Substituted judgement is often used in the absence of advanced directives to guide decision-making when patients lack decisional capacity. We present a remarkable case of family members exercising substituted misjudgement for a 42-year-old man hospitalized with multiorgan failure on life support. Feeling that their loved one would rather die than face severe disability, they elected to withdraw life support. Although this was done, the patient remained alive and recovered enough to clearly indicate his preference for life, even with severe disability. (...) This case suggests that in instances of unusual quality-of-life judgements where the patient's wishes cannot be known with reasonable certainty, families and physicians should be very wary using substituted judgement to refuse life support. Unless there are strong considerations based on the patient's prior statements, actions and values to decline life support, it would seem ethically appropriate to continue treatment, even with substantial disability the likely outcome. (shrink)

In this paper, I write about nurses of colour who have made significant contributions to nursing, yet are actively ignored in traditional nursing textbooks related to colonized thinking. One consequence of this is that when we think about comparing the disparities of the past to the present day, we see that we have not made much of a difference. The disparity is still huge. I call on all of us as nurses to challenge ourselves to think beyond the box of (...) colonized thought to what we know is true. (shrink)

We used a retrospective survey to model the patterns of appraisal, motivation, and coping that uniquely correspond with 12 positive emotions (affection/love, amusement, awe, challenge/det...

This book employs contemporary philosophy, scientific research, and clinical reports to argue that pain, though real, is not an appropriate object of scientific generalisations or an appropriate target for medical intervention. Each pain experience is instead complex and idiosyncratic in a way which undermines scientific utility. In addition to contributing novel arguments and developing a novel position on the nature of pain, the book provides an interdisciplinary overview of dominant models of pain. The author lays the needed groundwork for improved (...) models and targeted treatments at a time when pain science, pain medicine, and philosophy are explicitly searching for both and failing to find them. The Complex Reality of Pain will be of interest to a broad range of researchers and students, including those working in philosophy of mind, philosophy of science, cognitive science, neuroscience, medicine, health, cognitive and behavioural psychology, and pain science. (shrink)

ABSTRACTMany of our emotions arise in social contexts, as we interact with and learn about others. What is not yet clear, however, is how such emotions unfold when we either react to others or attempt to regulate our emotions. To address this issue, 30 healthy volunteers reacted to or reappraised positive or negative information that was paired with neutral faces. While they were doing this task, we assessed pupillary responses. We also asked participants to provide ratings of accountability and experienced (...) emotion. Findings indicated that appraised accountability increased in response to emotional information, and changes in accountability were associated with commensurate changes in valence reports and increased pupil diameter. During reappraisal, accountability and emotion decreased, but pupil diameter increased. The findings highlight the importance of accountability appraisals during the generation and regulation of emotional reactions to others, while also documenting pupillary increases during emot... (shrink)

Background: The concept of dignity is recognised as a fundamental right in many countries. It is embedded into law, human rights legislation and is often visible in organisations’ philosophy of care, particularly in aged care. Yet, many authors describe difficulties in defining dignity and how it can be preserved for people living in long term care. Objectives: In this article, Nordenfelt’s ‘four notions of dignity’ are considered, drawing on research literature addressing the different perspectives of those who receive, observe or (...) deliver care in the context of the long-term care environment. Methods: A review of the literature was undertaken using the terms ‘nursing homes’, ‘residential care’ or ‘long-term care’. The terms were combined and the term ‘human dignity’ was added. A total of 29 articles met the inclusion criteria from the United Kingdom (14), United States (2), Australia (1), Sweden (3), Hong Kong (2), Norway (3), Nordic (1), Taiwan (1), Netherlands (1). Ethical Considerations: Every effort has been made to ensure an unbiased search of the literature with the intention of an accurate interpretation of findings. Discussion: The four notions of dignity outlined by Nordenfelt provide a comprehensive description of the concept of dignity which can be linked to the experiences of people living in long-term care today and provide a useful means of contextualising the experiences of older people, their families and significant others and also of staff in long-term care facilities. Of particular interest are the similarities of perspectives of dignity between these groups. The preservation of dignity implies that dignity is a quality inherent in us all. This links directly to the exploration and conclusions drawn from the literature review. Conversely, promoting dignity implies that dignity is something that can be influenced by others and external factors. Hence, there are a number of implications for practice. Conclusion: We suggest that two of Nordenfelt’s notions, ‘dignity of identity’ and ‘dignity of Menschenwüde’, are a common thread for residents, family members and staff when conceptualising dignity within long-term care environments. (shrink)

Over the past four decades, stakeholder research has united a chorus of voices from different disciplines using different terminology for different audiences all related to a seemingly similar topic: those that affect and are affected by business. By juxtaposing a comprehensive review of the early years of stakeholder research against more recent stakeholder research, we identify areas of common convergence as well as emergent scholarship. We develop an organizing framework consisting of three stakeholder-related themes: who or what is a stakeholder; (...) mechanisms underlying stakeholder relationships; and outcomes-oriented stakeholder research. Future research opportunities include: simultaneously examining multiple stakeholders at multiple levels; multiplier effects along the value chain and across geographies; and net impacts. We conclude by identifying how stakeholder research can “move the needle” on important business issues such as: income inequality and CEO pay; human rights and building community inclusion; disease alleviation; and food security in firms’ continuous quest to create value. (shrink)

The Federal Trade Commission has an important role to play in the governmental oversight of mobile health apps, ensuring consumer protections from unfair and deceptive trade practices and curtailing anti-competitive methods. The FTC’s consumer protection structure and authority is outlined before reviewing the recent FTC enforcement activities taken on behalf of consumers and against developers of mhealth apps. The article concludes with identification of some challenges for the FTC and modest recommendations for strengthening the consumer protections it provides.

As countries around the world work to restrict unhealthy food and beverage marketing to children, the U.S. remains reliant on industry-self regulation. The First Amendment’s protection for commercial speech and previous gutting of the Federal Trade Commission’s authority pose barriers to restricting food marketing to children. However, false, unfair, and deceptive acts and practices remain subject to regulation and provide an avenue to address marketing to young children, modern practices that have evaded regulation, and gaps in the food and beverage (...) industry’s self-regulatory approach. (shrink)

ABSTRACTResearchers have suggested that religious individuals engage primarily in intuitive over analytic processing. We investigated a connection between specific aspects of religiosity and the attribution of causation to social and physical events. College undergraduates completed measures of religiosity online and were asked to determine the causes of events that varied in type, outcome, and likelihood, as well as the personality characteristics of the protagonist. Individuals with greater intrinsic religious orientation, fundamentalism, who viewed God as loving, who were more dogmatic, and (...) had an external locus of control were more likely to attribute supernatural phenomena to events compared to those lower in those traits. Supernatural causation was invoked more often when the character of the protagonist and the outcome of social event matched in valence than when they did not match. Individuals low and high in religiosity.. (shrink)

Neuroeconomics has the potential to fundamentally change the way economics is done. This article identifies the ways in which this will occur, pitfalls of this approach, and areas where progress has already been made. The value of neuroeconomics studies for social policy lies in the quality, replicability, and relevance of the research produced. While most economists will not contribute to the neuroeconomics literature, we contend that most economists should be reading these studies.

The Russian invasion of Ukraine in 2022 was met with condemnation from the European Union and the United States as an "unprovoked and unjustified military aggression" that undermines the liberal international order. However, some international relations scholars, such as John Mearsheimer, argue that Russia had genuine security concerns with regard to Ukraine and that the invasion was a response to the threat of NATO membership for Ukraine. Both liberal and realist perspectives on the invasion rely on the assumption of rational, (...) cost-benefit calculations by actors, but cultural factors and irreconcilable non-material interests may also be at play in shaping the actions and motivations of states. Understanding the cultural and national identity factors at play in the invasion of Ukraine is complex and difficult, but they cannot be ignored in attempting to understand and address the conflict. (shrink)

The negativity bias is a broad psychological principle according to which the negative is more causally efficacious than the positive. Bad, as it is often put, is stronger than good. The principle is widely accepted and often serves as a constraint in affective science. If true, it has significant implications for everyday life and philosophical inquiry. In this article, I submit the negativity bias to its first dose of philosophical scrutiny and argue that it should be rejected. I conclude by (...) offering some alternative hedonic hypotheses that survive the offered arguments and may prove fruitful. (shrink)

When a cause interacts with unobserved factors to produce an effect, the contingency between the observed cause and effect cannot be taken at face value to infer causality. Yet, it would be computationally intractable to consider all possible unobserved, interacting factors. Nonetheless, two experiments found that when an unobserved cause is assumed to be fairly stable over time, people can learn about such interactions and adjust their inferences about the causal efficacy of the observed cause. When they observed a period (...) in which a cause and effect were associated followed by a period of the opposite association, rather than concluding a complete lack of causality, subjects inferred an unobserved, interacting cause. The interaction explains why the overall contingency between the cause and effect is low and allows people to still conclude that the cause is efficacious. (shrink)

IntroductionFew studies have examined psychological distress in healthcare workers across the care continuum. This study describes distress levels reported by HCWs across care settings and factors associated with distress.MethodsA cross-sectional survey of HCWs from Windsor, Ontario, was conducted between May 30th, 2020, and June 30th, 2020. The survey included the Kessler Psychological Distress Scale, sociodemographic, frontline status, perceptions of training, protection, support, respect among teams, and professional and personal stressors. Univariate analyses were used to compare across settings and multivariate logistic (...) regression assessed factors associated with distress.ResultsFour hundred and three HCWs from the hospital, community health and social service, first responder, primary care, home, and long-term care participated in the survey. Common concerns included fear of transmitting COVID-19 to family, safety on the job, and balancing personal care with work demands. LTC and home-care HCWs reported greater concern about workload and staffing levels, whereas community health workers were more anxious about their financial security. Overall, 228 HCWs who completed the K10 reported high distress, with greater rates among hospital and LTC HCWs. Distress was more likely in HCWs who identified as female, younger than 55, perceived lower respect among team, and experienced greater worry about physical and mental health and managing high workloads.ConclusionResults showed a high degree of distress experienced by HCWs across care settings and the impact of the COVID-19 pandemic on personal and work-related stress. Promoting self-care and supportive and collaborative healthcare teams are promising avenues for mitigating symptoms of distress. (shrink)

Moral exemplarism, which insists on the centrality of particular embodiments of exemplary virtue to the moral life, is currently receiving significant attention within moral philosophy as well as theological and religious ethics. This introductory essay situates the contributions made by this focus issue on moral exemplarity in relation to the history of attention to moral exemplars, the twentieth‐century turn to virtue, philosopher Linda Zagzebski’s exemplarist moral theory, Stanley Hauerwas’s particularist embrace of Christian discipleship, Foucauldian turns to critique and self‐cultivation, and (...) the significance of exemplars in Jeffrey Stout’s democratic piety. Arguing for the critical importance of articulating the authority of exemplars, this essay points to the ways in which the present focus can assist us to navigate between the shoals of nostalgic deference to tradition and dismissive critiques of authoritarianism. (shrink)

Findings suggest a positive impact of bilingualism on cognition, including the later onset of dementia. However, it is not clear to what extent these effects are influenced by variations in attentional control demands in response to specific task requirements. In this study, 20 bilingual and 20 monolingual older adults performed a task-switching task under explicit task-cuing vs. memory-based switching conditions. In the cued condition, task switches occurred in random order and a visual cue signaled the next task to be performed. (...) In the memory-based condition, the task alternated after every second trial in a predictable sequence without presenting a cue. The performance of bilinguals did not vary across experimental conditions, whereas monolinguals experienced a pronounced increase in response latencies and error rates in the cued condition. Both groups produced similar switch costs and mixing costs, but bilinguals produced them with lower response latencies. The cognitive benefits of bilingualism seem not to apply to executive functions per se but to affect specific cognitive processes that involve task-relevant context processing. The present results suggest that lifelong bilingualism could promote in older adults a flexible adjustment to environmental cues, but only with increased task demands. However, due to the small sample size, the results should be interpreted with caution. (shrink)

Experimental philosophy, at least in its ‘negative’ variety, has standardly been portrayed as presenting a dramatic challenge to traditional philosophical methodology. As such, it has prompted a large variety of counter-arguments and defenses of intuition. In this paper, I argue that many of these objections to experimental philosophy rest on various oversimplifications that both experimental philosophers and their opponents have made regarding intuitions and philosophical methodology. Once these oversimplifications are abandoned, I argue that the experimentalist critique of current philosophical methods (...) becomes somewhat less dramatic, but also much less open to objection. (shrink)

Unknowing is at the center of spiritual life. It is only by creating a space in which anything can happen that we allow God to speak; only by stepping back that we allow space for that unpredictable Spirit that brings us gifts beyond any of our imaginings.

This article evaluates New Zealand’s Medicines Amendment Bill 2011. This Bill is currently before Parliament and will amend the Medicines Act 1981. On June 20, 2011, the Australian and New Zealand governments announced their decision to proceed with a joint scheme for the regulation of therapeutic products such as medicines, medical devices, and new medical interventions. Eventually, the joint arrangements will be administered by a single regulatory agency: the Australia New Zealand Therapeutic Products Agency. The medicines regulations in Australia and (...) New Zealand will be updated as part of this process. The Medicines Amendment Bill addresses some of the well-recognised deficiencies in the Medicines Act 1981. However, a comprehensive overhaul of the Act is not being undertaken. I argue that repealing and replacing the Medicines Act 1981 would be preferable and advisable, given the number of legal difficulties with the Act and, in particular, where it does not align with equivalent current international law. (shrink)

Duchenne's muscular dystrophy (DMD), which affects 1/3500 live male births, involves a progressive degeneration of skeletal and cardiac muscle, leading to early death. The protein dystrophin is lacking in DMD and present, but defective, in the allelic, less severe, Becker muscular dystrophy and is also missing in the mdx mouse. Experiments on the mdx mouse have suggested two possible therapies for these myopathies. Implantation of normal muscle precursor cells (mpc) into mdx skeletal muscle leads to the conversion of dystrophin‐negative fibres (...) to ‐positive, with consequent improvement in muscle histology. Direct injectidn of dystrophin cDNA into skeletal or cardiac muscle also gives rise to dystrophin‐positive fibres. Although both appear promising, there are a number of questions to be answered and refinements to be made before either technique could be considered possible as treatments for myopathies in man. (shrink)

English popular science was more than a mid-nineteenth century phenomenon, whether defined as practical, utilitarian and comprehensible knowledge, or as a nexus of ¡deas, rhetoric and practice. All these criteria were fulfilled in four Stationers’ Company almanacs for forty years by Henry Andrews, an astronomer, mathematician, astrologer and meteorologist. Andrews employed these as instruments for an extensive campaign in the history of science education devised to acquaint working class readers with the key figures, ideas and methodologies of science.