This article describes the situated nature of two intertwined dimensions of the context of medical encounters - expertise and compliance - within the interactional practices of referrals and accounts of referrals. Families who display their expertise and compliance have referral and account sequences with notably different features compared to sequences with families who display a lack of compliance and expertise. The display of expertise significantly affects the course of the interaction, and asymmetrical sequences often occur in interactions when the professionals (...) see families' expertise and compliance as problematic. (shrink)

Wisdom is a multi-component trait that is important for mental health and well-being. In this study, we sought to understand gender differences in relative strengths in wisdom. A total of 659 individuals aged 27–103 years completed surveys including the 3-Dimensional Wisdom Scale and the San Diego Wisdom Scale. Analyses assessed gender differences in wisdom and gender’s moderating effect on the relationship between wisdom and associated constructs including depression, loneliness, well-being, optimism, and resilience. Women scored higher on average on the 3D-WS (...) but not on the SD-WISE. Women scored higher on compassion-related domains and on SD-WISE Self-Reflection. Men scored higher on cognitive-related domains and on SD-WISE Emotion Regulation. There was no impact of gender on the relationships between wisdom and associated constructs. Women and men have different relative strengths in wisdom, likely driven by sociocultural and biological factors. Tailoring wisdom interventions to individuals based on their profiles is an important next step. (shrink)

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...) in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...) of their own ethics consultation service (ECS) and few concerns about quality. Our findings suggest that the ethics-related needs of small, rural, non-teaching hospitals may be very different from those of academic medical centers, and therefore, different approaches to addressing ethical issues might be warranted. (shrink)

In recent years, a debate concerning the nature of knowing-how has emerged between intellectualists who claim that knowledge-how is reducible to knowledge-that and anti-intellectualists who claim that knowledge-how comprises a unique and irreducible knowledge category. The arguments between these two camps have clustered largely around two issues: intellectualists object to Gilbert Ryle's assertion that knowing-how is a kind of ability, and anti-intellectualists take issue with Jason Stanley and Timothy Williamson's positive, intellectualist account of knowing-how. Like most anti-intellectualists, in this paper (...) I will raise objections to Stanley and Williamson's account of knowing-how and also defend the claim that ability is necessary for knowing-how attributions. Unlike most discussions of knowing-how, however, I will return to more Rylean considerations in order to illustrate that any intellectualist account of knowing-how, not simply Stanley and Williamson's preferred variety, will fail because it will be unable to account for fundamental differences in the knowledge required to instantiate an ability and the knowledge involved in propositional thought. (shrink)

In formulating a theory of perception that does justice to the embodied and enactive nature of perceptual experience, proprioception can play a valuable role. Since proprioception is necessarily embodied, and since proprioceptive experience is particularly integrated with one’s bodily actions, it seems clear that proprioception, in addition to, e.g., vision or audition, can provide us with valuable insights into the role of an agent’s corporal skills and capacities in constituting or structuring perceptual experience. However, if we are going to have (...) the opportunity to argue from analogy with proprioception to vision, audition, touch, taste, or smell, then it is necessary to eschew any doubts about the legitimacy of proprioception’s inclusion into the category of perceptual modalities. To this end, in this article, I (1) respond to two arguments that Shaun Gallagher ( 2003 ) presents in “Bodily self-awareness and objectperception” against proprioception’s ability to meet the criteria of object perception, (2) present a diagnosis of Gallagher’s position by locating a misunderstanding in the distinction between proprioceptive information and proprioceptive awareness, and (3) show that treating proprioception as a perceptual modality allows us to account for the interaction of proprioception with the other sensory modalities, to apply the lessons we learn from proprioception to the other sensory modalities, and to account for proprioceptive learning. Finally, (4) I examine Sydney Shoemaker’s ( 1994 ) identification constraint and suggest that a full-fledged notion of object-hood is unnecessary to ground a theory of perception. (shrink)

In the current literature, discussions of cognitive penetrability focus largely either on interpreting empirical evidence in ways that is relevant to the question of modularity :343–391, 1999; Wu Philos Stud 165:647–669, 2012; Macpherson Philos Phenomenol Res, 84:24–62, 2012) or in offering epistemological considerations regarding which properties are represented in perception :519–540, 2009, Noûs 46:201–222, 2011; Prinz Perceptual experience, Oxford University Press, Oxford, pp 434–460, 2006). In contrast to these debates, in this paper, I explore conceptual issues regarding how we ought (...) to understand the “cognitive” side of cognitive penetrability. I argue that it is only on its most narrow construal that a full-fledged defense of cognitive impenetrability has been forwarded. Specifically, I argue that the defenders of modularity have tacitly identified cognitive states with propositional states, and have thus only defended the idea that early perceptual systems are immune to the impacts of propositional knowledge. My aim then is to raise doubts about the identification of cognitive states with propositional ones. In particular, by focusing on skill, I will broaden the conceptual space for a greater number of states to have the potential to impact perceptual processing in a way that would constitute a genuine instance of cognitive penetrability. (shrink)

Coverage error is an important type of error that occurs in survey studies when there is a mismatch between the target population and the sampling frame from which a sample is drawn. Coverage error...

Arid Waters is a photographic response to the growing crisis of water scarcity, which exists because our culture thinks of water as a commodity, or an abstract legal right, rather than the most basic physical source of life. The Water in the West Project began as a collaborative effort designed to present an artistic response to water as a social issue. Photography historian Ellen Manchester and the photographers - Mark Klett, Terry Evans, Laurie Brown, Peter Goin, Robert Dawson, Martin (...) Stupich, Gregory Conniff, and Wanda Hammerbeck - address the question: How can photography contribute to the urgent public debate over water use and allocation? Project members prepared an exhibition of their work, defining it as a laboratory and emphasizing the process of working through ideas. Contact prints and numerous work prints were displayed on the walls of the Sheppard Fine Art Gallery at the University of Nevada, Reno, and simultaneously the Nevada Humanities Committee sponsored a conference entitled "Water in the Arid West." Participants included historians, writers, ranchers, politicians, lawyers, students, and community members. Arid Waters documents the evolution of the Water in the West Project from its inception as a group collaboration to the foundation of an archive. Ellen Manchester, codirector of the Water in the West Project, has written an informative introduction that provides a historical perspective for the collaboration. Including 59 photographs from the eight photographers, Arid Waters is a testimony to the role photography has played in western history. (shrink)

This editorial presents the background for the article collection ‘ELSA and RRI’. It sets the stage for the topics discussed in the collection and briefly presents the different contributions. It concludes by opening up for continued discussion of the relations between ELSA and RRI.

BackgroundThis paper represents a portion of the findings from one of the first research studies eliciting the lived experience of adults with an early diagnosis of Phenylketonuria living in Ireland. Ireland has one of the highest prevalence rates of PKU in Europe, however, little is known about the experience of Irish adults with PKU. Furthermore, Ireland is one of the first countries in the world to introduce neonatal screening followed by the introduction of long-term dietary therapy over 50 years ago. (...) This study presents the first comprehensive assessment of the lived experience of Irish adults with PKU on long term dietary therapy.MethodsNarrative data was collected from eleven self-selected participants, using semi-structured interviews. The interviews were divided into five sections focused on eliciting a holistic understanding of the lived experience of adults with PKU living in Ireland. Thematic analysis was guided by Colaizzi's Framework in conjunction with NVivo qualitative data analysis software.FindingsFindings from the original research encompassed a broad understanding of the lived experience of adults with PKU living in Ireland, including factors influencing dietary therapy and managing PHE blood levels. The themes being discussed within this article are those which appear to be least represented within current literature: living with PKU, including reproductive health, the importance of self-management and establishing routine, support networks in adulthood and concerns regarding aging with PKU.ConclusionIt was evident from the findings that a diagnosis of PKU can influence how adults with PKU may experience aging and their own mortality. These findings offer new insight into the vulnerability attached to the experience of aging with PKU and may be beneficial to advocacy groups and for future development of policy and practice. (shrink)

The Holocaust takes on a riveting immediacy in these true stories of the everyday, understated heroism that saved thousands of Jews from annihilation at the hands of the Third Reich. Combining personal interviews with contemporary and vintage photographs, To Save a Life pairs the stories of a handful of rescuers with those of people they saved. Ellen Land-Weber creates a moving, multidimensional picture of the evasive strategies and heartstopping close calls that filled the years of the Holocaust for both (...) rescuers and rescued. In paperback for the first time, the rescues narrate their growing awareness of the tightening circle of Nazi terror, their experiences in hiding, often being shunted from one safehouse to another, and their hair's-breadth separation from friends and family who did not escape. Promotional Information: Life-saving acts of heroism by ordinary people in the face of Nazi tyranny. (shrink)

First Published in 2005. Routledge is an imprint of Taylor & Francis, an informa company.

International law evolved to end and prevent armed conflict as much as for any other reason. Yet, the law against war appears weaker today than ever in its long history, evidenced by raging armed conflicts in which people are killed, injured, and forcibly displaced. The environment is devastated, and the planet impoverished. These consequences can be traced to the dominant ideology of realism. In 1946, Hersch Lauterpacht challenged that ideology by contrasting it with the idea of international law, composed of (...) natural law, positive law, and process theory. The Art of Law in the International Community revives his vision, rebuilding the understanding of why international law binds, what its norms require, and how courts are the ideal substitutes for war. The secret to the renewal of international law lies in revitalizing the moral foundation of natural law through drawing on aesthetic philosophy and the arts. (shrink)