The role of Human Research Ethics Committees (HRECs) in health research is well established. Ethics committees have the good of research participants in mind but they must also assess scientific merit including the design and conduct of studies. In this article the authors’ focus is on qualitative research method and the challenge that the National Statement on Ethical Conduct in Human Research (2007) poses for ethics committees when they assess proposals using the methods outlined in the National Statement.We set out (...) a process for judging the standard of qualitative research proposals and propose that qualitative health research can be assessed using a hierarchy designed for evaluating interview studies. We contrast well-designed studies with those that have design flaws in order to focus on the hallmarks of research merit in studies that use qualitative research methods. Finally, we show that our proposal is compatible with the National Statement.Ethics review provides an early opportunity to identify and redesign inadequate studies that will not contribute to our knowledge base. The challenge for members of ethics committees with little experience in qualitative studies is to be able to assess research excellence by assessing research merit in proposals, recognising the special design features of qualitative research methods. (shrink)

Autistic children with sensory processing differences successfully navigate and engage in meaningful family daily occupations within home and community environments through the support of their family. To date however, much of the research on autistic children with sensory processing differences, has primarily been deficit focused, while much of the caregiver research has focused on issues of distress, burden, effort, and emotional trauma in coping with their child's diagnosis. This study aimed to conduct a qualitative evidence synthesis, using a meta-ethnographic approach (...) to explore the gap identified in understanding successful occupational experiences of family participation and daily family routines when supporting an autistic child with sensory processing differences and to offer an alternative strengths-based perspective. Inclusion criteria were studies which were peer-reviewed qualitative design, published from 2000 to 2021, and that concerned parents/caregivers' perspectives of family occupations of children diagnosed with autism spectrum disorder. Studies were electronically searched in eight databases from October to December 2021 and 23 studies were identified which met the inclusion criteria. Noblit and Hare's seven step approach for conducting analysis in meta-ethnography was used, and three themes identified: sensory processing differences in daily life, what is hard about hard, and orchestrating family life. Results identified the centrality of sensory experiences in understanding family life. Living with unpredictability while orchestrating certainty through routines was core to successful participation. This review provides insights into how parents negotiate the complexities of constructing family life when living with an autistic child. The results can inform the design of future interventions that specifically address the relationship between meaningful participation in family occupations and daily routines and sensory processing in autistic children.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022298938, identifier: CRD42022298938. (shrink)

Sex determines much about one's life, but what determines one's sex? The answer is complicated and incomplete: on close examination, ordinary notions of female and male are vague. In 2012, the International Olympic Committee further specified what they mean by woman in response to questions about who, exactly, is eligible to compete in women's Olympic events. I argue, first, that their stipulation is evidence that the use of vague terms is better described by semantic approaches to vagueness than by epistemic (...) approaches. In addition, the IOC's 2012 stipulation was made with sensitivity to its practical consequences. Linguistic actions often have morally relevant consequences, and I contend that, other things equal, we should adopt theories about language that acknowledge the responsibility we bear for what we say. Taking vagueness to be an epistemic phenomenon precludes the sense of agency needed for moral responsibility; taking it to be semantic does not. Thus I advance two arguments for semantic approaches to vagueness, as against epistemic approaches: one descriptive and one normative. (shrink)

The Palgrave Handbook of Philosophical Methods contains twenty-six original and substantive papers examining a wide selection of philosophical methods. Drawing upon an international range of leading contributors, this Handbook will help shape future debates about how philosophy should be done. Topics explored include philosophical disagreement, thought experiments, intuitions, rational reflection, conceptual analysis, explanation, parsimony, and experimental philosophy. Written in a clear and accessible form, and drawing upon the most recent thinking in the field, the papers will be of particular interest (...) to researchers and high-level undergraduates. (shrink)

Some bemoan the incivility of our times, while others complain that people have grown too quick to take offense. There is widespread disagreement about what counts as an insult and when it is appropriate to feel insulted. Here I propose a definition and a preliminary taxonomy of insults. Namely, I define insults as expressions of a lack of due regard. And I categorize insults by whether they are intended or unintended, acts or omissions, and whether they cause offense or not. (...) Unintended insults are of particular concern since greater understanding may help us to avoid them. And insults by omission warrant special consideration because they suggest an interesting extension of Grice’s theory of conversational implicature. (shrink)

Medical professionals often deny patients who inject opioids a second or third heart valve replacement, even if such a surgery is medically indicated. However, such a position is not well defended. As this paper demonstrates, the ethical literature on the topic too often fails to develop and apply an ethical lens to analyse the issue of multiple valve replacements. This paper addresses this lacuna by analysing the case of Mr Walsh, a composite case which protects the identity of any one (...) patient, through the principlist approach of Beauchamp and Childress. It argues that the hospital should offer Mr Walsh, a second valve replacement because the procedure is: medically indicated, autonomously requested, non-maleficent, beneficent and does not violate a formal account of justice. The paper concludes with clinical ethical guidelines for valve surgery for patients with opioid use disorder. (shrink)

The arguments advanced in this paper are the following. Firstly, that just as Trevarthen’s three subjective/intersubjective levels, primary, secondary, and tertiary, mapped out different modes of access, so too response is similarly structured, from direct primordial responsiveness, to that informed by shared pragmatic concerns and narrative contexts, to that which demands the distantiation afforded by representation. Secondly, I propose that empathy is an essential mode of intentionality, integral to the primary level of subjectivity/intersubjectivity, which is crucial to our survival as (...) individuals and as a species. Further to this last point, I argue that empathy is not derived on the basis of intersubjectivity, nor does it merely disclose intersubjectivity, rather it is constitutive of intersubjectivity at the primary level. Empathy is a direct, irreducible intentionality separable in thought from the other primary intentional modes of perception, rationality, memory and imagination, but co-arising with these. In regard to the inter-personal level, the concrete relations with others, primary empathy is both the ground for the possibility of the secondary manifestations—pity, sympathy, perspective taking, etc., and motivates them. Thirdly, it is the movement in the core of subjectivity initially generated by shifting attention between the ‘I’ and ‘we’ perspectives and later ‘solidified’ through affect to become shifting identification, which opens up the intersubjective domain. So we can affirm that we are not only born into sociality but our sociality goes to the roots of our being as Husserl, Heidegger and Merleau-Ponty have claimed. (shrink)

Today, the linguistic approach offers us an irreplaceable method for the direct study of the constitutive processes of social phenomena (A. Delobelle, 1981). In fact, each social phenomenon is basically inhabited or interpreted by language. It is language processes that give its ramifications to the social and form disstinct sub-groups in it. This is why, when these processes are observed in their formal dynamics, outside their vehiculated “contents,” it is as though we find ourselves faced with the very functioning of (...) the social: as though we have in it a typically experimental terrain for the direct study of social phenomena. (shrink)

People often assume that everyone can be divided by sex/gender (that is, by physical and social characteristics having to do with maleness and femaleness) into two tidy categories: male and female. Careful thought, however, leads us to reject that simple ‘binary’ picture, since not all people fall precisely into one group or the other. But if we do not think of sex/gender in terms of those two categories, how else might we think of it? Here I consider four distinct models; (...) each model correctly captures some features of sex/gender, and so each is appropriate in some contexts. But the first three models are inadequate when tough questions arise, like whether trans women should be admitted as students at a women’s college or when it is appropriate for intersex athletes to compete in women’s athletic events. (‘Trans’ refers to the wide range of people who have an atypical gender identity for someone of their birth-assigned sex, and ‘intersex’ refers to people whose bodies naturally develop with markedly different physical sex characteristics than are paradigmatic of either men or women.) Such questions of inclusion and exclusion matter enormously to the people whose lives are affected by them, but ordinary notions of sex/gender offer few answers. The fourth model I describe is especially designed to make those hard decisions easier by providing a process to clarify what matters. (shrink)

More than four years ago I ventured to put forward some ideas about the philosophy of Ludwig Wittgenstein. The publication, within the last year or two, of a number of important books of Wittgensteiniana has seemed to offer a good occasion for reviewing this earlier essay. The present article proposes to assess these books and, in the light of them to reconsider the writer’s earlier interpretation of Wittgenstein, as well as to embark on a more ambitious study of Wittgenstein’s later (...) thought. I shall begin with some general remarks about the books in question. (shrink)

In his stimulating new book The Construction of Logical Space , Agustín Rayo offers a new account of mathematics, which he calls ‘Trivialist Platonism’. In this article, we take issue with Rayo’s case for Trivialist Platonism and his claim that the view overcomes Benacerraf’s dilemma. Our conclusion is that Rayo has not shown that Trivialist Platonism has any advantage over nominalism.

Cutting out all reference to the popular and polemical, psychological and ideological resonances evoked in and by Sartre, this study takes up the challenge of considering the impressive work of Sartre as the latest metamorphosis of the Western philosophical heritage. As Professor Hartmann explains, he has included sufficient exposition of Sartre’s views to enable the reader without extensive knowledge of Sartre to follow the interpretation, but expects him to be conversant with Hegel and, to a lesser extent, with Husserl and (...) Heidegger. If this does not suit the generality of English-speaking students of philosophy who usually know of Sartre, Heidegger, Husserl and Hegel in that order of detail, nevertheless the Hegelian bias of the lengthy critical exposition gives us a new, incisive, and it seems to me, definitive treatment of Sartre which will benefit those who have come to him through phenomenology. (shrink)

Authors present a practical approach to developing health care trainees' native ability as moral agents to become responsible health care practitioners. Highly recommended. Full text available free online.

Rousseau's understanding of legislation as the expression of the general will implies a constitutional principle of legislative supremacy. In turn, this should translate to a narrow, mechanical account of adjudication, lest creative judicial interpretation subvert the primacy of legislative power. Yet in his constitutional writings, Rousseau recommends open-textured and vague legislative codes, which he openly admits will require judicial development. Thus he apparently trusts a great deal in judicial discretion. Ostensibly, then, he overlooks the problem of how legislative indeterminacy—and correspondingly, (...) judicial discretion—may undermine the authority of the general will. However, I argue that Rousseau aims to check judicial subversion of legislative supremacy simply by extending his broader social politics—and specifically, his peculiar concept of republican virtue—to the domain of law. His main concern is that the law should not develop as a mystifying expert practice; therefore, he necessarily rejects any understanding of judicial virtue as lying in principled discourse. Instead, he envisages that judicial power will be checked by a more generic sense of republican virtue. In turn this echoes his apprehension of social differentiation and social complexity as sources of domination and hierarchy. (shrink)

The presence of the past is of prime importance in today's Mexican society. According to José Fuentes Mares, among the “peoples of the world the Mexican is the one who lives history the most”. With regard to the unsatisfactory relations between Mexico and North America, the journalist Alan Riding asks himself: “How can a people who relish the past to the point of intoxication understand another that looks constantly to the future?” In the Republic of Mexico, according to him, “the (...) entire past of the country throws a dense shadow over the present”. Conforming to a universal custom, every country divides its present past into four groups (survival, residues, memories and history), but in few nations are the four groups as copious as in this one. Although Mexico is rapidly shedding many old customs and is selling residual objects to foreign collectors on the sly, its historical treasure is still enormous, perhaps the largest in the world. (shrink)

The extremely pernicious and paganly immoral principles stated by the Florentine secretary run counter to all national thought and have incontestably exercised a corrupting influence on it.F. SchlegelWe must be grateful to Machiavelli and other writers who like him have openly and without dissimulation shown not how men ought to act, but how they do normally act.F. BaconThe interpretation of Machiavelli's philosophy of history encounters specific difficulties. His contribution to the history of thought is unique and yet rooted in the (...) culture that was typical of the Renaissance; it constitutes—something rarely found among the creative spirits of the High Renaissance—the logical-historical limit of that culture, the critical point at which the contradictions that characterize it tragically come to light. (shrink)

Because of the widespread feminine priority that makes it the receptacle of śakti, India is definitely “one of the last bastions of the Mother,” as is pointed out in a recent book. If in fact there is a “maternalistic” culture it is certainly that of India, in spite of the legal regime, in which the element of affectionate magic characterizing all life and all organic intimacy is affirmed through the warm symbiosis of mother-child love. A miracle of that absolute love (...) incarnated with a natural serenity by millions of mothers dispensing a felicitous affectionate security, instilled in the Indian soul throughout its entire life. The traits of the Hindu personality and the principle content of its culture are organized and ordered around this center, characterized by an extraordinary coherence. Since its construction begins with this “dual unity” the Hindu personality has necessarily the popolarity of fusion-separation as a pivot. This is the central theme of S. Kakar, who, basing his conclusions on results of clinical psychoanalyses of Hindu individuals as well as on contributions from the collective imagination (folklore and myths) claims to discern the ontogenetic source of the supreme ideal of deliverance (mokṣa) in early childhood and, more specifically, in the strong unconscious desire to find again the benevolent presence of the “good mother”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Lisa’s StoryLisa P. (wife of patient) and Jeanne KerwinMy husband suffered from sudden onset of heart failure with a very low ejection fraction and was on IV Milrinone at the age of 47. One of the most powerful things he told me was that he was not afraid to die and therefore did not want to move forward with Milrinone. He eventually “did it for the kids.” After (...) the Milrinone drip was no longer working, he was offered an LVAD (left ventricular assist device) to keep him alive. He refused, but the doctor again convinced him to “do it for your kids” and said, “we put these devices in 80-year-olds.” He did not have time to explore any other options and reluctantly accepted the LVAD. It was implanted in May of 2014 in a very long and complicated surgery with a long and difficult recovery. He was in the hospital for a long time, and then he refused to go to rehab upon discharge, making it difficult for our family to manage, as he was extremely weak and needed care of his wound dressing. He worried about the financial [End Page 7] impact of a heart transplant and the medications required, as we were already struggling with the medical bills. He refused to have more surgery with the potential complications and never agreed to get on the transplant waiting list.After the implanted LVAD, my husband was not able to do most of what he loved in life. He couldn’t work (he was a truck driver), he couldn’t go fishing or swimming in the ocean, he couldn’t go hunting and fishing, and his overall physical condition was so poor that he couldn’t cook, garden and, most aggravating to him, he could not take a regular hot shower. The LVAD had to be covered with plastic in order to avoid getting the drive-line area wet, so bathing was a complicated process. He had trouble with stairs, had neuropathic pain in his legs from diabetes, and because of the pain medications, he felt cloudy and dizzy and slept most of the day in his recliner. I took care of him, even after I had to go back to work, and at the same time, I managed our two children (ages 9 and 12 at the time of LVAD).After almost two years of living with the LVAD, multiple hospitalizations for GI bleeds then seizures, more medications, and weekly blood draws for INR1, my husband requested that the LVAD be de-activated and that he be allowed to die of his heart failure. He described his life as “miserable.” He watched as his misery impacted his children and me. He suffered daily and had none of the joys that made life worth living for him. When we approached the cardiac team that implanted and monitored his LVAD with his request, they said “no.” They would not de-activate the LVAD because it was working. It was keeping him alive and he had no other terminal illness. His palliative doctor, who was treating his pain, also heard his request and told us to call for an “ethics consult” to determine if he would be “allowed” to have the LVAD de-activated. We got the number and called on March 31, 2016.At the time of the call to Ethics, we had no idea what “Ethics” was, other than a general definition of the word ethics as in professional behaviors and such. We did not know what to expect but we called. We would never have known to call “Ethics” if the palliative doctor had not advised us to do so, and my husband might have suffered a longer, more painful life both mentally and physically prolonged by the LVAD.We explained the request to the ethics consultant. She listened to my husband describe his daily living and his dissatisfaction with the quality of his life, his physical and emotional suffering, and his wish to rid himself of the LVAD and allow nature to take its course. There was actually no decision to be made on his part. He had already made up... (shrink)

Someone called A. N. Whitehead “the latest and greatest of the Cambridge Platonists”. That the tradition of Platonic scholarship still survives in Cambridge is evidenced by the appearance of these two books, one by the veteran Professor Hackforth, the other by the young scholar, Mr. John Gould. As produced by the University Press, both are examples of British book-making at its best.

Fessard, G. Jeanne Hersch, genèse d'une œuvre.--Muralt, A. de. Phénoménologie et métaphysique.--Philonenko, A. Leibniz et le platonisme.--Christoff, D. Représentation et décision dans la temporalité selon Kant.--Tilliette, X. De l'illusion au savoir, la philosophie.--Widmer, G. Variations kierkegaardiennes sur l'édifiant.--Dufour-Kowalska, G. L'imagination maîtresse de vérité.--Leyvraz, J.-P. Des noms.--Piguet, J.-C. Liberté esthétique et liberté éthique.--Schaerer, R. Le philosophe entre oui et non.--Scheurer, P.-B. Vues nouvelles sur la science du temps et l'histoire.--Starobinski, J. La littérature et l'irrationnel.--Aron, R. De la libéralisation.--Werner, E. La (...) digue et la vie.--Cottier, G. La fascination du vide, éléments pour un diagnostic. (shrink)

Job evaluation systems are becoming increasingly important in Europe to counter sex‐discrimination, but evaluation criteria can themselves be discriminatory. Dr Jeanne de Bruijn is Professor in Women and Policy at the Free University of Amsterdam.

In the cities of industrialized countries, the sudden keen interest in urban agriculture has resulted, inter alia, in the growth of the number and diversity of urban collective gardens. While the multifunctionality of collective gardens is well known, individual gardeners’ motivations have still not been thoroughly investigated. The aim of this article is to explore the role, for the gardeners, of the food function as one of the functions of gardens, and to establish whether and how this function is a (...) motivating factor for them. We draw on a set of data from semi-structured interviews with 39 gardeners in 12 collective gardens in Paris and Montreal, as well as from a survey on 98 gardeners and from field observations of the gardeners’ practices. In the first part we present the nature and diversity of garden produce, and the gardeners’ assessment thereof. In the second part we describe the seven other functions mentioned by the gardeners, which enables us to situate the food function in relation to them. We conclude that the food function is the most significant function of the gardens, and discuss the implications for practitioners and policy makers. (shrink)

Unpublished writing on Jaina doctrines, philosophy, rituals, tirthankars, Gujarati Jain poets and their works.

Offers a comprehensive view of St Augustine's political ideas.

BackgroundWe review original papers on ovarian-hormone status in two areas of emotional processing: facial emotion recognition and emotional memory. Ovarian-hormone status is operationalized by the levels of the steroid sex hormones 17β-estradiol and progesterone, fluctuating over the natural menstrual cycle and suppressed under oral contraceptive use. We extend previous reviews addressing single areas of emotional processing. Moreover, we systematically examine the role of stimulus features such as emotion type or stimulus valence and aim at elucidating factors that reconcile the inconsistent (...) results.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included papers published until September 2020 indexed in PubMed and Web of Science databases. Search terms were MeSH terms AND AND with representing our separately searched areas, resulting in, and. To be included, articles had to be written and published in English, examine healthy, non-pregnant adult women in their reproductive age, and measure or at least estimate levels of E2 and P4. In PubMed, the search was limited to humans and to the search term present in the title or abstract.ResultsFeatures of the provided stimulus material constitute a relevant influence that interacts with E2- and P4-related ovarian-hormone status. For instance, recognition of basic emotions appears to be more related to P4- than E2-levels. Quite consistent, OC intake was accompanied by impaired recognition accuracy of basic and also complex emotions, although not in a recent large-sample study assessing complex emotions. Memory recall of negative content was mainly enhanced by P4, especially after having been stressed.Discussion and ConclusionWe document the methodological diversity in the field, presumably contributing to the heterogeneity of results. More studies explicitly contrasting the early follicular phase, mid-cycle phase, mid-luteal, and OC intake while standardizing tasks are needed. Research would take advantage of using within-subject designs and accounting for the recognition of complex emotions. (shrink)