Since his death in 1980, there has been a resurgence of scholarly interest in the life and work of Jean-Paul Sartre, as interpreters have searched for the threads that link the diverse elements of his thought. In this book, Stuart Zane Charme uses the concept of vulgarity as a key to understanding the interaction of Sartre's social background and his analysis of existential authenticity.

This book explores major theoretical issues in the study of an individual life through its focus on Jean-Paul Sartre. Sartre's quest for an "existential psychoanalysis" led him to develop what he called "true novels" in the landmark studies of Flaubert and others. In clarifying Sartre's philosophical ideas in relation to the analysis of the self, Stuart L. Charme examines the attraction/repulsion of Freudian concepts and explores parallels to Erikson's ego psychology. Certain "mythic" qualities in religious biography and autobiography are (...) seen as central to Sartre, who presents lives--including his own--as normative models. The book concludes by making a provocative link between the modern preoccupation with self-analysis in biography and autobiography and a fundamental religious need that was once fulfilled by primitive myth. (shrink)

Non‐homologous end‐joining (NHEJ) is the dominant means of repairing chromosomal DNA double strand breaks (DSBs), and is essential in human cells. Fifteen or more proteins can be involved in the detection, signalling, synapsis, end‐processing and ligation events required to repair a DSB, and must be assembled in the confined space around the DNA ends. We review here a number of interaction points between the core NHEJ components (Ku70, Ku80, DNA‐PKcs, XRCC4 and Ligase IV) and accessory factors such as kinases, phosphatases, (...) polymerases and structural proteins. Conserved protein‐protein interaction sites such as Ku‐binding motifs (KBMs), XLF‐like motifs (XLMs), FHA and BRCT domains illustrate that different proteins compete for the same binding sites on the core machinery, and must be spatially and temporally regulated. We discuss how post‐translational modifications such as phosphorylation, ADP‐ribosylation and ubiquitinylation may regulate sequential steps in the NHEJ pathway or control repair at different types of DNA breaks. (shrink)

Jean-Paul Sartre''s position on religion has traditionally been reduced to variations of his well-known atheism. This is a result of collapsing the distinction between religion and theism, as both critics and supporters of Sartre have commonly done. Consequently, attention to Sartre''s persistent and pervasive concern with religious ideas, symbols, and experiences has been neglected. While the religious implications of Sartre''s thought have mostly been considered in relation to Christian theology, other newer areas of religious studies suggest additional avenues for considering (...) Sartre. Sartre''s possible connections to four such areas are discussed: 1) Eastern religions; 2) Jewish studies; 3) feminist theology, and 4) the psychoanalysis of religion. (shrink)

Furthermore, adults with decision-making capacity, including pregnant women, can currently accept interventions with moderate net risks for themselves in other settings (e.g., open f...

We assume that acting ethically is a skill. We then use a phenomenological description of five stages of skill acquisition to argue that an ethics based on principles corresponds to a beginner’s reliance on rules and so is developmentally inferior to an ethics based on expert response that claims that, after long experience, the ethical expert learns to respond appropriately to each unique situation. The skills model thus supports an ethics of situated involvement such as that of Aristotle, John Dewey, (...) and Carol Gilligan against the detached, rationalist ethics of Kant, John Rawls, Lawrence Kohlberg, and Jürgen Habermas. (shrink)

Against the background assumptions that knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service. These evaluations were collected through (...) a quality assessment effort at our institution. Drawing from the qualitative elements of our survey instrument, we describe unexpected variations among the requests for ethics consultation and the retrospective reports from those colleagues making the requests. Focusing on just one aspect – the reason for request – raised several core questions about how we should evaluate those retrospective reports, what could be learned from the differences that we were now encountering, and what we could learn about the process of evaluating our practices. Working through these questions, we suggest several issues to consider in ongoing efforts to describe and evaluate clinical ethics consultation: the role of time and memory in evaluating retrospective evaluations, the importance of attending to the language of moral shift or disruption with which our colleagues describe their experiences, and how to understand the role of ethics consultation in creating ‘moral space’ for colleagues to process their moral experiences. (shrink)

Web scraping involves using computer programs for automated extraction and organization of data from the Web for the purpose of further data analysis and use. It is frequently used by commercial companies, but also has become a valuable tool in epidemiological research and public health planning. In this paper, we explore ethical issues in a project that “scrapes” public websites of U.S. county jails as part of an effort to develop a comprehensive database to enhance HIV surveillance and improve continuity (...) of care for incarcerated populations. We argue that the well-known framework of Emanuel et al. provides only partial ethical guidance for the activities we describe, which lie at a complex intersection of public health research and public health practice. We suggest some ethical considerations from the ethics of public health practice to help fill gaps in this relatively unexplored area. (shrink)

Volume 19, Issue 10, October 2019, Page 43-46.

Bruno and Arora (2018) present a range of important ethical issues emerging from the development of procedures for uterine transplant (UT). They approach those issues by drawing on parallels to oth...

Despite increased attention to the question of how best to evaluate clinical ethics consultations and emphasis on external evaluation, there has been little sustained focus on how we, as clinicians, make sense of and learn from our own experiences in the midst of any one consultation. Questions of how we evaluate the request for, unfolding of, and conclusion of any specific ethics consultation are often overlooked, along with the underlying question of whether it is possible to give an accurate account (...) of clinical ethics consultants’ experience as experienced by ethics consultants. Before the challenge of submitting one’s accounts or case reports for review and evaluation from others, there is an underlying challenge of understanding and evaluating our own accounts. To highlight this crucial and deeply challenging dimension of actual clinical ethics practice, we present an account of a complex consultation, explicitly constructed to engage the reader in the unfolding experience of the consultant by emphasizing the multiple perspectives unfolding within the consultant’s experience. Written in script format, the three perspectives presented—prototypical clinically descriptive account; didactically reflective and self-evidentiary account often seen in journal presentations; highly self-critical reflective account emphasizing uncertainties inherent to clinical ethics practice—reflect different manners for responding to the ways actual clinical involvement in ethics consultation practice accentuates and refocuses the question of how to understand and evaluate our own work, as well as that of our colleagues. (shrink)

BackgroundCentral to ethically justified clinical trial design is the need for an informed consent process responsive to how potential subjects actually comprehend study participation, especially study goals, risks, and potential benefits. This will be particularly challenging when studying deep brain stimulation and whether it impedes symptom progression in Parkinson’s disease, since potential subjects will be Parkinson’s patients for whom deep brain stimulation will likely have therapeutic value in the future as their disease progresses.MethodAs part of an expanded informed consent process (...) for a pilot Phase I study of deep brain stimulation in early stage Parkinson’s disease, an ethics questionnaire composed of 13 open-ended questions was distributed to potential subjects. The questionnaire was designed to guide potential subjects in thinking about their potential participation.ResultsWhile the purpose of the study (safety and tolerability) was extensively presented during the informed consent process, in returned responses 70 percent focused on effectiveness and 91 percent included personal benefit as potential benefit from enrolling. However, 91 percent also indicated helping other Parkinson’s patients as motivation when considering whether or not to enroll.ConclusionsThis combination of responses highlights two issues to which investigators need to pay close attention in future trial designs: (1) how, and in what ways, informed consent processes reinforce potential subjects’ preconceived understandings of benefit, and (2) that potential subjects see themselves as part of a community of Parkinson’s sufferers with responsibilities extending beyond self-interest. More importantly, it invites speculation that a different paradigm for informed consent may be needed. (shrink)

This paper examines structural barriers to the adoption of climate change mitigation practices and the evolution of a climate change ethic among American farmers. It examines how seed corn contracts in Michigan constrain the choices of farmers and allow farmers to rationalize the over-application of fertilizer and associated water pollution and greenhouse gas emissions. Seed corn contracts use a competitive “tournament” system where farmers are rewarded for maximizing yields. Interviews and a focus group were used to understand fertilizer over-application and (...) barriers to participating in a climate change mitigation program. Results indicate that farmers agree that they over-apply fertilizer but would be unlikely to participate in a mitigation program due to their contracts and lack of support from seed corn companies. Because only a few companies control access to the seed corn market, farmers feel they have few choices. Farmers rationalized their practices as their only option given the competitive nature of their contracts and blamed other sources of pollution. Despite increasing efforts to educate farmers about climate change, structural barriers will continue to constrain participation in mitigation efforts and the development of a climate change ethic. (shrink)

Since the concept of the living wills emerged nearly 50 years ago, there have been practical challenges in translating the concept of an advance directive into documents that are clinically useful across various healthcare settings and among different patient populations and cultures. Especially, challenging has been the reliance in most ADs on pre-selected “choices” about specific interventions which either revolve around broad themes or whether or not to utilize particular interventions, both of which about most laypersons know little and, more (...) importantly, lacking context, prove to be of limited meaningfulness. Moreover, whether by foundational frame, decade-long misunderstanding in medicine and bioethics, or different societal customs, these ADs present decision-making responsibility for initiating, continuing, or withdrawing medical interventions as a patient responsibility—creating a burden for which most patients are unprepared—and hence reducing healthcare providers’ responsibility to mere technical application or customer service. At our institution, significant efforts have focused on embracing the unique and complementary responsibilities of patients and physicians for enabling appropriate plans of care. This includes re-structuring our AD form to more accurately represent patient’s values as the frame within which physicians are responsible for determining appropriate care. Rather than specifying interventions, the AD makes patients responsible for specifying what matters to them as well as what they value in terms of function, interaction, and level of acceptable burden, thus providing clear goals for clinicians to pursue—or when goals are not reachable by available medical interventions, to acknowledge and allow for logical shifts to what may be achieved, including, in end of life contexts, care focused on respect and dignity. (shrink)

Clinical ethics consultants (CECs) work in complex environments ripe with multiple types of expectations. Significantly, some are due to the perspectives of professional colleagues and the patients and families with whom CECs consult and concern how CECs can, do, or should function, thus adding to the moral complexity faced by CECs in those particular circumstances. We outline six such common expectations: Ethics Police, Ethics Equalizer, Ethics Superhero, Ethics Expediter, Ethics Healer or Ameliorator, and, finally, Ethics Expert. Framed by examples of (...) requests for ethics consultation that illustrate each kind, along with brief descriptions, we argue that while these expectations ought to be resisted for clear and practical reasons, they also create opportunities for CECs to articulate, educate, and ultimately be responsible to the professional demands of clinical ethics work. Recognizing, acknowledging, and at times resisting those expectations thus become key activities and responsibilities in the performance of ethics consultation. (shrink)