Parents who are facing decisions about life-sustaining treatment for their seriously ill or dying child are supported by their child's doctors and nurses. They also frequently seek other information sources to help them deal with the medical and ethical questions that arise. This might include written or web-based information. As part of a project involving the development of such a resource to support parents facing difficult decisions, some ethical questions emerged. Should this information be presented in a strictly neutral fashion? (...) Is it problematic if narratives, arguments or perspectives appear to favour stopping over continuing life-sustaining treatment? Similar questions might arise with written materials about decisions for adults, or for other ethically contentious decisions. This paper explores the meaning of ‘balance’ in information provision, focusing particularly on written information about life-sustaining treatment for children. We contrast the norm of non-directiveness in genetic counselling with the shared decision-making model often endorsed in end-of-life care. We review evidence that parents do not find neutrality from medical professionals helpful in discussions. We argue that balance in written information must be understood in the light of the aim of the document, the most common situation in which it will be used, and any existing biases. We conclude with four important strategies for ensuring that non-neutral information is nevertheless ethically appropriate. (shrink)

This is a unique, groundbreaking study in the history of philosophy, combining leading men and women philosophers across 2600 years of Western philosophy, covering key foundational topics, including epistemology, metaphysics, and ethics. Introductory essays, primary source readings, and commentaries comprise each chapter to offer a rich and accessible introduction to and evaluation of these vital philosophical contributions. A helpful appendix canvasses an extraordinary number of women philosophers throughout history for further discovery and study.

Minority female youth are significantly affected by the HIV epidemic. The purpose of this pilot study was to explore sexual behavior practices, disclosure of HIV status, attitudes about disclosure, and knowledge of HIV disclosure laws among female youth with HIV. Findings suggest that the majority of YWH studied have been sexually active since their HIV diagnosis, although the nature and extent of sexual activity varied. Rates of nondisclosure to sexual partners varied based on the type of question asked, but at (...) least some of the YWH in this sample reported sexual activity with a partner who was unaware of the participant’s HIV status. YWH appear to be more likely to disclose before, as opposed to after, sexual activity. Although most YWH believe disclosure to sexual partners is important for a variety of reasons, many reasons exist for nondisclosure, including fear of rejection and limited communication skills. The majority of YWH in this sample were aware of the potential legal ramifications of nondisclosure although fear of legal repercussions was not the most important factor related to disclosure. These findings favor the implementation of HIV disclosure interventions over the enactment of HIV criminalization laws as a strategy for reducing HIV transmission. (shrink)

This paper examines, on the basis of a longitudinal corpus of 50 early modern authors, how change at the aggregate level of the community interacts with variation and change at the micro-level of the individual language user. In doing so, this study aims to address the methodological gap between collective change and entrenchment, that is, the gap between language as a social phenomenon and the cognitive processes responsible for the continuous reorganization of linguistic knowledge in individual speakers. Taking up the (...) case of the prepositional passive, this study documents a strong community-wide increase in use that is accompanied by increasing schematicity. A comparison of the 50 authors reveals that regularities arising at the macro-level conceal highly complex and variable individual behavior, aspects of which may be explained by studying the larger (social) context in which these individuals operate (e. g., age cohorts, community of practice, biographical insights). Further analysis, focusing on how authors use the prepositional passive in unique and similar ways, elucidates the role of small individual biases in long-term change. Overall, it is demonstrated that language change is an emergent phenomenon that results from the complex interaction between individual speakers, who themselves may change their linguistic behavior to varying degrees. (shrink)

For a long time, linguists more or less denied the existence of individual differences in grammatical knowledge. While recent years have seen an explosion of research on individual differences, most usage-based research has failed to address this issue and has remained reluctant to study the synergy between individual and community grammars. This paper focuses on individual differences in linguistic knowledge and processing, and examines how these differences can be integrated into a more comprehensive constructionist theory of grammar. The examination is (...) guided by the various challenges and opportunities that may be extracted from scattered research that exists across disciplines touching on these matters, while also presenting some new data that illustrate how differentiation between individuals can improve models of long-term language change. The paper also serves as the introduction to this special issue of Cognitive Linguistics, which collects seven contributions from various linguistic disciplines focusing on key aspects of individuals’ grammars. (shrink)

Controlled human malaria infection (CHMI) studies involve the deliberate infection of healthy volunteers with malaria parasites under controlled conditions to study immune responses and/or test drug or vaccine efficacy. An empirical ethics study was embedded in a CHMI study at a Kenyan research programme to explore stakeholders’ perceptions and experiences of deliberate infection and moral implications of these. Data for this qualitative study were collected through focus group discussions, in‐depth interviews and non‐participant observation. Sixty‐nine participants were involved, including CHMI study (...) volunteers, community representatives and research staff. Data were managed using QSR Nvivo 10 and analysed using an inductive‐deductive approach, guided by ethics literature. CHMI volunteers had reasonable understanding of the study procedures. Decisions to join were influenced by study incentives, trust in the research institution, their assessment of associated burdens and motivation to support malaria vaccine development. However, deliberate malaria infection was a highly unusual research strategy for volunteers, community representatives and some study staff. Volunteers’ experiences of physical, emotional and social burdens or harms were often greater than anticipated initially, and fluctuated over time, related to specific procedures and events. Although unlikely to deter volunteers' participation in similar studies in furture, we argue that the dissonance between level of understanding of the burdens involved and actual experiences are morally relevant in relation to community engagement, informed consent processes, and ongoing support for volunteers and research staff. We further argue that ethics oversight of CHMI studies should take account of these issues in deciding whether consent, engagement and the balance of benefits and harms are reasonable in a given context. (shrink)

We have conducted a retrospective study of deaths on a paediatric medical intensive care unit over a two-year period and reviewed similar series from outside the UK. There were 89 deaths out of 651 admission (13.7% mortality). In almost two-thirds of the cases death occurred with a decision to limit medical treatment or withdraw mechanical ventilation, implying that additional or further therapy was considered futile. We highlight this as a crucially important issue in the practice of intensive care. More comprehensive (...) studies are needed to help clinicians derive consensus on what constitutes a futile intervention, and therefore when such an intervention should be withheld. This will help families and society better understand the limitations of intensive care. (shrink)

In Poetics of Deconstruction, Lynn Turner develops an intimate attention to independent films, art, and the psychoanalyses by which they might make sense other than under continued license of the subject that calls himself man. Drawing extensively from Jacques Derrida's philosophy in precise dialogue with feminist thought, animal studies and posthumanism (Hélène Cixous, Luce Irigaray, Donna Haraway, Cary Wolfe) this book explores the vulnerability of the living as rooted in non-oppositional differences. From abjection to mourning, to the speculative and (...) the performative, it reposes concepts and buzzwords seemingly at home in feminist theory, visual culture and the humanities more broadly. Stepping away from the carno-phallogocentric legacies of the signifier and the dialectic, Poetics of Deconstruction asks you to welcome nonpower into politics, always sexual but no longer anchored in sacrifice. (shrink)

This paper uses Popper's treatment of probability and an epistemic constraint on probability assignments to conditionals to extend the Bayesian representation of rational belief so that revision of previously accepted evidence is allowed for. Results of this extension include an epistemic semantics for Lewis' theory of counterfactual conditionals and a representation for one kind of conceptual change.

The Geneva Consensus Declaration, introduced by the Trump-Pence administration in 2020 and signed by thirty-two countries, claims that there is no international right to abortion. Although the Declaration was subsequently repudiated by the Biden administration, it did not die. This paper traces the afterlife of the Geneva Consensus Declaration as part of an ongoing antiabortion strategy to form a global coalition. Its supporters hope to mobilize signing nations to remove sexual and reproductive rights from the agendas of multilateral agencies including (...) the United Nations and Organization of American States. The Geneva Consensus Declaration puts antiabortion politics above all other considerations, creating common cause among governments that oppose reproductive and sexual rights by undermining multilateral governance. (shrink)

SummaryA sample of 104 British parents with criminal convictions had an average fertility of 3·91 children as compared with 2·21 for the general population. The result suggests that fertility for criminal behaviour is dysgenic involving an increase in the genes underlying criminal behaviour in the population.

Scotland is usually portrayed as being a country that had weak and terrible queens, like Margaret Tudor and Mary Queen of Scots. Saint Margaret is the only queen who is constantly portrayed positively. However, that is not because of her actions as queen consort, but because she was a devote Christian. Scotland is also portrayed for not producing well known or strong female rulers. This essay will examine two contemporary female rulers from the mid-fifteenth century, one from Scotland, Eleanor of (...) Scotland, and one imported to Scotland, Mary of Gueldres. Using these case studies it will be demonstrated that Scotland did produce strong female rulers along with acquiring them. (shrink)

“The Role of the Individual in Evolution” is a prescient yet neglected 1941 work by the 20th century’s most important paleontologist, George Gaylord Simpson. In a curious intermingling of explanation and critique, Simpson engages questions that would become increasingly fundamental in modern biological theory and philosophy. Did individuality, adaptation, and evolutionary causation reside at more than one level: the cell, the organism, the genetically coherent reproductive group, the social group, or some combination thereof? What was an individual, anyway? In this (...) introduction, we highlight two points in a wider historical context. First, recognizing the political context of Simpson’s writing profoundly deepens our understanding of the development of his science as the Modern Evolutionary Synthesis infused biology. Second, this story illuminates the emergence of debates around what would eventually come to be called multilevel selection theory. The organism-centered concept of biological individuality defended by Simpson is situated in relation to the then-emerging Synthesis, in which he was a renowned player, and also in relation to the views he opposed: the “metaphysical” ideas of paleontologists such as Henry Fairfield Osborn, who claimed that some evolutionary trends derived from potentialities already implanted in the germplasm; and the organicist ideas of Ralph W. Gerard and the Chicago School of ecologists, which he derided as all too congenial to totalitarianism. We find parallels between the ways that Simpson thought then about human individuality under totalitarianism and the way he thought about individuality in evolution; not that any causal relationship linked the two, but that commonalities of hierarchical structure exist between single entities and groups in both instances. We then trace the subsequent development of Simpson’s political and philosophical takes on the role of the individual in evolution through the 1960s and lightly sketch out the later fate of the organicist ideas of the Chicago School. Simpson’s paper, originally published in the Journal of the Washington Academy of Sciences, is available as supplementary material in the online version of this article, as part of the "Classics in Biological Theory" collection. (shrink)

We generalize the Unstable Formula Theorem characterization of stable theories from Shelah [11], that a theory T is stable just in case any infinite indiscernible sequence in a model of T is an indiscernible set. We use a generalized form of indiscernibles from [11], in our notation, a sequence of parameters from an L-structure M, , indexed by an L′-structure I is L′-generalized indiscernible inM if qftpL′=qftpL′ implies tpL=tpL for all same-length, finite ¯,j from I. Let Tg be the theory (...) of linearly ordered graphs in the language with signature Lg={<,R}. Let Kg be the class of all finite models of Tg. We show that a theory T has NIP if and only if any Lg-generalized indiscernible in a model of T indexed by an Lg-structure with age equal to Kg is an indiscernible sequence. (shrink)

The author has previously shown that for a certain class of structures $\mathcal {I}$, $\mathcal {I}$-indexed indiscernible sets have the modeling property just in case the age of $\mathcal {I}$ is a Ramsey class. We expand this known class of structures from ordered structures in a finite relational language to ordered, locally finite structures which isolate quantifier-free types by way of quantifier-free formulas. This result is applied to give new proofs that certain classes of trees are Ramsey. To aid this (...) project we develop the logic of EM-types. (shrink)

Across mammals, when fathers matter, as they did for hunter-gatherers, sex-similar pair-bonding mechanisms evolve. Attachment fertility theory can explain Schmitt's and other findings as resulting from a system of mechanisms affording pair-bonding in which promiscuous seeking is part. Departures from hunter-gatherer environments (e.g., early menarche, delayed marriage) can alter dating trajectories, thereby impacting mating outside of pair-bonds.

The relationship between ethics and economics has never been easy. Opponents in a tug of war, friends in a warm embrace, ships passing in the night—the relationship has been highly variable. In recent years, the friendship model has been gaining credence, particularly among U.S. corporate executives. Increasingly, companies are launching ethics programs, values initiatives, and community involvement activities premised on management’s belief that “Ethics pays.”.

This paper argues that moral thinking is an essential management capability which strengthens organizations and contributes to theirperformance in the marketplace. The paper explains what moral thinking is, and addresses the most common reasons for considering it inappropriate or irrelevant to managerial practice. The argument provides a compelling rationale for the corporate ethics initiatives undertaken in recent years.

Usage-based linguistics postulates that multi-word expressions constitute a substantial part of language structure and use, and are formed through repeated chunking and stored as exemplar wholes. They are also re-used to produce new sequences by means of schematization. While there is extensive research on multi-word expressions in many spoken languages, little is known about the status of multi-word expressions in the mainstream U.S. variety of American Sign Language. This paper investigates recurring multi-word expressions, or sequences of multiple signs, that involve (...) a high-frequency sign of visual perception glossed as look and the family of ‘look’ signs. The look sign exhibits two broad functions: look/‘vision’ references literal or metaphorical vision and look/‘reaction’ signals a person’s reaction to a visual stimulus. Data analysis reveals that there are recurring sequences in distinct syntactic environments associated with the two functions of look, suggesting that look is in the process of grammaticalization from a verb of visual perception to a stance verb. The sequences demonstrate the emergence of linguistic structure from repeated use through the domain-general cognitive process of chunking in ASL. (shrink)

The University of Pittsburgh Medical Center (UPMC) "Policy for the Management of Terminally Ill Patients Who May Become Organ Donors after Death" proposes to take organs from certain patients as soon as possible after expected cardiopulmonary death. This policy requires clear understanding of the descriptive state of the donor's critical cardiopulmonary and neurologic functional capacity at the time interventions to sustain or harvest organs are undertaken. It also requires strong consensus about the moral and legal status of the donor during (...) dying and confirmation of death. There has been no need for the clarity and precision that this policy relies upon, and thus the needed research and conceptual work has not previously been generated. The empiric base and societal consensus are both too frail to provide justification for this policy at this time. (shrink)

This collection of essays reveals that across Jacques Derrida's work as a whole, as well as that of Hélène Cixous and Nicholas Royle, deconstruction has always addressed questions about animality.

During the past decade, a new term has entered the medical/legal lexicon : maternal-fetal conflict. Implicit in the terminology is the assumption that a pregnant woman and her fetus have separate and competing rights. This concept has stimulated extensive legal and ethical debate, primarily in the context of medical interventions forced on unwilling pregnant women, and in corporate efforts to bar fertile women from hazardous jobs. On one side of the debate are the proponents of the future child's right to (...) be born of sound mind and body, and society's interest in the delivery of healthy newborns. On the other side, are advocates of a woman's right to reproductive autonomy, bodily integrity, due process, confidential medical treatment, and freedom from gender discrimination. Neither side has challenged the formulation of the problem, or has examined its permeation into public health policy. (shrink)

During the past decade, a new term has entered the medical/legal lexicon : maternal-fetal conflict. Implicit in the terminology is the assumption that a pregnant woman and her fetus have separate and competing rights. This concept has stimulated extensive legal and ethical debate, primarily in the context of medical interventions forced on unwilling pregnant women, and in corporate efforts to bar fertile women from hazardous jobs. On one side of the debate are the proponents of the future child's right to (...) be born of sound mind and body, and society's interest in the delivery of healthy newborns. On the other side, are advocates of a woman's right to reproductive autonomy, bodily integrity, due process, confidential medical treatment, and freedom from gender discrimination. Neither side has challenged the formulation of the problem, or has examined its permeation into public health policy. (shrink)

I outline a pragmatic account of evidence, arguing that it allows us to underwrite two implications of feminist scholarship: that knowledge is socially constructed and constrained by evidence, and that social relations, including gender, race, and class, are epistemologically significant. What makes the account promising is that it abandons any pretense of a view from nowhere, the view of evidence as something only individuals gather or have, and the view that individual theories face experience in isolation.

‘Tympaniser’, Alan Bass tells us, is an ‘archaic verb meaning to ridicule publicly’ or to decry. In the essay fronting Margins of Philosophy called ‘Tympan’ Derrida decries the philosophy that would own its limits, absorbing ‘the margin of its own volume’. While it is Derrida’s late work on the ‘animal question’ that has brought his insistence on the nourishment of the limits between species as limitrophy to wider attention, it is also named as the general condition of the interface of (...) the limits in the much earlier text, ‘Tympan.’ There, in dislocating the tympanum, the margins of philosophy are eaten. Equally, given the rhythmic address of the tympanum, we might say that the margins of philosophy are beaten. Struggling within the strictures of a small town amateur dramatic rehearsal, Selma, the lead protagonist in Dancer in the Dark, makes a plea for more rhythm. But there is no license for tap-dancing in The Sound of Music. This chapter considers Dancer’s persistent play on rhythmic sounds as that which trip Selma’s fantasy song and dance numbers as a ‘tympanising’ of the limits, notably of the limits of the law in both juridical and symbolic senses, as they also work the edges of the film’s two styles. In a provocative analysis of this film, Cary Wolfe suggests that we might understand Selma’s vocal style as a refusal of the phallic imposition of language, and that her virtually suicidal submission to the death sentence construed as a Lacanian ‘feminine’ act, allow for a notion of a ‘posthuman feminine’. ‘Tympan Alley’ redirects Wolfe’s tantalising term ‘posthuman feminine’ through a more consistently Derridean line of thought. It draws on Derrida’s late work on the animal, in which it is polemically clear that deconstruction has never been confined to the signifier nor to the human, and sounds out the implications of his early work on b/eating the limits through Selma’s percussive ear. (shrink)

ABSTRACT Much has been made of the apparent tensions in Nietzsche's ethical and metaethical views. In this essay I examine a kind of value standard available to Nietzsche that is present in his work. I offer an interpretation of honesty as both a Nietzschean virtue and a means of ethical assessment. Despite Nietzsche's well-known criticisms of truth, he upholds honesty as the only remaining virtue of his free spirits. Honesty has been treated in the literature primarily in the contexts of (...) truth or life affirmation, but I argue that we should instead recognize honesty as a virtue within the context of valuing. I defend honesty as a distinct kind of truthfulness and sincerity involving what I call confrontation. The seeds of Nietzsche's mature view are first evident in his work on tragedy, then developed further in Zarathustra, ultimately revealing a constraint on valuing that is essential to Nietzsche's broader normative projects. (shrink)

Discourses of recovery and resilience have risen to positions of dominance in the mental health field. Models of recovery and resilience enjoy purchase, in both policy and practice, across a range of settings from self-described psychiatric survivors through to mental health charities through to statutory mental health service providers. Despite this ubiquity, there is confusion about what recovery means. In this article we problematize notions of recovery and resilience, and consider what, if anything, should be recovered from these concepts. We (...) focus on three key issues, i) individualization, ii) the persistence of a deficit model, and iii) collective approaches to recovery. Through documentary analysis we consider these issues across third sector organizations, and public and mental health policy. Firstly, definitional debates about recovery reflect wider ideological debates about the nature of mental health. The vagueness of these concepts and implicit assumptions inherent in dominant recovery and resilience discourses render them problematic because they individualize what are social problems. Secondly, these discourses, despite being seen as inherently liberatory are conceptually dependent on a notion of deficit in that talk of “positives” and “strengths” requires the existence of “negatives” and “weaknesses” for these concepts to make sense. We argue that this does little to substantially transform dominant understandings of psychological distress. Thirdly, these issues combine to impact upon the progressive potential of recovery. It comes to be seen as an individualistic experiential narrative accompaniment to medical understandings where the structural causes of distress are obscured. This in turn impacts upon the potential for recovery to be used to explore more collective, political aspects of emotional distress. Drawing on the work of Fraser, we use this critique to characterize “recovery” as a “struggle for recognition,” founded on a model of identity politics which displaces and marginalizes the need for social, political and economic redistribution to address many of the underlying causes of emotional distress. We conclude by stating that it is only when the collective, structural experiences of inequality and injustice are explicitly linked to processes of emotional distress that recovery will be possible. (shrink)

Moral distress is a phenomenon that has been receiving increasing attention in nursing and other health care disciplines. Moral distress is a concept that entered the nursing literature – and subsequently the health care ethics lexicon – in 1984 as a result of the work done by American philosopher and bioethicist Andrew Jameton. Over the past decade, research into moral distress has extended beyond the profession of nursing as other health care disciplines have come to question the impact of moral (...) constraint on individual practitioners, professional practice, and patient outcomes. Along with increased interest in the phenomenon of moral distress have come increasing critiques – critiques that in their essence point to a serious lack of conceptual clarity in the definition, study, and application of the concept. Foundational to gaining conceptual clarity in moral distress in order to develop strategies to prevent and ameliorate the experience is a careful revisiting of the epistemological assumptions underpinning our knowledge and use of the concept of moral distress. It is our contention that the conceptual challenges reveal flaws in the original understanding of moral distress that are based on an epistemological stance that holds a linear conception of cause and effect coupled with a simplistic perspective of ‘constraint’ and ‘agency’. We need a more nuanced approach to our study of moral distress such that our ontological and epistemological stances help us to better appreciate the complexity of moral agents acting in organizational contexts. We believe that critical realism offers such a nuanced approach. (shrink)

Workplace spirituality research has sidestepped religion by focusing on the function of belief rather than its substance. Although establishing a unified foundation for research, the functional approach cannot shed light on issues of workplace pluralism, individual or institutional faith-work integration, or the institutional roles of religion in economic activity. To remedy this, we revisit definitions of spirituality and argue for the place of a belief-based approach to workplace religion. Additionally, we describe the construction of a 15-item measure of workplace religion (...) informed by Judaism and Christianity – the Faith at Work Scale (FWS). A stratified random sample (n = 234) of managers and professionals assisted in refining the FWS which exhibits a single factor structure (Eigenvalue = 8.88; variance accounted for = 59.22%) that is internally consistent (Cronbach’s α = 0.77) and demonstrates convergent validity with the Faith Maturity Scale (r = 0.81, p > 0.0001). The scale shows lower skew and kurtosis with Mainline and Catholic adherents than with Mormons and Evangelicals. Validation of the scale among Jewish and diverse Christian adherants would extend research in workplace religion. (shrink)

Professor Copi provides us with the following example:Remove all cards except aces and kings from a deck, so that only eight cards remain, of which four are aces and four are kings. From this abbreviated deck, deal two cards to a friend. If he looks at his cards and announces that his hand contains an ace, what is the probability that both his cards are aces? If he announces instead that one of his cards is the ace of spades, what (...) is the probability then that both his cards are aces? (shrink)