Medicine is often thought of as a science of the body, but it is also a science of data. In some contexts, it can even be asserted that data drive health. This article focuses on a key piece of data technology central to contemporary practices of medicine: the medical record. By situating the medical record in the perspective of its history, we inquire into how the kinds of data that are kept at sites of clinical encounter often depend on informational (...) requirements that originate well outside of the clinic, in particular in health insurance records systems. Although this dependency of today's electronic medical records on billing requirements is widely lamented by clinical providers, its history remains little studied. Following the archaeology of medicine developed by Michel Foucault in The Birth of the Clinic and expanding his methodology in light of more recent contributions to the field of media archaeology, this article excavates some of the underexplored technological conditions that help constitute today's electronic medical record. If in some contexts, it is true that data drive health, then an archaeology of medical records helps reveal how health insurance records often impact clinical care and, by extension, health and disease. (shrink)

Mary Kalantzis was from 2006 to 2016 Dean of the College of Education at the University of Illinois, Urbana-Champaign. Bill Cope is a Professor in the College of Education at the University of Illinois, Urbana-Champaign. They are co-authors of multiple books including Making Sense: Reference, Agency, and Structure in a Grammar of Multimodal Meaning (Cambridge, forthcoming), New Learning: Elements of a Science of Education (Cambridge, 2008, 2012), Literacies (Cambridge 2012, 2016) and e-Learning Ecologies (2017).

The ethical debate about neurotechnologies—including both drugs and implanted devices—has been largely framed around the questions of whether and when these technologies could damage or promote authenticity. Patients can experience changes in mood, behavior, emotion, or preferences—seemingly, changes in character or personality. Some describe such changes by saying they feel like different people; that they have become either more or less themselves; or that they feel as though some of their moods, behaviors, emotions or preferences are not their own. These (...) kinds of statements are used to describe both changes that a drug or device is... (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)

Defends an account of mathematical knowledge in which mathematical knowledge is a kind of modal knowledge. Leng argues that nominalists should take mathematical knowledge to consist in knowledge of the consistency of mathematical axiomatic systems, and knowledge of what necessarily follows from those axioms. She defends this view against objections that modal knowledge requires knowledge of abstract objects, and argues that we should understand possibility and necessity in a primative way.

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)

This study explores the impact of mood on individuals’ ethical decision-making processes through the Graham [Graham, J. W.: 1986, Research in Organizational Behavior 8, 1–52] model of Principled Organizational Dissent. In particular, the research addresses how an individual’s mood influences his or her willingness to report the unethical actions of a colleague. Participants’ experienced an affectively charged, unrelated event and were then asked to make a decision regarding whistle-blowing intentions in a public accounting context. As expected, negative mood was associated (...) with lower intentions to report the unethical actions of others to a superior within the organization. The Graham model, which proposes that reporting intentions are impacted by the three determinants of seriousness, personal responsibility and cost, was employed to more clearly understand the nature of the affect–reporting intention relationship. The role of affect was explained by demonstrating that two determinants mediate the relationship between mood and whistle-blowing intentions. Specifically, as seriousness and responsibility have a positive impact on reporting intentions, the reduction of these perceptions by negative mood reduces the intent to report. The negative impact of personal cost on reporting intentions was significant, although not as a mediator of mood. (shrink)

Recently, concerns have been raised about the phenomenon of ‘overdiagnosis’, the diagnosis of a condition that is not causing harm, and will not come to cause harm. Along with practical, ethical, and scientific questions, overdiagnosis raises questions about our concept of disease. In this paper, we analyse overdiagnosis as an epistemic problem and show how it challenges many existing accounts of disease. In particular, it raises ques- tions about conceptual links drawn between disease and dysfunction, harm, and risk. We argue (...) that ‘disease’ should be considered a vague concept with a non-classical structure. On this view, overdiagnosed cases are ‘borderline’ cases of disease, falling in the zone between cases that are clearly disease, and cases that are clearly not disease. We then develop a pre ́cising definition of disease designed to provide practical help in preventing and limiting overdiagnosis. We argue that for this purpose, we can define disease as dysfunction that has a significant risk of causing severe harm to the patient. (shrink)

While Wallace disagreed with Darwin that domesticates provided a great deal of useful information on wild populations,71 Darwin continued to draw on his domesticated animals and plants to inform him on the workings of his theory. Unlike Wallace, his exposure to natural populations was extremely limited after his return from the Beagle voyage. By the 1850s, he had settled into a life at Down House and was becoming more and more withdrawn from London scientific circles. He turned to his network (...) of informants, visits from colleagues such as Hooker and T. H. Huxley, subscriptions to various journals, and his own experimental studies at Down.This work on domesticates was clearly related to other natural history studies conducted by Darwin and others during the same period. For example, during the 1850s when Darwin worked on domesticates, he was also engaged in questions of geographic distribution. To study the dispersal and subsequent viability of introduced seeds, he soaked various seeds in a tub filled with seawater and counted which of the seeds floated after a given period; later he planted the seeds in the yard at Down to look for potential viability. There was no attempt at controlled, replicated experiments in these studies, or in his work with domesticates, nor should there have been. To Darwin the results of one experiment represented a potential truth of nature, and he was quick to seize upon these results as supporting evidence for his theory.I have suggested in this paper that his work on domesticates was not simply meant to provide an analogy for natural selection but rather became a research program to investigate other aspects of his natural selection theory, especially inheritance and variability; these subjects were integral parts of his theory of natural selection, but by 1859 he had not found a mechanism to account for them. The experiments brought home the difficult problems of inheritance, and Darwin specifically formulated pangenesis to account for these problems. Pangenesis was not an afterthought but an integration of several decades of thinking on inheritance. It was a unified theory to explain the complicated results he witnessed in his own experiments.Much of the Darwin scholarship has focused on Darwin's path toward the discovery of natural selection. Natural selection per se was a major interest, but not the only area of interest to Darwin. Inheritance was an area of serious concern for him both before and after he had formulated natural selection. His experimentation with domesticates was an attempt to look beyond natural selection and to concentrate on the difficult subject of inheritance. He found inheritance especially troublesome, requiring a “provisional hypothesis” to account for it. To see domesticates, as they are described in the Origin, as merely an analogy for natural selection, does not account for the importance Darwin placed on them. For him they were not man's monstrous productions, but worthy experimental subjects providing him with crucial information on inheritance. (shrink)

We hypothesize that effective collaboration is facilitated when individuals and environmental components form a synergy where they work together and regulate one another to produce stable patterns of behavior, or regularity, as well as adaptively reorganize to form new behaviors, or irregularity. We tested this hypothesis in a study with 32 triads who collaboratively solved a challenging visual computer programming task for 20 min following an introductory warm‐up phase. Multidimensional recurrence quantification analysis was used to examine fine‐grained (i.e., every 10 (...) s) collective patterns of regularity across team members' speech rate, body movement, and team interaction with the shared user interface. We found that teams exhibited significant patterns of regularity as compared to shuffled baselines, but there were no systematic trends in regularity across time. We also found that periods of regularity were associated with a reduction in overall behavior. Notably, the production of irregular behavior predicted expert‐coded metrics of collaborative activity, such as teams' ability to construct shared knowledge and effectively negotiate and coordinate execution of solutions, net of overall behavioral production and behavioral self‐similarity. Our findings support the theory that groups can interact to form interpersonal synergies and indicate that information about system‐level dynamics is a viable way to understand and predict effective collaborative processes. (shrink)

After we die, our persona may live on in the minds of the people we know well. Two essential elements of this process are mourning and acts of commemoration. These behaviors extend well beyond grief and must be cultivated deliberately by the survivors of the deceased individual. Those who are left behind have many ways of maintaining connections with their deceased, such as burials in places where the living are likely to return and visit. In this way, culturally defined places (...) often serve as metaphors of social association and shared experience. Humans are the only kind of animal that buries their dead, and this gesture is preserved in Paleolithic sites as early as 120,000 years ago. Though not the only method of honoring the dead in human cultures, the emergence of burial traditions in the Middle Paleolithic implies that both Neandertals and early anatomically modern humans had already begun to conceive of the individual as unique and irreplaceable. Claims of primitive mortuary behavior in earlier periods than the Middle Paleolithic fall short in that they lack any signs of positive social-spatial associations between the deceased and survivors. The archaeological evidence for burial behavior in the Middle Paleolithic provides the first clear translation of mourning into a stereotypical action. These burials therefore may represent the first ritualized bridge between the living and the deceased in human evolutionary history. (shrink)

Personalised medicine has been discussed as a medical paradigm shift that will improve health while reducing inefficiency and waste. At the same time, it raises new practical, regulatory, and ethical challenges. In this paper, we examine PM strategies epistemologically in order to develop capacities to address these challenges, focusing on a recently proposed strategy for developing patient-specific models from induced pluripotent stem cells so as to make individualised treatment predictions. We compare this strategy to two main PM strategies—stratified medicine and (...) computational models. Drawing on epistemological work in the philosophy of medicine, we explain why these two methods, while powerful, are neither truly personalised nor, epistemologically speaking, novel strategies. Both are forms of correlational black box. We then argue that the iPSC models would count as a new kind of black box. They would not rely entirely on mechanistic knowledge, and they would utilise correlational evidence in a different way from other strategies—a way that would enable personalised predictions. In arguing that the iPSC models would present a novel method of gaining evidence for clinical practice, we provide an epistemic analysis that can help to inform the practical, regulatory, and ethical challenges of developing an iPSC system. (shrink)

Technological advances are making devices that functionally replace body parts—artificial organs and limbs—more widely used, and more capable of providing patients with lives that are close to “normal.” Some of the ethical issues this is likely to raise relate to how such prostheses are conceptualized. Prostheses are ambiguous between being inanimate objects and sharing in the status of human bodies—which already have an ambiguous status, as both objects and subjects. At the same time, the possibility of replacing body parts with (...) artificial objects puts pressure on the normative status typically accorded to human bodies, seemingly confirming that body parts are replaceable objects. The paper argues that bodies’ normative status relies on the relation of a body to a person and shows that persons could have similar relations to prostheses. This suggests that in approaching ethical issues surrounding prostheses, it is appropriate to regard them as more like body parts than like objects. (shrink)

Herbert Fingarett's achievements range from his assault upon the misconceived 'disease theory' of alchoholism, through social philosophy, philosophy of law, and philosophical psychology, to Chinese studies and Confucian thought. Fingarette's major works include 'The Self in Transformation' (1963), 'Self-Deception' (1969), 'Confucius---The Secular as Sacred' (1972), and 'The Meaning of Criminal Insanity' (1972). His Book, 'Heavy Drinking: The Myth of Alchoholism as a Disease' (1988), transformed the public debate on alchohol treatment and made Fingarette the target of an intense barrage of (...) abuse and vituperation from entrepreneurs in the alchohol-treatment industry. 'Rules, Rituals, and Responsibilities' contains Fingarette's intellectual autobiography, nine papers by leading scholars on different aspects of Fingarette's thought, and Fingarette's response to each of these papers. (shrink)

In the study of gender and society, science is a strategic analytic research site—because of the hierarchical nature of gendered relations, generally, and the hierarchy of science, particularly. Academic science, especially, is crucial to, and revealing of, status in science and society. This article focuses on three questions: What is the status of women in scientific careers and the role of graduate education in these careers? What are the implications for the analysis of gender? Where can we intervene, and how? (...) In addressing these questions, the arguments concentrate on the social and organizational context of science and its relationship to gender and status. (shrink)

Although a conventional environmentalism focuses on the health of ecological systems, Pope Francis’s 2015 environmental encyclical Laudato Sí invokes St. Francis of Assisi to emphasize God’s love for the individual organism, no matter how small. Decrying the tendency to regard other creatures as mere objects to be controlled and used, Pope Francis urges our enactment of a ‘universal communion’ governed by love. I suggest, however, that Laudato Sí’s animal ethic, as focused on ordering human and animal need, is inadequate to (...) its overarching vision of cross-species communion. This vision requires the sort of cross-species relational bridge implicit in Maurice Merleau-Ponty’s view of agency as an irreducibly ‘animate’ expression of choice and afforded further definition in Kenneth J. Shapiro’s conception of a ‘kinesthetic empathy.’ As the phenomenological epistemology underlying both discourses makes possible a rough correspondence, I put these in conversation to demonstrate that a Merleau-Pontyan and reciprocal agency is a constitutive aspect of the fullest sort of cross-species relation, such that recognition of this agency can both deepen our understanding of ‘universal communion’ and foster engagement in its practice. (shrink)

Offers information on English jurist and philosopher Jeremy Bentham (1748-1832), as part of the McMaster University Archive for the History of Economic Thought. Lists Bentham's published works and offers access to works by and about Bentham.

Reflecting on their service as mentors in the fellowship program, the authors describe their experiences and offer thoughts on lessons learned about mentoring, individuals' roles in institutional changes, their own professional growth, and implications for and evaluation of legal and interprofessional education.

This research aimed to analyse inclusive practice in academic integrity in the teaching, support, policies and procedures involved at one UK HE institution. Data was collected through two sets of stakeholder interviews: three students from disadvantaged groups who had experienced academic conduct investigations; eleven staff with key roles in academic integrity. A third set of data comprised four institutional academic integrity documents which were analysed in terms of meeting Universal Design for Learning principles for inclusion. The four main findings emerging (...) from the study are: academic conduct processes create high levels of anxiety among students, particularly related to perceived judgement; students experience difficulty understanding academic integrity documents which lack consistency and do not meet inclusive criteria; students from certain backgrounds including widening participation, students with a disability and international non-native speakers need more institutional support in order to follow academic conduct processes and assimilate expected practice; there is a willingness among staff to try to develop more inclusive practice. The research findings led to a revised, more inclusive and educative institutional academic conduct procedure. The implication for practice is that attention is urgently needed to improve inclusive approaches to academic integrity. (shrink)

Respect and dignity are central to moral life, and have a particular importance in health care settings such as the intensive care unit (ICU). We conducted 15 semistructured interviews with 21 participants during an ICU admission to explore the definition of, and specific behaviors that demonstrate, respect and dignity during treatment in the ICU. We transcribed interviews and conducted thematic qualitative analysis. Seven themes emerged that focused on what it means to be treated with respect and/or dignity: treated as a (...) person; Golden Rule; acknowledgement; treated as family/friend; treated as an individual; treated as important/valuable; and treated as equal. Participants described particular behaviors or actions that were considered related to demonstrating treatment with respect and dignity: listening; honesty/giving information; attention to body/modesty/appearance; caring/bedside manner; patient and family as an information source; attention to pain; and responsiveness. These behaviors provide a framework for improving experiences with care in the ICU. (shrink)

In this book, Mary Townsend proposes that, contrary to the current scholarship on Plato's Republic, Socrates does not in fact set out to prove the weakness of women. Rather, she argues that close attention to the drama of the Republic reveals that Plato dramatizes the reluctance of men to allow women into the public sphere and offers a deeply aporetic vision of women’s nature and political position—a vision full of concern not only for the human community, but for the (...) desires of women themselves. (shrink)

In 1989, Helga Wanglie, 86 years old, broke her hip. This began a medical downhill course that a year later caused her health care providers to conclude that she would not benefit from continued medical treatment. It would be futile, and therefore, should not be provided. Her husband disagreed, and the conflict eventually led to a lawsuit. The Wanglie case touched off an extended debate in the medical and bioethical literature about medical futility: what it means and how useful the (...) concept is in making ethical decisions about starting or stopping treatment. (shrink)

This book provides an introduction to literacy pedagogy within today's new media environment.

This book engages contemporary debates about the notion of secularism outside of the field of education in order to consider how secularism shapes the formation of progressive sexuality education. Focusing on the US, Canada, Ireland, Aotearoa-New Zealand and Australia, this text considers the affinities, prejudices, and attachments of scholars who advocate secular worldviews in the context of sexuality education, and some of the consequences that ensue from these ways of seeing. This study identifies and interrogates how secularism infuses progressive sexuality (...) education. It asks readers to consider their own investments in particular ways of thinking and researching in the field of sexuality education, and to think about how these investments have developed and how they shape existing discourses within the field of sexuality education. It hones in on how progressive sexuality education has come to develop in the way that it has, and how this relates to conceits of secularism. This book prompts a consideration of how "progressive" scholarship and practice might get in the way of meaningful conversations with students, teachers, and peers who think differently about the field of sexuality education. (shrink)

What should a Quinean naturalist say about moral and mathematical truth? If Quine’s naturalism is understood as the view that we should look to natural science as the ultimate ‘arbiter of truth’, this leads rather quickly to what Huw Price has called ‘placement problems’ of placing moral and mathematical truth in an empirical scientific world-view. Against this understanding of the demands of naturalism, I argue that a proper understanding of the reasons Quine gives for privileging ‘natural science’ as authoritative when (...) it comes to questions of truth and existence also apply to other stable and considered elements of our inherited world-view, including, arguably, our firmly held mathematical and moral beliefs. If so, then the ‘thin’ mathematical and moral realisms of Penelope Maddy and T. M. Scanlon, respectively, are vindicated. We do not need to shoehorn mathematical and moral truths into the pushings and pullings of our empirical scientific world-view; for the busy sailor adrift on Neurath’s boat, mathematical and moral truths already have their place. (shrink)

Introduction/Background: Moral distress and related concepts surrounding morality and ethical decision-making have been given much attention in nursing. Despite the general consensus that moral distress is an affective response to being unable to act morally, the literature attests to the need for increased clarity regarding theoretical and conceptual constructs used to describe precisely what the experience of moral distress involves. The purpose of this study is to understand how student nurses experience morally distressing situations when caring for patients with different (...) values and beliefs than their own in the clinical environment -/- Methods: This study is based on secondary analysis of participant data. The stories of eight student nurses who completed the original study were reviewed following Yin’s multiple-case study design. -/- Results: Findings suggest there is a subtle form of moral distress that has been under appreciated in the literature and differs from Jameton’s classic definition. While traditional institutional triggers to moral distress are pervasive, personal conflict as a result of differing value systems may be a moral challenge faced by nursing students working with culturally diverse patients. -/- Conclusion: Ethics education is needed in nursing school to reduce moral distress in the clinical environment. Nursing students need opportunities to develop moral reasoning skills in addition to their clinical skills. A philosophical approach to ethics education may be needed to prevent and alleviate moral distress. (shrink)

Like most other Australian languages, Warlpiri – a Pama-Nyungan language of the Ngumpin-Yapa group – is rich in figurative expressions that include a body-part noun. In this article we examine the collocations involving two body parts:langa‘ear’, which mostly relates to cognition; andmiyalu‘belly’, which mostly relates to emotion. Drawing on an extensive Warlpiri database, we analyse the semantic, figurative and syntactic dimensions of these collocations. We note how reflexive variants of certain collocations impose a non-literal aspectual reading, as also observed in (...) Romance and Germanic languagesinter alia. The article also highlights differences between the range of body-based emotion metaphors found in Warlpiri, and that reported for the non-Pama-Nyungan languages of Australia. We hypothesize that these differences sometimes reflect grammatical differences. In particular, Warlpiri allows body-part nouns in syntactic functions that rarely found in non-Pama-Nyungan languages, due to the prevalence of body-part noun incorporation in the latter group. (shrink)

This article examines the participation of women in the 1985 labor strike at Wheeling-Pittsburgh Steel. The author views the strike as a deeply gendered act of protest where the issues, strategies, tactics, and resources used by women workers differ from those used by men, and simultaneously, as the occupational site that provided workers an opportunity to affirm, to modify, and to contest their understandings of gender. Paradoxically, women both challenge and conform to normative gender scripts for protest. They resisted the (...) efforts of men to impose a gender division of labor and sought to mobilize the community in support of the strike. (shrink)

A basic principle of objectification theory is that a mere glance from a stranger represents the potential to be sexualized, triggering women to take on the perspective of others and become vigilant to their appearance. However, research has yet to document gendered gaze patterns in social groups. The present study examined visual attention in groups of varying gender composition to understand how gender and minority status influence gaze behavior. One hundred undergraduates enrolled in psychology courses were photographed, and an additional (...) 76 participants viewed groupings of these photographs while their point of gaze was recorded using a remote eye-tracking device. Participants were not told that their gaze was being recorded. Women were viewed more frequently and for longer periods of time than men in mixed-gender groups. Women were also more likely to be looked at first and last by observers. Men spent more time attending to pictures of women when fewer women were in the group. The opposite effect was found for pictures of men, such that male pictures were viewed less when fewer pictures of men were in the group. Female observers spent more time looking at men compared to male observers, and male observers spent more time looking at women than female observers, though both female and male observers looked at women more than men overall. Consistent with objectification theory, women’s appearance garners more attention and interest in mixed-gender social groups. (shrink)

We review the findings of Cho et al.(1) on the crystal structure of a p53 tumor suppressor‐DNA complex. The core DNA binding domain of p53 folds into a structure termed a β‐sandwich, which organizes two loops and a loop‐sheet‐helix structure on one surface of p53 to interact with the consensus DNA recognition sequence of p53. These structures help to explain the functions of wild‐type p53 and the effects of tumor‐associated mutations on p53 DNA binding, transactivation and suppression of cellular proliferation.