Cultural narratives shape how we think about the world, including how we decide when the end of life begins. Hospice care has become an integral part of the end‐of‐life care in the United States, but as it has grown, its policies and practices have also imposed cultural narratives, like those associated with the “six‐month rule” that the majority of the end of life takes place in the final six months of life. This idea is embedded in policies for a range (...) of care practices and reimbursement processes, even though six months is not always a meaningful marker. In the case of people living with advanced dementia, six months is both too early in the trajectory to facilitate conversations and too late in the trajectory to ensure decision‐making capacity. This essay encourages scholars and policy‐makers to consider how cultural narratives may limit what they think is possible in care for people living with dementia. (shrink)

Breastfeeding remains an understudied topic in research and theorizing about reproductive experience and women's bodies. This article reports on women's experiences of breastfeeding in public as revealed through in-depth interviews with 51 women. The current construction of the good maternal body requires women to carefully manage the performance of breastfeeding in specific ways and with particular attention to the dominant notion of a sexualized rather than nurturing breast. Women accommodate to, and resist, the perceived boundaries of the good maternal body (...) through their breastfeeding behaviors. (shrink)

La conceptualización del saber artesanal es compleja y requiere del reconocimiento epistemológico dentro del contexto sociocultural y económico en el que opera lo artesanal, donde es necesario resaltar el valor ancestral, pues, dentro del aprendizaje hay una transferencia de conocimiento tradicional cuando no hay una ruptura en la producción de sentido que se constituye.Por ello, esta investigación busca, por medio de un documental, visibilizar la labor que cumplen los artesanos y cesteros del municipio de Tocaima, Cundinamarca, logrando construir un espacio (...) de integración y capacitación donde sean los cesteros quienes se beneficien y logren transmitir los saberes de la cestería. (shrink)

Este estudio buscó describir e interpretar las teorías subjetivas sobre la identidad profesional docente que se construyen y difunden noticiosamente durante la educación de emergencia por la pandemia de COVID 19. Se utilizó un estudio de análisis documental, metodología cualitativa y un diseño de estudio de casos. El muestreo intencionado y por conveniencia corresponde a 40 noticias de prensa escrita en español, sobre el profesor(a) en pandemia y publicadas en diferentes medios que fueron recolectadas a través de Google Noticias desde (...) el 11 de marzo de 2020 y hasta el 01 de noviembre de 2020. A partir de una codificación temática, los resultados evidenciaron teorías subjetivas asociadas a las exigentes características, roles, funciones y valores con los que se identifica al profesorado durante la pandemia. El análisis mostró los distintos sentidos del ejercicio profesional y las competencias asociadas a su desempeño en la prensa. En la discusión, se utilizaron estudios relativos a la práctica docente para interpretar estos resultados. (shrink)

In THE CONSTITUTION OF EQUALITY, Thomas Christiano takes on the question of why decisions that have been democratically arrived at should be treated as authoritative even if we do not agree with them. A key element of that argument is the concept of a “common world”. Christiano takes the connections between people produced by subjection to the same state as the paradigmatic case of a common world, and seems to assume that state-based common worlds take normative priority over common-world-like connections (...) produced by other social and institutional structures. This identification of the worlds created by states and other groupings is not necessary to the function that common worlds perform in Christiano’s argument, and there are good reasons for resisting such identification. These reasons become most apparent when we consider that the problems that minorities within a state face typically reflect ongoing injustice in the terms of their incorporation into the common world produced by the state that encompasses them. States’ capacities to produce and maintain common worlds depends on an international institutional context that accepts and reinforces exclusive jurisdiction with respect to a territory and population. This international context raises several questions: whether state-based groupings ought to be privileged in this way; how boundaries must be drawn for such privilege to be defensible; and what the proper relationship is between decisions by state-based and other groupings. The Constitution of Equality offers interesting resources for grappling with these questions. But we must be willing to think beyond the state. (shrink)

A popular strategy for answering the question of why and how laws bind is to use the concept of political justification: to argue that laws bind when they can be justified in the political domain. Being defensible in the political domain is supposed to make laws emotionally compelling in virtue of their being justified for each member of the community, and intellectually compelling in virtue of their having emerged from a process that is subject to constraints of rationality such as (...) consistency and coherence. However, being politically justifiable does not and cannot explain why it is reasonable to expect individuals to conform because it places too much emphasis on deference to the judgments of public actors. In this paper I use a distinction between general availability and general acceptability accounts of publicity to explain why the answer to what makes laws binding lies in developing an account of good reasons, not an account of why political reasons should take priority. (shrink)

Neal Berlin, Ann Arbor City Administrator, Tom Blessing, Assistant City Attorney, plus some Cable Communications Commission (CCC) members are trying to put free speech restrictions into Community Television Network�s policies and remove City Council from the debate. CTN, Ann Arbor�s community access cable TV station, is run by the city but not paid for by tax dollars. It is one of the first public access cable stations in the U.S., founded in 1973.

At the turn of the nineteenth century when anatomy and hands-on dissection became the prerequisite for a medical career, the medical community in England and France increasingly relied upon visual representations as part of a complex system of reinforcement of their professional goals. The production of novel illustrated textbooks that disseminated arguments through systematizing illustrations were thus integral to their professional status. Through an examination of a series of realistic diagrams that outlined the new methods of surgical and preservation techniques, (...) this paper argues that visual diagrams were instrumental in supporting the systematic codification and prestige on which nineteenth-century medical knowledge was to depend. It analyses the visual rhetoric and the complex representational languages of these intricate and equally precise illustrations by asking how these illustrations embraced new representational strategies as well as embodied idealizing aesthetic techniques. (shrink)

This book provides an in-depth discussion of the aspects of a whole-child learner paradigm including how educator and school-based influences interrelate with personal and interpersonal demonstrations of learning to create a holistic learning system.

The practice of placing men and women in the same hospital room (mixed gender rooms) has been prohibited in the UK National Health Service for over a decade. However, recent research demonstrates that the practice is common and increasing in a major New Zealand public hospital. Reports and complaints show that the practice also occurs in Australia. We argue that mixed gender rooms violate the fundamental human rights of personal security and dignity. The high rates of cognitive impairment, sensory impairment (...) and frailty in hospital wards exacerbates the risk for these violations and subsequent harm. We argue for the adoption of specific national policies prohibiting mixed gender rooms and public reporting of breaches. Importantly, these guidelines can be adopted without compromising the rights of gender minorities. In the long term, hospitals should be built with single occupancy rooms. (shrink)

Background Current requirements for ethical research in Canada, specifically the standard of active or signed parental consent, can leave Indigenous children and youth with inequitable access to research opportunities or health screening. Our objective was to examine the literature to identify culturally safe research consent processes that respect the rights of Indigenous children, the rights and responsibilities of parents or caregivers, and community protocols. Methods We followed PRISMA guidelines and Arksey and O’Malley’s approach for charting and synthesizing evidence. We searched (...) MEDLINE, PsycINFO, ERIC, CINAHL, Google Scholar, Web of Science, Informit Indigenous Collection, Bibliography of Native North Americans, and Sociological Abstracts. We included peer-reviewed primary and theoretical research articles written in English from January 1, 2000, to March 31, 2022, examining Indigenous approaches for obtaining informed consent from parents, families, children, or youth. Eligible records were uploaded to Covidence for title and abstract screening. We appraised the findings using a Two-Eyed Seeing approach. These findings were inductively coded using NVivo 12 and analyzed thematically. Results We identified 2,984 records and 11 eligible studies were included after screening. Three key recommendations emerged: addressing tensions in the ethics of consent, embracing wise practices, and using relational approaches to consent. Tensions in consent concerned Research Ethics Board consent requirements that fall short of protecting Indigenous children and communities when culturally incongruent. Wise practices included allowing parents and children to consent together, land-based consenting, and involving communities in decision-making. Using relational approaches to consent embodied community engagement and relationship building while acknowledging consent for Indigenous children cannot be obtained in isolation from family and community. Conclusions Very few studies discussed obtaining child consent in Indigenous communities. While Indigenous communities are not a monolith, the literature identified a need for community-driven, decolonized consent processes prioritizing Indigenous values and protocols. Further research is needed to examine nuances of Indigenized consent processes and determine how to operationalize them, enabling culturally appropriate, equitable access to research and services for all Indigenous children. (shrink)

Over the past decade AIDS research has turned toward the use of pharmacology in HIV prevention, including pre-exposure prophylaxis (PrEP): the use of HIV medication as a means of preventing HIV acquisition in those who do not have it. This paper explores the contradictory reasons offered in support of PrEP—to empower women, to provide another risk-reduction option for gay men—as the context for understanding the social meaning of the experimental trials that appear to show that PrEP works in gay men (...) and heterosexual couples but not single women. The PrEP debates reveal the different ideas about “demedicalization” in the earlier gay health and women’s health movements and highlight the relationship between health activism and critique of research ethics in the context of a global pharmaceutical market. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who Tells the StoryCindy BitterThirty years later, I do not remember her name, but I definitely remember her face, and this is how I remember her story.She came into the office for her flu shot. She was in her 70s and had a mild case of COPD attributed [End Page 87] to years of exposure to pesticides on the family farm. She said she was trying to stay healthy, (...) as the grandkids were due for a visit, and everyone had gotten a cold after Thanksgiving the year before. I was a sub-intern doing a required rural medicine rotation and diligently did an exam, finding asymptomatic new-onset atrial fibrillation of uncertain duration. We admitted her to the hospital and started anticoagulation. My attending also ordered a calcium channel blocker to slow her pulse, which was running 90–100 while she was at rest. The attending insisted that it would convert her back to sinus rhythm. The nurses were not experienced with the medication and were uncomfortable giving it. I was pretty sure the calcium channel blocker was not indicated, and a quick check of my pocket manual confirmed the drug would lower her heart rate and maybe her blood pressure but that it would not fix the abnormal rhythm. I refused to administer it. The attending came in, pushed the medication, and returned home. A few minutes later, the patient was struggling to speak. Her pulse fell to in the 30s, and her blood pressure had dropped dangerously low. I asked for the crash cart and calcium, and my attending, then started CPR when she lost her pulse. Half an hour later, my attending called her time of death.Hers was not the first death I'd witnessed, but it was the first time I felt like my patient would have been better off without our interventions. As a medical student hundreds of miles from the main hospital campus, I felt powerless to contradict the attending, and did not know where to turn for support in the moment. I rationalized it by saying that I had not actively contributed to her death by pushing the medication, but I held myself morally culpable for doing the exam and finding an asymptomatic abnormality that started her down that path. I felt I should have known the pathophysiology and medication side effects better, or been more assertive, or called for help.One could argue whether I was suffering from a grief reaction or falling into depression, but I questioned my calling to medicine and seriously considered leaving the field. But I was quite certain that I did not want another patient to be put at risk, or a student to feel cornered into taking actions against their better judgment. After returning to the main hospital, I met with the clerkship director and helped develop a pathway for students to raise safety concerns in real-time. Now I recognize the feeling I experienced as moral injury, but we weren't using that term at the time, or talking about Six Sigma safety, or stopping the line.Ultimately, I continued through medical school and trained as an emergency physician. My prior reverence for my attendings moderated to a healthier respect that had to be earned. I read voraciously, trying to prepare myself for unexpected situations. I became an advocate for patient safety and was an early adopter of shared decision-making. I strive to be a physician who welcomes questions and respects the concerns of all team members. Many of the principles that ground my career in medicine grew out of my exposure to this patient.It was always my least favorite of the tropes common to television medical dramas—the circumstances of the patient-of-the-week illuminated some aspect of our main characters' lives, providing a very important life lesson. I felt it positioned patients to be in service of the physician's aims, using patients as a means to our ends, when we should be using our knowledge and experience to further the patient's goals. Very un-Kantian, in addition to transgressing against multiple other philosophers and medical ethicists. As medicine learns more about the power of... (shrink)

Is there something special about group rights? Many would say "yes". For some, only certain kinds of groups---ones that are oppressed, or play a special role in well-being---may have rights. For others, the kind of group is not as important as the group's culture and internal structure. At the very least, many argue, group rights ought to be more restricted than individualistic ones. For these reasons, arguing the merits of a group right is often thought to require a theory of (...) groups or of group identity. If only certain kinds of groups may have rights then one has to identify the roles that various groups and/or identities play in personal well-being. If a group's culture or internal structure must meet certain standards then one must develop a theory of how culture or the internal organization of a minority influences people. ;I argue that it is a mistake to think that arguing a group right requires a theory of groups. This mistake reflects a tendency to think about group membership as a kind of good and to focus on its internal, psychological significance. But if one thinks about group membership as a vehicle of action, and focuses on the concrete effects it may have, it becomes apparent that arguing for a group right does not require a theory of groups, group identity or culture. For in the end, the issues that one must address in arguing a group rights are issues about groups. Rather, they are issues about political and moral authority, and about the extent to which moral and political norms ought to recognize and reinforce the ways that people depend upon one another. These are important issues and they raise pressing questions for political philosophy. But they are not about groups. (shrink)

Everyone agrees that the international community must develop better mechanisms for responding to humanitarian crises. The best mechanism for responding is simply to intervene to prevent a crisis from developing in the first place. However, because the principle of sovereignty imposes strict constraints on action across state borders, international actors are often unwilling or unable to interpose themselves until after conditions have escalated into a full-blown crisis, by which time it has usually become a matter of managing human misery rather (...) than ending or averting it. Respect for sovereignty is an organizing principle of the existing international legal system, and so abandoning it would fundamentally change how the units of international politics are constituted and relate to one another. The strongest argument against abandoning sovereignty is the potential for unintended consequences with respect to peace, political stability, and the effective protection and promotion of human rights. One way to defuse this worry is to frame interventions across borders as principle-based exceptions to a general rule of state sovereignty. If we assume that protecting and promoting individual human rights is the primary goal of the international system, and that both state sovereignty and peace and security are important to us primarily as vehicles for achieving this, then (it is argued) we may use the standards of international human rights to identify, and limit, cases in which the presumption of sovereignty may legitimately be set aside. However, the relationship between sovereignty and humanitarian crises is more complex than this picture allows. Theorizing about humanitarian crises inevitably includes recommendations about states and this makes it a species of non-ideal theory. All actual states are rife with injustice, both in their internal structures and in the relationships these structures establish with those outside a state’s borders. This fact must be reflected in our reasoning about humanitarian responses. (shrink)

In a recent paper, Michael Levin argues that both statements reporting causal relations and causal explanatory statements are extensional. We show that his argument for the extensionality of causal explanatory statements fails to establish that conclusion. His claim that certain 'because' statements are elliptical for statements of what he terms the 'causal explanatory' form is unsubstantiated. The argument for the referential transparency of the allegedly explanatory form, regardless of whether it is a distinct explanatory form, fails because of scope problems. (...) Finally, we argue that the apparent referential opacity of explanations, the attribution of certain kinds of properties to explanations, and our satisfaction with explanations in what appear to be disparate forms are best accounted for, not by the assumption of ellipticality of statements in various forms for statements in some inherently explanatory form, but rather by an account of explanation as a speech act, the success or failure of which may be affected by which of several co-referring expressions is employed. (shrink)

Are there wrongs for which states cannot apologise? In this chapter, I argue that the answer is 'Yes'. I begin with the simple observation that reasoning as a state official requires a conception of what officials do, and so a conception of what is - and is not - properly undertaken on behalf of the state. To act as an official, then, requires a theory of what happens in a well functioning state: it requires a 'normative theory of the state. (...) What officials believe to be necessary for a state to be a good example of its kind will affect what they recognise as outside the bounds of what a state official ought to do. This limit on what can be recognised as something prior officials ought not to have done is illustrated by Canada's official apology for imposing residential schools on indigenous peoples. Canada's official apology left out a crucial feature of the schools policy in part because of the influence of integrationist theories of the state. An integrationist view of good statehood has limited officials' ability to see the project of restructuring indigenous communities and inculcating attachment to an overarching identity as a wrong in itself, and distorted officials' diagnosis of what went wrong in previous policy. One effect has been to allow contemporary officials to offer a sincere and comprehensive apology for past officials' human rights violations in indigenous communities while themselves pursuing policies in these communities that violate human rights. The lesson of the Canadian apology is that how state officials theorise the state can undermine their capacity to recognise human rights violations for what they are and distort their judgements of what must be done in remedy. (shrink)

A shift in emphasis can change the truth-value of a singular causal sentence. This poses a challenge to the view that singular sentences predicate a relation. I argue that emphasized causal sentences conjoin predication of a causal relation between events with predication of a relation of causal relevance between states of affairs (or perhaps facts). This is superior to the treatments of such sentences offered by Achinstein, Dretske, Kim, Sanford, Bennett, and Levin. My proposal affords clarity regarding logical structure, at (...) least at a certain level of detail. It makes the relation between the content of an emphasized causal sentence and the unemphasized version clear. It answers some questions about the ontological requirements of the truth of emphasized causal sentences, without introducing new entities (as do some other accounts) or unacceptable consequences for identity and individuation of events. (shrink)

We live in a world of states: a world in which the dominant form of “persisting structure” for the wielding of political power is characterized by territorially concentrated power exercised through political institutions that exert sovereign control in the sense of being able to exclusively command compliance. Within such a world, calls for reorganization of the way these institutions are organized so as to devolve power to groups oppressed or marginalized within existing structures are inevitable. However, for proponents of liberal (...) states, such calls for devolving power pose a problem. When substate groups call for a reorganization in which power is devolved rather than reformed, they imply that within some portions of the state’s territory, or for certain of the state’s inhabitants, state-level political institutions cannot rightfully command compliance, or at least, cannot do so exclusively. Proponents of liberal states might respond to this problem by letting go of the need for exclusive command. However, for many proponents of liberal states, the prospect of a competing source of rightful command that may assert priority over decision making that applies to the entire territory is impractical, and conceptually difficult to sustain. An alternative response, one that preserves the pre-eminent position of institutions that encompass the state’s entire territory and population, is to insist that such institutions have a vital role in ensuring that the decision making of sub-state groups meets minimal conditions of moral equality and respect for human rights. Emphasizing the role of institutions that encompass the entire territory in guaranteeing minimal conditions of moral equality and respect for human rights seems promising, but it cannot provide a satisfactory account of the desirability of empowering state officials to exercise powers of oversight, and so it cannot justify reserving such powers in the face of calls for power to be devolved. This is most obvious in relation to oppressed an marginalized groups, as state officials recognize cannot reasonably expect members of such groups to accept officials as credible guarantors of moral equality or human rights. This problem aside, there is a basic problem with the way decision making is conceived of in arguments for the importance of reserving powers of oversight as groups calling for devolution of power are not susceptible to the kind of characterization that state officials would have to engage in to effectively gauge whether to intervene to secure moral equality and human rights. (shrink)

Zaller's model of public-opinion formation portrays the average citizen as an automaton who responds unthinkingly to elite cues. That is, once people have received information from political elites, they tend to abide by whatever their respective cue-givers dictate, since rejecting information is more cognitively costly than simply accepting it. Empirical research in psychology on priming supports this view of the citizen as a passive receiver of information. For example, people are likely to be unconsciously influenced by subtle cues and they (...) tend to base their opinions on the accessibility of information in memory. However, some citizens, under certain conditions, may be ?active processors? of information: actively interpreting it, elaborating on its implications, and negotiating its meaning. Whether or not Zaller's model is an accurate representation of the process of public-opinion formation depends substantially upon the inclusiveness of the researcher's views about what constitutes public opinion and how to study its determinants. (shrink)

Robert Card argues that although Susan Okin’s analysis in Justice, Gender and the Family leads to the conclusion that justice within the family requires elimination of gendered roles within marriage, this conclusion is not compatible with a conception of justice in which neutrality between reasonable conceptions of the good, and protection of individuals’ contractual capabilities are taken to be fundamental values. Although Card is right that there is tension in Okin’s work between where the analysis of injustice within the gender-structured (...) family leads and where, as a reformer, Okin is willing to go, and he is right to locate the source of that tension in Okin’s attempt to remain within Rawlsian liberalism, Okin’s view has more resources to respond to this critique than Card acknowledges. In the end, these additional resources may not be sufficient to address the problems that Card notes, but they do suggest a more complex relationship between Okin’s view and the liberal tradition than Card allows.. (shrink)

Conventional wisdom suggests that promoting self-determination for peoples and protecting the human rights of individuals are competing priorities. However, many recent international human rights documents include rights of peoples in their lists of basic human rights. In this paper, I defend including at least one people’s right, the right to self-determination, in the list of basic rights. Recognizing that self-determination is a constitutive element of human dignity casts state sovereignty in a different light, with interesting consequences both for international law (...) and for philosophical debates about the rights of minorities. (shrink)

Throughout the 1980s, the American right wing attempted to control the field of social politics and social policy through a rhetoric of `family'. In response, the left, including much of the lesbian and gay movement, abandoned an early, theorized antipathy to family, attempting to recapture the political field with ideas like `alternative families' and `families we chose'. These moves do not sufficiently account for the hidden glue that binds bodies to politics, national or anti-national. The glue, or, as Benedict Anderson (...) calls it, `political love' is no longer an affect to be rejected but a `feeling' to be embraced. Examining the case of sexual abstinence in early right-wing AIDS discourse and in current websites, this article suggests that micro-politics of love are inextricable from macro-politics of nationalism. (shrink)