Harvey and Gurvir’s Law is a bill proposed to the Legislative Assembly of Ontario (Canada) to reduce stigma and bias associated with Down syndrome, by developing and disseminating quality information about Down syndrome in the context of prenatal testing.

BackgroundThe aim of this survey was to determine the level of awareness and understanding of peer review and peer review models amongst junior hospital doctors and whether this influences clinical decision-making.MethodsA 30-question online anonymous survey was developed aimed at determining awareness of peer review models and the purpose of peer review, perceived trustworthiness of different peer review models and the role of peer review in clinical decision-making. It was sent to 800 trainee doctors in medical specialties on the University College (...) London Partners trainee database.ResultsThe response rate was (178/800) 22%. Most respondents were specialist registrars. Checking that research is conducted correctly (152/178, 85%) and the data interpreted correctly (148/178, 83%) were viewed as the most important purposes of peer review. Most respondents were aware of open (133/178, 75%), double-blind (125/178, 70%) and single-blind peer review (121/178, 68%). 101/178 (57%) had heard of collaborative, 87/178 (49%) of post publication and 29/178 (16%) of decoupled peer review. Of those who were aware of double-blind, single-blind open and collaborative peer review, 85 (68%), 82 (68%), 74 (56%) and 24 (24%), respectively, understood how they worked. The NEJM, Lancet and The BMJ were deemed to have most trustworthy peer review, 137/178 (77%), 129/178 (72%) and 115/178 (65%), respectively. That peer review had taken place was important for a journal content to be used for clinical decision-making 152/178 (85%), but the ability to see peer review reports was not as important 22/178 (12%). Most felt there was a need for peer review training and that this should be at the specialist registrar stage of training.ConclusionsJunior hospital doctors view peer review to be important as a means of quality control, but do not value the ability to scrutinize peer review themselves. The unquestioning acceptance of peer review as final validation in the field of medicine emphasises not only the responsibility held by medical journals to ensure peer review is done well but also the need to raise awareness amongst the medical community of the limitations of the current peer review process. (shrink)

ZusammenfassungDie Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

Jeffery Aubin ,Marie Chantal ,Dianne Cole ,Julio Chaves ,Cathelyne Duchesne ,Christel Freu ,Steve Johnston ,Brice Jones ,Amaury Levillayer ,Stéphanie Machabée ,Paul-Hubert Poirier ,Philippe Therrien ,Jonathan von Kodar ,Martin Voyer ,Jennifer Wees ,Eric Crégheur.

Die Diskussionen um Sterbehilfe und Patientenverfügung sowie der Ruf nach einer Stärkung der Palliativmedizin nehmen viel Platz in der deutschen Presselandschaft ein. Da Zeitungen einerseits Meinungen und Wissen der Bevölkerung abbilden, andererseits auch zu deren Meinungsbildung und Information beitragen, wurde eine Analyse der Darstellung der Sterbehilfedebatte und der Palliativmedizin durchgeführt. Als empirisches Material dienten 433 Artikel aus den Jahren 2006 und 2007, die mithilfe einer Suche nach den Schlagworten „Palliativmedizin“, „Hospiz“, „Sterbebegleitung“, „Patientenverfügung“, „Patientenautonomie“ und „Sterbehilfe“ in den Print-Archiven verschiedener deutscher (...) Zeitungen identifiziert wurden. Diese Artikel wurden einer qualitativen Inhaltsanalyse unterzogen. Mit Würde, Selbstbestimmung, Unterversorgung und Unsicherheit zeigten sich vier Hauptargumente innerhalb der Sterbehilfedebatte. Würde wird dabei als Argument sowohl für wie gegen aktive Sterbehilfe benutzt. Eine Unsicherheit zeigt sich in der Terminologie der Sterbehilfe. Das Bild der Palliativmedizin ist gekennzeichnet von der Hoffnung, dass sie eine Alternative zur Sterbehilfe bieten kann, sofern sie weiter ausgebaut und besser finanziert wird. Die Ergebnisse bestätigen die in verschiedenen Studien aufgezeigte Bedeutung der Begriffe Würde und Selbstbestimmung für die Einstellung der Bevölkerung zu Sterbehilfe, Suizidbeihilfe und Patientenverfügungen. Das Potential und die noch zu gering ausgebauten Strukturen der Palliativmedizin werden zunehmend erkannt. Demgegenüber erschwert das mangelnde Wissen um die Sterbehilfe-Terminologie und die rechtlichen Grundlagen der Therapiebegrenzung und Patientenverfügungen eine Diskussion um die Sterbehilfe auch auf fachlicher Ebene. (shrink)

There is a global shortage of nurses, leading many countries to recruit internationally qualified nurses (IQNs) to fill the gap. However, IQNs encounter challenges in integrating into their new professional environment, particularly in their interactions with locally qualified nurses (LQNs). Intraprofessional cultural competence (IPCC), defined as ‘a set of congruent behaviours and attitudes that enable professionals to work respectfully and effectively in cross‐cultural situations’, may be a strategy to address these challenges. Content analysis was used to examine nursing regulatory documents (...) (Standards for Practice [Standards] and Codes of Conduct [Codes]) from the United Kingdom, New Zealand and Australia. Data were extracted and organised based on four key themes relevant to IPCC. The analysis revealed a focus on ‘Mutual collaboration and professional relationships’ in six regulatory documents, with explicit commitments to preventing racism and discrimination in the Australian and NZ Codes. However, issues such as racism, discrimination, bullying and harassment faced by IQNs are not comprehensively addressed, as the documents mainly prioritize culturally appropriate patient interactions over relationships between colleagues. Using regulatory documents to address IPCC may influence positive change such as improving communication, and preventing racism, bullying, discrimination and harassment within nursing. (shrink)

The primary goal of this article is point out certain close parallels between some ideas of the radical feminist theorist Mary Daly and those of the French philosopher Henri Bergson. These similarities are particularly striking regarding distinctions made by both authors between two fundamentally contrasting types of cognitive faculty, of time and temporal experience, and of self and emotion. Daly departs from Bergson inasmuch as she employs these distinctions in her own way. She does not—like Bergson—employ them to depict the (...) result of a natural process of consciousness or life, and the dangers for human freedom and thought of not properly respecting these differences. Rather, she locates these differences within a more liberatory, ethical perspective to ground a sharp, inimical contrast between feminist creative movement on the one hand, and static, fixing, and “fixating” patriarchy, with its “technocratic” pretensions, on the other. My hope is that highlighting the similarities between Daly and Bergson will open new paths of appreciation and critique of Daly’s work. (shrink)

BackgroundIn the early phase of the COVID-19 pandemic, many restrictions hit people in ways never seen before. Mental wellbeing was affected and burden was high, especially for high-risk groups such as parents. However, to our knowledge no research has yet examined whether being a parent was not only a risk for psychological burden but also a way to cope with the COVID-19 pandemic.MethodsAn online survey was used to collect data from 1,121 participants from April to June 2020. In addition to (...) demographic variables, risk factors and protective factors were collected. The dataset was divided into three groups: parents whose children lived at home, parents whose children did not live at home, and people who were not parents.ResultsA linear mixed effect model showed that parents had no higher burden than non-parents, and even less when children did not live at home. Expected risk factors were generally less important, and there were no differences between parents and non-parents. In contrast, parents had advantages in protective factors.ConclusionIn the early phase of the COVID-19 pandemic, it was shown that parents were not necessarily at risk due to additional burden, but also had prospects of coping better with the situation than people without children. (shrink)

Photographic representations of women living with or beyond breast cancer have gained prominence in recent decades. Postmillennial visual narratives are both documentary projects and dialogic sites of self-construction and reader-viewer witness. After a brief overview of 30 years of breast cancer photography, this essay analyzes a collaborative photo-documentary by Stephanie Byram and Charlee Brodsky, Knowing Stephanie , and a memorial photographic essay by Brodsky written ten years after Byram’s death, “Remembering Stephanie” . The ethics of representing women’s postsurgical bodies and (...) opportunities for reader-viewers to engage in “productive looking” are the focal issues under consideration. (shrink)

Dans le cadre de notre thèse, nous avons confronté les Lais de Marie de France datant du xiie siècle qui présentent la particularité alors inédite d’avoir pour auteur une femme et le Genji Monogatari de Murasaki Shikibu (une femme également), écrit au xie siècle au Japon, qui fait aussi figure d’exception dans un paysage scriptural majoritairement masculin, a fortiori pour une œuvre d’une telle ampleur. Le rapprochement entre les deux œuvres était avant tout motivé par une thématique de fond, (...) l’imaginaire féminin, déployé dans deux cultures géographiquement et sociologiquement éloignées, cependant immergées dans un milieu élitiste, celui de la Cour. Ce choix s’inscrivait surtout dans la perspective d’une approche mythocritique plutôt que strictement littéraire, dont l’intérêt se situait en deçà du cadre du texte, puisqu’il puisait dans la mythologie fondatrice des deux cultures, source de l’émergence d’un imaginaire féminin à des époques chiches de féminité. Or, cette analyse, que nous avons qualifiée de contrastive, a permis l’ouverture de la réflexion sur d’autres perspectives que seul autorisait un tel rapprochement ; elle a également cherché à distinguer, parmi les motifs communs aux deux textes, ceux qui relevaient d’une universalité (contextuelle) de ceux qui relevaient d’une commune origine eurasiatique. La réflexion était axée sur la notion d’altérité selon une acception très large mais concentrée sur la représentation par l’imaginaire féminin de l’Autre sexe et d’un Ailleurs avant tout textuel et narratif. (shrink)

by Charlee BrodskyStephanie Byram was my friend. She died of breast cancer at age thirty-eight on June 9, 2001. She lived eight years after the disease was discovered.With her cancer diagnosis at age thirty, Stephanie’s life changed. She became more known to others than she would have otherwise. She always had a close circle of friends who were drawn to her because of her candor, her intellect, her impish humor, her steadiness, her sensitivity. But after her diagnosis, many more people (...) knew of Stephanie Byram because of her willingness to share. Stephanie went public with breast cancer.Stephanie called the work that we produced our “art project.” The work consisted of my photographs and her words, and it took many forms. We exhibited in galleries; published pieces in newspapers, magazines, and journals; produced a thirty-minute video with filmmaker Mary Rawson; and the Univeristy of Pittsburgh published the work as a book. The project garnered recognition and many awards.Recently, I d .. (shrink)

“Remembering Stephanie” by Charlee Brodsky is part of the symposium “Disease, Communication, and the Ethics of Visibility” published in the 11 issue of the Journal of Bioethical Inquiry and guest edited by Martha Stoddard Holmes and Monika Pietrzak-Franger. Although this article was included in the print version of the journal, in error it was not published online or included in the table of contents for the symposium. We republish it in the 12 issue of the Journal of Bioethical Inquiry for (...) these reasons.Additionally, the article “Documenting Women’s Postoperative Bodies: Knowing Stephanie and ‘Remembering Stephanie’ as Collaborative Cancer Narratives” by Mary K. DeShazer, which was published in the 11 symposium and is available at DOI 10.1007/s11673-014-9582-8, comments on and makes direct reference to “Remembering Stephanie” by Charlee Brodsky. (shrink)

Discussion of Wittgenstein's Tractatus is currently dominated by two opposing interpretations of the work: a metaphysical or realist reading and the 'resolute' reading of Diamond and Conant. Marie McGinn's principal aim in this book is to develop an alternative interpretative line, which rejects the idea, central to the metaphysical reading, that Wittgenstein sets out to ground the logic of our language in features of an independently constituted reality, but which allows that he aims to provide positive philosophical insights into (...) how language functions. McGinn takes as a guiding principle the idea that we should see Wittgenstein's early work as an attempt to eschew philosophical theory and to allow language itself to reveal how it functions. By this account, the aim of the work is to elucidate what language itself makes clear, namely, what is essential to its capacity to express thoughts that are true or false. However, the early Wittgenstein undertakes this descriptive project in the grip of a set of preconceptions concerning the essence of language that determine both how he conceives the problem and the approach he takes to the task of clarification. Nevertheless, the Tractatus contains philosophical insights, achieved despite his early preconceptions, that form the foundation of his later philosophy. -/- The anti-metaphysical interpretation that is presented includes a novel reading of the problematic opening sections of the Tractatus, in which the apparently metaphysical status of Wittgenstein's remarks is shown to be an illusion. The book includes a discussion of the philosophical background to the Tractatus, a comprehensive interpretation of Wittgenstein's early views of logic and language, and an interpretation of the remarks on solipsism. The final chapter is a discussion of the relation between the early and the later philosophy that articulates the fundamental shift in Wittgenstein's approach to the task of understanding how language functions and reveal the still more fundamental continuity in his conception of his philosophical task. (shrink)

Back cover: This book develops a philosophical account that reveals the major characteristics that make an explanation in the life sciences reductive and distinguish them from non-reductive explanations. Understanding what reductive explanations are enables one to assess the conditions under which reductive explanations are adequate and thus enhances debates about explanatory reductionism. The account of reductive explanation presented in this book has three major characteristics. First, it emerges from a critical reconstruction of the explanatory practice of the life sciences itself. (...) Second, the account is monistic since it specifies one set of criteria that apply to explanations in the life sciences in general. Finally, the account is ontic in that it traces the reductivity of an explanation back to certain relations that exist between objects in the world (such as part-whole relations and level relations), rather than to the logical relations between sentences. Beginning with a disclosure of the meta-philosophical assumptions that underlie the author’s analysis of reductive explanation, the book leads into the debate about reduction(ism) in the philosophy of biology and continues with a discussion on the two perspectives on explanatory reduction that have been proposed in the philosophy of biology so far. The author scrutinizes how the issue of reduction becomes entangled with explanation and analyzes two concepts, the concept of a biological part and the concept of a level of organization. The results of these five chapters constitute the ground on which the author bases her final chapter, developing her ontic account of reductive explanation. (shrink)

This book argues that the extraordinary force of the image in contemporary life--the contemporary imaginary--can be traced back to the Byzantine iconoclastic controversy of the eighth and ninth centuries.

The book is about logical analysis of natural language. Since we humans communicate by means of natural language, we need a tool that helps us to understand in a precise manner how the logical and formal mechanisms of natural language work. Moreover, in the age of computers, we need to communicate both with and through computers as well. Transparent Intensional Logic is a tool that is helpful in making our communication and reasoning smooth and precise. It deals with all kinds (...) of linguistic context in a fully compositional and anti-contextual way. (shrink)

Philosophers have studied mechanisms in many fields in biology. The focus has often been on molecular mechanisms in disciplines such as neuroscience, genetics and molecular biology, with some work on population-level mechanisms in ecology and evolution. We present a novel philosophical case study of individual-level mechanisms, mechanisms in ecology and evolution that concern the interactions between an individual and its environment. The mechanisms we analyze are called Niche Choice, Niche Conformance and Niche Construction (NC3) mechanisms. Based on a detailed analysis (...) of biologists’ research practices, we develop metaphysical claims about the components and organization of NC3 mechanisms, the phenomena they bring about and how these phenomena relate to individual differences, a major explanatory target in the field. We provide reasons for why processes of niche choice, conformance and construction are mechanisms and how they differ from molecular mechanisms underlying individual differences. Finally, we demonstrate that a general representation of NC3 mechanisms is highly abstract, with more specific types of NC3 mechanisms in particular study systems exhibiting more complex components organized in more complex ways. Our case study highlights some distinctive features of individual-level mechanisms in ecology and evolution, such as complex and heterogeneous organization and multiple phenomena. (shrink)

Cet article est une tentative pour mesurer les conséquences démographiques, pour l�Empire, de la perte des provinces orientales du fait de la conquête musulmane. Les sources, surtout les sources grecques, sont rares et donnent seulement quelques informations ponctuelles sur les transferts forcés de population, sur quelques individus quittant le califat et rejoignant l�Empire à dessein et enfin sur la destinée de quelques renégats. Comme d�habitude à cette époque, en raison du quasi monopole des sources ecclésiastiques, les renseignements sont plus nombreux (...) sur le clergé et le flot ininterrompu d�exilés depuis l�Anastasis à Jérusalem jusqu�à Constantinople et Sainte-Sophie. (shrink)