Background High levels of moral distress in nursing professionals, of which oncology nurses are particularly prone, can negatively impact patient care, job satisfaction, and retention. Aim “Positive Attitudes Striving to Rejuvenate You: PASTRY” was developed at a tertiary cancer center to reduce the burden of moral distress among oncology nurses. Research Design A Quality Improvement (QI) initiative was conducted using a pre- and post-intervention design, to launch PASTRY and measure its impact on moral distress of the nursing unit, using Hamric’s (...) Moral Distress Scale–Revised (MDS-R.) This program consisted of monthly 60-minute sessions allowing nurses to address morally distressing events and themes, such as clinicians giving “false hope” to patients or families. The PASTRY program sessions were led by certified clinicians utilizing strategies of discussion and mind-body practices. Participants Clinical nurses working on an adult leukemia/lymphoma unit. Ethical considerations This was a QI initiative, participation was voluntary, MDS-R responses were collected anonymously, and the institution’s Ethics Committee oversaw PASTRY’s implementation. Findings While improvement in moral distress findings were not statistically significant, the qualitative and quantitative findings demonstrated consistent themes. The PASTRY program received strong support from nurses and institutional leaders, lowered the nursing unit’s moral distress, led to enhanced camaraderie, and improved nurses’ coping skills. Discussion Measurement of moral distress is innately challenging due to its complexity. This study reinforces oncology nurses have measurable moral distress. Interventions should be implemented for a safe and healing environment to explore morally distressing clinical experiences. Poor communication among multidisciplinary team members is associated with moral distress among nurses. Programs like PASTRY may empower nurses to build support networks for change within themselves and institutions. Conclusion This QI initiative shows further research on moral distress reduction should be conducted to verify findings for statistical significance and so that institutional programs, like PASTRY, can be created. (shrink)

Philosophy has long been concerned with ‘moral status’. Discussions about the moral status of children, however, seem often to promote confusion rather than clarity. Using the creation of ‘savior siblings’ as an example, this paper provides a philosophical critique of the moral status of children and the moral relevance of parenting and the role that formative experience, regret and relational autonomy play in parental decisions. We suggest that parents make moral decisions that are guided by the moral significance they (...) attach to children, to sick children and most importantly, to a specific sick child (theirs). This moral valorization is rarely made explicit and has generally been ignored by both philosophers and clinicians in previous critiques. Recognizing this, however, may transform not only the focus of bioethical discourse but also the policies and practices surrounding the care of children requiring bone marrow or cord blood transplantation by better understanding the values at stake behind parental decision making. (shrink)

Grey’s Anatomy focuses on the personal and professional life of protagonist Meredith Grey. Throughout the long series, a consistent theme is that the audience is confronted with moral dilemmas in Meredith’s professional work with patients as well as in her personal life. Grey’s decision-making often breaks professional protocol in order to do what she believes is best for her patients and those close to her. We argue that Grey’s approach to morality is representative of Simone de Beauvoir’s approach in (...) The Ethics of Ambiguity. In this text, Beauvoir argues that an existentialist ethic must reject a childlike approach to morality in which moral rules are absolute and moral dilemmas have obvious answers. Instead, she argues for a rejection of universalist ethics in favor of acknowledging the ambiguity of the moral realm. By tracing Meredith’s decision-making throughout the course of different seasons of the show, we argue that Meredith exemplifies an existential authenticity compatible with Beauvoir’s existentialist approach to ethics. (shrink)

In recent years, much attention has been given to the puzzling relationship between tense and evidence type found in languages where a single morpheme appears to encode both reference to time and to the evidential source for the assertion. In natural language, _tense_ has long been understood as serving to locate the time at which the proposition expressed by the sentence holds. The two main theories of _evidentials_ both agree that these morphemes serve to identify the type of evidence (...) the speaker has for their assertion. In languages with evidential-tense morphology, these two categories of meaning are intertwined in ways that are unexpected given our understanding of both phenomena. Specifically, these evidential-tense morphemes appear to encode reference to a time that is linked to the situation in which the speaker gains evidence for their assertion. Two competing approaches have emerged in the literature as to whether these evidential-tense morphemes make crucial reference to the _time_ evidence was acquired (Lee 2013 ; Smirnova 2013 ) or to the _time and place_ of the speaker with respect to the event (Faller 2004 ; Chung 2007 ). This paper examines the temporal and evidential properties of the Mvskoke (or Creek) _graded_ past tense system and finds novel support for the view in which evidential-tenses encode _Evidence Acquisition Time_ (EAT). Mvskoke is shown to have three evidential-tenses which form part of its graded tense system, comprising recent, middle, and distant past. The main proposal is a formalization of EAT as a moment of belief-state change, i.e., the moment the speaker comes to believe the proposition. It is shown that Mvskoke’s evidential-tenses are compatible with a range of evidence types, and this distribution is explained through interactions with viewpoint aspect. (shrink)

The potential for biased responses that occur when researchers interact with their study participants has long been of interest to both academicians and practitioners. Given the sensitive nature of the field, researcher interaction biases are of particular concern for business ethics researchers regardless of their preference for survey, experimental, or qualitative methodology. Whereas some ethics researchers may inadvertently bias data by misrecording or misinterpreting responses, other biases may occur when study participants' responses are systematically influenced by the mere introduction (...) of researchers into the participants' environment. Although substantial empirical research has been conducted on the general topic of researcher interaction biases, none has focused specifically on business ethics research. In order to remedy this lack of empirical substantiation in the field, we review the related literature on researcher interaction biases, present an empirical example of how such biases can influence research results in an experiment assessing reactions to insurance fraud, and discuss the implications for business ethics research. (shrink)

It has long been recognized that cancer onset and progression represent a type of reversion to an ancestral quasi‐unicellular phenotype. This general concept has been refined into the atavistic model of cancer that attempts to provide a quantitative analysis and testable predictions based on genomic data. Over the past decade, support for the multicellular‐to‐unicellular reversion predicted by the atavism model has come from phylostratigraphy. Here, we propose that cancer onset and progression involve more than a one‐off multicellular‐to‐unicellular reversion, and (...) are better described as a series of reversionary transitions. We make new predictions based on the chronology of the unicellular‐eukaryote‐to‐multicellular‐eukaryote transition. We also make new predictions based on three other evolutionary transitions that occurred in our lineage: eukaryogenesis, oxidative phosphorylation and the transition to adaptive immunity. We propose several modifications to current phylostratigraphy to improve age resolution to test these predictions. Also see the video abstract here: https://youtu.be/3unEu5JYJrQ. (shrink)

Over 100 million Americans suffer from chronic pain, which causes more disability than any other medical condition in the United States at a cost of $560–$635 billion per year. Opioid analgesics are frequently used to treat CP. However, long term use of opioids can cause brain changes such as opioid-induced hyperalgesia that, over time, increase pain sensation. Also, opioids fail to treat complex psychological factors that worsen pain-related disability, including beliefs about and emotional responses to pain. Cognitive behavioral therapy (...) can be efficacious for CP. However, CBT generally does not focus on important factors needed for long-term functional improvement, including attainment of personal goals and the psychological flexibility to choose responses to pain. Acceptance and Commitment Therapy has been recognized as an effective, non-pharmacologic treatment for a variety of CP conditions. However, little is known about the neurologic mechanisms underlying ACT. We conducted an ACT intervention in women with chronic musculoskeletal pain. Functional magnetic resonance imaging data were collected pre- and post-ACT, and changes in functional connectivity were measured using Network-Based Statistics. Behavioral outcomes were measured using validated assessments such as the Acceptance and Action Questionnaire, the Chronic Pain Acceptance Questionnaire, the Center for Epidemiologic Studies Depression Scale, and the NIH Toolbox Neuro-QoLTM scales. Results suggest that, following the 4-week ACT intervention, participants exhibited reductions in brain activation within and between key networks including self-reflection, emotion, and cognitive control. These changes in connectivity strength were correlated with changes in behavioral outcomes including decreased depression and pain interference, and increased participation in social roles. This study is one of the first to demonstrate that improved function across the DMN, SN, and FPN may drive the positive outcomes associated with ACT. This study contributes to the emerging evidence supporting the use of neurophysiological indices to characterize treatment effects of alternative and complementary mind-body therapies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 99 the movement of the Dutch to France. Only in the second half of the century, as DutchFrench relations deteriorated, and Protestantism was actively persecuted, did Dutch students turn away from France. Professor Dibon reveals the kinds of untapped source materials that exist for tracing these student voyages, for assessing the intellectual conditions in France, and for tracing the course of ideas. Items found ill funeral orations, (...) guide books, letters, unpublished student travel diaries, various Album amicorum that students carried with them, university records, applications of students for funds, etc., provide the basis for Professor Dibon's sketch of where Dutch students went, how they were received in Paris and elsewhere, whom they met, what universities they attended, and how long they spent at various stages of their tours. Professor Dibon clearly shows that there is a rich mine of information to be found through careful, painstaking research in these many manuscripts or rare printed sources. The picture he presents of the travels of Gronovius' brother-in-law, Samuel Ten Nuyl, later professor of history and eloquence at the University of Nijmegen, indicates the valuable materials that can be unearthed from such labors. Ten Nuyl was in and around Paris from 1659-1661. Letters of Introduction from Gronovius, Heinsius, and Van Schooten led to his being accepted in the highest Protestant and Catholic intellectual circles, got him into the Royal Library (t), and into the circles of Pierre-Daniel Huet, Mfinage, DailI~, Guy Patin, Chapelain, and many others. A study of these Dutch voyagers throws much light on the milieu at certain university centers, such as Caen and Orleans, on the possible exchanges and interchanges of ideas, and on the careers of some of the major figures in the Dutch universities. Professor Dibon has performed a most valuable service in this superbly written and documented study in pointing to an area of research that can aid us greatly in understanding the actual intellectual currents and cross-currents of the seventeenth century. His concluding paragraph (pp. 34-35) sums up what we can learn from such data. Ainsi nous pouvons esp6rer voir naitre de la convergence de multiples d6tails recueillis dans les journaux, dans les albums amicorum, les registres universitaires et autres documents d'archives une ~tude d'ensemble du Voyage en France des ~tudiants n6erlandais au XVIIe sidle. Une telle ~tude, fond~e sur une connaissance, qui serait ~t ~largir et h preciser, des milieux universitaires et des cercles ~rudits de la France du XVIIe sidle, nourrie de la substance de rant de correspondances en grande partie in6dites, constituerait h coup stir le chapitre le plus attachant d'une histoire des relations culturelles franco-nberlandaises. Elle ne manquerait pas par surcrolt de faire apparaitre en pleine lumi~re ce fait trop souvent m6connu que les relations culturelles en ce temps restaient, en d~pit des conflits politiques ou des rivalit& ~conomiques, au sein m~me des pol~miques religieuses, des &hanges de personne ~t personne. I1 faut se bien convaincre que c'est dans une tr6s large mesure /~ partir de tels 6changes,--. (shrink)

BackgroundRandomized controlled trials (RCTs) are often complex and expensive to perform. Less than one third achieve planned recruitment targets, follow-up can be labor-intensive, and many have limited real-world generalizability. Designs for RCTs conducted using cohorts and routinely collected health data, including registries, electronic health records, and administrative databases, have been proposed to address these challenges and are being rapidly adopted. These designs, however, are relatively recent innovations, and published RCT reports often do not describe important aspects of their methodology in (...) a standardized way. Our objective is to extend the Consolidated Standards of Reporting Trials (CONSORT) statement with a consensus-driven reporting guideline for RCTs using cohorts and routinely collected health data.MethodsThe development of this CONSORT extension will consist of five phases. Phase 1 (completed) consisted of the project launch, including fundraising, the establishment of a research team, and development of a conceptual framework. In phase 2, a systematic review will be performed to identify publications (1) that describe methods or reporting considerations for RCTs conducted using cohorts and routinely collected health data or (2) that are protocols or report results from such RCTs. An initial “long list” of possible modifications to CONSORT checklist items and possible new items for the reporting guideline will be generated based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statements. Additional possible modifications and new items will be identified based on the results of the systematic review. Phase 3 will consist of a three-round Delphi exercise with methods and content experts to evaluate the “long list” and generate a “short list” of key items. In phase 4, these items will serve as the basis for an in-person consensus meeting to finalize a core set of items to be included in the reporting guideline and checklist. Phase 5 will involve drafting the checklist and elaboration-explanation documents, and dissemination and implementation of the guideline.DiscussionDevelopment of this CONSORT extension will contribute to more transparent reporting of RCTs conducted using cohorts and routinely collected health data. (shrink)

As more young people feel safe to outwardly identify as transgender or gender expansive (TGE), meaning that their gender identity does not align with the sex they were assigned at birth, an increasing number of youth who identify as TGE seek gender-affirming medical care (GAMC). GAMC raises a number of ethical questions, such as the capacity of a minor to assent or consent, the role of parents or legal guardians in decisions about treatment, and implications for equitable access to care (...) when differing parental or custodial viewpoints are present. These questions are further complicated by the difficulties in explaining the limits of long-term research in GAMC, with regard to the preservation of fertility, for example. We present two de-identified composite case studies to highlight dilemmas that may arise and offer recommendations to better support patient- and family-centered decision making for GAMC. These include employing a multidisciplinUniverary shared decision-making approach, disentangling informed consent and assent from chronological age, developing a consistent approach to the assessment of decisional capacity, and developing age-appropriate informational materials. (shrink)

To understand the long-term impact of the COVID-19 pandemic on healthcare workers, it is crucial to examine the complex interplay between moral distress, moral injury, and moral stress. Buchbinder...

Philosophers and scientists have long speculated about the nature of color. Atomists such as Democritus thought color to be "conventional," not real; Galileo and other key figures of the Scientific Revolution thought that it was an erroneous projection of our own sensations onto external objects. More recently, philosophers have enriched the debate about color by aligning the most advanced color science with the most sophisticated methods of analytical philosophy. In this volume, leading scientists and philosophers examine new problems with (...) new analytic tools, considering such topics as the psychophysical measurement of color and its implications, the nature of color experience in both normal color-perceivers and the color blind, and questions that arise from what we now know about the neural processing of color information, color consciousness, and color language. Taken together, these papers point toward a complete restructuring of current orthodoxy concerning color experience and how it relates to objective reality. Kuehni, Jameson, Mausfeld, and Niederee discuss how the traditional framework of a three-dimensional color space and basic color terms is far too simple to capture the complexities of color experience. Clark and MacLeod discuss the difficulties of a materialist account of color experience. Churchland, Cohen, Matthen, and Westphal offer competing accounts of color ontology. Finally, Broackes and Byrne and Hilbert discuss the phenomenology of color blindness. Contributors: Justin Broackes, Alex Byrne, Paul M. Churchland, Austen Clark, Jonathan Cohen, David R. Hilbert, Kimberly A. Jameson, Rolf Kuehni, Don I.A. MacLeod, Mohan Matthen, Rainer Mausfeld, Richard Niederée, Jonathan Westphal The hardcover edition does not include a dust jacket. (shrink)

It is a long-held belief that states must retain the monopoly over political violence in order to be states, and to survive. However, there are recent criticisms of this view forcing us to consider not just the state's use of political violence but the very nature of the state. Elizabeth Frazer and Kimberly Hutchings's Can Political Violence Ever Be Justified? argues that it cannot. Ned Dobos's Ethics, Security, and the War-Machine raises a series of arguments against states having (...) standing militaries, and Alex Vitale's The End of Policing similarly raises a series of arguments against the institution of the police. In this review essay, I suggest that these arguments all force us to revisit the very nature of the state. There are concerns about simply abolishing these institutions of political violence, but we can indeed conceive of states without the monopoly on violence. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kant's Critique of Berkeley HENRY E. ALLISON THE CLAIMTHAT KANT'S IDEALISM,or at least certain strands of it, is essentially identical to that of Berkeley has a long and distinguished history. It was first voiced by several of Kant's contemporaries such as Mendelssohn, Herder, Hamann, Pistorius and Eberhard who attacked the alleged subjectivism of the Critique of Pure Reason. 1 This viewpoint found its sharpest contemporary expression in the (...) notorious Garve-Feder review to which Kant responded at length in the Prolegomena. In subsequent times it has been championed by Schopenhauer, and most nineteenth century German commentators on the relation between the two philosophers. 2 In addition, it has been, and continues to be, the prevailing view of the vast majority of British writers on Kant, including, with significant qualifications, Norman Kemp Smith. 3 This tradition continues despite the fact that Kant specifically, and in no uncertain terms, repudiated this identification in the Prolegomena and the second edition of the Critique. In both works he responds to the charges of subjectivism, and in so doing distinguishes his position from that of Berkeley, who in the eighteenth century was commonly regarded as a solipsist and denier of the "external world." 4 In contra-distinction to Kant's own critical or transcendental idealism, which explains the possibility of synthetic a priori knowledge within the realm of possible experience, Berkeley is characterized as a "dogmatic" or "visionary idealist." He is judged guilty of "degrading bodies to mere illusion" (B69), of regarding things in space as "merely imaginary entities" (B274), and of holding with all "genuine idealists" that: "all knowledge through the senses and experience is i Cf. Hans Vaihinger, Commentar zu Kant's Kritik der Reinen Vernunft (Stuttgart, Berlin, Leipzig, 1892), II, 494-505. Cf. Friederich Fredericks, Der Phainomenale Idealisraus Berkeley's und Kant's (Berlin, 1871); Robert Zimmerman, "Ober Kant's Widerlegung des Idealismus yon Berkeley" (Sitzungsberichte der Akademie der Wissenschaften, Vienna, Philox.-hist. Kl.), LXVIII (1871); Gustav Dieckert, tiber dos Verhiiltnis des Berkeleyschen ldealismus zu Kantischen Vernun]tkritik (Konitz, 1888). Tiffs is a consequence of the general British tendency to view Kant in phenomenalist terms. A typical recent example is found in P. F. Strawson, The Bounds of Sense (London, 1966). Kemp Smith in his Commentary to Kant's Critique o[ Pure Reason (2nd ed., rev., 1923) takes greaZ pains to distinguish between the subjectivist strand in Kant's thought, which is essentially identical to Berkeley's position, and the genuine critical doctrine which stands side by side with it in the text. 9 Cf. I-I.M. Bracken, The Early Reception of Berkeley's Materialism 1710-1733, rev. ed. (The Hague: Martinus Nijhoff, 1965). [43] 44 HISTORY OF PHILOSOPHY nothing but sheer illusion, and only in the ideas of pure understanding is there truth" (374). 5 One of the chief reasons for the continuation of the Kant-Berkeley tradition is that these, and similar statements about Berkeley, which we find in these works and in Kant's correspondenc e with Beck, have not been taken very seriously by Kant's critics. They are usually dismissed as obvious misinterpretations, due to Kant's ignorance of Berkeley's actual writings, and of his reliance upon distorted second and third hand accounts of Berkeley's thought such as is to be found in Beattie. Furthermore, this view is often supported by the philological reflection that Kant did not read English, and that Berkeley's writings were not yet available in German translation. 6 The philological argument, however, loses much of its force when we consider that there was indeed a German translation of Berkeley's Dialogues, which although apparently unknown to nineteenth century scholars, was readily accessible to Kant. This is to be found, together with a translation of Collier's Clavis Universalis and critical analyses, in a work by the professor of philosophy at Rostock, Johann Christian Eschenbach, entitled: Samlung der vornehmsten Schri[tsteller die die tFirklichkeit ihres eignen K~rpers und der ganzen Ki~rperwelt leugnen (Rostock, 1756). Furthermore, in addition to this work, which was probably known to Kant, there is Berkeley's important Latin work, De Motu (1721), as well as French translations of many of... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Berkeley au siècle des Lumières: Immatérialisme et scepticisme au XVIIIe siècleTodd RyanSébastien Charles. Berkeley au siècle des Lumières: Immatérialisme et scepticisme au XVIIIe siècle. Preface by Geneviève Brykman. Paris: Vrin, 2003. Pp. 368. Paper, € 28,00.The reception accorded to Berkeley's immaterialism by eighteenth-century philosophers constitutes one of the great puzzles of early modern philosophy. How is it possible that Berkeley, whose announced purpose in both the Principles and (...) Three Dialogues was to refute "Skeptics and Atheists," should quickly come to be seen as the foremost champion of Pyrrhonian skepticism, and indeed of atheistic solipsism? To be sure the caricature of philosophical opponents for polemical purposes is hardly limited to Berkeley. Yet from the [End Page 495] modern point of view Berkeley, the "good Bishop" who tirelessly insisted on the consonance of immaterialism with common sense, as well as the indispensable role of God as cause of our ideas of sense, seems a rather unlikely candidate for the near universal hostility—one might even say vilification—that was to be his lot.Forty years ago Harry M. Bracken attempted to unravel this paradox in his classic study The Early Reception of Berkeley's Immaterialism. Through a careful and philosophically informed examination of early accounts of Berkeley's immaterialism, Bracken argued that the distorted image of Berkeley that was to become the common currency of Enlightenment thinkers had its origin in the earliest accounts of Berkeley's work, most notably a pair of reviews in the Jesuit journal Mémoires de Trévoux, and a vituperative attack on "the atheism of the Immaterialists" by Father Tournemine. According to Bracken, the image of Berkeley as a radical disciple of Malebranche who pushed the Oratorian's philosophy to its logical conclusion by denying the existence of matter was promoted by the Jesuits as part of their theological and political struggle against Cartesianism. It was also in these early reviews that Berkeley's name was first associated with the legendary "egoist" philosopher who in addition to denying the existence of material substance, further claimed that his was the only created spirit in existence.Sébastien Charles's impressive new study extends Bracken's work by carefully documenting the dissemination of this distorted image of Berkeley throughout the intellectual world of eighteenth-century Europe. Charles's book is a comprehensive and impressively erudite survey of the use (and misuse) of Berkeley in the writings of the philosophes, as well as later thinkers, including the Idéologues and members of the Berlin Academy. Sadly, though perhaps not unexpectedly, the texts that Charles surveys afford little critical insight to interpreters of Berkeley. The misreadings of Berkeley are so egregious and so pervasive that the philosophy of the Principles and Three Dialogues is generally disfigured beyond recognition. Indeed, even to speak of a "misreading" of Berkeley is somewhat misleading, since many of those who took up the task of refuting immaterialism seem not to have read him at all.However, Charles's aim is much less to shed interpretive light on Berkeley's philosophy than to rectify the long-standing image of the eighteenth century as an era of unbridled epistemological optimism. Emphasizing the confrontations with radical skepticism to be found in the writings of thinkers as diverse as Rousseau and Diderot, La Mettrie and Destutt de Tracy, Charles argues that far from ignoring the threat of radical skepticism, materialists and dualists, deists and Christians made common cause in their struggle against what they took to be Berkeley's alleged "egoism." Indeed, for Charles, "the question of solipsism was the central problem for the metaphysics of the Enlightenment."The ubiquity of references to Berkeley among these thinkers certainly argues in favor of Charles's thesis. Yet the attempt to survey such a large number of authors frequently necessitates an abbreviated treatment that renders difficult the task of assessing the relative importance of the confrontation with radical skepticism in any individual thinker's system. Further, the very weakness and formulaic character of the attempted refutations might reasonably raise suspicions as to whether the threat of solipsism was taken as seriously as Charles maintains... (shrink)

Neo-Fregean logicists claim that Hume’s Principle (HP) may be taken as an implicit definition of cardinal number, true simply by fiat. A long-standing problem for neo-Fregean logicism is that HP is not deductively conservative over pure axiomatic second-order logic. This seems to preclude HP from being true by fiat. In this paper, we study Richard Kimberly Heck’s Two-Sorted Frege Arithmetic (2FA), a variation on HP which has been thought to be deductively conservative over second-order logic. We show that (...) it isn’t. In fact, 2FA is not conservative over n-th order logic, for all $n \geq 2$. It follows that in the usual one-sorted setting, HP is not deductively Field-conservative over second- or higher-order logic. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Oppression, Normative Violence, and VulnerabilityThe Ambiguous Beauvoirian Legacy of Butler’s EthicsLisa C. KniselyJudith Butler’s most recent writings are a sophisticated theorization of the significance of human vulnerability as a resource for “a non-violent ethics... that is based upon an understanding of how easily human life is annulled” (Butler 2004, xvii). Butler argues that recognition of the constitutive vulnerability of human existence provides the condition of possibility through which we (...) can respond to an ethical “appeal” or “call” for nonviolence (Butler 2009, 165, 170). This recent work carries on the feminist theoretical tradition of theorizing nonviolence via an attention to human vulnerability that has been strongly present in feminist care ethics (Held 2006; Kittay 1999; Ruddick 1989; Noddings 1984; Gilligan 1982). However, rather than turning to the care ethicists to think through the ethical relationship between vulnerability and violence, Butler produces an innovative feminist ethics by turning to a variety of thinkers in continental philosophy and psychoanalysis, such as Hegel, Freud, Cavarero, and especially Levinas. Butler’s recent discussion of the ethical import of human vulnerability therefore extends a long-standing feminist tradition of arguing for nonviolence while also helping to expand the theoretical resources feminists have used for this task.This article places Butler’s recent ethical focus on nonviolence1 in conversation with Simone de Beauvoir’s earlier existentialist feminist ethical writings2 [End Page 145] concerning the ethico-political import of violence. Together, these two thinkers reorient the dominant feminist conversation about violence away from an emphasis on women’s violent and oppressive victimization and toward an idea of gendered actors who are simultaneously ethically enabled and constrained by the bodily, historical, and political situations out of which they act. Ultimately, however, Beauvoir’s argument that ethics are always deeply contextual and are thus normatively ambiguous is a preferable feminist alternative to Butler’s attempt to delineate a specifically nonviolent ethics. This is because Beauvoir gives thorough attention to contexts of oppression as a major mitigating factor that shapes our ethical possibilities.For Beauvoir, there is no guarantee that a nonviolent response to vulnerability is a priori the most ethical response. Beauvoir does not insist on a nonviolent ethics because the ethicality of violence must be derived from within the embodied situations out of which people are acting. Ethicality cannot be determined prior to, or outside of, the lived contexts in which people are situated. Beauvoir’s ethics remind contemporary feminist theorists that both vulnerability, and responses to vulnerability, whether violent or nonviolent, are always contextually mediated by the forces of history, politics, and circumstance. This reminder is essential if we do not wish feminist ethical claims to override the feminist political goal of lessening oppression. Beauvoir’s attention to contextual specificity shows us that our possible responses to vulnerability are ethically ambiguous in the sense that no normative claim about how one ought to respond to human vulnerability, taken in the abstract, can be elucidated without the risk of making our ethics potentially oppressive.By returning to Beauvoir’s ethics, especially Beauvoir’s attention to oppression and freedom, the discussion here is meant to echo the concerns of a growing number of contemporary feminist theorists who express hesitation about the recent “turn” to vulnerability in feminist theory (Bergoffen 2001; Butler 2004, 2005, 2009; Fineman 2008; Oliver 2008)3 and more generally about moral claims that are made in the name of feminism (Murphy 2009; Dean 2008; Halley 2008; Mills 2007; Brown 1995). In addition, the emphasis on Beauvoir’s ethics here is meant to help return the contemporary feminist discussion of violence toward a more general emphasis on the importance of thinking about freedom as a primary feminist concern (Zerilli 2005; Willett 2001, 1995). Beauvoir’s ethics demonstrate that the ethicality of our responses to vulnerability cannot be judged without a thorough attention to the ethical freedom4 of oppressed ethical actors.Feminist ethicists have tended to undervalue attention to specific historico-political contexts in their discussions of violence as they develop normative arguments against violence. As Kimberly Hutchings notes in her article “Simone de Beauvoir and the Ambiguous Ethics of Political Violence,” there are two contemporary feminist positions on violence... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 47, no. 1. © 2021 by Feminist Studies, Inc. 201 Ileana Nachescu Censoring Anglogynophobia: Reconsidering the Disappearance of the National Alliance of Black Feminists Black women’s activism in the 1970s has often been located in the fissures between the civil rights movement, women’s liberation movement, and Black nationalism—a form of “interstitial feminism,” in the words of Kimberly Springer.1 Providing crucial interventions to disrupt male supremacy and (...) sexism within Black organizations as well as racism and homophobia within feminist organizations, Black feminist politics modeled a “vanguard center” whose liberation signaled the liberation of all.2 The Combahee River Collective’s “Black Feminist Statement” (1977), which has become a classic in women’s, gender, and sexuality studies curricula, encapsulates the power of this transformative image. The Combahee River Collective was not the only Black feminist group active in the second half of the 1970s, of course. The Third World Women’s Alliance (TWWA), founded in 1969, had a vibrant presence on both the East Coast and the West Coast throughout this decade. The National Black Feminist Organization (NBFO), active between 1973 and 1975, mobilized Black women around the country and gave the impetus for the formation of several local chapters. After NBFO ended, the 1. Kimberly Springer, “The Interstitial Politics of Black Feminist Organizations,” Meridians 1, no. 2 (Spring 2001): 156. 2. Benita Roth, Separate Roads to Feminism: Black, Chicana, and White Feminist Movements in America’s Second Wave (Cambridge, MA: Cambridge University Press, 2003), 91. 202 Ileana Nachescu National Alliance of Black Feminists (NABF) became perhaps the bestknown Black women’s organization at the time due to appearances on national television, articles and essays published in multiple Black and feminist venues, and its attempt to build a national organization. In October 1977, NABF’s national conference, “A Meeting of the Minds,” attracted more than two hundred African American women to Chicago for two days in order to discuss their experiences, listen to speakers, and develop an agenda to address the most pressing issues of the day. To this day, the long list of resolutions passed at this conference constitutes the most comprehensive set of political, economic, and cultural demands collectively devised by African American women. Yet, more than four decades later, NABF has disappeared from public consciousness, remembered only by a small group of feminist historians. The erasure of NABF from women’s history and Black history is a puzzle—in part because the organization excelled at the kinds of activities that leave visible traces. In an interview with Kimberly Springer, Combahee River Collective founder Barbara Smith noted that “People who write get far more visibility than those who don’t.”3 But NABF Executive Director Brenda Eichelberger published many essays in regional and national periodicals documenting diverse initiatives by Black feminists in the 1970s. Furthermore, unlike many feminist organizations that did not record their operations or whose records have been lost, NABF intentionally gathered and preserved rich archival materials.4 Using materials from the National Alliance of Black Feminists archives, I suggest that NABF defies many received views about Black feminist activism, and this defiance makes attention to NABF all the more vital to the history of US feminism. By examining NABF’s original theorization of “Anglogynophobia,” Black women’s distrust of and animosity toward white women, I advance a much darker explanation for the 3. Kimberly Springer, Living for the Revolution: Black Feminist Organizations, 1968–1980 (Durham, NC: Duke University Press, 2005), 75. 4. For this article, I have conducted research at the following archival sites: Brenda Eichelberger / National Alliance of Black Feminists Papers, Vivian G. Harsh Research Collection of Afro-American History and Literature, Chicago Public Library; Brenda Eichelberger / National Alliance of Black Feminists Papers, 1974–1997, Chicago History Museum Research Center; and National Black Feminist Organization collection, Special Collections and University Archives, University of Illinois at Chicago. Ileana Nachescu 203 disappearance of NABF from feminist histories—one linked to the politics of erasure. There is clear evidence that NABF’s efforts to reveal Black women’s perceptions of persistent racism and white supremacy within the feminist movement was censored, as the series of articles titled “Anglogynophobia!” was canceled prior to completion by... (shrink)

The current assessment of behaviors in the inventories to diagnose autism spectrum disorders (ASD) focus on observation and discrete categorizations. Behaviors require movements, yet measurements of physical movements are seldom included. Their inclusion however, could provide an objective characterization of behavior to help unveil interactions between the peripheral and the central nervous systems. Such interactions are critical for the development and maintenance of spontaneous autonomy, self-regulation and voluntary control. At present, current approaches cannot deal with the heterogeneous, dynamic and stochastic (...) nature of development. Accordingly, they leave no avenues for real-time or longitudinal assessments of change in a coping system continuously adapting and developing compensatory mechanisms. We offer a new unifying statistical framework to reveal re-afferent kinesthetic features of the individual with ASD. The new methodology is based on the non-stationary stochastic patterns of minute fluctuations (micro-movements) inherent to our natural actions. Such patterns of behavioral variability provide re-entrant sensory feedback contributing to the autonomous regulation and coordination of the motor output. From an early age, this feedback supports centrally driven volitional control and fluid, flexible transitions between intentional and spontaneous behaviors. We show that in ASD there is a disruption in the maturation of this form of proprioception. Despite this disturbance, each individual has unique adaptive compensatory capabilities that we can unveil and exploit to evoke faster and more accurate decisions. Measuring the kinesthetic re-afference in tandem with stimuli variations we can detect changes in their micro-movements indicative of a more predictive and reliable kinesthetic percept. Our methods address the heterogeneity of ASD with a personalized approach grounded in the inherent sensory-motor abilities that the individual has already developed. (shrink)

Increasingly, professionalism has been recognized as a core competency for health service professionals and is the domain in which vexing competence problems are observed in trainees. We begin by describing manifestations of problems of professionalism in accord with the values that fall within the rubric of this multifaceted construct. We provide an approach for evaluating problems of professionalism and discuss intervention for trainees with mild, moderate, or severe problems in this domain. We propose implications for training focused on enhancing the (...) culture of programs; bolstering the education, guidance, and mentoring provided related to professionalism; and encouraging best practices for addressing trainees with problems of professionalism. We conclude by sharing ideas about defining professionalism, identifying problems of professionalism, strengthening our approach to assessing professionalism and intervening when problems are evident, developing strategies for preventing professionalism problems, and ensuring that psychologists take seriously their responsibility to address professionalism concerns with colleagues. (shrink)

The three of us (be)come together, yes on Zoom calls and in Google docs, and in a way that re-imagines the sitting together at a well-worn kitchen table to animate our current shared preoccupations. The table has seen many conversations before us, so it’s well-worn by feminist scholars who were also troubled, yearning, and adamant about leaving their marks. We have come to, become at, this type of table for centuries, sitting together preparing food, folding laundry, and washing up, all (...) while also reckoning that our stories matter and can make a difference. In a context that is both practical and intellectual – centring fat liberation in public health nutrition – how do we remain good scholarly support to one another in and through challenging times? Times of dissent. Times of tedium. This chapter reveals the stories we need most now as we grapple with our places in the neoliberal university and public health pedagogy, specifically as a critique of policies that we read as non-liberatory. We grapple with how our complicity within these spaces might be considered from a place of mutual support and a shared commitment to unlearning and unsettling colonial ways of knowing, especially as we contemplate the problematics of public health imperatives regarding “intuitive eating” and health behaviour change. And we ask what this means for scholarship that is accountable to liberation, that is, personal survival and collective healing and learning. (shrink)

ABSTRACTJust as accountability policies have led to increased levels of teacher data use, teachers have begun to increase the extent to which students track and analyse data about their own learnin...

Green New Deal policies are proposed to tackle the climate emergency. These policies focus on driving climate innovation through unprecedented financial policy levers. However, while the macro-level financing dynamics are clear, the influence of niche level dynamics of sustainable innovation financing remain unexplored within these policy settings. Through the context of the European Green Deal and a focus on the agri-tech start-up sector in the Netherlands, we identify factors likely to reduce the efficacy of these policies from an innovation management (...) perspective—such as project matching issues, socio-ethical factors or the characteristics of agri-food climate innovations. We go on to conceptualise that these challenges represent a range of asymmetries—from classic information asymmetries to less common value and objective asymmetries—between climate innovators and private investors and financers. Many remedies for asymmetries involve costs, likely to further inhibit the efficacy of the European Green Deal and similar policies. A partnering approach is proposed, where the non-financial resources of incumbent actors are harnessed and leveraged to enhance climate innovation performance. (shrink)

Plato was central both to the genesis of Stoic theory and to subsequent debates within the Stoa. These essays provide new and detailed explorations of the complex relationship between Plato and the Greek and Roman Stoic traditions, and together they show the directness and independence with which Stoics examined Plato's writing. What were the philosophical incentives to consulting and then returning to Plato's dialogues? To what extent did Plato, rather than Xenophon or Antisthenes, control Stoic reconstructions of Socrates' ethics? What (...) explains the particular focus of Stoic polemic against Plato, and how strong is the evidence for a later reconciliation between Plato and Stoicism? This book will be important for all scholars and advanced students interested in the relationship between a major philosopher and one of the most important philosophical movements. (shrink)

John Hick’s revolutionary, “Copernican” approach to religious diversity received a great deal of criticism in his lifetime from more conservative theologians and philosophers of religion, many of whom were seeking to preserve a unique place of pre-eminence for Christianity amongst the world’s faiths. Critical responses to Hick’s Pluralistic Hypothesis have also emerged, however, from amongst his fellow religious pluralists, who have sought either to build upon or to go beyond his pivotal and groundbreaking work. In the same spirit as the (...) responses given by this latter group, this chapter will seek to look beyond Hick’s important work, certainly not in an unfriendly fashion, but with the understanding that Hick is the proverbial “giant” upon whose shoulders subsequent generations of pluralists are standing as we seek to advance pluralism even further than he did in his work. Specifically, this chapter will draw on the Jain concepts of anekāntavāda, nayavāda, and syādvāda, as well as the thought of Alfred North Whitehead and his successors in the movement of process philosophy, to reconceptualize the Real, not on a Kantian foundation, as is done in the Pluralistic Hypothesis, but on the basis of a robust metaphysical realism. The aim of this approach to pluralism is to capture more fully the sense of mystics from diverse religious traditions that they have actually perceived the Real as such, and not merely one of its phenomenal appearances. (shrink)

We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation’s first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was (...) consulted, and salient features of the consults themselves. We include three case studies that illustrate important consult themes during this period. Our findings expand knowledge about the structure and workings of hospital ethics committees and illustrate how one ethics committee has developed and utilized policies on end-of-life care. More generally, we model a sociological approach to the study of clinical ethics consultation that could be utilized to contextualize institutional practices over time. (shrink)

Although formal barriers to women’s social and political participation have crumbled, society remains, to a significant degree, gendered in the roles that women and men play. Women’s and men’s choices regarding work and family are largely responsible for maintaining and reinforcing the differences. While feminists recognize the need to criticize women’s choices, too often they focus on restrictive conditions rather than the choices themselves. Kimberly A. Yuracko argues instead that encouraging women to make choices in accordance with a grounded (...) and well-defined conception of perfectionism—a philosopy concerned with human flourishing—is the most effective way to redress persistent gender inequality. To this end, Yuracko seeks not only to expose the perfectionism underlying current choice critiques, but to articulate a concrete set of feminist perfectionist principles that would improve the quality of individual women’s lives and improve the social standing of women as a whole. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 9.2 (2002) 187-188 [Access article in PDF] Listening to Foucault Patrick J. Bracken ERICA LILLELEHT'S INTERESTING PAPER combines philosophy, history, service analysis, and social commentary. The philosophical themes are below the surface, implicit rather than explicit. As such the paper echoes the work of Foucault himself. The subjects of his books and other writings ranged from histories of madness and psychiatry, hospitals and medicine, (...) prisons and punishment, to sexuality and ethics. But these were clearly more than histories. In doing what he initially called archaeology and later genealogy, Foucault was writing about different dimensions of how the Western world has come to understand what it is to be human. In Foucault's hands history becomes philosophy. The essence of his work is an invitation to question the project of Enlightenment. However, his interrogation of the legacy of Enlightenment is far from a rejection of reason as has sometimes been claimed. Rather it represents a realization that there are different forms of reason, none of which can claim a place of privilege over others. Foucault challenged the idea that we have to choose to be for or against Enlightenment (Foucault, 1984).Of central concern for him is the idea that knowledge and power imply each other and cannot be separated. This, of course, is anathema to both Marxist and liberal analysts who hold out the idea that truth and ideology are mutually exclusive. The assumption is that if we get the starting point of our analysis right, the truth ("pure and simple") will emerge. For Foucault there are "regimes of truth," discourses through which certain things can be said and statements can be judged as true or false. Such regimes are social products, bound up with the economic, cultural, and political realities of their times. This is not some sort of mindless relativism nor a nihilistic advocacy that, when it comes to knowledge claims, "anything goes." As human beings in an imperfect world we have to struggle continuously toward a better understanding of ourselves and the make-up of this world. As individuals, we have to continue to debate and argue about ideas, facts, and the nature of knowledge. We have to present evidence, argue our case, and prepare to be contradicted as well as supported. This is not in question. Instead, what is involved here is recognition that there is no neutral asocial, acultural, or apolitical vantage point from we can judge the validity of one position over another. Foucault's work nurtures a healthy skepticism of those who claim to have found such a vantage point.Importantly, he rejected the idea that power is always repressive in its nature: working to silence, obscure, and suppress. Particularly in the modern era power is more characteristically productive. Its operations are bound up with the ever-multiplying discourses we produce about ourselves. While increasing scientific knowledge about the human condition appears to represent progress, listening to Foucault means coming to appreciate that things are a great deal more complex. The title of Lilleleht's paper reflects this. At [End Page 187] a time when there is a great deal of talk about "progress" in the area of mental health, her analysis is opportune. Unless we pay attention to the micropolitics of clinical encounters we are at some risk of simply endorsing new forms of professional power. In one light, the psychiatric rehabilitation approach of William Anthony and colleagues appears obviously progressive. It does not depend on the "medical model" and the use of medication and seems genuinely committed to the idea of empowerment. However, with the sort of sensibility engendered through an encounter with Foucault, other issues come into view. Beneath its focus on skills and training we see a very clear normative framework centered on the idea that the person with psychiatric problems should be guided and trained toward fitting in with "his or her particular environment." At stake here is the assumption that the deficit is in the patient. It is he or she who needs to change. Herein lies the issue of power: who is in control of the way in which... (shrink)

Governing Animals explores the role of the liberal state in protecting animal welfare. Examining liberal concepts such as the social contract, property rights, and representation, Kimberly K. Smith argues that liberalism properly understood can recognize the moral status and social meaning of animals and provides guidance in fashioning animal policy.

Bracken synthesizes Polanyi’s notion of morphogentic field and Whitehead’s notion of societies of actual occasions. These comments emphasize the implications of the metaphors involved in these notions. The rnetaphor of plants growing in afield lies beyond the concept of a morphogenetic field, and the metaphor of a society of interacting persons lies behind the concept of a society of actual occasions. I suggest that one of the implications of this metaphor is that there is not, as Bracken argues, (...) a problem of continuity in Whitehead’s metaphysics of events. (shrink)