Respect for patients’ autonomy has taken a central place in the practice of medicine. Received wisdom holds that respect for autonomy allows overriding a patient’s treatment preferences only if the patient has been found to lack capacity. This understanding of respect for autonomy requires a dichotomous approach to assessing capacity, whereby a patient must be found either to have full capacity to make some particular treatment decision or must be found to lack capacity to make that decision. However, clinical reality (...) is more complicated, and, in borderline cases, different physicians may arrive at disparate judgments of capacity. In such cases, when capacity-determination protocols fail to achieve consensus, physicians would benefit from guidance regarding the clinical decision-making process necessary to elucidate the most ethically sound course of action. This article considers one such case and argues that, in a limited number of cases, respect for autonomy may require overriding a patient’s stated treatment preference when a capacity determination is equivocal, even though the patient has not clearly demonstrated a lack of capacity. (shrink)

Article de Michael Burawoy « The Future of Sociology » publié dans Brym R. (ed.), New Society, 7th Edition, Scarborough, Nelson Education, 2014, traduit par Carolyne Grimard et Marc-Henry Soulet. Cette traduction a déjà paru dans SociologieS, accompagnée d'une introduction par Marc-Henry Soulet accessible ici. Nous remercions Michael Burawoy et la revue SociologieS de nous avoir autorisé à la reproduire ici. La marchandisation du monde Une vague de marchandisation déferle sur le monde. Des (...) - Sociologie – Nouvel article.

Few would argue against the importance of ethics in early childhood teacher preparation and practice. However, arguing for something in principle does not always lead to action. The purpose of this paper is to bring attention to the need for a sharper applied focus on ethics in early childhood education than that which currently exists. A context for professional ethics in early childhood education is outlined, a case highlighting specific ethical considerations is presented, and, finally, concerns and insights are discussed. (...) The discussion is anchored in professional ethical codes and the literature on teacher preparation and ethics education. (shrink)

Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – the family of a very elderly non-English speaking Asian lady did not want her to be informed that she had incurable lymphoma. The case study summarises the reflections of the Committee and focusses on: the role of cultural norms in healthcare decision making; the extent to which the views of the family about what is best for the patient should (...) be respected, whether the patient should have been informed of her terminal diagnosis and the role of the clinician in navigating complex family dynamics. (shrink)

Members of the Student Clinical Ethics Committee discussed whether tube feeding should be instigated for a man who had indicated through his actions that he may be refusing it, although his family stated that he would have wanted to be kept alive in such a situation. The Committee considered the key issues of capacity and best interests, which in this case were confounded by lack of clarity about whether the patient’s actions amounted to a valid refusal of life sustaining treatment, (...) and if his previous views still pertained to his current, yet unforeseen, circumstances. As the discussion progressed, it became apparent that some members were reluctant to accept that non-insertion of clinically assisted feeding could ever be in a patient’s best interests. (shrink)

Members of the Student Clinical Ethics Committee discussed the ethical issues arising in a case referred for consideration – a homeless man presenting to the emergency department of a busy London hospital with recent self-reported suicide attempts. Should he be admitted overnight in order to address a short-term shelter problem? The case study summarises the reflections of the Committee and focusses on the doctor’s duty of care and patient responsibility, benefits of admission and resource considerations.

Members of the Student Clinical Ethics Committee discussed the ethical and legal issues arising in a case referred for consideration – a female patient in her mid-60s, who had a very long history of multiple sclerosis, withdrew her previous consent to treatment following discussion with her son. The case study summarises the reflections of the Committee and focusses on: the meaning and practical application of respect for patient autonomy; whether a refusal of clinically indicated treatment may challenge the notion of (...) capacity; the role of others in the process of decision-making; if the current decision to refuse treatment was the patient’s own and whether, in the circumstances, it should be respected. (shrink)

If the opening sequence of a film is a microscopic 'event' that achieves far more than setting the tone and whetting the appetite for what we are about to see, then Todd Haynes' I'm Not There is exemplary. This paper works its way through the conceptually dense and intricately woven textual layers of the film's opening to stage a three-way dialogue between Haynes, Bob Dylan and Jacques Derrida: three mavericks who defy simple categorisation, by transgressing the boundaries of their respective (...) fields (song writing, cinema and philosophy). By introducing Derrida's deconstructive logic of hauntology as a strategy for reading Haynes' biopic on Dylan, the figure of the ghost is called upon to situate the quest for an identity's authenticity as a perennial, irresolvable problem in song, cinema and philosophy. Belonging to a time that is neither past nor present, a place that is neither here nor there, the ghost offers the perfect medium to join Haynes, Dylan and Derrida in (re)thinking identity in terms that respond to a call (in the name of art, justice and truth, among other things) that is not based on an unyielding conception of authenticity. (shrink)

Interoception can be broadly defined as the sense of signals originating within the body. As such, interoception is critical for our sense of embodiment, motivation, and well-being. And yet, despite its importance, interoception remains poorly understood within modern science. This paper reviews interdisciplinary perspectives on interoception, with the goal of presenting a unified perspective from diverse fields such as neuroscience, clinical practice, and contemplative studies. It is hoped that this integrative effort will advance our understanding of how interoception determines well-being, (...) and identify the central challenges to such understanding. To this end, we introduce an expanded taxonomy of interoceptive processes, arguing that many of these processes can be understood through an emerging predictive coding model for mind–body integration. The model, which describes the tension between expected and felt body sensation, parallels contemplative theories, and implicates interoception in a variety of affective and psychosomatic disorders. We conclude that maladaptive construal of bodily sensations may lie at the heart of many contemporary maladies, and that contemplative practices may attenuate these interpretative biases, restoring a person’s sense of presence and agency in the world. (shrink)

We discuss our surgical philosophy concerning the subtle interplay between the size of the surgical margin taken and the resultant morbidity from ablative oncological. procedures, which is ever more evident in the treatment of head and neck malignancy. The extent of tissue resection is determined by the "trade off" between cancer control and the perioperative, functional and aesthetic morbidity and mortality of the surgery. We also discuss our dilemmas concerning recent minimally invasive endoscopic microsurgical. techniques for the trans-oral laser removal. (...) or co-ablation of aero-digestive tract tumours, which result in a minimal. surgical margin of oncological clearance. By a process of inductive argument as to the nature of the surgical margin, we consider whether the risks of taking a lesser margin with adjuvant therapy is justified by the attendant gain in reduced surgical morbidity and the possible costs in tumour control. (c) 2006 Elsevier Ltd. All rights reserved. (shrink)

The progression of research and scholarly inquiry does not occur in isolation and is wholly dependent on accurate reporting of methods and results, and successful replication of prior work. Without mechanisms to correct the literature, much time and money is wasted on research based on a crumbling foundation. These guidelines serve to outline the respective responsibilities of researchers, institutions, agencies, and publishers or editors in maintaining the integrity of the research record. Delineating these complementary roles and proposing solutions for common (...) barriers provide a foundation for best practices. (shrink)

Farmer participatory approaches were used to identify problems and needs as perceived by local people and to develop strategies to achieve fodder security in south Indian villages. Indigenous knowledge systems as they relate to agroforestry were explored. The farmer participatory approaches have laid the foundations for selecting appropriate agroforestry technologies and developing suitable fodder security policy options. Potential benefits and risks as a result of implementing agroforestry projects were also discussed.

In accord with social neuroscience's progression to include interactive experimental paradigms, parents' brains have been activated by emotionally charged infant stimuli including baby cry and picture. More recent research includes the use of brief video clips and opportunities for maternal response. Among brain systems important to parenting are those involved in empathy. This research may inform recent studies of decreased societal empathy, offer mechanisms and solutions.

Critically significant parental effects in behavioral genetics may be partly understood as a consequence of maternal brain structure and function of caregiving systems recently studied in humans as well as rodents. Key parental brain areas regulate emotions, motivation/reward, and decision making, as well as more complex social-cognitive circuits. Additional key environmental factors must include socioeconomic status and paternal brain physiology. These have implications for developmental and evolutionary biology as well as public policy.

The chapter provides an overview of the structure and content of the textbook to help situate the reader. It begins by introducing this unique collaborative project, including a general introduction to the fields of philosophy, cognitive science, and neuroscience. It then segues into explaining the structural features of each chapter that provide uniformity across the textbook. The chapter concludes with an overview of the content provided in the textbook. Through a survey of the major themes and their interconnections the reader (...) will be better able to appreciate the rich interplay between philosophy and cognitive neuroscience in each of the topical chapters. (shrink)

For ten years, between 1903 and 1913, Gertrude Stein saw human relationships as painful mathematical puzzles in need of solutions. Again and again, she converted the predicaments of her personal life into literary material, the better to solve and to exorcise them. The revelation that relationships had a structural quality came to her during the composition of Q.E.D. , when she grasped the almost mathematical nature of her characters' emotional impasse. Stein's persona in the novel comments on their triangular affair, (...) "Why it's like a piece of mathematics. Suddenly it does itself and you begin to see."1 The theory encouraged her to examine such situations as if they were case histories: she continued to study the same piece of mathematics from different angles in Fernhurst , Three Lives , and The Making of Americans . But whatever the sexual arrangements in these triangles, the powerful generally managed to impose their wills upon the less powerful, and the triangles resolved themselves into oppositional structures, pitting two against one. Gradually, when the couple began to replace the triangle as her structural model, Stein composed numerous verbal portraits of couples and their relationships. In two of these, "Ada" and "Two Women," Stein applied her general theory of relationships to the particular puzzle of female friendships because, I think, she felt that women's characters were most intensely molded in same-sex involvements. Although she attempted to "prove" these theories in distanced, deliberately depersonalized prose, we as readers must examine "the complex interplay of self-discovery and writing" from which her portraits emerged.2Stein's portraits of women entangled in familial and erotic bonds seem to invite us into "the process whereby the self creates itself in the experience of creating art"; to read them, we must "join the narrator in reconstructing the other woman by whom we know ourselves."3 This task of reconstruction implies that we must also rethink the place of biography—generally dismissed by New Criticism and its subsequent post-structuralist permutations as "mere" biography—in feminist critical projects. If it is true that "in reading as in writing, it is ourselves that we remake," then feminist critics have a special stake in understanding the biographical, and autobiographical, impulses at work in these activities.4 Stein's portraits, which hover between fiction and biography, raise important questions about the ways in which biographical information can justify our suspicion that female writers may be "closer to their fictional creations than male writers are."5 Recently, feminist critics have adapted psychoanalytic theory to examine the particular closeness of female characters in women's writing or to suggest a related closeness between the female author and her characters. We find it useful to speak of the pre-Oedipal structures and permeable ego boundaries that seem to shape women's relationships. Although Stein used very different psychological paradigms, she approached these same issues in her own studies of female friendships. Realizing that she preferred to write about women, she observed, "It is clearer…I know it better, a little, not very much better."6 In spite of her qualifications, she knew that she could see the structuring principles of relationships with greater clarity when writing from her own perspective.1. Stein, "Fernhurst," "Q.E.D.," and Other Early Writings, ed. Leon Katz , p. 67.2. Elizabeth Abel, "Reply to Gardiner," Signs 6 : 444. For a very useful critical discussion of this complex issue, see Abel, "Merging Identities: The Dynamics of Female Friendship in Contemporary Fiction by Women," and Judith Kegan Gardiner, "The es of dentity: a Response to Abel on 'Merging Identities,'" in the same issue of Signs .3. Gardiner, "The es of dentity," p. 442.4. Jonathan Morse, "Memory, Desire, and the Need for Biography: The Case of Emily Dickinson," The Georgia Review 35 : 271. See also J. Gerald Kennedy's suggestive remarks on the "tension between personal confession and implacable theory" in Barthes' later work .5. Abel, "Reply to Gardiner," p. 444.6. Stein, The Making of Americans, cited in Richard Bridgeman, Gertrude Stein in Pieces , p. 78.Carolyn Burke, an Affiliated Scholar at the Center for Research on Women, Stanford University, has published articles on French feminist writing and on Mina Loy, whose biography she is now completing. The theoretical implications of this essay will be explored in her related study in progress on feminist biography. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:American Journal of Philology 127.1 (2006) 137-140 [Access article in PDF] Derek Collins. Master of the Game: Competition and Performance in Greek Poetry. Hellenic Studies 7. Washington, D.C.: Center for Hellenic Studies, 2004. Distributed by Harvard University Press, Cambridge, Mass. xx + 267 pp. Paper, $19.95. Collins states the purpose of his book clearly in the opening paragraph of his introduction (ix): "to offer a detailed examination of the (...) competitive performance of Greek poetry from the late archaic to the classical period. Its central argument is that the basic response pattern called "capping" is a pervasive competitive performance technique common to tragic and comic stichomythia, dramatic representations of lament, forms of Platonic dialectic and dialogue, the sympotic performance of elegy, skolia and related verse games, as well as the rhapsodic performance of epic." In order to fulfill this ambitious purpose, Collins divides his book into three parts: drama, symposia, and epic. An introduction, two appendices (one on ritual aischrologia and the other a brief survey of comparative typologies), bibliography, and indices complete the volume.Collins focuses on specific elements within these genres: stichomythia in Aeschylus, Aristophanes, Euripides' Cyclops, and Plato's Euthydemus occupy part 1. Part 2 is based on skolia, Aristophanes, and a selection of poets—Xenophanes, Heraclitus, Solon, and Anacreon—who offer a sympotic perspective on rhapsodes and competition. In part 3, Collins' evidence for the competitive and creative nature of rhapsodic performance ranges from scholiasts through Homer, the Certamen, Polybius, and inscriptions. Collins has brought together a very wide range of material, complete with translations, which he discusses in a way that I often found convincing and, even when I did not, found stimulating to consider.Collins bases much of his discussion on capping, enjambement, and word play, specifically riddles and puns. He offers a brief definition of capping, the fundamental concept of his work (ix): when two (or more) speakers or singers perform, "one participant sets a topic or theme in speech or verse to which another responds by varying, punning, riddling, or cleverly modifying that topic or theme." Without giving a detailed definition of enjambement, Collins shows its importance for the speaker who must respond to a line already sung by the first performer and argues that enjambement should be seen as a mark of a singer's creativity, his ability to adapt the material given him by the first singer. Collins applies the terms "pun" and "riddling" somewhat too loosely, I think, to many of the passages from tragedy that he discusses. If we understand a pun to be word play based on a word with more than one meaning or based on two different words that are similar in sound, then I am not certain why the image [End Page 137] of famine as an ally of the Greeks, in the words of Darius (Aeschylus, Persians 490–91) should be considered one (9). And what is riddling about the exchange between Talthybius and the elder coryphaeus (Agamemnon 538–50; pp. 15–16)? These passages seem to me simply to be ambiguous. Collins' discussion of puns and riddles in symposia is more convincing (124–29).Collins' reading of the exchange between Euripides and Aeschylus in Aristophanes' Frogs (1198–1248), in which Aeschylus caps Euripides' prologues with the tag ("he lost his little bottle of oil"), is particularly valuable, because he does not limit himself to one approach or perspective. He shows the many grammatical and metrical subtleties of the exchange, its links to other genres, and the possibly sexual jokes (33–43). We can imagine everyone in the audience finding something to laugh at in this scene.Collins conceives of symposia as occasions for amusement, intellectual discussion, and even for violence, if drinking or teasing get out of hand. He suggests that symposiasts and rhapsodes have more in common than we might imagine if we look only at what the symposiasts say about themselves or at the metrical and philosophical differences between the two kinds of performances (85, 135–46). Whether the antagonism toward rhapsodes expressed by oligarchs at symposia has any... (shrink)

Bishop and Trout here present a unique and provocative new approach to epistemology. Their approach aims to liberate epistemology from the scholastic debates of standard analytic epistemology, and treat it as a branch of the philosophy of science. The approach is novel in its use of cost-benefit analysis to guide people facing real reasoning problems and in its framework for resolving normative disputes in psychology. Based on empirical data, Bishop and Trout show how people can improve their reasoning by relying (...) on Statistical Prediction Rules. They then develop and articulate the positive core of the book. Their view, Strategic Reliabilism, claims that epistemic excellence consists in the efficient allocation of cognitive resources to reliable reasoning strategies, applied to significant problems. The last third of the book develops the implications of this view for standard analytic epistemology; for resolving normative disputes in psychology; and for offering practical, concrete advice on how this theory can improve real people's reasoning. This is a truly distinctive and controversial work that spans many disciplines and will speak to an unusually diverse group, including people in epistemology, philosophy of science, decision theory, cognitive and clinical psychology, and ethics and public policy. (shrink)

The release of genetically engineered organisms into the shared environment raises scientific, ethical, and societal issues. Using some form of democratic deliberation to provide the public with a voice on the policies that govern these technologies is important, but there has not been enough attention to how we should connect public deliberation to the existing regulatory process. Drawing on lessons from previous public deliberative efforts by U.S. federal agencies, we identify several practical issues that will need to be addressed if (...) relevant federal agencies are to undertake public deliberative activities to inform decision‐making about gene editing in the wild. We argue that, while agencies may have institutional capacity to undertake public deliberative activities, there may not be sufficient political support for them to do so. Advocates of public deliberation need to make a stronger case to Congress about why federal agencies should be encouraged and supported to conduct public deliberations. (shrink)

Skin is one of the most thoroughly studied epithelia and can be used as a model for transcriptional control of epithelial differentiation. In particular, the stages of epidermal development and differentiation from a simple epithelium are well characterized. Temporal gene expression during development can be used to assign roles for transcription factors in epidermal differentiation. Approaches to understanding transcriptional regulation in epidermis include extensive promoter analysis and expression studies, in some cases coupled to functional studies. This work has not produced (...) any consensus about the importance of any particular factor or class of factors in epidermal specification. There is, as yet, nothing similar to the myo D family of tissue‐specific and cell‐type determining factors in epidermis. These studies, however, have revealed much about control of the differentiation process in epidermis. Most recently, there has been a suggestion that epithelial transcription can be influenced directly by the status of the adhesion complexes at the cell surface, providing a direct link between one of the distinguishing features of the epithelial state and gene transcription. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 34.2 (2001) 179-181 [Access article in PDF] Book Review Rethinking the Rhetorical Tradition: From Plato to Postmodernism Rethinking the Rhetorical Tradition: From Plato to Postmodernism. James L. Kastely. New Haven, CT: Yale University Press, 1997. Pp. viii + 293. $30.00. In Rethinking the Rhetorical Tradition, James Kastely presents an alternative to the "standard" rhetorical tradition; he calls this alternative skeptical rhetoric, describes its characteristic activity as (...) refutation, and claims for it special relevance in negotiating postmodern challenges to rhetoric, specifically, that it can serve as a "refutation of postmodernism" (23). This alternative tradition inheres in a canon of works somewhat different from the standard canon, and an examination of key works organizes most of the chapters in this book. To establish and articulate this tradition in the classical era, Kastely examines Plato's Gorgias and Meno, Sophocles' Philoctetes, and Euripides' Hecuba; he then moves to the modern era, and to two works that address themes central to ancient rhetorical skepticism: Jane Austen's Persuasion (1818) and Jean-Paul Sartre's What Is Literature? (1949). Finally, Kastely turns to the two prongs of the postmodern reappropriation of traditional rhetoric, the tropological formalism of Paul de Man and the ideological approaches of Marxist critics such as Terry Eagleton, challenging both of them with the comic skepticism of Kenneth Burke.The skeptical tradition begins with Socrates, of course. It takes as its central problem, not the impossibility or contingency of knowledge, but the existence of injustice. In a political community, the unavoidability of doing inadvertent injury both requires rhetoric and at the same time makes it party to continued injustice: "[D]oing injury is an inescapable aspect of a being who is born into a world that is shaped by a language and by conventional practices that embody a particular set of values" (42). It is these prior commitments and conventional practices that, Kastely argues, lead us to cause injury. Thus, the positive task of rhetoric is not to persuade others away from injustice or to promote remedies; it is to keep us constantly open to refutation, to the possibility of seeing an alternative to the inadvertent wrong we commit. The inherency of injustice is what makes rhetoric a philosophical problem, but refutation is what rhetoric can offer to philosophy (a claim that might surprise philosophers). And in his reading of the Meno, Kastely argues explicitly for a rhetorical, rather than philosophical or logical, understanding of refutation.Overall, Kastely offers us a Plato who is not the enemy of rhetoric, but rather "the most sophisticated and profound rhetorical theorist" (30), who dramatizes in dialogue the philosophical dilemma of rhetoric. In [End Page 179] Sophocles and Euripides, he finds dramatists who illustrate practical forms the dilemma can take, specifically the problem of the unavailable audience. In the Philoctetes, the problem is how to regain the trust and confidence of the marginalized and disenfranchised, how to restore the status of rhetorical audience to one who no longer believes that justice is possible. In the Hecuba, the problem is how a disempowered rhetor can speak to the powerful. In both plays, but especially in Hecuba, the proximity of rhetoric to violence is a practical consequence of the unsolved philosophical problem.Kastely admits that the skeptical legacy from classical rhetoric has had little effect since antiquity. His argument that this alternate tradition deserves recognition is made primarily by his chapters on Austen and Sartre. He sees the works he examines here as raising a question central to rhetorical skepticism: "Can there be a way of speaking and writing that can effectively challenge the marginalization and dehumanization of people in a world in which traditional structures of authority that made discourse coherent have vanished or, at least, are seriously and irretrievably eroded?" (139-40). Both question Enlightenment assumptions about universality and at the same time confront the vacuum left by the erosion of local communal and authority structures. Austen's "active exploration" of a "crisis in discursive practice" (141) and Sartre's concern with the "social responsibility of the writer" and the loss of a public... (shrink)

This book includes a selection of contributions to the Iowa State University Symposium on agricultural bioethics in november 1987. The papers are grouped in the sections "Safety and regulatory issues", "Impact on scientific and industrial communities", "Public perceptions", "Economic prospects", "Social considerations" and "Ethical dilemmas".

New and radically reformative thinking about the enactive and embodied basis of cognition holds out the promise of moving forward age-old debates about whether we learn and how we learn. The radical enactive, embodied view of cognition (REC) poses a direct, and unmitigated, challenge to the trademark assumptions of traditional cognitivist theories of mind—those that characterize cognition as always and everywhere grounded in the manipulation of contentful representations of some kind. REC has had some success in understanding how sports skills (...) and expertise are acquired. But, REC approaches appear to encounter a natural obstacle when it comes to understanding skill acquisition in knowledge-rich, conceptually based domains like the hard sciences and mathematics. This paper offers a proof of concept that REC’s reach can be usefully extended into the domain of science, technology, engineering, and mathematics (STEM) learning, especially when it comes to understanding the deep roots of such learning. In making this case, this paper has five main parts. The section “Ancient Intellectualism and the REC Challenge” briefly introduces REC and situates it with respect to rival views about the cognitive basis of learning. The “Learning REConceived: from Sports to STEM?” section outlines the substantive contribution REC makes to understanding skill acquisition in the domain of sports and identifies reasons for doubting that it will be possible to apply the same approach to knowledge-rich STEM domains. The “Mathematics as Embodied Practice” section gives the general layout for how to understand mathematics as an embodied practice. The section “The Importance of Attentional Anchors” introduces the concept “attentional anchor” and establishes why attentional anchors are important to educational design in STEM domains like mathematics. Finally, drawing on some exciting new empirical studies, the section “Seeing Attentional Anchors” demonstrates how REC can contribute to understanding the roots of STEM learning and inform its learning design, focusing on the case of mathematics. (shrink)

Four studies tested the hypothesis that a weaker belief in free will would be related to feeling less gratitude. In Studies 1a and 1b, a trait measure of free will belief was positively correlated with a measure of dispositional gratitude. In Study 2, participants whose free will belief was weakened (vs. unchanged or bolstered) reported feeling less grateful for events in their past. Study 3 used a laboratory induction of gratitude. Participants with an experimentally reduced (vs. increased) belief in free (...) will reported feeling less grateful for the favor. In Study 4, a reduced (vs. increased) belief in free will led to less gratitude in a hypothetical favor scenario. This effect was serially mediated by perceiving the benefactor as having less free will and therefore as being less sincerely motivated. These findings suggest that belief in free will is an important part of being able to feel gratitude. (shrink)

At a time in medicine where the cost of human clinical labor continues to rise, with an overall shortage of providers at all levels, improved AI performance raises critical, pressing questions with...