This paper examines the use of language and metaphor in the reception of recombinant DNA in the USA between 1973 and 1988. The Archives of Stanford University are used to show how changing images of production were conveyed, and how academic–industrial policies were shaped, in a rapidly advancing field of biotechnology.

Diffusion and institutionalization are of prime sociological importance, as both processes unfold at the intersections of relations and structures, as well as persistence and change. Yet they are often confounded, leading to theoretical and methodological biases that hinder the development of generalizable arguments. We look at diffusion and institutionalization distinctively, each as both a process and an outcome in terms of three dimensions: the objects that flow or stick; the subjects who adopt or influence; and the social settings through which (...) an innovation travels. We offer examples to flesh out these dimensions, and formulate testable propositions from our analytic framework that could lead to further theoretical refinement and progress. (shrink)

American universities are purported to excel at technology transfer. This assumption, however, masks important features of American innovation. Attempts to emulate the US example must recognize the heterogeneity of its industries and institutions of higher education. Stanford University and the biomedical cluster in Boston, Massachusetts, illustrate the diversities that characterize this dynamic system.

ABSTRACTComputers are now able to automatically generate metaphors, but some automatically generated metaphors are more well received than others. In this article, we showed participants a series of “A is B” type metaphors that were either generated by humans or taken from the Twitter account “MetaphorIsMyBusiness”, which is linked to a fully automated metaphor generator. We used these metaphors to assess linguistic factors that drive metaphor appreciation and understanding, including the role of novelty, word frequency, concreteness, and emotional valence of (...) the topic and vehicle terms. We additionally assessed how these metaphors were understood in three languages, including English, Spanish, and Mandarin Chinese, and whether participants thought they had been generated by a human or a computer. We found that meaningfulness, appreciation, speed in finding meaning, and humanness ratings were reliably correlated with each other in all three languages, which we interpret to indicate a mor... (shrink)

Dual functional brain asymmetry refers to the notion that in most individuals the left cerebral hemisphere is specialized for language functions, whereas the right cerebral hemisphere is more important than the left for the perception, construction, and recall of stimuli that are difficult to verbalize. In the last twenty years there have been scattered reports of sex differences in degree of hemispheric specialization. This review provides a critical framework within which two related topics are discussed: Do meaningful sex differences in (...) verbal or spatial cerebral lateralization exist? and, if so, Is the brain of one sex more symmetrically organized than the other? Data gathered on right-handed adults are examined from clinical studies of patients with unilateral brain lesions; from dichotic listening, tachistoscopic, and sensorimotor studies of functional asymmetries in non-brain-damaged subjects; from anatomical and electrophysiological investigations, as well as from the developmental literature. Retrospective and descriptive findings predominate over prospective and experimental methodologies. Nevertheless, there is an impressive accummulation of evidence suggesting that the male brain may be more asymmetrically organized than the female brain, both for verbal and nonverbal functions. These trends are rarely found in childhood but are often significant in the mature organism. (shrink)

Nurses and ethicists worry that the implementation of care at a distance or telecare will impoverish patient care by taking out ‘the heart’ of the clinical work. This means that telecare is feared to induce the neglect of patients, and to possibly hinder the development of a personal relation between nurse and patient. This study aims to analyse whether these worries are warranted by analysing Dutch care practices using telemonitoring in care for chronic patients in the Netherlands. How do clinical (...) practices of nursing change when telecare devices are introduced and what this means for notions and norms of good nursing? The paper concludes that at this point the practices studied do not warrant the fear of negligence and compromised relations. Quite the contrary; in the practices studied, telecare lead to more frequent and more specialised contacts between nurses and patients. The paper concludes by reflecting on the ethical implications of these changes. (shrink)

There is a gap between health economic evaluation methods and the value judgments of coverage decision makers, at least in Germany. Measuring preference satisfaction has been claimed to be inappropriate for allocating health care resources, e.g. because it disregards medical need. The existing methods oriented at medical need have been claimed to disregard non-consequentialist fairness concerns. The aim of this article is to propose a new, contractarian argument for justifying needs-based economic evaluation. It is based on consent rather than maximization (...) of some impersonal unit of value to accommodate the fairness concerns. This conceptual paper draws upon contractarian ethics and constitution economics to show how economic evaluation can be viewed as an institution to overcome societal conflicts in the allocation of scarce health care resources. For this, the problem of allocating scarce health care resources in a society is reconstructed as a social dilemma. Both disadvantaged patients and affluent healthy individuals can be argued to share interests in a societal contract to provide technologies which ameliorate medical need, based on progressive funding. The use of needs-based economic evaluation methods for coverage determination can be interpreted as institutions for conflict resolution as far as they use consented criteria to ensure the social contract’s sustainability and avoid implicit rationing or unaffordable contribution rates. This justifies the use of needs-based evaluation methods by Pareto-superiority and consent. The view of economic evaluation presented here may help account for fairness concerns in the further development of evaluation methods. This is because it directs the attention away from determining some unit of value to be maximized towards determining those persons who are most likely not to consent and meeting their concerns. Following this direction in methods development is likely to increase the acceptability of health economic evaluation by decision makers. (shrink)

This paper describes the approach of empirical ethics, a form of ethics that integrates non-positivist ethnographic empirical research and philosophy. Empirical ethics as it is discussed here builds on the ‘empirical turn’ in epistemology. It radicalizes the relational approach that care ethics introduced to think about care between people by drawing in relations between people and technologies as things people relate to. Empirical ethics studies care practices by analysing their intra-normativity, or the ways of living together the actors within these (...) practices strive for or bring about as good practices. Different from care ethics, what care is and if it is good is not defined beforehand. A care practice may be contested by comparing it to alternative practices with different notions of good care. By contrasting practices as different ways of living together that are normatively oriented, suggestions for the best possible care may be argued for. Whether these suggestions will actually be put to practice is, however, again a relational question; new actors need to re-localize suggestions, to make them work in new practices and fit them in with local intra-normativities with their particular routines, material infrastructures, know-how and strivings. (shrink)

This timely book provides a critical look at the profession's rise and subsequent fall.

Schools of economic ethics inspired by Buchanan propose viewing ethical conflicts as prisoners’ dilemmas to facilitate solutions based on Pareto-improving institutional changes. Given that healthcare is determined by complex institutional arrangements, it has been claimed that this approach is also suitable for business ethics in healthcare. To scrutinize this claim, this research systematically searched for studies reporting PD structures in healthcare. PubMed, EconLit, and EconBiz were searched to find articles in German and English. Study type, characteristics of the game, and (...) the proposed means to overcome the dilemma were extracted and analyzed for aspects supporting or challenging the claim. Across 53 studies, 68 descriptions of various dilemmas in healthcare and public health were identified. Many authors successfully developed proposals for institutional change to overcome these dilemmas. However, many of these analyses exhibited limitations such as oversimplifications or inconsistencies. Also, the quality of evidence on both the characteristics of dilemmas and the effectiveness of proposed solutions was very poor. The subsamples of studies that explicitly cited the ethical approach were disjunct from those that applied empirical methods to analyze the dilemmas. The large number of identified PDs indicates that economic ethics is relevant to healthcare. However, there is a need for further evidence to substantiate both the descriptive and prescriptive claims of this ethical theory. It should thus be seen as a complement that needs justification, rather than a substitute superior to other ethical frameworks. (shrink)

Science and technology studies concerned with the study of lay influence on the sciences usually analyze either the political or the normative epistemological consequences of lay interference. Here I frame the relation between patients, knowledge, and the sciences by opening up the question: How can we articulate the knowledge that patients develop and use in their daily lives and make it transferable and useful to others, or, `turn it into science’? Elsewhere, patient knowledge is analyzed either as essentially different from (...) or similar to medical knowledge. The category of experiential knowledge is vague and is used to encompass many types of experience, whereas the knowledge of the `expert patient’ may be assumed to have the shape of up-to-date medical information. This paper shows through a case study of people with severe lung disease that patient knowledge can be understood as a form of practical knowledge that patients use to translate medical and technical knowledge into something useful to their daily life with disease. Patients coordinate this with homegrown know-how and advice from fellow patients, weighing different values - of which `taking good care of one’s body’ is but one - that may conflict in a specific situation. These practices result in sets of techniques that may be made useful to others. The paper argues for two alternatives to state-of-the-art medical research to turn patient knowledge into science: ethnographies of knowledge practices and the collection and making accessible of techniques. (shrink)

This book confronts one of the central questions of political science: how people choose to accept or not to accept particular governments. In contrast to the prevailing view that citizens' decisions about the legitimacy of their governments are strongly conditioned by political culture and socialization and are hence largely non-rational, Ronald Rogowski argues that such decisions may indeed be the product of rational choice. The book proceeds both from recent work in the theory of voting and constitutional choice and (...) from the older tradition of contract theory to postulate that decisions about legitimacy are really choices among alternative regimes. The author suggests that members of a society choose among these alternative regimes on the basis of a knowledge of ethnic and occupational divisions in their society. From these postulates a general theory is derived, which finds expression in numerous testable hypotheses. Originally published in 1974. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

concepts are often embodied through metaphor. For example, we talk about moving through time in metaphorical terms, as if we were moving through space, allowing us to 'look back' on past events. Much of the work on embodied metaphor to date has assumed a single set of universal, shared bodily experiences that motivate our understanding of abstract concepts. This book explores sources of variation in people's experiences of embodied metaphor, including, for example, the shape and size of one's body, one's (...) age, gender, state of mind, physical or linguistic impairments, personality, ideology, political stance, religious beliefs, and linguistic background. It focuses on the ways in which people's experiences of metaphor fluctuate over time within a single communicative event or across a lifetime. Combining theoretical argument with findings from new studies, Littlemore analyses sources of variation in embodied metaphor and provides a deeper understanding of the nature of embodied metaphor itself. (shrink)

Dignity is a fundamental concept, but its meaning is not clear. This paper attempts to clarify the term by analysing and reconnecting two meanings of dignity: humanitas and dignitas. Humanitas refers to citizen values that protect individuals as equal to one another. Dignitas refers to aesthetic values embedded in genres of sociality that relate to differences between people. The paper explores these values by way of an empirical ethical analysis of practices of washing psychiatric patients in nursing care. Nurses legitimate (...) the washing of reluctant patients with reference to dignity. The analysis shows the intertwinement of humanitas and dignitas that gives dignity its fundamental meaning. (shrink)

BackgroundThe emergence of artificial intelligence (AI) in medicine has prompted the development of numerous ethical guidelines, while the involvement of patients in the creation of these documents lags behind. As part of the European PROFID project we explore patient perspectives on the ethical implications of AI in care for patients at increased risk of sudden cardiac death (SCD).AimExplore perspectives of patients on the ethical use of AI, particularly in clinical decision-making regarding the implantation of an implantable cardioverter-defibrillator (ICD).MethodsSemi-structured, future scenario-based (...) interviews were conducted among patients who had either an ICD and/or a heart condition with increased risk of SCD in Germany (n = 9) and the Netherlands (n = 15). We used the principles of the European Commission’s Ethics Guidelines for Trustworthy AI to structure the interviews.ResultsSix themes arose from the interviews: the ability of AI to rectify human doctors’ limitations; the objectivity of data; whether AI can serve as second opinion; AI explainability and patient trust; the importance of the ‘human touch’; and the personalization of care. Overall, our results reveal a strong desire among patients for more personalized and patient-centered care in the context of ICD implantation. Participants in our study express significant concerns about the further loss of the ‘human touch’ in healthcare when AI is introduced in clinical settings. They believe that this aspect of care is currently inadequately recognized in clinical practice. Participants attribute to doctors the responsibility of evaluating AI recommendations for clinical relevance and aligning them with patients’ individual contexts and values, in consultation with the patient.ConclusionThe ‘human touch’ patients exclusively ascribe to human medical practitioners extends beyond sympathy and kindness, and has clinical relevance in medical decision-making. Because this cannot be replaced by AI, we suggest that normative research into the ‘right to a human doctor’ is needed. Furthermore, policies on patient-centered AI integration in clinical practice should encompass the ethics of everyday practice rather than only principle-based ethics. We suggest that an empirical ethics approach grounded in ethnographic research is exceptionally well-suited to pave the way forward. (shrink)

This paper is the English translation and adaptation of my inaugural lecture in Amsterdam for the Chair Anthropology of Everyday Ethics in Health Care. I argue that the challenges in health care may look daunting and unsolvable in their scale and complexity, but that it helps to consider these problems in their specificity, while accepting that some problems may not be solved but have become chronic. The paper provides reflections on how to develop a scientific approach that does not aim (...) to eradicate bad things but explores ways in which to live with them. Crucial in this quest is the attention to how we conceptualize problems, and whether this is specific enough for addressing present day concerns. I propose an anthropology of everyday ethics as a way to study people’s everyday ways of handling a variety of goods in practice. I draw specific attention to exploring aesthetic values in everyday life amongst these, values that are used abundantly to qualify events in everyday life but rarely theorized in philosophy or social science. (shrink)

This paper articulates dignity as relational engagement in concrete care situations. Dignity is often understood as an abstract principle that represents inherent worth of all human beings. In actual care practices, this principle has to be substantiated in order to gain meaning and inform care activities. We describe three exemplary substantiations of the principle of dignity in care: as a state or characteristic of a situation; as a way to differentiate between socio-cultural positions; or as personal meaning. We continue our (...) analysis by presenting cases on dignity in care related to us in focus groups with medical professionals. Our empirical ethical lens is in this paper is to analyse, not the meaning of dignity, but the way in which it emerges in practices where it is pursued, within relationships between people, technologies, places, regulations, and the values cherished by or embedded in them. We show that professional caregivers recognize in the dignity of the person they care for their own dignity; giving up on the one implies no less than giving up on the other. This ‘mirrored experience’ of dignity expresses itself in professional’s engagement with the situation. The value of this engagement, we argue, lies not primarily in realizing the particular content of the values at stake. We point to the importance of engagement itself, even if the values engaged with cannot be realized to the full, and even if competing versions of dignity are at stake simultaneously. In this way the caregivers provide us with interesting examples of moral actorship in situations of conflicting values. (shrink)

The article presents an analysis of the relationship between market as a social and economic sphere and morality as a fundamental aspect of human deeds. It discusses the nature of the market, with a special focus on a person as a main precondition for the existence of the market. The result of the analysis is a pro-posal for a new definition of the market: the market consists in the decisions and actions of persons concerning what product to buy or sell, (...) at what price, where and when. (shrink)

The article presents results of empirical research made amongst entrepreneurs of the Tarnobrzeg region concerning moral dimension of their activities. A few hundred persons were examined (mainly owners of small companies). They were asked about their businesses in moral aspect. Entrepreneurs work hard, have respect to other people and try to be honest. Most important values for them are family, health and love. The work is also very important for entrepreneurs, but they complain about lack of free time.

This article analyzes how the recent call for accounting in health care interferes with daily care practice and raises the question of how accounting practices relate to the aim of good care. The most influential accounting methods in the Netherlands suggest ways for professionals to legitimize their activities. The analysis of washing patients in long-term mental health care shows that different styles of accounting evaluate and legitimize care while structuring notions of what good care is. A specific style of accounting (...) enforces certain values but does not tell about the tragic or unexpected effects that come with it, nor does it provide a repertoire to deal with these. Thus, care practices incorporating specific styles of accounting remain dependent on forms of care that are not accountable or ask for new forms of reflexivity. (shrink)

This review discusses the possible role of α‐tubulin detyrosination, a reversible post‐translational modification that occurs at the protein's C‐terminus, in cellular morphogenesis. Higher eukaryotic cells possess a cyclic post‐translational mechanism by which dynamic microtubules are differentiated from their more stable counterparts; a tubulin‐specific carboxypeptidase detyrosinates tubulin protomers within microtubules, while the reverse reaction, tyrosination, is performed on the soluble protomer by a second tubulin‐specific enzyme, tubulin tyrosine ligase. In general, the turnover of microtubules in undifferentiated, proliferating cells is so rapid (...) that the microtubules accumulate very little detyrosinated tubulin; that is, they are enriched in tyrosinated tubulin. However, an early event common to at least three well‐studied morphogenetic events myogenesis, neuritogenesis, and directed cell motility is the elaboration of a polarized array of stable microtubules that become enriched in detyrosinated tubulin. The formation of this specialized array of microtubules in specific locations in cells undergoing morphogenesis suggests that it plays an important role in generating cellular asymmetries. (shrink)

The “patient perspective” serves as an analytical tool to present patients as knowing subjects in research, rather than as objects known by medicine. This paper analyses problems encountered with the concept of the patient perspective as applied to long-term mental health care. One problem is that “having a perspective” requires a perception of oneself as an individual and the ability to represent one’s individual situation in language; this excludes from research patients who do not express themselves verbally. Another problem is (...) that the idea of “talk” as a representation of the world ignores the fact that talk is also performative in the world: it requires, at least, the ability to deal with an interview situation. To think up alternative ways of including patients as subjects in research, I develop an approach that takes this performativity as a starting point. Analysing practical situations and activities, I argue that patients enact appreciations, making known what they like or dislike by verbal or non-verbal means in a given material environment, in situations that are co-produced by others. Thus, subjectivity is linked to situations and interactions, rather than just to individual characteristics; to “patient positions,” rather than “patient perspectives.”. (shrink)

Effective communication and interpersonal skills have long been recognized as fundamental to the delivery of quality health care. However, there is mounting evidence that the pressures of communication in high stress work areas such as hospital emergency departments present particular challenges to the delivery of quality care. A recent report on incident management in the Australian health care system cites the main cause of critical incidents, as being poor and inadequate communication between clinicians and patients. This article presents research that (...) describes and analyses spoken interactions between health care practitioners and patients in one ED of a large, public teaching hospital in Sydney, Australia. The research aimed to address the challenges and critical incidents caused by breakdowns in communication that occur between health practitioners and patients and by refining and extending knowledge of discourse structures, to identify ways in which health care practitioners can enhance their communicative practices thereby improving the quality of the patient journey through the ED. The research used a qualitative ethnographic approach combined with discourse analysis of audio-recorded interactions. Some key findings from the analysis of data are outlined including how the absence of information about processes, the pressure of time within the ED, divergent goals of clinicians and patients, the delivery of diagnoses and professional roles impact on patient experiences. Finally, the article presents an in-depth linguistic analysis on interpersonal and experiential patterns in the discursive practices of patients, nurses and doctors. (shrink)

Abstract (German version follows): -/- This paper develops a new proposal for a coherentist business ethic in which ethically justified and empirically supported proposed solutions to economic problems are developed through a coherentist process of adjustments between the three levels of (1) conception of problem and its solution, (2) positive economic theory, and (3) ethical theories. Using an example, it illustrates how in this framework, Homann's business ethics gains in validity and relevance but loses its claim to universality. // -/- (...) Diese Arbeit entwickelt eine kohärentistische Wirtschaftsethik, in der ethisch begründete und empirisch gestützte Lösungsvorschläge für ökonomische Probleme durch einen kohärentistischen Anpassungsprozess zwischen den drei Ebenen (1) Auffassung von Problem und Lösungsansatz, (2) positive ökonomische Theorie, sowie (3) ethischen Theorien erarbeitet werden. Anhand eines Beispiels wird illustriert, wie Homanns Wirtschaftsethik in diesem Rahmen an Validität und Relevanz gewinnt, jedoch ihren Universalitätsanspruch verliert. (shrink)

Discussing the workings of technology in care as aesthetic rather than as ethical or epistemological interventions focusses on how technologies engage in and change relations between those involved. Such an aesthetic study opens up a repertoire to address values that are abundant in care, but are as yet hardly theorized. Kamphof studies the problem that sensor technology reveals things about the elderly patients without the patients being aware of this. I suggest improvement of these relations may be considered in aesthetic (...) terms, for instance by developing the affective quality of people’s technological relationships. (shrink)

There is a long tradition of employing a phenomenological approach to gain greater insight into the unique experience of psychiatric illness. Researchers in this field have shed light upon a distur...

How do technologies such as webcams influence health care and what concepts may describe this? This article explores the literature and analyses what people looking through webcams do within a particular health care practice in the Netherlands, that is, within the rehabilitation of people suffering from severe chronic obstructive pulmonary disease or asthma. Several ways to describe the activities webcams support and perform are identified. The webcam is concentrating the activities of its users, by making them focus on the task (...) at hand and magnifies the characteristics of the already existing relationships between webcam users by imposing a relational distance that fits best with intimate contacts. Although webcams shift notions of space and distance, their working appears to be related, to a great extent, to their location. (shrink)

This paper describes a study conducted in collaboration with a marketing agency and a nonprofit organization providing regional sexual health services, which included advice on, and testing f...

Cardiovascular diseases present the leading cause of death worldwide. Over the last decade, their preventio has become not only a central medical and public health issue but also a matter of political concern as well as a major market for pharma, nutrition, and exercise. A preventive assemblage has formed that integrates diverse kinds of knowledges, technologies, and actors, from molecular biology to social work, to foster a specific healthy lifestyle. In this article, the authors analyze this preventive assemblage as a (...) heterogeneous engineer, that is, as an attempt to order complex everyday life into an architecture of modernism. This article draws on research conducted as part of the interdisciplinary research cluster ‘‘preventive self’’ bringing together analyses from social anthropology, history, linguistics, sociology of knowledge, and medicine. The authors report here primarily from ethnographic investigations into biomedical research, primary care, and educational practices in kindergartens. The authors conclude that the preventive assemblage largely fails to install any kind of singular order. Instead, it is translated into existing orderings producing heterogeneity of a different nuance. (shrink)

The series of psychological explanations for the atrocities of Hitler’s Germany followed a development that started with the personality of the perpetrators and subsequently focused on the situation, almost to the exclusion of the person component. Milgram’s experimental series marks a turning point. His construct of destructive obedience claims a validity that transcends the Nazi context and has far-reaching implications for human behavior in hierarchies, irrespective of the political system. The merits of his approach can be understood in comparison and (...) in connection with other theoretical and empirical venues that each provide a unique insight into the mechanisms underlying the Holocaust. (shrink)

Each year in the UK there are approximately 250,000 miscarriages, 3,000 stillbirths and 3,000 terminations following a diagnosis of fetal-abnormality. This paper draws from original empirical research into the experience of pregnancy loss and the accompanying decisionmaking processes. A key finding is that there is considerable variation across England in the range of options that are offered for disposal of pregnancy remains and the ways in which information around disposal are communicated. This analysis seeks to outline the key features of (...) what constitutes effective communication in this context, where effective communication is taken to mean that patients are provided with the key information necessary, in an appropriate manner, so that they are fully able to make a decision. A primary source of evidence includes interviews with the bereaved and pregnancy-loss support workers, in order to understand how the options available, and associated necessary procedures, are communicated. In addition, patient information leaflets are also analyzed as they offer an important tool for information delivery at a difficult and emotionally charged time. Following this, an overview is provided of the information that these leaflets should contain, along with guidance on effective presentation of this information. (shrink)

The paper presents the experiences of advisers in implementing the concept of CSR in Polish enterprises. The article presents the results of surveys covering such issues as the implementation of CSR motives and actions taken by operators in the implementation of CSR policies. CSR advisors also identified that companies can use unethical practices. This is also a characteristic of CSR advisors.

_The Relational Horse_ explores the possibilities of including the horse’s perspective into the study of human-horse relationships. Case studies from across a range of time periods, activities, and disciplines provide fresh ways to understand horses, themselves, in relationships with humans.