In the last half century, oral history has emerged as a historical approach that is being considered by archivists involved with the collection and accessibility of archival collections for researchers and interested members of the public. The approach to ethics by oral historians has emerged from two major fears: the fear of failing as researchers and the fear of failing the narrators and doing harm. Archivists also need to be cognisant of these fears when collecting oral history. Confronting these fears (...) makes it possible to understand the complex questions behind oral historians’ and archivists’ preoccupations and sheds light on how oral history has evolved and expanded as a field. The research objectives of this article are to determine the three principles identified from the Belmont Report that relate and should be applied to the collection of oral histories by archivists and historians from communities and individuals residing and working in and alongside the Kruger National Park. The theoretical framework for this article is the critical race theory to address historical accounts from communities and individuals sidelined by the mainstream media in South Africa. For the purposes of this article, the study was conducted with the Makuleka and Tsonga communities to determine what ethical implications need to be respected when conducting oral history projects with communities.Contribution: This article will contribute to ethics concerning social sciences and specifically the collection of oral history. (shrink)

The anticipated social capabilities of robots may allow them to serve in authority roles as part of human-machine teams. To date, it is unclear if, and to what extent, human team members will comply with requests from their robotic teammates, and how such compliance compares to requests from human teammates. This research examined how the human-likeness and physical embodiment of a robot affect compliance to a robot's request to perseverate utilizing a novel task paradigm. Across a set of two studies, (...) participants performed a visual search task while receiving ambiguous performance feedback. Compliance was evaluated when the participant requested to stop the task and the coach urged the participant to keep practicing multiple times. In the first study, the coach was either physically co-located with the participant or located remotely via a live-video. Coach type varied in human-likeness and included either a real human, a Nao robot, or a modified Roomba robot. The second study expanded on the first by including a Baxter robot as a coach and replicated the findings in a different sample population with a strict chain of command culture. Results from both studies showed that participants comply with the requests of a robot for up to 11 min. Compliance is less than to a human and embodiment and human-likeness on had weak effects on compliance. (shrink)

The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of ‘relational autonomy’ in particular have argued that people’s identities, needs, interests – and indeed autonomy – are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at (...) an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangibl... (shrink)

Background: Treating medication-refractory freezing of gait in Parkinson’s disease remains challenging despite several trials reporting improvements in motor symptoms using subthalamic nucleus or globus pallidus internus deep brain stimulation. Pedunculopontine nucleus region DBS has been used for medication-refractory FoG, with mixed findings. FoG, as a paroxysmal phenomenon, provides an ideal framework for the possibility of closed-loop DBS.Methods: In this clinical trial, five subjects with medication-refractory FoG underwent bilateral GPi DBS implantation to address levodopa-responsive PD symptoms with open-loop stimulation. Additionally, PPN (...) DBS leads were implanted for CL-DBS to treat FoG. The primary outcome of the study was a 40% improvement in medication-refractory FoG in 60% of subjects at 6 months when “on” PPN CL-DBS. Secondary outcomes included device feasibility to gauge the recruitment potential of this four-lead DBS approach for a potentially larger clinical trial. Safety was judged based on adverse events and explantation rate.Findings: The feasibility of this approach was demonstrated as we recruited five subjects with both “on” and “off” medication freezing. The safety for this population of patients receiving four DBS leads was suboptimal and associated with a high explantation rate of 40%. The primary clinical outcome in three of the five subjects was achieved at 6 months. However, the group analysis of the primary clinical outcome did not reveal any benefit.Interpretation: This study of a human PPN CL-DBS trial in medication-refractory FoG showed feasibility in recruitment, suboptimal safety, and a heterogeneous clinical effect in FoG outcomes. (shrink)

Many drugs used in paediatric medicine are off-label. There is a rising call for the use of adaptive clinical trial designs in responding to the need for safe and effective drugs given their potential to offer efficiency and cost-effective benefits compared with traditional clinical trials. ADs have a strong appeal in paediatric clinical trials given the small number of available participants, limited understanding of age-related variability and the desire to limit exposure to futile or unsafe interventions. Although the ethical value (...) of adaptive trials has increasingly come under scrutiny, there is a paucity of literature on the ethical dilemmas that may be associated with paediatric adaptive designs. This paper highlights some of these ethical concerns around safety, scientific/social value and caregiver/guardian comprehension of the trial design. Against this background, the paper develops a non-static conceptual lens for understanding PADs. It shows that ADs are epistemically open and reduce some of the knowledge-associated uncertainties inherent in clinical trials as well as fast-track the time to draw conclusions about the value of evaluated drugs/treatments. On this note, the authors argue that PADs are ethically justifiable given they have multiple layers of safety, exposing enrolled children to lesser potential risks, create social/scientific value generally and for paediatric populations in particular, specifically foster the flourishing of paediatric populations and can significantly improve paediatric trial efficiency when properly designed and implemented. However, because PADs are relatively new and their regulatory, ethical and logistical characteristics are yet to be clarified in some jurisdictions, the cooperation of various public and private stakeholders is required to ensure that the interests of children, their caregivers and parents/guardians are best served while exposing paediatric research subjects to the most minimal of risks when they are enrolled in paediatric trials that use ADs. Data sharing not applicable as no datasets generated and/or analysed for this study. Not applicable. (shrink)

The world of work has been severely affected by the COVID-19 pandemic due to the high instability observed in the labor market, bringing several new challenges for leaders and employees. The present study aims to analyze the role of organizational and job resources in predicting employees’ job insecurity during the first wave of the COVID-19 outbreak, through the mediating role of work engagement. A sample of 207 Portuguese employees participated, of which 64.7% were women. Data was collected using an online (...) survey, including self-report measures of organizational resources, job resources, job insecurity, and work engagement. Data showed that job and organizational resources negatively influenced job insecurity. Moreover, work engagement was a significant mediator of the relation between performance feedback and job insecurity. Findings suggest that investing in job and organizational resources can act as protective factors to minimize feelings of job insecurity. Likewise, leaders should foster work engagement among employees to help them balance the relation between these resources and job insecurity, especially in crisis situations. Overall, this study takes a new, underexplored perspective, theoretically bridging organizational and job resources with job insecurity and work engagement during a time of great uncertainty, such as the COVID-19 pandemic. (shrink)

According to one view about the rationality of belief, such rationality is ultimately nothing other than the rationality that one exhibits in taking the means to one’s ends. On this view, epistemic rationality is really a species or special case of instrumental rationality. In particular, epistemic rationality is instrumental rationality in the service of one’s distinctively cognitive or epistemic goals (perhaps: one’s goal of holding true rather than false beliefs). In my (2003), I dubbed this view the instrumentalist conception of (...) epistemic rationality. (shrink)

At the end of a chapter in his book Race, Racism and Reparations, Angelo Corlett notes that “[t]here remain other queries about racism [than those he addressed in his chapter], which need philosophical exploration. … Perhaps most important, how might racism be unlearned?” (2003, 93). We agree with Corlett’s assessment of its importance, but find that philosophers have not been very keen to directly engage with the issue of how to best deal with, and ultimately do away with, racism. Rather, (...) they have tended to make cursory remarks about the issue at the end of papers devoted to defining “racism” or attempting to capture the essence of racism itself. In this article, we put the issue of how to best deal with racism front and center. We need not start from scratch, however. Despite not being central to many philosophical discussions about race, a number of different strategies for dealing with racism have been suggested. To that end, we have identified three of the most concrete proposals made by philosophers and social theorists, each of which seeks to mitigate racism by inducing psychological changes in individuals.2 For each, we formulate the.. (shrink)

Background and aim Nursing students form a professional identity from their core values, role models, and past experiences, and these factors contribute to the development of their professional identity. The hidden curriculum, a set of ethics and values learned within a clinical setting, may be part of developing a professional identity. Nursing students will develop a professional identity throughout school; however, their identity might be challenged as they attempt to balance their core values with behaviors learned through the hidden curriculum. (...) The purpose of this project was to educate students on the hidden curriculum in the development of their professional identity. Materials and methods A sample of 112 senior nursing students was recruited from a northeastern university in the United States for this study. Pre–post survey design was used, and an educational session was administered prior to the post-survey. Descriptive statistics and a valid percentage were used to describe the data within the surveys. Ethical consideration Study was approved by the author’s University Institutional Review Board. Findings A significant finding was for advocacy as students would speak up if witnessing inappropriate behavior toward patients or families with a mean score increase from 2.50 (pre-survey) to 1.45 (post-survey). Also, over 95% ( n = 106) found the educational session beneficial as they learned they had the ability to advocate and speak up for their patients. Conclusion Students were able to use their core values and advocate for their patients and families which allows for safer patient care. (shrink)

Treatise 2.3.6, “Of the influence of the imagination on the passions,” provides a magnified view into the relationship between motivation, morality, and politics in Hume’s philosophy. Here, Hume analyzes a “noted passage” from the history of antiquity in which the citizens of fifth-century Athens deliberated over whether to burn the ships of their neighboring Grecians after winning a decisive naval victory against the Persians. Hume finds the passage notable precisely because of a failure of the imagination to exert an influence (...) on the Athenians’ passions during their deliberations, leading them to abstain from further military action. This paper discusses how Hume’s analysis of this event reveals new connections between his passional, moral, and political theories in the Treatise. (shrink)

Mark Schroeder’s Slaves of the Passions defends a version of the Humean Theory of Reasons he calls “Hypotheticalism,” according to which all reasons an agent has for action are explained by desires that are in turn explained by reference to her psychology. This paper disputes Schroeder’s claim that his theory has the potential to allay long-standing worries about moral objectivity and normativity within a Humean framework because it fails to attain the requisite level of agent-neutrality for moral reasons. The particular (...) problems, and their concomitant solutions, push us in the direction of a more modest ambition for the objectivity of this neo-Humean morality. Moreover, even if all the pieces of Schroeder’s theory are tweaked just enough to make a roughly universal morality practicable, the kind of universality gained might still omit some putatively desirable features of any moral system. (shrink)

This empirical work attends to the tensions and contradictions medical students articulate when they discuss their objection to industry’s influence in medicine. Findings are based on 50 semi-structured interviews with medical students who are critical of the pharmaceutical industry’s influence in medical education in the United States and Canada. These students advocate evidence-based medicine as one solution to the problems with industry influence in medicine; namely industry bias in medical research. This investigation is an effort to understand why EBM is (...) posed as a solution to industry bias in light of the literature demonstrating the ways that what is considered ‘evidence-based’ is influenced by industry. Participants articulate a struggle to find the ‘best’ evidence in a context where industry interests are integral in the production of medical knowledge. (shrink)

Grief research in philosophy agrees that one who grieves grieves over the irreversible loss of someone whom the griever loved deeply, and that someone thus factored centrally into the griever’s sense of purpose and meaning in the world. The analytic literature in general tends to focus its treatments on the paradigm case of grief as the death of a loved one. I want to restrict my account to the paradigm case because the paradigm case most persuades the mind that grief (...) is a past-directed emotion. The phenomenological move I propose will enable us to (1) respect the paradigm case of grief and a broader but still legitimate set of grief-generating states of affairs, (2) liberate grief from the view that grief is past directed or about the past, and thus (3) account for grief in a way that separates it from its closest emotion-neighbor, sorrow, without having to rely on the affective quality of those two emotions.If the passing of the beloved causes the grief but is not what the grief is about, then we can get at the nature of grief by saying its temporal orientation is in the past (the event of the passing), but its temporal meaning is the present and future—the new significance of a world with the pervasive absence that is the world without the beloved. The no-longer of grief is a no-longer oriented by a past (that which is no longer) that is referred a present and future (that which is a no-longer understood as not now as it once was). Looking at the griever’s relation to time can tell us much about the pain and the object of grief, then. As the griever puts the past before himself with a certainty about this world “henceforth,” a look at the griever’s lived sense of the fi nality of the irreversibly lost (1) liberates grief from the tendency in the literature to be reduced to a past-directed emotion, (2) accounts for grief ’s intensity, its affective force or poignancy, and thus (3) enables us to separate grief from sorrow according to its intentionalobject in light of the temporal meaning of these emotions. (shrink)

Philosophical logicians proposing theories of rational belief revision have had little to say about whether their proposals assist or impede the agent's ability to reliably arrive at the truth as his beliefs change through time. On the other hand, reliability is the central concern of formal learning theory. In this paper we investigate the belief revision theory of Alchourron, Gardenfors and Makinson from a learning theoretic point of view.

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as ‘what makes a case or example truly local, and why?’, ‘what topics have we found to be best explained through local cases or (...) examples?’, and ‘how does one identify a relevant local case?’ Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles. (shrink)

Like many critics of Rawls, Habermas believes that the Original Position (OP) implicitly utilizes normative (and unargued for) assumptions. The author defends the OP by arguing that its basic concepts are the product of a rational reconstruction of the everyday know-how, or common sense, employed by citizens in democratic practices. The author identifies this reconstruction in Rawls's work but suggests that while this answers the charge of circularity, it raises the problem of contextual relativism. It is concluded that Rawls can (...) avoid such relativism only on a stronger commitment to social scientific research in support of a more transcendental form of rational reconstruction. (shrink)

In this article, I consider the interoperation of twin contemporary governmental imperatives, fostering economic growth and ensuring biopolitical security, in the face of the COVID-19 pandemic. At a theoretical level, I thereby consider the question of the applicability of a Marxist analysis vis-à-vis a Foucauldian one in understanding state responses to the pandemic. Despite the apparent prioritization of preserving life over economic activity by governments around the world in this context, I will argue that the basic problem that COVID-19 posed (...) for the state was one of sheer unknowability and that the fundamental motive for the governmental response was a concern for security in Foucault’s sense, that is, ensuring a baseline predictability in the social field, upon which economic activity, like myriad other social activity, is premised. I argue that this drive for security motivated states to appeal to medical experts to determine the direction of their response, who in turn applied a default model of quarantine. While we cannot be certain that the medically-guided response was optimal in terms either of health outcomes or economically, I argue it served its essential purpose by providing a structured framework for social action in the face of the unknown. While this is vital for the maintenance of the basic coordinates of capitalist society, I argue it nonetheless cannot entirely be explained simply by an appeal to Marxist categories and instead requires Foucault’s insights into the medicalization of society. (shrink)

then essentially characterized the hypotheses that mechanical scientists can successfully decide in the limit in terms of arithmetic complexity. These ideas were developed still further by Peter Kugel [4]. In this paper, I extend this approach to obtain characterizations of identification in the limit, identification with bounded mind-changes, and identification in the short run, both for computers and for ideal agents with unbounded computational abilities. The characterization of identification with n mind-changes entails, as a corollary, an exact arithmetic characterization of (...) Putnam's n-trial predicates, which closes a gap of a factor of two in Putnam's original characterization [12]. (shrink)

Purpose This paper aims to examine how metadata taxonomies in embodied computing databases indicate context and describe ways to track the evolution of the embodied computing industry over time through digital media archiving. Design/methodology/approach The authors compare the metadata taxonomies of two embodied computing databases by providing a narrative of their top-level categories. After identifying these categories, they describe how they structure the databases around specific themes. Findings The growing wearables market often hides complex sociotechnical tradeoffs. Marketing products like Vandrico (...) Inc.’s Wearables Database frame wearables as business solutions without conveying information about the various concessions users make. Potential solutions to this problem include enhancing embodied computing literacy through the construction of databases that track media about embodied computing technologies using customized metadata categories. Databases such as FABRIC contain multimedia related to the emerging embodied computing market – including patents, interviews, promotional videos and news articles – and can be archived through user-curated collections and tagged according to specific themes. One of the benefits of this approach is that users can use the rich metadata fields to search for terms and create curated collections that focus on tradeoffs related to embodied computing technologies. Originality/value This paper describes the importance of metadata for framing the orientation of embodied computing databases and describes one of the first attempts to comprehensively track the evolution of embodied computing technologies, their developers and their diverse applications in various social contexts through media archiving. (shrink)

U.S. law imposes strict recording and reporting requirements on all entities that manufacture and distribute controlled substances. As a result, the prescription opioid crisis has unfolded in a data-saturated environment. This article asks why the systematic documentation of opioid transactions failed to prevent or mitigate the crisis. Drawing on a recently disclosed trove of 1.4 million internal records from Mallinckrodt Pharmaceuticals, a leading manufacturer of prescription opioids, we highlight a phenomenon we propose to call data diversion, whereby data ostensibly generated (...) or collected for the purpose of regulating the distribution of controlled substances were repurposed by the industry for the opposite aim of increasing sales at all costs. Systematic data diversion, we argue, contributed substantially to the scale of drug diversion seen with opioids and should become a focus of policy intervention. (shrink)

What is the optimal size of a democratic society? While not taking an explicit stand on this issue, Hélène Landemore's model of democracy in Democratic Reason suggests that democracies ought to be small, certainly smaller than many existing states. If, as Landemore argues, we must rely on the random selection of representatives, then we should be concerned about both the size of the population and the way cognitive diversity is distributed within it. Given the realities of party politics and media (...) framing, this means that smaller political societies will yield wiser decisions than very large ones. (shrink)

Moral condemnation has become the public narrative of our criminal justice practices, but the distribution of criminal sanctions is not and should not be guided by judgments of what individual wrongdoers morally deserve. Criteria for evaluating a person’s liability to criminal sanctions are general standards that are influenced by how we understand the relative social urgency and priority of reducing crimes of various types. These standards thus depend on considerations that are not a matter of individual moral desert. Furthermore, the (...) moral desert is doubtful when members of socially disadvantaged groups face unequal prospects for being subjected to criminal justice sanctions. Social injustice is an intolerable context for distributing punishment according to individual desert. A rightsprotectingscheme of criminal justice might permissibly burden individual offenders, but not as an expression of what they morally deserve. (shrink)

In this chapter, the author analyzes Foucault's conception of subjectivity and his history of technologies of the self, the collections of practices by which subjectivity constitutes itself. The first section situates Foucault's conception of subjectivity in his overall body of work and intellectual context, particularly in relation to two figures in French philosophy. The second section explores the conception of the subject that Foucault develops in his late work. Having explained the importance of historical practices to his conception of subjectivity, (...) the third section considers his history of Western practices of the self, mapping the relative fortunes of what Foucault calls the “technologies” of ethics and spirituality. The fourth section explores Foucault's consideration of the contemporary implications of his position, his assessment of the scope for and importance of spiritual or ethical practices today. (shrink)

In The Foundations of Arithmetic, Gottlob Frege contended that the difference between concepts and objects was absolute. He meant that no object could be a concept and no concept an object. Benno Kerry disagreed; he contended that a concept could be an object, and that therefore the difference between concepts and objects was only relative. In this book, Jolley aims to understand the debate between Frege and Kerry. But Jolley's purpose is not so much to champion either side; rather, it (...) is to utilize an understanding of the debate to shed light on the work of Ludwig Wittgenstein-and vice versa. Jolley not only sifts through the debate between Frege and Kerry, but also through subsequent versions of the debate in J. J. Valberg and Wilfred Sellars. Jolley's goal is to show that the central notion of Philosophical Investigations, that of a 'conceptual investigation', is a legacy of the Frege/Kerry debate and also a contribution to it. Jolley concludes that the difference between concepts and objects is as absolute in its way in Philosophical Investigations as it was in The Foundations of Arithmetic and that recognizing the absoluteness of the difference in Philosophical Investigations provides a beginning for a 'resolute' reading of Wittgenstein's book. (shrink)

Belief revision theory aims to describe how one should change one’s beliefs when they are contradicted by newly input information. The guiding principle of belief revision theory is to change one’s prior beliefs as little as possible in order to maintain consistency with the new information. Learning theory focuses, instead, on learning power: the ability to arrive at true beliefs in a wide range of possible environments. The goal of this paper is to bridge the two approaches by providing a (...) learning theoretic analysis of the learning power of belief revision methods proposed by Spohn, Boutilier, Darwiche and Pearl, and others. The results indicate that learning power depends sharply on details of the methods. Hence, learning power can provide a well-motivated constraint on the design and implementation of concrete belief revision methods. (shrink)

In this essay, I take as a starting point Foucault’s rejection of two different ways of thinking about the future, prophecy and utopianism, and use this rejection as a basis for the elaboration of a more detailed rejection of them, invoking complexity-based epistemic limitations in relation to thinking about the future of political society. I follow Foucault in advocating immanent political struggle, which does not seek to build a determinate vision of the future but rather focuses on negating aspects of (...) the current conjuncture. I extend this argument into an ethical register, arguing that the same arguments apply mutatis mutandis to our personal lives. I conclude by engaging with Jacques Lacan’s account of subjectivity, and the interpretation of its political import furnished by Yannis Stavrakakis, drawing from these additional supports for my position, in particular the rejection of utopianism as an attempt to avoid limitation by the real. (shrink)

Group work is a very common practice in higher education when it comes to developing key competences for students’ personal and professional growth. The goals that students pursue when working in teams determine how they organize and regulate their behavior and how they approach the tasks. The academic goals are a relevant variable that can condition the success of the group, as they guide and direct the students towards involvement in the task, the effort they make, and the desire to (...) increase their academic competence, and their learning. Thus, the need arises to create new evaluation instruments to help us understand the importance of academic goals when students work as a team. The purpose of this paper is to corroborate the construct validity of the Questionnaire on Teamwork Learning Goals (QTLG) based on the Achievement Goal Questionnaire (3x2 AGQ) of Elliot, Murayama & Pekrun (2011) in the context of teamwork, and to determine if the model 3X2 offers a better fit to the data than other models, such as: 2x2; Trichotomous; Definition; Valence, among others. The results obtained from a sample of 700 students from 6 Spanish universities confirm that, in the context of teamwork, the 3x2 model fits the data better than the rest of the models subjected to confirmatory analysis, with contrasting evidence of validity and reliability. Therefore, we considered it a useful instrument for studying motivation in the group work context. The QTLG has practical applications, allowing us to explore in detail the academic goals of university students. (shrink)

Rather than set out an overarching view or take a stand on the debunking of morality tout court, in what follows I’ll explore a divide and conquer strategy. First, I will briefly sketch a debunking argument that, instead of targeting all of morality or human moral nature, has a more narrow focus—namely, the intuitive moral authority of disgust. The argument concludes that as vivid and compelling as they can be while one is in their grip, feelings of disgust should be (...) granted no power to justify moral judgments. Importantly, the argument is grounded in empirical advances concerning the character of the emotion itself. Next, I will step back and consider the argument’s general form. I then point to arguments that others have made that seem to share this form and selective focus, and comment on what such arguments do and do not presuppose. Finally, I locate the selective strategy with respect to other approaches moral debunking. (shrink)

We argue that work on norms provides a way to move beyond debates between proponents of individualist and structuralist approaches to bias, oppression, and injustice. We briefly map out the geography of that debate before presenting Charlotte Witt’s view, showing how her position, and the normative ascriptivism at its heart, seamlessly connects individuals to the social reality they inhabit. We then describe recent empirical work on the psychology of norms and locate the notions of informal institutions and soft structures with (...) respect to it. Finally, we argue that the empirical resources enrich Witt’s ascriptivism, and that the resulting picture shows theorists need not, indeed should not, choose between either the individualist or structuralist camp. (shrink)

In 2017, Partridge et al. published remarkable experimental results concerning the use of a new artificial womb technology (AWT) with lambs, developed at Children’s Hospital of Philadelphia, called...

The UK government has recently committed to adopting a new policy—dubbed ‘Martha’s Rule’—which has been characterised as providing patients the right to rapidly access a second clinical opinion in urgent or contested cases. Support for the rule emerged following the death of Martha Mills in 2021, after doctors failed to admit her to intensive care despite concerns raised by her parents. We argue that framing this issue in terms of patient rights is not productive, and should be avoided. Insofar as (...) the ultimate goal of Martha’s Rule is the provision of a clinical service that protects patient safety, an approach that focuses on the obligations of the health system—rather than the individual rights of patients—will better serve this goal. We outline an alternative approach that situates rapid clinical review as part of a suite of services aimed at enhancing and protecting patient care. This approach would make greater progress towards addressing the difficult systemic issues that Martha’s Rule does not, while also better engaging with the constraints of clinical practice. (shrink)

Chris Stewart’s account of his experiences after purchasing a farm in Andalusia, in an isolated farmhouse in the mountains adjacent to Granada, are far from the traditionally bucolic depictions of a pastoral landscape, in which the drawbacks of agricultural life become unquestionably compensated by the bliss of life in nature. Even though, as the title indicates, he seems to be a born romantic and optimist, undefeated by the inconveniences of a life without the everyday commodities of a First-World country in (...) the twenty-first century, his memoir narrative is soon balanced by his own testimony, which provides a realistic counterbalance to Stewart’s initial idealistic portrayal of life in rustic Alpujarras. Nonetheless, as this article intends to demonstrate, it is precisely this necessary demystification of the rural setting prevailing in certain areas in Andalusia that becomes crucial for the establishment of an essential complicity with the audience, thereby trained to appreciate—and even become enthralled by—the reality of the rural surroundings which the contemporary reader can no longer envision as merely a place of “vales and hills” softly covered by “a host of golden daffodils”. El relato que lleva a cabo Chris Stewart acerca de sus experiencias tras adquirir una finca en Andalucía, en un lugar apartado de la sierra lindante con Granada, se aleja de las descripciones bucólicas de paisajes pastorales en los que las desventajas de la vida agrícola quedaban incuestionablemente compensadas por el gozo de la vida en mitad de la naturaleza. Incluso pese a que, tal y como el título de su novela indica, Chris Stewart parece ser un romántico y un optimista de nacimiento, que no se deja vencer por los inconvenientes de una vida sin las comodidades cotidianas de un país del primer mundo en el siglo xxi, su memoria-narrativa se ve inmediatamente equilibrada por su propio testimonio, que proporciona un contrapunto realista al idealizado retrato inicial de la vida en las rústicas Alpujarras. No obstante, como el presente artículo pretende demostrar, es precisamente esta necesaria desmitificación del entorno rural de ciertas zonas de Andalucía lo que resulta crucial para poder establecer una esencial complicidad con el lector, que llega, de este modo, a valorar, e incluso, a sentirse fascinado, por la realidad del contexto agrario, el cual deja ya de percibir meramente como un lugar de «valles y colinas» delicadamente cubierto por «una cohorte de dorados narcisos». (shrink)

In this article, I re-examine the relationship between the thoughts of contemporaneous and associated late twentieth-century French philosophers Michel Foucault and Louis Althusser, through the prism of the notion of the problem. I discuss the philology of the use of the noun “problematic” in French philosophy in relation to Foucault and Althusser’s use of it, concluding that while Althusser makes this a term of art in his thought, Foucault does not make any particular use of this concept. I nonetheless consider (...) the possibility of the existence of a similar notion under a different name, episteme, in Foucault’s thought, but conclude that this is a distinct notion from Althusser’s “problematic.” I then consider Foucault’s later, idiosyncratic notion of problematization and its possible relation to Althusser’s conceptual framework. I conclude that, despite divergent vocabularies, Althusser and Foucault do have a common problematic and approach to problematization, though Foucault also problematizes aspects of Althusser’s problematic, effectively taking problematization a step further. (shrink)

RESUMO Este artigo1 pretende evidenciar as características do livro-álbum pós-moderno, concretamente, na obra de Anthony Browne, criador britânico de reconhecido valor na conformação deste segmento privilegiado da edição infantojuvenil contemporânea, cuja narrativização resulta da relação triádica texto-imagem-suporte. A revisitação do conjunto da sua obra, a partir de um corpus necessariamente restrito e mais representativo, propõe evidenciar as potencialidades estético-literárias e formativas de uma produção sui generis, reconhecendo o seu contributo na consolidação de um novo paradigma da literatura para a infância. (...) Partindo de anteriores investigações em torno das recentes tendências do livro-álbum, com destaque para teorizações relativas aos conceitos de intertextualidade e metaficcionalidade - estratégias fundadoras da “escrita” do autor apreciado -, observam-se procedimentos formais, retórico-estilísticos e ideotemáticos numa leitura dialógica das componentes verbal e visual, concluindo-se acerca das suas exigências ao nível da receção, bem como do seu impacto na educação literária, crítica e reflexiva dos seus destinatários preferenciais, embora não exclusivos. (shrink)

What exactly is a genetic disease? For a phrase one hears on a daily basis, there has been surprisingly little analysis of the underlying concept. Medical doctors seem perfectly willing to admit that the etiology of disease is typically complex, with a great many factors interacting to bring about a given condition. On such a view, descriptions of diseases like cancer as geneticseem at best highly simplistic, and at worst philosophically indefensible. On the other hand, there is clearly some practical (...) value to be had by classifying diseases according to theirpredominant cause when this can be accomplished in a theoretically satisfactory manner. The question therefore becomes exactly how one should go about selecting a single causal factor among many to explain the presence of disease. When an attempt to defend such causal selection is made at all, the standard accounts offered (Koch's postulates, Hill's epidemiological criteria, manipulability) are all clearly inadequate. I propose, however, an epidemiological account of disease causation which walks the fine line between practical applicability and theoretical considerations of causal complexity and attempts to compromise between patient-centered and population-centered concepts of disease. The epidemiological account is the most basic framework consistent with our strongly held intuitions about the causal classification of disease, yet it avoids the difficulties encountered by its competitors. (shrink)

European and international regulation of human health research is typified by a morass of interconnecting laws, diverse and divergent ethical frameworks, and national and transnational standards. There is also a tendency for legislators to regulate in silos—that is, in discrete fields of scientific activity without due regard to the need to make new knowledge as generalisable as possible. There are myriad challenges for the stakeholders—researchers and regulators alike—who attempt to navigate these landscapes. This Delphi study was undertaken in order to (...) provide the first interdisciplinary and crosscutting analysis of health research regulation, as it is experienced by such stakeholders in the UK context. As well as reinforcing existing understandings of the regulatory environment, Delphi participants called for greater collaboration, and even co-production, of processes involved in health research regulation. On the basis of this research, we offer insights about how health research regulation can become a matter with which a wider range of stakeholders—including researchers, regulators, publics and research sponsors—can engage. The evidence supports the normative claim that health research regulation should continue to move away from strict, prescriptive rules-based approaches, and towards flexible principle-based regimes that allow researchers, regulators and publics to co-produce regulatory systems serving core principles. By unpacking thorny concepts and practices at the heart of health research regulation—including the public interest and public engagement—our results have the potential to situate and breathe life into them. The results also demonstrate that while proportionality is well-recognised as a crucial element of flexible regulatory systems, more must be done to operationalise this as an ethical assessment of the values and risks at stake at multiple junctures in the research trajectory. This is required if we are to move beyond proportionality as a mere risk-management tool. Compliance culture no longer accurately reflects the needs and expectations of researchers or regulators, nor does it necessarily produce the best research. Embracing uncertainty—both as a human practice and a regulatory objective—may represent the brighter future for health research. (shrink)

Kant stated that there are three mental faculties: cognition, feeling, and desire. The faculty of feeling has received the least scholarly attention, despite its importance in Kant's broader thought, and this volume of new essays is the first to present multiple perspectives on a number of important questions about it. Why does Kant come to believe that feeling must be described as a separate faculty? What is the relationship between feeling and cognition, on the one hand, and desire, on the (...) other? What is the nature of feeling? What do the most discussed Kantian feelings, such as respect and sublimity, tell us about the nature of feeling for Kant? And what about other important feelings that have been overlooked or mischaracterized by commentators, such as enthusiasm and hope? This collaborative and authoritative volume will appeal to Kant scholars, historians of philosophy, and those working on topics in ethics, aesthetics, and emotions. (shrink)