Confidentiality is a cornerstone of the physician-patient relationship. Breaches of confidentiality in the context of genetic testing are of particular concern for a number of reasons. First, genetic testing reveals information not only about a particular patient, but also about his or her family members. Second,genetic testing can label healthy people as “at risk,” subjecting them to possible stigmatization or discrimination by third parties. Third, as genetic testing becomes more widespread and is incorporated into primary care, breaches of confidentiality might (...) inadvertently occur more frequently because primary care providers may not be trained to understand the uniqueness of genetic information. Until now, genetic services have been provided primarily by medical geneticists and genetic counselors. However, with the proliferation of new genetic presymptomatic and carrier tests, primary care physicians are going to become increasingly involved in genetic testing. Currently, little is known about physicians’ attitudes toward disclosure of confidential genetic information to third parties. (shrink)

Though antiretroviral therapy is the standard of care for people living with HIV, its treatment limitations, burdens, stigma and costs lead to continued interest in HIV cure research. Early-phase cure trials, particularly those that include analytic treatment interruption, involve uncertain and potentially high risk, with minimal chance of clinical benefit. Some question whether such trials should be offered, given the risk/benefit imbalance, and whether those who choose to participate are acting rationally. We address these questions through a longitudinal decision-making study (...) nested in a Thai acute HIV research cohort. In-depth interviews revealed central themes about decisions to join. Participants felt they possessed an important identity as members of the acute cohort, viewing their bodies as uniquely suited to both testing and potentially benefiting from HIV cure approaches. While acknowledging risks of ATI, most perceived they were given an opportunity to interrupt treatment, to test their own bodies and increase normalcy in a safe, highly monitored circumstance. They were motivated by potential benefits to themselves, the investigators and larger acute cohort, and others with HIV. They believed their own trial experiences and being able to give back to the community were sufficient to offset participation risks. These decisions were driven by the specific circumstances experienced by our participants. Judging risk/benefit ratios without appreciating these lived experiences can lead to false determinations of irrational decision- making. While this does not minimise vital oversight considerations about risk reduction and protection from harm, it argues for inclusion of a more participant-centered approach. (shrink)

Delivering high quality genomics-informed care to patients requires accurate test results whose clinical implications are understood. While other actors, including state agencies, professional organizations, and clinicians, are involved, this article focuses on the extent to which the federal agencies that play the most prominent roles — the Centers for Medicare and Medicaid Services enforcing CLIA and the FDA — effectively ensure that these elements are met and concludes by suggesting possible ways to improve their oversight of genomic testing.

While questions about the environmental sustainability of contemporary farming practices and the socioeconomic viability of rural communities are attracting increasing attention throughout the US, these two issues are rarely considered together. This paper explores the current and potential connections between these two aspects of sustainability, using data on community members’ and farmers’ views of agricultural issues in California’s Central Valley. These views were collected from a series of individual and group interviews with biologically oriented and conventional farmers as well as (...) community stakeholders. Local marketing, farmland preservation, and perceptions of sustainable agriculture comprised the primary topics of discussion. The mixed results indicate that, while many farmers and community members have a strong interest in these topics, sustainable community development and the use of sustainable farming practices are seldom explicitly linked. On the other hand, many separate efforts around the Valley to increase local marketing and agritourism, improve public education about agriculture, and organize grassroots farmland preservation initiatives were documented. We conclude that linking these efforts more explicitly to sustainable agriculture and promoting more engagement between ecologically oriented farmers and their communities could engender more economic and political support for these farmers, helping them and their communities to achieve greater sustainability in the long run. (shrink)

: This response seeks to pick up on the key questions and concerns raised by Nancy C. M. Hartsock and Karen Houle in their critiques of The Spectacle of Violence. I mold my response around two emotions that are never far from the question of violence: fear and hope. Is it fear of ambiguity that stops us from delicately blending the experiential with the discursive, the nodal with the circular, the corporeal with the epistemic, or the oppressive with the (...) constitutive? If so, we can only hope that the power of such ambivalence lies in its ability to unsettle these treasured lines of force. (shrink)

The general conceit of Schiller’s aesthetic education is that our experiences with art and beauty set us free from internal and external constraints and allow us to embrace our full humanity as rational and sensuous beings. Experiencing the aesthetic, or the play impulse, puts one in a state of aesthetic determinacy—or rather indeterminacy—that Schiller calls the highest sense of freedom, aesthetic freedom. Gail K. Hart examines Anthony Burgess’s A Clockwork Orange as an example of what Schillerian aesthetic education might (...) look like in practice. Though it represents a distortion of Schiller’s aesthetic education, Hart argues that it also reveals an ineradicable element of coercion in aesthetic education. I argue that Burgess’s Ludovico Technique leaves out a key element of Schiller’s conception of aesthetic cultivation—play—and that Hart’s analysis of Schiller’s work likewise lacks a robust analysis of his notion of play. I argue that, when Schiller’s account of the play impulse is taken seriously as a necessary condition for aesthetic cultivation to take place, coercion is by definition made impossible. Aesthetic play is accomplished by the mutual destruction of physical and moral determinations, and this mutual erasure leads to a higher and more expansive freedom. External constraints and coercion cannot induce the aesthetic state, so aesthetic education as Schiller presents it in On the Aesthetic Education of Man cannot contain the element of coercion Hart suspects. (shrink)

: In this essay, Houle focuses in on the ways in which a Foucauldian-framed account of violence, such as the one Gail Mason offers in Spectacles of Violence, rattles liberal (theoretical and 'common-sensical') understandings of culpability and lawfulness. Mason's analysis dares to suggest that violence is constitutive, not simply destructive of selves, of lives. Asking after the ways in which that constitution is asymmetrical in events of violence, Houle reintroduce some cautions and concerns about drawing from a poststructuralist perspective. (...) This, in turn, raises the question as to which ontology of the self such a rebalancing requires. The essays ends by making use of Mason's own distinction between our selves as 'who' and 'what,' to give a modified reading of the ways these aspects of selfhood are constituted or made possible in events of violence, which does not fall back upon the liberal conception of the self. (shrink)

It is an ancient view, to be found even in Aristotle’s analysis of friendship, that the other is an alter ego, another myself. More recently, this conception has provoked spirited debate within and without the phenomenological tradition. It can be found in a wide variety of texts, from Husserl’s Cartesian Meditations to Thomas Nagel’s “What is it like to be a bat?” The basic position can be summarized as follows. Intentional experiences are subjective, first-person experiences, not objective, third-person experiences.

This paper is a counter to the view that names are always predicates with the same extension as a metalinguistic predicate with the form “is a thing called “N”” (the Predicate View). The Predicate View is in opposition to the Referential View of names. In this paper, I undermine one argument for the Predicate View. The Predicate View’s adherents take examples of uses of names that have the surface appearance of a predicate and generalise from these to treat uses of (...) names that do not have the surface appearance of a predicate. They show that the Predicate View can provide a unified account of these two uses and assume that the Referential account cannot. I propose an alternative view of names, the Polysemy View. This view allows one to resist the pressure to generalise from the cases with the surface appearance of predicates to all uses of names while nevertheless providing connections between the uses. On the Polysemy View names are not, in their core use, metalinguistic predicates. Names are predominantly referring expressions but they also freelance as metalinguistic predicates on occasion. They have a double life. This double life is possible because of the pragmatic and conventional connections between the two aspects of that life. My main aim in this paper is to show that the Predicate View is not the only view that can give a good account of apparently predicative uses of names. In addition, I offer some inconclusive reasons to prefer the Polysemy View over the Predicate View. My paper assumes a background framework that the Predicate and Referentialist Views share and I do not attempt to justify that framework. I ignore many other views of names (notably descriptivist views and relevance theoretic views) in order to focus on the debate between these two opponents. (shrink)

If social, political, and material transformation is to have a lasting impact on individuals and society, it must be integrated within ordinary experience. Refiguring the Ordinary examines the ways in which individuals' bodies, habits, environments, and abilities function as horizons that underpin their understandings of the ordinary. These features of experience, according to Gail Weiss, are never neutral, but are always affected by gender, race, social class, ethnicity, nationality, and perceptions of bodily normality. While no two people will experience (...) the ordinary in exactly the same way, the multiplicities, possibilities, overlaps, and limitations of day-to-day horizons are always intersubjectively constituted. Weiss turns her attention to changing the conditions and experiences of oppression from ordinary to extraordinary. This book is an impressive phenomenological, feminist reading of the complexities of human experience.M. V. Marder, University of Toronto, Feb. 2009. (shrink)

Existing metasemantic projects presuppose that word- (or sentence-) types are part of the non-semantic base. We propose a new strategy: an endogenous account of word types, that is, one where word types are fixed as part of the metasemantics. On this view, it is the conventions of truthfulness and trust that ground not only the meaning of the words (meaning by convention) but also what the word type is of each particular token utterance (words by convention). The same treatment extends (...) to identifying the populations through which the conventions prevail. We consider whether this proposal leads to new underdetermination challenges for metasemantics, and make a case that it does not. (shrink)

ACCORDING TO HUSSERL, THE REVOLUTION brought about by the new mathematical science of the seventeenth century was primarily an ontological one: a shift in the conception of the real. That Husserl opposes the new Galilean-Cartesian ontology is clear. This much is evident from the potent rhetoric of the Crisis declaiming Galileo as an "entdeckender und verdeckender Genius", forgetful of the lifeworld, failing to grasp what the mathematical-empirical method he brought to such a degree of perfection actually achieves. Indeed, even without (...) the ringing Crisis passages, one could already expect that Husserl, the phenomenologist, would oppose the Platonizing scientific realism of a Galileo or a Descartes. However, Husserl's critique of Galileo poses many puzzling questions, questions which are not directly addressed in the Crisis, and which can be answered only in terms of the broader position outlined by Husserl elsewhere. To whit: what is the more precise content of Husserl's objections against Galileo, and how are these justified? Further, if scientific realism is to be rejected on phenomenological grounds, does this imply that a phenomenological approach is necessarily instrumentalist? Finally, what solution does Husserl's thought offer to the realism/instrumentalism debate? (shrink)

This study explores gratitude as a multidimensional and work-specific construct. Utilizing a sample of 625 employees from a variety of positions in a medium-sized school district in the United States, we developed and evaluated a new measure, namely the Work Gratitude Scale, which encompasses recognized conative, cognitive, affective, and social aspects of gratitude. A systematic, six-phased approach through structural equation modeling was used to explore and confirm the factorial structure, internal consistency, measurement invariance, concurrent, convergent, and discriminant validity of the (...) WGS. The results supported a 10-item measure with three dimensions: “grateful appraisals”, “gratitude toward others”, and “intentional attitude of gratitude”. Thereafter, first-order, second-order, and bifactor confirmatory models were estimated and compared. Work gratitude was found to be best described by a second-order construct with three underlying first-order dimensions. Measurement invariance was supported in relation to gender. Concurrent validity was supported in relation to two existing dispositional gratitude scales, namely the Gratitude Questionnaire and the Gratitude, Resentment, and Appreciation Scale. Convergent validity was supported in relation to the Core Self-Evaluations Scale and the Psychological Capital Questionnaire. Discriminant validity was supported in relation to various demographic factors such as age, gender, occupation, and tenure. The findings support the WGS as a multidimensional measure that can be used in practice to measure overall work-related gratitude and to track the effectiveness of gratitude-related workplace interventions. (shrink)

IN SCIENCE, PERCEPTION, AND REALITY, Sellars marvels at the power of fashion in philosophy, which all too often offers us the spectacle of a stampede rather than a careful sifting of gold from dross. Sellars was worried that the flight from phenomenalism would lead to the familiar pendulum effect and so thwart his effort to “usher analytic philosophy out of its Humean and into its Kantian stage,” as Rorty has put it. Accordingly, Sellars’s critique of the Myth of the Given (...) aimed to show that what was really wrong with phenomenalism was nothing particular to the sense-data of the positivists but the framework of givenness itself. (shrink)

Lecturer in social foundations of education and women's studies, Victoria College, Australia.

The multifaceted work of the late Susan Leigh Star is explored through a selection of her writings and essays by friends and colleagues. Susan Leigh Star (1954–2010) was one of the most influential science studies scholars of the last several decades. In her work, Star highlighted the messy practices of discovering science, asking hard questions about the marginalizing as well as the liberating powers of science and technology. In the landmark work Sorting Things Out, Star and Geoffrey Bowker revealed the (...) social and ethical histories that are deeply embedded in classification systems. Star's most celebrated concept was the notion of boundary objects: representational forms—things or theories—that can be shared between different communities, with each holding its own understanding of the representation. Unfortunately, Leigh was unable to complete a work on the poetics of infrastructure that further developed the full range of her work. This volume collects articles by Star that set out some of her thinking on boundary objects, marginality, and infrastructure, together with essays by friends and colleagues from a range of disciplines—from philosophy of science to organization science—that testify to the wide-ranging influence of Star's work. Contributors Ellen Balka, Eevi E. Beck, Dick Boland, Geoffrey C. Bowker, Janet Ceja Alcalá, Adele E. Clarke, Les Gasser, James R. Griesemer, Gail Hornstein, John Leslie King, Cheris Kramarae, Maria Puig de la Bellacasa, Karen Ruhleder, Kjeld Schmidt, Brian Cantwell Smith, Susan Leigh Star, Anselm L. Strauss, Jane Summerton, Stefan Timmermans, Helen Verran, Nina Wakeford, Jutta Weber. (shrink)

Since her death in 1986 and the publication of her letters and diaries in 1990, interest in the philosophy of Simone de Beauvoir has never been greater. In this engaging and timely volume, Margaret A. Simons and an international group of philosophers present 16 essays that reveal Beauvoir as one of the century’s most important and influential thinkers. As they set Beauvoir’s work into dialogue with Husserl, Merleau-Ponty, Heidegger, Foucault, Levinas, and others, these essays consider questions such as Beauvoir’s philosophical (...) relationship with Sartre; her ethic of the erotic; her views on marriage, motherhood, and female friendship; and her interpretations of oppression and liberation. This book discusses the full range of Beauvoir’s work, including The Second Sex, her unpublished diaries, autobiographical writings, novels, and philosophical essays, and broadens the scope and interpretive context of her unique philosophy. Contributors are Nancy Bauer, Debra Bergoffen, Suzanne Laba Cataldi, Edward Fullbrook, Eva Gothlin, Sara Heinämaa, Laura Hengehold, Stacy Keltner, Michèle Le Doeuff, Ann Murphy, Shannon M. Mussett, Margaret A. Simons, Ursula Tidd, Andrea Veltman, Karen Vintges, Julie Ward, Gail Weiss. (shrink)

Little is known about health care professionals’ perceptions regarding what it means to treat patients and families with respect and dignity in the intensive care unit (ICU) setting. To address this gap, we conducted nine focus groups with different types of health care professionals (attending physicians, residents/fellows, nurses, social workers, pastoral care, etc.) working in either a medical or surgical ICU within the same academic health system. We identified three major thematic domains, namely, intrapersonal (attitudes and beliefs), interpersonal (behaviors), and (...) system (contextual) factors that influence treatment with respect and dignity. Participants suggested strategies for improving treatment of patients and families in the ICU with respect and dignity, as well as the related need for enhancing respect among the multidisciplinary team of clinicians. Implementing these strategies will require innovative educational interventions and leadership. Future research should focus on the design and evaluation of such interventions on the quality of care. (shrink)

The article explores E.M. Forster’s story The Machine Stops as an example of dystopian literature and its possible associations with the use of technology and with today’s cyber culture. Dystopian societies are often characterized by dehumanization and Forster’s novel raises questions about how we live in time and space; and how we establish relationships with the Other and with the world through technology. We suggest that the fear of technology depicted in dystopian literature indicates a fear that machines are mimicking (...) the roles that humans already play in relational encounters. Our relationship with machines frequently suggests a classical “I-it” situation. However, a genuine dialogue is where there is no master and where communication and understanding are achieved through the encounter and through openness to difference and to change. The article examines the ways machines and automata are imagined and become part of lived human existence, in the light of Martin Buber’s philosophy of dialogue and Merleau-Ponty’s phenomenology of perception and otherness. The problem seems to be how everyday technological interfaces can change the way we first perceive the world and the possibility that with certain types of mediation there is a loss of connection with the Other. It is argued that understanding dialogical conditions could help turn the relationship with technology into something more humane. Literature such as Forster’s is considered as an example of such a dialogical condition, suggesting ways of dealing with human dilemmas by exploring the field of possibilities. (shrink)

The purpose of the university should be grounded in the concept of citizenship rather than the promise of increased future earnings and research consultancy work. However, this conception of citizenship should be republican rather than liberal. British higher education institutions have suffered at the hands of mechanisms intended to promote accountability. The concept of accountability has undermined the legitimate authority of the university. As pressures from student fee increases, fiscal austerity and accountability mechanisms further undermine the ethic of scholarship, the (...) idea of the university needs to recover its central purpose to ward off civic privatism. (shrink)

At a basic level, the university is regarded in instrumental and economic terms, conflating ethical-political considerations into the economic and diminishing the function of the university in developing and sustaining culture. The political role that higher education plays has been insufficiently addressed by academics in recent decades while the development of social media means the ways in which ‘public opinion’ is formed have changed. By applying Habermas’ theory of communicative action, this book seeks to reconnect educational and political theory and (...) provide an institutional analysis which complements the recent focus on the intersections between political philosophy and legal theory. (shrink)

This investigation examines the discursive history and contemporary courtroom discourse of expert witnesses in Anglo-American courts, incorporating the methods of Michel Foucault into a Critical Discourse Analysis framework. The history of experts is marked by a profound discontinuity in the role of experts, during the late medieval period, with experts relegated to a witness role instead of a juror role - that of the privately knowledgeable investigator - they previously held. Examination of the discourse of contemporary experts in three high-profile (...) US trials documents a different witness status for experts along three parameters: amplification of question responses; the use of the contrastive discourse marker well to express professional disagreement with their interlocutors; and the embedding of professional practices into so clauses. These parameters stand in sharp contrast to ordinary witness discourse. The study concludes with a discussion of the stakes in legal control of expert witnesses including asymmetrical access to experts by economic status, the possible suppression of some expert testimony by recent US Supreme Court decisions, and the hierarchicalization of expert knowledge. (shrink)

Marketisation is rife in higher education. Asymmetries between consumers and producers in markets result in inefficiencies. To address imbalances, policy-makers pushing higher education towards a market model have a tendency to increase the market power of the student by increasing information or amplifying voice. One such policy in England is called ‘students as partners.’ However, I argue here that student partnership can easily undermine relations of authority and trust between students and academic teachers.

Heidegger's attacks against humanism have come under renewed scrutiny, especially in France, as the latest wave of polemics over his political engagement has metamorphosed into a debate over the nature of humanism itself. Yet these recent discussions give rise to a number of perplexities. Firstly, for all their differences, it is remarkable how Heidegger's critics and defenders alike distort his position. On the one side, his French defenders hold that humanism is the attribution of a fixed essence to man, according (...) to which definition "even Nazism is a humanism." The fact that the early Heidegger was still enmeshed in the snares of humanism is then invoked to explain his political views in the thirties. (shrink)

The only obvious successor in our day to the philosophies of Jefferson and Emerson and Whitman is the "pragmatism" of William James and John Dewey. All of the critics from whose writings selections have been made for this volume agree that Pragmatism is an indigenous American philosophy; most of them would add that it is the philosophy which best expresses the "climate of opinion" peculiar to American civilization. Their criticisms, therefore, take two forms: they may argue that, granted pragmatism is (...) a native philosophy, it is but a partial and inadequate representation of certain trends within our culture; or they may contend that pragmatism is only too faithful a transcription of American life. Critics of the first sort will disparage those particular traits of our society which they think pragmatism represents; critics of the second kind will deliver a wholesale condemnation of"Americanism." In effect, therefore, all of these writers in their discussions of the pragmatic philosophy are censuring what is distinctive of American culture itself,in some of its aspects or as a whole. (shrink)