This evidence brought new challenges to the presenteeism literature. This article investigates how individual, economic/societal, and organizational/sectorial/supervisory-related variables can moderate the role of a (...) contagious disease, such as the COVID-19, in explaining presenteeism behavior. Moreover, the current research presents a multi-level conceptual model to describe how a new construct of remote-work presenteeism behavior mediates the relationship between different post pandemic health conditions and future cumulative negative consequences. The authors suggested that the widespread pervasive adoption of remote work because of COVID-19 has important implications for the presenteeism literature and opens avenues for further research. (shrink)

Intensive care units provide focused, aggressive medical intervention to critically ill patients. Physicians responsible for ICU triage must decide which patients are sick enough to require this level of care and which can be managed on the general wards. While some patients are too well for the ICU, intensivists increasingly rely on another category, “too sick to benefit,” when denying ICU admission, even if beds are readily available. Recent studies indicate that between 19 and 37 percent of patients (...) refused ICU admission were declined because they were thought too sick to benefit from it, suggesting that physician use of this category is common in ICU triage.The idea of being too sick to benefit may seem paradoxical given that ICUs exist to treat the sickest of the sick. There is, however, increasing awareness that some diseases progress despite maximal intervention. Although there have been systematic attempts to define these diseases—most notably during the medical futility debates of the 1980s and early 1990s—there is little evidence about which conditions make a patient too sick to benefit from ICU admission. In the absence of a clear understanding of which diseases progress despite maximal care, ICU triage under the category “too sick to benefit” is currently done on a case‐by‐case basis. Contemporary decisions about who is too sick to benefit thus raise a number of ethical issues about what constitutes standard of care, the role of health care providers' judgments of quality of life in triage, and the just allocation of resources.Addressing these ethical concerns requires us to better define the population of critically ill adults who are too sick to benefit—a conceptual and empirical project. In this article, I recommend employing a diagnostic concept from the neonatal literature: namely, a lethal disease. (shrink)

The relations of power between healthcare-related institutions and the professionals that interact with them are changing. Generally, the institutions are gaining the upper hand. Consequently, the intellectual abilities necessary for professionals to pursue the internal goods of healthcare are changing as well. A concrete case is the struggle over sickness benefits in Sweden, in which theSwedish Social Insurance Agency(SSIA) and physicians are important stakeholders. The SSIA has recently consolidated its power over the sickness certificates that doctors issue for their patients. (...) The result has been a stricter gatekeeping of sickness benefits. In order to combat the inroads made by state institutions into sickness certification, and into the sphere of medical practice, some doctors have developed cunning “techniques” to maximize the chance to have their sickness certificates accepted by the SSIA. This article attempts to demonstrate that cunning intelligence—the ability of the weak to “outsmart” a stronger adversary—plays an important role in the practice of medicine. Cunning intelligence is not merely a defective form of prudence (phronesis), nor is it simply an instance of instrumental reason (techne), but rather an ability that occupies a distinct place among the intellectual abilities generally ascribed to professionals. (shrink)

The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate, however, VR content also plays a significant role. The primary objective of this systematic review and meta-analysis was to examine the literature on HMDs that report Simulator Sickness Questionnaire (SSQ) scores to determine the (...) impact of content. User factors associated with VR sickness were also examined. A systematic search was conducted according to PRISMA guidelines. Fifty-five articles met inclusion criteria, representing 3,016 participants (mean age range 19.5-80; 41% female). Findings show gaming content recorded the highest total SSQ mean 34.26 (95%CI 29.57-38.95). VR sickness profiles were also influenced by visual stimulation, locomotion and exposure times. Older samples (mean age ≥35 years) scored significantly lower total SSQ means than younger samples, however, these findings are based on a small evidence base as a limited number of studies included older users. No sex differences were found. Across all types of content, the pooled total SSQ mean was relatively high 28.00 (95%CI 24.66-31.35) compared with recommended SSQ cut-off scores. These findings are of relevance for informing future research and the application of VR in different contexts. (shrink)

This paper discusses the accounts given of the nature of religious affectivity by Nietzsche, Otto and Bataille and pursues their shared claim as to the primacy of the affective dimension of religion over its conceptual, doctrinal and moral elements and to the development of a religious critique of Christianity. The first section clarifies the nature of Nietzsche’s religiosity and reconstructs his critique of Christianity from this perspective. In subsequent sections Nietzsche’s critique of Christianity is compared to both Otto’s critical defence (...) and Bataille’s ‘Nietzschean’ critique of it. Three themes are proposed as evaluative criteria for the comparative evaluation of the three thinkers undertaken. Firstly, the task of rethinking the nature of religious affectivity in ‘impersonalist’ or ‘a-subjective’ terms. Secondly, the role of the notion of ‘immanence’ in both the rethinking of transcendence given the demise of the transcendent and in a reconceiving of the critique of religion in general, and Christianity in particular, in non-oppositional terms. Thirdly, the question of the ‘autonomy of religion’ not only in relation to the ‘theoretical’, ‘moral’ and ‘aesthetic’ domains but also, ultimately, to the ‘human’ itself. In short, the thinkers considered are evaluated in terms of what they seek to formulate, namely, a radically non-anthropomorphic conception of religion. It is argued that only Bataille attains to both senses of ‘immanence’ identified in the paper in his development of a non-transcendent notion of transcendence and a critique of Christianity that finds suppressed ‘traces’ of the impersonal and a-moral force of the ‘sacred’ operative within it. (shrink)

In The Sickness unto Death, Kierkegaard describes selfhood as an achievement, specifically claiming that the self’s task ‘is to become itself’ (SUD, 29/SKS 11, 143). But how can one can become who or what one already is, and what sort of achievement is it? This chapter draws on the work of Christine Korsgaard, another philosopher who sees selfhood as an achievement, using her notion of practical identity to explore Kierkegaard’s accounts of the structure of the self and of selfhood as (...) achievement. Kierkegaard’s treatment of selfhood—as aspirational and, if undertaken well, appropriately grounded in one’s facticity (i.e. the concrete facts of one’s situation)—suggests how consciously endorsed identities can guide (or fail to guide) our agency. Having a practical identity involves striving to inhabit adopted roles by aligning our actions with relevant normative demands, but also sometimes embracing and consciously adopting identities already tacitly guiding our engagement with the world. This framework also suggests several ways we can be alienated from desires, actions, or, more generally, our selves. Putting Kierkegaard in conversation with contemporary agency theory, this chapter has two guiding lines of inquiry. First, what does it mean to achieve selfhood and how can the notion of practical identity illuminate or be illuminated by this question? Second, how can this analysis clarify the experience of not being oneself, whether resulting from self-deception, self-ignorance, or the potentially frustrating gap between who one is and who one wants to be? (shrink)

The main aim of the present study was to examine whether an ethical organizational culture is associated with sickness absence in a Finnish public sector organization at both the individual and work unit levels. The underlying assumption was that employees working for organizations that are characterized by a strong ethical organizational culture report less sickness absence. The sample consisted of 2192 employees from one public sector city organization that included 246 different work units. Ethical organizational culture was measured with the (...) Corporate Ethical Virtues scale covering eight sub-dimensions. Sickness absence was inquired by asking the participants to report how many days they had been absent from work because of their own sickness over the past year. Multilevel structural equation modelling showed that, at the individual level, perceptions of a strong ethical organizational culture were associated with less sickness absences after controlling for the background factors. This link was not found at the work-unit level. The findings indicate that an ethical organizational culture plays a significant role in enhancing employee well-being measured as sickness absence. It seems that especially supervisor’s ethical role modeling and possibilities to discuss about ethical issues are important factors in preventing sickness absence in the organizations. (shrink)

The purpose of this cross-sectional study was to examine whether psychosocial working conditions may be a mediator between indoor physical working conditions and the type of vague general health symptoms included in the diagnosis of sick building syndrome (SBS). The study was based on survey data from 1505 British white-collar workers from 20 different organizations. A path analysis revealed that there was a significant direct relation between physical working conditions and vague symptoms and also psychosocial job strain (Effort-Reward Imbalance (...) ratio), which in turn also strongly related to the vague symptoms. The findings thus suggested a mediating role between physical working conditions and symptoms for psychosocial job strain. Due to the cross-sectional study design no conclusions on causality can be drawn. (shrink)

Selection pressure from health risk is hypothesized to have shaped adaptations motivating individuals to attempt to become valued by other individuals by generously and recurrently providing beneficial goods and/or services to them because this strategy encouraged beneficiaries to provide costly health care to their benefactors when the latter were sick or injured. Additionally, adaptations are hypothesized to have co-evolved that motivate individuals to attend to and value those who recurrently provide them with important benefits so they are willing in (...) turn to provide costly care when a valued person is disabled or in dire need. Individuals in egalitarian foraging bands can provide a number of valuable benefits, such as defense, diplomacy, food, healing, information, technical skill, or trading savvy. We therefore expect that humans have evolved psychological mechanisms motivating the pursuit and cultivation of a difficult-to-replace social role based on the provisioning of a benefit that confers a fitness advantage on its recipients. We call this phenomenon social niche specialization. One such niche that has been well-documented is meat-sharing. Here we present cross-cultural evidence that individuals cultivate two other niches, information and tool production, that serve (among other things) to buffer health risk. (shrink)

One of the best-known principles of halakha is that Shabbat is violated to save a life. Who does this saving and how do we know that a life is in danger? What categories of illness violate Shabbat and who decides? A historical-sociological analysis of the roles played by Jew, non-Jew, and physician according to the approach of “medical cosmology” can help us understand the differences in the approach of the Shulchan Aruch compared to later decisors (e.g., the Mishnah Berurah). Such (...) differences illuminate how premodern medical triage coexisted with a different halakhic understanding than that of the biomedical age. (shrink)

This article explores ‘the politics of sentimentality’ with specific reference to the documentary film Sick, which represents the narrative of a young lesbian woman, Ana, who was confined in a psychiatric hospital in Croatia and ‘treated’ for her homosexuality. We consider the ways our most intimate emotional relationships and states, such as pain and suffering, articulate with a wider context of familial citizenship and critically examine the political limits of compassion within the sentimentalised public sphere. In this analysis, we (...) problematise the film’s emotional logic, which presents an individualised narrative resolution at the expense of dwelling on the political question of institutional violence. We examine the role that politics of sentimentality plays in neutralising the film’s political critique of the state apparatuses that enforce heterosexual norms. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.3 (2003) 225-226 [Access article in PDF] Travelers in the Land of Sickness Eric J. Cassell THE PROBLEM OF knowing another person and the world in which that person lives, particularly someone with major mental illness, is addressed in this interesting and rich essay. The number of different metaphors and concepts Potter employs to describe the task of crossing into and then understanding the thoughts, (...) emotions, symptoms, constraints, context, and perspectives of another testifies to the difficulties involved.Yet, as I read the essay, it was not clear what the clinician world traveler, moral tourist, empathizer (and other categories) is supposed to do on the journey to another person. Why do we reach out to the sick person? What is it that we want to know or do that makes this trip necessary? Potter is primarily concerned with mental illness—the examples she cites are patients with schizophrenia—while my experience has in the main been with persons with physical illness, but for the moment, the differences are less important than the central lesson. The illness that the patient presents—the experience of the symptoms, the impairments, disability, and disruptions of the emotional and social existence that happen because of the disease result from an amalgam of the disease process with the specific nature of the sick person. There is no disease in pure form; there is no disease in abstract for clinicians. There is only this sick person. She correctly quotes me, because of all this, as pointing out the importance of integrating knowledge of this particular patient with the abstract knowledge of disease to understand the illness as it is expressed in this person. All to form a basis for the treatment of the patient and especially to help relieve suffering because suffering is always personal, particular, and individual. (It is important in thinking about this topic to remember that most serious diseases, psychiatric and otherwise, are chronic and take place over significant lived time. The acute schizophrenic symptoms or the acute infectious diseases, as dramatic as they are, distract attention from the importance of the place of the sick person.)In physical disease, our long (and continuing) history of separating human beings from nature and the body, and the importance medicine places on objectivity and the objective, have made the inevitable personalization of the disease and symptoms virtually invisible. After ages of explaining psychiatric diseases as the alienation of the person, and a long psychoanalytic period of finding their origins in the person, in the last 30 years these diseases have become increasingly objectified. The place of the person has been diminished as psychiatry has entered the DSM, neurotransmitter, and effective psychotropic drug era. For both physical and mental disease, however, and whatever the current ideology, the nature of person is crucial in determining the onset, diagnosis, course, treatment, and outcome of each illness. It is in order to have an impact on these crucial aspects of sickness that clinicians must come to know their patients to the degree possible. [End Page 225]But there is something more. Nancy Potter quotes a woman with schizophrenia as saying, "All that was my former self has crumbled and fallen together and a creature has emerged of whom I know nothing. She is a stranger to me... She is not real—she is not I... She is I—and because I still have myself on my hands, even if I am a maniac, I must deal with me somehow." (Potter, 2003, p. 215)Must she deal with this crazy self alone? Is that not what her doctors and caregivers are for? But how can they take care of her, protect her, keep what is left intact, and sustain her until she is (hopefully) better without knowing who she is? She makes clear in those few phrases that inside her there is a person with a past, a family, a world, a culture, a role(s) in life, relationships, a body, dreams for the future, things she does, and all the other things that make up a person. It is in... (shrink)

During the Nazi regime (1933–1945), more than 300 000 psychiatric patients were killed. The well‐calculated killing of chronic mentally ‘ill’ patients was part of a huge biopolitical program of well‐established scientific, eugenic standards of the time. Among the medical personnel implicated in these assassinations were nurses, who carried out this program through their everyday practice. However, newer research raises suspicions that psychiatric patients were being assassinated before and after the Nazi regime, which, I hypothesize, implies that the motives for these (...) killings must be investigated within psychiatric practice itself. An investigation of the impact of the interplay between the notes left by nurses and those by psychiatrists illustrates the active role of the psychiatric medical record in the killing of these patients. Using theoretical insights from Michel Foucault and philosopher Giorgio Agamben and analyzing one part of a particularly rich patient file found in the Langenhorn Psychiatric Asylum in the city of Hamburg, I demonstrate the role of the record in both constructing and deconstructing patient subjectivities. De‐subjectifying patients condemned them to specific zones in the asylum within which they were reduced to their ‘bare life’‐ a precondition for their physical assassination. (shrink)

According to the literature, the family is now considered to be the most important resource for the care and support of a sick family member. Families are being increasingly invited and trained to play a utilitarian role, not just as family caregivers, but as healthcare agents. Healthcare institutions, based on neoliberal health policies, are encouraging them to perform increasingly complex and professionalized tasks. The burden associated with this expanded healthcare function, however, is significant (fatigue, emotional distress and exhaustion). (...) The aim of this article was to present French sociologist Jacques Donzelot's theoretical perspective on governing through the family. According to Donzelot, such a government is exercised through various power techniques, including the instrumentalization of the family role and the transfer to families of the responsibility for health care. This author describes how healthcare institutions call on the family to perform hospital and biomedical practices within the home. A spin‐off of neoliberalism, the practices of governing through families specifically target women, who are considered to be the pillar of the family. Donzelot's perspective is very relevant to nursing, but is still rarely mobilized in the discipline. His critical perspective allows for a re‐reading of relations of power and mechanisms of surveillance and control of families, issues that are often overlooked in nursing research. (shrink)

I became a philosopher because I was fascinated by the ethics of abortion. Not only is abortion a crucial practical issue – a matter of life or death – but it forces us to grapple with some of the hardest and yet most significant philosophical questions: If we agree that all human beings have a right to life, what entities do we count as human beings? What characteristics, if any, are necessary? What happens when one entity’s life clashes with another’s (...) bodily integrity? What are the roles of responsibility, consent and fore-knowledge? (shrink)

This paper examines the concept of empowerment and how it relates to nursing. It notes that empowerment is a concept used to describe most human activities. The fact that empowerment applies to almost any activity denotes its ambiguity rather than its parsimony. To clarify the concept a definition is offered together with some suggestions for its origin. Some examples of empowerment programmes are given, including the Freirian empowerment philosophy that has had a profound effect in Brazil. The paper then focuses (...) on nursing and discusses whether or not nursing can empower patients. It is argued that nursing cannot empower patients, at least at the present time. Two specific problems are identified as the main reasons why nursing cannot empower patients. It is argued that the first problem or reason is a philosophical one explored using the philosophy of existentialism. The second problem is the nurse–patient interaction and the psychological dynamics involved within such interaction. For example, the continued use of the term ‘patient’ by nurses and other healthcare professionals is seen as militating against empowerment. This is because of the traditional conception of a patient, which invariably assumes not only the patient's sick role but also the passivity associated with being a patient. Furthermore, the hierarchical nature of the profession makes it difficult to empower others. The paper examines some research studies related to patient empowerment. The findings suggest there are problems and some of them stem from the hierarchical and authoritarian nature of nursing. The paper concludes by suggesting ways by which the ideals of patient empowerment may be turned into reality. (shrink)

BackgroundKnowledge about the psychosocial experiences of sick-listed workers in the first months of sick leave is sparse even though early interventions are recommended. The aim of this study was to explore psychosocial experiences of being on sick leave and thoughts about returning to work after 8–12 weeks of sickness absence.MethodsSixteen individuals at 9–13 weeks of sick leave participated in semi-structured individual interviews. Data was analyzed through Giorgi’s descriptive phenomenological method.ResultsThree themes emerged: energy depleted, losing normal life, (...) searching for a solution. A combination of health, work, and family challenges contributed to being drained of energy, which affected both work- and non-work roles. Being on sick leave led to a loss of social arenas and their identity as a contributing member of society. Participants required assistance to find solutions toward returning to work.ConclusionEven in this early stage of long-term sick leave, sick listed workers faced complex challenges in multiple domains. Continuing sick leave was experienced as necessary but may challenge personal identity and social life. Those not finding solutions may benefit from additional early follow-up that examine work-related, social and personal factors that influence return to work. (shrink)

SummaryMalaria is a major cause of under-five mortality in Mali and many other developing countries. Malaria control programmes rely on households to identify sick children and either care for them in the home or seek treatment at a health facility in the case of severe illness. This study examines the involvement of mothers and other household members in identifying and treating severely ill children through case studies of 25 rural Malian households. A wide range of intra-household responses to severe (...) illness were observed among household members, both exemplifying and contravening stated social norms about household roles. Given their close contact with children, mothers were frequently the first to identify illness symptoms. However, decisions about care-seeking were often taken by fathers and senior members of the household. As stewards of the family resources, fathers usually paid for care and thus significantly determined when and where treatment was sought. Grandparents were frequently involved in diagnosing illnesses and directing care towards traditional healers or health facilities. Relationships between household members during the illness episode were found to vary from highly collaborative to highly conflictive, with critical effects on how quickly and from where treatment for sick children was sought. These findings have implications for the design and targeting of malaria and child survival programming in the greater West African region. (shrink)

By comparing Pierre Klossowski’s works on Nietzsche and the Marquis de Sade, the paper attempts to clarify his understanding of the part played by the ‘bodily remainder’ in recruiting a following of readers to their texts. Klossowski’s designation of the ‘simulacrum’ of eternal return in Nietzsche’s philosophy is compared with his account of the role played by sodomy in Sade’s writings. Klossowski contends that, through these figures, a bodily contagion, is communicated to the reader, but esoterically: that is, only (...) to a select few, whose bodies can replicate the impulses that the text conceals. Ultimately, what Klossowski’s interpretations of Nietzsche and Sade achieve, however, is the dissimulation of identity, as well as of a decisive difference between the reader and the philosopher whom she reads. (shrink)

I am lying on a small table in a tiny room, dizzy with nausea and apprehension. A young woman busies herself with the preparations of a plaster mold that will be used to position my arm and chest for the twenty five ‘shots’ of radiotherapy that I will undergo during the ensuing five weeks. I had called the hospital that morning to say that I was too sick to come for this appointment. I had better come, said a young (...) man from the department, because if I missed this appointment I would I might not get a new appointment in time start the treatments within the recommended time frame. So I am here, on the table. I mention the nausea to the technician. My apprehension at this moment is that I might become so dizzy as to somehow swirl out of control. The young woman gives me a mask to blunt the smell of the plaster. The procedure will take twenty-five minutes. I keep my mind focused on each breath and get through the ordeal breath by breath. She seems, in contrast to me, gloriously free of distress and worry, listening to the radio while she works. I envy her good fortune. As we finish up the procedure I take a chance and share my experience: I say that being a cancer patient can be tricky because you are sometimes utterly in the grip of the idea that the cancer will spread and you’ll die soon and in a very unpleasant way. After each round of chemo I was admitted to hospital for extreme nausea and dehydration. During those days in the cancer ward some of those who were dying called out and moaned distressingly, sometimes for hours, during the night. I was, at those moments, unable to shake off the belief that I too would be in that state within a few months. The signs of cancer had been missed on the mammogram two years earlier and, when the lump made itself evident, I was in Stage III. When I mentioned this experience of being gripped by the idea of death she said “Oh I know exactly what you mean, my mother has breast cancer, and every time she has an examination I go searching the internet to find out what I can.” This young woman was twenty four, and I fifty six at the time, and she had given me an unexpected small precious gift that I took with me out of that little cupboard of a room.. (shrink)

The referral of a patient for subspecialty consultation and examination is but one facet of the primary care physician's involvement with his patient. Using examples from my practice, I argue that the term “gatekeeper” is an inadequate term for describing what the primary care physician does, or should do, for his patient. “Virgil Role” is offered as an alternative expression based on a proposed parallel between Dante's passage through the Inferno accompanied by his mentor-guide, Virgil, and a sick (...) person's journey through his personal Hell of illness and the labyrinthine medical care system, guided by his physician. (shrink)

This paper uses the concept of causal stories to explore how death, sickness and misfortune lead to accusations of sorcery or witchcraft. Based on empirical research in Papua New Guinea, we propose a new analytical framework that shows how negative events may trigger particular narratives about the use of the supernatural by individuals and groups. These narratives then direct considerations about the cause of the misfortune, the agent who can heal it, and the appropriate response from those affected by the (...) misfortune. We also categorise the factors that attract people towards magical causal narratives or towards competing non-magical causal narratives. We situate our analysis within a context of worldview pluralism, where individuals possess multiple worldviews, such as a magical worldview or a scientific worldview. We argue that causal stories operate to activate the dominance of one worldview or a combination of worldviews in given circumstances. Our theoretical contribution may be extended to discrimination and violence against those suffering from health-related stigma, as this too gives rise to competing causal stories that either take hold or are ignored depending upon diverse factors. (shrink)

In this analysis of the Iran-Iraq war, Sick asserts that two major naturally wealthy regional powers consciously chose to forego diplomatic means to resolve their disputes.

In letter 7.24 Pliny provides his readers with a character sketch of the elderly matriarch of a distinguished and wealthy Italian family-Ummidia Quadratilla. Ummidia passed her later years as a fan of the theater; specifically, "she had pantomimes." Pliny disapproves of the shows presented by these performers, and he chastises Ummidia for her interest in pantomime. In fact he views her conduct as symptomatic of a vice among women in general: "I have heard that she herself used to relax her (...) mind with checkers or watch her pantomimes, as women do in the idleness of their sex." We should not be surprised by these comments; there was a tradition of ambivalence among the Romans toward the professions of the theater, and when women became involved with these professions, the ambivalence could turn to contempt. Given the general disposition of Roman males toward pantomime and women, modern readers should not so readily accept Pliny's assessment. By training her slaves as pantomimes, Ummidia was greatly increasing their value. From numerous ancient sources we know that the monetary value of slaves trained in the theatrical professions was among the highest accorded any slave. Moreover, because of Ummidia's endowment of a theater in her native Casinum and the performance of Ummidia's pantomimes in public games, we might say that she was the manager of a small "theatrical empire." Finally, because of the great interest in pantomime on the part of the masses and the desire of the upper classes, including members of various imperial families, to soothe these masses with games, control of popular pantomimes might have given Ummidia access to limited political power. (shrink)

In his book, Wizard of the Crow ( 2007 ), the renowned Kenyan novelist, Ngugi wa Thiong’o, expresses the view that a successful society is only guaranteed when women issues are well settled. In light of post-colonial Africa and the era of COVID-19, African women – like the biblical Miriam, the co-liberator with Moses and Aaron (Mi 6:4) – are seen as Nyawiras (plural for Nyawira, the hardworking woman), as their critical role in preserving the family and society is (...) evident. While relying on a critical review of wa Thiong’o’s works and in engaging a selected religio-cultural literature, the article seeks to explore the role of African women [ Nyawiras ] in societal sustenance. With postcolonial Africa encountering a hotchpotch of challenges, are Nyawiras the best suited persons to deconstruct the status quo and eventually reconstruct the ‘sick’ society under greedy-grabbing male-leaders of nation-states (Aburirias) that have lost their moral compasses? Are women best suited to bring back sanity; and have they crossed the Rubicon in the 21st century? In drawing from diverse examples from Africa and beyond, the research article will be significant in helping the modern African society understand the myriad of problems they are facing in the local and global scene, and eventually appraise women’s heroine roles. Contribution: This research uses a multi-disciplinary approach and engages a dialogue between African literature and Africa’s religio-cultural discourses in order to better understand the complex situation facing Africa. (shrink)

I argue that Fichte (rather than Kant or Hegel or some amalgam of the two) was the primary historical model for the ethical standpoint described in Kierkegaard's Either/Or II. I then explain how looking at Kierkegaard's texts with Fichte in mind helps in interpreting the criticism of the ethical standpoint in works like The Sickness unto Death and Concluding Unscientific Postscript, as well as the significance of the discussion of secular ethics in Fear and Trembling. I conclude with a brief (...) look at the relevance for contemporary Kantian ethics of Kierkegaard's characterization and his criticism. (shrink)