A community's abilities to promote health and maximize its response to public health threats require fulfillment of one of the four elements of public health legal preparedness, the capacity to effectively coordinate law-based efforts across different governmental jurisdictions, as well as across multiple sectors and disciplines. Government jurisdictions can be viewed “vertically” in that response efforts may entail coordination in the application of laws across multiple levels, including local, state, tribal, and federal governments, and even with international organizations. Coordination of (...) legal responses to public health emergencies also may involve a horizontal dimension comprising numerous and diverse sectors, such as public health, public and private health care, emergency management, education, law enforcement, the judiciary, and the military.Although responses to many acute health threats can implicate multiple jurisdictions and sectors, the jurisdictional and sectoral dimensions of legal preparedness are complex and may vary substantially by the nature of a threat, its geographic and geopolitical extent, and the operational response demanded. (shrink)

In the history of palliative care, all roads lead back to Dame Cicely Saunders, a remarkable social worker/nurse/physician who promoted the concept of total pain and founded the first modern hospic...

Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation model. They offer two (...) historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced. (shrink)

In the United States, food banks served an estimated 46 million people in 2015. A combination of government policy reforms and political economic trends contributed to the rising numbers of individuals relying on private food assistance in the US, the United Kingdom and other high-income countries. Although researchers frequently map urban food environments, this project is one of the first to map private food assistance and potential need at the census-tract scale. We utilize Geographic Information Systems, demographic data, and food (...) assistance locations to develop a rapid assessment tool that could support food banks, pantries, soup kitchens, and government agencies that seek to answer the question of whether people with the greatest need have food distribution sites in close proximity. We define access based on distance and then calculate potential food insecurity using either poverty rates or a food insecurity index. We apply these methods in a case study analysis of Santa Clara County, California. Our findings suggest that food assistance distribution locations match the areas of potential need in more than 80% of urban census tracts. However, there are several potentially underserved locations and populations that could benefit from new food assistance operations. The poverty and index-based approaches show significant spatial overlap in mapped areas of high food insecurity and low access. The poverty only approach produces a higher estimate of food insecurity rates, is easier to calculate, and draws attention to the need to address poverty as a root cause of hunger. (shrink)

The ‘multicultural clinical interaction’ presents itself as a dilemma for the mental health practitioner. Literature describes two problematic areas where this issues emerges - how to make an adequate distinction between religious rituals and the rituals that may be symptomatic of ‘obsessive compulsive disorder’ (OCD), and how to differentiate ‘normative’ religious or spiritual beliefs, behaviours, and experiences from ‘psychotic’ illnesses. When it comes to understanding service user’s ‘idioms of distress’, beliefs about how culture influences behaviour can create considerable confusion and (...) ‘normative uncertainty’ for mental health practitioners. In the absence of clear diagnostic and assessment criteria on distinguishing between ‘culture’ and ‘psychopathology’, practitioners have had to rely on their own intuition and seek out possible ‘strategies’ or ‘procedures’ from a contradictory and cross-disciplinary evidence base. Decontextualisation of service users’ experiences may result in the pathologisation of culturally ‘normative’ phenomenon, ‘category fallacy’ errors, and poor health care experiences and outcomes for service users. This paper situates this dilemma within a wider debate that has concerned both the biomedical and social sciences, namely, the unresolved question of ‘normality’ or ‘abnormality’. Indeed, issues that arise from dilemmas surrounding the question of ‘culture’ or ‘psychopathology’ are intimately tied to wider cultural ideas about what is considered ‘normal’. The disciplines of psychiatry, psychology, and medical anthropology have struggled to establish workable criteria against which to judge behaviour as ‘normal’, ‘abnormal’, or ‘pathological’. Three models for understanding mental ‘abnormality’ are evident in ‘transcultural psychiatry’ (what is now commonly known as ‘cultural psychiatry’), and these models have corresponded closely to the interpretive models used by anthropologists attempting to make sense of the apparent diversity of human societies. The three models of ‘absolutism’, ‘universalism’ and ‘cultural relativism’ have not only important consequences for the nature and conduct of research enquiry, but also have implications for how the dilemma of ‘culture’ or ‘psychopathology’ is attended to in clinical practice. (shrink)

Latinx migrant farmworkers face numerous barriers in accessing health care which are linked in part to self-medication practices using health products manufactured and sold abroad. This study explores the use of mail-ordered medication among the understudied population of Latinx migrant dairy workers in Vermont, a northeastern international border state. Thirty-four Latinx migrant dairy workers or their domestic partners were interviewed. Data analysis found that myriad health access barriers compounded by increased fear of law enforcement as a result of international border (...) proximity results in unequal knowledge about and local access to desired health care products and services. This unequal access experienced by those living closest to the border in addition to a familiarity and trust in Latin American pharmaceutical drugs, and varied experiences accessing health care services, are significant factors influencing the decision to request health products by mail. (shrink)

SummaryIn this paper we develop a general concept of a theory analogous to that of an empirical theory. It is shown that axioms can be regarded as rules for performing operations. Using this connection we give a definition of an intellectual structure, and it turns out that mathematical theories represent intellectual structures in a natural way.RésuméCet article développe un concept général de théorie analogue à celui de théorie empirique. II montre que les axiomes peuvent être considérés comme des régles pour (...) réaliser des opérations . Cette connexion permet de définir une structure intellectuelle, et il se trouve que les theories mathématiques représentent ces structures intellectuelles de façon naturelle.ZusammenfassungIn dieser Arbeit wird der allgemeine Begriff einer mathematischen Theorie entwickelt, der dem einer empirischen Theorie analog ist. Es wird gezeigt, dass sich Axiome als Regeln zur Durchführung von Operationen auffassen lassen. Unter Benutzung dieses Zusam‐rnenhangs wird eine Definition von intellektueller Struktur gegeben und es zeigt sich, dass mathe‐matische Theorien in natürlicher Weise intellektuelle Strukturen repräsentieren. (shrink)

We human persons have an abiding interest in understanding what kind of beings we are. However, it is not obvious how to attain such an understanding. Traditional analytic metaphysicians start with a priori accounts of the most general, abstract features of the world— e.g., accounts of properties and particulars—features that, they claim, in no way depend upon us or our activity.1 Such accounts are formulated in abstraction from what is already known about persons and other things, and are used as (...) constraints on metaphysical investigation of everything else. So, if we accept traditional metaphysics, we should be prepared to yield to abstruse pronouncements—either by giving up our most secure beliefs about the world that we encounter or by abandoning our conception of what those beliefs are really about. (shrink)

Abstract This paper addresses the teaching of mandatory ethics courses in a military context, with particular reference to the Service Academies of the United States Armed Forces. In seeking to optimize the core ethics course's potential to develop Midshipmen and Cadets' moral reasoning skills I suggest a model that employs case-based scenarios, woven together into a metanarrative, in place of the traditional historical case study and in a manner that gives students deliberate, guided practice in ethical decision-making. The described model (...) also commends a resource- and pedagogy-driven partnership between civilian philosophers/ethicists and senior military officers in teaching the course. Also proposed is the deliberate use of a simple but formal method of applying the central ethical theories usually taught in such courses, what I call ?ethical triangulation?. The employment of Computer Aided Argument Mapping is also recommended. (shrink)

M any philosophers who otherwise have disparate views on the mind share a fundamental assumption. The assumption is that mental processes, or at least those that explain behavior, are wholly determined by properties of the individual whose processes they are.' As elaborated by..

When laypeople learned what decisions physicians were making about laypeople's health they were often appalled. … They discovered that physicians … were making controversial moral moves, choices th...

Although “transition” is an established area of educational research, there has been little empirically exploration of how shifts in the ways that knowledge is packaged and valued impact on students’ reading and writing as they transition into higher education. This article draws on a longitudinal ethnographic study that traced the experiences, practices and understandings of 11 students from their last year of A-levels through to their second year of undergraduate study. Analysis shows that the forms of knowledge privileged and the (...) ways that knowledge is packaged vary significantly between the two educational contexts, impacting on students’ engagement with texts as they transition into university. This article further illustrates that as a result of shifts in what counts as knowledge between these levels, students face challenges adapting to undergraduate literacies, which disrupts the simplistic notion of transition evoked in the dominant positioning of “the transition to uni... (shrink)

This chapter contains sections titled: Maybe It's Simple Sexism Do Not Go Gentle Universal Praise for the Natural? What About Natural Disasters? Focus on the Pain Recommending Pain Humble Mamas Praise Mama Notes.

In this paper, the limitations associated widi current research approaches to the study of clinical decision‐making are discussed. Research examining the clinical decision‐making of nurses and doctors, and associated work in information procession, is reviewed. It is concluded that although die research is valuable in furthering die understanding of clinical decision‐making, diere are limitations associated with die current research approaches. The limitations are primarily related to the research approaches employed and the concentration on experienced nurses. The research fails to examine (...) die development of clinical decision‐making ability and die learning diat occurs in practice. Phenomenography is proposed as an alternative approach. The aim of phenomenography is to describe an individual's perception of a phenomenon. Phenomenography is relevant to die study of clinical decision‐making as it is concerned with variation in experience. When applied to die study of new graduate nurses, phenomenography can provide valuable information in relation to individual differences in learning diat arise from experience, what factors influence learning and how diey affect clinical decisionmaking ability. (shrink)

Nihilism, for Nietzsche, is the nothing that results from the devaluation of the highest values. There is widespread agreement with Nietzsche’s claim that the apostle Paul was the great devaluer of the values of the ancient world, even to the extent of breaking the history of the world in two. Yet the mode of Paul’s devaluating nihilism is contested. Using Nietzsche’s three types of nihilist, I frame this debate over Paul as giving us, respectively, Paul the reactive nihilist (Nietzsche), Paul (...) the active nihilist (Taubes) and Paul the overman (Badiou). I then read Agamben’s messianic Paul as a way to avoid the problem of nihilism tout court, which the two earlier accounts, despite releasing Paul from Nietzsche’s charge of passive nihilism, do not. I finish by arguing that while Agamben’s construction of the Pauline messianic vocation does indeed break with Nietzsche’s categories of nihilism, nihilism remains necessary to a genealogy of both Paul’s and Agamben’s messianism. (shrink)

Can war be morally justified? What is the philosophy behind armed conflict? How do you conduct an ethical war? And what guides military action as the nature of conflict changes over time? Based on a MOOC (Massive Open Online Course) designed for both military personnel and non-specialists across the globe, Key Concepts in Military Ethics is structured as a series of 'mini-chapters' that cover a huge range of topics and issues: moral dilemmas, military and civilian interactions, freedom of the press, (...) peacekeeping, terrorism, and humanitarian intervention. Written by a team of academic experts, many with military experience, the book contains scenarios and case studies, including the Gulf War, the Falklands War, 'Ground Zero' in New York City and more conventional theatres of war through history, as well as cyber-terrorism, the role of military contractors and unmanned weapons systems. (shrink)

For many years, scholars have been moving away from the idea of a singular, secular, rationalistic, and mechanistic "Enlightenment project." Historian Peter Reill has been one of those at the forefront of this development, demonstrating the need for a broader and more varied understanding of eighteenth-century conceptions of nature. Life Forms in the Thinking of the Long Eighteenth Century is a unique reappraisal of Enlightenment thought on nature, biology, and the organic world that responds to Reill's work. The ten essays (...) included in the collection analyse the place of historicism, vitalism, and esotericism in the eighteenth century--three strands of thought rarely connected, but all of which are central to Reill's innovative work. Working across national and regional boundaries, they engage not only French and English but also Italian, Swiss, and German writers. (shrink)

Les États cheminent entre concurrence et convergence, les entreprises trans-nationales entre opportunisme et autorégulation. Il est futile d’imaginer qu’un ordre unifié et stable émerge de cette tension. Le monde normatif des entreprises transnationales doit plutôt être compris en appréhendant la direction de ses changements, et non pas en cher-chant à trouver un état d’équilibre. Pour l’auteur, les convections essentielles relèvent tant des efforts des États pour ajuster leur pouvoir normatif et promouvoir leur attractivité dans un monde globalisé, que de la (...) perméabilité croissante des entreprises et de leurs dirigeants à certains objectifs sociétaux qui vont au-delà du juridique et qui viennent se rajouter à la performance financière comme indicateurs complémentaires de la vitalité d’une entreprise. (shrink)

Amie Thomasson and I are in agreement about artifacts, in particular about the existential dependence of artifacts on human intentions. Thomasson says, “Since the very idea of an artifact is of something mind-dependent in certain ways, accepting mindindependence as an across-the-board criterion for existence gives us no reason to deny the existence of artifacts; it merely begs the question against them.” I agree entirely.