Against the historical backdrop of early Christian–Muslim apologetics in the Middle East, an apologetics that was overwhelmingly polemical in its scope, I consider the contribution of the mystics, in providing a dialogical model that would overcome the state of impasse that inter-religious debate had reached. Dialogue moves beyond the established polemical binaries of two rival belief systems, towards the clarification of defensible difference, in which the other is allowed to speak in all its polyvocality and even to impinge on the (...) truth claims of one’s own tradition. (shrink)

This book explores the mystical thought of Gregory Barhebraeus (1226-1286CE) and its contemporary relevance, to offer a reading of Barhebraeus' mystical texts by bringing them into conversation with critical religious studies and the hermeneutical tradition of philosophy. Griggs emphasises the problem of conceptual categories for the academic study of mysticism, seeking to avoid traditional assumptions concerning 'mysticism' and attend to the particularity of 'mystic' traditions. Through this approach, she examines the mystical hermeneutics of the love of God developed by (...) Barhebraeus, as a response to the elaboration of this theme by the Islamic theologian Abu Hamid al-Ghazālī (1058-1111CE), and as a resolution of the tensions between scholastics and ascetics within his own Syriac tradition. (shrink)

This discussion is about the moods characteristic of depressive and manic states. Moods are distinguished from the emotions they often accompany, and the relationship between these less and more cognitive, and seemingly less and more intentional, states is provided preliminary clarification. Epistemic deficiencies identified here, when combined with differences of quality and quantity in the moods and motivations that beset the depression and mania sufferer, seem likely to hinder self-knowledge and self-integration. These deficiencies, it is argued, may help explain why (...) the extreme moods found in states of depression and mania contribute to our inclination to regard these conditions as disorder. (shrink)

Psychiatric ethics spans several overlapping domains, including the guidelines for ethical research in psychiatry, the professional ethics required in the practice of psychiatry, and a broader set of moral and ethical problems and dilemmas distinctive to, or at least magnified by, the mental health care setting. Reviewed here are selected issues arising in the last two domains, some seemingly inevitable components of mental disorder and its cultural history and others resultant from recent changes and discoveries. Even as science explains and (...) demystifies mental disorder, it is concluded, new ethical problems will continue to arise in psychiatry and certain recalcitrant problems will likely persist. (shrink)

Most words in English are ambiguous between different interpretations; words can mean different things in different contexts. We investigate the implications of different types of semantic ambiguity for connectionist models of word recognition. We present a model in which there is competition to activate distributed semantic representations. The model performs well on the task of retrieving the different meanings of ambiguous words, and is able to simulate data reported by Rodd, Gaskell, and Marslen‐Wilson [J. Mem. Lang. 46 (2002) 245] on (...) how semantic ambiguity affects lexical decision performance. In particular, the network shows a disadvantage forwords with multiple unrelated meanings (e.g., bark) that coexists with a benefit for words with multiple related word senses (e.g., twist). The ambiguity disadvantage arises because of interference between the different meanings, while the sense benefit arises because of differences in the structure of the attractor basins formed during learning. Words with few senses develop deep, narrow attractor basins, while words with many senses develop shallow, broad basins. We conclude that the mental representations of word meanings can be modelled as stable states within a high‐dimensional semantic space, and that variations in the meanings of words shape the landscape of this space. (shrink)

This special issue of Science, Technology, & Human Values assembles papers that consider relations among science, ethics, and justice. The papers are drawn from a 2011 National Science Foundation-sponsored workshop that brought together interdisciplinary scholars to consider, incorporate, and attend to the meanings, uses, and social consequences of ethical questions and justice ideals in technoscientific projects. The papers included in this special issue examine key areas that emerged from this workshop, including public participation, the production of knowledge, what counts as (...) consent, ownership of biomaterials, and others. Together, the papers raise questions about new directions and articulations of power, justice, and inequalities in science and technology studies. (shrink)

This book explores Hume's concern with the destructiveness of religious factions and his efforts to develop, in his moral philosophy, a solution to factional conflict. Sympathy and the related capacity to enter into foreign points of view are crucial to the neutralization of religious zeal and the naturalization of ethics. Jennifer Herdt suggests that Hume's preoccupation with religious faction is the key which reveals the unity of his varied philosophical, aesthetic, political and historical works.

Around the world, many schools were closed as one of the measures to contain the spread of the COVID-19 pandemic. School closure brought about important challenges to the students' learning process. This context requires strong self-regulatory competences and agency for autonomous learning. Moreover, online remote learning was the main alternative response to classroom learning, which increased the inequalities between students with and without access to technological resources or for those with low digital literacy. All considered, to level the playing field (...) for students without digital resources, there is an urgent need to promote self-regulatory competences through offline intervention solutions. The current paper describes a project with this purpose, using radio broadcasting and letters to reach elementary students without digital resources. Moreover, potential reach and participants' perspectives of the project implementation are presented and discussed. The project draws on a prior evidence-based story-tool intervention grounded on a self-regulated learning framework. The original intervention was set previous to the COVID-19 pandemic and was implemented in the classroom context (N= 1,103 students). Once the schools had been closed down, the mode of intervention was adapted with the collaboration of the community. Alternative solutions were developed as follows: (i) story chapters were read on the radio and students received to their homes a printed script, prompting reflection, and suggesting related activities; (ii) students were provided with the story-tool to read autonomously and received letters from the main characters of the story which included, for example, suggestions for activities and reflection. These two alternative modes of intervention delivery potentially reached 394 elementary students, including students with digital resources. Interviews conducted with a group of students were provided information about the positive aspects of these two modes of intervention delivery, perceived learning (e.g., planning), constraints, and suggestions to improve the project. The current work is likely to merit attention from researchers and educational practitioners, given the need to use offline alternatives to provide support for students without digital resources to engage in autonomous learning during the pandemic period. This project may also be used as an alternative or a complementary solution to online modality. (shrink)

Environments are increasingly becoming technologized sites of data production. From smart cities to smart forests, digital networks are analyzing and joining up environmental processes. This commentary focuses on one such understudied smart environment, smart forests, as emerging digital infrastructures that are materializing to manage and mitigate environmental change. How does the digitalization of forests not only change understandings of these environments but also generate different practices and ontologies for addressing environmental change? I first analyze smart forests within the expanding area (...) of smart environments, and then discuss five digital practices that characterize smart forests. Based on this analysis, I suggest that forests are not only becoming highly digital environments but also that forests are transforming into technologies for managing environmental change. Smart forest interventions therefore expand the scope of what could count as a technology, especially in the context of data-oriented planetary governance. (shrink)

While there are now an increasing number of studies that critically and rigorously engage with Big Data discourses and practices, these analyses often focus on social media and other forms of online data typically generated about users. This introduction discusses how environmental Big Data is emerging as a parallel area of investigation within studies of Big Data. New practices, technologies, actors and issues are concretising that are distinct and specific to the operations of environmental data. Situating these developments in relation (...) to the seven contributions to this special collection, the introduction outlines significant characteristics of environmental data practices, data materialisations and data contestations. In these contributions, it becomes evident that processes for validating, distributing and acting on environmental data become key sites of materialisation and contestation, where new engagements with environmental politics and citizenship are worked through and realised. (shrink)

This essay surveys the theme of solidarity in the respective works of Hans-Georg Gadamer and Hannah Arendt. Recent discourses in continental political philosophy have arrived at an impasse regarding solidarity. On the one hand, solidarities are important for galvanizing historically oppressed peoples against dominant discourses. On the other hand, solidarities that impose similarities in advance run the risk of absorbing difference and becoming exclusionary. Gadamer and Arendt, each in different manners, promise a distinctive approach to discourses on solidarity through their (...) emphasis on the existential concern for human finitude. Both suggest that insofar as we are finite, we are bound together not by familiarity and sameness but rather by shared vulnerability, finding help with this vulnerability by remaining open to the difference and otherness that is always at stake in communal life. In this, Gadamer and Arendt open new paths to theorizing collectives in ways that embrace and defend difference rather than rejecting it. Moreover, both remind us of the urgency of such a notion of solidarity for responding to what, in allusion to Arendt, we may be inclined to call the dark times in which we live. (shrink)

This article examines Jacques Derrida’s criticism of the significance Hannah Arendt attributes to her mother tongue in, “What Remains? The Language Remains.” I begin by developing Derrida’s claim in The Monolingualism of the Other that despite Arendt’s suggestion otherwise, the German language can and did go mad. I argue that his criticism, while powerful, overlooks the political concerns at work in Arendt’s commitment to her mother tongue. I turn to Arendt’s analysis of language in Eichmann in Jerusalem to show that (...) by distinguishing Eichmann’s “empty talk” from the mother tongue, she suggests that our primary language is integral to political life insofar as it reminds us of our radical singularity and our responsibility to the world. With this, I maintain that Derrida’s decisive intervention in this discourse does not settle the question of the mother tongue; instead it raises new questions concerning the political significance of our relation to language. (shrink)

Do English-speakers think about anger as “red” and sadness as “blue”? Some theories of emotion suggests that color(s) - like other biologically-derived signals- should be reliably paired with an emotion, and that colors should differentiate across emotions. We assessed consistency and specificity for color-emotion pairings among English-speaking adults. In study 1, participants (n = 73) completed an online survey in which they could select up to three colors from 23 colored swatches (varying hue, saturation, and light) for each of ten (...) emotion words. In study 2, different participants (n = 52) completed a similar online survey except that we added additional emotions and colors (which better sampled color space). Participants in both studies indicated the strength of the relationship between a selected color(s) and the emotion. In study 1, four of the ten emotions showed consistency, and about one-third of the colors showed specificity, yet agreement was low-to-moderate among raters even in these cases. When we resampled our data, however, none of these effects were likely to replicate with statistical confidence. In study 2, only two of twenty emotions showed consistency, and three colors showed specificity. As with the first study, no color-emotion pairings were both specific and consistent. In addition, in study 2, we found that saturation and lightness, and to a lesser extent hue, predicted color-emotion agreement rather than perceived color. The results suggest that previous studies which report emotion-color pairings are likely best thought of experiment-specific. The results are discussed with respect to constructionist theories of emotion. (shrink)

This paper explores the two-factor theoretical model currently widely used to provide an explanatory analysis of the delusions that regularly accompany neurological disease or damage. The model hypothesizes a combination of an experiential factor – a strange or untoward experience – and a cognitive factor, such as an impairment of reasoning. The two-factor model has been devised formonothematicdelusions that are usually manifested in a single, implausible idea. These have to be distinguished from the more elaborated,polythematicdelusions that are found in psychiatry. (...) Psychiatric delusions exceed neurological ones in frequency and, often, semantic complexity. This text offers a preliminary clarification of underlying assumptions about the breadth, terminology and presuppositions of two-factor theorizing, exploring its potential application to psychiatric delusions. (shrink)

We outline some ways in which motor neglect (the underutilization of a limb despite adequate strength) and hysterical paralysis (failure to move a limb despite no relevant structural damage or disease) may throw light on the pathophysiology of catatonia. We also comment on the manifold inadequacies of distinguishing too firmly between symptoms of “neurologic origin” and of “psychiatric origin.”.

Despite some recognition that Aboriginal women who have experienced breast cancer may have unique health needs, little research has documented the experiences of Aboriginal women from their perspective. Our main objective was to explore and to begin to make visible Aboriginal women's experiences with breast cancer using the qualitative research technique, photovoice. The research was based in Saskatchewan, Canada and participants were Aboriginal women who had completed breast cancer treatment. Although Aboriginal women cannot be viewed as a homogeneous group, participants (...) indicated two areas of priority for health‐care: (i) Aboriginal identity and traditional beliefs, although expressed in diverse ways, are an important dimension of breast cancer experiences and have relevance for health‐care; and (ii) there is a need for multidimensional support which addresses larger issues of racism, power and socioeconomic inequality. We draw upon a critical and feminist conception of visuality to interrogate and disrupt the dominant visual terrain (both real and metaphorical) where Aboriginal women are either invisible or visible in disempowering ways. Aboriginal women who have experienced breast cancer must be made visible within health‐care in a way that recognizes their experiences situated within the structural context of marginalization through colonial oppression. (shrink)

This is the first collection dedicated to presenting research directly influenced by the innovative and groundbreaking ideas of the eminent linguist Ruqaiya Hasan. The collection offers an insight into the breadth and depth of Hasan's distinctive linguistic approaches and theoretical concerns. The chapters cover areas such as verbal art, context of situation, semantic networks, cohesive harmony, text structure and literacy education, contributed by well-known scholars in the field such as M.A.K. Halliday, Geoffrey Williams, David Butt, Donna Miller, Wendy L. Bowcher, (...) Tom Bartlett and Margaret Berry. The volume contains an interview with Ruqaiya Hasan by David Butt and Jennifer Yameng Liang, and a section in which the contributors describe their connection and/or history with Ruqaiya Hasan and her work. This book is of particular value to scholars and students working in sociolinguistics, literary criticism, stylistics, functional linguistic theories, literacy pedagogy, social semiotics, multimodality and applied linguistics. (shrink)

This special issue of Science, Technology, & Human Values contains articles concerned with ethics in and around scientific practice. These articles ask how organizational routines both produce and diffuse concerns about the risks and benefits of scientific research and products, and why context remains elusive in formal ethical analysis. These cases are from diverse settings, with several touching on issues of economic inequality and participation in scientific research. Each article describes in some way how cultural and institutional configurations shape ethical (...) thinking and the distribution of goods and harms in science. (shrink)

This chapter focuses on one of the common fallacies in Western philosophy, 'false dilemma (FD)'. According to Andrea A. Lunsford, John J. Ruskiewicz, and Keith Walters, a FD tends to “reduce a complicated issue to excessively simple terms” or, when intentionally created, tends to “obscure legitimate alternatives”. FD reflects incorrect thinking because it presents a problem or issue as having only two possible solutions when in fact there are more. Liam Dempsey noted that shows such as The Daily Show and (...) The Colbert Report often employed FD in order to highlight the “theatrics” that are found in political events or the use of FD by politicians. Politics aside, an FD exists anytime an extreme dichotomy of choices appears as the only possible answers. Advertisers also create an FD when creating a situation with only two outcomes and the only correct or positive outcome leads to their brand. (shrink)

In the closing years of the eighteenth century, a great intellectual and moral challenge to European empire was launched by many of the most innovative thinkers of the day, including Kant, Adam Smith, Bentham, Burke, Diderot, and Condorcet. They drew on a strikingly wide range of ideas to argue against empire: among others, the rights of man and the imperative of popular self‐determination, the economic wisdom of free trade and foolishness of conquest, the corruption of natural man by a degenerate (...) civilization, the hypocrisy required for self‐governing republics to rule despotically over powerless subjects, and the impossibility of sustaining freedom at home while practicing despotism abroad. (shrink)

In this paper I shall first expose a weakness shared by several philosophical discussions of self-deception: I shall show that these discussions have failed to give it a complete analysis. The apparent phenomenon of self-deception is all too familiar, and yet its adequate characterization in general terms is wanting. More exactly, I shall argue that to understand self-deception statically, as these accounts have done, has been—and must be—to fail to give a characterization of it as a state of mind, sufficient (...) to distinguish it from other mental states not born of self-deception. (shrink)

Government-sponsored school lunch programs have garnered attention from activists and policymakers for their potential to promote public health, sustainable diets, and food sovereignty. However, across country contexts, these programs often fall far short of their transformative potential. It is vital, then, to identify policies and organizing strategies that enable school lunch programs to be redesigned at the national scale. In this article, we use document analysis of historical newspapers and government data to examine the motivating factors and underlying conditions that (...) allowed South Korea’s universal free, eco-friendly school lunch program to become a tool for advancing social justice and ecological goals at the national scale. We analyze the socio-historical evolution and current status of the Korean school lunch program, combining the multi-level perspective with insights from environmental sociology and critical food studies, in order to shed light on the factors that enabled the program to become an innovative niche and articulate the opportunities and challenges it now faces. We identify the state-sponsored creation of what we call “precautionary infrastructure” as a key anchoring mechanism between the school food niche and agri-food regime. Precautionary infrastructure includes new supply chains, certification standards, and sourcing policies that provide a stable market for eco-friendly farms and small-scale producers, while minimizing the environmental health risks of school lunch by delivering organic and pesticide-free ingredients to on-site kitchens that serve free lunches to all students. This analysis offers insight into how public school-lunch programs can become protected niches that help drive sustainability transitions within agri-food systems. (shrink)

We argue that strong moral objections to widespread implementation of uterine transplantation persist despite recent live births following the procedure. These objections relate not only to the serious medical risk to which live donors are currently subject but also to the strength of pronatalistic and biologistic social forces. We explore medical risk in light of various factors and treat questions relating uterine transplantation to gestational surrogacy.

Recent research in the humanities and social sciences suggests that individuals who understand themselves as belonging to something greater than the self--a family, community, or religious or spiritual group--often feel happier, have a deeper sense of purpose or meaning in their lives, and have overall better life outcomes than those who do not. Some positive and personality psychologists have labeled this location of the self within a broader perspective "self-transcendence." This book presents and integrates new, interdisciplinary research into virtue, happiness, (...) and the meaning of life by re-orienting these discussions around the concept of self-transcendence. The essays are organized around three broad themes connected to self-transcendence. First, they investigate how self-transcendence helps us to understand aspects of the moral life as it is studied within psychology, including the development of wisdom, the practice of moral praise, and psychological well-being. Second, they explore how self-transcendence is linked to virtue in different religious and spiritual traditions including Judaism, Islam, Christianity, Buddhism, and Confucianism. Finally, they ask how self-transcendence can help us theorize about Aristotelean and Thomist conceptions of virtue, like hope and piety, and how this helps us to re-conceptualize happiness and meaning in life. (shrink)

This July 2022 issue of the JME contains several articles addressing ethical issues related to COVID-19 as well as reproductive ethics—a timely topic, given the leaked U.S. Supreme Court document, anticipating the overturn of Roe v. Wade. On the COVID-19 front, original articles in this issue include an analysis of ethical issues related to sharing research samples and data between low/middle-income countries and high-income countries,1 a retrospective analysis of European scientific societies’ triage policies early in the pandemic,2 an assessment of (...) the fairness of the allocation framework used by the WHO for their COVID-19 Vaccines Global Access Facility,3 balancing physicians’ freedom to express opinions on medical matters with public interest when they run contrary to each other,4 and a survey of Americans’ views on race-based and place-based COVID-19 vaccine prioritisation.5 The articles include a mix of looking back and …. (shrink)

The assessment of text quality is a transdisciplinary issue concerning the research areas of educational assessment, language technology, and classroom instruction. Text length has been found to strongly influence human judgment of text quality. The question of whether text length is a construct-relevant aspect of writing competence or a source of judgment bias has been discussed controversially. This paper used both a correlational and an experimental approach to investigate this question. Secondary analyses were performed on a large-scale dataset with highly (...) trained raters, showing an effect of text length beyond language proficiency. Furthermore, an experimental study found that pre-service teachers tended to undervalue text length when compared to professional ratings. The findings are discussed with respect to the role of training and context in writing assessment. (shrink)

Until a few years ago, the prevailing view was that children should not be participants in clinical research trials because children were incapable of consenting to such nontherapeutic interventions and are particularly vulnerable to abuse. That view has undergone a significant shift in the last few years, particularly in the context of trials to test the safety and effectiveness of drugs. A number of events facilitated this change, including the widespread off-label distribution of drugs to children and developments in the (...) AIDS epidemic. These social forces have shifted the core ethical question from whether children should be research subjects to when children should be research subjects.The presumption in favor of including children as research subjects for drug trials has manifested itself primarily through two different reforms: a 1997 federal statute and a set of regulations promulgated by the Food and Drug Administration that recently became effective. Together they reflect the view that children deserve the same access to safe and effective therapies as adults. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Corrupting Youth: Political Education, Democratic Culture, and Political TheoryJennifer RobertsJ. Peter Euben. Corrupting Youth: Political Education, Democratic Culture, and Political Theory. Princeton: Princeton University Press, 1997. xvi 1 271 pp. Cloth, $55, £37.50; paper, $18.95, £13.95.Who, Socrates asks Meletus, improves the young men of Athens? The laws, Meletus replies. But which people, Socrates wants to know, which men? These very dicasts here. All of them, Meletus, or just (...) some? Oh, all of them. Goodness; and what about the audience? Them too? Yes, them too. And the members of the Boule? Certainly. And the men in the Assembly? Yes, them too. In other words, Meletus, what you are saying is that absolutely everyone in Athens improves young men except me. Is that right? Yes, that is exactly right, Meletus replies.Socrates has succeeded in making a fool of Meletus precisely because the question of “improving” the young (or anyone else) is so problematic. In this wide-ranging study of political thought in classical Athens, Peter Euben locates Greek explorations of the civic community, and how one educates people for it, in the context of contemporary debates over higher education in the United States. Taking as a springboard (and a title) the accusation of corrupting the youth made against Socrates at his trial, Euben seeks to mediate the claims of “canonists,” who advocate a focus on classical texts on the grounds that they instill Values with a capital V, and “multiculturalists,” who are suspicious of such texts, believing them to embody the narrow and bankrupt values of dead white males—dead white slave-holding males at that. His strategy is to stress what he sees as the polyphonal and multivocal nature of the Athenian corpus, emphasizing the impossibility of these revered but disparate texts’ “teaching” any virtue other than that of constant scrutiny of self and other. The texts he examines, moreover—tragedy, comedy, and dialogue—often deal directly with the question of education for democratic citizenship, a project dear to Euben’s heart.To do this, of course, Euben must demonstrate a pro-democratic agenda in both tragedy and Old Comedy, and here I think he succeeds, although the matter is far from simple; and then there is the question of Socrates/Plato. Readers will probably be persuaded by his arguments in the following order: Sophocles’ Antigone, yes; Aristophanes’ Clouds, maybe; Plato’s Gorgias, very dubious. It is in its discussion of the troubling Gorgias that Euben’s book is most challenging and provocative.Demonstrating multiple voices in Antigone is not a daunting task. The play works as a pro-democratic statement on many levels, beginning with its very surface. Most simply, Haemon and the chorus appear to embody the voice [End Page 621] of reason against Creon’s rigidity and vulgarity, and Haemon explicitly sides with the chorus against his autocratic father. At a deeper level, however, the polyphony of the play represents what Euben sees as the multivocal nature of democratic debate, as the conflicting claims of law and family are both enacted and articulated on the stage. Here, as elsewhere in the book, he finds the process of deliberation and analysis intrinsically democratic and gives it as least as much weight as the conclusions to which it leads, if not more.Creon, who rejects discussion and deliberation and associates yielding with unmanliness, seeks to deny the richness and complexity of human life and the human community. If Creon stands for autocracy, does the equally rigid Antigone then represent democracy? It would seem to me that she does not, since the primacy she gives to religious over civic obligations appears to place her in the camp of the female/religious force that Aeschylus rejected in the Oresteia as pre-democratic, replacing it with the patriarchal state of men and civic laws as the Furies are tamed and the rulings of male juries are constituted as the laws of the community. Euben, however, puts forward an interesting argument to the opposite effect: while Creon, he writes, “may regard Antigone as the amorphous anarchic symbol of womanly power, it is worth recalling that conservatives regarded Athenian democracy the same way” (171). (We might... (shrink)

This article examines Hannah Arendt’s concern for remembrance in political life in light of contemporary discourses regarding the memory of slavery and colonization in the African diaspora. Arendt’s blindness to questions of exclusion within this context has given way to a set of critical debates in Arendt studies concerning the viability of her political project. In this paper, I give further contour to these debates by considering Arendt’s discourse on revolution in light of an analysis of the Haitian Revolution. In (...) so doing, my aim is to deepen and challenge Arendt’s understanding of the revolutionary tradition that she believes we are responsible for remembering and appropriating anew in political life today. (shrink)

In this essay Robert Rhoads, Jennifer Berdan, and Brit Toven-Lindsey examine some of the key literature related to the open courseware (OCW) movement (including the emergence and expansion of massive open online courses, or MOOCs), focusing particular attention on the movement's democratic potential. The discussion is organized around three central problems, all relating in some manner or form to issues of power: the problem of epistemology, the problem of pedagogy, and the problem of hegemony. More specifically, the authors raise (...) issues related to the narrow notion of knowledge typically conveyed in the OCW movement, a limited understanding of what constitutes empowering pedagogy, and the lack of treatment of inequities associated with the production of courseware materials. The authors go on to argue that the lack of critical analysis of the OCW movement is tied to its relative alignment with educational reforms driven by neoliberal ideology and that such alignment serves to limit the movement's democratic possibilities. (shrink)

Issues-driven shareholder activism suggests that specific issue characteristics brought by shareholders, a group to which firms are obligated to respond, interact in a way that affects the materiality of the issue in the eyes of the modern corporation. Relevant issue characteristics include: issue type, social significance, and issue life cycle stage.

Melanie presented at twenty weeks of gestation to an obstetrics clinic in a critical access hospital in rural Vermont. She was excited to undergo routine fetal ultrasonography, but her obstetrician gave her grave news: the ultrasound revealed hypoplastic left heart syndrome, a devastating congenital heart defect. Initially, Melanie agreed in general to pursue surgical care for her fetus—a three‐stage process that has somewhat uncertain results and could only be done in tertiary care facilities far from her home in Vermont. A (...) week later, while the maternal fetal medicine and pediatric cardiology units made arrangements with colleagues in Boston, Melanie began having second thoughts. An ethics meeting was called to discuss conflicting clinician reactions to Melanie's dilemma. Most of the clinicians were stunned that the patient would change her mind. What advice should the ethics consultant offer the team about caring for Melanie? (shrink)