The Last Gift is an observational HIV cure-related research study conducted with people with HIV at the end of life at the University of California San Diego. Participants agree to voluntarily donate blood and other biospecimens while living and their bodies for a rapid research autopsy postmortem to better understand HIV reservoir dynamics throughout the entire body. The Last Gift study was initiated in 2017. Since then, 30 volunteers were enrolled who are either terminally ill with a concomitant condition and (...) have a prognosis of 6 months or less or chronically ill with multiple comorbidities and nearing the EOL.Multiple ethical and logistical challenges have been revealed during this time; here, we share our lessons learnt and ethical analysis. Issues relevant to healthcare research include surrogate informed consent, personal and professional boundaries, challenges posed conducting research in a pandemic, and clinician burnout and emotional support. Issues more specific to EOL and postmortem research include dual roles of clinical care and research teams, communication between research personnel and clinical teams, legally required versus rapid research autopsy, identification of next of kin/loved ones and issues of inclusion. Issues specific to the Last Gift include logistics of body donation and rapid research autopsy, and disposition of the body as a study benefit.We recommend EOL research teams to have clear provisions around surrogate informed consent, rotate personnel to maintain boundaries, limit direct contact with staff associated with clinical care and have a clear plan for legally required versus research autopsies, among other recommendations. (shrink)
BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the United States (...) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable.ResultsAll four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL.ConclusionBecause of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings. (shrink)
The U.S. National Institute of Allergies and Infectious Diseases and the National Institute of Mental Health have a new research priority: inclusion of terminally ill persons living with HIV in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. As end-of-life HIV cure research is relatively new, the scientific community has a timely opportunity to (...) examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable. (shrink)
Los autores de esta obra dedicada a la compilación y comentario de las concepciones de la guerra existentes en nuestra historia de la filosofía son conscientes de que ninguna filosofía podría dar una definición de qué sea la guerra, cuáles sean sus causas, sus justificaciones o bajo qué concepción de la naturaleza humana cabe explicar este fenómeno o cuál sea el papel jugado por los Estados sin que, para ello, ponga la filosofía en juego todas las dimensiones que la componen: (...) desde la política, la metafísica, la ética, el derecho, etc. presentes en su devenir histórico. Esto es lo mismo que decir que la filosofía sólo puede dar una respuesta compleja y plural a la pregunta acerca de qué sea la guerra y de cómo llega a producirse ésta. Complejidad y pluralidad que hacen aconsejable un seguimiento histórico de las concepciones mismas de la guerra, y aunque no esté en boga hacer uso de este tipo de seguimientos que examinan, implícitamente, a la filosofía en su historia misma, qué duda cabe, por otra parte –y vaya ello en defensa de esta inteligente compilación–, de que también estamos hoy día recuperados de esa visión peyorativa de la historia, precisamente porque la pluralidad y complejidad de los planteamientos o concepciones de este fenómeno han de ser estudiados en el conjunto de la historia o historias: un futuro pasado, como diría Reinhart Koselleck, a cuyo examen estamos todos convocados. (shrink)
Este libro es un homenaje a la trayectoria intelectual y académica de la profesora María Teresa López de la Vieja, Catedrática emérita de la Universidad de Salamanca. En él se trazan algunos de los caminos que, con su obra, nos invita a transitar. El volumen recoge contribuciones de colegas de varias nacionalidades y procedentes de diversos ámbitos de reflexión que le son afines: la filosofía moral y política, la literatura, la teoría de la argumentación, los estudios feministas, las éticas aplicadas, (...) la bioética. Los capítulos que componen este libro dan voz a varias generaciones de investigadoras e investigadores que han acompañado y acompañan su andadura académica y que aquí dialogan con ella haciendo propias sus preocupaciones intelectuales. Con su participación contribuyen al justo reconocimiento de su dedicación a la labor docente e investigadora. (shrink)
Al considerar el tratamiento que realiza Juan David García Bacca de Process and Reality de Alfred North Whitehead, el articulo busca apreciar la afinidad entre ambos autores en su caracterización de las deficiencias de la ontología clásica y en su invención de conceptos para un nuevo enfoque de la ontología; a saber, una metafísica de la creación y la novedad.
La belleza ha sido, desde tiempo de los griegos, el tormento de los filósofos; conformarse tal idea apresándola bajo una definición a la que se niega ha ocupado, siempre en vano, la tarea de no pocos pensadores hasta la actualidad. La hermosura no deja racionalizarse y hace así de la razón una sinrazón; ni es cognoscible, ni posee estructura lógica. Es por ello que a través de la percepción estética aprehendemos lo que en sí no es perceptible; es la experiencia (...) de apertura de una interioridad que hasta el momento había permanecido oculta a los ojos de lo cotidiano y adquiere ahora un rango de primer orden. (shrink)
En este artículo se presenta un análisis crítico de la novela El amor en los tiempos del cólera, del escritor colombiano Gabriel García Márquez, basado en las categorías o aspectos que propician la narración de los acontecimientos pasados. A partir de la hipótesis de que la obra constituye una evocación del pasado o, en otras palabras, un viaje a los recuerdos, se analizan los siguientes aspectos con el fin de determinar cómo la narración de las experiencias se construye a partir (...) de ellos: la narración, que incluye al narrador y las técnicas narrativas; los detonadores gracias a los cuales se efectúa la rememoración; el contexto cotidiano en el que se introducen; la representación del tiempo y del espacio y las relaciones entre los personajes. (shrink)
This paper presents the notion of transfinite developed by García Bacca in his «Infinito, transfinito, finito». This concept is a reaction to the Aristotelian concepts of «nature» and «finite», making man a historical being. García Bacca argues that man has lost his nature and his finitude through technology. So, strictly speaking, is not finite, nor infinite.
Despite its philosophical interest, Susanna Newcome’s Enquiry Into the Evidence of the Christian Religion (1728, revised 1732) has received little attention from commentators. This paper seeks to redress this oversight by offering a reconstruction of Newcome’s innovative argument for God’s existence. Newcome employs a cosmological argument that differs from Thomist and kalām version of the argument. Specifically, Newcome challenges that idea that the causal chains observed in nature can exist independently. She does this through an appeal to findings from (...) Newtonian natural philosophy that suggest that the universe has entropic tendencies. This suggests that the continued operations of nature are dependent on a cause external to the universe. Newcome identifies this external cause with God. Various strengths and weaknesses of Newcome’s argument are discussed and an attempt is made to situate the argument within her broader epistemic framework and the larger context of Newtonian physico-theology. The paper also explores what is known of Newcome’s biography and intellectual milieu. (shrink)
La psicología y los psicólogos han dedicado bastante esfuerzo para conseguir una comprensión mejor y más profundea de las emociones y los sentimientos. Roberto Colom con sus respuestas nos ofrece una visión de primera mano de todas esas aportaciones así como el punto de vista de un psicólogo sobre el valos y la importancia de las emociones, los sntimientos y la vida afectiva en general para la personalidad humana.
What do we see? We are visually conscious of colors and shapes, but are we also visually conscious of complex properties such as being John Malkovich? In this book, Susanna Siegel develops a framework for understanding the contents of visual experience, and argues that these contents involve all sorts of complex properties. Siegel starts by analyzing the notion of the contents of experience, and by arguing that theorists of all stripes should accept that experiences have contents. She then introduces (...) a method for discovering the contents of experience: the method of phenomenal contrast. This method relies only minimally on introspection, and allows rigorous support for claims about experience. She then applies the method to make the case that we are conscious of many kinds of properties, of all sorts of causal properties, and of many other complex properties. She goes on to use the method to help analyze difficult questions about our consciousness of objects and their role in the contents of experience, and to reconceptualize the distinction between perception and sensation. Siegel's results are important for many areas of philosophy, including the philosophy of mind, epistemology, and the philosophy of science. They are also important for the psychology and cognitive neuroscience of vision. (shrink)
The rapidly growing research on hybrid organizations in recent years suggests that these organizations may have particular abilities to facilitate institutional change. This article contributes to our understanding of change and, in particular, sustainable transformation in society by highlighting the importance of organizational forms. Looking more closely at the role of hybrid organizations in processes of path generation, we analyze the conditions under which hybrid organizations may enable path generation. A retrospective exploratory case study of the Swedish hybrid organization The (...) Natural Step confirms how hybrids can take part in- and may facilitate the early phases of path generation: assimilation and coalescence. The conclusion drawn is that hybrids have multivocal abilities that enable them to earn trust and authority to open up “neutral” spaces for orientation and connection between actors in separated sub-paths, and that this in turn may ease tensions and trigger dialogue and exchange, also between former opponents. Yet, as also seen in the case, this enabling position of the hybrid may be both fragile and temporary. (shrink)
The introduction of social distancing, as part of efforts to try and curb the spread of the COVID-19 pandemic, has brought about drastic disruption to the world of the performing arts. In the UK the majority of professional orchestral musicians are freelance and therefore self-employed. These players, previously engaged in enjoyable, busy, successful, portfolio careers, are currently unable to earn a living carrying out their everyday work of performing music, and their future working lives are surrounded by great uncertainty. The (...) aim of the present study was to examine how established professional musicians are experiencing this period, and to look for similarities and differences between the experiences of musicians in the middle of their performing careers, with those of older players. Single semi-structured interviews were carried out over Zoom with 24 freelance, self-employed orchestral musicians; 12 mid-career musicians aged 35–45, and 12 seasoned musicians aged 53 and over. Thematic analysis identified themes common to both groups: the loss of a much-loved performing career, missing music making and colleagues, and anxiety about the future of the music profession. It also identified differences between the two groups: challenges to their identity as a musician, the extent of their anxiety about finances, the extent of their emotional distress, attitudes toward practicing and engaging in collaborative music making, and confusion over future career plans. Findings are discussed with reference to lifespan models of musicians' career development, the PERMA model of wellbeing, and the concept of resilience. (shrink)
El presente trabajo, escrito en ocasión del centenario de García Bacca, pretende poner de manifiesto la dimensión pedagógica del Maestro. Y ello, a propósito de su trabajo como estudioso de la Filosofía Colonial Venezolana, tema frecuentemente obviado cuando se valora el trabajo de este filósofo.
This paper defends a principle I call Equal Treatment, according to which the rationality of a belief is determined in precisely the same way as the rationality of any other state. For example, if wearing a raincoat is rational just in case doing so maximizes expected value, then believing some proposition P is rational just in case doing so maximizes expected value. This contrasts with the popular view that the rationality of belief is determined by evidential support. It also contrasts (...) with the common idea that in the case of belief, there are two different incommensurable senses of rationality, one of which is distinctively epistemic. I present considerations that favor Equal Treatment over these two alternatives, reply to objections, and criticize some arguments for Evidentialism. I also show how Equal Treatment opens the door to a distinctive kind of response to skepticism. (shrink)
This paper proposes that the question “What should I believe?” is to be answered in the same way as the question “What should I do?,” a view I call Equal Treatment. After clarifying the relevant sense of “should,” I point out advantages that Equal Treatment has over both simple and subtle evidentialist alternatives, including versions that distinguish what one should believe from what one should get oneself to believe. I then discuss views on which there is a distinctively epistemic sense (...) of should. Next I reply to an objection which alleges that non-evidential considerations cannot serve as reasons for which one believes. I then situate Equal Treatment in a broader theoretical framework, discussing connections to rationality, justification, knowledge, and theoretical vs. practical reasoning. Finally, I show how Equal Treatment has important implications for a wide variety of issues, including the status of religious belief, philosophical skepticism, racial profiling and gender stereotyping, and certain issues in psychology, such as depressive realism and positive illusions. (shrink)
There is an important division in the human mind between perception and reasoning. We reason from information that we have already, but perception is a means of taking in new information. Susanna Siegel argues that these two aspects of the mind become deeply intertwined when beliefs, fears, desires, or prejudice influence what we perceive.
Some prominent evidentialists argue that practical considerations cannot be normative reasons for belief because they can’t be motivating reasons for belief. Existing pragmatist responses turn out to depend on the assumption that it’s possible to believe in the absence of evidence. The evidentialist may deny this, at which point the debate ends in an impasse. I propose a new strategy for the pragmatist. This involves conceding that belief in the absence of evidence is impossible. We then argue that evidence can (...) play a role in bringing about belief without being a motivating reason for belief, thereby leaving room for practical considerations to serve as motivating reasons. I present two ways in which this can happen. First, agents can use evidence as a mere means by which to believe, with practical considerations serving as motivating reasons for belief, just as we use tools (e.g. a brake pedal) as mere means by which to do something (e.g. slow down) which we are motivated to do for practical reasons. Second, evidence can make it possible for one to choose whether or not to believe – a choice one can then make for practical reasons. These arguments push the debate between the evidentialist and the pragmatist into new territory. It is no longer enough for an evidentialist to insist that belief is impossible without evidence. Even if this is right, the outcome of the debate remains unsettled. It will hang on the ability of the evidentialist to respond to the new pragmatist strategy presented here. (shrink)
There is an important division in the human mind between perception and reasoning. We reason from information that we have already, but perception is a means of taking in new information. Susanna Siegel argues that these two aspects of the mind become deeply intertwined when beliefs, fears, desires, or prejudice influence what we perceive.
Evidentialists and Pragmatists about reasons for belief have long been in dialectical stalemate. However, recent times have seen a new wave of Evidentialists who claim to provide arguments for their view which should be persuasive even to someone initially inclined toward Pragmatism. This paper reveals a central flaw in this New Evidentialist project: their arguments rely on overly demanding necessary conditions for a consideration to count as a genuine reason. In particular, their conditions rule out the possibility of pragmatic reasons (...) for action. Since the existence of genuine pragmatic reasons for action is common ground between the Evidentialist and the Pragmatist, this problem for the New Evidentialist arguments is fatal. The upshot is that the deadlock between these two positions is restored: neither side can claim to be in possession of an argument that could convince the other. As it happens, I myself favor Pragmatism about reasons for belief, and although I don't claim to be able to convince a committed Evidentialist, I do make a prima facie case for Pragmatism by describing particular scenarios in which it seems to be true. I then go on to develop my own preferred version of the view: Robust Pragmatism, according to which a consideration never constitutes a reason for believing a proposition purely in virtue of being evidence for it. (shrink)
Perception is our key to the world. It plays at least three different roles in our lives. It justifies beliefs and provides us with knowledge of our environment. It brings about conscious mental states. It converts informational input, such as light and sound waves, into representations of invariant features in our environment. Corresponding to these three roles, there are at least three fundamental questions that have motivated the study of perception. How does perception justify beliefs and yield knowledge of our (...) environment? How does perception bring about conscious mental states? How does a perceptual system accomplish the feat of converting varying informational input into mental representations of invariant features in our environment? -/- This book presents a unified account of the phenomenological and epistemological role of perception that is informed by empirical research. So it develops an account of perception that provides an answer to the first two questions, while being sensitive to scientific accounts that address the third question. The key idea is that perception is constituted by employing perceptual capacities - for example the capacity to discriminate instances of red from instances of blue. Perceptual content, consciousness, and evidence are each analyzed in terms of this basic property of perception. Employing perceptual capacities constitutes phenomenal character as well as perceptual content. The primacy of employing perceptual capacities in perception over their derivative employment in hallucination and illusion grounds the epistemic force of perceptual experience. In this way, the book provides a unified account of perceptual content, consciousness, and evidence. (shrink)
