This article explores trends in the presence and centrality of males and females in American children's picture books in the twentieth century. Using the Children's Catalog as a population base and a time series analysis, we found that the imbalance in depicting males and females varies through the century in a curvilinear fashion. The earlier and later periods of the century show more egalitarian representations of females in titles and central roles. However, when stories involving only adults or animal characters (...) are considered, males become more prominent over time. Changes in literary themes and the position of women during this time span may be useful in developing a theory to account for these trends. (shrink)

Gender representations reproduce and legitimate gender systems. To examine this aspect of the gendered social order, we analyze the representation of males and females in the titles and central characters of 5,618 children’s books published throughout the twentieth century in the United States. Compared to females, males are represented nearly twice as often in titles and 1.6 times as often as central characters. By no measure in any book series are females represented more frequently than males. We argue that these (...) disparities are evidence of symbolic annihilation and have implications for children’s understandings of gender. Nevertheless, important differences in the extent of the disparity are evident by type of character, book series, and time period. Specifically, representations of child central characters are the most equitable and animals the most inequitable; Little Golden Books contain the most unequal representations; and the 1930s-1960s—the period between waves of feminist activism—exhibits greater disparities than earlier and later periods. Examining multiple types of books across a long time period shows that change toward gender equality is uneven, nonlinear, and tied to patterns of feminist activism and backlash throughout the century. (shrink)

The past 20 years have seen dramatic rises in suicide rates in the United States and other countries around the world. These trends have been identified as a public health crisis in urgent need of new solutions and have spurred significant research efforts to improve our understanding of suicide and strategies to prevent it. Unfortunately, despite making significant contributions to the founding of suicidology – through Emile Durkheim’s classic Suicide (1897/1951) – sociology’s role has been less prominent in contemporary efforts (...) to address these tragic trends, though as we will show, sociological theories offer great promise for advancing our understanding of suicide and improving the efficacy of suicide prevention. Here, we review sociological theory and empirical research on suicide. We begin where all sociologists must: with Durkheim. However, we offer a more comprehensive understanding of Durkheim’s insights into suicide than the prior reviews provided by those in other disciplines. In so doing, we reveal the nuance and richness of Durkheim’s insights that have been largely lost in modern suicidology, despite being foundational to all sociological theories of suicide – even those that have moved beyond his model. We proceed to discuss broadly acknowledged limitations to Durkheim’s theory of suicide and review how more recent theoretical efforts have not only addressed those concerns, but have done so by bringing a larger swatch of sociology’s theoretical and empirical toolkit to bare on suicide. Specifically, we review how recent sociological theories of suicide have incorporated insights from social network theories, cultural sociology, sociology of emotions, and sociological social psychology to better theorize how the external social world matters to individual psychological pain and suffering. We conclude by making explicit bridges between sociological and psychological theories of suicide; by noting important limitations in knowledge about suicide – particularly regarding the roles of organizations, inequality, and intersectionality in suicide – that sociology is well situated to help address. (shrink)

Suppose “chicken” eggs could be produced by quasi‐chickens—genetically engineered humps of living chicken‐flesh that do nothing but lay eggs. Would there be anything amiss with that? Animal ethicists invoke the notion of animal integrity in order to give intellectual content to the intuition that there would be. On inspection, ‘integrity’ isn't everything its proponents want it to be. Yet there's enough in it to make reasoned argument possible.

The leading question of this article is whether it is acceptable, from a moral point of view, to take wild animals that are ill out of their natural habitat and temporarily bring them under human control with the purpose of curing them. To this end the so-called 'seal debate' was examined. In the Netherlands, seals that are lost or ill are rescued and taken into shelters, where they are cured and afterwards reintroduced into their natural environment. Recently, this practice has (...) been criticised because it is thought to interfere with the wildness of the animals and population. In this research, the moral assumptions behind the arguments of both the proponents and opponents of sheltering have been analysed within a morally pluralistic framework. It is concluded that sheltering on too large a scale would be contrary to the efforts of the last few decades to maintain an independent or wild seal population, which means that a certain amount of caution is called for. However, in the current situation there is no decisive reason to completely prohibit shelters either. Good arguments can even be given in favour of sheltering. It also becomes clear that the acceptability of sheltering wild animals depends on the specific circumstances in which an animal is encountered. (shrink)

The Nazis' use and misuse of Nietzsche is well known. The Superman, the "will to power," Nietzsche's equation of bourgeois democracy and decadence, and his denigration of reason were staples of Nazi propaganda. Communists also used and misused Nietzsche, but that fact is largely unknown because Soviet propagandists invoked reason and labeled Nietzsche the "philosopher of fascism," even while covertly appropriating his ideas. In this pioneering book, Bernice Glatzer Rosenthal excavates the trail of long-obscured Nietzschean ideas that took root (...) in late Imperial Russia, intertwining with other elements in the culture to become a vital ingredient of Bolshevism and Stalinism. Nietzsche made a difference. He furnished intellectual ammunition for a prolonged conflict about culture, society, and politics that began around the turn of the century. His first Russian admirers were poets, philosophers, and political activists. They responded to the changes transforming their society by espousing new values and seeking a new faith by which to live and work. This response resulted in new aesthetic and political amalgams, such as Symbolism, Futurism, Nietzschean Christianity, and Nietzschean Marxism. The ensuing debates between and among their partisans reverberated throughout the wider culture and therefore also into Bolshevism, becoming the subject of an uninterrupted polemic between Bolsheviks and non-Bolsheviks, and among Bolsheviks, that continued into the 1930s. In Stalin's time, unacknowledged Nietzschean ideas were used to mobilize the masses for the great tasks of the first Five-Year Plan and the Cultural Revolution, which was intended to eradicate "bourgeois" values and attitudes from Soviet life and to construct a distinctly Socialist culture. Nietzsche's belief that people need illusions to shield them from reality underlay Socialist Realism, the official Soviet aesthetic from 1934 on. In the aftermath of de-Stalinization, the government cast Nietzsche as the personification of "bourgeois" nihilism and "bourgeois" individualism. Soviet intellectuals wishing to reappropriate their lost cultural heritage discovered the Nietzsche-influenced intellectuals of late Imperial Russia and reopened discussion on the issues they had posed. More than an exercise in historical rediscovery, _New Myth, New World_ offers a new interpretation of modern Russian history. By uncovering the buried influence of Nietzschean ideas on Soviet culture and politics, Rosenthal opens new avenues for understanding Soviet ideology and its influence on the twentieth century. (shrink)

The importance of medical confidentiality is obvious to anyone who has ever been a patient, and protecting private information about patients is one of the key responsibilities of healthcare professionals. However, maintaining the confidentiality of patients who are incarcerated in prisons poses several ethical challenges. In this chapter we explain the importance of confidentiality in general, and the dilemmas that sometimes face doctors with regard to it, before describing some of the specific difficulties faced by prison doctors. Although healthcare professionals (...) working in prisons have the same duty to respect confidentiality as those working in the wider community, the conflicts of interest caused by their dual loyalty to prisoners and to prison authorities can make it very difficult to strike the right balance between respecting confidentiality and protecting prisoners and third parties. We illustrate some of the dilemmas facing prison doctors with a series of case discussions before providing suggestions for resolving these difficult situations. Ideally, a combination of great ethical and legal sensitivity on the part of healthcare professionals and general respect for prisoners’ rights on the part of other prison staff enables most issues to be resolved without the need to compromise patients’ confidentiality. (shrink)

This article examines international and European regulations on research involving prisoners for consensus, differences, and their consequences, and offers a critical evaluation of the various approaches. Agreement exists that prisoners are at risk of coercion, which might interfere with their ability to provide voluntary informed consent to research. Controversy exists about the magnitude of this risk and the consequences that should follow from this risk. Two strategies are proposed for a method of protecting prisoners that does not lead to discrimination: (...) first, more caution to assure non-coerced consent and second, restrictions on the type of research. Most regulations stress the importance of the principle of equivalence of healthcare in places of detention as part of an efficient protection against research risks and discrimination. All the presented approaches have shortcomings. While 'over-use' of prisoners for research as compared to the general population is ethically unjustified, not granting prisoners access to studies beneficial to their own health because of over-strict regulations is equally unjustified. A middle solution should be preferred, one that grants a minimum of protection together with the lowest possible barriers. Research that does not entail a direct benefit for the individual detainee should be restricted to types of research that have a benefit for detainees as a group and that are of low risk. What will ultimately protect prisoners best, while producing the greatest benefit for them, is access to the same healthcare available to members of the community including research as a true option. (shrink)

A celebration of a distinctly American form of commercial architecture The only comprehensive history of America's 5-&-10-cent stores It was where you went to browse the latest issues of Life and Photoplay, where the folks bought reading glasses, and where your mom took you for a hot dog and a malted. It was the local 5-&-10-cent store, and it was an integral part of everyday life. In this lavishly illustrated homage to the 5-&-10-cent store, architectural historian Bernice Thomas looks (...) at the architectural achievements of the Kress Company. Devoted to bringing outstanding design to Main Street America, Kress supported an architectural division of more than 100 architects and draftsmen. The over 200 stores these people designed and built between 1900 and 1950 set a new standard in commercial architecture. Thomas takes us on an illustrated tour of sites across the United States —from New Orleans to Honolulu, Albuquerque to New York. She introduces us to the architects and how they deftly balanced sound merchandising principles with aesthetics. (shrink)

It is well known that prisoners’ human rights are often violated. In this chapter we examine whether guidelines can be effective in preventing such violations and in helping physicians resolve the significant conflicts of interest that they often face in trying to protect prisoners’ rights. We begin by explaining the role of clinical and ethical guidelines outside prisons, in the context of healthcare for non-incarcerated prisoners, and then the specific role of such guidelines within prisons, where the main concerns are (...) ensuring respect for the principle of equivalence of care, and for a prisoner patient’s autonomy in health care decisions. After reviewing and analysing various national and international guidelines, we review the literature and assess whether the good practices set out in these guidelines actually translate into changes in professional behaviour and consequent benefits for prisoners. It emerges that physicians both outside and within prisons tend to be insufficiently familiar with the relevant guidelines, and that they too infrequently use the guidance to make decisions, preferring instead to use personal codes of conduct. Guidelines designed specifically for the prison context are important to ensure equivalence of care and should be better known by health care personnel and other professional groups working in prison. Further guidelines should be developed that describe challenging situations and provide concrete guidance as to how to deal with them. (shrink)

With more than 700 specific strategies and solutions to use in the classroom, school, and community, this book covers just about everything that educators need, providing a comprehensive and detailed blueprint for an overall plan and policy to prevent and deal with peer harassment.

This volume recognizes and addresses the health care issues of prisoners, to establish best practices and to learn about approaches to these challenges from around the world. It presents new evidence on several emerging and classical prison health issues. The first goal of this volume is to address emerging issues related to health in prison. Second, it presents the most recent research-based evidence and translates it to the practice. The third goal, is that it allows for sufficient diversity while also (...) incorporating updates of some important already recognized prison health. The volume discusses prisons and the life and well-being of prisoners and staff, after growing problems as drug misuse (incl. tobacco smoking), infectious diseases (HIV/AIDS, hepatitis, STIs and TB), psychiatric problems, inadequate and unhealthy living conditions (incl. nutrition), overcrowding of prisons. These are addressed adequately in order to meet the international requirements of equivalence of health care. The scope of this volume is at the same type specific and diverse enough to cover the interests of a large audience that includes many types of practitioners involved in health-related issues in the field of prison health care, such as psychologists, nurses and prison administration officers responsible for health care, legal professionals and social workers. (shrink)

Background Decisions regarding Cardio-Pulmonary Resuscitation (CPR) and Do Not Attempt Resuscitation (DNAR) orders remain demanding, as does including patients in the process. Objectives To explore physicians’ justification for CPR/DNAR orders and decisions regarding patient inclusion, as well as their reports of how they initiated discussions with patients. Methods We administered a face-to-face survey to residents in charge of 206 patients including DNAR and CPR orders, with or without patient inclusion. Results Justifications were provided for 59% of DNAR orders and included (...) severe comorbidity, patients and families’ resuscitation preferences, patients’ age, or poor prognosis or quality of life. Reasons to include patients in CPR/DNAR decisions were provided in 96% and 84% of cases, and were based on respect for autonomy, clinical assessment of the situation as not too severe, and the view that such inclusion was required. Reasons for not including patients were offered in 84% of cases for CPR and in 70% for DNAR. They included absent decision-making capacity, a clinical situation viewed as good (CPR) or offering little hope of recovery (DNAR), barriers to communication, or concern that discussions could be emotionally difficult or superfluous. Decisions made earlier in the patient's management were infrequently viewed as requiring revision. Residents reported a variety of introductions to discussions with patients. Conclusions These results provide better understanding of reasons for CPR/DNAR decisions, reasons for patient inclusion or lack thereof, and ways in which such inclusion is initiated. They also point to potential side-effects of implementing CPR/DNAR recommendations without in-depth and practical training. This should be part of a regular audit and follow-up process for such recommendations. (shrink)

The coronavirus disease 2019 pandemic is responsible for the large-scale devastation experienced all over the world. This ‘invisible stranger’ interrupting our daily lives is highlighting in a new and acute way the vulnerability of the human race. Life as we knew it is being changed forever. COVID-19 also exposed the injustices embedded in social structures all over the world. What will life with and after COVID-19 look like in South Africa? The pandemic reveals that South Africa is not the fair (...) and just society we hoped for since the transition to a democratic country in 1994. In light of this, we should be preparing ourselves for the new ‘abnormal’ as what seemed normal was problematic and therefore, truly abnormal. Seeking guidance from evolutionary anthropology, this article will explore whether the evolutionary story of Homo sapiens might offer us insights on how to successfully navigate the multiple challenges COVID-19 unmasks and also brings forth. A discussion on the evolutionary history of homo sapiens within the context of niche construction theory reveals that our unique capacity for imagination and creative collaboration made us successful as a species. It is these capacities for imagination and cooperation that might facilitate us in successfully imagining and thereafter living the new ‘abnormal’. In this article, the question of imaging the new ‘abnormal’ will be explored.Contribution: By creatively integrating the perspectives evident in this research, this article explores whether the Prophets of Israel might offer a feasible paradigm to determine coordinates for the imagined new ‘abnormal’ to be a more fair and just society. (shrink)

As the world population is growing and government directives tell us to consume more fatty acids, the demand for fish is increasing. Due to declines in wild fish populations, we have come to rely more and more on aquaculture. Despite rapid expansion of aquaculture, this sector is still in a relatively early developmental stage. This means that this sector can still be steered in a favorable direction, which requires discussion about sustainability. If we want to avoid similar problems to the (...) ones we have experienced with livestock farming, we need to generate knowledge of the biology, profitability, environmental aspects, consumer awareness, and product appreciation of particular fish species. However, the discussion about a sustainable aquaculture also raises the question how we should treat fish. This moral question is regularly addressed as a problem of applied ethics with a focus on tailoring ethical principles to practical questions. In this article we do not deny the importance of the practical accounts, but we start from the fundamental question whether and why fish matter in our moral deliberations, i.e., from the discussion on moral status. We elaborate the distinction between moral considerability and moral significance in order to show both the importance and the limitations of the discussion about moral status for practical problems in aquaculture. We illustrate these points with a case-study about the farming of a specific fish species, the African catfish. (shrink)

With In Focus Sacred Geometry, learn the fascinating history behind this ancient tradition as well as how to decipher the geometrical symbols, formulas, and patterns based on mathematical patterns. People have searched for the meaning behind mathematical patterns for thousands of years. At its core, sacred geometry seeks to find the universal patterns that are found and applied to the objects surrounding us, such as the designs found in temples, churches, mosques, monuments, art, architecture, and nature. Learn the fundamental principles (...) behind: Interpreting the sacred symbolism and principles behind shapes Calculating numbers used in sacred geometry Applying the golden ratio and Fibonacci’s Sequence to objects Translating symbolic and geometrical letters and alphabets This accessible and beautifully designed guide to sacred geometry includes a frameable poster of the main sacred geometrical shapes and their unique, innate arrangements. The In Focus series applies a modern approach to teaching the classic body, mind, and spirit subjects. Authored by experts in their respective fields, these beginner's guides feature smartly designed visual material that clearly illustrates key topics within each subject. As a bonus, each book includes reference cards or a poster, held in an envelope inside the back cover, that give you a quick, go-to guide containing the most important information on the subject. (shrink)

Aim: While there is widespread agreement on the broad aspects of what constitutes a biobank, there is much disagreement regarding the precise definition. This research aimed to describe and analyse the definitions of the term biobank offered by various stakeholders in biobanking. Methods: Interviews were conducted with 36 biobanking stakeholders with international experience currently working in Switzerland. Results: The results show that, in addition to the core concepts of biological samples and linked data, the planned use of samples (including sharing) (...) is held to be a key criterion. It also emerges that some researchers avoid the term in order to circumvent certain regulatory guidelines, including informed consent requirements. Conclusion: Developments in the field of biobanking will be complicated if researchers are unaware, or deny that their collection is a biobank. A clear definition of the term is therefore an important step towards fostering collaboration amongst researchers, enabling them to more easily identify potential sources of samples. (shrink)

Biobanks are vital for diagnostic, epidemiological and research purposes following radiation disasters, but there is a history of delays in this type of research and specifically in setting up important resources including tissue repositories following the rare occurrence of these events. Here, we argue that one key lesson from Chernobyl and Fukushima has still not been learned: it is essential to agree on a proactive international plan for a radiation disaster biobank and accompanying data collection before the next disaster occurs.

Healthcare cybersecurity is increasingly targeted by malicious hackers. This sector has many vulnerabilities and health data is very sensitive and valuable. Consequently, any damage caused by malicious intrusions is particularly alarming. The consequences of these attacks can be enormous and endanger patient care. Amongst the already-implemented cybersecurity measures and the ones that need to be further improved, this paper aims to demonstrate how penetration tests can greatly benefit healthcare cybersecurity. It is already proven that this approach has enforced cybersecurity in (...) other sectors. However, it is not popular in healthcare since many prejudices still surround the hacking practice and there is a lack of education on hackers’ categories and their ethics. The present analysis aims to comprehend what hacker ethics is and who ethical hackers are. Currently, hacker ethics has the status of personal ethics; however, to employ penetration testers in healthcare, it is recommended to draft an official code of ethics, comprising principles, standards, expectations, and best practices. Additionally, it is important to distinguish between malicious hackers and ethical hackers. Amongst the latter, penetration testers are only a sub-category. Acknowledging the subtle differences between ethical hackers and penetration testers allows to better understand why and how the latter can offer their services to healthcare facilities. (shrink)

In spite of their performance of highly valuable roles in the civil rights movement, southern Black women remain a category of invisible, unsung heroes and leaders. Utilizing archival data and a subsample of personal interviews conducted with civil rights leaders, this article explores the specific leadership roles of Black women activists; describes the experiences of selected Black women activists from their own “standpoint”; and offers explanations for the lack of recognition and non-inclusion of Black women in the recognized leadership cadre (...) of the civil rights movement. The modern southern-based struggle is most illustrative of how the interlocking systems of gender, race, and class structure Black women's movement leadership and participation. (shrink)

The Institute of Medicine (IOM) Committee on Ethical Considerations for Revisions to DHHS Regulations for Protection of Prisoners Involved in Research published its report in 2006. It was charged with developing an ethical framework for the conduct of research with prisoners and identifying the safeguards and conditions necessary to ensure that research with prisoners is conducted ethically. The recommendations contained in the IOM report differ from current European regulations in several ways, some being more restrictive and some less so. For (...) example, the IOM report suggests limiting the percentage of prisoners that should be involved in a biomedical study to 50%, a limit that does not exist in Europe. However, the report does not specifically advise against research without a direct benefit to an individual prisoner: the European regulations are more restrictive than the IOM committee recommendations in this respect. The definition of minimal risk varies, as well as the proposed role of the minimal risk requirement and of the principle of subsidiarity (research that can only be done effectively in prisons). The IOM report proposes a number of thoughtful suggestions, which it would be beneficial to implement everywhere, such as registers of research on prisoners. The European regulations offer pragmatic solutions to several thorny issues. In summary, the IOM committee report represents an admirable effort to tackle the present inconsistencies and deficiencies of federal regulations in the US on research on prisoners (45 CFR 46 Subpart C). Nonetheless, before acting on the recommendations, US regulators might consider revisiting international guidelines such as those published by the Council for International Organizations of Medical Science (CIOMS) and the Declaration of Helsinki. (shrink)

Elger splendidly describes the evolving global responses---both creative and misguided---to the ethical challenges arising in research using genetic databases and offers thoughtful suggestions for balancing the interests of science and `donors'. As insightful as it is comprehensive, this book is essential reading not only for bioethicists but for anyone who uses, oversees, or simply wants to understand biobanks, which are playing an increasingly essential role in biomedical and epidemiological research. Alexander M. Capron, University of Southern California, USA --.

In this article, two ways of thinking about the potential disruptiveness of de-extinction and gene drives for conservation are presented. The first way of thinking zooms in on particular technologies and assesses the disruptiveness of their potential implications. This approach is exemplified by a framework proposed by Hopster (2021) that is used to conduct our assessment. The second way of thinking turns the logic of the first around. Here, the question is how gene drives and de-extinction fit into a wider (...) and partly pre-existing context of disruption of human-nature relations. By only zooming in on a particular technology and its potential implications, the context out of which the technology is born is unavoidably disregarded. Gene drives and de-extinction are catalysts of a wider disruption already underway. And it is precisely because this disruption is already underway that the terrain is opened for the development and application of these technologies. In other words, the disruptiveness of these technologies strengthens the disruptiveness that was already underway and vice versa. It is argued that the two ways of thinking about emerging technologies in conservation need to go together, meaning in technology assessment both perspectives need to be included. (shrink)

Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children’s position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity (...) is discussed, followed by an examination of Vygostky’s contextualist view on children’s development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults’ decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties. (shrink)

This introduction provides an overview of the life, career, and social thought of Gerhard Lenski. Following a preliminary description of Lenski's contributions, this essay is divided into two sections. The first section examines the origins, education, and biographical influences on Lenski as a major social theorist as well as the intellectual foundation of his sociological theories. The second section presents Lenski's work, impact, and legacy and sets the stage for the original essays that are grouped around four of six key (...) areas of Lenski's work, which has had enormous impact on both American and international sociology: (1) teaching sociology; (2) "status crystallization" and "status inconsistency"; (3) sociology of religion and "the religious factor"; (4) social stratification, "power and privilege"; (5) gender stratification in comparative-historical perspective; and (6) ecological-evolutionary theory. While these six areas do not correspond neatly to the progressive phases of Lenski's theory development and sociological career, they are interconnected and reflect Lenski's central concerns in asking the big questions about human societies and in providing explanations for understanding the processes of social change, differentiation, and inequality among and within human societies, across time and space, from hunting and gathering to postindus trial societies. (shrink)

A new Swiss law requires that any research involving humans must aim to answer "a relevant research question". This paper explains the relevance of the relevance criterion in research, analyses the Swiss and British guidelines on relevance, and proposes a framework for researchers and REC members that enables a clearer conception of the role of relevance in research. We conclude that research must be either scientifically or societally beneficial in order to qualify as relevant, and RECs therefore cannot avoid reviewing (...) the scientific aspects of proposed studies. Normally only scientifically relevant studies can be of benefit to society, but research of low scientific relevance can nonetheless be relevant to society if it forms part of the education of new doctors and scientists. (shrink)

Personal recovery entails the idea of learning to live a good life in the face of mental illness. It takes place in a continuous dynamic between change and acceptance and involves the existential dimension in the broadest sense. With cognitive self-regulation and empowerment as central elements, however, current models of recovery mostly have an individual focus instead of a relational one. Furthermore, there seems to be an emphasis on the component of change. Little attention is payed to the role and (...) integration of dealing with loss in personal recovery. In this paper, the role of loss in mental illness will be elaborated from an existential perspective. This will be done by relating existential changes to possibly disruptive experiences of loss in wider experience. With the help of several perspectives on dealing with loss it will be argued this can be integrated in processes of recovery. Then, it will be elaborated how reexperiencing a state of being surrounded, or being included, being held is a necessary part of recovery. The result consists of a refinement of the view on personal recovery. The aim of this paper is therefore twofold: (1) to arrive at a better understanding of what existential loss and loss in wider experience in the context of psychopathology entails, and (2) to further develop perspectives on recovery in mental health care. (shrink)

Due to its emphasis on experiential interests, animal ethics tends to focus on individuals as the sole unit of moral concern. Many issues in animal ethics can be fruitfully analysed in terms of obligations towards individual animals, but some problems require reflection about collective dimensions of animal life in ways that individualist approaches can’t offer. Criticism of the individualist focus in animal ethics is not new; it has been put forward in particular by environmental ethics approaches. However, the latter tend (...) to be so far removed from the concerns of animal ethicists that both groups talk at cross purposes. We think the gap between environmental and animal ethics could be bridged by on the one hand focusing more on the collective dimensions of our concerns with animals - after all, individuals are constituted by the collective of which they are a part - and on the other hand, by showing that moral status can also be attributed to groups in an indirect way, related to the moral status of their individual members. In our paper we explore various ways of conceptualising the moral relevance of collectiveness in animal life. We draw on insights from public health ethics, as this field of inquiry has also developed - at least partly—in response to individualist approaches in human bioethics, creating more room for recognizing the value of population health, interpersonal relations, solidarity, and ways in which a collective is constituted. (shrink)

Taking Parenting Public makes a compelling case that parenting has become dangerously undervalued in America today. It calls for a new investment—both personal and public—into the work of raising children and argues that we are all "stockholders" in the next generation. With a foreword by Sylvia Ann Hewlett and Cornel West, Taking Parenting Public crosses boundaries to bring together thinkers from diverse fields spanning the political spectrum. It features contributions from distinguished experts in economics, political science, public policy, child development, (...) public health, history, and the media. While recent books have focused on working mothers or absent fathers, Taking Parenting Public is the first volume to take a comprehensive look at the common struggles of parents. These essays go beyond the usual chest-beating about busy parents torn between work and family demands to suggest bold solutions. Instead of the typical call for "parent replacement"—more child care, more after school programs and more mentors—the contributors offer fresh strategies for "parent replenishment," ways to put mothers and fathers back into the lives of their children not only as economic providers, but also as emotional and moral providers. (shrink)

Vulnerability and politics are among the relevant and key topics of discussion in the Ethiopian healthcare context. Attempts by the formal bioethics structure in Ethiopia to deliberate on ethical issues relating to vulnerability and politics in healthcare have been limited, even though the informal analysis of bioethical issues has been present in traditional Ethiopian communities. This is reflected in religion, social values, and local moral underpinnings. Thus, the aim of this paper is to discuss the bioethical implications of vulnerability and (...) politics for healthcare in Ethiopia and to suggest possible ways forward. First, we will briefly introduce what has been done to develop bioethics as a field in Ethiopia and what gaps remain concerning its implementation in healthcare practice. This will give a context for our second and main task – analyzing the healthcare challenges in relation to vulnerability and politics and discussing their bioethical implications. In doing so, and since these two concepts are intrinsically broad, we demarcate their scope by focusing on specific issues such as poverty, gender, health governance, and armed conflicts. Lastly, we provide suggestions for the ways forward. (shrink)

Developments in the last several years have sparked renewed interest in the ethics of research involving humans. Issues relating to the global extent of research and its guiding principles are of particular importance to researchers, health officials, and individual ethics committees who want a deeper and more encompassing inquiry regarding the foundation and evolution of human research. This department of CQ launches a long overdue effort to explore these wider issues. Readers are invited to submit papers to Charles MacKay, 5011 (...) Worthington Drive, Bethesda, MD, 20816, USA. E-mail: [email protected]. a. (shrink)

Interpreting a scene of lactation failure allows us to represent breast-feeding as a contested social practice. This essay reads a novelistic scene of lactation failure in the context of the decline of breast-feeding in the twentieth century. The protagonist's ignorance of the female experiences of pregnancy, childbirth, and lactation is an effect of her objectification within the opposition between science and nature. Unnatural as a woman because she is a natural individual, the pastor's wife exemplifies the dilemmas of breast-feeding as (...) a biosocial practice of maternity in a technological society which features the breakdown of traditional female networks in which knowledge about maternity and breast-feeding are circulated. (shrink)

Whereas theories on health generally argue in favor of one specific concept, we argue that, given the variety of health practices, we need different concepts of health. We thus approach health concepts as a Wittgensteinian family of thick concepts. By discussing five concepts of health offered by theory, we argue that all capture something that seems relevant when we talk and think about health. Classifying these concepts reveals their family resemblances: each of these concepts differs from the others in at (...) least one respect and resembles the others in several respects. Moreover, our classification shows that “health” always both describes a condition and evaluates that condition at the same time. Having both descriptive and evaluative dimensions, we can see health concepts as “thick concepts.” It is because of this evaluative dimension that it is important to reflect on the question of what understanding of health guides specific practices. We show that the distinctions revealed by our classification can serve as a conceptual toolbox for reflection on the assumptions and purposes of particular health practices. Finally, we illustrate how such reflection could work out by briefly exploring three specific health practices. (shrink)

Climate change could be described as an unstructured policy problem, in which we encounter disagreement on facts and values, problem definition, policy aims, procedures and instruments. For the solution of this type of problem public deliberation is often proposed. According to theories of deliberative democracy all those potentially affected by a decision should have the opportunity to participate in the drafting of that decision. However, in the context of climate change many of the potentially affected cannot speak for themselves, because (...) they do not yet exist. Could future generations nevertheless be represented in public deliberations? And if so, who could legitimately represent them? Moreover, how could such representation get shape institutionally within a deliberative democracy? I will examine some obstacles––in particular the non-identity and the pluralism problems––that have to be overcome before future generations can be represented and question how deliberative democracy could deal with these.. (shrink)

Pedigree dog breeding has been the subject of public debate due to health problems caused by breeding for extreme looks and the narrow genepool of many breeds. Our research aims to provide insights in order to further the animal-ethical, political and society-wide discussion regarding the future of pedigree dog breeding in the Netherlands. Guided by the question ‘How far are we allowed to interfere in the genetic make-up of dogs, through breeding and genetic modification?’, we carried out a multi-method case-driven (...) research, reviewing literature as well as identifying the perceptions of pedigree dog breeding of a variety of parties in the Netherlands. We examined what moral arguments and concepts different stakeholders, including breeders, veterinarians and animal protection societies, put forward when considering this question. While welfare arguments were often used as a final justification, we also frequently encountered arguments beyond welfare in practice, in particular the arguments that certain adaptations were unnatural, that they instrumentalised animals, or that they amounted to playing God. We argue that the way these arguments are employed points to a virtue ethical approach, foregrounding the virtue of temperance, as a balance between extreme positions was sought by our respondents in a variety of ways. Moreover, we argue against a rejection of unnaturalness arguments based on the naturalistic fallacy, as philosophers tend to do. We point out that unnaturalness arguments are related to people’s worldviews, including views on the proper human–animal relationship. We argue that such arguments, which we label ‘life-ethical’, should be the subject of more public discussion and should not be relegated to the private sphere. (shrink)

Background: Multi-collaborator research is increasingly becoming the norm in the field of biomedicine. With this trend comes the imperative to award recognition to all those who contribute to a study; however, there is a gap in the current “gold standard” in authorship guidelines with regards to the efforts of those who provide high quality biosamples and data, yet do not play a role in the intellectual development of the final publication. -/- Methods and findings: We carried out interviews with 36 (...) individuals working in, or with links to, biobanks in Switzerland, in order to understand how they interpret, apply and value authorship criteria in studies involving biosamples. The majority of respondents feel that authorship is an important motivating factor in working and publishing collaboratively. However, our findings suggest that in some cases, authorship guidelines are being ignored in favor of departmental standards which recognize “scientific work” as meriting authorship. -/- Conclusions: Our results support the current calls in the literature for an alternative method of crediting biomaterial contributions, in order to ensure appropriate authorship inclusion and promote collaborative research involving biobanks. (shrink)

While the implementation of digital technology in psychiatry appears promising, there is an urgent need to address the implications of the absence of ethical design in the early development of such technologies. Some authors have noted the gap between technology development and ethical analysis and have called for an upstream examination of the ethical issues raised by digital technologies. In this paper, we address this suggestion, particularly in relation to digital healthcare technologies for patients with schizophrenia spectrum disorders. The introduction (...) of digital technologies in psychiatry offers a broad spectrum of diagnostic and treatment options tailored to the health needs and goals of patients’ care. These technologies include wearable devices, smartphone applications for high-immersive virtual realities, smart homes, telepsychiatry and messaging systems for patients in rural areas. The availability of these technologies could increase access to mental health services and improve the diagnostics of mental disorders.Additional Instruction AbstractIn this descriptive review, we systematize ethical concerns about digital technologies for mental health with a particular focus on individuals suffering from schizophrenia. There are many unsolved dilemmas and conflicts of interest in the implementation of these technologies, such as (1) the lack of evidence on efficacy and impact on self-perception; (2) the lack of clear standards for the safety of their daily implementation; (3) unclear roles of technology and a shift in the responsibilities of all parties; (4) no guarantee of data confidentiality; and (5) the lack of a user-centered design that meets the particular needs of patients with schizophrenia. mHealth can improve care in psychiatry and make mental healthcare services more efficient and personalized while destigmatizing mental health disorders. To ensure that these technologies will benefit people with mental health disorders, we need to heighten sensitivity to ethical issues among mental healthcare specialists, health policy makers, software developers, patients themselves and their proxies. Additionally, we need to develop frameworks for furthering sustainable development in the digital technologies industry and for the responsible usage of such technologies for patients with schizophrenia in the clinical setting. We suggest that digital technology in psychiatry, particularly for schizophrenia and other serious mental health disorders, should be integrated into treatment with professional supervision rather than as a self-treatment tool. (shrink)

Biobanks are essential tools for furthering a broad range of medical research areas. However, despite the plethora of national and international laws and guidelines which apply to them, the access and sharing policies of biobanks are only sparsely addressed by regulatory bodies. The ‘give and take’ process of biosample sharing is largely left up to biobank stakeholders themselves to oversee; it is therefore both in stakeholders' power, and in their interest, to ensure that sample accessibility is fair. This is an (...) important step in motivating researchers to collaborate and pool samples, and is crucial to fostering trust in the absence of universally accepted standard practices. To date, little attention has been paid to how fairness considerations affect scientific material sharing, and no empirical research has been carried out to determine the role that fairness plays in collaborative studies. In order to begin to gain understanding in this area, we interviewed 36 biobank stakeholders currently working in Switzerland, focusing on their perceptions of current and optimal fair sharing practices. Our findings reveal that fairness is an important feature of exchange situations for these stakeholders, and that they have well-formed notions about the practical elements of fair sample access, although ideas about the concept of fairness itself are vague. In order to support efforts to network biobanks, attention should be paid to this issue to reassure all involved that they are getting a fair share in their cooperative efforts. (shrink)

Although medical and public health practitioners aim for high rates of vaccination, parent vaccination concerns confound doctors and complicate doctor-patient interactions. Medical and public health researchers have studied and attempted to counter antivaccination sentiments, but recommended approaches to dispel vaccination concerns have failed to produce long-lasting effects. We use observations made during a small study in a rural area in a southeastern state to demonstrate how a shift away from analyzing vaccination skepticism as a national issue with a global remedy (...) reveals the nuances in vaccination sentiments based on locality. Instead of seeing antivaccinationists as a distinct public based on statistical commonalities, we argue that examining vaccination beliefs and practices at the local level offers a fuller picture of the contextualized nature of vaccination decisions within the psychosocial spaces of families. A view of vaccination that emphasizes the local public, rather than a globally conceived antivaccination public, enables medical humanists and rhetoricians to offer important considerations for improving communications about vaccinations in clinical settings. (shrink)

BackgroundEvaluation of decision-making capacity to consent to medical treatment has proved to be difficult in patients with dementia. Studies showed that physicians are often insufficiently trained in the evaluation of decision-making capacity. In this study, we present findings from a secondary analysis of a qualitative interviews with physicians. These interviews were initially used to assess usability of an instrument for the evaluation of decision-making capacity. By looking at difficult cases of decision-making capacity evaluation in patients with dementia, we provide recommendations (...) for such evaluations in clinical practice.MethodsWe used thematic coding to analyse physicians’ narratives of problematic decision-making capacity evaluations in patients with dementia to uncover challenging issues of decision-making capacity evaluation.ResultsIn this study, decision-making capacity evaluations in patients with dementia were mainly perceived as challenging when they pertained to treatment refusals and treatment unrelated circumstances, such as psychiatric consultation, advance directives, and new living arrangements. Furthermore, the physicians reported training needs regarding situation-independent challenges with decision-making capacity evaluation.ConclusionsUpon further examining self-reported training needs and challenging cases, we have developed recommendations to improve decision-making capacity evaluations in clinical practice. In these recommendations, we argue that being able to evaluate decision-making capacity is an integral part of the informed consent process. (shrink)

ABSTRACT The objective of the study was to identify future lawyers’ and physicians’ views on testing children for Huntington’s disease (HD) against parents’ wishes. After receiving general information about HD, patient autonomy and confidentiality, law students and advanced medical students were shown an interview with a mother suffering from HD who is opposed to informing and testing her two children (aged 10 and 16) for HD. Students then filled out questionnaires concerning their agreement with testing. No significant differences were found (...) between medical and law students or between students from different courses concerning the adolescent son. Three quarters of students thought that he should be told about his mother’s disease, and 91% thought the adolescent son should have the opportunity of genetic testing for HD for himself. However, significant differences were found concerning the 10‐year old son, with 44% of law students and 30% of medical students in favour of testing the child for HD. Students raised some important ethical issues in their elective comments. In conclusion, we found highly positive attitudes towards informing a 16‐year old of his mother’s HD and offering to test him. These attitudes were not in tune with guidelines. Students did not consider several practical and ethical issues of genetic testing of children and adolescents. Specific education should ensure that attitudes are based on sufficiently detailed knowledge about all aspects of genetic testing of children to discourage pressures on persons at risk of HD. (shrink)

In certain cases of sudden death, forensic experts may discover during an investigation or autopsy that family members of the deceased are also at risk of harm—from genetic disease, for instance. But do they have a duty to warn them? Looking at similar duties of physicians and researchers to warn third parties of risk suggests they do.