Shavelson and colleagues (2023) describe how medical aid-in-dying laws in the United States prohibit assistance in administering aid-in-dying medication. This prohibition distinguishes aid in dying...

Persons with dementia often prefer to participate in decisions about their health care, but may be prevented from doing so because healthcare decision-making law facilitates use of advance directives or surrogate decision makers for persons with decisional impairments such as dementia. Federal and state disability law provide alternative decision-making models that do not prevent persons with mild to moderate dementia from making their own healthcare decisions at the time the decision needs to be made. In order to better promote autonomy (...) and wellbeing, persons with dementia should be accommodated and supported so they can make their own healthcare decisions. (shrink)

Patient narratives from two investigational deep brain stimulation trials for traumatic brain injury and obsessive‐compulsive disorder reveal that injury and illness rob individuals of personal identity and that neuromodulation can restore it. The early success of these interventions makes a compelling case for continued post‐trial access to these technologies. Given the centrality of personal identity to respect for persons, a failure to provide continued access can be understood to represent a metaphorical identity theft. Such a loss recapitulates the pain of (...) an individual's initial injury or illness and becomes especially tragic because it could be prevented by robust policy. A failure to fulfill this normative obligation constitutes a breach of disability law, which would view post‐trial access as a means to achieve social reintegration through this neurotechnological accommodation. (shrink)

Greek text, english translation and commentary on the surviving fragments of Empedocles (fragments as known in 1981, does not include more recent finds).

Pickering, Newton-Howes, and Young assert that the traditional view of decisional capacity, premised on assessing patients’ abilities to communicate, understand, appreciate,...

Academic dishonesty has serious consequences for human lives, social values, and economy. The main aim of the study was to explore a model of relations between personal and cultural variables and academic dishonesty. The participants in the study were N = 2,586 individuals from nine countries (Pakistan, Israel, Italy, India, the USA, Peru, Romania, Ghana, and Poland). The authors administered the Academic Dishonesty Scale to measure academic dishonesty, the Kessler Psychological Distress Scale to measure distress, the Almost Perfect Scale – (...) Revised to measure perfectionism, the Brief Self-Control Scale to measure self-control, and the Singelis Scale to measure independent self-construal. The results showed that the theoretical model was well fitted to the dataset in six countries: Pakistan, the United States, Romania, Ghana, Israel, and Poland. However, it was not well fitted in Italy, India, and Peru. Our results also showed that perfectionism significantly predicted academic dishonesty, but not in all countries. Self-control significantly predicted cheating, falsification, and plagiarism in the USA. Moreover, we found that distress was related to cheating o0nly in Ghana. Finally, independent self-construal predicted academic dishonesty. Our findings provide a cross-cultural contribution to the debate on academic dishonesty by highlighting its significant predictors and may inform interventions aimed at eliminating it. Our results can be used in preventing and curbing academic dishonesty. Knowledge on cross-cultural differences can be useful in international education for example, as an indicator accepting or relaxing attitude toward academic dishonesty in students from different countries. (shrink)

Discussion of supported decision making has been dominated by legal scholars, philosophers, and advocates for persons with disabilities. Peterson et al.’s primary contribution is introducing...

This is the first article in a two-part series describing subject and family perspectives from the central thalamic deep brain stimulation for the treatment of traumatic brain injury using the Medtronic PC + S first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury, with subjects who were deemed capable of providing voluntary informed consent. In this article, we report on interviews conducted prior to surgery wherein we asked participants about their experiences recovering from (...) brain injury and their perspectives on study enrollment and participation. We asked how risks and benefits were weighed, what their expectations and fears were, and how decisions were reached about trial participation. We found that informed consent and enrollment decisions are fraught. Subjects and families were often split, with subjects more focused on putative benefits and families concerned about incremental risk. Both subjects and families viewed brain injury as disruptive to personal identity and relationships. As decisions were made about study enrollment, families struggled with recognizing the re-emergent agency of subjects and ceding decision-making authority to subjects who had previously been dependent upon them for protection and guidance. Subjects and family members reported a hope for the relief of cognitive disabilities, improved quality of life, normalization of interpersonal interactions, and a return to work or school as reasons for study participation, along with altruism and a desire to advance science. Despite these aspirations, both subjects and families appreciated the risks of the intervention and did not suffer from a therapeutic misconception. A second essay to be published in the next issue of Cambridge Quarterly of Healthcare Ethics—Clinical Neuroethics will describe interviews conducted after surgery, the effects of cognitive restoration for subjects, families, and challenges presented to the social structures they will call upon to support them through recovery. This subsequent article will be available online prior to its formal publication in October 2023. (shrink)

This is the second paper in a two-part series describing subject and family perspectives from the CENTURY-S (CENtral Thalamic Deep Brain Stimulation for the Treatment of Traumatic Brain InjURY-Safety) first-in-human invasive neurological device trial to achieve cognitive restoration in moderate to severe traumatic brain injury (msTBI). To participate, subjects were independently assessed to formally establish decision-making capacity to provide voluntary informed consent. Here, we report on post-operative interviews conducted after a successful trial of thalamic stimulation. All five msTBI subjects met (...) a pre-selected primary endpoint of at least a 10% improvement in completion time on Trail-Making-Test Part B, a marker of executive function. We describe narrative responses of subjects and family members, refracted against that success. Interviews following surgery and the stimulation trial revealed the challenge of adaptation to improvements in cognitive function and emotional regulation as well as altered (and restored) relationships and family dynamics. These improvements exposed barriers to social reintegration made relevant by recoveries once thought inconceivable. The study’s success sparked concerns about post-trial access to implanted devices, financing of device maintenance, battery replacement, and on-going care. Most subjects and families identified the need for supportive counseling to adapt to the new trajectory of their lives. (shrink)

This essay brings psychoanalytic theory on trauma together with film and television criticism on rape narrative in an analysis of Michael Coel’s 2020 series I May Destroy You. Beyond the limited carceral framework of the police procedural, which dislocates the act of violence from the survivor’s history and context, Coel’s polyvalent, looping narrative metabolizes rape television’s forms and genres in order to stage and restage both trauma and genre again and anew. Contesting common conceptions of vulnerability and susceptibility that prefigure (...) a violent breach of autonomy, Coel’s series and her interviews about it invite an ethics of looking that embraces a curiosity in the unknowable and untreatable kernel of subjective experience and defies and resists a policing of the survivor’s thoughts and emotions. By emphasizing and exploring what psychoanalysis calls the “afterwardness” of trauma, Coel foregrounds her main character’s subjectivity prior to her victimization, widens the sphere of consequence beyond the victim and criminal justice system to the survivor’s larger community, and entreats that community to preserve a space for her to look and look again at everything, without judgment. (shrink)

McCarthy and Howard (2023) advocate for supported decision making for patients with intellectual and developmental disabilities (IDD). Departing from the “mental prosthesis” model of supported deci...

Deaths of Despair (DoD), or mortality resulting from suicide, drug overdose, and alcohol-related liver disease, have been rising steadily in the United States over the last several decades. In 2020, a record 186,763 annual despair-related deaths were documented, contributing to the longest sustained decline in US life expectancy since 1915–1918. This forum feature considers how health humanities disciplines might fruitfully engage with this era-defining public health catastrophe and help society better understand and respond to the crisis.

As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

Two and a half thousand years ago Greek philosophers "looked up at the sky and formed a theory of everything." Though their solutions are little credited today, the questions remain fresh. Early Greek thinkers struggled to come to terms with and explain the totality of their surroundings, to identitify an original substance from which the universe was compounded, and to reconcile the presence of balance and proportion with the apparent disorder of the cosmos. M. R. Wright examines cosmological theories of (...) the "natural philosophers" from Thales, Anaximander and Anaximenes to Plato, the Stoics and the NeoPlatonists. The importance of Babylonian and Egyptian forerunners is also emphasized. Cosmology in Antiquity is a comprehensive introduction to the cosmological thought in ancient times. (shrink)

Plato's Timaeus contains a powerful and influential myth, of the construction of the universe by a divine craftsman. A god imposes reason on necessity, to bring order from a primeval 'receptacle' of disordered matter. There results the 'child' that is the cosmos - a copy of an eternally-existing perfect model. Here eight new essays from a distinguished international cast, explore aspects of this challenging work: the principles of the mythical narrative, how the world soul and human body are formed, implications (...) for illness - mental and physical, the importance of music and harmonious proportion. Later developments are also treated: Aristotle's theory of generation, the commentary of Proclus and elements of modern evolutionary theory. (shrink)

There has been a growing debate about the ethics of management buy-outs (MBOs). One possible criticism of the MBO is that it serves the interests of incumbent management at the expense of shareholders. In this paper we develop the general arguments concerning the ethical aspects of the MBO to include other forms of buy-out beyond going privates and apply the analysis to MBOs as a mode of privatisation in Central and Eastern Europe (CEE). MBOs are justified in this context postperestroika (...) as a means of incentivising economic activity by giving managers an ownership stake in former state enterprises. The actual mode of privatisation, though, raises issues of social justice and the criticism that MBOs are at the expense of the broader social good. The ethical problem for the CEE is to balance the economic gains of a move to markets with the ethical risks to the agents of these markets. (shrink)

Incapacitated adults with a legally appointed guardian or conservator may be recruited for or involved with medical, behavioral, or social science research. Much of the research in which such persons participate is aimed at evaluating medical interventions for them, or contributing to general knowledge about disorders from which they may suffer. In this paper we will consider how the appointment of guardians for patients with disorders of consciousness —severe brain injuries that affect a patient’s level of arousal and ability to (...) interact —impacts such patients’ access to research.Such persons may be under guardianship because they have lost decisional capacity (i.e., those in a coma or... (shrink)

Each of the following papers gives an account of a different UK clinical ethics committee. The committees vary in the length of time they have been established, and also in the main focus of their work. The accounts discuss the development of the committees and some of the ethical problems that have been brought to them. The issues raised will be relevant for other National Health Service (NHS) trusts in the UK that wish to set up such a committee.

This article explores early Greeks' cosmological speculation, showing how they explored the possibility of a “theory of everything” and human understanding of the cosmos. In the exposition of competitive cosmologies, there are three questions still unresolved: the form of most of the matter in the universe is not known; the process of beginning of the universe is not known; and whether the universe is finite or infinite is also not known. Presocratic solutions to these problems, still perplexing to the contemporaries, (...) are tackled in this article, with the addition of a note on what is called the anthropic principle, which addresses the place of human life and human observation in the whole. (shrink)

ABSTRACT Across the Mexico-United States borderlands, overlapping white supremacist and Anglo-nationalist movements are building private walls as monuments to Donald Trump. Numerous social justice activists and ecological stewards have warned that these Trumpist border walls present specific and new threats to social and ecological landscapes, particularly along the riparian sections of the borderlands. To slow their building and even topple these walls, justice activists and ecological caretakers are working to fortify networks with similar efforts elsewhere. In an effort to provide (...) analyses useful to such justice endeavors, I employ Achille Mbembe’s concept of necropolitics to situate the borderland activist struggles against the Trumpist walls within a broader context of struggle against the commemoration of racist terror in the US South. Specifically, I use Mbembe’s theorization of necropolitical deathworlds to illustrate some potential common cause linking protests against Trumpist walls in the Paso del Norte region of the Mexico-US border with a Black Lives Matter/Say Her Name coalition that is bringing down Confederate monuments in central Texas. In placing these movements in connection with each other, I highlight a synergy of the white supremacy of Jim Crow with the Anglo nationalism behind a Juan Crow variant of racist terror and anti-immigrant hatred driving the Trumpist wall constructions. Recognition of this convergence is one way, I maintain, for identifying opportunities for making common cause across the Americas’ myriad struggles to destroy the racist monuments that glorify the necropolitical legacy of racist colonialism and its ongoing social and ecological devastation. (shrink)

To redefine work as a concept, the author develops the theoretical contours of a multidimensional continuum model of women's work that moves away from older dual spheres models, using oral histories of older rural white women from Iowa and Missouri. Based on a grounded theory analysis, the author discusses three important dimensions of a continuum model of work: economic benefits, location, and time control characteristics. These dimensions tend to funnel women into multiple work strategies where they combine several labor options (...) to maximize economic benefit. A multidimensional continuum model allows us to observe some of the mechanisms operating in women's labor decision-making process. It suggests new ways of thinking about women's life course patterns. By providing us with a definition of work that more accurately reflects observed experience, it casts doubt on some of our social policies, especially those regarding the care of children and the elderly. (shrink)

The Science Museum, London, has recently acquired four fragments of a portable sundial with associated calendrical gearing. All the fragments are made of low zinc brass of substantially the same composition. The sundial is of a type known in other examples, some the products of recent archaeological excavations and all dated to the Late Antique or Early Byzantine period. Dating by the place names included in the latitude table, by the style of the heads of the planetary gods used to (...) identify the days of the week, and by the style of the script, all indicate that the instrument dates from the late fifth century of the Christian era or the first half of the sixth.The gearing, of which two arbors survive, carrying four toothed wheels and one ratchet, seems to have resembled that of a calendrical device described by al-Bīrūnī in about AD 1000. Like al-Bīrūnī's device and the geared calendar associated with a Persian astrolabe of AD 1221/2 now in the Museum of the History of Science, Oxford, the Byzantine instrument displayed the shape of the Moon and its age in days. Probably the calendar further resembled its Islamic counterparts in also displaying the positions of Sun and Moon in the Zodiac.The emergence of Byzantine mathematical gearing indicates that the Hellenistic tradition attested by the Antikythera machine continued to be active in the Byzantine period, and suggests that it may have influenced the Islamic tradition. Once again an artefact has shown up the inadequacy of the evidence derived from literary sources. (shrink)

We assess the extent to which Chinese MBOs of listed corporations enable a balance to be achieved between facilitating growth and supporting the interests of minority shareholders other than the buyout organization. Using novel, hand-collected data from 19 MBOs of listed corporations in China, a matched sample of 19 non-MBOs and the population of listed corporations, we examine the extent to which boards of directors are changed to bring in executive and outside directors with the skills to grow as well (...) as restructure a business. We also examine the extent to which outside directors become involved in actions to develop the business rather than actions related to fostering the interests of all shareholders. We find in fact little evidence that outside board members have the skills to add value to the MBO firms. Boards appear to focus mainly on related-party transactions with some more limited attention to growth strategies. Outside directors do not seem to openly disagree with incumbent managers on the disclosure of their actions but may express their views and exert pressure behind the scenes. (shrink)

This article explores the role of Athenian literary prizes in the development of ancient literary criticism. It examines the views of a range of critics , and identifies several recurrent themes. The discussion reveals that ideas about what was good or bad in literature were not directly affected by the award of prizes; in fact the ancient critics display what is called an “anti-prize” mentality. The article argues that this “anti-prize” mentality is not, as is often thought, a product of (...) intellectual developments in the fourth century BC. It is suggested that the devaluation of prizes is actually a contemporary, integral feature of prize-awarding culture in general. This article draws on recent approaches from cultural sociology to offer some conclusions about the way in which prizes function in popular and critical discourse. (shrink)

Volume 24, Issue 8, August 2024, Page 121-123.

Previous research on youths’ online risky experiences has mostly utilized quantitative designs. However, some of this research does not account for youths’ views and perceptions. This qualitative study fills this gap by describing online problematic situations from the perspectives of European youths, focuses on classifying online problematic situations based on youths’ perspectives and interrelates these with their developmental contexts. As a theoretical framework, the co-construction model was adopted, which proposes that youths’ online and offline worlds are interconnected. Interviews and focus (...) groups were conducted with youths between the ages of 9 and 16 from Belgium, the Czech Republic, Greece, Malta, Italy, Portugal, Romania, Spain, and the United Kingdom. Youths’ responses reflected the complexity of the various problematic situations online they encountered or indirectly experienced, and how such experiences were interconnected with the developmental contexts of peer relationships, parent-child relationships, romantic relationships, school, sexuality, identity, health, and morality. We recommend the development of complex educational programs focused on youths about problematic situations online, which discuss the possible situations they may encounter and how to deal with them. (shrink)

The payment of human subjects is an area where Institutional Review Boards have wide discretion. Although the “Common Rule” requires the provision of full information to human research participants to secure valid consent, the Rule is silent on the issue of payment. Still, some federal agencies offer guidance on the matter. For example, the National Science Foundation cautions that high payments for risky research “may induce a needy participant to take a risk that they normally would prefer not to take.” (...) For research under its purview, the Food and Drug Administration guidance provides that “[a]dvertisements may state that subjects will be paid, but should not emphasize the payment or the amount to be paid, by such means as larger or bold type.” One might read the FDA guidance to permit the advertisement for human subjects to state the specific amount of payment, as long as it is not emphasized. (shrink)

Pullman (2023) compares medically-assisted dying (MAiD) laws and rates of medically-assisted deaths in Canada and California, noting some differences in the legal regime and a higher rate of MAiD i...

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.

This essay argues that a new, politicized mestiza is emerging within the cultural borderlands of the Mexico-U.S. divide. She works in the upper ranks of the multinational maquiladoras and raises many challenges for a feminist theorization of a new border politics. Through a presentation of research in one maquiladora, the essay demonstrates how understanding the dynamic between metaphorical and material space is vital for imagining a feminist politics in the cultural borderlands.

The comic dramatists of the fifth centuryb.c.were notable for their preoccupation with poetics – that is, their frequent references to their own poetry and that of others, their overt interest in the Athenian dramatic festivals and their adjudication, their penchant for parody and pastiche, and their habit of self-conscious reflection on the nature of good and bad poetry. I have already explored these matters at some length, in my study of the relationship between comedy and literary criticism in the period (...) before Plato and Aristotle. This article continues the story into the fourth century and beyond, examining the presence and function of poetical and literary-critical discourse in what is normally called ‘middle’ and ‘new’ comedy. (shrink)

In list-method directed forgetting, reexposure to forgotten List 1 items has been shown to reduce directed forgetting. proposed that reexposure to a few List 1 items only during a direct test of memory reinstates the entire List 1 episode. In the present experiments, part-list reexposure in the context of indirect as well as direct memory tests reduced directed forgetting. Directed forgetting was reduced when 50% or more of the items were reexposed, and was intact when only 25% were reexposed. Furthermore, (...) part-list reexposure appeared to reinstate only reexposed items-not the entire List 1 episode. (shrink)

Cicero's De Finibus 3 gives in Latin, through the persona of Cato, an outline of Stoic ethical theory, and is the main continuous text on this subject extant from the ancient world. This edition with text and sub-titles, facing translation and commentary, aims to present to the modern reader the arguments in a clear and accessible form against the background of the turmoil of political events in Rome surrounding the death of Caesar, and in a presentation that will allow those (...) with only a little Latin to follow the original text. The Paradoxes give in a more popular form, and with many examples from Roman life and history, the contradictions resulting from a literal or unsympathetic application of strict Stoic theory to practice. Rosemary Wright has taught at the University College of Wales, Aberystwyth and was Senior Lecturer in Classics at the University of Reading. She is currently Head of Department at University of Wales, Lampeter. (shrink)

The authors claim that disciplinary epistemologies—disciplinary habits of mind and ways of thinking—offer productive lenses for observing teaching practices. Furthermore, they argue that educational developers who draw from multiple epistemologies in combination provide rich evidence with regard to teaching and learning and can speak to academic colleagues from an array of disciplines. Clarity is provided for career paths in educational development for colleagues from academic disciplines who are contemplating part‐ or full‐time work in a teaching center. The authors hope that (...) this opening collection develops into a toolkit and area of inquiry about disciplinary approaches to the practice of educational development. (shrink)

Selfhood and the Soul is a collection of new and original essays in honour of Christopher Gill, Emeritus Professor of Ancient Thought at the University of Exeter. Although they all share the same concern - the experience of being a person and the question of how best to live - as in the work of the honorand himself they are distinguished by a diversity of approach and subject matter, taking the reader on a journey from ancient philosophy to medical writing (...) via discussions of topics as varied as money, love, free will, and cookery. (shrink)