SummaryThis article documents understandings and responses to mass drug administration for the treatment and prevention of lymphatic filariasis among adults and children in northern coastal Tanzania from 2004 to 2011. Assessment of village-level distribution registers, combined with self-reported drug uptake surveys of adults, participant observation and interviews, revealed that at study sites in Pangani and Muheza districts the uptake of drugs was persistently low. The majority of people living at these highly endemic locations either did not receive or actively rejected (...) free treatment. A combination of social, economic and political reasons explain the low uptake of drugs. These include a fear of treatment ; divergence between biomedical and local understandings of lymphatic filariasis; and limited and ineffective communication about the rationale for mass treatment. Other contributory factors are the reliance upon volunteers for distribution within villages and, in some locations, strained relationships between different groups of people within villages as well as between local leaders and government officials. The article also highlights a disjuncture between self-reported uptake of drugs by adults at a village level and the higher uptake of drugs recorded in official reports. The latter informs claims that elimination will be a possibility by 2020. This gives voice to a broader problem: there is considerable pressure for those implementing MDA to report positive results. The very real challenges of making MDA work are pushed to one side – adding to a rhetoric of success at the expense of engaging with local realities. It is vital to address the kind of issues raised in this article if current attempts to eliminate lymphatic filariasis in mainland coastal Tanzania are to achieve their goal. (shrink)

Why were the Vestals virgins? An explanation drawing on anthropological studies of witchcraft and the work of Giovannini, Girard, and Douglas allows a partial solution to this and three other puzzles: 1) their unique legal status; 2) their murder at moments of political crisis; 3) the odd details of those murders. The untouched body of the Vestal Virgin is a metonymy for the untouched city of Rome. Her unique legal status frees her from all family ties so that she can (...) incarnate the collective. Thus, in times of crisis, she serves as a pharmakos/pharmakon. Equally, Roman society reveals a deep fear of witchcraft directed at its own matrons. Danger to the urbs is warded off by the punishment of women, both Vestals and wives, and the foundation of public cults of chastity with admonitory and apotropaic functions. A series of incidents over a thousand-year span reveals a world view deeply rooted in sympathetic magic, where the women embody the state and their inviolability is objectified as the inviolability of the community. (shrink)

Aunque el modelo de atención en salud ha evolucionado, aún suele desplazar la importancia de incluir la narrativa del paciente e intenta uniformar las necesidades de las personas enfermas. La medicina narrativa nos da la capacidad de interpretar y comunicar los relatos de nuestros pacientes, a través de la escucha activa, así como de valorar la complejidad del ser humano, a diferencia de la salud basada en la evidencia, donde las experiencias de un individuo son extrapolables a otros pacientes sin (...) importar su historia, con lo que se reduce gran parte de la narración a una clasificación objetiva en la ficha clínica, cuando lo correcto sería integrar el paradigma narrativo en la atención de personas enfermas. Creemos que enseñar competencias narrativas y saber científico a profesionales de odontología permitirá estrechar la relación clínica con los pacientes a partir de valores como la empatía y la compasión, mermando el sufrimiento ligado a lo objetivo de sus enfermedades. (shrink)

The Supreme Court ended its last term by making unconstitutional a choice Brown v. Board of Education once required - the voluntary, and race conscious, pursuit of integration - to little public outcry. As a society, we continue to find comfort in segregation. This Article argues that this acceptance is wrong, both educationally and constitutionally. It does so through the lens of teacher segregation, a topic all but ignored in the current literature. The first step of this argument is demonstrating, (...) by an original empirical study, the segregation of teachers, thereby proving a more profound school segregation than is generally recognized. The second step establishes, through an extensive review of the existing social science literature, that the typical minority student benefits from integration because it ensures a fundamental resource - experienced teachers. Lastly, the inherent inequality of segregation should have constitutional implications. While the Rehnquist Court utilized an interest balancing approach to the Equal Protection clause and recognized the constitutional harms of segregation, the Roberts Court has begun to minimize the Equal Protection to concern only capitalizing individual treatment and has erred in creating a "constitutional chill" toward the value of integration. (shrink)

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.

“I have a hard year, a year of effort before me. . . . I think I shall very soon be completely ruined; it seems inevitable. What I have to do is to peg away and try to do my duty, and starve if necessary. One thing I must make up my mind to clearly. I must earn some money every day” (W8 lxiv). Peirce wrote these words in his diary on New Year’s Day 1892, at 12:05 a.m. His forced (...) resignation from the Coast and Geodetic Survey, his most reliable source of income, had taken effect at midnight. On another front, he had recently published the first two articles in his landmark Monist metaphysical series (selections 22–24). A replacement for his Coast Survey income never did appear, but three more papers in the Monist .. (shrink)

This article is the fourth dialogue in a series in which two characters, a pro‐business experienced manager and a critical management academic idealist, debate contemporary management. In this dialogue, the discussion concerns the curriculum of business and management courses. Though as usual there is little agreement between the two participants, the discussion clearly shows just how difficult it will be to change business education without also changing the market position of business schools. Other topics concern the sort of economic assumptions (...) embedded in much of the curriculum, and the relationship between practical skills and political descriptions of capitalism. (shrink)

Allan Franklin has identified a number of strategies that scientists use to build confidence in experimental results. This paper shows that Franklin's strategies have direct analogues in the context of computer simulation and then suggests that one of his strategies—the so-called 'Sherlock Holmes' strategy—deserves a privileged place within the epistemologies of experiment and simulation. In particular, it is argued that while the successful application of even several of Franklin's other strategies (or their analogues in simulation) may not be sufficient for (...) justified belief in results, the successful application of a slightly elaborated version of the Sherlock Holmes strategy is sufficient. (shrink)

Climate change fingerprint studies investigate the causes of recent climate change. I argue that these studies have much in common with Steel’s (2008) streamlined comparative process tracing, illustrating a mechanisms-based approach to extrapolation in which the mechanisms of interest are simulated rather than physically instantiated. I then explain why robustness and variety-of-evidence considerations turn out to be important for understanding the evidential value of climate change fingerprint studies.

BackgroundLiterature on issues relating to comprehension during the process of obtaining informed consent (IC) has largely focused on the challenges potential participants can face in understanding the IC documents, and the strategies used to enhance comprehension of those documents. In this review, we set out to describe the factors that have an impact on comprehension and the strategies used to enhance the IC process in sub-Saharan African countries.MethodsFrom November 2021 to January 2022, we conducted a literature search using a PRISMA (...) tool. We searched electronic databases (PubMed, EMBASE, EBSCOHOST) to identify relevant peer reviewed studies. We then reviewed the references of these articles to find additional literature that might have been missed through the initial search. We were particularly interested in full text articles in English that focused on the IC process in SSA published between 2006 and 2020. We included systematic reviews, and studies from Western and Asian countries that included data about SSA. We excluded articles that focused on medical interventions and studies that did not require IC.ResultsOut of the 50 studies included most were multi-country (n = 13) followed by single country studies in South Africa (n = 12); Kenya, Tanzania, Uganda (n = 5) each; Gambia, Ghana and Nigeria (n = 2)each ; and one each for Botswana, Malawi, Mali, Mozambique. We identified three areas of focus: (1) socio-cultural factors affecting IC; (2) gaps in the ethical and legal frameworks guiding the IC process; and (3) strategies used to improve participants’ understanding of IC.ConclusionOur review showed wide recognition that the process of achieving IC in SSA is inherently challenging, and there are limitations in the strategies aimed at improving comprehension in IC. We suggest that there is a need for greater flexibility and negotiation with communities to ensure that the approach to IC is suited to the diverse socio-cultural contexts. We propose moving beyond the literal translations and technical language to understanding IC comprehension from the participants’ perspectives and the researchers’ views, while examining contextual factors that impact the IC process. (shrink)

In After God: Morality and Bioethics in a Secular Age, H. Tristram Engelhardt, Jr. explores the broad implications for moral reasoning once a culture has lost a God’s-eye perspective. In this paper, I focus on the implications of Engelhardt’s views for clinical ethics consultation. I begin by examining the question of whether clinical ethics consultants should advocate a particular viewpoint and/or process during consultations or adopt a neutral stance. I then examine the implications of Engelhardt’s views for this question. Finally, (...) I discuss some of Engelhardt’s foundational ontological, metaphysical, meta-ethical, and epistemological commitments and how these commitments connect to his views on clinical ethics consultation. (shrink)

What follows is a dialogue, in the Platonic sense, concerning the justifications for "business ethics" as a vehicle for asking questions about the values of modern business organisations. The protagonists are the authors, Gordon Pearson – a pragmatist and sceptic where business ethics is concerned – and Martin Parker – a sociologist and idealist who wishes to be able to ask ethical questions of business. By the end of the dialogue we come to no agreement on the necessity or (...) justification for business ethics, but on the way discuss the uses of philosophy, the meanings of integrity and trust, McDonald''s, a hypothetical torture manufacturer and various other matters. (shrink)

An important role of the philosopher is to critically reflect on what is often taken for granted, using the tools of argument and analysis. This article engages with six different papers that offer critical reflections on conventional concepts and beliefs in bioethics regarding informed consent, continuous deep sedation, traditional moral theories underlying bioethical thinking, the definition of mental disease, and codes of ethics for particular medical specialties.

As an application of his Material Theory of Induction, Norton (2018; manuscript) argues that the correct inductive logic for a fair infinite lottery, and also for evaluating eternal inflation multiverse models, is radically different from standard probability theory. This is due to a requirement of label independence. It follows, Norton argues, that finite additivity fails, and any two sets of outcomes with the same cardinality and co-cardinality have the same chance. This makes the logic useless for evaluating multiverse models based (...) on self-locating chances, so Norton claims that we should despair of such attempts. However, his negative results depend on a certain reification of chance, consisting in the treatment of inductive support as the value of a function, a value not itself affected by relabeling. Here we define a purely comparative infinite lottery logic, where there are no primitive chances but only a relation of ‘at most as likely’ and its derivatives. This logic satisfies both label independence and a comparative version of additivity as well as several other desirable properties, and it draws finer distinctions between events than Norton's. Consequently, it yields better advice about choosing between sets of lottery tickets than Norton's, but it does not appear to be any more helpful for evaluating multiverse models. Hence, the limitations of Norton's logic are not entirely due to the failure of additivity, nor to the fact that all infinite, co-infinite sets of outcomes have the same chance, but to a more fundamental problem: We have no well-motivated way of comparing disjoint countably infinite sets. (shrink)

This paper illustrates a role that bioethics should play in developing and criticizing protocols for breast cancer genetic screening. It demonstrates how a critical bioethics, using approaches and reflecting concerns of contemporary philosophy of science and science studies, may critically interrogate the normative and conceptual schemes within which ethical considerations about such screening protocols are framed. By exploring various factors that influence the development of such protocols, including politics, cultural norms, and conceptions of disease, this paper and the critical bioethics' (...) approach it endorses illuminate and critically assess some of the competing worldviews informing protocol development. One of the frequently neglected worldviews in traditional bioethics' treatment of protocols concerning breast care is constituted by women's own views of their breasts and breast cancer, both within the technologically-oriented social practice of American medicine and in light of the social construction of their breasted experience in American society. This paper attempts to redress and critically assess this neglect on the part of traditional bioethics. Finally, in contrast to traditional bioethics, critical bioethics critically interrogates its own normative and conceptual commitments. In this final capacity, a critical bioethics' approach makes a valuable contribution to the evolution of bioethics. (shrink)

It is increasingly asserted that the disagreements of abstract principle between adversaries in the euthanasia debate fail to account for the complex, particular and ambiguous experiences of people at the end of their lives. A greater research effort into experiences, meaning, connection, vulnerability and motivation is advocated, during which the euthanasia 'question' should remain open. I argue that this is a normative strategy, which is felicitous to the status quo and further medicalises the end of life, but which masquerades as (...) a value-neutral assertion about needing more knowledge. (shrink)

Autonomy has been the central principle underpinning changes which have affected the practice of medicine in recent years. Medical education is undergoing changes as well, many of which are underpinned, at least implicitly, by increasing concern for autonomy. Some universities have embarked on graduate courses which utilize problem-based learning (PBL) techniques to teach all areas, including medical ethics. I argue that PBL is a desirable method for teaching and learning in medical ethics. It is desirable because the nature of ethical (...) enquiry is highly compatible with the learning processes which characterize PBL. But it is also desirable because it should help keep open the question of what autonomy really is, and how it should operate within the sphere of medical practice and medical education. (shrink)

Relativism in psychology unravels the truth-claims and oppressive\npractices of the discipline, but simply relativizing psychological knowledge\nhas not been sufficient to comprehend and combat the discipline\nas part of the ‘psy-complex’. For that, a balanced review of the contribution\nand problems of relativism needs to work dialectically, and so\nthis article reviews four problematic rhetorical balancing strategies in\nrelativism before turning to the contribution of critical realism. Critical\nrealism exposes positivist psychology’s pretensions to model itself\non what it imagines the natural sciences to be, and it grounds (...) discursive\naccounts of mentation in social practices. The problem is that those\nsympathetic to mainstream psychology are also appealing to ‘realism’\nto warrant it as a science and to discredit critical research that situates\npsychological phenomena. Our use of critical realism calls for an\naccount of how psychological facts are socially constructed within\npresent social arrangements and for an analysis of the underlying historical\nconditions that gave rise to the ‘psy-complex’. Only by understanding\nhow the discipline of psychology reproduces notions of\nindividuality and human nature, a critical realist endeavour, will it be\npossible to transform it, and to socially construct it as something different. (shrink)

This dialogue engages with the ethics of politics of capitalism, and enacts a debate between two participants who have divergent views on these matters. Beginning with a discussion concerning definitions of capitalism, it moves on to cover issues concerning our different understandings of the costs and benefits of global capitalist systems. This then leads into a debate about the nature and purposes of regulation, in terms of whether regulation is intended to make competition work better for consumers, or to prevent (...) negative outcomes for citizens. The conclusion speculates about the usefulness or otherwise of this Socratic method of dialogue. (shrink)

This paper presents a computational model that integrates a dynamically structured holographic memory system into the ACT-R cognitive architecture to explain how linguistic representations are encoded and accessed in memory. ACT-R currently serves as the most precise expression of the moment-by-moment working memory retrievals that support sentence comprehension. The ACT-R model of sentence comprehension is able to capture a range of linguistic phenomena, but there are cases where the model makes the wrong predictions, such as the over-prediction of retrieval interference (...) effects during sentence comprehension. Here, we investigate one such case involving the processing of sentences with negative polarity items and consider how a dynamically structured holographic memory system might provide a cognitively plausible and principled explanation of some previously unexplained effects. Specifically, we show that by replacing ACT-R's declarative memory with a dynamically structured memory, we can explain a wider range of behavioral data involving reading times and judgments of grammaticality. We show that our integrated model provides a better fit to human error rates and response latencies than the original ACT-R model. These results provide proof-of-concept for the unification of two independent computational cognitive frameworks. (shrink)

Ethics and Organizations provides a rich and valuable overview of an increasingly important issue for management and organizations in contemporary society. Debates about equal opportunities, environmental responsibility, consumer redress, and corporate governance have given ethics a prominent place in the study of organizations in their social and natural environments. Within the organization, new management styles that seek to energize employees by manipulating their beliefs have highlighted the moral-ethical principles at issue in contemporary management. At the same time, debates around postmodernism (...) and relativism have moved ethics to a new centrality in contemporary social theory. This volume addresses the questions that these and other developments raise for the study of management and organizations, from a multidisciplinary perspective. Ethics and Organizations will be invaluable to advanced-level students and academics engaged in analyzing the moral, political, and ethical dimensions of organization theory and organizational practice. (shrink)

Recent debates have led some to question the legitimacy of physicians refusing to provide legally permissible services for reasons of conscience. In this paper, I will explore the question of whether medical professionals have a collective duty to ensure that their profession provides nondiscriminatory access to all medical services. I will argue that they do not. I will also argue for an approach to dealing with intractable moral disagreements between patients and physicians that gives both parties veto power with regards (...) to participation. Finally, I will respond to three objections to allowing physicians broad freedom to act on their consciences: such allowances would violate the conscience of the patient, would lead to unfairness, and would thwart important societal goals. (shrink)

The clinical years of medical student education are an ideal time for students to practise and refine ethical thinking and behaviour. We piloted a new clinical ethics teaching activity this year with undergraduate medical students within the Rural Clinical School at the University of New South Wales. We used a modified teaching ward round model, with students bringing deidentified cases of ethical interest for round-table discussion. We found that students were more engaged in the subject of clinical ethics after attending (...) the teaching sessions and particularly appreciated having structured time to listen to and learn from their peers. Despite this, we found no change in student involvement in managing or planning action in situations that they find ethically challenging. A key challenge for educators in clinical ethics is to address the barriers that prevent students taking action. (shrink)

To increasing numbers of people, sustainability is the key challenge of the twenty-first century. In the many fields where it is a goal, persistent problems obstruct the efforts of those trying to make a difference. The task of this book is to provide an overview of the current state of philosophy in the context of what philosophy is, could be or should be – in relation to sustainability and the human future on Earth. The book is conceived as a contribution (...) to the UN Decade of Education for Sustainable Development, helping to link work on philosophy and sustainability. Critiquing Sustainability, Changing Philosophy focusses on the importance of philosophical work to the formation and effectiveness of global civil society and social movements for sustainability in the context of the Anthropocene age of the Earth. It takes a transdisciplinary systems approach that challenges philosophy and concludes by proposing a greatly enhanced role for philosophy in contributing to global public reason for sustainability. This book will be of interest to philosophers, sustainability practitioners and thinkers, policy makers and all those engaged in the global movement for sustainability. (shrink)

As described by the ancient metricians, catalexis is a matter of arithmetic rather than rhythm. They develop the idea in their usual way, mechanically and mathematically, adding and subtracting elements, so as to produce ‘brachycatalexis’ and ‘hypercatalexis’. These are now mere metrical-glossary terms, but in catalexismodern metricians have seen a genuine relationship between cola and a rhythmic effect more or less comprehensible even to us. Wilamowitz, T.D. Goodell, and A.M. Dale explore the concept to some extent, but current hand books (...) and general treatises give it only perfunctory and superficial treatment, while casual appearances of the term offer the reader glimpses of a theoretical substructure which hasnot been explicitly and coherently explained. (shrink)

The use of video for research purposes is something that has attracted ethical attention and debate. While the usefulness of video as a mechanism to collect data is widely agreed, the ethical sensitivity and impact of recording equipment is more contentious. In some clinical settings the presence of a camera has a dual role, as a portal to a reflecting team and as a recording device to obtain research data. Using data from one such setting, family therapy sessions, this article (...) shows how the role played by recording equipment is negotiated in the course of talk and other activities that constitute sessions. Analysis reveals that members of the therapy interaction orient in different ways and for different purposes to the value of recordings. The article concludes that there are layers of benefit to be derived from recording of clinical interactions, including for members themselves, and this has wider implications for the ways in which qualitative research designs in health sciences are evaluated. (shrink)

With the question “What is ' discourse?' “ as the starting point, this paper addresses ways of identifying particular discourses, and attends to how these discourses should be distinguished from texts. The emergence of discourse analysis within psychology, and the continuing influence of linguistic and post-structuralist ideas on practitioners, provide the basis on which discourse -analytic research can be developed fruitfully. This paper discusses the descriptive, analytic and educative functions of discourse analysis, and addresses the cultural and political questions which (...) arise when discourse analysts reflect on their activity. Suggestions for an adequate definition of discourse are proposed and supported by seven criteria which should be adopted to identify discourses, and which attend to contradictions between and within them. Three additional criteria are then suggested to relate discourse analysis to wider political issues. (shrink)