Families of children with mental health challenges may have been particularly vulnerable to emotional distress during the COVID-19 pandemic. This cross-sectional study surveyed 81 parents of children ages 6–17 years receiving mental health treatment in an outpatient clinic during the pandemic. We sought to characterize the impact of the pandemic on family relationships and parental well-being. Additionally, regression and ANCOVA models examined associations between four potentially protective factors—parents’ psychological resilience, perceived social support, positive family experiences during the pandemic, and children’s (...) use of cognitive or behavioral coping strategies—with family relationships and parental well-being. Findings suggest that families of children with mental health conditions experienced remarkable challenges to family relationships, parental well-being, and parents’ perceived capacity to support their children’s mental health. Nearly 80% of parents reported a negative impact of the pandemic on their own well-being, and 60% reported reduced ability to support their children’s mental health. Simultaneously, protective factors appeared to mitigate the negative impact of the pandemic. Particularly, support within the family and from external sources were associated with better self-reported well-being for parents and their capacity to support their children. Children’s use of coping tools, likely enhanced by mental health treatment, was also positively related to better family relationships and parental ability to support children with mental health challenges. Our findings highlight the need for enhancing supports for families at multiple levels including individual skill-building, family-based/parenting support, and community-based support. (shrink)

Urban agriculture is a promising avenue for food system change; however, projects often struggle with a lack of volunteers—limiting both their immediate goals and the broader movement-building to which many alternative food initiatives (AFIs) aspire. In this paper, I adopt a case study approach focusing on Farm X, an urban farm with a strong volunteer culture located in Tāmaki-Makaurau Auckland, New Zealand’s largest city. Drawing on a significant period of researcher participation and 11 in-depth interviews with volunteers and (...) project coordinators, I first contextualise and explore the history of Farm X, then offer themes to describe key factors which help or hinder their volunteer engagement. Engagement is helped by strong leadership, learning by doing, socialising around plants, and contributing to a movement. Conversely, engagement is hindered by time scarcity, economic hurdles, and struggles over direction. Drawing on McClintock’s (Local Environ 19(2): 147–171, 2014, 10.1080/13549839.2012.752797) insights into the hybrid and contradictory nature of urban agriculture as a tool for social change, the paper continues with a discussion of two important trade-offs involved in both farm management and the movement building promoted by Farm X: focused leadership verses volunteer agency; and asking more verses less of volunteers. Finally, I suggest several avenues that may be useful for other urban agriculture projects interested in movement building. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:preface This special issue of Feminist Studies presents an eclectic view of women ’s friendships from across Western history and from several different cultures. Several of the articles question whether identity or sameness is a prerequisite for friendship and ask what friendships across difference look like, including charting the difficulties of making and sustaining such friendships. The articles in this issue contrast the variety and functions of women’s friendships (...) with the narcissistic masculinist ideals of classical Western thought about friendship in which friends serve as reflections of a person—typically a male and upper-class person. The authors in this issue present women’s friendships that are more pragmatic and more vulnerable and that contend more fully with difference. Some authors reflect on the high expectations placed on friendship within Second Wave feminism in the United States, noting how competition and feelings of betrayal can suffuse friendships; others trace more autonomous, productive, and forgiving contemporary visions of friendship. The issue opens with Susan Van Dyne’s archival study of student friendships in a pioneering US women’s college, revealing how love, flirtation, and desire between women was expressed in Smith College’s class of 1883. In another historical study, sociologist Harriet Bjerrum Nielsen contrasts the narratives of Norwegian girls and young women from the late nineteenth century with those of present-day women and girls, noting differences between rural and urban contexts. Ivy Schweitzer 272Preface surveys classical Western masculinist ideals of friendship from Aristotle to Montaigne and traces the transformation of this tradition into the present quest for equality without hierarchy. Alexandra Verini addresses models of female friendship in the European Middle Ages, arguing that Christine de Pizan and Margery Kempe illustrate a “viable female alternative ” to classical models. The vulnerability of women’s close relationships comes to the fore in Nancy K. Miller’s moving elegies for deceased feminist friends, while Judith Taylor explores the more open and autonomous friendships adumbrated in contemporary fictions by Zadie Smith and Jillian and Mariko Tamaki, themes also addressed in Judith Kegan Gardiner’s review essay of advice books on friendships between women and other studies of women’s friendships. Richa Nagar’s interview articulates an ideal of feminist friendships that “enable continuous evolution of our beings and mindsets... without feeling threatened by one another.” If our articles focus on the close bonds between women, our News and Views pieces in this issue point to collective ties formed in response to political and social threats: Dalia Abd El-Hameed and Nadine Naber describe responses by Egyptian feminists to government crackdowns, and our forum “Orlando: Observances” offers a selection of first-person accounts from vigils organized to mark the massacre at the Pulse nightclub this summer. This issue also presents internal negotiations of identity, identification, and body image in Stephanie Han’s short story and in the vivid and bold transgressions of Wangechi Mutu’s collages as described by Sarah Jane Cervenak. In “‘Abracadabra’: Intimate Inventions by Early College Women,” Susan Van Dyne takes us on a fascinating journey into the “the early formation of a homosocial student culture and the bonds between women” at Smith College in the late nineteenth century. Mining an archive of diaries, letters, photos, and other materials from a group of friends from the class of 1883, she focuses on two kinds of written evidence: one, the inchoate expressions of homoerotic desire in one student’s journal at a moment when “lesbian” did not yet exist as an identity, and the other, a love poem to two students, written as a parody by one of their women professors, but which reverberated beyond the college and ignited male opprobrium. In her discussions of these developments, rather than ascribing identity, Van Dyne navigates the “messiness” of the archive, keeping her eye trained on the “only partially intelligible strategies of self-representation that can’t be translated or reduced to the modern Preface 273 language of sexual self-recognition.” What is most surprising in her account is not that young women would feel desire for one another, nor that male peers or authorities might find this threatening, but that the fabric of the students’ homosocial community had such resilience, nurturing... (shrink)

The article critically responds to "A Planetary Health Pledge for Health Professionals in the Anthropocene" which was published by Wabnitz et al. in The Lancet in November 2020. It focuses on the different roles and responsibilities of a physician. The pledge is criticised because it neglects the different roles, gives no answers in case of conflicting goals, and contains numerous inconsistencies. The relationship between the Planetary Health Pledge and the Declaration of Geneva is examined. It is argued that the Planetary (...) Health Pledge should have supplemented the Declaration of Geneva instead of changing it. (shrink)

The Hippocratic Oath and the Declaration of Geneva of the World Medical Association are compared in terms of content and origin. Their relevance for current medical practice is investigated. The status which is ascribed to these documents will be shown and the status which they can reasonably claim to have will be explored. Arguments in favor of the Hippocratic Oath that rely on historical stability or historical origin are being examined. It is demonstrated that they get caught up in paradoxes. (...) Should doctors swear the Hippocratic Oath or the Declaration of Geneva? The Hippocratic Oath is a remarkable historic document, which contains important elements still relevant for medical ethics today. Its interpretation as a timeless, still valid medical code is unfounded. The historical arguments, that should justify its validity, are untenable. The Declaration of Geneva, and not the Hippocratic Oath, can legitimately claim to come close to representing the most important principles of professional medical conduct in today’s globalised world. (shrink)

In reference to historical developments, this article introduces the topic of this special issue of Theoretical Medicine and Bioethics, that is, the relationship(s) between theory and practice. The authors emphasize the need for scientific research in this neglected area for the sake of both clinical practice and medical education.

Zusammenfassung Die Forschungs- und Regulierungsebene bei datenintensiver Forschung in der Medizin liegen auseinander. Ein heterogenes Feld aus regulierenden Institutionen mit regional ungleichen Regelungen, sowohl hinsichtlich der Dichte als auch der Restriktivität von Regelungen, steht einer globalen Entwicklung der Technologien entgegen. Trotz oder gerade wegen mangelnder global-gültiger Regulierungen können auch unverbindliche oder nur bedingt verbindliche normative Vorgaben der Orientierung dienen. Doch wie soll eine solche normative Regulierung angesichts datenintensiver Forschung in der Medizin ausgestaltet werden und woran soll sie sich orientieren? Die (...) Frage, wie konkret und detailliert man eine solche Forschung regulieren sollte, lässt sich nur im Einzelfall für bestimmte Situationen und Institutionen beantworten. Ob dabei neue Normen oder Gewichtungen von Normen vorgenommen werden sollen, oder ob die Normen und deren Gewichtung weiterhin bestehen bleiben sollen, lässt sich nur mit Verweis auf starke normative Argumente beantworten. An zwingenden Argumenten für neue Normen angesichts der datenintensiven medizinischen Forschung mangelt es bisher. Dennoch ist eine Umsetzungsarbeit von Normen, egal ob neue oder alte, und deren Anwendung auf eine neue Methode oder Technologie allemal zu erbringen. Es bedarf daher – wie schon bisher – beider: sowohl etablierter und transparent kommunizierter Normen als auch des unabhängigen Urteils zur Anwendung dieser Normen. Angesichts der besonderen Eignung für diese Aufgabe sollten auch weiterhin Ethik-Kommissionen als prozedurale Instanz bei der Bewilligung von datenintensiver Forschung in der Medizin gefordert und befähigt werden, die als unabhängige Institution ein Urteil im Einzelfall anhand vorgegebener Normen fällen. Nichtsdestotrotz können sich die veränderten Praktiken datenintensiver Forschungsprojekte auch in neuen Anforderungen an Ethik-Kommissionen niederschlagen, denen mit Reformen der Arbeitsweise begegnet werden sollte. (shrink)

To what extent can postmodern developments be observed in modern medicine and which theories of postmodern philosophy can we draw on with regard to medicine's theoretical problem? This article explores these questions with special emphasis on the epistemological status of medicine, the concept of disease, and the anthropological model. It is examined whether medicine's inherent duty to act can be questioned in the light of the plurality that characterizes postmodernity. It is concluded that, according to postmodern philosophy, medicine should be (...) characterized by a justified variety of paradigms. Cooperation within the variety must continue to be guaranteed, always in favor of the constitutive moral duty of medicine. (shrink)

The article presents the judgment of the German Federal Constitutional Court from 26 February 2020 on assisted suicide. The statements regarding human dignity, human rights and the relationship between citizens and the state are examined. Furthermore, the consequences resulting from this interpretation of human dignity for states that are pluralistic and based on human rights will be laid out. The court’s judgment limits the power of parliaments and poses a challenge to many laws in states that see themselves as pluralistic, (...) human rights-based states. There are no data in this work. (shrink)

ZusammenfassungDer Artikel untersucht die Frage, ob es sinnvoll ist, Doping im Sport unter ärztlicher Kontrolle freizugeben. Dazu werden die Auswirkungen einer Freigabe untersucht, die stets nur eine begrenzte Freigabe wäre, allein wegen der Risiken. Die unangenehmen Begleiterscheinungen der Dopingkontrollen würden nicht entfallen. Die Auswirkungen einer Freigabe von Doping im Wettkampfsport wären entweder unsinnig oder aber mit Nachteilen behaftet. Es ist nicht notwendig, die Frage zu klären, was die „Idee des Sportes“ ausmacht und ob sie verändert werden darf. Allein unter praktischen (...) Aspekten zeigt sich, dass dem Sport mit einer Freigabe des Dopings keine Vorteile, aber viele Nachteile erwachsen. (shrink)

Personalized medicine plays an important role in the development of current medicine. Among the numerous statements regarding the future of personalized medicine, some can be found that accord medicine a new scientific status. Medicine will be transformed from an art to a science due to personalized medicine. This prognosis is supported by references to models of historical developments. The article examines what is meant by this prognosis, what consequences it entails, and how feasible it is. It refers to the long (...) tradition of epistemological thinking in medicine and the use of historical models for the development of medicine. The possible answers to the question “art or science” are systematized with respect to the core question about the relationship between knowledge and action. The prediction for medicine to develop from an ‘empirical healing art’ to a ‘rational, molecular science’ is nonsensical from an epistemological point of view. The historical models employed to substantiate the development of personalized medicine are questionable. (shrink)

The article tries to clarify the relation between history of medicine and medical ethics. Therefore it distinguishes between the double meaning of the german word Geschichte , which means both: development of events and story . For the first option no systematic relation between history and ethics can be reconstructed. In the second sense historical knowledge can be a readable and worth reading text for the ethical debate. Therefore the methodological professionality of the historian is required.

The article examines the statements made by Immanuel Kant with reference to medicine as well as the impact of his philosophy on medicine. It describes the initial reaction of Kantian philosophy on medicine in the late 18th and early 19th century and its influence in the late 20th century.

ABSTRACT Definition of the problem: The regulation of residents' work hours involves several ethical conflicts which need to be systematically analysed and evaluated. Arguments and conclusion: The most important ethical principle when regulating work hours is to avoid the harm resulting from the over‐work of physicians and from an excessive division of labour. Additionally, other ethical principles have to be taken into account, in particular the principles of nonmaleficence and beneficence for future patients and for physicians. The article presents arguments (...) for balancing the relevant ethical principles and analyses the structural difficulties that occur unavoidably in any regulation of the complex activities of physicians. (shrink)

Technical reasoning refers to making inferences about how to use tools. The degree of technical reasoning is indicated by the bias of the gaze on the functional part of the tool when in use. Few studies have examined whether technical reasoning differs between familiar and unfamiliar novel tools. In addition, what effect the intention to use the tool has on technical reasoning has not been determined. This study examined gaze shifts in relation to familiar or unfamiliar tools, under three conditions, (...) among 14 healthy adults. The cumulative fixation time on the functional part of the tool served as a quantitative indicator of the degree of technical reasoning. The two-way analysis of variance for tools and conditions revealed that the cumulative fixation time significantly increased under free viewing and use conditions, compared to lift conditions. Relative to the free viewing condition, cumulative fixation time for unfamiliar tools significantly decreased in the lift condition and significantly increased in the use condition. Importantly, the results showed that technical reasoning was performed in both the use and the free viewing conditions. However, technical reasoning in the free viewing condition was not as strong as in the use condition. The difference between technical reasoning in free viewing and use conditions may indicate the difference between automatic and intentional technical reasoning. (shrink)

A series of Six-Party Talks involving the United States, China, Japan, South and North Korea, and Russia resulted in the emergence of a narrative of a . Given the prevalence of nuclear weapons amidst Sino-American rivalry, the area is hardly . Instead, the phrase has evolved into a common signifier for the US and China, suggesting that, despite their rivalries, the North Korean nuclear issue can be detrimental for both nuclear-free’ seriously, recasting the phrase as borne of both mutual scepticism, (...) as well as convergent interests, over the Korean Peninsula. (shrink)

This commentary critically examines Barnes’ ameliorative skepticism about health, which is a distinctive form of skepticism. While we agree with Barnes that health is indeed messy, involving biological, normative, societal, and phenomenological factors in a complex manner that defies simplistic explanation, we do not think that health is messy in a distinctive way. We argue that health is in fact remarkably similar to another messy phenomenon that is familiar to philosophers (i.e. truth), and that an existing philosophical account of another (...) messy phenomenon (i.e. pluralism about truth) can be applied to health. (shrink)

Die Frage, ob sie eine Kunst oder eine Wissenschaft sei, begleitet die Medizin seit der Antike. Die vorliegende Arbeit untersucht die Frage insbesondere im Hinblick auf den Einfluss Kants, Fichtes und Schellings auf das Selbstverstandnis der Medizin. Sie zeichnet die geschichtlichen Linien nach, die zum Verstandnis der gegenwartigen Situation fuhren und liefert wichtige Argumente zu einem zeitgemassen Selbstverstandnis der Medizin, das fur die wissenschaftstheoretische und ethische Diskussion in der Medizin von heute unverzichtbar ist. Since antiquity, the question has been whether (...) medicine is an art or a science. This work explores the question, in particular in view of Kants, Fichtes and Schellings influence on the self-conception of medicine. It traces the historical timelines which help to understand the current situation and provides important arguments for a timely self-conception of medicine which is indispensable for the discussion of scientific theory and ethics in todays medicine. (shrink)

When the 15-year-old Auguste Böhmer, daughter of Caroline Schlegel and stepdaughter of August Wilhelm Schlegel, died on 12th July 1800, Friedrich Wilhelm Joseph Schelling was accused of being responsible for this tragic event, because he tried to treat her according to the medical system of John Brown. The ensuing scandal became a symbol for the danger of every progressive movement of that time: the Romantic literature, the natural philosophy of Schelling and Brownianism in its German version, represented by Andreas Röschlaub. (...) An attempt is made to analyse the social and political background of the scandal and to argue the historical meaning as a fight against a fundamental reform of medicine. (shrink)

Der Beitrag untersucht die ethischen Konflikte, die einer Regelung der Arbeitszeit von Ärzten zugrunde liegen. Als oberstes ethisches Prinzip ist die Vermeidung von Schäden zu beachten, die durch Überarbeitung der Ärzte sowie durch übermäßige Aufteilung der Arbeit entstehen. Zudem sind andere ethische Prinzipien zu berücksichtigen, insbesondere die Schadensvermeidung und Nutzenmehrung für zukünftige Patienten sowie für die Ärzte. Der Beitrag begründet Präferenzen bei konfligierenden ethischen Prinzipien und untersucht überdies die strukturellen Schwierigkeiten, die unvermeidlich bei der Regelung einer komplexen Tätigkeit, wie der (...) ärztlichen, anfallen. (shrink)

Nanomedicine promises unprecedented innovations for diagnosis and therapy as well as for predicting and preventing diseases. On the other hand it raises fears linked to new and unknown characteristics of nanoscale materials. Both, promises and fears, are closely linked to the realm of uncertainty. To a large extent it is currently not known which expectations could become reality and which suspected adverse events might come true. Medicine is quite familiar with decision-making under uncertainty. Rules and regulations for clinical research have (...) been developed to reduce possible harm for research participants without abandoning necessary investigations. Here we examine whether clinical research trials of nanomedicine need new regulations and conclude that the established rules should suffice. (shrink)