The importance of patient involvement is increasing in healthcare, and initiatives are constantly implemented to reach the ideal of involved and educated patients. This secondary analysis was initially embedded in a randomized controlled study where the aim was to gain insight into perceptions and experiences within a group of women undergoing fertility treatment through two focus group interviews. In this secondary analysis, we investigated how patient involvement was strived for in both clinical practice and research. During the analysis, it became (...) apparent that the women exercised and maintained a clear perspective on their hope for a child, Project Child, while the interviewer pursued a treatment perspective, Project Treatment. Despite different perspectives, the conversation during the interviews seemed effortless, and it became apparent how the interviewer and the participants were actually focusing partly on the same, but primarily on different issues but without addressing or acknowledging this. Knowledge and awareness of the difference in perspectives is important when healthcare professionals seek to involve patients both in clinical practice and in research. Patient involvement in both research and clinical practice has shown to be a challenge and entails that pathways are organized and decisions shared by healthcare professionals. (shrink)

Background: In modern society, death has become ‘forbidden’ fed by the medical technology to conquer death. The technological paradigm is challenged by a social-liberal political ideology in postmodern Western societies. The question raised in this study was as follows: Which arguments, attitudes, values and paradoxes between modern and postmodern tendencies concerning treatment and care of older persons with an implantable cardioverter defibrillator appear in the literature? Aims: The aim of this study was to describe and interpret how the field of (...) tension concerning older persons with an implantable cardioverter defibrillator – especially end-of-life issues – has been expressed in the literature throughout the last decade. Methods: Paul Ricoeur’s reflexive interpretive approach was used to extract the meaningful content of the literature involving qualitative, quantitative and normative literature. Analysis and interpretation involved naive reading, structural analysis and critical interpretation. Ethical considerations: The investigation complied with the principles outlined in the Declaration of Helsinki. Findings and discussions: The unifying theme was ‘Normativity under change’. The sub-themes were ‘Death has become legitimate’, ‘The technological imperative is challenged’ and ‘Patients and healthcare professionals need to talk about end-of-life issues’. There seems to be a considerable distance between the normative approach of how practice ought to be and findings in empirical studies. Conclusion: Modern as well as postmodern attitudes and perceptions illustrate contradictory tendencies regarding deactivation of the implantable cardioverter defibrillator and replacement of the implantable cardioverter defibrillator in older persons nearing the end of life. The tendencies challenge each other in a struggle to gain position. On the other hand, they can also complement each other because professionalism and health professional expertise cannot stand alone when the patient’s life is at stake but must be unfolded in an alliance with the patient who needs to be understood and accepted in his vulnerability. (shrink)

This article argues that personal meaning should be considered important when addressing issues of learning. It is claimed that meaningful learning is not primarily intra-psychological, as suggested by humanistic psychologists and parts of cognitive psychology, but is an integrated part of the person’s participation in various social practices. Inspired by critical psychology and situated learning, it is suggested that in order to comprehend what people in everyday life experience as meaningful, we have to understand the concerns subjects pursue across different (...) contextual settings and the kind of conduct of everyday life they try to realise. A case example from an ongoing research project about how baker apprentices learn their trade is outlined in order to exemplify some of the theoretical considerations. Two baker apprentices, Peter and Charlotte, are presented to illustrate how they orientate their learning activities in the bakeries according to their future participation in the baking trade and in relation to the conduct of everyday life they wish to pursue. (shrink)

Social media offers a platform for diffused stakeholders to interact with firms—alternatively praising, questioning, and chastising businesses for their CSR performance and seeking to engage in two-way dialogue. In 2014, 163,402 public messages were sent to Fortune 200 firms’ CSR-focused Twitter accounts, each of which was either shared, replied to, “liked,” or ignored by the targeted firm. This paper examines firm reactions to these messages, building a model of firm response to stakeholders that combines the notions of CSR communication and (...) stakeholder salience. Our findings show that firm response to a stakeholder on social media is positively and most significantly associated with what we refer to as the stakeholder’s connective power but negatively associated with the firm’s own connective power. To a lesser extent, firm response is positively associated with the stakeholder’s normative power but negatively associated with the firm’s own normative power. Firm response is also shown to be positively associated with stakeholder urgency in terms of both the originality of a stakeholder message and the expression of positive sentiment. (shrink)

Whether regarded as a perplexing object, a morally captivating force, an ineffable entity beyond language, or an inescapably embodied human practice, music has captured philosophically inclined minds since time immemorial. In turn, musicians of all stripes have called on philosophy as a source of inspiration and encouragement, and scholars of music through the ages have turned to philosophy for insight into music and into the worlds that sustain it. In this Handbook, contributors build on this legacy to conceptualize the rich (...) interactions of Western music and philosophy as a series of meeting points between two vital spheres of human activity. They draw together key debates at the intersection of music studies and philosophy, offering a field-defining overview while also forging new paths. Chapters cover a wide range of musics and philosophies, including concert, popular, jazz, and electronic musics, and both analytic and continental philosophy. (shrink)

This volume reconsiders the relation between visibility and transcendence. The focus is on the contributions to this issue from the theological tradition in protestant Europe between the 16th and the 21st Centuries. A thematically broad field is covered embracing a plurality of methods drawn from theology, philosophy, and the theory of art. In five sub-themes the volueme deals with modes of appearing or hiding of phenomena, the fundamental understand and use of language, with the theological anthropology, the theological discourses behind (...) the religious uses of the different artistic media, and the idea of "vicarious representation"--Back cover. (shrink)

As the average age of the population increases, so too do the number of people living with chronic illnesses. With limited resources available, the development of dialogue-based e-health systems that provide justified general health advice offers a cost-effective solution to the management of chronic conditions. It is however imperative that such systems are responsible in their approach. We present in this paper two main challenges for the deployment of e-health systems, that have a particular relevance to dialogue and argumentation: collecting (...) and handling health data, and trust. For both challenges, we look at specific issues therein, outlining their importance in general, and describing their relevance to dialogue and argumentation. Finally, we go on to propose six recommendations for handling these issues, towards addressing the main challenges themselves, that act both as general advice for dialogue and argumentation research in the e-health domain, and as a foundation for future work on this topic. (shrink)

Background People who are at elevated risk of suicide stand to benefit from internet-based interventions; however, research in this area is likely impacted by a range of ethical and practical challenges. The aim of this study was to examine the ethical issues and practical barriers associated with clinical studies of internet-based interventions for suicide prevention. Method This was a mixed-methods study involving two phases. First, a systematic search was conducted to identify studies evaluating internet-based interventions for people at risk of (...) suicide, and information pertaining to safety protocols and exclusion criteria was extracted. Second, investigators on the included studies were invited to complete an online survey comprising open-ended and forced-choice responses. Quantitative and qualitative methods were used to analyse the data. Results The literature search identified 18 eligible studies, of which three excluded participants based on severity of suicide risk. Half of the 15 suicide researchers who participated in the survey had experienced problems obtaining ethics approval, and none had encountered adverse events attributed to their intervention. Survey respondents noted the difficulty of managing risk in online environments and the limitations associated with implementing safety protocols, although some also reported increased confidence resulting from the ethical review process. Respondents recommended researchers pursue a collaborative relationship with their research ethics committees. Conclusion There is a balance to be achieved between the need to minimise the risk of adverse events whilst also ensuring interventions are being validated on populations who may be most likely to use and benefit from them. Further research is required to obtain the views of research ethics committees and research participants on these issues. Dialogue between researchers and ethics committees is necessary to address the need to ensure safety while also advancing the timely development of effective interventions in this critical area. (shrink)

This paper examines potential ethical and legal issues arising during the research, develop- ment and clinical use of a proposed strategy in personalized medicine (PM): using human induced pluripotent stem cell (iPSC)-derived tissue cultures as predictive models of individ- ual patients to inform treatment decisions. We focus on epilepsy treatment as a likely early application of this strategy, for which early-stage stage research is underway. In relation to the research process, we examine issues associated with biological samples; data; health; vulnerable (...) populations; neural organoids; and what level of accuracy justifies using the iPSC-derived neural tissue system. In relation to clinical use, we examine potential uses in pre-natal screening, and effects on clinical decision-making. Although our focus is providing recommendations for researchers developing work in this area, we identify the novel issue of deciding on an acceptable accuracy level for the system. We also emphasize an issue thus far neglected in the ethics of PM: PM tends to represent treatment decisions as though they should be directed solely by biomedical information, but this in itself could be detri- mental to best personalizing treatment decisions in the clinic. (shrink)

In this paper I examine Aristotle's account of sexual difference in Generation of Animals, arguing that Aristotle conceives of the production of males as the result of a successful teleological process, while he sees the production of females as due to material forces that defeat the norms of nature. My suggestion is that Aristotle endorses what I call the "degrees of perfection" model. I challenge Devin Henry's attempt to argue that Aristotle explains sex determination exclusively with reference to material necessity (...) (in particular, levels of "vital heat" in the male semen), for Aristotle's notion of "sufficient" or "deficient" vital heat is itself teleological. If, as Aristotle is aware, male and female embryos appear with approximately equal frequency in most species, how, in light of Physics II, can he conceive of the former as in accordance with nature, and the latter as somehow contrary to nature? My proposal is that Aristotle's notion of what happens usually (ως επì τò πoλυ) is bifurcated: the usual need not be more frequent. (shrink)

Resumen: Este trabajo propone una aproximación a tres obras centrales de la poesía latinoamericana: Trilce, Altazor y En la masmédula, tomando como base la confrontación entre las limitaciones que el lenguaje necesariamente impone y la voluntad radicalmente transgresora que estos textos exhiben. En particular, el trabajo explora la tensión entre la tendencia del lenguaje a fragmentar la realidad mediante conceptos y la aspiración a la unidad -la superación de toda fragmentación- que denotan los procesos verbales desplegados en estas obras. Para (...) profundizar el análisis, se propone un diálogo entre el lenguaje poético y el pictórico, tomando como referencia los planteamientos teóricos de Piet Mondrian y su visión acerca de la relación entre lo “individual” y lo “universal”.: This article presents an approach to three masterpieces of Latin American poetry: Trilce, Altazor, and En la masmédula, based on the confrontation between the limitations that language necessarily entails and the rule-breaking attitude that these poetical works display. Specifically, this study explores the tension between the tendency to divide reality into segments inherent in language and the quest of unity -the cancellation of any kind of segmentation- that underlies verbal processes in Trilce, Altazor, and En la masmédula. In order to deepen the analysis, this work poses a significant connection between poetical and pictorial language, taking as reference Piet Mondrian’s theoretical contributions about the relationship between “individual” and “universal” forms. (shrink)

Will globalization promote or hinder social justice throughout the world? In this cogent analysis philosopher Kai Nielsen argues that in its present form capitalist globalization will only ensure that the rich get richer and the poor poorer. Noting that the ratio of the richest countries to the poorest has steadily grown larger under capitalism in the 20th century and that the total dollar value of the world economy has increased fivefold while the number of people living in poverty has (...) doubled, Nielsen clearly demonstrates that globalization has made and still is making a bad situation worse. While inveighing against capitalist globalization, he makes the important point that a globalization based on "market socialism" - to ensure both needed efficiency and an egalitarian conception of justice - would be a trend that people in all nations would welcome. Democratic socialism, despite historical betrayals and recent setbacks, Nielsen contends, is still humanity's best hope for achieving a classless, nonracist, and nonsexist world community. He devotes a number of chapters to a discussion of the critical theory that is the basis of this vision of a completely egalitarian international society, and he compares and contrasts his own position with that of such thinkers as Richard Rorty, John Rawls, Juergen Habermas, G. A. Cohen, and others. This well-argued critique of capitalist globalization and defense of democratic socialism as a viable alternative is essential reading for philosophers, political scientists, students of international relations, and anyone concerned about the future of democratic and egalitarian ideals. (shrink)

That PTSD nightmares are highly realistic threat simulations triggered by trauma is difficult to reconcile with the disturbed, sometimes debilitating sleep and waking functioning of PTSD sufferers. A theory that accounts for fundamental forms of imagery other than threat scenarios could explain the selection of many more adaptive human functions – some still pertinent to survival today. For example, interactive characters, a virtually ubiquitous form of dream imagery, could be simulations of attachment relationships that aid species survival in many different (...) ways. [Revonsuo]. (shrink)

Humans are one of the most cooperative and altruistic species on the planet. At the same time, humans have a long history of violent and deadly intergroup conflicts, i.e. wars. Recently, contemporary evolutionary theorists have revived Charles Darwin’s idea that human in-group altruism and out-group hostility might have co-evolved. Groups with more cooperatively aggressive men, they suggest, were more likely to prevail in the frequent lethal quarrels of human pre-history, and these men, therefore, more likely to have passed on their (...) genes. After a short introduction to evolutionary perspectives on war heroism, we describe selected characteristics of 988 modern war heroes, the US-American Medal of Honor recipients of WWI, WWII, the Korean and the Vietnam War, and discuss whether an evolutionary perspective can help us understand why these men risked their lives ‘beyond the call of duty’. (shrink)

Fred Adams and Charlotte Shreve ABSTRACT: Last year Charlotte Shreve and I presented an argument that synesthesia contains evidence against higher order thought theories of consciousness. Rocco Gennaro took up the challenge and argued that H.O.T. theories like his could handle the example and dismiss the argument. Below we suggest...

I discuss the justification of political violence even within democracies. I define ?violence? and indicate how its evaluative force sometimes has conceptually distorting effects. Though acts of violence are at least prima facie wrong, circumstances can arise where, even in democracies, some of them are morally justified. To establish this, three paradigm cases of non?revolutionary political violence are examined. The question is then discussed whether revolutionary violence is ever justified as a means of establishing or promoting human freedom and happiness. (...) I state the conditions which must be satisfied for such violence to be justified and argue that sometimes these conditions have been satisfied. Finally I argue that discussions of violence are frequently confused by ideological mystification and attempt to go some way towards revealing the sources of that mystification. (shrink)

We shall have to evolve problem-solvers—galore since each problem they solve creates ten problems more— Piet HeinThe new reproductive technologies, especially in vitro fertilization, have extended the possi- bilities of assisted reproduction to the benefit of the childless couples. At the same time these technologies and their added techniques, however, have fragmented reproduction and exposed the human egg to intervention yet unknown:The embryo may be divided into several embryos; may be sold; donated; cryopreserved; borne by another woman and returned; or (...) used for research;Genetic parentage may be present without sexual intercourse, may be different from social parentage and the natural time-span between fertilization and birth may be interrupted. (shrink)

Medical assistance in dying (MAiD) is unique among the arsenal of medical therapeutics though it does return us to a dilemma Hippocrates addressed 2400 years ago. It provides welcome relief for suffering patients and their families, but MAiD is not suicide – it is invited homicide. It is more like a death ritual than a therapeutic procedure. Unlike medical interventions, MAiD cures no diseases and true informed consent cannot be obtained. It separates the body from the soul and perceived doctors’ (...) errors are punishable through criminal prosecution. If badly administered, it could undermine trust in the medical profession. The providers are also at risk for delayed remorse. As the inclusion criteria for MAiD become more relaxed, doctors who currently decide on candidates for MAiD should have access to established panels for guidance. The panels should include legal and ethical specialists. (shrink)

Cet article a déjà paru dans Beiträge zur geistigen Situation der Gegenwart Jg. 8, Heft 3. Nous remercions Cathrin Nielsen de nous voir permis de la reproduire ici. Im Oktober 1887, also knapp zwei Jahre vor seinem geistigen Zusammenbruch, schreibt Nietzsche an Hermann Levi in München : „Vielleicht hat es nie einen Philosophen gegeben, der in dem Grade im Grund so sehr Musiker war, wie ich es bin“. Wenig später vertraut er seinem engen Freund Heinrich Köselitz alias Peter Gast (...) an : es - XIXe siècle – Nouvel article. (shrink)

Requirement‐sensitive legal moralism is a species of legal moralism in which the legitimacy of turning moral into legal demands depends on the existence of a legitimate moral requirement, producing a legitimate social requirement, which can then ground a legitimate legal requirement. Crucially, each step is defeasible by contingent or instrumental, but not intrinsic moral factors. There is no genuinely moral sphere (e.g., a private sphere) in which the law is not to interfere; only contingent, non‐moral factors can defeat this. Using (...) William A. Edmundson's Three Anarchical Fallacies as a foil, this idea is spelled out; it is shown why considerations based on the harm principle, consent, and the fact of pluralism do not immediately defeat it, but several problems with Edmundson's account are examined to point out where the idea could be further developed. (shrink)

Concentration and lack of plurality of media control is significant and appears to be increasing. The potential danger to a democracy of a lack of plurality of media control is serious. There are opportunities for greater plurality and freedom of expression through professional employee decision making partcipation. There are practical precedents for professional employee management participation in the media. Therefore, professional media employee management participation deserves to be seriously considered. Limitations of the principle are also considered.

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee she (...) was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

Kai Nielsen is one of Canada's most distinguished political philosophers. In a career spanning over 40 years, he has published more than 400 papers in political philosophy, ethics, meta-philosophy, and philosophy of religion. Pessimism of the Intellect presents a thoughtful collection of Nielsen's essays complemented by an extended reflective interview with Nielsen. This collection allows the reader to grasp the systematic scope of his thought and methodology.