Ethical clinical practice requires cultural competency. In the United States, Hispanics report stronger attitudinal barriers to drug abuse treatment than any other racial/ethnic group. Hispanics report feeling that drug abuse treatment providers do not understand their unique cultural needs and are unfamiliar with their experiences of discrimination and immigration. Using this case study to explore broader ethical and policy issues, this study investigates the extent to which US universities train counselors to address the culturally specific needs of Hispanic patients and (...) how this is reflected in practice in Los Angeles County. Based on a content analysis of the required courses, syllabi, and course descriptions at 30 universities related to culture/race/racism/ethnicity/diversity at the undergraduate and graduate levels on the addiction therapist track, and thematic analysis of eight in-depth interviews with counselors working in outpatient rehabilitation centers in Los Angeles, I argue that cultural competency education for drug abuse counselors is too surface level and infrequent to adequately prepare students for a career in addiction counseling for Hispanic clients. Significant changes must be made to how cultural diversity is valued and prioritized in the field of psychology to provide better care for Hispanic people with a substance use disorder and fulfill the moral obligation to eliminate this health disparity. Although this study focuses on counselors in Los Angeles, these findings are relevant for professionals and healthcare systems across the United States and beyond who seek to provide equitable and effective care for Hispanic patients. (shrink)

In the first monograph in this exciting area since then, William Fish develops a comprehensive disjunctive theory, incorporating detailed accounts of the three ...

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

It may seem that I am simply confirming Davis’ assertion that in my view of the critical process “different interpretive strategies create completely different texts with no point of comparison” ; but the differences are not all that complete. While many readers now see a God who is more dramatically effective than Pope’s “school divine,” they still see a God who exists in a defining relationship with the figure of Satan, a Satan who is himself significantly changed from the energy-bearing (...) Byronic antihero who was for so long a “given” in the interpretive landscape. The point is, again, that changes do not occur in isolation, because the facts that have undergone change did not exist in isolation either. In the history of Milton criticism, any judgment against God is always and simultaneously a judgment for Satan ; and it follows that a reversal in one pole of the judgment cannot occur without a corresponding—that is, related—reversal in the other. Any increase in the literary “cash value” of Milton’s God will be registered at the expense of his Satan.In short, since literary judgments or observations are not made piecemeal, the process of challenging and changing them is not piecemeal either. That is why it is not “contradictory,” as Davis asserts, “to talk about recalcitrant features of a text” in the context of a thesis that makes the text’s features a function of interpretation . The source of recalcitrance or resistance is not the text as it exists independently of interpretation, but the text as an authoritative and elaborated interpretation has given it to us. I stress “elaborated” because the interpretation is not a single assertion but a complex of assertions; and when a challenge is made to the interpreted text at one point, its other points constitute a reservoir from which objections and “counterchallenges” can emerge. Thus, when someone offers a revisionist account of Milton’s God, a skeptical or unpersuaded reader will respond by observing that this account is incompatible with what we know to be true about other parts of the poem: the characterization of Satan, or of the War in Heaven, or of books 11 and 12. It is then the obligation of the revisionist critic either to demonstrate there is no incompatibility or to extend his new reading in such a way as to recharacterize those parts of the poem that seem to stand as refutations of the revisionist’s reading. He will then be working against resistance, but it will not be the resistance of something that stands outside interpretation; rather it will be the resistance offered by one interpretively produced shape to the production of another. Stanley Fish is the William Kenan, Jr., Professor of English and the Humanities at the Johns Hopkins University. His contributions to Critical Inquiry include “Working on the Chain Gang: Interpretation in the Law and in Literary Criticism” and “Profession Despise Thyself: Fear and Self-Loathing in Literary Studies”. (shrink)

In this article three viewpoints on the relation of body and language are discussed: the poststructuralist viewpoint of Judith Butler, the phenomenological viewpoint of Maurice Merleau-Ponty and the postmodernist viewpoint of Jean-François Lyotard. The reason juxtaposing for these three accounts is twofold. First, the topic requires a combination of post-structuralist and phenomenological insights, and second, the accounts are supplementary. Butler's account raises questions that can be answered with the help of Merleau-Ponty's work. Lyotard's anthropology of the inhuman offers a perspective (...) of finitude that is missing in the other two. The aim of the article is to outline the necessary ingredients of an adequate conception of the speaking embodied subject. (shrink)

The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Children and young people -- Confidentiality -- Health records -- Contraception, abortion, and birth -- Assisted reproduction -- Genetics -- Caring for patients at the end of life -- Euthanasia and physician assisted suicide -- Responsibilities after a patient's death -- Prescribing and administering medication -- Research and innovative treatment -- Emergency situations -- Doctors with dual obligations -- Providing treatment and (...) care in detention settings -- Education and training -- Teamwork, referral, delegation, and shared care -- Public health dimensions of medical practice -- Reducing risk, clinical error, and poor performance. (shrink)

In this bracing book, Fish argues that there is no realm of higher order impartiality--no neutral or fair territory on which to stake a claim--and that those ...

El asesinato de George Floyd en Minneapolis (Estados Unidos) ha desatado múltiples manifestaciones sociales antirracistas en distintos países del mundo, las cuales han adquirido diferentes formatos: marchas, disturbios, pintadas callejeras, militancia hashtag a partir del lema #BlackLiveMatters y el accionar contra diferentes estatuas de personajes históricos polémicos. Dichos monumentos, conmemoraciones a, principalmente, esclavistas y colonizadores, han sido pintados, mutilados o derribados en señal de protesta, pero también como un modo de disputa por los sentidos y las memorias legitimadas en el (...) espacio público, que, además, tiene como antecedente las manifestaciones en Chile a fines de 2019. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

: This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

It is commonly thought that that the best system account of lawhood ((Mill (1843), Ramsey (1978)[fp. 1928], Lewis (1973)) makes available a nice explanation for why laws are ‘distinctively appropriate targets of scientific inquiry’ (Hall, 2015). The explanation takes the following general form: laws are especially valuable for agents like us because they efficiently encode a lot of valuable (non-nomic) information in a tractable format. The goal of this paper is to challenge this style of explanation: I argue that the (...) general principle it presupposes is in conflict with our best account of practical rationality. After considering and rejecting a number of proposals for dissolving the tension, I conclude that BSA proponents may need to scale back the explanatory ambitions of their theory; in particular, they may need to give up the hope of non-circular explanations of the value of nomic information. I end by outlining some challenges for the humean world-view that results after this shift. (shrink)

Body representations are known to be dynamically modulated or extended through tool use. Here, we review findings that demonstrate the importance of a user's tool experience or expertise for successful tool embodiment. Examining expert tool users, such as individuals who use tools in professional sports, people who use chopsticks at every meal, or spinal injury patients who use a wheelchair daily, offers new insights into the role of expertise in tool embodiment: Not only does tool embodiment differ between novices and (...) experts, but experts may experience enhanced changes to their body representation when interacting with their own, personal tool. The findings reviewed herein reveal the importance of assessing tool skill in future studies of tool embodiment. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

Husserlian phenomenology of time, as it is developed on theLectures on the Phenomenology of Inner Time Consciousness, shows some difficulties to explain certain temporal experiences. This is the case of the incompatibility between the rigidity of the retentional modification and the effective approach that a subject may have with his memories. On the one hand, according to the Lectures’ explanation, the darkening of the past occurs in an homogeneous way: The more distant an experience is, the lower the clarity of (...) the associated retention. However, our relation with the past is not so direct. Complementing the studies of the Lectureswith those of the Analysis concerning passive synthesiscould allow to explain this kind of temporal phenomena. (shrink)

Las Lecciones de fenomenología de la conciencia interna del tiempohan sido caracterizadas tanto por su enigmática belleza textual como por su dificultades e inconsistencias. El objetivo de esta comunicación es intentar establecer algunos puntos centrales de la teoría del tiempo husserliana en sus textos tempranos, conducido por el texto de las Leccionesyacompañado por la totalidad de escritos del período y las discusiones más relevantes que se han hecho al respecto.

In the eyes of some of its critics, disjunctivism fails to support adequately the key claim that a particular hallucination might be indistinguishable from a certain kind of veridical perception despite the two states having nothing other than this in common. Scott Sturgeon, for example, has complained that disjunctivism ‘‘offers no positive story about hallucination at all’’ (2000: 11) and therefore ‘‘simply takes [indistinguishability] for granted’’ (2000: 12). So according to Sturgeon, what the disjunctivist needs to provide is a plausible (...) explanation of just how two mental states which have no common component might be indistinguishable for their subject and this in turn will require the telling of a positive story about hallucination. This is the goal of the present essay. (shrink)

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were (...) collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

Stanley Fish argues here for a narrower conception of academic freedom, one that does not grant academics a legal status different from other professionals.

This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

This paper deals with epistemological and methodological complexities in gender studies, when applied to the social movements of indigenous and peasant women in rural Mexico. Their problems, actions, achievements, projects and utopia, allow the appropriation and redefinition of concepts from local ..

Humans are social animals that rely on different ways to interact with each other. The COVID-19 pandemic strongly changed our communication strategies. Because of the importance of direct contact for our species, we predict that immediately after the forced social isolation, people were more prone to engage in direct rather than in virtual interactions, thus showing a lower mimicry response in the use of smartphones. In a non-longitudinal study, we collected behavioral data under naturalistic contexts and directly compared the data (...) of the mimicry response gathered immediately following the Italian lockdown (May–September 2020) with those gathered one year later (May–October 2021). Contrary to our expectations, the mimicry response in the use of smartphones was higher immediately after the lockdown than a year later. Probably the large use of these devices during the lockdown translated into a greater sensitivity to be affected by others’ smartphone manipulation. Indeed, social isolation modified, at least in the short term, the ways we interact with others by making us more prone to engage in “virtual” social interactions. The bright side of the coin unveiled by our findings is that the effect seems to diminish over time. The large behavioral dataset analyzed here (1,608 events; 248 people) also revealed that the mimicry response in the use of smartphones was higher between familiar subjects than between strangers. In this view, mimicry in manipulating smartphones can be considered an example of joint action that fosters behavioral synchrony between individuals that, in the long-term, can translate into the formation of social bonding. (shrink)

In this essay I compare Nussbaum's and Arendt's approach to narrativity. The point of the comparison is to find out which approach is more adequate for practical philosophy: the approach influenced by cognitive theory or the one influenced by hermeneutic phenomenology. I conclude that Nussbaum's approach is flawed by methodological solipsism, which is due to her application of cognitive theory.

Introduction: Three key principles -- Sense datum theories -- Adverbial theories -- Belief acquisition theories -- Intentional theories -- Disjunctive theories -- Perception and causation -- Perception and the sciences of the mind -- Perception and other sense modalities.

We contribute to feminist and gender scholarship on cultural notions of motherhood by analyzing the importance of motherhood among mothers and non-mothers. Using a national probability sample of U.S. women ages 25-45, we find a continuous distribution of scores measuring perceptions of the importance of motherhood among both groups. Employing OLS multiple regression, we examine why some women place more importance on motherhood, focusing on interests that could compete with valuing motherhood, and controlling for characteristics associated with becoming a mother. (...) Contrary to cultural schemas that view mother and worker identities as competing, we find that education level is not associated with the importance of motherhood for either group and that valuing work success is positively associated with valuing motherhood among mothers. Consistent with feminist explanations for delayed fertility, valuing leisure is negatively associated with valuing motherhood for non-mothers. (shrink)

We define a program size complexity function $H^\infty$ as a variant of the prefix-free Kolmogorov complexity, based on Turing monotone machines performing possibly unending computations. We consider definitions of randomness and triviality for sequences in ${\{0,1\}}^\omega$ relative to the $H^\infty$ complexity. We prove that the classes of Martin-Löf random sequences and $H^\infty$-random sequences coincide and that the $H^\infty$-trivial sequences are exactly the recursive ones. We also study some properties of $H^\infty$ and compare it with other complexity functions. In particular, $H^\infty$ (...) is different from $H^A$, the prefix-free complexity of monotone machines with oracle A. (shrink)

As críticas de Newton e Voltaire endereçadas à negação do vazio por parte de Descartes compartilham uma estrutura básica: ambos parecem concordar que tal tese cartesiana conduz a implicações indesejáveis tanto no campo da mecânica, quanto no que diz respeito à teologia. Entretanto, embora Newton admita as implicações teológicas da negação do vazio, elas não constituem o fim último de sua crítica, o que parece ocorrer na crítica de Voltaire. Ao contrário, os argumentos newtonianos para assumir o vazioencontram na mecânica (...) não apenas um campo de prova; eles constituem uma parte importante da fundamentação de um dos pilares do newtonianismo: o espaço absoluto. (shrink)

In an era when much of what passes for debate is merely moral posturing--traditional family values versus the cultural elite, free speech versus censorship--or reflexive name-calling--the terms "liberal" and "politically correct," are used with as much dismissive scorn by the right as "reactionary" and "fascist" are by the left--Stanley Fish would seem an unlikely lightning rod for controversy. A renowned scholar of Milton, head of the English Department of Duke University, Fish has emerged as a brilliantly original critic (...) of the culture at large, praised and pilloried as a vigorous debunker of the pieties of both the left and right. His mission is not to win the cultural wars that preoccupy the nation's attention, but rather to redefine the terms of battle. In There's No Such Thing as Free Speech, Fish takes aim at the ideological gridlock paralyzing academic and political exchange in the nineties. In his witty, accessible dissections of the swirling controversies over multiculturalism, affirmative action, canon revision, hate speech, and legal reform, he neatly eviscerates both the conservatives' claim to possession of timeless, transcendent values, and the intellectual left's icons of equality, tolerance, and non-discrimination. He argues that while conservative ideologues and liberal stalwarts might disagree vehemently on what is essential to a culture, or to a curriculum, both mistakenly believe that what is essential can be identified apart from the accidental circumstances to which the essential is ritually opposed. In the book's first section, which includes the five essays written for Fish's celebrated debates with Dinesh D'Souza, Fish turns his attention to the neoconservative backlash. In his introduction, Fish writes, "Terms that come to us wearing the label 'apolitical'--'common values', 'fairness', 'merit', 'color blind', 'free speech', 'reason'--are in fact the ideologically charged constructions of a decidedly political agenda. I make the point not in order to level an accusation, but to remove the sting of accusation from the world 'politics' and redefine it as a synonym for what everyone inevitably does." Fish maintains that the debate over political correctness is an artificial one, because it is simply not possible for any party or individual to occupy a position above or beyond politics. Regarding the controversy over the revision of the college curriculum, Fish argues that the point is not to try to insist that inclusion of ethnic and gender studies is not a political decision, but "to point out that any alternative curriculum--say a diet of exclusively Western or European texts--would be no less politically invested." In Part Two, Fish follows the implications of his arguments to a surprising rejection of the optimistic claims of the intellectual left that awareness of the historical roots of our beliefs and biases can allow us, as individuals or as a society, to escape or transcend them. Specifically, he turns to the movement for reform of legal studies, and insists that a dream of a legal culture in which no one's values are slighted or declared peripheral can no more be realized than the dream of a concept of fairness that answers to everyone's notions of equality and jsutice, or a yardstick of merit that is true to everyone's notions of worth and substance. Similarly, he argues that attempts to politicize the study of literature are ultimately misguided, because recharacterizations of literary works have absolutely no impact on the mainstream of political life. He concludes his critique of the academy with "The Unbearable Ugliness of Volvos," an extraordinary look at some of the more puzzing, if not out-and-out masochistic, characteristics of a life in academia. Penetrating, fearless, and brilliantly argued, There's No Such Thing as Free Speech captures the essential Fish. It is must reading for anyone who cares about the outcome of America's cultural wars. (shrink)

Developing World Bioethics, Volume 21, Issue 4, Page 211-226, December 2021.

In this paper we consider the problem of how to measure the strength of statistical evidence from the perspective of evidence amalgamation operations. We begin with a fundamental measurement amalgamation principle : for any measurement, the inputs and outputs of an amalgamation procedure must be on the same scale, and this scale must have a meaningful interpretation vis a vis the object of measurement. Using the p value as a candidate evidence measure, we examine various commonly used approaches to amalgamation (...) of evidence across similar studies, including standard forms of meta-analysis. We show that none of these methods satisfies MAP. Thus an underlying measurement problem remains. We argue that a successful approach to evidence amalgamation necessitates a solution to the problem of evidence measurement, and we suggest some lines of reasoning that might guide further work towards this end. (shrink)

The accepted view that Gassendi's ethics is a Christianized form of Epicureanism is incomplete: there is extensive and direct influence of Aristotle's works on the key concepts of Gassendi's ethics, while Epicurean ethics is itself largely informed by Aristotle's views. In the first part of this paper, the notion of freedom as choice informed by rational judgment is examined, and the foundation of Gassendi's intellectualist view of freedom is established in Aristotle's notion of prohairesis. In the second part, the nature (...) of happiness is examined, as well as the relationship between happiness and pleasure, and the contemplative as well as active components of happiness. The third part examines the significance of ethics as an ongoing activity of discernment and regulation of desires: the development of a "second nature" through habitual practice of virtues. The paper concludes with a brief consideration of Aristotle's influence on Gassendi's political philosophy. (shrink)

Right from the start of the Spanish Civil War, thousands of prisoners were executed by shooting. Today, many of them remain anonymous, but others, thanks to their writing, have passed into history. In the final hours before their execution, these men and women had the chance to write a few farewell letters to their nearest and dearest. These letters, known by historians as ?chapel letters,? passed either through official channels exercising prior censorship or else were sent clandestinely. In their farewell (...) letters, the condemned to death informed their families of their tragic fate and dedicated their last words to them. Genuine family relics, material and spiritual testaments, instruments of denunciation and propaganda, these chapel letters are regarded as the most sincere documents of any historical period. Since prisoners expressed in them their most intimate feelings and thoughts, they constitute the most exceptional testimony of all epistolary forms practised behind bars. By using an interdisciplinary approach this essay seeks to define the material and functional characteristics of this genre and to contextualise it in the framework of ordinary writings and scribal culture. (shrink)