Philosophers are drawn to the Atomic Theory like a dog to an old shoe, but my results about realism and anti-realism in Tracking Truth, and the distinctive position I have carved out on their basis, are independent of the fate of my comments about that historical case. I will defend those comments against Stanford’s objections below, but first I will explain the argument of my chapter, because its results undermine not only historically important antirealist positions, but also the approach via (...) unconceived conceivables that Stanford’s criticisms (and his pessimistic induction) depend on. The issue is claims about equal evidential support that empiricist defenses of epistemological anti-realism, including Stanford’s, must and do appeal to. In Chapter 6 of Tracking Truth, I show that the best known probabilistic definitions of evidential support imply the anti-realist’s key equalsupport claims are either false or inconsistent with the view he wants to base on them. There are reasons to think that it is not even possible to define a probabilistic notion of support that will do the job the anti-realist needs. It follows from this, as I explain below, that the anti-realist has not defended the claim that we are in principle, or even probably, unable to confirm high-level theories – for this, I say, we must wait and see, and make our best estimates. This, and my claim that we have actually gotten beyond observables – a point made with pregnancy tests and tests for medical conditions – make room for realism. I do not endorse the kind of realist claim that says we generally have a right to believe our successful hypotheses that go beyond observables. Some successful hypotheses are better confirmed than others, and some are not at all. However, since the anti-realist’s general skeptical arguments fail, I also do not think we need such general claims in order to have a right to confidence in those particular hypotheses for which we do have good evidence. I call my approach to the epistemological realism-anti-realism debate “evidential.” The nub of the issue between the two camps has always been whether we have a right to believe our scientific theories – in some sense that includes at least some of their claims about unobservable matters – on the basis of our evidence.1 Answers to this question depend on what our evidence actually is, and on the definition or criteria for evidential support.. (shrink)

Evidentialist views in epistemology, like that of Earl Conee and Richard Feldman, define epistemic justification at least partially in terms of evidential support. According to these views, a person is justified in believing a proposition p just when her evidence supports p. The subject of this dissertation is the evidential support relation at the heart of these views—viz., the relation which obtains between a person’s evidence e and a proposition p just when e supports p in the sense (...) required by these views. I engage three initially tempting accounts of this relation in terms of meta-attitudes, explanatory relations, and probabilistic relations, finding all three accounts wanting. I then propose a fourth, causal account. My thesis is that evidentialists like Conee and Feldman should find this causal account of the evidential support relation more attractive than the other three kinds of account. (shrink)

We agree with Penn et al. that our human cognitive superiority derives from our exceptional relational ability. We far exceed other species in our ability to grasp analogies and to combine relations into higher-order structures (Gentner 2003). However, we argue here that possession of an elaborated symbol system is necessary to make our relational capacity operational.

Science museums aim to provide educational experiences for both children and adults. To achieve this goal, museum displays must convey scientifically-relevant relationships, such as the similarities that unite members of a natural category, and the connections between scientific models and observable objects and events. In this paper, we explore how research on comparison could be leveraged to support learning about such relationships. We describe how museum displays could promote educationally-relevant comparisons involving natural specimens and scientific models. We also discuss (...) how these comparisons could be supported through the design of a display—in particular, by using similarity, space, and language to facilitate relational thinking for children and their adult companions. Such supports may be pivotal given the informal nature of learning in museums. (shrink)

We present five experiments and simulation studies to establish late analogical abstraction as a new psychological phenomenon: Schema abstraction from analogical examples can revive otherwise inert knowledge. We find that comparing two analogous examples of negotiations at recall time promotes retrieving analogical matches stored in memory—a notoriously elusive effect. Another innovation in this research is that we show parallel effects for real‐life autobiographical memory (Experiments 1–3) and for a controlled memory set (Experiments 4 and 5). Simulation studies show that a (...) unified model based on schema abstraction can capture backward (retrieval) effects as well as forward (transfer) effects. (shrink)

Over the last decade, several extensions of Dung’s Abstract Argumentation Frameworks (AFs) have been introduced in the literature. Some of these extensions concern the nature of the attack relation, such as the consideration of recursive attacks, whereas others incorporate additional interactions, such as a support relation. Recently, the Attack–Support Argumentation Framework (ASAF) was proposed, which accounts for recursive attacks and supports, attacks to supports and supports to attacks, at any level, where the support relation is interpreted as (...) necessity. Currently, to determine the accepted elements of an ASAF (which may be arguments, attacks, and supports) it is required to translate such an ASAF into a Dung’s AF. In this work, we provide a formal characterization of acceptability semantics directly on the ASAF, without requiring such a translation. We prove that our characterization is sound since it satisfies different results from Dung’s argumentation theory; moreover, we formally show that the approach proposed here for addressing acceptability is equivalent to the preexisting one, in which the ASAF was translated into an AF. Also, we formalize the relationship between the ASAF and other frameworks on which it is inspired: the Argumentation Framework with Recursive Attacks (AFRA) and the Argumentation Framework with Necessities (AFN). (shrink)

While the agricultural knowledges and practices of Black, Indigenous, and People of Color and women have shaped agriculture in the US, these knowledges have been colonized, exploited, and appropriated, cleaving space for the presently dominant white male agricultural narrative. Simultaneously, these knowledges and practices have been transformed to fit within a society that values individualism, production, efficiency, and profit. The authors use a decolonial Feminist Political Ecology framework to highlight the ways in which the knowledges of Indigenous, Black, and women (...) farmers have been and are being colonized; a tradition that makes alternative agriculture a predominantly white space. The authors interviewed 10 BIPOC and women farmers in Colorado to understand what values and knowledges were shaping their often-appropriated agricultural practices. Three themes emerged: people, place, and patterns. By centering these values, farmers create relational agricultural practices that support the well-being of human and more-than-human beings. To support the widespread implementation of these practices, food systems practitioners must elevate the voices and knowledges of historically excluded farmers. Only then can truly just and equitable alternative agricultural practices be realized in the US. (shrink)

Scientists know that human activities, primarily fossil fuel combustion, are causing Earth’s temperature to increase. Yet in 2021, only 60% of the US population understood that human activities are the primary cause of global warming. We experimentally test whether information about the human causes of global warming influences Americans’ beliefs and concerns about global warming and support for climate policies. We find that communicating information about the human-causes of global warming increases public understanding that global warming is human-caused. This (...) information, both alone and with additional information about climate impacts and policy solutions, also increases public concern about global warming and support for climate policies, although the effects on climate concern and policy support are smaller. Importantly, the treatment effects are consistent across political party, with no backlash effects among Republicans. This suggests that when informed about climate change causes, impacts and solutions, most Americans can update their own climate change beliefs, risk perceptions, and policy support. (shrink)

The purpose of this study was to examine individual and organizational antecedents and consequences of safety-related moral disengagement. Using Conservation of Resources theory, social exchange theory, and psychological contract breach as a theoretical foundation, this study tested the proposition that higher job insecurity is associated with greater levels of subsequent safety-related moral disengagement, which in turn is related to reduced safety performance. Moreover, we examined whether perceived organizational and supervisor support buffered or intensified the impact of job insecurity on (...) moral disengagement. Using a two-wave lagged design, anonymous survey data collected from N = 389 working adults in the U.S. supported the hypothesized moderated mediation model. Specifically, the conditional indirect effects of job insecurity on safety performance via moral disengagement were intensified as levels of perceived organizational and supervisor support increased. These results suggest that the threat of job insecurity may prompt employee moral disengagement; this effect is even stronger among employees who perceived higher levels of organizational and supervisor support. We interpret these counterintuitive findings in light of increasingly insecure contemporary work arrangements and how these may give rise to potentially unethical safety-related decision making and behavior. (shrink)

We propose Rhythmic Relating for autism: a system of supports for friends, therapists, parents, and educators; a system which aims to augment bidirectional communication and complement existing therapeutic approaches. We begin by summarizing the developmental significance of social timing and the social-motor-synchrony challenges observed in early autism. Meta-analyses conclude the early primacy of such challenges, yet cite the lack of focused therapies. We identify core relational parameters in support of social-motor-synchrony and systematize these using the communicative musicality constructs: pulse; (...) quality; and narrative. Rhythmic Relating aims to augment the clarity, contiguity, and pulse-beat of spontaneous behavior by recruiting rhythmic supports and relatable vitality; facilitating the predictive flow and just-ahead-in-time planning needed for good-enough social timing. From here, we describe possibilities for playful therapeutic interaction, small-step co-regulation, and layered sensorimotor integration. Lastly, we include several clinical case examples demonstrating the use of Rhythmic Relating within four different therapeutic approaches. These clinical case examples are introduced here and several more are included in the Supplementary Material. A suite of pilot intervention studies is proposed to assess the efficacy of combining Rhythmic Relating with different therapeutic approaches in playful work with individuals with autism. Further experimental hypotheses are outlined, designed to clarify the significance of certain key features of the Rhythmic Relating approach. (shrink)

This paper assesses the relational effects of perceived organizational support, fear of COVID-19, and work-related stress on the safety performance of healthcare staff. The sample for this research was extracted from the University College Hospital in the Oyo State of Nigeria. The participants were midwives, doctors, auxiliary services staff, and nurses who functioned in a COVID-19 hospital ward, fever or respiratory ICU, Auxiliary services, or outpatient clinics. This investigation espoused a clinical cross-sectional survey involving self-reported surveys. Of the 150 (...) questionnaires distributed, 147 were fit for scrutiny and analyzed with Statistical Packages for the Social Sciences. This paper established a relationship between POS and safety performance. Besides, it showed a significant positive correlation between FOC-19 and SP. It further noted that work-related stress negatively relates to safety performance. Moreover, this study showed the significant joint strong influence of POC, FOC-19, and WRS on the safety performance of healthcare workers. Hence, healthcare institutions are encouraged to create adequate support for healthcare workers, particularly during a global health crisis. Government and healthcare institutions should also develop an awareness program on the danger and consequences of getting infected by the virus or infecting other significant others. This will increase the fear of COVID-19 and, consequently, health workers’ safety performance. Besides, it is recommended that the management of healthcare institutions provides a proper work structure and schedule to help reduce workloads, consequently reducing WRS, as lowering it improves healthcare workers’ safety performance. (shrink)

Susan Sherwin's approach to bioethics promotes more inclusive and less oppressive sociopolitical environments within healthcare for marginalized groups. Sherwin's relational theory of autonomy endorses this aim in targeting live options as bellwethers for recognizing contexts constraining or promoting autonomy. Those contexts closing off certain options as pursuable in practice limit autonomy while those promoting a plurality of practically pursuable courses of action are autonomy enhancing. Attending to what is possible in practice is thus key to understanding how autonomy is impacted. (...) In healthcare contexts, those implicated in social structures systematically limiting autonomy sustain oppressive contexts... (shrink)

We join McCarthy and Howard (2023) in advocating supported decision-making for patients with diminished mental capacity that meaningfully expands the role of trustees beyond merely channeling the i...

We propose a theory that relates perceived evidence to numerical probability judgment. The most successful prior account of this relation is Support Theory, advanced in Tversky and Koehler. Support Theory, however, implies additive probability estimates for binary partitions. In contrast, superadditivity has been documented in Macchi, Osherson, and Krantz, and both sub- and superadditivity appear in the experiments reported here. Nonadditivity suggests asymmetry in the processing of focal and nonfocal hypotheses, even within binary partitions. We extend Support (...) Theory by revising its basic equation to allow such asymmetry, and compare the two equations’ ability to predict numerical assessments of probability from scaled estimates of evidence for and against a given proposition. Both between- and within-subject experimental designs are employed for this purpose. We find that the revised equation is more accurate than the original Support Theory equation. The implications of asymmetric processing on qualitative assessments of chance are also briefly discussed. (shrink)

The scientific and practical fields—especially high-performance sports—increasingly request a stronger focus be placed on individual athletes in human movement science research. Machine learning methods have shown efficacy in this context by identifying the unique movement patterns of individuals and distinguishing their intra-individual changes over time. The objective of this investigation is to analyze biomechanically described movement patterns during the fatigue-related accumulation process within a single training session of a high number of repeated executions of a ballistic sports movement—specifically, the frontal (...) foot kick (mae-geri) in karate—in expert athletes. The two leading research questions presented for consideration are (1) Can characteristics of individual movement patterns be observed throughout the entire training session despite continuous changes, i.e., even as fatigue-related processes increase? and (2) How do intra-individual movement patterns change as fatigue-related processes increase throughout a training session? Sixteen expert karatekas performed 606 frontal foot kicks directed toward an imaginary target. The kicks were performed in nine sets at 80% (K-80) of the self-experienced maximal intensity. In addition, six kicks at maximal intensity (K-100) were performed after each of the nine sets. Between the sets, the participants took a 90-s break. Three-dimensional full-body kinematic data of all kicks were recorded with 10 infrared cameras. The normalized waveforms of nine upper- and lower-body joint angles were classified using a supervised machine learning method (support vector machine). The results of the classification revealed a disjunct distinction between the kinematic movement patterns of individual athletes. The identification of unique movement patterns of individual athletes was independent of the intensity and the degree of fatigue-related processes. In other words, even with the accumulation of fatigue-related processes, the unique movement patterns of an individual athlete can be clearly identified. During the training session, changes in intra-individual movement patterns could also be detected, indicating the occurrence of adaptations in individual movement patterns throughout the fatigue-related accumulation process. The results suggest that these adaptations can be modeled in terms of changes in patterns rather than increasing variance. Practical consequences are critically discussed. (shrink)

The aim of the present research was twofold. First, we examined the effects of perceived organizational support on workplace conflict (i.e., relationship conflict and task conflict). Second, we identified one mechanism explaining these relationships, namely failure-related trust. Using a sample of 263 teachers from Belgium, the results of Study 1 indicated that perceived organizational support is negatively related to relationship conflict and is also, unexpectedly, negatively related to task conflict. Furthermore, using a sample of 477 Belgian employees, Study (...) 2 replicated these results and further demonstrated that failure-related trust mediates the negative relationship between perceived organizational support and both types of workplace conflict. Theoretical and practical insights of this research are discussed. (shrink)

Cancer-related electronic support groups (ESGs) may be regarded as a complement to face-to-face groups when the latter are available, and as an alternative when they are not. Advantages over face-to-face groups include an absence of barriers imposed by geographic location, opportunities for anonymity that permit sensitive issues to be discussed, and opportunities to find peers online. ESGs can be especially valuable as navigation aids for those trying to find a way through the healthcare system and as a guide to (...) the cancer journey. Outcome indicators that could be used to evaluate the quality of ESGs as navigation aids need to be developed and tested. Conceptual models for the navigator role, such as the Facilitating Navigator Model, are appropriate for ESGs designed specifically for research purposes. A Shared or Tacit Model may be more appropriate for unmoderated ESGs. Both conceptual models raise issues in Internet research ethics that need to be address. (shrink)

IntroductionThe present study aims at analysing how social support received and provided by parents of children, adolescents and young adults (AYA) diagnosed with cancer, as well as their sociodemographic and clinical variables, affect those parents’ stress levels and life and family satisfaction.Materials and MethodsA total of 112 parents of children and AYAs who had been diagnosed with cancer and who received treatment in Malaga participated in the study. In the study, participated all parents who voluntarily agreed to fulfil the (...) questionnaire. The main inclusion criterion was that their child had cancer. Instruments used were Questionnaire on the Frequency of and Satisfaction with Social Support (QFSSS), Paediatric Inventory for Parents (PIP), Life Satisfaction Scale and Family Satisfaction Scale.ResultsIn the mean difference analyses, male parents showed 3.38 (SD = 0.56) in social support received and female parents showedM = 3.08 (SD = 0.72). Conversely, in social support provided, female parents showed 3.22 and male parents showedM = 3.55 (p = 0.020). Significant differences were also found in family satisfaction, where female parents (M = 3.64) feel more satisfied than male parents (M = 3.06;p = 0.027). Parents of children aged between 0 and 14 years (M = 3.06) feel more stress than those parents of children aged 15–21 (M = 2.61;p = 0.021). The correlation analysis shows that there is a negative and significant relation between stress levels experienced by parents when facing different situations related to the child’s disease and both types of support, receivedr = −0.411,p < 0.001 and providedr = −0.282,p < 0.01. There is also a positive and significant relation between life satisfaction and social support receivedr = 0.292,p < 0.01, and social support providedr = 0.409,p < 0.001. There is a positive and significant relation between family satisfaction and social support receivedr = 0.330,p < 0.01, in the same way as with social support providedr = 0.222,p < 0.05. The regression analysis related to stress levels of parents indicates that social support received predicts levels of stress significantlyp < 0.001, with the variable of number of children being the one that showed to be significantp < 0.05. Social support provided showed the most significant resultsp = 0.001, meaning that social support provided increased life satisfaction. Social support received explains family satisfaction (p = 0.50), as it increases the family satisfaction of parents of children with cancer.DiscussionAnalysing social support received and provided, as well as sociodemographic and clinical variables, allowed us to broaden the knowledge on the effect social support has on stress levels, life satisfaction and family satisfaction in parents of children and AYAs diagnosed with cancer. This may have relevant practical implications for the design of interventions that would improve parents’ lives. (shrink)

The present paper aims to contribute to the substantivalism versus relationalism debate and to defend general relativity (GR) against pseudoscientific attacks in a novel, especially inclusive way. This work was initially motivated by the desire to establish the incompatibility of any ether theories with accelerated cosmic expansion and inflation (motto: where would a hypothetical medium supposedly come from so fast?). The failure of this program is of interest for emergent GR concepts in high energy particle physics. However, it becomes increasingly (...) important to guard scientific results against their misrepresentation by fundamentally anti-scientific agendas. We therefore argue that although it is not known whether the perceived space-time is fundamental (rather than a condensed state or a particular membrane), in a fundamental theory, space-time must be abstract relational: fundamental space-time is the consistent spatial-temporal arrangement of events. To pursue its own goals, this work should be accessible to a wide audience: physicists, philosophers of science, those being tempted by anti-relativity theories, but also those who vigorously defend some orthodox relativity that is not actually supported by GR. It must thus be extensive in order to satisfy the different parties’ desire to have included and understood their respective positions. (shrink)

In this study, we explain differences in support for interreligious lawful and violent protests against the religious outgroup. Combining religiosity and social identity approaches, we take three dimensions of religiosity into consideration related to support for interreligious conflict, next to relevant control characteristics. The analysis is based on survey data collected among a random sample of Muslims and Christians across the Indonesian archipelago. Our findings show that members of the Muslim community are, on average, more inclined to (...) class='Hi'>support interreligious conflict, both lawful and violent protests. Participation in rites of passage is a crucial aspect of religious practices found to be positively related to both kinds of protest. Religious beliefs show great importance but vary in their influence: particularistic views and intratextual fundamentalism are related to support for lawful protest, whereas religiocentrism is related to support both for lawful and violent protests. In contrast, salience reduces support for violent protest. As such, the findings offer a differentiated way to understand present-day interreligious conflicts among the general population in Indonesia. (shrink)

Leech et al.'s analysis adds to an emerging consensus of the role of priming in analogy-making. However, their model cannot scale up to adult-level performance because not all relations can be cast as functions. One-size-fits-all accounts cannot capture the richness of analogy. Proportional analogies and transitive inferences can be made by nonstructural mechanisms. Therefore, these tasks do not generalize to tasks that require structure mapping.

Polysemy has only recently entered the debate on semantic minimalism and contextualism. This is surprising considering that the key linguistic examples discussed in the debate, such as ‘John cut the grass’ or ‘The leaf is green’ appear to be prime examples of polysemy. Moreover, François Recanati recently argued that the mere existence of polysemy falsi!es semantic minimalism and supports radical contextualism. The aim of this paper is to discuss how the minimalism-contextualism debate relates to polysemy. This connection turns out to (...) be far from clear-cut. This is partly due to the fact that the term ‘polysemy’ is used in a number of different ways in the literature, which will be reviewed in this paper. Finally, I discuss and reject Recanati’s claim that the existence of polysemy supports radical contextualism against moderate versions and semantic minimalism. I show that minimalism has a number of plausible options to account for polysemy. (shrink)

Daydreaming appears to have a complex relationship with life satisfaction and happiness. Here we demonstrate that the facets of daydreaming that predict life satisfaction differ between men and women , that the content of daydreams tends to be social others , and that who we daydream about influences the relation between daydreaming and happiness variables like life satisfaction, loneliness, and perceived social support . Specifically, daydreaming about people not close to us predicts more loneliness and less perceived social (...) class='Hi'>support, whereas daydreaming about close others predicts greater life satisfaction. Importantly, these patterns hold even when actual social network depth and breadth are statistically controlled, although these associations tend to be small in magnitude. Individual differences and the content of daydreams are thus important to consider when examining how happiness relates to spontaneous thoughts. (shrink)

Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention—a bridge to recovery or transplant—not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor (...) of withdrawal, including distributive justice, quality of life, patients’ rights, professional integrity, and the Equivalence Thesis. We find that existing justifications for unilateral withdrawal of ECMO support in capacitated patients are problematic, which leads us to conclude that either: (1) additional ethical arguments are necessary to defend this approach or (2) the claim that it is not appropriate to use ECMO as a destination therapy should be questioned. (shrink)

The study of biodiversity spans many disciplines and includes data pertaining to species distributions and abundances, genetic sequences, trait measurements, and ecological niches, complemented by information on collection and measurement protocols. A review of the current landscape of metadata standards and ontologies in biodiversity science suggests that existing standards such as the Darwin Core terminology are inadequate for describing biodiversity data in a semantically meaningful and computationally useful way. Existing ontologies, such as the Gene Ontology and others in the Open (...) Biological and Biomedical Ontologies (OBO) Foundry library, provide a semantic structure but lack many of the necessary terms to describe biodiversity data in all its dimensions. In this paper, we describe the motivation for and ongoing development of a new Biological Collections Ontology, the Environment Ontology, and the Population and Community Ontology. These ontologies share the aim of improving data aggregation and integration across the biodiversity domain and can be used to describe physical samples and sampling processes (for example, collection, extraction, and preservation techniques), as well as biodiversity observations that involve no physical sampling. Together they encompass studies of: 1) individual organisms, including voucher specimens from ecological studies and museum specimens, 2) bulk or environmental samples (e.g., gut contents, soil, water) that include DNA, other molecules, and potentially many organisms, especially microbes, and 3) survey-based ecological observations. We discuss how these ontologies can be applied to biodiversity use cases that span genetic, organismal, and ecosystem levels of organization. We argue that if adopted as a standard and rigorously applied and enriched by the biodiversity community, these ontologies would significantly reduce barriers to data discovery, integration, and exchange among biodiversity resources and researchers. (shrink)

This chapter provides an overview of six topics related to governance, ethical, legal, and social implications of artificial intelligence (AI) for sustainable development goals (SDGs) initiatives. We identified six common challenges and related opportunities to mitigate such challenges, as referred to by the authors analysing the chapters provided in the book The Ethics of Artificial Intelligence for the Sustainable Development Goals. They are (1) governance and collaboration, (2) private investments and the role of big tech companies, (3) AI and communities, (...) (4) AI and individuals, (5) jobs and skills, and (6) impact assessment. (shrink)

Due to increasing empiricalinformation on farm animal welfare since the1960s, the prospects for sound decisionmakingconcerning welfare have improved. This paperdescribes a strategy to develop adecision-making aid, a decision support system,for assessment of farm-animal welfare based onavailable scientific knowledge. Such a decisionsupport system allows many factors to be takeninto account. It is to be developed accordingto the Evolutionary Prototyping Method, inwhich an initial prototype is improved inreiterative updating cycles. This initialprototype has been constructed. It useshierarchical representations to analysescientific statements and (...) statements describingthe housing system. Welfare is assessed fromwhat is known about the biological needs of theanimals, using a welfare model in the form of atree that contains these needs as welfarecomponents. Each state of need is assessedusing welfare relevant attributes of thehousing system and weighting factors.Attributes are measurable properties of thehousing system. Weighting factors are assignedaccording to heuristic rules based on theprinciple of weighting all components(attributes and needs) equally, unless thereare strong reasons to do otherwise. Preliminarytests of the prototype indicate that it may bepossible to perform assessment of farm-animalwelfare in an explicit way and based onempirical findings. The procedure needs to berefined, but its prospects are promising. (shrink)

Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and the (...) sanctity of life, Japanese society may not be ready to make changes needed to enable patients to have LVADs deactivated under certain circumstances to avoid needless suffering. Western ethical views that permit LVAD deactivation based mainly on respect for autonomy and dignity have not been accepted thus far in Japan and are unlikely to be accepted, given the current Japanese culture and traditional values. Some healthcare professionals might regard patients as ineligible for DT unless they have prepared advance directives. If this were to happen, the right to prepare an advance directive would instead become an obligation to do so. Furthermore, patient selection for DT poses another ethical issue. Given the predominant sanctity of life principle and lack of cost-consciousness regarding medical expenses, medically appropriate exclusion criteria would be ignored and DT could be applied to various patients, including very old patients, the demented, or even patients in persistent vegetative states, through on-site judgment. There is an urgent need for Japan to establish and enact a basic act for patient rights. The act should include: respect for a patient’s right to self-determination; the right to refuse unwanted treatment; the right to prepare legally binding advance directives; the right to decline to prepare such directives; and access to nationally insured healthcare. It should enable those concerned with patient care involving DT to seek ethical advice from ethics committees. Furthermore, it should state that healthcare professionals involved in the discontinuation of life support in a proper manner are immune to any legal action and that they have the right to conscientiously object to LVAD deactivation. (shrink)

Background Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and (...) the sanctity of life, Japanese society may not be ready to make changes needed to enable patients to have LVADs deactivated under certain circumstances to avoid needless suffering. Main text Western ethical views that permit LVAD deactivation based mainly on respect for autonomy and dignity have not been accepted thus far in Japan and are unlikely to be accepted, given the current Japanese culture and traditional values. Some healthcare professionals might regard patients as ineligible for DT unless they have prepared advance directives. If this were to happen, the right to prepare an advance directive would instead become an obligation to do so. Furthermore, patient selection for DT poses another ethical issue. Given the predominant sanctity of life principle and lack of cost-consciousness regarding medical expenses, medically appropriate exclusion criteria would be ignored and DT could be applied to various patients, including very old patients, the demented, or even patients in persistent vegetative states, through on-site judgment. Conclusion There is an urgent need for Japan to establish and enact a basic act for patient rights. The act should include: respect for a patient’s right to self-determination; the right to refuse unwanted treatment; the right to prepare legally binding advance directives; the right to decline to prepare such directives; and access to nationally insured healthcare. It should enable those concerned with patient care involving DT to seek ethical advice from ethics committees. Furthermore, it should state that healthcare professionals involved in the discontinuation of life support in a proper manner are immune to any legal action and that they have the right to conscientiously object to LVAD deactivation. (shrink)

Managing cardiac illness is not easy because it dramatically disrupts people’s daily life and both the patient and his/her spouse are at risk for experiencing distress, which, in turn, may affect the support provided by the partner as caregiver. The partner, in fact, is the main source of support, but his/her support may sometimes be inadequate. In addition, dyadic coping could likely be a moderating factor. The main aim of the present study was to examine the role (...) that dyadic coping plays in moderating the link between patient and partner cardiac illness-related distress and partner support. The study included 100 married couples faced with cardiac illness who completed a self-report questionnaire. We analyzed our data in PROCESS using multiple regressions in order to assess the moderating effects of DC responses in the relationship between the couple’s cardiac illness-related distress and partner support. With regard to patient distress, results showed that higher levels of patient anxiety and depression were linked with ineffective partner support. With regard to partner distress, higher levels of partner depression were linked with hostility; higher levels of partner depression and anxiety were associated with less partner support for patient engagement. Moreover, the association between distress and partner support was moderated by the quality of DC. In particular, low positive DC represented a risk factor for both the patient and the partner during a cardiac illness, as low positive DC exacerbated the link between patient and partner distress and less effective partner support styles. Also, higher levels of negative DC were risky for couples: The association between distress and less adequate partner supportive behaviors was stronger in the case of higher negative DC. These results imply a need for psychosocial interventions for couples in cardiac illness, especially for couples lacking relational competences, such as positive dyadic coping. (shrink)

Community-supported agriculture (CSA) initiatives are spaces where diverse work relations are performed. From a postcapitalist perspective, these initiatives attempt to create alternative-capitalist and non-capitalist work relations next to capitalist ones. While analyses of work relations in CSA abound, it remains uncertain how such diversification is made possible and how it is shaped by the micro-politics of and power relations in these initiatives. This paper addresses this gap by analysing how power shapes transformations to postcapitalist work (...) class='Hi'>relations in CSA. It provides substantial empirical evidence of multiple manifestations of power enabling or constraining postcapitalist work relations through a comparative case study of three CSA initiatives in Portugal. Results show that while CSA creates postcapitalist work relations that are non-alienated, non-monetised and full of care, they insufficiently unmake unbalanced power relations established in capitalist work relations. This paper argues that, when establishing postcapitalist work relations, the selected CSA initiatives could benefit from actively deconstructing internal hierarchies, de-centralising decision-making power from farm owners and addressing oppressive power relations that are ossified in their local and cultural context. (shrink)

Autonomy has been central to moral and political philosophy for millenia, and has been positioned as a critical aspect of both justice and wellbeing. Research in psychology supports this position, providing empirical evidence that autonomy is critical to motivation, personal growth and psychological wellness. Responsible AI will require an understanding of, and ability to effectively design for, human autonomy (rather than just machine autonomy) if it is to genuinely benefit humanity. Yet the effects on human autonomy of digital experiences are (...) neither straightforward nor consistent, and are complicated by commercial interests and tensions around compulsive overuse. This multi-layered reality requires an analysis that is itself multidimensional and that takes into account human experience at various levels of resolution. We borrow from HCI and psychological research to apply a model (“METUX”) that identifies six distinct spheres of technology experience. We demonstrate the value of the model for understanding human autonomy in a technology ethics context at multiple levels by applying it to the real-world case study of an AI-enhanced video recommender system. In the process we argue for the following three claims: 1) There are autonomy-related consequences to algorithms representing the interests of third parties, and they are not impartial and rational extensions of the self, as is often perceived; 2) Designing for autonomy is an ethical imperative critical to the future design of responsible AI; and 3) Autonomy-support must be analysed from at least six spheres of experience in order to approriately capture contradictory and downstream effects. (shrink)

Methodological strategies for the identification and synthesis of ‘evidence’ to support decision‐making in relation to complex healthcare systems and practices This paper addresses the limitations of current methods supporting ‘evidence‐based health‐care’ in relation to complex aspects of care, including those questions that are best supported by descriptive or non‐empirical evidence. The paper identifies some new methods, which may be useful in aiding the synthesis of data in these areas. The methods detailed are broadly divided into those that facilitate the (...) identification of evidence and those that enable the interpretation of the data retrieved. To illustrate some of the issues involved, reference is made to a multimethod review recently completed by the authors, which aimed to identify factors that promote continuity in the transition from child to adult health and social care. It is argued that as healthcare organisations are becoming increasingly preoccupied with the evidence base of practice, such methods may help ensure that aspects of care and approaches that are outside the dominant pharmaco‐medical domain maintain a prominent position on the healthcare agenda while remaining open to external scrutiny. Healthcare professionals who use such approaches need to know their relative utility and benefits to inform clinical decisions, so as to ensure that best practice is observed. (shrink)