The Covid‐19 pandemic has revealed myriad social, economic, and health inequities that disproportionately burden populations that have been made medically or socially vulnerable. Inspired by state and local governments that declared racism a public health crisis or emergency, the Anti‐Racism in Public Health Act of 2020 reflects a shifting paradigm in which racism is considered a social determinant of health. Indeed, health inequities fundamentally rooted in structural racism have been exacerbated by the Covid‐19 pandemic, which calls for the integration of (...) antiracist praxis to promote ethical public health research processes. This commentary describes ways in which antiracist praxis—which emphasizes empowerment of traditionally marginalized populations—offers strategies to explicitly address power imbalance, stigmatization, and other consequences of structural racism in public health research. (shrink)

Surveying a wide range of cultural controversies, from the Mapplethorpe affair to Salman Rushdie's death sentence, from canon-revision in the academy to the scandals that have surrounded Anthony Blunt, Martin Heidegger, and Paul de Man, Wendy Steiner shows that the fear and outrage they inspired are the result of dangerous misunderstanding about the relationship between art and life. "Stimulating. . . . A splendid rebuttal of those on the left and right who think that the pleasures induced by art (...) are trivial or dangerous. . . . One of the most powerful defenses of the potentiality of art."--Andrew Delbanco, New York Times Book Review "A concise and . . . readable account of recent contretemps that have galvanized the debate over the role and purposes of art. . . . [Steiner] writes passionately about what she believes in."--Michiko Kakutani, New York Times "This is one of the few works of cultural criticism that is actually intelligible to the nonspecialist reader. . . . Steiner's perspective is fresh and her perceptions invariably shrewd, far-ranging, and reasonable. A welcome association of sense and sensibility."-- Kirkus Reviews, starred review "Steiner has succeeded so well in [the] task she has undertaken. The Scandal of Pleasure is itself characterized by many of the qualities Steiner demans of art, among them, complexity, tolerance and the pleasures of unfettered thought."--Eleanor Heartly, Art in America "Steiner . . . provides the best and clearest short presentation of each of [the] debates."--Alexander Nehamas, Boston Book Review "Steiner has done a fine job as a historian/reporter and as a writer of sophisticated, very clear, cultural criticism. Her reportage alone would be enough to make this a distinguished book."--Mark Edmundson, Lingua Franca. (shrink)

Partnerships with Families and Communities: Building Dynamic Relationships is a comprehensive and accessible resource that provides pre-service teachers with the tools required to build effective, sustainable and proactive partnerships in both early childhood and primary educational settings. This text introduces models of home-school-community partnerships in educational contexts and presents a comprehensive partnerships approach for best practice in applying and leading effective relationships with key stakeholders. It explores essential underpinning policies, legislation and research theories that position strong, positive and proactive (...) partnerships as a systemic solution to children's learning development. Key topics covered include diversity in partnership work, reflective practice and tools for evaluating working partnerships. Each chapter includes focused pedagogy, key terms and definitions, scenarios and review questions, which enable readers to deeply engage with new concepts. 'Proactive Partners' boxes explore real-world scenarios and encourage readers to link theory with practice. (shrink)

Moral injury occurs when a person perpetrates, bears witness to, or fails to prevent an act that transgresses their deeply held moral beliefs. The deeply held moral belief that physicians share is the oath they take when completing their lengthy training and embarking on their career: Put the needs of patients first. In today's American healthcare system, doctors, nurses, and other healthcare providers are increasingly forced to consider the demands of other stakeholders -- insurers, hospitals, even their own financial security (...) -- before the needs of their patients. Whenever they are forced to make a decision that contravenes their patient's best interest, they feel a sting of moral injustice. Over time, these repetitive insults amass into moral injury. Moral injury and its causes help explain why healthcare workers started leaving the field in droves long before the COVID-19 pandemic exposed weaknesses in the US system, why a rich country has such poor outcomes in certain categories, why there is a shortage of young doctors training for critical areas, and why patients feel so frustrated. In If I Betray These Words, Wendy Dean explores and exposes the impacts of moral injury through vividly told stories that are at once bewildering and eye-opening. Her book serves as a roadmap through a healthcare landscape that can be confounding, and at times even hellish, for those who must navigate it, and it suggest alternative routes for healers and their patients. (shrink)

The major challenge facing today’s biomedical researchers is the increasing competition for available funds. The competitive review process, through which the National Institutes of Health (NIH) awards grants, is built upon review by a committee of expert scientists. The NIH is firmly committed to ensuring that its peer review system is fair and objective.

This article summarizes the April 5–6, 2002 conference on Conflict of Interest and Its Significance in Science and Medicine. Several themes are identified and addressed, including the globalization of science, the widespread presence of conflicts, the increased interest and involvement in conflict of interest by a number of organizations, the difference between academic research and research conducted by industry, and the tension between science and medicine. At the heart of the matter lies objectivity in research and the need for transparency (...) to ensure objectivity. Several future activities were discussed, including the need to share specific examples of how conflict has been managed, and the need for behavioral research to provide a sound empirical understanding of the best ways to provide informed consent for research subjects. (shrink)

To study Earth’s climate, scientists now use a variety of computer simulation models. These models disagree in some of their assumptions about the climate system, yet they are used together as complementary resources for investigating future climatic change. This paper examines and defends this use of incompatible models. I argue that climate model pluralism results both from uncertainty concerning how to best represent the climate system and from difficulties faced in evaluating the relative merits of complex models. I describe (...) how incompatible climate models are used together in ‘multi-model ensembles’ and explain why this practice is reasonable, given scientists’ inability to identify a ‘best’ model for predicting future climate. Finally, I characterize climate model pluralism as involving both an ontic competitive pluralism and a pragmatic integrative pluralism. (shrink)

Objective We reviewed human–robot interaction (HRI) participatory design (PD) research with older adults. The goal was to identify methods used, determine their value for design of robots with older adults, and provide guidance for best practices. Background Assistive robots may promote aging-in-place and quality of life for older adults. However, the robots must be designed to meet older adults’ specific needs and preferences. PD and other user-centered methods may be used to engage older adults in the robot development process (...) to accommodate their needs and preferences and to assure usability of emergent assistive robots. Method This targeted review of HRI PD studies with older adults draws on a detailed review of 26 articles. Our assessment focused on the HRI methods and their utility for use with older adults who have a range of needs and capabilities. Results Our review highlighted the importance of using mixed methods and including multiple stakeholders throughout the design process. These approaches can encourage mutual learning (to improve design by developers and to increase acceptance by users). We identified key phases used in HRI PD workshops (e.g., initial interview phase, series of focus groups phase, and presentation phase). These approaches can provide inspiration for future efforts. Conclusion HRI PD strategies can support designers in developing assistive robots that meet older adults’ needs, capabilities, and preferences to promote acceptance. More HRI research is needed to understand potential implications for aging-in-place. PD methods provide a promising approach. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Duality and Non-Duality in Christian Practice:Reflections on the Benefits of Buddhist-Christian Dialogue for Constructive TheologyWendy FarleyThe question before us is the desirability of Buddhist-Christian dialogue in the work of (what Christians call) constructive theology. As a feminist theologian whose work is ever more deeply shaped by such a dialogue, my immediate answer is an unequivocal yes.1 This dialogue fits a general pattern over two thousand years in which theologians (...) have drawn from the wisdom of other traditions or cultures to better understand the mysteries of human experience. Without neo-Platonism and Aristotle there could hardly have been anything we recognize as Christian theology. Without pre-Christian Irish religion, there would be no Saint Brigit or Celtic Christianity. Without phenomenology, process, and Marxist philosophy the greatest works of twentieth-century Christian thought would not exist. Christianity, like all religions, is a moving river changed by time and culture and nearly as interiorly diverse as its members. The dialogue with Buddhism might be seen as a contemporary example of Christianity's openness to exchange with other ways of thinking that broadens and deepens its best insights. It is perhaps analogous to Origen's reliance on neo-Platonism or Thomas Aquinas's inspiration by the rediscovery of Aristotle.2The porous boundaries between Christianity and its culture open it to wisdom beyond itself but they also open it to cruelty and ignorance. Nothing protects religions from participating in the human condition and thus the prejudices and power structures that mutilate human society. Consumer culture and oppressions by class, ethnicity, and gender are seamlessly incorporated into Christian identity. The tacit synthesis of a culture's values with those of a religion neutralizes possible critique and can elevate a society's oppressions to a sacred duty. For this reason, too, dialogue with Buddhism is important to call Christianity back to its ethical moorings in the ideal of universal love and compassion.Religions are porous to the world around them, but they tend to conceal this from themselves and often imagine themselves to be not only untainted but also uniquely [End Page 135] qualified to mediate salvation. Religions provide human beings with language and practice through which dimensions of reality that cannot simply be read off of nature or experience are (in some sense) encountered. This is their great gift. The difficulty of religions is that tradition can become an end in itself. Because a tradition really does offer meaning and tools for transformation it is easy to slip into the existential posture of so idealizing a tradition that it seems in some direct and exclusive way to correlate to ultimate truth. The curvature of the ego onto itself, so attached to its own pain and pleasure that everything else seems a mere shadow, moves from the microcosm of the self to the macrocosm of religious tradition. The particular religion—or that element within it with which I identify—becomes identical with sacred reality. In the hostility to other religions characteristic of many Christians we see the illusion of egocentrism in its religious form. Paul Tillich described this tendency to absolutize itself as the demonic distortion of religion.3 Religious dialogue is a potent medicine against this overattachment to one's own tradition.These different senses in which a religion integrates into itself the wisdom and illusions of its time and place create enormous diversity within a religious tradition. Root concepts within Christianity concerning soteriology, divinity, and suffering do not have any agreed upon meaning. That is, there is no "Christian" view of salvation. Gregory of Nyssa's ideal of theosis, Luther's emphasis on salvation by grace through faith, an evangelical's experience of being born again, a liberal Protestant's commitment to social justice are so diverse that they seem to represent almost different religions.In light of the malleability and interior diversity of traditions, dialogue may not be between two self-sufficient religions but between participants who inhabit their tradition in a variety of ways.4 With this in mind, I would like to experiment with practice as a basis for some kinds of dialogue. Practice is concretely located in a religious tradition and yet reflects... (shrink)

Throughout March and April 2020, debate raged about how best to allocate limited intensive care unit resources in the face of a growing COVID-19 pandemic. The debate was dominated by utility-based arguments for saving the most lives or life-years. These arguments were tempered by equity-based concerns that triage based solely on prognosis would exacerbate existing health inequities, leaving disadvantaged patients worse off. Central to this debate was the assumption that ICU admission is a valuable but scarce resource in the (...) pandemic context.In this paper, we argue that the concern about achieving equity in ICU triage is problematic for two reasons. First, ICU can be futile and prolong or exacerbate suffering rather than ameliorate it. This may be especially true in patients with COVID-19 with emerging data showing that most who receive access to a ventilator will still die. There is no value in admitting patients with poor prognostic indicators to ICU to meet an equity target when intensive critical care is contrary to their best interests. Second, the focus on ICU admission shifts focus away from important aspects of COVID-19 care where there is greater opportunity for mitigating suffering and enhancing equitable care.We propose that the focus on equity concerns during the pandemic should broaden to include providing all people who need it with access to the highest possible standard of end-of-life care. This requires attention to culturally safe care in the following interlinked areas: palliative care, communication and decision support and advanced care planning. (shrink)

Following the seemingly endless debate over managed care liability, I cannot suppress thoughts of Yeats’s poem, “The Second Coming.” It is not the wellknown phrase, “Things fall apart; the centre cannot hold,” that comes to mind; although that could describe the feeling of a health-care system unraveling. The poem’s depiction of lost innocence — “The best lack all conviction, while the worst/Are full of passionate intensity” — does not allude to the legislature, the industry, the public, or the medical (...) or legal profession. What resonates is the poem’s evocation of humanity’s cyclical history of expectation and disappointment, with ideas as grand as justice and occupations as pedestrian as managed care. Writing in 1919, Yeats described the end of an era with images of war’s destructive forces. The poem expresses a universal desire for some miraculous rebirth or resolution of all problems: “Surely some revelation is at hand.” But instead, the brutish Sphinx-like creature emerges, possibly the Antichrist. New gods displace old gods in the cycle of civilization, and man must muddle on. (shrink)

Following the seemingly endless debate over managed care liability, I cannot suppress thoughts of Yeats’s poem, “The Second Coming.” It is not the wellknown phrase, “Things fall apart; the centre cannot hold,” that comes to mind; although that could describe the feeling of a health-care system unraveling. The poem’s depiction of lost innocence — “The best lack all conviction, while the worst/Are full of passionate intensity” — does not allude to the legislature, the industry, the public, or the medical (...) or legal profession. What resonates is the poem’s evocation of humanity’s cyclical history of expectation and disappointment, with ideas as grand as justice and occupations as pedestrian as managed care. Writing in 1919, Yeats described the end of an era with images of war’s destructive forces. The poem expresses a universal desire for some miraculous rebirth or resolution of all problems: “Surely some revelation is at hand.” But instead, the brutish Sphinx-like creature emerges, possibly the Antichrist. New gods displace old gods in the cycle of civilization, and man must muddle on. (shrink)

In this paper, we examine recent critiques of the debate about defining disease, which claim that its use of conceptual analysis embeds the problematic assumption that the concept is classically structured. These critiques suggest, instead, developing plural stipulative definitions. Although we substantially agree with these critiques, we resist their implication that no general definition of “disease” is possible. We offer an alternative, inductive argument that disease cannot be classically defined and that the best explanation for this is that the (...) concept is structured as a cluster. We further argue that we do not need to reject the possibility of defining the general concept “disease” to legitimate developing stipulative definitions of disease that are relative to particular purposes. A cluster definition of disease is compatible with contextually motivated definitions, which may be considered précisifications of the more general cluster concept. (shrink)

Omnipresent calls for more women in university administration assume these women will prioritize using resources and power to increase female representation, especially in STEM fields where women are most underrepresented. However, empirical evidence is lacking for systematic differences in female versus male administrators’ attitudes. Do female administrators agree on which strategies are best, and do men see things differently? To answer this question, we explored United States college and university administrators’ opinions regarding policies, strategies, and structural changes in their (...) organizations designed to increase women professors’ representation and retention in STEM fields. A comprehensive review of past research yielded a database of potentially-effective, recommended policies (e.g., increasing emphasis on teaching, service, and administration during promotion reviews; stopping the tenure clock for childbearing; providing on-campus childcare; couples-hiring; sharing tenure lines; having more women chair search committees; setting gender quotas for promotion). A survey based on these recommended policies was sent to provosts, deans, associate deans, and department chairs of STEM fields at 96 public and private research universities (formerly called R1s) across the U.S. These administrators were asked to rate the quality and feasibility of each recommended policy; 474 provided data, of which 334 contained complete numerical data used in the analyses, so our results are based on a large, geographically diverse group of administrators at research universities. Our data revealed that female administrators perceived the 44 strategies to be higher in quality overall than did male administrators--but not higher in feasibility--with 9 policies perceived differently when rated by women versus men administrators, after imposing conservative statistical controls. There was broad general agreement on the relative rankings of the 44 policies in terms of their perceived quality. Overall, our national survey of U.S. administrators supported the assertion that placing women in administrative roles creates greater emphasis on the importance of enacting policies to attract and retain women in STEM. Topics of disagreement between women and men regarding strategy quality are important focuses of future policy and planning, because female administrators may have insights into how to retain women professors that male administrators do not share. (shrink)

The purpose of this article is to examine and challenge the assumption that the theological legacy of Archbishop William Temple is best continued in the work of Ronald Preston. Preston's concerns in the areas of social ethics and ecumenical relations, as well as his championing of middle axioms, demonstrate his indebtedness to Temple's influence. However, a closer examination of the doctrinal foundations of Preston's social and ecumenical thought did not display a deep understanding of Temple's thought. This is most (...) noticeable in the area of ecclesiology. If Preston had not dismissed Temple's earlier works in favour of the 1942 Christianity and Social Order, he might have avoided developing a theory of the church whose being does not support the tasks Preston requires it to do. (shrink)

This paper raises questions about the epistemological foundations of evidence-based medicine . We argue that EBM is based upon reliabilist epistemological assumptions, and that this is appropriate - we should focus on identifying the most reliable processes for generating and collecting medical knowledge. However, we note that this should not be reduced to narrow questions about which research methodologies are the best for gathering evidence. Reliable processes for generating medical evidence might lie outside of formal research methods. We also (...) question the notion of the knower that is assumed by EBM. We argue that EBM assumes an enlightenment conception of knowers as autonomous, substitutable individuals. This conception is troubled by the way that clinicians learn the role of anecdote in health care and the role of patient choice, all of which bring into play features of clinicians and patients as situated individuals with particular backgrounds and experiences. EBM's enlightenment conception of the knower is also troubled by aspects of the way evidence is produced. Given these limitations, we argue that EBM should retain its reliabilist bent, but should look beyond formal research methodologies in identifying processes that yield reliable evidence for clinical practice. We suggest looking to feminist epistemology, with its focus on the standpoints of individual situated knowers, and the role of social context in determining what counts as knowledge. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A great deal of ink has been spilled on the topic of "Augustinian illumination" over the past two hundred years. Why add more? Although there have been, and continue to be, disagreements over the philosophical relevance of "Augustinian illumination," a standard picture of "Augustinian illumination" is widespread in journal articles, encyclopedias, and commentaries on medieval philosophy. "Augustinian illumination" is widely understood as that Platonic account of knowledge that holds (...) that absolutely certain, necessary truth is attained not via the senses, which are mutable and thus incapable of delivering certainty, but via awareness of the eternality of the divine ideas in the mind of God. Further, the secondary literature has routinely described "Augustinian illumination" as offering an account of knowledge that is different from and incompatible with Aristotle's emphasis on the necessity of input from sensible species in our knowledge of the natures of material things. Finally, the literature has consistently represented Bonaventure as continuing "Augustinian illumination," and Aquinas as rejecting it, and has represented Bonaventure and Aquinas as in agreement that Aristotle and Augustine's cognitive psychologies are incompatible.I have argued elsewhere that this standard representation of "Augustinian illumination" is perhaps best seen as the product of the era of the retrieval of medieval philosophy in the late nineteenth and early twentieth century. Here, my focus is on two texts long considered central to Bonaventure's continuation of "Augustinian illumination" and Aquinas's rejection of it: Bonaventure's Question IV of the Quaestiones disputatae de scientia Christi , and Aquinas's Summa theologiae Ia. 84, 1-8 . My argument is that Aquinas and Bonaventure do not interpret Augustine as following a Platonic epistemological schema, nor do they agree that Aristotle and Augustine hold contradictory cognitive psychologies. Instead, both Bonaventure and Aquinas interpret Augustine as consciously rejecting Platonic epistemology and as ripe for assimilation with Aristotelian epistemological givens, including the notion that paradigmatic knowledge proceeds from the senses, and both articulate a cognitive psychology that harmonizes Augustinian and Aristotelian elements. In other words, if by "Augustinian illumination" we mean the continuation of a Platonic account of knowledge at odds with an Aristotelian emphasis on the necessity of the senses in the creation of certain knowledge, then at least in these texts, Bonaventure does not continue "Augustinian illumination," nor does Aquinas reject it, because "it" does not exist in their reading or interpretation of Augustine's texts.After some brief remarks about the history of the interpretative strain that has marked the commentary on these texts, I begin with Aquinas's ST Ia 84.1-8 in section I. Although it is chronologically a decade or so later, Aquinas's streamlined treatment of the role of the eternal reasons in the production of scientia sets up a clear comparison with Bonaventure's slightly earlier, longer Quaestiones disputatae de scientia Christi , which I discuss in section II. The similarities between Bonaventure and Aquinas's positions can be seen with greater clarity when contrasted with Henry of Ghent's slightly later treatment in the Summa theologiae, Q. 1, art. 1, 2, which I treat in section III. In particular what emerges is a clear contrast with how Ghent reads and assimilates the Augustinian corpus: Ghent's is an explicitly pro-Platonic Augustine, and his formulation of "illumination" is precisely the reading of Augustine that Bonaventure and Aquinas reject. I conclude with remarks highlighting the similarities in Bonaventure and Aquinas's approach vis a vis Ghent's and suggest the need to revise our notions of thirteenth century approaches to "Augustinian illumination" as well as our narratives regarding the assimilation of Aristotle's epistemological corpus in the middle-decades of the thirteenth-century.Interpretative strainBonaventure's question IV and Aquinas's ST Ia 84, 1-8 have long shown signs of interpretive strain. Detailed commentaries on this section of the Summa often skip over article 5 on the Augustinian eternal reasons entirely, or simply reiterate stock interpretations. Alternatively, it is grudgingly admitted that Question 84 evidences an. (shrink)

Patient visits are an important opportunity for general practitioners to discuss the risks of smoking and cessation strategies. In Australia, the guidelines on cessation published by the Royal Australian College of General Practitioners represent a key resource for GPs in this regard. The predominant message of the Guidelines is that pharmacotherapy should be recommended as first-line therapy for smokers expressing an interest in quitting. This, however, ignores established evidence about the success of unassisted quitting. Our analysis of the Guidelines identifies (...) a number of potential conflicts of interest which may have affected the advice provided. These include extensive funding by the pharmaceutical industry of sources cited to support the recommendations, and relations between members of the Guidelines Content Advisory Group and the pharmaceutical industry. Recommendations issued by professional bodies have enormous potential impact upon public health and there is a need for the highest levels of scrutiny and transparency in their development. Information about research cited in guidelines should include funding sources, and developers should be free of obvious conflicts of interest. Smoking remains the leading preventable cause of global mortality. Concerns related to pharmaceutical industry funding of research, scientific integrity and recommendations on smoking cessation by medical advisory groups clearly have implications beyond Australia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 39.1 (2006) 45-71 [Access article in PDF] Presencing "Communion" in Chaïm Perelman's New Rhetoric Richard Graff Wendy Winn Department of RhetoricUniversity of MinnesotaOver the second half of his long and distinguished career, Chaïm Perelman reiterated the central themes of his theory of rhetoric many times. As the audience for his work expanded, Perelman was repeatedly invited to summarize the principles presented in La nouvelle rhétorique, (...) his magnum opus authored in collaboration with Lucie Olbrechts-Tyteca, which appeared in 1958. On these occasions, he would often attempt to clarify or refine the major concepts presented in that treatise. Nevertheless, even today many aspects of Perelman's work remain enigmatic. In outline, The New Rhetoric itself conveys a sense of structural and theoretical clarity, but for many readers this first impression evaporates when they confront the complexity and detail of the work's exposition. In the preface to their new study of Perelman, Alan Gross and Ray Dearin observe:The New Rhetoric is difficult to read, a task made even more difficult for American audiences because virtually all its examples and illustrations are from a literature in a foreign language.... Moreover, Perelman's later attempts to achieve clarity, in The Realm of Rhetoric, and numerous shorter articles, are equally puzzling. Consequently, some of Perelman's best ideas are virtually buried in a very long work, and therefore largely lost even to the most careful readers. In addition, on such central issues as the relationship between rhetoric and philosophy Perelman remains maddeningly obscure. (2003, ix) While Perelman's status as a pioneering figure in the rejuvenation of rhetorical study in Continental Europe is secure, as is his placement among the canonical twentieth-century theorists by American scholars, such difficulties constitute an impediment to contemporary understanding and future appreciation of his achievement; and the sprawling character of The New Rhetoric certainly has not helped to counteract the less [End Page 45] sympathetic reception his work has received in some corners of rhetorical and argumentation studies.1Gross and Dearin's volume joins several other recent studies that have contributed to the untangling of Perelman's thought and to the profitable application of his ideas.2 Still, some of Perelman's "best ideas" remain buried and sorely in need of excavation. Chief among these are considerations prompted by Perelman's use of the evocative yet mysterious term "communion." Although communion appears repeatedly among the panoply of concepts and argumentative techniques described in The New Rhetoric, explicit discussion of it there is brief and scattered, and the subject receives only glancing mention in Perelman's subsequent publications. In turn, communion has been all but ignored in the scholarship responding to or extending Perelman's work.3 This is even the case in studies where one would expect to see more serious engagement with Perelman's ideas on the subject—notably, in those that consider the status of values in argumentation and the role of rhetoric in the constitution and maintenance of community.4In this essay, we offer a detailed analysis of Perelman's conception of communion and, in the course of endowing the concept with greater "presence," aim to show its rich implications for these areas of inquiry. We argue that the idea of communion is a vital, if understated, component of Perelman's proposed "new rhetoric." Like other aspects of Perelman's theory, however, it is an expansive and somewhat slippery notion. In The New Rhetoric, communion is used in a very general sense as the term denoting a community's agreement on questions of value, but also, more narrowly, as an objective sought in certain forms of discourse and as an effect of specific linguistic-stylistic devices. The exegesis needed to indicate the subtle links between these senses will enable us to describe the manner in which Perelman endeavored to integrate the technical lore inherited from the classical tradition of rhetoric with a broadly social and determinedly pluralisticconception of argumentation.We begin by examining communion in relation to Perelman and Olbrechts-Tyteca's ideas... (shrink)

This book is a collection from the articles of 'The Skeptic' and brings together the best from the magazine's archive in one myth-busting volume. It includes mystery articles on the weeping statue at a Dublin suburban home, Turin Shroud, Britain's Roswell, Nostradamus's predictions and UFOs.

Many observers have argued that the US health care system could be more efficient, and achieve better outcomes if providers focused more on improving the community's health, not just the welfare of individual patients. The passage of the Affordable Care Act in 2010 seemed to herald the promise of such reforms, and greater integration of the health care and public systems. In this article, we reassess the quest for integration, a quest we call the “integration project.” After examining the modest (...) steps taken so far toward integration, we consider some conceptual barriers to integration as well as some of the risks it might portend for the public health system. Our assessment contributes to wide-ranging debates among public health advocates, practitioners, and policymakers as to the health care system's role in protecting public health, and how the public health system can best be organized to meet expected population health challenges. (shrink)

Trustworthiness is typically regarded as a desirable feature of national identification systems (NISs); but the variegated nature of the trustor communities associated with such systems makes it difficult to see how a single system could be equally trustworthy to all actual and potential trustors. This worry is accentuated by common theoretical accounts of trustworthiness. According to such accounts, trustworthiness is relativized to particular individuals and particular areas of activity, such that one can be trustworthy with regard to some individuals in (...) respect of certain matters, but not trustworthy with regard to all trustors in respect of every matter. The present article challenges this relativistic approach to trustworthiness by outlining a new account of trustworthiness, dubbed the expectation-oriented account. This account allows for the possibility of an absolutist (or one-place) approach to trustworthiness. Such an account, we suggest, is the approach that best supports the effort to develop NISs. To be trustworthy, we suggest, is to minimize the error associated with trustor expectations in situations of social dependency (commonly referred to as trust situations), and to be trustworthy in an absolute sense is to assign equal value to all expectation-related errors in all trust situations. In addition to outlining the features of the expectation-oriented account, we describe some of the implications of this account for the design, development, and management of trustworthy NISs. (shrink)

From the mid nineteenth to mid twentieth century sanatoria loomed large in the popular consciousness as the space for the treatment of tuberculosis (TB). A review of the historiography of sanatoria at the beginning of this paper shows that the nursing contribution to the care of TB patients is at best ignored and at worst attracts negative comment. Added to this TB nursing was not viewed as prestigious by contemporaries, leading to problems attracting recruits. Using a case study approach (...) based on surviving archival material, this paper sets out to provide a glimpse of the work of TB nurses in a rural sanatorium at Westwood, Queensland, Australia. For the nurses geographical isolation was compounded by professional stagnation, which created a working environment influenced by friction and discord among the staff. It reveals how despite this, nurses coped with working in hostile conditions, to make the long stay of their patients, separated from their families and familiar life style more bearable. (shrink)

Grenada Chocolate Company (GCC) is the world’s smallest chocolate factory. After being hit with several hurricanes, the founders of GCC must decide the best way to continue their business. This case addresses the possibilities GCC has while exploring the benefits and pitfalls of a small business.

Peer review of manuscripts has recently become a subject of academic research and ethical debate. Critics of the review process argue that it is a means by which powerful members of the scientific community maintain their power, and achieve their personal and communal aspirations, often at others' expense. This qualitative study aimed to generate a rich, empirically‐grounded understanding of the process of manuscript review, with a view to informing strategies to improve the review process. Open‐ended interviews were carried out with (...) 35 journal editors and peer reviewers in the United Kingdom, the USA and Australia. It is clear from this research that relations of power and epistemic authority in manuscript review are complex and dynamic, and may have positive and negative features, and that even where power is experienced as controlling, restrictive and illegitimate, it can also be resisted. In conclusion, the manuscript review process is best thought of not in terms of simple dominance of reviewers and editors over authors, but rather as a shifting “net” of power relations. These complex power relations need to be understood if reviewers are to be encouraged to participate in the process and to do so in the the most ethical and effective manner. (shrink)

Children's rights, lone motherhood and the breakdown of families are all issues at the forefront of current social debate in the West, with little agreement on what constitutes good parenting, or how the needs of both mother and child are best met. The feminist contribution to this debate is particularly important in keeping in view the diverse identities of all those who provide mothering. The psychoanalytic contribution is often undervalued and misunderstood. _Mothering and Ambivalence_ brings together authors from therapeutic, (...) academic and social work backgrounds to discuss dependency, anxiety and gender relations within families. Drawing on extensive professional experience the contributors combine a psychoanalytic and feminist approach to mothering which transcends the polarized and simplistic political debate about women's and children's needs. They also show how such an approach can inform and improve professional practice. (shrink)

The pharmaceutical industry plays an increasingly dominant role in healthcare, raising concerns about “conflicts of interest” on the part of the medical professionals who interact with the industry. However, there is considerable disagreement over the extent to which COI is a problem and how it should be managed. Participants in debates about COI have become entrenched in their views, which is both unproductive and deeply confusing for the majority of medical professionals trying to work in an increasingly commercialized environment. We (...) used a modified meta-narrative review method to analyse debates about COI in the academic and grey literature. We found two Discourse Models: The Critical Discourse Model sees COI in health and biomedicine as a major problem that both can and should be addressed, while the Defensive Discourse Model argues that current efforts to control COIs are at best unnecessary and at worst harmful. Each model is underpinned by profoundly differing views about how society should be organized—in particular whether market forces should be encouraged or curtailed—and how the dangers associated with market forces should be managed. In order to make any headway, academics and policymakers must recognize that these debates are underpinned by profoundly differing worldviews. (shrink)

While articulating a philosophy of ecology which reconciles deep ecology with ecofeminism may be a laudable project, it remains at best unclear whether this attempt will be successful. I argue that one recent attempt, Carol Bigwood 's feminized deep ecology, fails in that, despite disclaimers, it reproduces important elements of some deep ecologist's essentializing discourse which ecofeminists argue are responsible for the identification with and dual oppression of women and nature. I then propose an alternative model for conceiving and (...) describing human and nonhuman nature modeled on Wittgenstein's remarks concerning anthropomorphizing which I argue is immune to this criticism. (shrink)

The problem that this essay will address is that of devising a viable use for psychological and intentional terms, in short, discourse concerning what-it-is-to-be-a-subject or "subjecthood" in light of, first, Derrida's deconstruction of the transcendental subject and, second, the materialist claim that recent advances in science effectively antiquate any viable role in empirical psychology for the use of terms traditionally associated with mind. I will argue that Wittgenstein's remarks concerning, among other things, the use of psychological terms, private mental objects (...) and the application of psychological terms to non-humans not only provides a clear and important connection between Derrida and contemporary materialism but that, supplemented by Daniel Dennett's intentional stance, offers an alternative model for the use of such terms in empirical psychological investigation. I will call this model a 'grammar of subjecthood'. ;Central to my argument is the claim that, as opposed to being conceived as names for mental objects or states, psychological terms are best understood as descriptive metaphors for the relationship between an organism and its bio/socio/historical context. That is, the Wittgensteinian notion of subjecthood describes a heuristic that, applied to behavior, provides information to empirical psychologists unavailable on a materialist model of explanation. A grammar of subjecthood, then, is both openly anthropomorphic, yet consistently naturalist, enlisting Dennett's intentional stance as an expansion of Wittgenstein's basic strategy. ;The success of such a strategy cannot be measured by showing in what way human beings are to be essentially distinguished from other organisms, but by how much more sense can be made out of something's behavior by speaking of it in terms of, for example, beliefs and intentions. Anything could be treated as a subject; the issue here is to what it is useful to apply such attributes. (shrink)

The emergence of large-scale social media systems, such as Wikipedia, Facebook, and Twitter, has given rise to a new multi-disciplinary effort based around the concept of social machines. For the most part, this research effort has limited its attention to the study of Web-based systems. It has also, perhaps unsurprisingly, tended to highlight the social scientific relevance of such systems. The present paper seeks to expand the scope of the social machine research effort to encompass the Internet of Things. One (...) advantage of this expansion is that it helps to reveal some of the links between the science of social machines and the sciences of the mind. A second advantage is that it furthers our conceptual understanding of social machines and supports the quest to derive a philosophically-robust definition of the term “social machine.” The results of the present analysis suggest that social machines are best conceived as systems in which a combination of social and technological elements play a role in the mechanistic realization of system-level phenomena. The analysis also highlights the relevance of cognitive science and the philosophy of mind to our general understanding of systems that transcend the cyber, physical, and social domains. (shrink)

We agree with Faunce’s proposal that academic legitimacy is important in ensuring that whistle-blowing is included in medical curricula. We disagree, however, with the assertion that this is best achieved by means of an over-arching theoretical foundation for health care whistle-blowing of the kind suggested by Faunce. We propose that systematic theoretical justification is neither the sole nor the main determinant of academic legitimacy when it comes to matters for inclusion in medical school curricula, and outline an alternative view, (...) together with a practical example of a healthcare whistle-blowing topic. (shrink)

Background Autism self-advocates’ views regarding genetic tests for autism are important, but critical questions about their perspectives arise.Methods We interviewed 11 autism self-advocates, recruited through autism self-advocacy websites, for 1 h each.Results Interviewees viewed genetic testing and its potential pros and cons through the lens of their own indiviudal perceived challenges, needs and struggles, especially concerning stigma and discrimination, lack of accommodations and misunderstandings from society about autism, their particular needs for services, and being blamed by others and by themselves (...) for autistic traits. Their views of genetic testing tended not to be binary, but rather depended on how the genetic test results would be used. Interviewees perceived pros of genetic testing both in general and with regard to themselves (e.g., by providing “scientific proof” of autism as a diagnosis and possibly increasing availability of services). But they also perceived disadvantages and limitations of testing (e.g., possible eugenic applications). Participants distinguished between what they felt would be best for themselves and for the autistic community as a whole. When asked if they would undergo testing for themselves, if offered, interviewees added several considerations (e.g., undergoing testing because they support science in general). Interviewees were divided whether a genetic diagnosis would or should reduce self-blame, and several were wary of testing unless treatment, prevention or societal attitudes changed. Weighing these competing pros and cons could be difficult.Conclusions This study, the first to use in-depth qualitative interviews to assess views of autism self-advocates regarding genetic testing, highlights key complexities. Respondents felt that such testing is neither wholly good or bad in itself, but rather may be acceptable depending on how it is used, and should be employed in beneficial, not harmful ways. These findings have important implications for practice, education of multiple stakeholders, research, and policy. (shrink)

Traditionally, physicians and parents made decisions about children’s health care based on western practices. More recently, with legal and ethical development of informed consent and recognition for decision making, children are becoming active participants in their care. The extent to which this is happening is however blurred by lack of clarity about what children — of diverse levels of cognitive development — are capable of understanding. Moreover, when there are multiple surrogate decision makers, parental and professional conflict can arise concerning (...) children’s ‘best interest’. Giving children a voice and offering choice promotes their dignity and quality of life. Nevertheless, it also presents with many challenges. Case studies using pseudonyms and changed situational identities are used in this article to illuminate the complexity of ethical challenges facing nurses in end-of-life care with children and families. (shrink)

This paper is one of four interrelated papers resulting from the National Summit on Legal Preparedness for Obesity Prevention and Control convened in June 2008 by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the American Society of Law, Medicine, Ethics. Each of the papers deals with one of the four core elements of legal preparedness: laws and legal authorities for public health practitioners; legal competencies public health practitioners and legal and policy decision makers need (...) for use of these laws and authorities; crossdisciplinary and cross-jurisdiction coordination of law-based public health actions; and information on public health law best practices. Collectively, they are referenced as the “white papers.”Our purpose is to offer action options that will help to improve the legal competencies of public health practitioners and policy decision makers with respect to drafting, interpreting. (shrink)

Packed with ideas designed to help children learn to sing, this booklet offers criteria for selecting songs, strategies to bring out the best in children's voices, and suggestions for games, ideas, and resources.

Genome-wide association studies raise important ethical and regulatory issues. This is particularly true of the current move toward broad sharing of genomic and phenotypic data. Our survey study examined the opinions of professionals involved in human subjects protection regarding genetic research review. The majority indicated that it is important for their institutional review board to offer guidance about developing and using a data repository or biobank that includes genetic data, and also about sharing this data with other investigators. Only one-third (...) of respondents reported that the National Institutes of Health policy regarding data sharing among researchers in genome-wide association studies is clear. Another third answered that they did not know whether this policy is clear. Findings from this study suggest a need for increased education for IRB professionals regarding the existing data sharing policy, collaboration among IRB professionals and researchers to define best practices, and further empirical research into prospective research participants’ information needs and preferences in the context of wide data sharing. (shrink)

The sociology of literature, in the first of many paradoxes, elicits negations before assertions. It is not an established field or academic discipline. The concept as such lacks both intellectual and institutional clarity. Yet none of these limitations affects the vitality and rigor of the larger enterprise. We use the sociology of literature here to refer to the cluster of intellectual ventures that originate in one overriding conviction: the conviction that literature and society necessarily explain each other. Scholars and critics (...) of all kinds congregate under this outsize umbrella only to differ greatly in their sense of what they do and what sociology of literature does. They subscribe to a wide range of theories and methods. Many would not accept the sociology of literature as an appropriate label for their own work; other would refuse it to their colleagues. Nevertheless, every advocate agrees that a sociological practice is essential to literature. For the sociology of literature does not constitute just one more approach to literature. Because it insists upon a sociology of literary knowledge and literary practice within the study of literature, the sociology of literature raises questions basic to all intellectual inquiry.The sociology of literature begins in diversity. The way that is combines the ancient traditions of art with the modern practices of social science makes the very term something of an oxymoron. There is not one sociology of literature, there are many sociological practices of literature, each of which operates within a particular intellectual tradition and specific institutional context. These practices cross basic divisions within the contemporary intellectual field, especially within the university. Inherently interdisciplinary, the sociology of literature is subject to constant reformulation as scholars re-evaluate their disciplines. In consequence, disciplinary boundaries seem less rigid, less logical, and, hence, less authoritative than ever before. Even so—and this is another paradox of the sociology of literature—any sociological conception of literature is best situated in terms of an original discipline and its institutional setting. However frequently individual scholars cross over disciplinary lines, the fundamental divisions retain their force. Priscilla Parkhurst Ferguson is professor of French at the University of Illinois at Chicago; she is author of Literary France: The Making of a Culture. Philippe Desan, whose Naissance de la method: Machiavelle, la Ramée, Bodin, Montaigne, Descartes was published in 1987, is an assistant professor at the University of Chicago. Wendy Griswold, associate professor of sociology at the University of Chicago, recently published Renaissance Revivals: City Comedy and Revenge Tragedy in the London Theatre, 1576-1980. (shrink)

This paper is one of four interrelated papers resulting from the National Summit on Legal Preparedness for Obesity Prevention and Control convened in June 2008 by the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the American Society of Law, Medicine, Ethics. Each of the papers deals with one of the four core elements of legal preparedness: laws and legal authorities for public health practitioners; legal competencies public health practitioners and legal and policy decision makers need (...) for use of these laws and authorities; crossdisciplinary and cross-jurisdiction coordination of law-based public health actions; and information on public health law best practices. Collectively, they are referenced as the “white papers.”Our purpose is to offer action options that will help to improve the legal competencies of public health practitioners and policy decision makers with respect to drafting, interpreting. (shrink)

We invoke the ideal of tolerance in response to conflict, but what does it mean to answer conflict with a call for tolerance? Is tolerance a way of resolving conflicts or a means of sustaining them? Does it transform conflicts into productive tensions, or does it perpetuate underlying power relations? To what extent does tolerance hide its involvement with power and act as a form of depoliticization? Wendy Brown and Rainer Forst debate the uses and misuses of tolerance, an (...) exchange that highlights the fundamental differences in their critical practice despite a number of political similarities. Both scholars address the normative premises, limits, and political implications of various conceptions of tolerance. Brown offers a genealogical critique of contemporary discourses on tolerance in Western liberal societies, focusing on their inherent ties to colonialism and imperialism, and Forst reconstructs an intellectual history of tolerance that attempts to redeem its political virtue in democratic societies. Brown and Forst work from different perspectives and traditions, yet they each remain wary of the subjection and abnegation embodied in toleration discourses, among other issues. The result is a dialogue rich in critical and conceptual reflections on power, justice, discourse, rationality, and identity. (shrink)

In Sleeping with Extra-Terrestrials , Wendy Kaminer argues that we are a society intoxicated by the irrational: religion, spirituality, and popular therapies threaten to replace rational thought with supernaturalism and impassioned but unexamined personal testimony. Ranging from our fascination with angels, aliens, and near- death experiences to the rise of junk science, the recovery movement, and the digital culture, Kaminer points out the amusing and ominous effects of our deference to spiritual authorities and resistance to critical thinking. She questions (...) conventional wisdom about the association of religious belief with virtue, identifying the sectarianism of efforts to establish religion in the public square. With both wit and empathy, Kaminer takes on what many people hold sacred. Kaminer is an eloquent and incisive critic and rationalist living in a superstitious, evangelical age. In Sleeping with Extra-Terrestrials she challenges us to exercise skepticism, reason, and irreverence and to appreciate the pleasures of free inquiry. (shrink)

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

Tolerance is generally regarded as an unqualified achievement of the modern West. Emerging in early modern Europe to defuse violent religious conflict and reduce persecution, tolerance today is hailed as a key to decreasing conflict across a wide range of other dividing lines-- cultural, racial, ethnic, and sexual. But, as political theorist Wendy Brown argues in Regulating Aversion, tolerance also has dark and troubling undercurrents. Dislike, disapproval, and regulation lurk at the heart of tolerance. To tolerate is not to (...) affirm but to conditionally allow what is unwanted or deviant. And, although presented as an alternative to violence, tolerance can play a part in justifying violence--dramatically so in the war in Iraq and the War on Terror. Wielded, especially since 9/11, as a way of distinguishing a civilized West from a barbaric Islam, tolerance is paradoxically underwriting Western imperialism. Brown's analysis of the history and contemporary life of tolerance reveals it in a startlingly unfamiliar guise. Heavy with norms and consolidating the dominance of the powerful, tolerance sustains the abjection of the tolerated and equates the intolerant with the barbaric. Examining the operation of tolerance in contexts as different as the War on Terror, campaigns for gay rights, and the Los Angeles Museum of Tolerance, Brown traces the operation of tolerance in contemporary struggles over identity, citizenship, and civilization. (shrink)

Neoliberalism and neoconservatism are two distinct political rationalities in the contemporary United States. They have few overlapping formal characteristics, and even appear contradictory in many respects. Yet they converge not only in the current presidential administration but also in their de-democratizing effects. Their respective devaluation of political liberty, equality, substantive citizenship, and the rule of law in favor of governance according to market criteria on the one side, and valorization of state power for putatively moral ends on the other, undermines (...) both the culture and institutions of constitutional democracy. Above all, the two rationalities work symbiotically to produce a subject relatively indifferent to veracity and accountability in government and to political freedom and equality among the citizenry. (shrink)

Critical Conversations in Philosophy of Education presents a series of conversations expressing many of the multiple voices that currently constitute the field of philosophy of education. Philosophy of education as a discipline has undergone several turns--the once marginal perspectives of the various feminisms, critical Marxism, and poststructuralist, postmodernist and cultural theory have gained ground alongside those of Anglo-analytic and pragmatic thought. Just as western philosophers in general are coming to terms with the "end of philosophy" pronouncement implicit in postmodernism, so (...) too are philosophers of education faced with similar challenges--challenges to long-held moral, political, aesthetic and epistemological commitments. The contributors take up these challenges through a dialogical structure, expressing differing positions without engaging in destructive critique. There is no intention to come to consensus; rather the point is to expand the number and kind of participating voices in the conversation and engage in a lively intellectual exchange that will insure the vitality of educational theorizing. (shrink)

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...) silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice. (shrink)

ABSTRACT:In a world filled with poverty, environmental degradation, and moral injustice, social enterprises offer a ray of hope. These organizations seek to achieve social missions through business ventures. Yet social missions and business ventures are associated with divergent goals, values, norms, and identities. Attending to them simultaneously creates tensions, competing demands, and ethical dilemmas. Effectively understanding social enterprises therefore depends on insight into the nature and management of these tensions. While existing research recognizes tensions between social missions and business ventures, (...) we lack any systematic analysis. Our paper addresses this issue. We first categorize the types of tensions that arise between social missions and business ventures, emphasizing their prevalence and variety. We then explore how four different organizational theories offer insight into these tensions, and we develop an agenda for future research. We end by arguing that a focus on social-business tensions not only expands insight into social enterprises, but also provides an opportunity for research on social enterprises to inform traditional organizational theories. Taken together, our analysis of tensions in social enterprises integrates and seeks to energize research on this expanding phenomenon. (shrink)

ABSTRACT:In a world filled with poverty, environmental degradation, and moral injustice, social enterprises offer a ray of hope. These organizations seek to achieve social missions through business ventures. Yet social missions and business ventures are associated with divergent goals, values, norms, and identities. Attending to them simultaneously creates tensions, competing demands, and ethical dilemmas. Effectively understanding social enterprises therefore depends on insight into the nature and management of these tensions. While existing research recognizes tensions between social missions and business ventures, (...) we lack any systematic analysis. Our paper addresses this issue. We first categorize the types of tensions that arise between social missions and business ventures, emphasizing their prevalence and variety. We then explore how four different organizational theories offer insight into these tensions, and we develop an agenda for future research. We end by arguing that a focus on social-business tensions not only expands insight into social enterprises, but also provides an opportunity for research on social enterprises to inform traditional organizational theories. Taken together, our analysis of tensions in social enterprises integrates and seeks to energize research on this expanding phenomenon. (shrink)