This article provides an ethnographic account of pediatric cochlear implantation, revealing an important shift in the definition of deafness from a sensory loss to a neurological processing problem. In clinical and long-term therapeutic practices involved in pediatric implantation, the cochlear implant is recast as a device that merely provides access to the brain. The “real” treatment emerges as long-term therapeutic endeavors focused on neurological training. This redefinition then ushers in an ensuing responsibility to “train the brain,” subsequently displacing failure from (...) the device onto the individual’s ability to train his or her brain. New caregiving techniques that accompany implantation are understood through neuropolitics, showing how parents are encouraged to engage in neuro-self-governance, and how the concept of neuroplasticity is used to cultural ends. (shrink)

BackgroundClinical ethics support aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we present a specific way of organizing CES, which we have called integrative CES, and argue that this approach meets some of the challenges regarding implementation and organization.MethodsThis integrative approach was developed in an iterative process, combining actual experiences in a case study (...) in which we offered CES to a team that provides transgender health care and reflecting on the theoretical underpinnings of our work stemming from pragmatism, hermeneutics and organizational and educational sciences.ResultsIn this paper we describe five key characteristics of an integrative approach to CES; 1. Positioning CES more within care practices, 2. Involving new perspectives, 3. Creating co-ownership of CES, 4. Paying attention to follow up, and 5. Developing innovative CES activities through an emerging design.ConclusionsIn the discussion we compare this approach to the integrated approach to CES developed in the US and the hub and spokes strategy developed in Canada. Furthermore, we reflect on how an integrative approach to CES can help to handle some of the challenges of current CES. (shrink)

In recent years, business ethics and economic scholars have been paying greater attention to the development of commons organizing. The latter refers to the processes by which communities of people work in common in the pursuit of the common good. In turn, this promotes commons organizational designs based on collective forms of common goods production, distribution, management and ownership. In this paper, we build on two main literature streams: the ethical approach based on the theory of the common good of (...) the firm in virtue ethics and the economic approach based on the theory of institutions for collective action developed by Ostrom’s research on common-pool resources to avert the tragedy of the commons. The latter expands to include the novel concepts of new commons, “commoning” and polycentric governance. Drawing on the analysis of what is new in these forms of organizing, we propose a comprehensive model, highlighting the integration of two sets of organizing principles—common good and collective action – and five problem-solving processes to explain the main dimensions of commons organizing. We contribute to business ethics literature by exploring the convergence between the ethical and economic approaches in the development of a commons organizing view. (shrink)

Externalist representationalism is touted as a superior rival to naïve realism, and yet a careful analysis of the externalist representationalist's analysis of our ordinary perceptual experiences shows the view to be far closer to naïve realism than we might have expected. One of the central advertised benefits of representationalist views in general is that they are compatible with the idea that ordinary, illusory and hallucinatory perceptual experiences are of the same fundamental kind. Naïve realists are forced to deny the ‘common (...) fundamental kind claim’ and adopt disjunctivism. However, I argue that externalist representationalism is also a version of disjunctivism. Consequently, one of the main rivals to naïve realism turns out not to be a rival at all. (shrink)

While committed to the view that Buddhist Reductionism offers the best account of the Abhidharma distinction of the two truths, Siderits (2009) argues that Buddhist Reductionism has the surprising consequence of making itself inexpressible. This inexpressibility follows from the semantic insulation between conventional and ultimate discourses that Siderits argues is required in order to preserve classical logic for both types of discourse, avoiding contradiction and bivalence failure. I argue that inexpressibility is a problematic consequence that threatens to constitute a reductio (...) of Buddhist Reductionism. (shrink)

: Although "brain death" and the dead donor rule—i.e., patients must not be killed by organ retrieval—have been clinically and legally accepted in the U.S. as prerequisites to organ removal, there is little data about public attitudes and beliefs concerning these matters. To examine the public attitudes and beliefs about the determination of death and its relationship to organ transplantation, 1351 Ohio residents ≥18 years were randomly selected and surveyed using random digit dialing (RDD) sample frames. The RDD telephone survey (...) was conducted using computer-assisted telephone interviews. The survey instrument was developed from information provided by 12 focus groups and a pilot study of the questionnaire. Three scenarios based on hypothetical patients were presented: "brain dead," in a coma, or in a persistent vegetative state (PVS). Respondents provided personal assessments of whether the patient in each scenario was dead and their willingness to donate that patient's organs in these circumstances. More than 98 percent of respondents had heard of the term "brain death," but only one-third (33.7%) believed that someone who was "brain dead" was legally dead. The majority of respondents (86.2%) identified the "brain-dead" patient in the first scenario as dead, 57.2 percent identified the patient in a coma as dead (Scenario 2), and 34.1 percent identified the patient in a PVS as dead (Scenario 3). Nearly one-third (33.5%) were willing to donate the organs of patients they classified as alive for at least one scenario, in seeming violation of the dead donor rule. Most respondents were not willing to violate the dead donor rule, although a substantial minority was. However, the majority of respondents were unaware, misinformed, or held beliefs that were not congruent with current definitions of "brain death." This study highlights the need for more public dialogue and education about "brain death" and organ donation. (shrink)

Scientists typically use a variety of representations, including different kinds of figures, to present and defend hypotheses. In order to understand the justification of scientific hypotheses, it is essential to understand how visual representations contribute to scientific arguments. Since the logical understanding of arguments involves the truth or falsity of the representations involved, visual representations must have the capacity to bear truth in order to be genuine components of arguments. By drawing on Goodman's analysis of symbol systems, and on Tarski's (...) work on truth, I show that the figures used in science meet this criterion. (shrink)

In order to move towards an Ethic of Accounting, one must start by defining the function and role of the accountant. This in turn depends to a great extent on the identity of the client or whatever party the Accountant owes his loyal agency to. The issue is one of cardinal importance, and it is perceived as such by the accountants themselves. Loeb for instance says that the client-identity issue is overriding importance now, and will become even more crucial in (...) the immediate years ahead. The question of what constitutes ethical behaviour on the part of the accountant will depend then upon the relation within which such ethical behaviour will have to be deployed.The main question raised in this paper will therefore be, is the accountant primarily engaged by one client (whether an individual or a corporation) to act as their agent, deal with their problems by loyally advancing their interests to the best of his professional competence, although within the limits imposed by law and morality? Or is the public sector to be considered the principal target of the accountant's resolute professionalism and unswerving loyalty? (shrink)

Background: The concept of dignity can be divided into two main attributes: absolute dignity that calls for recognition of an inner worth of persons and social dignity that can be changeable and can be lost as a result of different social factors and moral behaviours. In this light, the nursing profession has a professional dignity that is to be continually constructed and re-constructed and involves both main attributes of dignity. Objectives: The purpose of this study was to determine how nurses (...) described nursing’s professional dignity in internal medicine and surgery departments in hospital settings. Research design: The research design was qualitative. Ethical considerations: This study was approved by the ethics committees of the healthcare organizations involved. All the participants were provided with information about the purpose and the nature of the study. Participants: A total of 124 nurses participated in this study. Method: The data were collected using 20 focus group sessions in different parts of Italy. The data were analysed by means of a conventional inductive content analysis starting from the information retrieved in order to extract meaning units and sorting the arising phenomena into conceptually meaningful categories and themes. Results: Nursing’s professional dignity was deeply embedded in the innermost part of individuals. Regarding the social part of dignity, a great importance was put on the values that compose nursing’s professional identity, the socio-historical background and the evolution of nursing in the area considered. The social part of dignity was also linked to collaboration with physicians and with healthcare assistants who were thought to have a central role in easing work strain. Equally important, though, was the relationship with peers and senior nurses. Conclusion: The organizational environments under scrutiny with their low staffing levels, overload of work and hierarchical interactions did not promote respect for the dignity of nurses. To understand these professional values, it is pivotal to comprehend the role of different health professions in their cultural milieu and the evolution of the nursing profession in diverse countries. (shrink)

Do not chew with your mouth open! Take your hat off when you enter a church! Do not skip the queue! Pay your taxes! Do not cross on a red light! These are familiar imperatives, and their immediate source are ‘socially constructed norms’: norms that exist as a matter of social fact. These range from informal etiquette and politeness norms to the complex norms making up our legal systems. While we often feel bound by these norms, we are also aware (...) that they can be pernicious: the product of injustice and vehicles for its perpetuation. The question thus arises: when and why, if ever, does the fact that a socially constructed norm requires us to perform a certain action place us under a genuine moral obligation to comply? In Morality and Socially Constructed Norms, I answer that such an obligation, when it exists, is grounded in a broader, familiar duty, namely the duty to respect people’s permissible and authentic exercises of agency. This is what I call the ‘Agency-Respect View.’ The first part of the book outlines and defends the view, the second part considers relevant applications. (shrink)

Publications in contemporary science journals often include figures like graphs, diagrams, photographs, and MRIs, which are presented as support for the hypothesis the author is defending. As a first step to explaining how figures contribute to confirmation, I present an account of visual representation and use examples to show how the visual format is involved in the support those figures provide the authors’ conclusions. I then show that attempts to explain what figures contribute to scientific arguments without analyzing them as (...) visual representations will not succeed. (shrink)

Vaccine hesitancy is a growing threat to public health. The reasons are complex but linked inextricably to a lack of trust in vaccines, expertise and traditional sources of authority. Efforts to increase immunization uptake in children in many countries that have seen a fall in vaccination rates are two-fold: addressing hesitancy by improving healthcare professional-parent exchange and information provision in the clinic; and, secondly, public health strategies that can override parental concerns and values with coercive measures such as mandatory and (...) presumptive vaccination. It is argued that such conflicting, parallel approaches seriously risk undermining trust that is crucial for sustaining herd immunity. Although public health strategies can be ethically justified in limiting freedoms, a parent-centered approach seldom acknowledges how it is impacted by contemporaneous coercive measures. In addition, the clinical encounter is not well suited to helping parents consider the public dimensions of vaccination, despite these being important for trust formation and informed decision-making. Efforts to address vaccine hesitancy require more consistent engagement of parental and citizen views. Along with evidence-based information, debates need to be informed by ethical support that equips parents and professionals to respond to the private and public dimensions of vaccination in a more even-handed, transparent manner. Efforts to address vaccine hesitancy need to avoid simple reliance on either parental values or coercive public policies. To do this effectively requires increasing citizen engagement on vaccination to help inform a parent-centered approach and legitimize public policy measures. In addition, cultivating a more ethically consistent strategy means moving beyond the current silos of health ethics - clinical and public health ethics. (shrink)

In this paper, we examine the drivers involved in an alternative business model: cross-sector social partnerships between for-profit, predominantly multinational corporations and nonprofit organizations. We explore these cross-sector social partnerships from the perspective of these primary stakeholders, examining the questions of power differentials and the definitions and determinants of success. In order more deeply to understand these drivers, we review the evolution of the concept of “value” and the perception of the value that each stakeholder brings to the partnership. We (...) then describe and offer the results of an empirical, qualitative study of 18 CSSPs, where we analyze each partner's representations of success, outcomes sought and distinctions in determinants of value within the partnerships. (shrink)

Sexual self-determination is considered a fundamental human right by most of us living in Western societies. While we must abide by laws regarding consent and coercion, in general we expect to be able to engage in sexual behaviour whenever, and with whomever, we choose. For older people with dementia living in residential aged care facilities (RACFs), however, the issue becomes more complex. Staff often struggle to balance residents' rights with their duty of care, and negative attitudes towards older people's sexuality (...) can lead to residents' sexual expression being overlooked, ignored, or even discouraged. In particular, questions as to whether residents with dementia are able to consent to sexual activity or physically intimate relationships pose a challenge to RACF staff, and current legislation does little to assist them. This paper will address these issues, and will argue that, while every effort should be made to ensure that no resident comes to harm, RACFs must respect the rights of residents with dementia to make decisions about their sexuality, intimacy and physical relationships. (shrink)

Petrus Ramus (Pierre de la Ramée, 1515-1572) fue profesor Real de Elocuencia y Filosofía en el Collège Royal (París). Movido por su vocación pedagógica redefinió el ámbito de las artes liberales, despojando a la retórica de su contenido tradicional. Para Ramus la retórica consiste solo en la elocuti..

The New Social Disease is about how we personalize our computers and associated technologies while depersonalizing others and ourselves.

From the earliest application of modern randomized controlled trials in medical research, scientists and observers have deliberated the ethics of randomly allocating study participants to trial control arms. Adaptive RCT designs have been promoted as ethically advantageous over conventional RCTs because they reduce the allocation of subjects to what appear to be inferior treatments. Critical assessment of this claim is important, as adaptive designs are changing medical research, with the potential to significantly shift how clinical trials are conducted. Policy-makers are (...) swiftly moving to encourage greater use of adaptive designs. In 2016, the newly enacted 21st Century Cures Act instructed the Food and Drug Administration to help product sponsors incorporate adaptive methods into proposed clinical trial protocols and applications for investigational drugs and also biological products. In this article, we review the ethical justifications commonly offered for adaptive designs, explore these arguments in the context of actual trials, and contend that clinical equipoise is a useful standard for adaptive-trial ethics. We distinguish between theoretical and clinical equipoise and explain why ethical arguments related to adaptive trials tend to focus on the former. Yet we contend that theoretical equipoise can be an unreliable standard for adaptive ethics. While we contend that clinical equipoise is the most critical principle for the primary ethical concerns posed by adaptive trials, we suggest ethical approaches to deal with some additional concerns unique to adaptive designs. (shrink)

Certification programs seek to promote decent work in global agriculture, yet little is known about their gender standards and implications for female workers, who are often the most disadvantaged. This study outlines the gender standard domains of major agricultural certifications, showing how some programs (Fair Trade USA, Rainforest) prioritize addressing gender equality in employment and others (Fairtrade International, UTZ) incorporate wider gender rights. To illuminate the implications of gender standards in practice, I analyze Fairtrade certification and worker experience on certified (...) flower plantations in Ecuador, drawing on a qualitative and quantitative field research study. (1) I show how Fairtrade seeks to bolster the wellbeing of female workers, addressing their workplace needs via equal employment, treatment, and remuneration standards and their reproductive needs via maternity leave and childcare services. My research demonstrates that for female workers, addressing family responsibilities is critical, since they shape women’s ability to take paid jobs, their employment needs, and their overall wellbeing. (2) I show how Fairtrade seeks to bolster the rights of women workers through individual and collective capacity building standards. My findings reveal how promoting women’s individual empowerment serves as a precondition for collective empowerment, and how targeting traditional labor rights is insufficient for empowering female workers, since their strategic choices are curtailed largely outside the workplace. While Fairtrade certification bolsters the wellbeing and rights of female workers in and beyond the workplace, much still needs to be done before women can claim their rights as workers and citizens. (shrink)

Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying (...) ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. (shrink)

In this paper, I focus on the concept of embeddedness as the background against which eros is a force and a power in and through interactions. To go beyond an internalist account of eros, I engage in a dialogue with some philosophical accounts of desire from an enactive perspective.This enables me to shed light on the location of the embodied tension as “in-between” lovers and “all-around” them. Crucial to this tensional account of embedded eros is the intertwining between self and (...) others’ becomings in processes of participatory sense-making. Through participatory sense-making lovers make their worlds, creating new ways of being and knowing in the ensemble. I advance some steps towards an enactive ethics of eros where, I claim, the cultivation of the space in-between and all-around lovers is the key to avoid the traps of a degenerated form of eros. (shrink)

It is common to believe that some of our concerns are deeper concerns of ours than are others and that some of our attitudes are central rather than peripheral to our psychological identity. What is the best approach to characterizing depth or centrality to the self? This paper addresses the matter of the depth and authenticity of attitudes and the relation of this matter to the autonomy of action. It defends a conception of the real self in terms of preferences (...) and convictions that cohere in a particular structural sense. It thereby gives content to the notion of wholeheartedness to which various action theorists make appeal. The approach is defended in part by an examination of how it handles the phenomenon of ambivalence.1. (shrink)

This article explores what cinema can contribute to recent philosophical engagements with animality and what the work of contemporary French filmmaker Arnaud des Pallières in particular can bring to debates around the zoomorphic or ‘creaturely’ dimensions of film. Examining two works by des Pallières — the documentary Is Dead and the feature-length film Adieu — and drawing principally on the work of Jacques Derrida, the article attends to cinematic, historically-framed configurations of a shared vulnerability between the human and the animal. (...) Such instances of commonality are shown here to unravel hierarchical taxonomies of being, in a rethinking of the ethics and politics of responsibility. These nonanthropocentric modes of cinematic inquiry also engage with issues of minerality and technicity, animating correspondences between forms of life and nonlife, philosophically broadening a consideration of relations between the human and the nonhuman. (shrink)

This book constructs a deepening, interdisciplinary understanding of adult learning and imaginatively reframes its transformative aspects. The authors explore the tension at the heart of current understanding of ‘transformative’ adult learning: that while it can be framed as both easy and imperative, personal transformation is in fact rooted in the context in which we live, our stories and relationships. At its core, transformation is never easy – nor always desirable – and the authors thus draw on interdisciplinary and auto/biographical inquiry (...) to explore what it means to change our presuppositions and frames of meaning that guide our thinking. Using their linguistic, gendered, academic and cultural differences, the authors illuminate how the social, contextual, cultural, cognitive and psychological dimensions of transformation intertwine. In doing so, they emphasise the importance of transformation as a contingent struggle for meaning and recognition, social justice, fraternity, and the pursuit of truth. This engaging book will be of interest to students and scholars of transformative learning and education. (shrink)

Aldo Leopold’s influence on environmental ethics cannot be overstated. I return to Leopold’s work in order to show the connection between the ethics of integrity and many of the points made by Leopold in his writings. I also show how the spirit of Leopold’s land ethic and his love and respect for wilderness is present and current in the Wildlands Project, and that it is a live part of public policy in North America, albeit a debated one.

An inaccessible cardinal $\kappa$ is supercompact when $(\kappa, \lambda)$-ITP holds for all $\lambda\geq \kappa$. We prove that if there is a model of ZFC with infinitely many supercompact cardinals, then there is a model of ZFC where for every $n\geq 2$ and $\mu\geq \aleph_n$, we have $(\aleph_n, \mu)$-ITP.

The following address considers the relevance of business ethics education to our students. Is our concept of ethics one of practiceand application? And, if so, are we accountable to our students, our institutions and ourselves, for the practical impact that we haveor, conversely, that we do not have? Aren’t we responsible in part if one of our students ventures forth and does not act in an ethicalmanner? Though a positive response to this query may not be popular, what is the (...) alternative? If we are not responsible for the impact(or lack thereof) that we have on our students, then what is our purpose? The discussion further explores the nature of this impact andthe process by which we can amplify the results. (shrink)

There is currently a gap in our understanding of how figures produced by mechanical imaging techniques play evidential roles: several studies based on close examination of scientific practice show that imaging techniques do not yield data whose significance can simply be read off the image. If image-making technology is not a simple matter of nature re-presenting itself to us in a legible way, just how do the images produced provide support for scientific claims? In this article I will first show (...) that there is a distinct question about the semiotics of mechanically produced images that has not yet been answered. I show that my account of visual representations can do so, and I argue that the role of convention involved in my account is compatible with the view that visual representations produced through mechanized imaging techniques can play genuine evidential roles in scientific reasoning. (shrink)

Feminist criticism of health care and ofbioethics has become increasingly rich andsophisticated in the last years of thetwentieth century. Nonetheless, this body ofwork remains quite marginalized. I believe thatthere are (at least) two reasons for this.First, many people are still confused aboutfeminism. Second, many people are unconvincedthat significant sexism still exists and aretherefore unreceptive to arguments that itshould be remedied if there is no largerbenefit. In this essay I argue for a thin,``core'' conception of feminism that is easy tounderstand and (...) difficult to reject. Corefeminism would render debate within feminismmore fruitful, clear the way for appropriaterecognition of differences among women andtheir circumstances, provide intellectuallycompelling reasons for current non-feminists toadopt a feminist outlook, and facilitatemutually beneficial cooperation betweenfeminism and other progressive socialmovements. This conception of feminism alsomakes it clear that feminism is part of alarger egalitarian moral and political agenda,and adopting it would help bioethics focus onthe most urgent moral priorities. In addition,integrating core feminism into bioethics wouldopen a gateway to the more speculative parts offeminist work where a wealth of creativethinking is occurring. Engaging with thisfeminist work would challenge and strengthenmainstream approaches; it should also motivatemainstream bioethicists to explore othercurrently marginalized parts of bioethics. (shrink)

Wittgenstein's conception of philosophy raises two questions about the teaching of philosophy and its place in a liberal arts curriculum. First, Wittgenstein denies that philosophy is a body of doctrine, affirms that it is an activity, and assumes that the two alternatives are incompatible. This implies that teaching a body of content is not teaching philosophy and leaves open the question whether there is any relevant sense of "teaching" appropriate to the activity. On the other hand, Wittgenstein understands ethics to (...) be an autonomous inquiry, separate from philosophy, into what is most valuable and important. This view suggests that concerns about our human condition and future are beyond the reach of philosophy, and leaves open the question whether insight into them through philosophy is possible at all.I discuss central features of Wittgenstein's conception of philosophy to explore answers to these questions and to reject the suggestion that philosophy could turn out to be utterly irrelevant in the education and life of students. I propose that the value of philosophy resides in what we do and take Wittgenstein's eloquent metaphor from Philosophical Investigations as a point of reference: "what we do is to bring words back from their metaphysical to their everyday uses". Philosophy, therefore, is not something we can teach, even though it is an activity we should encourage. (shrink)

Xenotransplantation - the transfer of living tissue between species - has long been heralded as a potential solution to the severe organ shortage crisis experienced by the United Kingdom and other 'developed' nations. However, the significant risks which accompany this biotechnology led the United Kingdom to adopt a cautious approach to its regulation, with the establishment of a non-departmental public body - UKXIRA - to oversee the development of this technology on a national basis. In December 2006 UKXIRA was quietly (...) disbanded and replaced with revised guidance, which entrusts the regulation of xenotransplantation largely to research ethics committees. In this article we seek to problematize this new regulatory framework, arguing that specialist expertise and national oversight are necessary components of an adequate regulatory framework for a biotechnology which poses new orders of risk, challenges the adequacy of traditional understandings of autonomy and consent, and raises significant animal welfare concerns. We argue for a more considered and holistic approach, based on adequate consultation, to regulating biotechnological developments in the United Kingdom. (shrink)

In current discussions on contemporary political philosophy some commonplaces around Rancière’s thought are restated with the effect of neutralizing the potential of his reflections. I refer in particular to the following assumptions: a dichotomic understanding of Rancière’s distinction between politics and the police, an ontological interpretation of this difference, an identification of Rancière’s political propositions as anti-institutionalist; a reading of the practices of emancipation as something ephemeral without a durable effect for the common world. In this article I question these (...) assumptions by emphasizing some usually neglected aspects of Rancière’s arguments. (shrink)