With the world's population aging, hospitals are facing pressure to adequately meet the needs of a growing number of frail older patients. For this population, comorbidities combined with a limited ability to face stressful situations contribute to frailty whereby a small injury or illness can lead to significant loss of function. It is widely recognized that hospitalized older patients are more vulnerable to physical or cognitive functional decline and require increased assistance in activities of daily living (Creditor 1993; Sager et (...) al. 1996; Mahoney, Sager, and Jalaluddin 1998; Kortebein et al. 2008; English and PaddonJones 2010; Covinsky, Pierluissi, and Johnston 2011; Zisberg et al. 2011;... (shrink)

In _Beyond Animal Rights_, Josephine Donovan and Carol J. Adams introduced feminist "ethic of care" theory into philosophical discussions of the treatment of animals. In this new volume, seven essays from _Beyond Animal Rights_ are joined by nine new articles-most of which were written in response to that book-and a new introduction that situates feminist animal care theory within feminist theory and the larger debate over animal rights. Contributors critique theorists' reliance on natural rights doctrine and utilitarianism, which, they (...) suggest, have a masculine bias. They argue for ethical attentiveness and sympathy in our relationships with animals and propose a link between the continuing subjugation of women and the human domination of nature. Beginning with the earliest articulation of the idea in the mid-1980s and continuing to the theory's most recent revisions, this volume presents the most complete portrait of the evolution of the feminist-care tradition. (shrink)

It is simple enough to claim that academic research institutions ought to be trustworthy. Building the culture and taking the steps necessary to earn and preserve institutional trust are, however, complex processes. The experience motivating this special report—a request for the Center for Talented Youth at Johns Hopkins University to collaborate on research regarding the genetics of intelligence—illustrates how ensuring institutional trustworthiness can be in tension with a commitment to fostering research. In this essay, we explore the historical context for (...) biomedical research institutions like Johns Hopkins that have worked to build local community trust. In so doing, we consider how the example under focus in this special report can lead to greater consideration of how research institutions balance fostering trust with their other commitments. (shrink)

As you might guess, the words goodness, truth, and beauty are not of heavy poetic value today. Terms of concept may be stressed again someday, and maybe soon, but at the moment have gone out of poetry in favor of more concreteness, more imagery, more connotative suggestion, less effect of the naming and labeling virtues, which Ezra Pound and other twentieth-century leaders have told us not to use. But actually these terms of abstract concept were lessened in major usage in (...) poetry long before the twentieth century. They had flourished in a setting of kings and courts. The love poetry, the political poetry, the philosophic poetry not only dealt directly with truth and goodness but used them constantly for evaluative commentary of other subjects. People, as well as moral issues, were good; lovers, as well as propositions, were true . . . Love and honor, good and true, these were terms of value in which poetry worked so strongly that a large proportion of its reference was limited to these alone, and so thoroughly that there was not a poet in the sixteenth and seventeenth centuries who did not share in this emphasis. Josephine Miles is a poet, critic, and University Professor of English at Berkeley. Her works of criticism include The Vocabulary of Poetry, The Continuity of Poetic Language, Eras and Modes in English Poetry, Style and Proportion, and Poetry and Change. She is also the author of a number of books of poems, from Lines at Intersection to Poems 1930-60, Kinds of Affection , and To All Appearances. (shrink)

Contains eight contributions which extend feminist ethic-of-care theory to the issue of animal well-being. As a group, the essays aim to suggest ways that theorists can move beyond the notion of animal rights to establish care as a basis for the ethical treatment of animals. Annotation c. by Book.

Maiese and Hanna (2019) argue that social institutions shape and transform our embodied minds, and that detrimental and harmful institutions can be reverted in order to promote mentally healthy, authentic, and fulfilling lives. This commentary aims to complement this proposal by understanding the role that narratives and narrative practices play in shaping our embodied minds, by highlighting narrativity’s (1) active, deliberative, and productive functions, and (2) its strong entanglement with embodiment. We will argue that this addition to Maiese and Hanna’s (...) account allows agents to assume a more active role within social institutions by engaging in conscious and deliberative self-narration. This is because, we contend, not only do we understand ourselves and others according to cultural narrative archetypes; we also, crucially, bring about concrete changes in our embodiment and behavior by narrative deliberation and intention formation. As such, self-narration is not only an intellectual endeavor, but can also have profound consequences for how we experience the world; in other words, narrative practices can purposefully alter our affective framing which, in Maiese and Hanna’s account, is fundamental in the process of changing detrimental institutions into constructive, enabling institutions. (shrink)

Over the years, companies have adopted hiring algorithms because they promise wider job candidate pools, lower recruitment costs and less human bias. Despite these promises, they also bring perils. Using them can inflict unintentional harms on individual human rights. These include the five human rights to work, equality and nondiscrimination, privacy, free expression and free association. Despite the human rights harms of hiring algorithms, the AI ethics literature has predominantly focused on abstract ethical principles. This is problematic for two reasons. (...) First, AI principles have been criticized for being vague and not actionable. Second, the use of vague ethical principles to discuss algorithmic risks does not provide any accountability. This lack of accountability creates an algorithmic accountability gap. Closing this gap is crucial because, without accountability, the use of hiring algorithms can lead to discrimination and unequal access to employment opportunities. This paper makes two contributions to the AI ethics literature. First, it frames the ethical risks of hiring algorithms using international human rights law as a universal standard for determining algorithmic accountability. Second, it evaluates four types of algorithmic impact assessments in terms of how effectively they address the five human rights of job applicants implicated in hiring algorithms. It determines which of the assessments can help companies audit their hiring algorithms and close the algorithmic accountability gap. (shrink)

In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some (...) clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy—they just don't talk about it. And while the decision whether to agree to prenatal screening and diagnostic testing is to be made with women's free and informed consent, many screening tests have been routinized in such a way that some women do not even recall agreeing to testing, while others feel that agreeing to testing is what their clinicians expect of them or that the testing is necessary to protect themselves and their families from the significant financial hardship of raising a child with a disability. In the face of these pressures, can one really say that women are freely choosing to undergo testing or are freely choosing to continue or terminate a pregnancy following receipt of test results? The reality of these pressures is requiring us to consider expanding the scope of our investigation beyond the clinical encounter to the broader context—to think harder about what reproductive autonomy means and how best to enhance it. (shrink)

Résumé Dans les situations sociomotrices, l’engagement des participants n’est pas seulement réductible aux communications directes. Il est surtout lié à l’émergence de systèmes de signes assurant la dynamique globale du jeu. Nous proposons d’appréhender la communication comme un système d’interaction global constitué de plusieurs canaux. On y retrouve les communications directes mais aussi quatre systèmes de signes : celui des praxèmes, des gestèmes, des gestes et des communications verbales. Ce travail interroge la place de chaque canal communicationnel dans deux sports (...) et deux jeux traditionnels. Nous recrutons trois groupes de 20 étudiants pour participer aux jeux mentionnés. Les communications sont filmées, décryptées, triées et catégorisées. On constate une forte prévalence des praxèmes dans les sports collectifs, tandis que la répartition des communications est plus équilibrée dans les jeux traditionnels. La quantité, la variabilité et l’organisation des signes sont sensibles à la logique interne. Globalement, cette recherche tend à montrer que les jeux sont un formidable laboratoire in vivo pour comprendre l’organisation des systèmes de signes. Spécifiquement, elle apporte des informations sur le pouvoir socialisant de la sémiotricité de chaque jeu et sur le renouvellement des pédagogies qu’elle peut engendrer. (shrink)

L’Union européenne nous invite à repenser les conditions et les attributs de la souveraineté traditionnellement rattachée aux États-nations. Dans cet article, est proposée une tentative de re-conceptualisation à partir des différentes définitions de la souveraineté, et de l’analyse d’un exemple : celui de la politique étrangère et de l’exercice diplomatique de l’Union européenne. En effet, la souveraineté possède toujours deux faces : une face interne qui se charge de définir la loi, le droit, et de les faire appliquer sur un (...) territoire délimité ; une face externe qui exporte et affirme les intérêts, les valeurs et les principes qui prévalent en interne. La politique étrangère et son outil principal qu’est l’action diplomatique, consistent dans l’expression vers l’extérieur de la souveraineté d’un corps politique. Nous nous interrogerons ainsi sur la nature de la souveraineté incarnée par l’Union européenne. (shrink)

Decoding Abortion Rhetoric: Communicating Social Change. By Celeste Michelle Condit.

The authors aim in this article to show why it is extremely difficult to expect representatives of missionary religions to engage in productive interreligious dialogue. The article demonstrates how the imperative to convert, which is rooted in a sense of epistemic authority that one holds the best version of truth, precludes interreligious dialogue among religionists. The authors note, on the one hand, that the primary condition for any dialogue is that each of those involved come to the dialogue intellectually humble. (...) On the other hand, the authors note that for missionary religionists to embrace intellectual humility requires a fundamental rethink of their claims of epistemological certainty and final epistemic authority. This implies abandoning the missionary mandate and witnessing built on a sense of intellectual certainty and pride. The authors therefore argue that intellectual humility is a necessary condition for productive interreligious dialogue. Because representatives of missionary religions claim certainty about the knowledge they espouse, what is paraded as interreligious dialogue is largely a myth. It will remain a mere concept that yields little to no tangible result unless these representatives embrace intellectual humility, which is more achievable within a secularist framework.Contribution: This research contributes to the seemingly easy but difficult discourse and practice about interreligious dialogue. It brings to the limelight a more appropriate conception of dialogue in the context of interreligious dialogue, and explains how side-lining that conception empties the predominant practice of interreligous dialogue. This contribution is useful to HTS, which focuses on theological and religious studies, as well as critical study of religions. (shrink)

One argument Robert and Baylis do not raise in their article on the creation of interspecies chimeras using human cellular material is that the creation of these chimeras would, or could, offend human dignity. Yet, human dignity is one of the most common concerns raised in public debates, academic arguments, and policy documents regarding biotechnology in general, and the creation animal-human chimeras in particular. … The concept is ill-defined within bioethics and … risks being dismissed as meaningless or uselessly vague. (...) However, this lack of definition should not yet cause us to abandon or ignore human dignity. At least in arguments about creating chimeras, an examination of what may be meant by appeals to human dignity can uncover important concerns or arguments that are not captured by other formulations of the debate. (shrink)

Since 1980, the number of twin births in the United States has increased 76 percent, and the number of triplets or higher‐order multiples has increased over 400 percent. These increases are due in part to increased maternal age, which is associated with spontaneous twinning. But the primary reason for these increases is that more and more people are undergoing fertility treatment. Despite an emerging (but not absolute) consensus in the medical literature that multiples, including twins, should be a far less (...) frequent outcome of fertility treatment, American clinicians currently practice fertility medicine in ways likely to result in twins and, occasionally, triplets—often, they tell us, at the request of their patients. At first blush, one might conclude that these practice patterns show that patients and their doctors have weighed the risks associated with twins against the benefits of swiftly completing their families and decided that the risks are worth taking. That is, their requests for twins must represent their free and informed choices. But there are reasons to be skeptical of this interpretation, including that the preferences of many patients seem to be very strongly shaped, if not sometimes completely constrained, by concerns about costs—costs that mainly result from the routine exclusion of in vitro fertilization from health insurance coverage. It is quite possible, we believe, that these cost concerns actually undermine the autonomy of fertility patients, pushing many of them to take risks with their health and the health of their hoped‐for future children. (shrink)

Until recently, medicine has had little to offer most of the millions of patients suffering from rare and ultrarare genetic conditions. But the development in 2019 of Milasen, the first genetic intervention developed for and administered to a single patient suffering from an ultrarare genetic disorder, has offered hope to patients and families. In addition, Milasen raised a series of conceptual and ethical questions about how individualised genetic interventions should be developed, assessed for safety and efficacy and financially supported. The (...) answers to these questions depend in large part on whether individualised therapies are understood as human subjects research or clinical innovation, different domains of biomedicine that are regulated by different modes of oversight, funding and professional norms. In this article, with development and administration of the drug Milasen as our case study, we argue that at least some individualised genetic therapies are not, as some have argued, either research or treatment. Instead, they are research-treatment hybrids, a category that has both epistemological and pragmatic repercussions for funding, ethics oversight and regulation. (shrink)

Laffin, Josephine The archbishop of Adelaide, it must be acknowledged, did not play a prominent role at Vatican II. Matthew Beovich never gave a speech in the aula, the Council 'hall' inside St Peter's Basilica, nor did he prepare a written submission. At first glance, his seemingly minimal participation reinforces the damning judgment of Patrick O'Farrell that members of the Australian hierarchy were 'frequently uncomprehending and even resistant to the spirit of change'. With this from the doyen of Catholic (...) historians in Australia in the late twentieth century, it is not surprising that Ian Breward concluded in his survey of Australian religious history: 'Most Australian bishops were bemused observers of a process which shattered their convictions about the uniformity of the Roman Catholic Church. Australian contributions to Council debates were few. The pragmatism and traditionalism of the Australian Church stood nakedly exposed'. (shrink)

Trying to obtain a medical history from a patient, I listen to her story. She’s a difficult patient, as in noncompliant, narcotic-seeking chronic-pain-in-the-ass patient. There’s a Physician’s Field Guide to the Difficult Patient, a chapter for each type. If you stop to listen, to question the words used, you may never finish this medical..

The theoretical value of talking to the media isn’t hard to appreciate. Who doesn’t want to shape the public conversation, whether to make it more nuanced and reasoned or to bring injustice and wrongdoing to light? Issues you’ve studied are in the news and you get to be the expert, pointing out what’s wrong, or right, or offering another way of thinking about a difficult question. If you’re lucky, you get your name in print—and in a publication your friends and (...) family actually read. But it can also be intimidating. I used to feel like the hapless witness about to be cross-examined by the wily attorney. I’d heard about the twenty-four-hour news cycle and the push to appeal to the lowest common denominator. .. (shrink)

In recent years, we have been observing the phenomenon of an emerging scientific field: _digital transformation research_ (DTR). Due to the diversity and complexity of its object of research digital, transformation is not effectively researchable if confined to the boundaries of individual disciplines. In the light of Scientific/Intellectual Movement theory (Frickel and Gross 2005 ), we wonder how interdisciplinarity could and should be mobilized to further advance the development of the field of DTR. To answer this question, we (a) need (...) to understand how interdisciplinarity is conceived and (b) how it is considered in research practice by researchers in the emerging field. This is important, as scientists’ application of interdisciplinarity will highly influence an emerging field, shape its growth, consolidation as well as its academic establishment. We conducted six group discussions with 26 researchers from different disciplines and career levels (PhD students, postdocs, professors). The discussions were studied with a structuring qualitative content analysis. The results reflect the vagueness of the concept of interdisciplinarity. Interdisciplinarity is largely conceived as multidisciplinarity. Further, the interviewees mentioned more challenges than opportunities when it comes to interdisciplinary DTR. The present study widens the scientific understanding about how researchers of different career levels perceive, learn, and practice interdisciplinarity in DTR. It further provides valuable indications of how interdisciplinary research in an emerging field can be profitably shaped for practice. (shrink)

This article is the lead piece in a special report that presents the results of a bioethical investigation into chimeric research, which involves the insertion of human cells into nonhuman animals and nonhuman animal embryos, including into their brains. Rapid scientific developments in this field may advance knowledge and could lead to new therapies for humans. They also reveal the conceptual, ethical, and procedural limitations of existing ethics guidance for human‐nonhuman chimeric research. Led by bioethics researchers working closely with an (...) interdisciplinary work group, the investigation focused on generating conceptual clarity and identifying improvements to governance approaches, with the goal of helping scholars, funders, scientists, institutional leaders, and oversight bodies (embryonic stem cell research oversight [ESCRO] committees and institutional animal care and use committees [IACUCs]) deliver principled and trustworthy oversight of this area of science. The article, which focuses on human‐nonhuman animal chimeric research that is stem cell based, identifies key ethical issues in and offers ten recommendations regarding the ethics and oversight of this research. Turning from bioethics’ previous focus on human‐centered questions about the ethics of “humanization” and this research's potential impact on concepts like human dignity, this article emphasizes the importance of nonhuman animal welfare concerns in chimeric research and argues for less‐siloed governance and oversight and more‐comprehensive public communication. (shrink)