In Iroquois and Algonquin legend there is the story of a girl who submits in the dark of night to a man she believes to be her brother. Every detail seems to identify him: physical appearance, clothing, a scratched cheek attesting to the heroine's virtue. When formally accused by her, the brother reveals that he has a second self (Sosie) or, more precisely, a double; the bond between them is so strong that everything befalling the one is automatically transmitted to (...) the other : the torn garment, the wounded face. In order to convince his incredulous sister, the young man kills his double before her eyes, but with this single blow he pronounces his own death sentence, since their destinies are one. (shrink)

Work-themed play may allow children to learn complex skills, and ethno-typical and gender-typical behaviors. Thus, play may have made important contributions to the evolution of childhood through the development of embodied capital. Using data from Aka foragers and Ngandu farmer children from the Central African Republic, we ask whether children perform ethno- and gender-typical play and work activities, and whether play prepares children for complex work. Focal follows of 50 Aka and 48 Ngandu children were conducted with the aim of (...) recording children’s participation in 12 categories of work and work-themed play. Using these data, we test a set of hypotheses regarding how age, gender, ethnicity, and task complexity influence children’s activities. As hypothesized, we find performance of work-themed play is negatively correlated with age. Contrary to our hypothesis, children do not play more than they work at complex tasks, but they work more than they play at simple ones. Gender and ethnicity are associated with play and work at culturally salient activities, despite availability of other-gender and other-ethnicity social partners. Our findings show that ethnic and gender biases are apparent in the play and work behavior of Aka and Ngandu children. Moreover, our results show that play helps both forager and farmer children learn complex skills, consistent with play having an adaptive learning function. (shrink)

In the face of mounting criticism against advance directives, we describe how a novel, computer-based decision aid addresses some of these important concerns. This decision aid, Making Your Wishes Known: Planning Your Medical Future , translates an individual's values and goals into a meaningful advance directive that explicitly reflects their healthcare wishes and outlines a plan for how they wish to be treated. It does this by (1) educating users about advance care planning; (2) helping individuals identify, clarify, and prioritize (...) factors that influence their decision-making about future medical conditions; (3) explaining common end-of-life medical conditions and life-sustaining treatment; (4) helping users articulate a coherent set of wishes with regard to advance care planning—in the form of an advance directive readily interpretable by physicians; and (5) helping individuals both choose a spokesperson, and prepare to engage family, friends, and health care providers in discussions about advance care planning. (shrink)

PurposeAdvance directives have been criticized for failing to help physicians make decisions consistent with patients’ wishes. This pilot study sought to determine if an interactive, computer-based decision aid that generates an advance directive can help physicians accurately translate patients’ wishes into treatment decisions.MethodsWe recruited 19 patient-participants who had each previously created an advance directive using a computer-based decision aid, and 14 physicians who had no prior knowledge of the patient-participants. For each advance directive, three physicians were randomly assigned to review (...) the advance directive and make five to six treatment decisions for each of six (potentially) end-of-life clinical scenarios.From the three individual physicians’ responses, a “consensus physician response” was generated for each treatment decision (total decisions = 32). This consensus response was shared with the patient whose advance directive had been reviewed, and she/he was then asked to indicate how well the physician translated his/her wishes into clinical decisions.ResultsPatient-participants agreed with the consensus physician responses 84 percent (508/608) of the time, including 82 percent agreement on whether to provide mechanical ventilation, and 75 percent on decisions about cardiopulmonary resuscitation (CPR).Across the six vignettes, patient-participants’ rating of how well physicians translated their advance directive into medical decisions was 8.4 (range = 6.5-10, where 1 = extremely poorly, and 10 = extremely well). Physicians’ overall rating of their confidence at accurately translating patients’ wishes into clinical decisions was 7.8 (range = 6.1-9.3, 1 = not at all confident, 10 = extremely confident).ConclusionFor simulated cases, a computer-based decision aid for advance care planning can help physicians more confidently make end-of-life decisions that patients will endorse. (shrink)

ICAP is a theory of active learning that differentiates students’ engagement based on their behaviors. ICAP postulates that Interactive engagement, demonstrated by co‐generative collaborative behaviors, is superior for learning to Constructive engagement, indicated by generative behaviors. Both kinds of engagement exceed the benefits of Active or Passive engagement, marked by manipulative and attentive behaviors, respectively. This paper discusses a 5‐year project that attempted to translate ICAP into a theory of instruction using five successive measures: (a) teachers’ understanding of ICAP after (...) completing an online module, (b) their success at designing lesson plans using different ICAP modes, (c) fidelity of teachers’ classroom implementation, (d) modes of students’ enacted behaviors, and (e) students’ learning outcomes. Although teachers had minimal success in designing Constructive and Interactive activities, students nevertheless learned significantly more in the context of Constructive than Active activities. We discuss reasons for teachers’ overall difficulty in designing and eliciting Interactive engagement. (shrink)

Whereas many evolutionary models emphasize within-group cooperation or between-group competition in explaining human large-scale cooperation, recent work highlights a critical role for intergroup cooperation in human adaptation. Here we investigate intergroup cooperation in the domain of shotgun hunting in northern Republic of the Congo. In the Congo Basin broadly, forest foragers maintain relationships with neighboring farmers based on systems of exchange regulated by norms and institutions such as fictive kinship. In this study, we examine how relationships between Yambe farmers and (...) BaYaka foragers support stable intergroup cooperation in the domain of shotgun hunting. In the study village, shotgun hunting is based on a specialization-based exchange wherein Yambe farmers contribute shotguns and access to markets to buy cartridges and sell meat while BaYaka foragers contribute their specialized forest knowledge and skill. To understand how costs and benefits are distributed, we conducted structured interviews with 77 BaYaka hunters and 15 Yambe gun owners and accompanied hunters on nine hunting trips. We found that hunts are organized in a conventional manner within a fictive kinship structure, consistent with the presence of intercultural mechanisms to stabilize cooperation. However, because bushmeat demand is high, gun owners can gain significant cash profit, while compensating hunters only with cigarettes, alcohol, and a traditional hunter’s portion of meat. To level payoffs, hunters strategically hide kills or cartridges from gun owners to feed their own families. Our results illustrate how each group prioritizes different currencies (e.g., cash, meat, family, intergroup relations) and provide insights into how intergroup cooperation is stabilized in this setting. The example of this long-standing intergroup cooperative system is discussed in terms of its contemporary entwinement with logging, the bushmeat trade, and growing market intersection. (shrink)

A father brings his six-year-old daughter and her older sister to their pediatrician to be evaluated for a history of cough, runny nose, and low-grade fever. In addition to signs of a cold, the girl's nasal bridge is quite swollen and bruised. When asked how her nose was injured, she shrugs, and her father's only conjecture is that she sleepwalks and might have bumped into something. The father sits impatiently and as questioning progresses becomes increasingly defensive, at one point angrily (...) declaring, “We don't beat our kids, if that's what you’re asking.” Further complicating the situation is information from nurses that this family is “on the brink” socially and financially, and that additional stress is likely “to blow this family apart.” A careful physical exam identifies no other injuries, and a thorough review reveals no evidence of prior suspicious injuries, frequent visits to the emergency room, or bleeding abnormalities. The evidence does not point to abuse as the most likely explanation for the injury, but it clearly is not ruled out. Should one report this family for suspected abuse? Is one required to report? (shrink)

Within the field of medical ethics there is a startling amount of diversity regarding which issues and relationships are deemed relevant for ethical inquiry and analysis, what strategies are appropriate for examining and resolving ethical conflict, what should be the goals for medical ethics, even who should participate in that project. What I will try to make clear in this paper is that how we go about this process of doing medical ethics, of examining, reflecting, decisionmaking, and behaving, makes a (...) practical difference, and not just a philosophical one, in terms of the understandings we will reach about ethical matters. Without attempting to resolve any of the conflicts within or between different conceptions of doing ethics, I will try to articulate the differences in orientation, and particularly the tone and educational emphasis, that attend four major contemporary approaches to ethical inquiry and analysis: deductivism, principlism, modern casuistry, and feminist/relationist ethics. Keywords: casuistry, deductivism, ethics, feminism, principlism, relationism CiteULike Connotea Del.icio.us What's this? (shrink)