Money is a symbol. Beginning with this simple notion, we have completed a qualitative study of how money exists in people’s everyday lives and how it is used symbolically. A review of the financial, economic, psychological, and semiotic literature shows that even though money is written and talked about exhaustively, little symbol theory appears in economic writing, and we rarely found money mentioned in semiotic texts. We used a qualitative, phenomenological approach to identify critical thematic elements and underlying structures of (...) participants’ experience. We also incorporated an accepted symbol-structure template in our analysis of the functions, emotions, actions, and reactions in the transactions our participants described. Participants refer to money both as wealth in the abstract and as concrete amounts about to be used. Our analysis of money in the abstract describes a structure of experience involving belonging, privacy and secrecy, unequal distribution, quantitative uncertainty, reflections of life history, and values. Our analysis of money in the concrete reveals a symbolic intention and a variety of “Others” engaged in the symbolic action. (shrink)

For many children with complex medical conditions, decisions regarding their goals of care lie in the zone of parental discretion. That is, clinicians appropriately recognize that in many cases whether to prioritize quantity of life or quality of life is a deeply personal, values-laden decision best made by those who are most deeply invested in the outcome. Once a family has committed to a goal, however, there may be new or ongoing conflict between parents and clinicians regarding the specific interventions (...) provided or not provided in support of that goal. To what extent is it ethically permissible for a seriously ill child’s surrogate decision makers to reject individual interventions that support their desired goal of care? This question might be best described thus: is pediatric healthcare “prix fixe,” in which clinicians help parents decide the best of one or more set combinations (“menus”) of interventions, or is it “à la carte,” in which parents are free to accept or reject each individual intervention? We argue that the concept of a “prix fixe” approach should be discussed with families early in the development of the clinical relationship, as an essential facet of shared decision making. (shrink)

An individual's health, genetic, or environmental-exposure data, placed in an online repository, creates a valuable shared resource that can accelerate biomedical research and even open opportunities for crowd-sourcing discoveries by members of the public. But these data become “immortalized” in ways that may create lasting risk as well as benefit. Once shared on the Internet, the data are difficult or impossible to redact, and identities may be revealed by a process called data linkage, in which online data sets are matched (...) to each other. Reidentification, the process of associating an individual's name with data that were considered deidentified, poses risks such as insurance or employment discrimination, social stigma, and breach of the promises often made in informed-consent documents. At the same time, re-ID poses risks to researchers and indeed to the future of science, should re-ID end up undermining the trust and participation of potential research participants. The ethical challenges of online data sharing are heightened as so-called big data becomes an increasingly important research tool and driver of new research structures. Big data is shifting research to include large numbers of researchers and institutions as well as large numbers of participants providing diverse types of data, so the participants’ consent relationship is no longer with a person or even a research institution. In addition, consent is further transformed because big data analysis often begins with descriptive inquiry and generation of a hypothesis, and the research questions cannot be clearly defined at the outset and may be unforeseeable over the long term. In this article, we consider how expanded data sharing poses new challenges, illustrated by genomics and the transition to new models of consent. We draw on the experiences of participants in an open data platform—the Personal Genome Project—to allow study participants to contribute their voices to inform ethical consent practices and protocol reviews for big-data research. (shrink)

The two target articles in this issue bring into focus the struggle for governance over biomedical interventions that may offer some families more agency—the capacity to act—in the context of many...

Background: Nurses and midwives have a professional obligation to promote health and prevent disease, and therefore they have an essential role to play in vaccination. Despite this, some nurses and midwives have been found to take an anti-vaccination stance and promulgate misinformation about vaccines, often using Facebook as a platform to do so. Research question: This article reports on one component and dataset from a larger study – ‘the positives, perils and pitfalls of Facebook for nurses’. It explores the specific (...) issue of nurses and midwives who take an anti-vaccination stance, deemed to be unprofessional by crossing professional boundaries and by providing medical information on Facebook that is not within their scope of practice. Participants: Data were collected via an online worldwide survey from nurse and midwife participants, distributed and ‘snowballed’ through relevant nursing and midwifery groups on Facebook. In total, 1644 Registered Nurses and Midwives, and Enrolled Nurses worldwide attempted the online survey. There were 1100 (66.9%) completed surveys and 54 partially (33.1%) completed surveys. Semi-structured interviews were also conducted online using Skype® with 17 participants in Australia. Ethical considerations: Ethical processes and procedures have been adhered to relating to privacy, confidentiality and anonymity of the participants. Findings/results: A mixed-methods approach was used, including descriptive and content analysis of the quantitative survey data and thematic analysis of the qualitative interview data. The main theme ‘blurred boundaries’ was generated, which comprised three sub-themes: ‘follow the science, ‘abuse of power and erosion of trust’ and ‘the moral and ethical responsibility to safeguard public health’. The results offer an important and unique understanding of how nurses and midwives interpret the conduct of fellow health professionals as unprofessional and crossing the professional boundary if they used Facebook to promulgate anti-vaccination messages and/or give medical advice online. Conclusion: There are many positives and negatives for nurses and midwives associated with using Facebook for personal and professional communication, which is in keeping with the results of the larger study from which this article is taken. Professional behaviour is a key theme in the larger research as is the ethical construct of ‘every act has a consequence’; however, in this article, the theme ‘blurred boundaries’ offers an overall understanding of how nurses and midwives interpret the behaviour of their colleagues who espouse anti-vaccination sentiment and/or give medical advice online that is outside their scope of practice and education. (shrink)

Background Families whose child has unexplained intellectual or developmental differences often hope that a genetic diagnosis will lower barriers to community-based therapeutic and support services. However, there is little known about efforts to mobilize genetic information outside the clinic or how socioeconomic disadvantage shapes and constrains outcomes.Methods We conducted an ethnographic study with predominantly socioeconomically disadvantaged families enrolled in a multi-year genomics research study, including clinic observations and in-depth interviews in English and Spanish at multiple time points. Coding and thematic (...) development were used to collaboratively interpret fieldnotes and transcripts.Results Thirty-two families participated. Themes included familial expectations that a genetic diagnosis could be translated into information, understanding, and assistance to improve the quality of a child’s day-to-day life. After sequencing, however, genetic information was not readily converted into improved access to services beyond the clinic, with families often struggling to use a genetic diagnosis to advocate for their child.Conclusion Families’ ability to use a genetic diagnosis as an effective advocacy tool beyond the clinic was limited by the knowledge and resources available to them, and by the eligibility criteria used by therapeutic service providers’ – which focused on clinical diagnosis and functional criteria more than etiologic information. All families undertaking genomic testing, particularly those who are disadvantaged, need additional support to understand the limits and potential benefits of genetic information beyond the clinic. (shrink)

One barrier to optimal pain management in the neonatal intensive care unit (NICU) is how the healthcare community perceives, and therefore manages, neonatal pain. In this paper, we emphasise that healthcare professionals not only have a professional obligation to care for neonates in the NICU, but that these patients are intrinsically worthy of care. We discuss the conditions that make neonates worthy recipients of pain management by highlighting how neonates are (1) vulnerable to pain and harm, and (2) completely dependent (...) on others for pain management. We argue for a relational account of ethical decision-making in the NICU by demonstrating how an increase in vulnerability and dependence may be experienced by the healthcare community and the neonate’s family. Finally, an ethical framework for decisions around neonatal pain management is proposed, focussing on surrogate decision-making and the importance of compassionate action through both a reflective and an affective empathy. As empathy can be highly motivating against pain, we propose that, in addition to educational programs that raise awareness and knowledge of neonatal pain and pain management, healthcare professionals must cultivate empathy in a collective manner, where all members of the NICU team, including parents, are compassionate decision-makers. (shrink)

_Black Intellectual Thought in Education_ celebrates the exceptional academic contributions of African-American education scholars Anna Julia Cooper, Carter G. Woodson, and Alain Leroy Locke to the causes of social science, education, and democracy in America. By focusing on the lives and projects of these three figures specifically, it offers a powerful counter-narrative to the dominant, established discourse in education and critical social theory--helping to better serve the population that critical theory seeks to advocate. Rather than attempting to "rescue" a (...) few African American scholars from obscurity or marginalization, this powerful volume instead highlights ideas that must be probed and critically examined in order to deal with prevailing contemporary educational issues. Cooper, Woodson, and Locke’s history of engagement with race, democracy, education, gender and life is a dynamic, demanding, and authentic narrative for those engaged with these important issues. (shrink)

Over the past decade, Canadian media coverage of street sex work has steadily increased. The majority of this interest pertains to graphic violence against street sex workers, most notably from Vancouver, British Columbia. In this article, the authors analyze newspaper coverage that appeared in western Canadian publications between 2006 and 2009. In theorizing the violence both depicted and perpetrated by newspapers, the authors propose an analytic framework capable of attending to the process of othering in all of its complexity. To (...) this end, the authors supplement a Foucauldian analysis of abjection by considering the work of Judith Butler along with Julia Kristeva's conceptualization of abjection. Using excerpts from western Canadian newspapers, the authors illustrate how the media's discursive practices function as triggers for the process of cultural abjection by inscribing street sex workers with images of defilement. The authors argue that newspaper coverage of street sex workers reinforces the inviolability of normalized life by constantly reiterating the horror reserved for abjected bodies. (shrink)

Black Americans are underrepresented members of the US accounting academy (Brown-Liburd and Joe 2020). By interviewing Black accounting faculty about their experiences during their doctoral education and institutional hiring and promotion processes, we discover stories of degradation, stereotyping, and exclusion (i.e., microaggressions) that participants report negatively impact their views of the academic accounting profession and increase their turnover intentions. Microaggressions committed against Black accounting faculty may contribute to underrepresentation that can be addressed through enlightenment, education, and interaction. Our findings (...) are important as they fill gaps in related extant literature concerning the existence and impacts of microaggressions, and they may help improve diversity and equity in the accounting academy. (shrink)

In a recent judgment1 the Court of Protection was highly critical of health professionals for continuing to provide clinically-assisted nutrition and hydration in the face of disagreement about the patient’s best interests, without seeking to resolve the issue. This hearing had been set up specifically to consider whether GU’s dignity had been properly protected, and if not why not, given concerns raised by the Official Solicitor about what she considered to be “a complete abrogation of responsibility to consider properly or (...) at all, and to determine whether it was in GU’s best interests and therefore lawful to continue to give him an invasive medical treatment, CANH.” In April 2014, at 63 years old and living in Thailand, GU sustained severe injuries after suffering from an electrocution accident. He sustained a cardiorespiratory arrest with a significant delay before cardiopulmonary resuscitation was started and was unconscious and unresponsive. In September 2014 he was transferred to the UK. In August 2018, GU’s brother made a request for a best interests decision concerning the continuation of CANH. The family met to discuss this and all except GU’s son, agreed that continuing CANH was not in GU’s best interests. In view of the fact that there was not unanimity among the family, a decision was made that CANH should continue. Commenting on this decision, Mr Justice Hayden said ‘the apparent assumption that in the face of family disagreement ‘ therefore will continue to be cared for by nursing staff ” is a troubling non sequitur’ and stressed that ‘family dissent to a medical consensus should never stand in the way of an incapacitated patients’ best interests being properly identified’. He also made clear that the responsibility for ensuring that a best interests assessment is undertaken rests with the …. (shrink)

In considering this perennial question of the relationship between science and religion it is important to avoid any appearance—or reality—of burking the facts. When one speaks of science one speaks of science as it is understood, and as research is carried out in it, by specialists in the various fields; and it is the most honest and the wisest course to consider in each separate science what exactly the results amount to and what the theories represent.

Popular uprisings, indignant youth, toppled dictators, oligarchic presidents dismissed, hopes dashed, liberties crushed in prisons, fixed trials, and bloodbaths. How are we to read these images? Could revolt, or what is called “riot” on the Web, be waking humanity from its dream of hyperconnectedness? Or could it just be a trick played on us so that the culture of spectacle can last longer? But what “revolt” are we talking about? Is it even possible?

Two of the most important concepts in medicine are “curing” and “caring”. Patients should enter clinical trials with the understanding that they benefit from the treatment or that there may be some benefit to others. In many cancer trials, for example, the best that can be hoped for is a prolongation of life. Whether or not life is prolonged, we argue that there exists an obligation which can be termed a “bond of responsibility” to provide appropriate palliative care within the (...) patient’s own cultural context.The Declaration of Helsinki,1 the principal code governing the conduct of medical research, shows this “bond of responsibility” to be at its core. A number of statements stand out: “the health of my patient will be my first consideration”2 and “a physician shall only act in a patient’s best interest when providing medical care which might have the effect of weakening the physical and mental …. (shrink)

Structured as a self-standing course in philosophy, this book presents and examines selections from the primary works of 18 of the best known philosophers from ancient to modern times. Each chapter focuses on the writings of a different philosopher--from Plato to Nietzsche, Augustine to Sartre--and includes an introduction and critical commentary by one of the professors.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Complete Poems of Tibullus: An En Face Bilingual Edition by Rodney G. DennisRobert J. BallRodney G. Dennis and Michael C. J. Putnam, trans. The Complete Poems of Tibullus: An En Face Bilingual Edition. With intro. by J. Haig Gaisser. Berkeley: University of California Press, 2012. x + 159 pp. Hardcover, $52.95, Paperback, $20.95.This welcome edition of Tibullus’ elegies contains a two-page preface, a twenty-eight-page introduction, an en (...) face bilingual text and translation of the elegies of Tibullus, Lygdamus, and Sulpicia, a seven-page section of notes, a ten-page glossary, an appendix containing a text and translation of Ovid Amores 3.9 (Ovid’s memorial to Tibullus), a select bibliography, and a general index.As related in the preface, after the death of Rodney Dennis, Curator of Manuscripts for twenty-five years at Harvard University’s Houghton Library, Michael Putnam and Julia Gaisser agreed to bring to fruition the Tibullus translation Dennis had worked on, which Dennis had wanted Gaisser to help him perfect and for which he had wanted Putnam to write the introduction. Putnam and Gaisser decided to reverse the roles that had been envisioned for them by Dennis, with the revision of the translation (and the addition of the poetry of Lygdamus and Sulpicia) diligently executed by Putnam, Professor Emeritus of Classics at Brown University, and the introduction insightfully authored by Gaisser, Professor Emerita of Latin at Bryn Mawr College.Gaisser’s introduction examines 1) the world of the Roman elegists, especially how, in an era of brilliant poets, the elegists defined their genre; 2) the themes and characters in Tibullus’ elegies and how the characters help shape the [End Page 295] arrangement of his poems; and 3) what the elegies of Lygdamus and Sulpicia have and do not have in common with those of the other elegists. Gaisser’s fine comment, “His [Tibullus’] poems glide easily, some would say dreamily, from theme to theme, moving almost like a slide show through apparently random images and musings” (1), recalls statements of some of the poet’s admirers at the dawn of the twentieth century, such as Johannes Vahlen, who likened the movement of the elegies to the tide of a summer sea. Gaisser takes the middle ground, as appropriate, in seeing Tibullus as a poet who speaks through a persona, yet who has “some (perhaps many) points in common with his creator” (7)—as he very likely does—since even within the context of his alternate universe, he touches on the contemporary world, where he refers to people and events outside the poem’s web of self-reference. Yet one may question Gaisser’s unqualified comment that “Tibullus’ poetic techniques are Alexandrian at almost every level” (17)—a thesis developed by Francis Cairns based on Hellenistic evidence of a fragmentary nature, substantiated by Alexandrian elements in some of Tibullus’ verses but with little relevance to those elegies governed by non-Alexandrian literary sources.The bilingual text and translation include the sixteen elegies written by Tibullus (1.1–10 and 2.1–6), the six by Lygdamus (3.1–6), and the six by Sulpicia (3.13–18 = 4.7–12); not included are the Panegyric of Messalla (3.7 = 4.1), the Garland of Sulpicia (3.8–12 = 4.2–6), and the elegy and epigram of debatable authorship appearing at the end of the corpus (3.19–20 = 4.13–14). In preparing this edition of the elegies, Putnam has followed, appropriately, Georg Luck’s Teubner text (Stuttgart 1988, rev. in 1998)—a text containing the most complete list of Tibullus’ manuscripts ever assembled and the most extensive citation of variants and conjectures for the poems, which Putnam supplements with his own variants. Verse form presents a serious challenge for anyone attempting to translate classical poetry into English, inasmuch as classical meters are quantitative whereas English verse is accentual; although translations of classical verses into the original meters may well result in a metrical tour de force, they tend to have a jingly sound, which can obscure and overshadow the poet’s artistry. Philip Dunlop translated some of Tibullus’ elegies into free... (shrink)

The Tractatus de suppositionibus, which is cited by Gerald Odonis in his commentary on the Sentences, probably dates from ca. 1315-25. In the Sentences commentary he refers to his treatment of 'suppositio communicabilis' and its species, indicating a type of supposition whose language seems new. This article attempts to find a source for it in contemporary authors and arrives at the conclusion that 'communicabilis' is simply a synonym for 'personalis', the most common form of supposition according to Odonis.

Theologian. Conspirator. Martyr. Saint. Dietrich Bonhoeffer was killed in the waning days of World War II, having been implicated in the July 20th assassination attempt on Hitler. Since his death, Bonhoeffer’s life and writings have inspired contradictory responses. He is often seen as a model for Christian pacifist resistance, and more recently for violent direct political action. Bonhoeffer’s name has been invoked by violent anti-abortion protestors as well as political leaders calling for support on a ‘war on terror’ in the (...) aftermath of 9/11. Petra Brown critically analyses Bonhoeffer’s writing preceding and during his conspiracy involvement, particularly his recurring concept of the ‘extraordinary.’ Brown examines this idea in light of ‘the state of exception,’ a concept coined by the one-time Nazi jurist and political theorist, Carl Schmitt. She also draws on the existentialist philosopher Sören Kierkegaard to consider what happens when discipleship is understood as obedience to a divine command. This book aims to complicate an unreflective admiration of Bonhoeffer’s decision for conspiracy, and draws attention to the potentially dangerous implications of his emerging political theology. (shrink)

Synesthesia is a fascinating phenomenon which has captured the imagination of scientists and artists alike. This inherited condition gives rise to a kind of 'merging of the senses. The Oxford Handbook of Synesthesia brings together a broad body of knowledge about this conditions into one definitive state-of-the-art handbook.