Most healthcare providers work from ethical principles based on a Western model of practice that may not adhere to the cultural values intrinsic to Indigenous peoples. Breaking bad news is an important topic of ethical concern in health research. While much has been documented on BBN globally, the ethical implications of receiving bad news, from an Indigenous patient perspective in particular, is an area that requires further inquiry. This article discusses the experiences of Māori lung cancer patients and their families, (...) in order to investigate the ethical implications of receiving bad news. Data collection occurred through 23 semistructured interviews and nine focus groups with Māori lung cancer patients and their families in four districts in the Midland Region of New Zealand: Waikato, Bay of Plenty, Lakes and Tairāwhiti. The findings of this study were categorised into two key themes: communication and context. Avenues for best practice include understanding the centrality of the HCP–patient relationship and family ties in the healthcare journey, and providing patients with the full range of viable treatment options including hope, clear advice and guidance when the situation calls for it. Overall, the findings of this study hold implications for providing culturally safe and humanistic cancer care when BBN to Māori and Indigenous patients. (shrink)

Macrocephaly is present in about 2–5% of the general population. It can be found as an isolated benign trait or as part of a syndromic condition. Brain overgrowth has been associated with neurodevelopmental disorders such as autism during the first year of life, however, evidence remains inconclusive. Furthermore, most of the studies have involved pathological or high-risk populations, but little is known about the effects of brain overgrowth on neurodevelopment in otherwise neurotypical infants. We investigated the impact of brain overgrowth (...) on basic perceptual learning processes during the first year of life. We recorded high density electroencephalograms in 116 full-term healthy infants aged between 3 and 11 months, 35 macrocephalic and 81 normocephalic classified according to the WHO head circumference norms. We used an adapted oddball paradigm, time-frequency analyses, and auditory event-related brain potentials to investigate differences between groups. We show that brain overgrowth has a significant impact on repetition effects and change detection response in the 10–20 Hz frequency band, and in N450 latency, suggesting that these correlates of sensorial learning processes are sensitive to brain overgrowth during the first year of life. (shrink)

Introduction: Although deep brain stimulation often improves levodopa-responsive gait symptoms, robust therapies for gait dysfunction from Parkinson's disease remain a major unmet need. Walking speed could represent a simple, integrated tool to assess DBS efficacy but is often not examined systematically or quantitatively during DBS programming. Here we investigate the reliability and functional significance of changes in gait by directional DBS in the subthalamic nucleus.Methods: Nineteen patients underwent unilateral subthalamic nucleus DBS surgery with an eight-contact directional lead in the most (...) severely affected hemisphere. They arrived off dopaminergic medications >12 h preoperatively and for device activation 1 month after surgery. We measured a comfortable walking speed using an instrumented walkway with DBS off and at each of 10 stimulation configurations at the midpoint of the therapeutic window. Repeated measures of ANOVA contrasted preoperative vs. maximum and minimum walking speeds across DBS configurations during device activation. Intraclass correlation coefficients examined walking speed reliability across the four trials within each DBS configuration. We also investigated whether changes in walking speed related to modification of step length vs. cadence with a one-sample t-test.Results: Mean comfortable walking speed improved significantly with DBS on vs. both DBS off and minimum speeds with DBS on. Pairwise comparisons showed no significant difference between DBS off and minimum comfortable walking speed with DBS on. Intraclass correlations were ≥0.949 within each condition. Changes in comfortable walk speed were conferred primarily by changes in step length.Conclusion: Acute assessment of walking speed is a reliable, clinically meaningful measure of gait function during DBS activation. Directional and circular unilateral subthalamic DBS in appropriate configurations elicit acute and clinically significant improvements in gait dysfunction related to PD. Next-generation directional DBS technologies have significant potential to enhance gait by individually tailoring stimulation parameters to optimize efficacy. (shrink)

In this study, the researchers investigated the relationships between character strengths and ethical engagement in online faculty. One of the ethical duties for higher education faculty is to engage in effective teaching practices. As online higher education becomes increasingly popular, online faculty also bear this duty. Numerous studies have shown that character strengths cultivate ethical behavior. Hence, we sought to determine the relationship between character strengths and ethical engagement in online faculty. Specifically, we focused on intellectual character strengths, interpersonal character (...) strengths, and emotional character strengths because of their relevance to online faculty’s teaching practices. Through correlational analyses, we learned that interpersonal and emotional character strengths were positively and moderately related to ethical engagement, whereas intellectual character strengths were weakly related to ethical engagement. The findings of this study provide insight into online faculty’s character strengths and ethical engagement. However, further research is needed to understand the role of character strengths and ethical engagement in promoting effective teaching practices in online higher education classrooms. (shrink)

Medical-legal partnerships connect legal advocates to healthcare providers and settings. Maintaining effectiveness of medical-legal partnerships and consistently identifying opportunities for innovation and adaptation takes intentionality and effort. In this paper, we discuss ways in which our use of data and quality improvement methods have facilitated advocacy at both patient (client) and population levels as we collectively pursue better, more equitable outcomes.

Political scientist Melissa Orlie asks what it means to live freely and responsibly when advantages are distributed disproportionately according to race, gender ...

Competition among scientists for funding, positions and prestige, among other things, is often seen as a salutary driving force in U.S. science. Its effects on scientists, their work and their relationships are seldom considered. Focus-group discussions with 51 mid- and early-career scientists, on which this study is based, reveal a dark side of competition in science. According to these scientists, competition contributes to strategic game-playing in science, a decline in free and open sharing of information and methods, sabotage of others’ (...) ability to use one’s work, interference with peer-review processes, deformation of relationships, and careless or questionable research conduct. When competition is pervasive, such effects may jeopardize the progress, efficiency and integrity of science. (shrink)

Researchers are studying how artificial intelligence (AI) can be used to better detect, prognosticate and subgroup diseases. The idea that AI might advance medicine’s understanding of biological categories of psychiatric disorders, as well as provide better treatments, is appealing given the historical challenges with prediction, diagnosis and treatment in psychiatry. Given the power of AI to analyse vast amounts of information, some clinicians may feel obligated to align their clinical judgements with the outputs of the AI system. However, a potential (...) epistemic privileging of AI in clinical judgements may lead to unintended consequences that could negatively affect patient treatment, well-being and rights. The implications are also relevant to precision medicine, digital twin technologies and predictive analytics generally. We propose that a commitment to epistemic humility can help promote judicious clinical decision-making at the interface of big data and AI in psychiatry. (shrink)

Programs, policies, and technologies — particularly those concerned with health equity — are often designed with justice envisioned as the end goal. These policies or interventions, however, frequently fail to recognize how the beneficiaries have historically embodied the cumulative effects of marginalization, which undermines the effectiveness of the intended justice. These well-meaning attempts at justice are bounded by greater socio-historical constraints. Bounded justice suggests that it is impossible to attend to fairness, entitlement, and equity when the basic social and physical (...) infrastructures underlying them have been eroded by racism and other historically entrenched isms. Using the case of Brazil’s National Health Policy for the Black Population, this paper proposes that bounded justice can contribute to justice discourses by serving as a concept, a proffering to a multi-disciplinary conceptual framework, and a potential analytic for those interested in the design of policy, technology, and programmatic interventions towards health equity. (shrink)

The development of empirical research methods in both the social and the natural sciences has had a deep impact on the self-conception of philosophy. Jürgen Habermas aims to strike a balance between two ways of understanding the relationship between philosophy and the sciences: between a conception of philosophy as an Archimedean point from which to view the human condition and a conception of philosophy as a mere artefact of Western culturally embedded assumptions. Against the first, Habermas aims to integrate the (...) resources and methods of the social sciences into philosophy and to deny that philosophy can proceed outside of historical and social contexts. On his view, philosophical knowledge is produced communicatively, through socially embedded dialogue. Against the second, Habermas claims fundamental questions about the human condition cannot be answered by purely social or natural scientific approaches. His “postmetaphysical” methodology aims to integrate empirical resources into philosophy without losing sight of what is unique to philosophy: namely, its ability to step back from the empirical data in order to reconstruct in a systematic way underlying universal truths about us, our societies and our place in the world. (shrink)

The paper asks what is living in political state-of-nature approaches, and answers by way of considering recent epistemic uses of state-of-nature arguments. Using Edward Craig's idea that a concept of knowledge can be explicated from the need for good informants, I argue that a concept of authority can be explicated from a parallel need for good practical informants. But this need not justify rule of a Platonic elite. Practically relevant epistemic advantages are more likely to be secured by the political (...) creation of institutions. In conclusion it is suggested that this approach can explain a problem of justification which arises for Joseph Raz's account of authority. (shrink)

For the millions of people who struggle with food and body issues, yoga and its practice of mindfulness can offer a surprisingly effective path to well-being. For Melissa Grabau, a psychotherapist who has battled her own eating disorders since she was a child, yoga contains the key ingredients to transforming our connection to food and to our bodies. The Yoga of Food invites you to explore contemplation prompts and meditations that will help you create a deeper appreciation of the body's (...) health and vitality. Sharing lessons and stories she's cultivated from years of clinical practice, Melissa provides a roadmap toward a healthier approach to nutrition and the human spirit. (shrink)

Since ancient Athens, democrats have taken pride in their power and inclination to change their laws, yet they have also sought to counter this capacity by creating immutable laws. In Democracy and Legal Change, Melissa Schwartzberg argues that modifying law is a fundamental and attractive democratic activity. Against those who would defend the use of 'entrenchment clauses' to protect key constitutional provisions from revision, Schwartzberg seeks to demonstrate historically the strategic and even unjust purposes unamendable laws have typically served, and (...) to highlight the regrettable consequences that entrenchment may have for democracies today. Drawing on historical evidence, classical political theory, and contemporary constitutional and democratic theory, Democracy and Legal Change reexamines the relationship between democracy and the rule of law from a new, and often surprising, set of vantage points. (shrink)

Abstract It is common practice to regard participants in assisted and collaborative reproduction (gamete donors, embryologists, fertility doctors, etc.) as simply providing a desired biological product or medical service. These agents are not procreators in the ordinary sense, nor do they stand in any kind of meaningful parental relation to the resulting offspring. This paper challenges the common view by defending a principle of procreative responsibility and then demonstrating that this standard applies as much to those who provide reproductive assistance (...) in the form of medical services or gametes, as it does to coital reproducers or intending parents. Drawing on vocabulary from the common law tradition, I suggest that it may be helpful to refer to the various participants in assisted and collaborative reproduction (ACR) as accessories to procreation. Referring to the participants in ACR as accessories to procreation highlights the fact that these agents are not just providing medical services or products. They are participating in a supply chain designed to bring about new persons. I conclude by arguing that regulative standards in the fertility industry should be structured such that they permit, facilitate, and encourage agents to satisfy the requirements of procreative responsibility. Content Type Journal Article Pages 1-16 DOI 10.1007/s10677-011-9330-7 Authors Melissa Seymour Fahmy, Department of Philosophy, University of Georgia, 107 Peabody Hall, Athens, GA 30602, USA Journal Ethical Theory and Moral Practice Online ISSN 1572-8447 Print ISSN 1386-2820. (shrink)

For nearly thirty years, Melissa Ann Pinney has been photographing girls and women, from infancy to old age, to portray how feminine identity is constructed, taught, and communicated. Pinney’s work depicts not only the rites of American womanhood, but also the informal passages of girlhood and adolescence. With each view—from solitary subjects in pensive moments to complex family and social situations—the audience gains a richer understanding of the connections between a daughter and her parents, grandparents, and the larger world of (...) friends and society. The pictures also reflect the ways in which a girl’s world in 2010 differs from the world Pinney knew growing up in the 1960s, and the ways in which the making of a person can transcend time and place. Girl Ascending is a sequel to Pinney’s widely praised first book, Regarding Emma: Photographs of American Women and Girls. Of that previous book Janina Ciezaldo wrote in Aperture, “Pinney brings compositional integrity, knowledge of color, and a Midwestern richness of light to her inquiries.” This second volume is even more accomplished, mature, and stylistically consistent. As David Travis writes in his introduction, “Pinney has regained that sense of wonder, making her view of girls ascending into young women both believable and enchanting.” Pinney’s photographs are powerful and insightful. As social and artistic documents, they reveal the subtle and bold aspects of feminine identity as it is expressed in American places and spaces, both private and public. (shrink)

Le philosophe américain Arthur Danto (1924-2013) est connu pour sa contribution majeure à la philosophie de l’art. Doté d’un indéniable talent pour la vulgarisation et l’examen des problèmes complexes, il a su contribuer au dialogue culturel entre l’Amérique et l’Europe. Si la valeur de sa contribution sur les arts visuels est établie, d’autres aspects de sa pensée demeurent peu explorés, notamment sur les liens entre littérature et philosophie et les considérations stylistiques liées à l’écriture philosophique. Pourtant, il accordait très tôt (...) à la littérature une place centrale dans ses travaux sur Sartre (qui était à la fois philosophe et auteur) et Nietzsche, qui ont toujours prêché pour une réconciliation entre art et philosophie : c’est donc à dire que ce sujet lui a fourni matière à réflexion. (shrink)

I propose a unified solution to two puzzles: Ross's puzzle and free choice permission. I begin with a pair of cases from the decision theory literature illustrating the phenomenon of act dependence, where what an agent ought to do depends on what she does. The notion of permissibility distilled from these cases forms the basis for my analysis of 'may' and 'ought'. This framework is then combined with a generalization of the classical semantics for disjunction — equivalent to Boolean disjunction (...) on the diagonal, but with a different two-dimensional character — that explains the puzzling facts in terms of semantic consequence. (shrink)

Functional magnetic resonance imaging and the electroencephalography -based technology of Brain Fingerprinting have been hailed as the next, best technologies for lie detection in America, particularly in the context of post-9/11 anxiety. In scientific journals and the popular press, each has been juxtaposed and deemed superior to traditional polygraphy, which measures changes in the autonomic nervous system and correlates these fluctuations with emotions such as anxiety, fear, and guilt. The author contends that the juxtaposition of polygraphy and brain-based detection is (...) a rhetorical strategy that foregrounds the corrective advantage of brain-based techniques, creates an artificial rupture between contiguous technologies, and ignores the shared assumptions foundational to fMRI, EEG, and two older ``truth telling'' technologies: polygraphy and fingerprinting. Far from describing the brain and its functions, fMRI and Brain Fingerprinting produce models of the brain that reinforce social notions of deception, truth, and deviance. (shrink)

Socrates wrote nothing; Plato's accounts of Socrates helped to establish western politics, ethics, and metaphysics. Both have played crucial and dramatically changing roles in western culture. In the last two centuries, the triumph of democracy has led many to side with the Athenians against a Socrates whom they were right to kill. Meanwhile the Cold War gave us polar images of Plato as both a dangerous totalitarian and an escapist intellectual. And visions of Plato have proliferated at the heart of (...) postmodern critiques of the very idea of metaphysics and politics. Plato's Progeny begins with an account of modern responses to the trial of Socrates and the controversial question of Socrates' relation to Plato. At its centre are two chapters exploring the idea of Platonic origins in and for philosophy, and of Platonic foundations for philosophical politics. Exploring unfamiliar as well as familiar invocations of Plato, Melissa Lane argues that twentieth-century ideological battles have obscured the importance of Socratic individualism, the nature of Platonic ethics, and the value of Platonic politics. Succinct and clearly written, this is an ideal guide for everyone interested in the way philosophers are still writing footnotes to Plato. (shrink)

"This edition of Eco-Republic is published by arrangement with Peter Lang Ltd; first published in 2011 by Peter Lang Ltd"--T.p. verso.

Abstract In the Critique of the Power of Judgment, Kant refers to the pleasure that we feel when judging that an object is beautiful as the pleasure of "mere reflection". Yet Kant never makes explicit what exactly is the relationship between the activity of "mere reflection" and the feeling of pleasure. I discuss several contemporary accounts of the pleasure of taste and argue that none of them is fully accurate, since, in each case, they leave open the possibility that one (...) can reflect without having a feeling of pleasure, and hence allow a possible skepticism of taste. I then present my own account, which can better explain why Kant thinks that when one reflects one must also have a feeling of pleasure. My view, which emphasizes the role of attention in Kant, depicts well what we do when we judge something to be beautiful. It can also suggest a way to explain the relation between judgments of taste and moral feeling, and begin to show how the faculty of feeling fills a gap in the system of our cognitive faculties. (shrink)

Mélissa Thériault,Dominique Sirois-Rouleau | : Bien connu pour ses prises de positions tranchées et polémiques sur le fonctionnement des institutions culturelles et des milieux artistiques, le philosophe français Yves Michaud est aussi un observateur assidu des nouvelles tendances de consommation. L’objectif de cette étude critique est d’ouvrir une discussion critique qui s’impose sur certaines affirmations dont le caractère polémique est aussi manifeste que fertile : la notion de vaporisation de l’art, le statut « orphelin » du design et son (...) rapprochement avec l’art et le luxe et, finalement, la question de l’authenticité. Nous discuterons chacun de ces éléments afin de répondre aux zones grises de l’analyse présentée dans l’essai de Michaud. Nous conclurons par une discussion sur la possibilité même de considérer l’art comme un luxe en montrant dans quelle mesure la conception du luxe telle que défendue par Michaud correspond en fait à un concept bien différent. | : Well known for his controversial positions on the functioning of cultural institutions and artistic communities, French philosopher Yves Michaud is also a fine observer of new consumer trends. The aim of this study is to open a critical discussion on polemic statements made by Michaud in Le nouveau luxe. Expérience, arrogances, authenticité : the notion of vaporization of the art, the “orphan” status of design and the connexion between art and luxury and, finally, authenticity. We discuss each of these elements to clarify the gray areas of the analysis presented by Michaud. We conclude with a discussion on the relevance to consider art as a luxury by showing how design, as understood by Michaud, matches a very different concept. (shrink)

According to epistemic instrumentalism, epistemic normativity arises from and depends on facts about our ends. On that view, a consideration C is an epistemic reason for a subject S to Φ only if Φ-ing would promote an end that S has. However, according to the Too Few Epistemic Reasons objection, this cannot be correct since there are cases in which, intuitively, C is an epistemic reason for S to Φ even though Φ-ing would not promote any of S’s ends. After (...) clarifying both EI and the Too Few Epistemic Reasons objection, I examine three major instrumentalist replies and argue that none of them is satisfactory. I end by briefly sketching a fourth possible response, which is, I suggest, more promising than the other three. (shrink)

The application of artificial intelligence and machine learning technologies in healthcare have immense potential to improve the care of patients. While there are some emerging practices surro...

There can be no doubt that Kant thought we should be reflective: we ought to care to make up our own minds about how things are and what is worth doing. Philosophical objections to the Kantian reflective ideal have centred on concerns about the excessive control that the reflective person is supposed to exert over her own mental life, and Kantians who feel the force of these objections have recently drawn attention to Kant’s conception of moral virtue as it is (...) developed in his later work, chiefly the Metaphysics of Morals. Melissa Merritt’s book is a distinctive contribution to this recent turn to virtue in Kant scholarship. Merritt argues that we need a clearer, and textually more comprehensive, account of what reflection is, in order not only to understand Kant’s account of virtue, but also to appreciate how it effectively rebuts long-standing objections to the Kantian reflective ideal. (shrink)

This dissertation develops and defends a conception of sexualized violence that is rooted in philosophical theories of violence, and at the same time helps us understand the way that violence is connected to various kinds of oppression, namely, the oppression of women. It argues that sexualized violence, which is typically theorized through related notions of physical violation and psychological trauma, is best understood in terms of its moral quality. Sexualized violence against women is fundamentally a moral problem insofar as it (...) disrupts victims' ability to grow and develop in relationships with others, to conceive and meet responsibilities to and emerging from those relationships, and well as the ability to challenge unjust social norms, practices and institutions that in part constitute who we are. This moral quality of violence is investigated through an engagement with the concept of moral integrity, arguing that integrity is grounded in authenticity, understood through the existential-phenomenological tradition. Integrity-as-authenticity paves the way for understanding sexualized violence as a form of moral disintegration, where the dynamism and flexibility required of authentic selfhood is frustrated. Understanding violence and victimization in this way, I argue for a robust notion of advocacy as part of our response to victims. Advocacy--giving voice--will require the development of new concepts and language adequate to the experiences of victims, it will also require the cultivation of spaces and relationships where victims can speak, and it may require that we lend our voices to and for victims. (shrink)

The android Data from Star Trek admired human emotion whereas Spock viewed emotion as irrational and maladaptive. The theory that emotions fulfil adaptive functions is widely accepted in academic psychology but little is known about laypeople’s theories. The present study assessed the extent to which laypeople share Data’s view of emotion as helpful or Spock’s view of emotion as a hindrance. We also assessed how help and hinder theory endorsement were related to reasoning, emotion regulation, and well-being. Undergraduates completed a (...) stressful timed reasoning task and questionnaires that assessed their theories of emotion, emotion regulation strategies, happiness, and social support. Overall, participants viewed emotion more as a help than a hindrance. The more they endorsed the view that emotion helps, the better their reasoning scores. Endorsing a help theory also predicted the use of reappraisal which, in turn, predicted greater happiness and social support. In contrast, endorsing the view that emotion hinders was associated with emotion suppression and less social support. Thus, people’s theories about the functionality of emotion may have important implications for their reasoning and emotional well-being. (shrink)

In this essay, I outline fundamental anthropological and moral principles related to human sexuality and gender identity and then apply these principles to analyze and evaluate the views of several authors who attempt to carve out a “middle way” between liberal and traditionalist approaches to these issues. In doing so, I engage especially with the claim that gender dysphoria, rather than being a psychological issue, is a type of biological intersex condition in which one’s “brain sex” is out of line (...) with one’s genital and chromosomal sex. I argue that understanding the human person as a unity of body and soul and recognizing human sexuality as ordered toward the human good of marriage understood as inseparably unitive and procreative reveals the flaws in this position and helps to show why hormonal or surgical gender reassignment therapy is not a medically or ethically appropriate response to gender dysphoria. I also offer an alternative characterization of gender dysphoria and suggestions for responding with true compassion to those who suffer from it. (shrink)

Journal of Philosophy of Education, EarlyView.