Contributors to this volume demonstrate how the ethics of care factors into a variety of social policies and institutions, and can indeed be useful in thinking about a number of different social problems. Divided into two sections, the first looks at care as a model for an evaluative framework that rethinks social institutions, liberal society, and citizenship at a basic conceptual level. The second explores care values in the context of specific social practices or settings, as a framework that should (...) guide thinking. (shrink)

The Covid-19 pandemic has compounded the global food insecurity crisis, disproportionately affecting the consumers, farmers, and food workers. The significant disruptions caused by Covid-19 have called international attention to food security and sparked conversations about how to better support food production and trade. Our paper contributes to a small but growing literature on the impacts and responses of agroecological farmers to Covid-19 in Costa Rica. Specifically, we interviewed 30 agroecological farmers about livelihood disruptions during Covid-19, the areas of food production (...) and sales most affected during this pandemic, and how farmers and consumers are adapting during this crisis. Our findings reveal multiple impacts on agroecological farmers including: economic hardships of lower incomes and inability to pay loans, changes in purchasing and consumption patterns, market disruptions, changes in sales, a decrease in agrotourism, and a shortage of farmworkers. Furthermore, we also report the following farmer adaptation strategies: minimizing distance with consumers to facilitate direct delivery, establishing e-commerce platforms. Based on our findings, we recommend the following: building farmer networks for knowledge sharing, increasing technological support for farmers, and providing government support to ensure that such crises do not increase unemployment among farmers and exacerbate food insecurity. (shrink)

In a time of rapid technological and social change, business organizations must help their employees develop a new appreciation of how social and ethical values are being shaped and challenged by evolving information technologies. Many ethical and social conflicts have arisen around the advanced information technology used today. The emerging technologies continue to create situations not previously encountered. There are numerous risks facing corporations involved in the use of computing technology. Leaders of organizations looking ahead to assess the impact of (...) technological changes can try to prepare their employees for the future. This paper addresses the urgent need for individuals in corporations to become more knowledgeable about computing technologies and their impact. (shrink)

In Helen Bannerman’s Little Black Sambo, the text describes its main character as witty, brave, and resourceful. The drawings of the story’s main character which accompany this text, however, present a unique kind of harm that only becomes clear when the work is read as a collection of single-panel comics rather than an illustrated book. In this chapter, I show what happens when we read drawings in books as textless comics, and, based on how things turn out from this (...) reading, motivate why we have some substantive reason to read both Little Black Sambo and other books with drawings-as-comics. (shrink)

The #metoo movement has forced many fans to consider what they should do when they learn that a beloved artist has acted immorally. One natural thought is that fans ought to give up the artworks of immoral artists. In Why It's OK to Enjoy the Work of Immoral Artists, Mary Beth Willard argues for a more nuanced view. Enjoying art is part of a well-lived life, so we need good reasons to give it up. And it turns out good (...) reasons are hard to find. Willard show that it's reasonable to believe that most boycotts of artists won't succeed, so most of the time there's no ethical reason to join in. Someone who manages to separate the art from the artist isn't making an ethical mistake by buying and enjoying their art. She then considers the ethical dimensions of canceling artists and so-called "cancel culture," arguing that canceling is ethically risky because it encourages moral grandstanding. Willard concludes by arguing that the popular debate has overlooked the power of art to change our lives for the good. It's of course OK to decide to give up the artwork of immoral artists, but--as Willard shows in this provocative little volume--it's OK to continue to enjoy their art, as well. Key Features Offers accessible discussions of complicated philosophical topics like aesthetic value, collective action problems, and epistemic justice Provides a unique perspective and underexplored argument on the popular issue of cancellation Explores the role of aesthetic value in our lives, including its relation to our ethical decisions and our well being. (shrink)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients (or their proxies) over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. (...) Based on the well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed "medically inappropriate" will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

Logic, Methodology, and the Philosophy of Science, the Proceedings of the 1960 International Congress at Stanford, is heavily weighted towards technical problems of logic, foundations of mathematics, and the special sciences, especially psychology, economic models, and structural linguistics, with little discussion of general problems of the philosophy of science. Problems about the idealization involved in the relation of theories to the world become problems about probabilistic models at various levels of abstraction ; induction becomes a problem in decision theory (...) ; language becomes the subject-matter of formalized syntactics, and so on. There is nothing in the least undesirable about these inquiries in a Philosophy of Science Congress, but there is a danger that, if they are not balanced by more informal discussions, real points of dispute are missed, or decided over-hastily in the brief preliminaries of formalization. The philosopher's job ought sometimes to be the more irritating one of returning to these points of dispute; a job which is well done in some of the contributions to this volume, but one could wish to find it being done in more. In what follows I shall have to restrict myself to commenting on only a handful of these more philosophical papers. (shrink)

Why do the big philosophical questions so often strike us as far-fetched and little to with everyday life? Mary Midgley shows that it need not be that way; she shows that there is a need for philosophy in the real world. Her popularity as one of our foremost philosophers is based on a no-nonsense, down-to-earth approach to fundamental human problems, philosphical or otherwise. In _Utopias, Dolphins and Computers_ she makes her case for philosophy as a difficult but necessary (...) tool for solving some of the most pressing issues facing contemporary society. How should we treat animals? Why are we so confused about the value of education? What is at stake in feminism? Why should we sustain our environment? Why do we think intelligent computers will save us? Mary Midgley argues that philosophy not only can, but should be used in thinking about these questions. _Utopias, Dolphins and Computers_ will make fascinating reading for philosophers, educationalists, feminists, environmentalists and indeed anyone interested in the questions of philosophy, ethics and life. (shrink)

An excerpt from CHAPTER I. THE FORCES OF NATURE. You have asked me to give you an account of the opinions really held by some of those authors whose views you have seen caricatured in Punch and censured in religious periodicals. The subjects on which you specially questioned me were the speculations of Mr. Darwin, and the real or pretended discoveries of mesmerists, spiritualists, homoeopathists, and phrenologists. But a little reflection will, I think, convince you, that if I pretended (...) to give you, in a few conversations, the result of the lifelong labours of a succession of earnest and clever men, I could in reality only succeed in puzzling you, and in proving my own unfitness to act as the interpreter of any serious thinker whatever. It will be, I think, more to the purpose if I endeavour to put into your hands an end of the golden thread which, as it seems to me, binds all science together, giving us a clue through its intricate mazes, bridging over its awful chasms, and enabling us to walk fearlessly, even where we can see no light. If you like it, I will afterwards try to tell you what I believe to be the true meaning of some of the real or supposed revelations of modern investigation : but my main object will be to show you how you may, throughout your studies, make facts speak for themselves, and get help from books instead of being confused by them. In the first chapter of the Bible we read that the earth was originally without form and void. Next it is said that the "Spirit of God" moved upon the face of the waters. And throughout the Old Testament it is easy to see that the writers attributed the settling down of things in general, the ordering of the heavens, the coming up of dry land from under the sea, the clearing away of mists and vapours, and the production of life upon the earth, to the action of this Spirit (or Word) of God upon the chaos of matter. And not only so, but they evidently believed this living Word or Spirit to be continually present throughout creation, at every rising of sun or moon or star, in all cosmical changes, at every birth of man or beast, at every recovery of man or beast from sickness, in all growth, in all life, in all enjoyment; and to be at each moment the indispensable preserver of every living thing from decay.... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume on Human Excellence Marie A. Martin Hume was, in important respects, still verymuch a part ofthe classical ethical tradition. This is something we tend to overlook because we come out of a distinctly modern moral tradition, and we normally approach Hume looking for answers to a set of questions that are distinct, and often far removed, from the central questions of the classical tradition. Yet, the classical aspects (...) of Hume's ethics are not irrelevant to contemporary moral debates. There is evidence in recent years of a growing discontent with all the permutations of the two dominant strands of contemporary moral thought, Kantianism and utilitarianism. The sort of radical critique found in the works of Maclntyre, the increasing popularity of communitarian theories, and the resurgence of interest in virtue ethics in general, and Aristotelianism in particular, are all indications of this discontent. What I wish to suggest is that Hume's moral thought might prove a rich source for those who are dissatisfied with the direction ofmodern moral theory, and especially for those who believe that there is something within the classical tradition of virtue ethics worth salvaging. For Hume is a virtue ethicist, albeit one in modern dress, who, poised between the ancients and moderns, self-consciously chose to align himself with the ancient tradition, asserting its superiority over the modern. The ancient moralists are, Hume claims, the "best models,"1 morals being the one science "inwhich theyare not surpassed by the moderns" (E 330). The aim of this paper is to take an initial step towards refocusing our view on the largely neglected classical aspects of Hume's moral thought. The relationship between Hume's moral thought and the classical tradition is both extensive and complex, and I do not pretend to do anything more in this paper than present the tip of the iceberg. But the tip I shall examine is central to all that lies below; it is Hume's conception ofhuman excellence. Virtue or Human Excellence Perhaps Hume's most complete description ofhuman excellence occurs in the conclusion ofAn Enquiry Concerning the Principles ofMorals. Hume presents us with the fictional character, Cleanthes, as one whom "a philosopher might select... as a model ofperfect virtue" (E 270). He is, Hume claims, "a man ofhonour andhumanity," one ofwhom "[e]very one, who has anyintercourse... is sure offair and kind treatment." His Volume XVIII Number 2 383 MARIE A. MARTIN "assiduous application... [and] quick penetration... prognosticate the greatest honours and advancement." His company is enjoyed by all because he has "so much wit with good manners; so much gallantry without affectation" and "so much ingenious knowledge." His "cheerfulness... runs through the whole tenor ofhislife, and preserves a perpetual serenity on his countenance, and tranquillity ofhis soul." Finally, "[h]e has met with severe trials, misfortunes as well as dangers; and by his greatness ofmind, was still superior to all ofthem" (E 269-70). In the Treatise, Hume offers a less specific, yet similar portrait of human excellence: when we enumerate the good qualities of any person, we always mention those parts ofhis character, which renderhim a safe companion, an easy friend, a gentle master, an agreeable husband, or an indulgent father. We consider him with all hisrelations in society; andlove orhate him, according as he affects those, who have any immediate intercourse with him. And 'tis a most certain rule, that if there be no relation oflife, in which I cou'd not wish to stand to aparticular person, his character must so far be allow'd to be perfect. If he be as little wanting to himselfas to others, his character is entirely perfect.2 Although there are numerous passages throughout Hume's works that paint the same general picture, I will offer only one more, his description of an ideally virtuous disposition from his essay, The Sceptic: that which leads to action and employment, renders us sensible to the social passions, steels the heart against the assaults offortune, reduces the affections to ajustmoderation, makes our own thoughts an entertainment to us, and inclines us rather to the pleasure of society and conversation, than to those ofthe senses.3 What is common to all these descriptions... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.4 (2004) 411-425 [Access article in PDF] Vulnerability, Vulnerable Populations, and Policy Mary C. Ruof "Special justification is required for inviting vulnerable individuals to serve as research subjects and, if they are selected, the means of protecting their rights and welfare must be strictly applied."Guideline 13: Research Involving Vulnerable Persons International Ethical Guidelines for Biomedical Research Involving Human Subjects Council for International Organizations (...) of Medical Sciences (CIOMS) and World Health Organization (WHO) Geneva, Switzerland, 2002 Within medical research and healthcare certain groups are afforded special protections and services because of their designation as vulnerable. The vulnerable require special justification to participate in human subject research in order to eliminate potential human rights abuses. The Nuremberg Code of 1947 was written in response to the extreme human subject abuses that occurred under the Nazi regime, and, although the intent of the 1947 Code was to protect human rights, rigid voluntary consent requirements deprived some individuals of the right to participate in clinical trials. Recent human research guidelines, such as the CIOMS/WHO guidelines referenced above and the guidelines referenced in Section V of this Scope Note, attempt to balance both protection from abuse in research and access to new, experimental treatments for the vulnerable.Although various protective guidelines stipulate special protections for vulnerable populations, the concept of vulnerability and consequently the criteria designating vulnerable populations remain vague. Precisely who are the vulnerable? The word "vulnerability" stems from the Latin vulnerare, "to wound." (Oxford Encyclopedic English Dictionary 1995). In clinical research, the term [End Page 411] vulnerable generally is applied to individuals who are unable to give informed consent or who are susceptible to coercion. The Common Rule (45 CFR 46, Subpart A) includes as vulnerable research subjects: children, prisoners, pregnant women, and persons who are handicapped, mentally disabled, economically disadvantaged, or educationally disadvantaged. Although the Common Rule specifies certain vulnerable categories, the guidelines were not intended to be exclusive, leaving open the interpretation of vulnerability.In medical research and health policy, vulnerability is an abstract concept that has concrete effects both for those labeled vulnerable and for those not. Clinical researchers, healthcare workers, ethical reviewers, and policymakers must be able to identify vulnerable subjects to establish how healthcare resources will be allocated and who will qualify for special protections and socialized benefits. Attempts to quantify vulnerability in clear, measurable ways have met little if any consensus. As Alexander Morawa (II, 2003, p. 150) states, "There is no single approach to definition of vulnerability. In fact, there is no purposeful categorisation at all."Difficulties in defining vulnerability have prompted discourse surrounding its utility as a qualifying factor in the allocation of health resources and its appropriateness as a guiding principle in bioethics. Some of the authors cited in this Scope Note argue against the labeling and categorization of vulnerable individuals and populations. "Labeling individuals as 'vulnerable' risks viewing vulnerable individuals as 'others' worthy of pity, a view rarely appreciated" (III, Danis and Patrick 2002, p. 320). The categories of vulnerable groups listed under the Common Rule have been the source of controversy, "for example, many find the suggestion that pregnant women are vulnerable to be quite sexist" (IV, DeBruin 2001, p. 7). Instead of creating categories of vulnerable populations, would it not be better to derive an account of just treatment from a just social policy at large that encompasses human vulnerabilities (II, Brock 2002, p. 283).For some of the authors listed here, the concept of vulnerability is essential to bioethics. Robert Goodin (I, 1985, p. 107) writes that the vulnerability of other human beings is the source of our special responsibilities to them. In contrast to the four American principles of biomedical ethics—autonomy, nonmaleficence, beneficence, and justice—the four principles of European bioethics and biolaw include vulnerability along with autonomy, dignity, and integrity. According to, Jacob Dahl Rendtorff and Peter Kemp (I, 2000, p. 274) "the principle of vulnerability is ontologically prior to the other [European] principles, it expresses better than all of the other ethical principles... the finitude of the human condition."Some of the... (shrink)

Retaliation against whistleblowers is a well-recognized problem, yet there is little explanation for why uninvolved peers choose to retaliate through ostracism. We conduct two experiments in which participants take the role of a peer third-party observer of theft and subsequent whistleblowing. We manipulate injunctive norms and descriptive norms. Both experiments support the core of our theoretical model, based on social intuitionist theory, such that moral judgments of the acts of wrongdoing and whistleblowing influence the perceived likeability of each actor (...) and ultimately influence intention to ostracize each actor and indicate more willingness to ostracize the whistleblower than the wrongdoer. When we vary norms for the wrongdoing in Experiment 1, we find that descriptive and injunctive norms indirectly influence intentions to ostracize both the wrongdoer and whistleblower. These relationships are serially mediated by the observers’ moral judgments of the act and likeability of the actor. When we vary norms for whistleblowing in Experiment 2, the injunctive norm manipulation affected moral judgment of the action of whistleblowing, and we do not observe any other significant effects of the norm manipulations on moral judgments of the actions of wrongdoing or whistleblowing. (shrink)

Mastery imagery has been shown to be associated with more positive cognitive and emotional responses to stress, but research is yet to investigate the influence of mastery imagery ability on imagery’s effectiveness in regulating responses to acute stress, such as competition. Furthermore, little research has examined imagery’s effectiveness in response to actual competition. This study examined (a), whether mastery imagery ability was associated with stress response changes to a competitive stress task, a car racing computer game, following an imagery (...) intervention, and (b), the effects of different guided imagery content on pre-task cognitive and emotional responses. In Session 1, 78 participants (M age = 20.03 years, SD = 1.28) completed ratings of pre-task anxiety intensity and direction, confidence, and perceived control. Imagery ability was also assessed before completing the task. In Session 2, participants were randomly allocated to an imagery condition (positive mastery, negative mastery, relaxation) or control group (no imagery) before completing the task and outcome measures again. For the negative mastery group, greater positive mastery imagery ability was associated with greater perceived control and perceiving anxiety as more facilitative. Furthermore, mastery imagery ability moderated the relationship between anxiety intensity and direction. Altogether, results suggest that positive mastery imagery ability may act as a potential buffer against the effects of negative images. (shrink)

Bernard Matolino has recently argued that African communitarianism is an ethics grounded in emotion aligned with reason. If he is correct, questions arise about what emotions have value within African communitarianism, especially as emotions like anger or resentment could stand in tension with important communitarian values, such as social harmony. While little critical attention has so far been paid to such emotions within an African communitarian framework, a wider philosophical literature examining the moral value of disruptive emotions could be (...) drawn on to develop analyses of emotion within African communitarianism. In this paper, I explore how such an analysis could proceed. I argue that drawing on the wider emotion literature, and especially the concept of reactive attitudes introduced by P. F. Strawson, provides an initial case for even disruptive emotions to have value. Even so, we must question whether an analysis of emotion plausibly based on individualistic commitments is compatible with relational communitarian commitments. I nevertheless defend the compatibility and argue that, not only can disruptive emotions have instrumental value through their epistemic and motivational roles in the promotion of community but, importantly, they are partially constitutive of the interpersonal relationships within which we are embedded and that form community. (shrink)

Background: Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives (to implement research protocols and advance science), setting (research facilities), and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about (...) whether research nurses experience unique ethical challenges distinct from those experienced by nurses in traditional patient-care settings. Research objectives: The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice. Research design: The study utilized a qualitative descriptive design with individual interviews. Participants and research context: Participating nurses (N = 12) self-identified as having experienced ethical challenges during screening. The majority were Caucasian (90%), female (83%), and worked in outpatient settings (67%). Approximately 50% had > 10 years of research experience. Ethical considerations: The human subjects review board approved the study. Written informed consent was obtained. Findings: Predominant themes were revealed: (1) the inability to provide a probable good, or/do no harm, and (2) dual obligations (identity as a nurse vs a research nurse). The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship. Discussion: Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science. Conclusion: Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

After the first callosotomy surgeries were performed, the general consensus among the medical community was that severing the corpus callosum had relatively little, if any, effect on an individual's behavior. Nearly twenty years later, researchers discovered that, under experimental conditions, the two hemispheres could simultaneously maintain very different interpretations of the same stimulus. These findings immediately called into question the unity of subjective experience, a fundamental characteristic of human consciousness. How could the split‐brain patient not experience any disruption in (...) his experience as a unified self when the two hemispheres are physically and functionally disconnected? In this chapter, we review the research that has led to a conceptualization of the split brain as two minds within one body and the implications of this research for the scientific study of consciousness. We argue that consciousness is a neural function that emerges from the integration of information across available functional modules. (shrink)

Medical ethics committees are increasingly called on to assist doctors, patients, and families in resolving difficult ethics issues. Although committees are becoming more sophisticated in the substance of medical ethics, little attention has been given to the processes these committees use to facilitate decision-making. In 1990, the National Institute for Dispute Resolution in Washington, D.C., provided a planning grant from its Innovation Fund to the Institute of Public Law of the University of New Mexico School of Law to look (...) at what ethics committees can learn from facilitation and mediation techniques. The study's thesis was that, if adapted for use by medical ethics committees, facilitation and mediation techniques can be helpful to those bodies in case review consultations and in other internal committee processes. This article reports on that project. (shrink)

An obvious result of including time rules into specifications of world patterns is the rather persuasive representation of rhythm. Rhythm as a property of world patterns has received relatively little attention recently, although it has had a long and distinguished history in psychology. Nonetheless, its recent neglect means that all too often we have failed to consider the implications of time patterning of stimuli that we as psychologists routinely present to individuals in our attempts to study human performance in (...) many tasks, tasks which often do involve explicitly musical stimuli. Often in our psychological studies we present as stimuli words, lights, colored forms, or other items in a fashion that is regularly spaced in time. It's just common sense, and besides it's easier. And other current paradigms have not encouraged experimental questions about the temporal patterning of stimuli. But consider what this pacing means. We are rhythmically programming events. Is it possible that this temporal regularity forms attentional waves that buoy up our studies and so make it likely that we can study what we are most interested in? And, with our own attention as psychologists fixed steadily upon the topic of our immediate concern , is it possible that we overlook the fact that underlying our effects is a rhythmic regularity that is crucial to having the subject's attention on the task at hand? Mari Riess Jones is professor of psychology at Ohio State University and has written numerous articles on the human response to patterns in time. (shrink)

Background A significant number of women experience childbirth as traumatic. These experiences are often characterised by a loss of control coupled with a perceived lack of support and inadequate communication with health care professionals. Little is known about the choices women make in subsequent pregnancy(s) and birth(s), or why they make these choices. This study aimed to understand these choices and explore the reasons behind them. Methods A longitudinal Grounded Theory Methods (GTM) study involving 9 women was conducted. Over (...) half of the participants had a formal diagnosis of PTSD and/or PND related to the previous birth. Interviews were carried out at 3 timepoints perinatally. These findings are from the first interviews at 12-20 weeks. Results From the first days of pregnancy, this cohort of women were focused on concerns that this birth would be a repeated traumatic experience. The women were deliberately searching out and analysing information about their choices in this pregnancy and birth, and making plans which had two aims; firstly to avoid a repeat of their previous birth experience, and secondly to avoid a loss of control to other people during the birth. The women considered a range of birth choices, from elective caesareans to freebirth. Some women felt well supported by those around them, including health care professionals, partners, friends and family. Others did not, and were anticipating conflict in trying to assert their birth choices. Many early relationships with health care professionals were characterised by fear and mistrust. Discussion Women who have previously experienced a traumatic birth become pregnant again, have a strong desire to avoid a repeat experience and to feel in control of their birth choices. Access to robust information appears to help reduce uncertainty and arm women in their discussions with professionals. Similarly making plans and seeking to have them agreed with health care professionals at an early stage is used a way to reduce the risk of having a further traumatic experience. Implications for practice include supporting women in formulating and confirming pregnancy and birth plans at an early stage to reduce uncertainty and foster a sense of control. (shrink)

Home-based service jobs have developed considerably across Western societies. In fact, chances are high that a working-class woman in France today will, at some point in her life, be a house cleaner, home-based child care provider, or home aide for the elderly. Going against political, scholarly, and everyday discourses that, saturated with the double prejudices of gender and class, treat all these home service occupations, which require little prior training, the same, this article illuminates the variability of the forms (...) of subordination experienced by women practicing these occupations in France. Comparing these jobs with the ensemble of low-skill jobs and with each other exposes what is specific to the particular form of subordination each job type entails, in terms of the extent of job supervision and the nature of the home where it is practiced, the presence or absence of relations with coworkers and/or a “public,” and the nature of this “public.” It mobilizes nationwide statistical data in a new way to shift attention to these numerous ordinary work situations, which are much less studied than those of the domestic workers of the wealthiest cities of the Western world. (shrink)

Overweight individuals often struggle to lose weight. While previous studies established goal setting as an effective strategy for weight loss, little is known about the effects of numeric goal precision. The present research investigated whether and how the precision of weight loss goals—the number of trailing zeros—impacts a goal’s effectiveness. In two preregistered, longitudinal experiments, we contrasted competing predictions as to whether precise or round goals are more effective compared to a waiting control condition. In Experiment 1, participants in (...) the two goal conditions lost more weight compared to the control condition—an effect that was mainly driven by precise goals. In Experiment 2, we sought to replicate this effect but found no significant weight loss differences. An individual participant data meta-analysis across both experiments revealed that the goal groups jointly lost more weight than the waiting control group and the precise and round goal groups did not differ in weight loss success. An IPD-based multiple mediation analysis showed that healthier eating, but not physical exercise accounted for goal-setting-induced weight loss. We discuss possible explanations for the null findings in Experiment 2 and highlight directions for future research. (shrink)

Little is known about how certain patient characteristics can affect the timing of an ethics consultation, which has been hypothesized to affect patient length of stay. This study assessed how specific patient characteristics affect the timing of an ethics consultation, namely, age (over 65 years), race, Medicaid status, the presence of a living will, the presence of a health care proxy, and the absence of decisional capacity. Moving beyond the typical case-series evaluation of an ethics consultation service, this study (...) used an innovative approach to model how predisposing, enabling, and need factors affect health behavior and subsequently affect health outcomes for patients who received an ethics consultation at a Catholic health care system in Oklahoma. (shrink)

The purpose of this text is to tell the story of the implementation of the _Act Respecting End-of-Life Care,_ referred to hereafter as _Law 2_ (Gouvernement du Québec, 2014) with an emphasis on the ambiguous role of ethics in the Interdisciplinary Support Groups (ISGs), created by Quebec's _Ministère de la santé et des services sociaux_ (MSSS). As established, ISGs provide “clinical, administrative and ethical support to health care professionals responding to a request for Medical aid in dying (MAiD)” (Gouvernement du (...) Québec, 2015). It is suggested that their composition includes the participation of a person with an expertise in ethics. These ISGs represent an important innovation for stakeholders involved in MAiD. To date, no scientific research has specifically addressed ISGs and little research has been conducted in other jurisdictions on the roles, operations and practices of MAiD support structures, especially the implication of ethics. Several ISGs have certainly developed promising practices that could benefit all stakeholders in the wider field of ethics and end of life. We will explore the development of ISGs in Quebec as a support structure for MAiD by highlighting the role that ethics has played (and should play) in these morally and humanly challenging situations. (shrink)

Patient’s duties are a topical but little researched area in nursing ethics. However, patient’s duties are closely connected to nursing practice in terms of autonomy, the best purpose of care and rethinking from the patient’s perspective. This article is a metasynthesis (N = 11 original articles) of patient’s duties, aimed to create a tentative model. In this article, a tentative model called ‘right-based duties of a patient’ was constructed. With its aid, a coherent structure of patient’s duties within different (...) roles and objects of a patient can be defined. In addition, the ethical basis, prerequisites, outcomes and risks of patient’s duties can be named. In conclusion, so-called right-based duties of a patient constitute the basic argument. Patient’s duties are not unambiguous for all patients, and the global perspective to duties has been challenged. However, due to both conceptual and practical reasons, rethinking of patient’s duties is needed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 13.2 (2005) 142-145 [Access article in PDF] The Doing of Philosophy in the Music Class: Some Practical Considerations. Response to Bennett Reimer Mary J. Reichling University of Louisiana at Lafayette How I respond to Bennett Reimer's challenge depends in part on how we define philosophy in this context. We might think of philosophy as a subject of study, that is, philosophy in itself (...) such as epistemology, metaphysics, and so on. Or we may conceive it as philosophy of music, better designated as aesthetics. Or we may consider philosophy as a verb in the sense of "doing" philosophy where our goal is to assist students in developing their thinking skills. It seems that Reimer is placing focus on the last, the doing of philosophy, not that these other views of philosophy are mutually exclusive; they are not.Yet even this distinction is not sufficient for discussion. I am reminded of a little book edited by Eunice Boardman, titled Dimensions of Musical Thinking and published by MENC in 1989. It is a real gem with many fine ideas. In particular it stresses the relationship of content-area knowledge to thinking, and that is what I want to do. Developing thinking skills does not take place in a vacuum: "Now I am going to think." It occurs with respect to a subject area. We have philosophy of science, philosophy of history, philosophy of art, and so on, and philosophy of music.Further, our thinking about music occurs in at least two different ways. I suggest that music possesses both instrumental and intrinsic value with respect to philosophical analysis, as well as instances where the two values are combined. In pondering these values we bring together several so-called philosophical 'methodologies': the search for meaning or understanding, analysis, criticism, [End Page 142] and synthesis. In the process we build arguments that are consistent, coherent, and correspond with the musical evidence.1And further, in our field, students, whether it be through course content itself or through performance classes, have the advantage of gaining both propositional knowledge, learning that, for example, the rhythmic value of eighth notes, and procedural knowledge or learning how, for example, performing eighth notes vocally or instrumentally.2Both of which challenge the students' thinking skills.It is also important to articulate several assumptions if we aspire to "doing" philosophy within the teaching of music. These include a belief that it is worthwhile to develop such thinking skills as I have outlined; that we are willing to take the time for dialogue within the music class or rehearsal hour; and that we as teachers are willing to be facilitators of questions rather than experts with answers.I shall attempt with a few examples to show how these thinking processes might be integrated into the music curriculum following Jerome Brunner's view that children can be taught anything if done so at their level of understanding.The first example relates to the instrumental value of music as it supports text or programmatic conceptions. Let us consider the text of a particular song such as "Blowing in the Wind" or the "Kookaburra" song, the subject of an opera such as Berg's Wozzeck, or the topic of war as exemplified in Britten's War Requiem or some of the protest songs. We ask students how the extra musical subjects are established musically, how the music communicates the ideas, why one musical setting is preferred or better than another, and so forth. In dialoging about these examples, students must first of all be perceptive listeners or participants, then analyze at their level of ability. For an elementary child such analysis might be as simple as pointing out the tempo, mood, rhythms, dynamics, or other expressive elements. Advanced students will have a more extensive musical background to draw upon. Through the analysis students come to a synthesis of these factors that leads to greater understanding of the meaning of the music as they approach questions of value and beauty. If the teacher... (shrink)

In recent years Community Supported Agriculture (CSA), an innovative grassroots movement connecting consumers with a local farm, has rapidly spread across Germany and other industrialized countries. An increasing number of consumers who are dissatisfied with conventional food supply chains have signed up to receive fresh produce, support a local community and protect the environment. So far little is known, though, about the underlying value structures of CSA. Nevertheless, identifying factors influencing consumers’ interest in CSA is regarded as a major (...) aim of contemporary CSA research. This research aims to provide insights into CSA members’ value structures, and delineates CSA members by comparing their value structures to those of the German population in general. Schwartz’s Portrait Value Questionnaire was used in a standardized online survey of CSA members to mirror the dataset which is available to the German public via the European Social Survey. A total sample of 205 CSA members was used to examine common value structures by comparing them with the German public. This study’s findings strongly indicate that a CSA membership goes along with a characteristic value pattern: CSA members highly appreciate self-transcendence and openness to change, but tend to reject conservation and self-enhancement values. Addressing members’ preference for openness to change and self-transcendence may help CSAs to reduce fluctuation rates. It might also enhance CSA marketing strategy by addressing potential members’ interests more precisely. Therefore, identifying and communicating common values of a CSA might be a key factor in determining its long-term success and stability. (shrink)

Numerous studies have documented the detrimental impact of age-based stereotype threat on older adults' cognitive performance and especially on veridical memory. However, far fewer studies have investigated the impact of ABST on older adults' memory distortion. Here, we review the subset of research examining memory distortion and provide evidence for the role of stereotype threat as a powerful socio-emotional factor that impacts age-related susceptibility to memory distortion. In this review we define memory distortion as errors in memory that are associated (...) with gist-based errors or source misattributions. Whereas, some of the reviewed experiments support the conclusion that ABST should be considered in the context of age-related differences in memory distortion, others reported little or no impact of stereotype threat. These discrepancies suggest that the role of ABST, and socio-emotional processes generally, in age-related changes in memory distortion are less clear. In this review, we argue that ABST does play an important role in age-related changes in memory distortion. We present evidence suggesting that discrepancies in the reviewed literature may be reconciled when evaluated in the context of the leading theories about stereotype threat: the Executive Resource Depletion hypothesis and the Regulatory Focus theory. We also discuss how differences in methodology and participant characteristics can account for a priori contradictory results in the literature. Finally, we propose some recommendations for researchers and practitioners when assessing memory in older adults. (shrink)

Patient self-disclosure is essential to the work of health professionals, and this is even more critical in mental health where speech is a reflection of the content of thought. Self-disclosure is then about invisible symptoms that are associated with health problems where discrimination and stigmatization are still very prevalent. This article explores the ethical issues of this phenomenon which has received very little study. Disclosure as a decision-making, interpersonal, dynamic and complex process will be defined and deepened with the (...) help of examples from research. Subsequently, the vulnerability of the person who discloses will be addressed, followed by issues of quality of care and related to the standards of professional practice associated with patient disclosure and their associated responsibility. These elements highlight many ethical issues and ultimately lead us to a proposal to situate the professionals involved. (shrink)

Competition for resources is one of the main evolutionary explanations for dispersal from the natal area. For humans this explanation has received little attention, despite the key role dispersal is thought to play in shaping social systems. I examine the link between dispersal and resources using historical data on people from the small farming town of Oakham, Massachusetts (1750–1850). I reconstruct individual life histories through a variety of records, identifying dispersers, their age at dispersal, and their destinations. I find (...) that sex, father’s wealth and social status, and age at father’s death were all significantly associated with one or more dispersal variables. Birth order and number of siblings were not significantly associated with any of the dispersal variables. I also use wills and deeds to study transfers of land from fathers to sons. More stayers than dispersers acquired Oakham land from their fathers, but some sons who acquired Oakham land later dispersed. I discuss the causality underlying the relationship between dispersal and resource acquisition, as well as implications for a general understanding of human dispersal. (shrink)

For a little more than a decade, professional organizations and healthcare institutions have attempted to develop guidelines and policies to deal with seemingly intractable conflicts that arise between clinicians and patients over appropriate use of aggressive life-sustaining therapies in the face of low expectations of medical benefit. This article suggests that, although such efforts at conflict resolution are commendable on many levels, inadequate attention has been given to their potential negative effects upon particular groups of patients/proxies. Based on the (...) well-documented tendency among many African Americans to prefer more aggressive end-of-life medical interventions, it is proposed that the use of institutional policy to break decision making impasse in cases for which aggressive treatment is deemed “medically inappropriate” will fall disproportionately on that group. Finally, it is suggested that the development and application of institutional conflict-resolution policies should be evaluated in the context of historical and current experiences of marginalization and disempowerment, lest such policies exacerbate that experience. (shrink)

Research relating to patients’ views of the good nurse has mainly focused on the perspectives of adult patients, with little exploring the perceptions of children. This article presents findings from a qualitative study that explored views of the good nurse from the perspective of hospitalized children. The aims of the study were threefold: to remedy a gap in the literature; to identify characteristics of the good nurse from the perspective of children in hospital; and to inform children’s nursing practice. (...) Twenty-two children were interviewed using an adapted ‘draw and write’ technique. Five themes relating to children’s views of the good nurse emerged from the analysis: communication; professional competence; safety; professional appearance; and virtues. Each of these will be discussed in relation to good nurse literature and recommendations made for children’s nursing practice. (shrink)

Nurses’ duties and patients’ rights have been important foci in nursing. Nurses’ rights legitimate the power and responsibility of the profession. There are few published articles on this subject in the nursing science literature. This article is a theoretical examination of nurses’ rights that aims to structure (i.e. show the internal logic of) those that have been little studied. It is based on the philosophical literature and published research. Nurses’ rights can be divided into: human and civil rights, rights (...) based on health care legislation, professional rights, and earned rights. In this context, professional rights relate to nursing and also to tasks shared with other health care professions. Analyzing nurses’ rights will help to promote these rights, improve nurses’ position both nationally and internationally, and provide possibilities for enhancing patient care. (shrink)

Health‐care and public sector institutions are high‐risk settings for workplace bullying. Despite growing acknowledgement of the scale and consequence of this pervasive problem, there has been little critical examination of the institutional power dynamics that enable bullying. In the aftermath of large‐scale failures in care standards in public sector healthcare institutions, which were characterised by managerial bullying, attention to the nexus between bullying, power and institutional failures is warranted. In this study, employing Foucault's framework of power, we illuminate bullying (...) as a feature of structures of power and knowledge in public sector institutions. Our analysis draws upon the experiences of a large sample (n = 3345) of workers in Australian public sector agencies – the type with which most nurses in the public setting will be familiar. In foregrounding these power dynamics, we provide further insight into how cultures that are antithetical to institutional missions can arise and seek to broaden the debate on the dynamics of care failures within public sector institutions. Understanding the practices of power in public sector institutions, particularly in the context of ongoing reform, has important implications for nursing. (shrink)

"Jada's working on her science project. She's finding out whether plants grow best in water, milk, juice, or soda. There's just one problem--she keeps getting interrupted. From her cousin texting and her friends stopping by to her little brother playing with the plants, Jada runs into one obstacle after another. Find out how [she] relies on grit to keep on going"--Back cover.

In their own words: nurses’ discourses of cleanliness from the Rehoboth Mission For nurses of the nineteenth and early twentieth centuries, cleanliness was often seen as a virtue next to godliness. For missionary nurses, this analogy took on multiple meanings. This study focuses on discourses of cleanliness at one site of missionary nursing in the early twentieth century: the Rehoboth Mission and its hospital, which provided health‐care to the Navajo in the southwestern USA from 1903 to 1965. Data sources included (...) denominational publications, institutional records, correspondence, questionnaires and interviews of the Dutch–American missionary nurses who practiced at the Rehoboth Mission. Discourse analysis was conducted on references to cleanliness, hygiene and sanitation in these texts. Secondary discourses of embodiment in daily practice, initiation and assimilation, caring, ignorance, environmental factors and gendered work were identified and analyzed. The study interrogates the whiteness of the nurses’ dominant culture and sheds light on nurses’ relationships with normative discursive frames that reflect and perpetuate inequalities, discredit non‐dominant practices, and leave little room for competing discourses. It also illustrates a blurring of religion and health‐care, and the need for a reflective and informed stance as a basis for cultural competence. (shrink)

As concern over the use of questionable research practices in academic science has increased over the last couple of decades, some reforms have been implemented and many others have been debated and recommended. While many of these proposals have merit, efforts to improve scientific practices are more likely to succeed when they are responsive to the prevailing views and concerns of scientists themselves. To date, there have been few efforts to solicit wide-ranging input from researchers on the topic of needed (...) reforms. This article is a qualitative report of responses from federally funded scientists to the question of what should be done to address the problem of QRPs in their disciplines. Overall, participants were concerned about how institutional and career-oriented incentives encourage the use of QRPs. Compared to previous recommendations, participants had surprisingly little confidence in the ability of ethics training to improve research integrity. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy of Music Education Review 12.1 (2004) 17-29 [Access article in PDF] Intersections Form, Feeling, and Isomorphism Mary J. Reichling University of Louisiana at Lafayette These three concepts hold meanings that differ among musicians and aestheticians. In this essay I shall explore them in the writings of Susanne Langer. Contemporary musicians and aestheticians continue today to engage Langer albeit some favorably and others with disdain. Whatever their reasons, (...) she remains a dominant force in the philosophy of music.1 My purpose is not to defend her against her detractors, but rather to examine and to elucidate various aspects of these three concepts in her writing, as they are fundamental to an understanding of her aesthetic theory and to the construction of a philosophy of music and music education.First, I consider the broad and complex notion of form and the various ways Langer employs it in her aesthetic theory. Next, the rather all-encompassing idea of feeling as Langer conceives it is studied in relation to the form of the musical work. The intersection of form and feeling in the concept of isomorphism concludes the discussion. [End Page 17] Form In her various writings Langer uses several adjectives associated with the word "form" which seem to organize well into three groups. The first concerns the dynamic, living, organic, and vital qualities of form; the second speaks to its logical and abstract nature; and the last relates to the emotional or feeling aspect of form including expressive and significant characteristics.2 These groupings overlap and intertwine, but focusing on each specifically rather than all as a totality offers important insights.Form as dynamic, living, organic, and vital suggests metaphorical reference. Obviously the form is not physically, biologically, alive; reference is to the apparent movement, growth, and aliveness of the musical form as it is heard or performed. Thus this idea of form implies an actual performance to be realized or perceived. Langer is sometimes criticized for giving little attention to the actual making of music, that is, performance, yet her theory assumes music as heard. Essential to perceiving a dynamic form or hearing a feeling is a processual event, namely, performance or listening to a performance. Rarely a professional musician or gifted amateur might be able to engage this concept of form by reading through a score and hearing the music in imagination.Dynamic form parallels Eduard Hanslick's notion of tonend bewegte Formen. One might object that Hanslick and Langer are in conflict as Hanslick opposes while Langer supports the conviction that form is expressive of feeling, but that is moving beyond the matter at hand and suggests a superficial reading of both Hanslick and Langer. Hanslick asserts emphatically that music's meaning is not the arousal of emotion but does not deny feeling in music; Langer holds the same view. But Hanslick allows that "the words content and form are used not in the purely logical, but in an artistic sense." To me this suggests that he recognizes a nonliteral or metaphorical interpretation. He writes about the relationship of musical tones as "fraught with significance... congruity and opposition, their separating and combining, their soaring and subsiding-this is what comes in spontaneous forms before our inner contemplation and pleases us as beautiful." Certainly this parallels Langer's description of dynamic form.3 What is significant is that both philosophers are addressing the fluid, processual, active, movement-of-notes-through-time nature of musical form.The premise that forms are created by motion, are dynamic, is easily grasped by offering some examples. Fast cameras are able to take a series of photos of the movements of a pianist's hands giving still pictures of the moving forms created while performing a given passage.4 Alternately, forms are created by the movements of clouds or fog through the mist and early light; they are, in effect, quite literally moving forms. Cartoon characters generate moving forms through the [End Page 18] use of many drawings or more recently by means of computer animation. Time is a dynamic or moving form which we divide into hours... (shrink)

NEOCLASSICAL ECONOMICS IS INSTRUMENTAL IN CHARACTER, FOCUSING on the efficient realization of the sovereign desires of consumers. The emphasis on instrumental reasoning leaves little room for consideration of economic virtue. The tradition of Catholic social teaching has drawn on St. Thomas Aquinas for a framework that approaches economic problems through the lens of virtue. Thomas's thought, however, hinges on the socially determined standards of living of his day, which have no modern counterpart. The neglected consumer economist Hazel Kyrk offers (...) a theory of consumption that does center on the standard of living and thus offers us a bridge between Thomas's thought and our modern economic setting. (shrink)

Although ethicists are increasingly interested in virtue ethics, very little has been written about the nature of virtue. Yet understanding it is crucial for understanding virtue ethics. Some philosophers of science claim that virtue is a property reducible to the mere disposition to behave in certain specified ways given a particular situation. A virtue is correctly ascribed after the observation of the relevant behavior. This view reverses the classical virtue ethics of Aristotle. For him, behavior is identified as virtuous (...) in the proper sense after determining that the agent has the relevant virtue. The focus on virtue rather than action differentiates virtue ethics from the action-centered theories that have been dominant untiI recently.In this paper, I argue that virtue is an actual qualily. In the first part, I review Aristotle’s claim that virtue is not a mere potentiality. In the second part, I propose that this claim is supported hy the fact that we are aware of some virtues as actual qualities. If and only if virtues are actual qualities can they be the fundamental values virtue ethicists claim they are. (shrink)

This collection of eleven new essays contains the latest developments in analytic feminist philosophy on the topic of pornography. While honoring early feminist work on the subject, it aims to go beyond speech act analyses of pornography and to reshape the philosophical discourse that surrounds pornography. A rich feminist literature on pornography has emerged since the 1980s, with Rae Langton's speech act theoretic analysis dominating specifically Anglo-American feminist philosophy on pornography. Despite the predominance of this literature, there remain considerable disagreements (...) and precious little agreement on many key issues: What is pornography? Does pornography constitute women's subordination and silencing? Does it objectify women in harmful ways? Is pornography authoritative enough to enact women's subordination? Is speech act theory the best way to approach pornography? Given the deep divergences over these questions, the first goal of this collection is to take stock of extant debates in order to clarify key feminist conceptual and political commitments regarding pornography. This volume further aims to go beyond the prevalent speech-acts approach to pornography, and to highlight novel issues in feminist pornography-debates, including the aesthetics of pornography, trans* identities and racialization in pornography, and putatively feminist pornography. (shrink)

What is coercion and why do we care? Coercion is widespread and used especially when raising children, but on its darker side coercion can have devastating consequences. We are worried about coercion as it can invalidate consent. This is seen in the USA where campus rape cases have soared in recent years and brought consent and coercion back to the forefront of debate. Coercion is a hotly debated legal, political and ethical concept. However, in all this debate we have seen (...) little in the way of what coercion means exactly and how we determine it is taking place. Wertheimer and Garnett have interesting views about how coercion can be understood, from the morally wrong side of coercion to the situations where people are left much worse off because of its use. Only the morally wrong situations are subject to the law but there is a whole set of coercive situations that could take place which look bad to the outsider but are not necessarily morally wrong. This is the area of coercion I wish to discuss further. Wertheimer states that there are two types of coercion, moralised and non moralised. Moralised coercion concerns whether it was ‘wrongful’ to propose the offer and the non-moralised notion examines whether the coerced had any other reasonable choice. In a similar vein to Wertheimer, Garnett believes that coercion has two roles, Deontic (wrong) and Eudaimonic (bad). This would vaguely map to Deontic as Moralised and Eudaimonic as Non Moralised. Garnett discusses the eudaimonic version at length believing it is relatively unexplored in situations of coercion. This paper consists of 4 sections: • Section 1 discusses what Coercion is • Section 2 reviews Wertheimer’s view of Moralised and Non Moralised Consent • Section 3 discusses Garnett’s View • Section 4 considers a cost-benefit analysis of eudaimonically wrong situations. In conclusion it is apparent that, in order to have a full picture of what kind of situations coercion actually covers we must not simply rely on the deontic concept. The Deontic way of looking at situations will tell us what is morally wrongful and possibly redressable in court but many situations simply sit badly with us. It is here, in this arena, that the eudaimonic concept comes into its own. (shrink)

Representing parthood relations in ORM has received little attention, despite its added-value of the semantics at the conceptual level. We introduce a high-level taxonomy of types of meronymic and mereological relations, use it to construct a decision procedure to determine which type of part- whole role is applicable, and incrementally add mandatory and uniqueness constraints. This enables the conceptual modeller to develop models that are closer to the real-world subject domain semantics, hence improve quality of the software.

Historians of modern philosophy have been paying increasing attention to contemporaneous scientific developments. Isaac Newton's Principia is of course crucial to any discussion of the influence of scientific advances on the philosophical currents of the modern period, and two philosophers who have been linked especially closely to Newton are John Locke and Immanuel Kant. My dissertation aims to shed new light on the ties each shared with Newtonian science by treating Newton, Locke, and Kant simultaneously. I adopt Newton's philosophy of (...) geometry as the starting point of investigation, for here I believe we have a constructive means by which to assess Locke and Kant's relationship to Newton, In particular, I defend the thesis that the justification Newton, Locke and Kant offer for applying geometrical principles to nature is central to understanding their respective ties to a Newtonian science characterized by the intermingling of mathematics and experiment, Although little is said by Locke in regard to a mathematical approach to nature, I hope to show that his interpretation of the origins of our geometrical ideas has a close affinity to Newton's own characterization of geometry, leading us to reexamine the extent of Locke's 'Newtonianism.' Kant famously attempts to bridge the gap between geometry and the empirical world by establishing space as a "pure form of intuition." My discussion of Kant's Newtonian approach to nature centers on the imagination, and I argue that the mediating work completed by this faculty in geometrical construction and experience in general is equally important to understanding Kant's application of geometry to the empirical realm, In the end, I hope my treatment of the strategies employed by Newton, Locke, and Kant to account for a mathematical-experimental method of natural philosophy sheds further light on the importance of Newton to the progress of modern philosophy. (shrink)

BackgroundCancer diagnosis and treatment represent a real upheaval both for the patient and for his or her life partner. Adjustment to cancer has been widely studied at the individual level, however, there is little in the literature about the experiences of the couple as an entity. This is especially true with regard to a population facing advanced cancer. This systematic review aimed to make an inventory of 1) the current knowledge relating to the experience of the patient-partner dyad when (...) confronted with advanced cancer, and 2) the psychosocial interventions specifically centered on this dyad.MethodThis review was conducted using the Cochrane methodology. The eligibility criteria for the literature review were: one of the members of the dyad being treated for advanced cancer, dyad composed of the patient and his/her life partner. Databases from PubMed, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection and Scopus were investigated. A thematic content analysis on the basis of admitted articles made it possible to respond to each of our research objectives.ResultsThree hundred eighty-nine citations were found. Twenty were admitted to the systematic review of the literature. It highlighted the following experiences of the advanced cancer patient-life partner dyad: uncertainty about the future, disjointed time, intrusion into the couple's intimacy, attachment style and caregiving within the couple, couple's adjustment to cancer symptomatology, the couple's supportive care needs, role changes, nature of communication within the couple, anticipation of the coming death, and the meanings and beliefs around death. This review also describes the range of couple therapies used in the context of advanced cancer: emotionally focused-couple therapy, existential therapy, art therapy, support therapy and couple communication and intimacy promotion. These therapies seem to have individual beneficial effects for both the patient and his or her life partner as well as improving marital functioning.ConclusionsThese results clearly highlight that consideration of the couple and communication within the couple during care are fundamental to dyadic adjustment to advanced cancer. Further studies are needed to better understand the couple's experience in order to adapt the management of the couple facing advanced cancer. (shrink)

The extent to which Latin was familiar to the inhabitants of late sixth- and early seventh-century Constantinople is a topic of current discussion and interest. While there is little evidence to suggest a significant knowledge of Latin even among the educated in the seventh century, it is clear that in the late sixth century the language was still familiar to a section of the upper classes. Among native easterners, the degree of this familiarity would certainly have varied considerably, from (...) those who could recognise a few words of Latin, through the lawyers, administrators and military men who had a specialised, professional knowledge, to the small proportion who could detect the Virgilian echoes in Corippus' panegyric of Justin II. Whether Paul the Silentiary, epigrammatist and panegyrist of the Emperor Justinian's church of S. Sophia, should be included in the small category who were acquainted with Latin literature is indeed a more far-reaching issue than that of the survival of Latin in the eastern capital, since it is an element in the larger problem of the extent to which late Greek poets knew and imitated the work of their Latin predecessors. The broad generalisations of the past no longer satisfy modern scholarship, which rightly demands rigorous scrutiny of the evidence for each individual author. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Teaching Ethics in the Health Care Setting Part I:Survey of the LiteratureMary Carrington Coutts (bio)The last twenty years have brought important changes to health care and health care education. Educators and students alike face an enormous number of new fields of study and new medical technologies. Health care professionals and institutions are also facing new challenges in the form of shrinking economic resources, and the AIDS epidemic. They must (...) also respond to increased patient participation in health care decisions, and public concern about abortion and euthanasia. These challenges to the health care professional have compelled educators to accommodate ethics within their already overcrowded curriculum. Those same dilemmas have influenced health care institutions to become active in health care ethics education.Medical ethics education gained a foothold in the United States during the late 1960s, when the medical schools of Pennsylvania State University, the University of Florida, and the State University of New York at Stonybrook established programs in the humanities (Pellegrino 1982). In 1978 Robert Veatch noted that formal teaching in medical ethics was rare; most institutions that taught medical ethics used "informal instruction in the apprenticeship mode" (Veatch 1978). However, by 1982 a survey by the American Medical Association (AMA) revealed that all but one of the 127 medical schools had courses that included medical ethics. Thirty eight of these had medical ethics as a required course (Pellegrino 1985). And by 1989, 43 of the 127 medical schools had separate courses in medical ethics, while 100 covered medical ethics within required courses. Medical ethics is now an accepted part of medical curriculum, though it is not fully mature, and its future remains somewhat unclear (Miles 1989).The evolution of ethics in the nursing curriculum has essentially mirrored that of the medical curriculum. A 1977 survey of baccalaureate nursing programs revealed that only 7 percent of nursing programs required courses in ethics [End Page 171] (Aroskar 1977). A decade later a second survey of undergraduate programs identified 85 percent of responding nursing schools as teaching nursing ethics either in separate ethics courses or within other required courses (Cassells and Redman 1989).Though the precise future of health care ethics may be unpredictable, there is little thought that the role of ethics will diminish in importance as the 21st century approaches. Ethics is seen as part of a larger plan to develop and enhance the health professional's human values, social conscience, and interpersonal skills. "This broader effort derives from concerns about the personal attributes and humanistic sensitivity of physicians, the recent overly 'scientized' trend in premedical education, the selection of medical students, and the socialization and cynicism engendered by medical education" (Miles 1989, p. 705).While nearly every medical and nursing school in the United States now teaches ethics in one form or another, the degree to which ethics is integrated into the curriculum varies from school to school. Some ethics courses are required elements of the students' education; some institutions require attendance at seminars and ethics grand rounds. Other schools offer an array of elective courses in topics that relate to ethics in medicine and nursing (including medical humanities, medicine and the law, literature and medicine, history of medicine, patient advocacy, and human values in nursing.) "Brown bag" seminars and journal clubs are also common.There is much debate over how health care ethics should be taught. Some argue that medical professionals should be conversant with theories of ethics and principles of biomedical ethics. Others think that a theoretical approach will alienate already over-worked medical or nursing students, and that instruction in ethical theory should be kept to a minimum. Case studies are frequently cited as a way to involve students in medical decision making, forcing them to analyze problems that they can relate to their own experiences.Additional concerns center around who should teach health care ethics. Frequently, physicians and nurses interested in ethics teach courses. Some commentators see this as the most desirable arrangement, asserting that practicing health care professionals best understand the conflicts faced by physicians and nurses-in-training. However, there is a growing pool of professionals who are undergoing training as medical ethicists. These individuals study ethical theory and bioethical... (shrink)

What are the driving forces of cultural macroevolution, the evolution of cultural traits that characterize societies or populations? This question has engaged anthropologists for more than a century, with little consensus regarding the answer. We develop and fit autologistic models, built upon both spatial and linguistic neighbor graphs, for 44 cultural traits of 172 societies in the Western North American Indian (WNAI) database. For each trait, we compare models including or excluding one or both neighbor graphs, and for the (...) majority of traits we find strong evidence in favor of a model which uses both spatial and linguistic neighbors to predict a trait’s distribution. Our results run counter to the assertion that cultural trait distributions can be explained largely by the transmission of traits from parent to daughter populations and are thus best analyzed with phylogenies. In contrast, we show that vertical and horizontal transmission pathways can be incorporated in a single model, that both transmission modes may indeed operate on the same trait, and that for most traits in the WNAI database, accounting for only one mode of transmission would result in a loss of information. (shrink)