Background: There is little research into medical students’ or doctors’ attitudes to abortion, yet knowing this is important, as policy makers should be aware of the views held by professionals directly involved in abortion provision and changing views may have practical implications for the provision of abortion in the future. Methods: We surveyed 300 medical students about their views on abortion, their beliefs about the status of the fetus and the rights of the mother, their attitude towards UK law and (...) their willingness to be involved in abortion provision as qualified doctors. Results: 62% of medical students were pro-choice, 33% pro-life and 7% undecided. Students’ views correlated with gender, year of study and holding a religious belief. Their beliefs about abortion, the status of the fetus and the rights of women significantly correlated with their attitudes towards the UK law and their willingness to be involved in abortion provision. Students’ willingness to be involved in abortion provision was related to their views on abortion, the extent of participation required, the circumstances of the pregnancy and the stage of pregnancy. Conclusions: The percentage of pro-choice students was lower than that found in research on general practitioners’ attitudes to abortion. It is unclear whether this is because students become more pro-choice as they progress through their medical career or because there is genuinely a change in attitudes to abortion. (shrink)

Objective: To determine the views of people with multiple sclerosis (MS) and professionals in relation to confidentiality, consent and access to data within a proposed MS register in the UK. Design: Qualitative study using focus groups (10) and interviews (13). Setting: England and Northern Ireland. Participants: 68 people with MS, neurologists, MS nurses, health services management professionals, researchers, representatives from pharmaceutical companies and social care professionals. Results: People with MS expressed open and altruistic views towards the use of their personal (...) information to facilitate service provision and research, placing trust in responsible guardianship and legitimate use of their information. Participant’s proposed that people with MS should be able to select their individual level of involvement in a register using levels of consent. It was agreed that access to the register should be governed by a guardianship committee composed of a range of stakeholders. People with MS did not wish their details to be used by marketing agencies and did not consider this a legitimate use of their data. Whilst participants were positive of the role a register could play in promoting research, participants felt that access to data by pharmaceutical industries should be administered by the guardianship committee. People with MS are concerned should their employers be able to access their personal information. Professionals were more cautious than people with MS in their approach to the use of patient personal data within a register. Conclusions: Whilst all stakeholders were positive of the benefits of an MS register, development of such a resource must incorporate robust data security and guardianship measures in order to ensure that, whilst opportunities are maximised, risks to the privacy of individuals and legal challenges to professionals are avoided. (shrink)

Supported decision making, as outlined by Peterson et al. highlights real-world challenges in the messy context of clinical care. We agree with Peterson et al. that patients...

In an international survey of rationing we have found that European physicians encounter scarcity-related ethical difficulties, and are dissatified with the resolution of many of these cases. Here we further examine survey results to explore whether ethics support services would be potentially useful in addressing scarcity related ethical dilemmas. Results indicate that while the type of help offered by ethics support services was considered helpful by physicians, they rarely referred difficulties regarding scarcity to ethics consultation. We propose that ethics consultants (...) could assist physicians by making the process less difficult, and by contributing to decisions being more ethically justifiable. Expertise in bringing considerations of justice to bear on real cases could also be useful in recognising an unjust limit, as opposed to a merely frustrating limit. Though these situations are unlikely to be among the most frequently referred to ethics support services, ethics consultants should be prepared to address them. (shrink)

This book is the first to articulate and challenge the consensus on the right and left that knowledge is the key to any problem, demonstrating how the left’s embrace of knowledge productivity keeps it trapped within capital’s circuits. As the knowledge economy has forced questions of education to the forefront, the book engages pedagogy as an underlying yet neglected motor of capitalism and its forms of oppression. Most importantly, it assembles new pedagogical resources for responding to the range of injustices (...) that permeate our world. Building on yet critiquing the Marxist notion of the general intellect, Derek R. Ford theorizes stupidity as a necessary alternative pedagogical logic, an anti-value that is infinitely mute and unproductive. (shrink)

Traversing the fields of pedagogy, philosophy, and political theory, this book develops a marxist theory of education that will be useful for academics and activists alike. The second edition includes two additional chapters as well as a new preface and revisions throughout.

BackgroundThere is increasing need for peer reviewers as the scientific literature grows. Formal education in biostatistics and research methodology during residency training is lacking. In this pilot study, we addressed these issues by evaluating a novel method of teaching residents about biostatistics and research methodology using peer review of standardized manuscripts. We hypothesized that mentored peer review would improve resident knowledge and perception of these concepts more than non-mentored peer review, while improving review quality.MethodsA partially blinded, randomized, controlled multi-center study (...) was performed. Seventy-eight neurology residents from nine US neurology programs were randomized to receive mentoring from a local faculty member or not. Within a year, residents reviewed a baseline manuscript and four subsequent manuscripts, all with introduced errors designed to teach fundamental review concepts. In the mentored group, mentors discussed completed reviews with residents. Primary outcome measure was change in knowledge score between pre- and post-tests, measuring epidemiology and biostatistics knowledge. Secondary outcome measures included level of confidence in the use and interpretation of statistical concepts before and after intervention, and RQI score for baseline and final manuscripts.ResultsSixty-four residents (82%) completed initial review with gradual decline in completion on subsequent reviews. Change in primary outcome, the difference between pre- and post-test knowledge scores, did not differ between mentored (−8.5%) and non-mentored (−13.9%) residents (p = 0.48). Significant differences in secondary outcomes (using 5-point Likert scale, 5 = strongly agree) included mentored residents reporting enhanced understanding of research methodology (3.69 vs 2.61; p = 0.001), understanding of manuscripts (3.73 vs 2.87; p = 0.006), and application of study results to clinical practice (3.65 vs 2.78; p = 0.005) compared to non-mentored residents. There was no difference between groups in level of interest in peer review (3.00 vs 3.09; p = 0.72) or the quality of manuscript review assessed by the Review Quality Instrument (RQI) (3.25 vs 3.06; p = 0.50).ConclusionsWe used mentored peer review of standardized manuscripts to teach biostatistics and research methodology and introduce the peer review process to residents. Though knowledge level did not change, mentored residents had enhanced perception in their abilities to understand research methodology and manuscripts and apply study results to clinical practice. (shrink)

Background: Clinical ethics consultation services have been established in many countries during recent decades. An important task is to discuss concrete clinical cases. However, empirical research observing what is happening during such deliberations is scarce. Objectives: To explore clinical ethics committees’ deliberations and to identify areas for improvement. Design: A pilot study including observations of committees deliberating a paper case, semistructured group interviews, and qualitative analysis of the data. Participants: Nine hospital ethics committees in Norway. Results and interpretations: Key elements (...) of the deliberations included identifying the ethical problems; exploring moral values and principles; clarifying key concepts and relevant legal regulation; exploring medical facts, the patient’s situation, the therapists’ perspective, analogous clinical situations, professional uncertainties, the patient’s and relatives’ perspective, and clinical communication; identifying the involved parties and how to involve them; identifying possible courses of action, and possible conclusion and follow-up. The various elements were closely interwoven. The content and conclusions varied and seemed to be contingent on the committee members’ interpretations, experience and knowledge. Important aspects of a clinical ethics deliberation were sometimes neglected. When the committees used a deliberation procedure and a blackboard, the deliberations tended to become more systematic and transparent. Many of the committees were insecure about how to include the involved parties and how to document the deliberations. Conclusion: Clinical ethics committees may provide an important arena for multidisciplinary discussions of complex clinical ethics challenges. However, this seems to require adequate composition, adoption of transparent deliberation procedures, and targeted training. (shrink)

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

The Centre for Communist Studies, an academic research centre staffed by an artistic and comradely collection of early-career researchers, lecturers, educators and workers, started several years ag...

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

Air is an immersive substance that envelopes us and binds us together, yet it has dominantly been taken for granted and left out of educational and other theorizations. This article develops a conceptualization of the pneumatic common in order to address this gap. The specific intervention staged is within recent educational literature on the common by Noah De Lissovoy, Tyson E. Lewis, and Alexander Means. This literature is surveyed and analyzed in relation to educational theory, curriculum, pedagogy, and policy. Claiming (...) that the air is a central feature of and paradigm for the common, I then concentrate on making the air conditions of the educational common explicit. I do this through a theoretical, historical, and sociological reading of air conditioning. While this explicitation is itself educational, I return to the educational common at the end of the article to ask how and what we can learn in, with, and from the air. (shrink)

It’s not uncommon for people to make reference to atmospheres, including in relationship with educational spaces. In this article, we investigate educational atmospheres by turning to Western and Chinese literature on the air and wind. We pursue this task in three phases. First, we examine the Western literature to see the possible strings of thought that would help us reinvigorate the element of air/atmosphere as a foundational component of an educational sphere. Second, we historicize the Chinese notion of wind as (...) a style of reasoning which structures ancient Chinese cosmology, tempo-spatiality, teaching, and governing into a grid of intelligibility. Third, we argue for a bracketing of a trap of philology and a signifier-signified representational logic through reconceptualizing the atmosphere as a thing that blurs the material-figural boundary and that pushes into a new genre of educational life. (shrink)

This article draws on theoretical resources from economic sociology and sociology of law to intervene in economic debates about the relationship between intellectual property and industrialization. Utilizing historical evidence from the earliest period of American intellectual property law and from a formative company in the New England textile industry, I propose a social process of influence that connects intellectual property law to industrialization. I argue that, consistent with the findings of New Economic Sociology, social relationship structures and social capital are (...) the proximate influential force in industrialization. However, I also argue that transformative changes in those social relationship structures are rooted in the emergence of a particular type of political culture: what I call here, borrowing from Hannah Arendt and Frank Dobbin, a “Natal-Industrial Culture.” A Natal-Industrial Culture, as I propose it here, is a political culture in which collective hopes for the future are placed in new technologies and new cultural products, as means for achieving economic growth. Intellectual property law contributed to the emergence of this new type of political culture by holding out the promise of property, as a reward for the provision of new technologies or new cultural products. Because of the way that hope works on motivation—through cognitive pre-rehearsals of future attainment, which involve semantically-meaningful propositions and contribute to positive emotional experience—the promise of property provided a powerful stimulant to social capital formation. Working through the semantic resonances of property, intellectual property law contributed to a political culture in which invention and creativity were expected to secure a future of growth within the political community, both for particular members and for the political community, as a whole. By fostering a Natal-Industrial Culture, intellectual property law contributed to systematic invention and social capital-formation, leading, in turn, to the transformative changes in working and material provisioning that constitute industrialization. (shrink)

The ability to notice and reflect on distressing internal experiences from an objective perspective, often called psychological decentering, has been posited to be protective against mental health difficulties. However, little is known about how this skill relates to age across adolescence, its relationship with mental health, and how it may impact key domains such as affective executive control and social cognition. This study analysed a pre-existing dataset including mental health measures and cognitive tasks, administered to adolescents in Greater London and (...) Cambridge (mean age (SD) = 14.4 (1.77) years, N = 553). A self-report index of decentering based on available questionnaire items in the dataset was developed. Multiple linear regression was used to examine associations between decentering and mental health, affective executive control (measured using an affective Stroop Task, affective Working Memory Task, and affective Sustained Attention to Response Task) and social cognition. Higher decentering was significantly associated with lower depression and anxiety scores and higher psychological wellbeing. Results did not indicate significant relationships between decentering, affective executive control and social cognition. Further research is needed to discover cognitive mechanisms associated with this process, which could allow for optimisation of existing psychological therapy and reveal new avenues of intervention. (shrink)

In an effort to theorize educational logics that are oppositional to capitalism, this article explores what it means to study like a communist. I begin by drawing out the tight connection between learning and capitalism, demonstrating that education is not a subset but a motor of political-economic relations. Next, I turn to the concept of study, which is being developed as an educational alternative to learning. While studying represents an educational challenge to capitalism, I argue that there are political limitations (...) to studying for which we need to account. Specifically, studying is not in itself political, but only represents the possibility of politics. To make this claim and to address these limitations, I turn to Jodi Dean’s work on the communist Party. Dean posits the Party not as a master, director, or prophet, but as an infrastructure of affective intensity that maintains a gap in the order of things. I show that the Party is one way to organize and to defend study. Throughout the article, I illuminate the ways in which educational philosophers can contribute to political movement building by showing, developing, and refining the educational components of politics that many organizers and theorists neglect. (shrink)

While there was a flurry of articles throughout the 1990s in philosophy of education on Lyotard, there are still several key concepts in his oeuvre that have import for but remain largely underdeveloped or absent in the field. One of the most interesting of these absent concepts is Lyotard’s notion of the figural. In this paper, I take the figural as an educational problematic and ask what new educational insights it can generate in regard to the existing literature. As such, (...) this article begins with a survey and synthesis of educational literature on Lyotard and the primary work on which most of it is based, exploring the relationship between knowledge, performativity, the differend, and “the system.” I then examine conceptions of education oriented toward defending the differend and disrupting the system and claim that, while helpful, these conceptions are limited in that they do not mention how educators and students might engage the alterity that the system seeks to repress. I believe that it is here that Lyotard’s notion of the figural can be productively engaged. The next section of the paper performs a partial and educationally partisan reading of Discourse, Figure. After this reading I move to formulate a figural education, which is composed of three educational processes and modes of engagement: reading, seeing, and blindness. A figural education, I argue, holds each of these practices in an uncertain and unsettling relation and, in so doing, can help educators defend the figural and the differend against the discursive demands of the system. (shrink)

Drawing on macro-historical sociological theories, this book traces the development of intellectual property as a new type of legal property in the modern nation-state system. In its current form, intellectual property is considered part of an infrastructure of state power that incentivizes innovation, creativity, and scientific development, all engines of economic growth. To show how this infrastructure of power emerged, Laura Ford follows macro-historical social theorists, including Michael Mann and Max Weber, back to antiquity, revealing that legal instruments very (...) similar to modern intellectual property have existed for a long time and have also been deployed for similar purposes. Using comparative and historical evidence, this groundbreaking work reflects on the role of intellectual property in our contemporary political communities and societies; on the close relationship between law and religion; and on the extent to which law's obliging force depends on ancient, written traditions. (shrink)

Through an educational reading of Édouard Glissant and Peter Sloterdijk, this article draws out and develops latent pedagogical philosophies that bear distinct relationships to colonialism and struggles against and beyond colonialism. In particular, it identifies two related educational philosophies that propel colonization and, in turn, proposes a theory of errant learning that might undergird decolonization. It focuses on Glissant’s minor remarks about different conceptions of understanding in order to identify the grasping drive as the educational foundation of the colonizing apparatus. (...) After articulating the other form of understanding he offers, giving-on-and-with, I point to a potential contradiction in this division as it relates to his overall project. By freeing grasping from the grasping drive, I reconfigure the relationship between grasping and giving-on-and-with in a way that allows for certain kinds of enclosures. This introduces the question of pedagogical form, a question explored in Sloterdijk’s sphereological investigations. Reading the colonizing phase of globalization through Sloterdijk’s notion of lordly imagining—which I link with the grasping drive—the article draws out how different educational processes produce different kinds of spheres. Finally, it articulates errant learning as a pneumatic process of grasping and giving-on-and-with that values opacity over transparency to produce foam formations with attention to the history of inequality and injury through immune deprivation. (shrink)

This paper largely engages with Brian Ellis’s description of categorical dimensions as put forward in his paper in this volume. The New Essentialism advocated by Ellis posits the ontologically-robust existence of both dispositional and categorical properties. I have argued that the distinction that Ellis draws between the two is unpersuasive, and that the causal role of categorical dimensions—what they do—is inseparable from what they are. This observation is reinforced by the fact that absolute physical quantities permit re-interpretations of measurement that (...) remove a clear differentiation between categoricity and dispositionality. Distinguishing between ‘pure power’ and ‘dispositionality’, I further argue that: i) there are no ontologically-robust categorical properties, although their apparent existence is explicable as higher-order and supervenient; ii) that the fundamental ingredients of the world may be accounted for in terms of pure-power that is neither categorical nor dispositional; and iii) that the categorical-dispositional distinction arises only at the higher-order level of objects, and does not in any case constitute ontologically-robust partitioning of reality. -/- . (shrink)

In this volume, critical scholars and educational activists explore the intricate dynamics between the enclosure of global commons and radical visions of a common social future that breaks through the logics of privatization, ecological degradation, and dehumanizing social hierarchies in education. In its institutional and informal configurations alike, education has been identified as perhaps the key stake in this struggle. Insisting on the urgency of an education that breaks free of the bonds of enclosure, the essays included in this volume (...) weave together bright threads of radical thought into a vivid tapestry illustrating a critical framework for enacting a global educational commons. (shrink)

The future of work is forcing the world to adjust to a new paradigm of working. New skills will be required to create and adopt new technology and working methods. Additionally, cognitive skills, particularly creative problem-solving, will be highly sought after. The future of work paradigm has threatened many occupations but bolstered others such as engineering. Engineers must keep up to date with the technological and cognitive demands brought on by the future of work. Using an exploratory mixed-methods approach, our (...) study sought to make sense of how engineers understand and use creative problem solving. We found significant associations between engineers’ implicit knowledge of creativity, exemplified creative problem solving, and the perceived value of creativity. We considered that the work environment is a potential facilitator of creative problem-solving. We used an innovative exceptional cases analysis and found that the highest functioning engineers in terms of knowledge, skills, and perceived value of creativity, also reported working in places that facilitate psychosocially safe environments to support creativity. We propose a new theoretical framework for a creative environment by integrating the Four Ps and psychosocial safety climate theory that management could apply to facilitate creative problem solving. Through the acquisition of knowledge to engage in creative problem solving as individuals or a team, a perception of value must be present to enforce the benefit of creativity to the engineering role. The future of work paradigm requires that organisations provide an environment, a psychosocially safe climate, for engineers to grow and hone their sought-after skills that artificial technologies cannot currently replace. (shrink)

Background: Medicine is full of value conflicts. Limited resources and legal regulations may place doctors in difficult ethical dilemmas and cause moral distress. Research on moral distress has so far been mainly studied in nurses. Objective: To describe whether Norwegian doctors experience stress related to ethical dilemmas and lack of resources, and to explore whether the doctors feel that they have good strategies for the resolution of ethical dilemmas. Design: Postal survey of a representative sample of 1497 Norwegian doctors in (...) 2004, presenting statements about different ethical dilemmas, values and goals at their workplace. Results: The response rate was 67%. 57% admitted that it is difficult to criticise a colleague for professional misconduct and 51% for ethical misconduct. 51% described sometimes having to act against own conscience as distressing. 66% of the doctors experienced distress related to long waiting lists for treatment and to impaired patient care due to time constraints. 55% reported that time spent on administration and documentation is distressing. Female doctors experienced more stress that their male colleagues. 44% reported that their workplace lacked strategies for dealing with ethical dilemmas. Conclusion: Lack of resources creates moral dilemmas for physicians. Moral distress varies with specialty and gender. Lack of strategies to solve ethical dilemmas and low tolerance for conflict and critique from colleagues may obstruct important and necessary ethical dialogues and lead to suboptimal solutions of difficult ethical problems. (shrink)

Some science educators claim that children enter science classrooms with a conception of heat considered by physicists to be incorrect and speculate that “misconceptions” may result from the way heat is talked about in everyday language (e.g., Lautrey and Mazens, 2004 ; Slotta and Chi, 2006 ). We investigated talk about heat in naturalistic conversation to explore the claim that children often hear heat discussed as a substance rather than as a process, potentially hindering later learning of heat as energy (...) involved in emergent processes. We explored naturalistic speech among children and adults to understand the nature and the frequency of heat- and temperature-related conversations that young children are involved in. This study aims to investigate the actual linguistic resources that children have available as part of a sociocultural approach to cognitive development. Parents’ everyday conversations about heat and temperature with their 2–6-year-old children were drawn from the Child Language Data Exchange System (CHILDES) language database and from a parent–child book-reading study. Parents used the word heat rarely, but they did so in ways that implied it is a substance. Parents never talked about heat as an emergent process but sometimes as a direct causal process. Most of the heat- and temperature-related talk, however, focused on words like hot and cold to describe temperature as a property of objects. This investigation of what young children actually experience in everyday conversations is a step toward studying how everyday language may play a role in children’s understanding of heat and temperature. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using a stratified (...) purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

Objectives: To summarise the types of case brought to the Clinical Ethics Committee of the National Hospital of Norway from 1996 to 2002 and to describe and discuss to what extent issues of information/communication have been involved in the ethical problems. Design: Systematic review of case reports. Findings: Of the 31 case discussions, (20 prospective, 11 retrospective), 19 cases concerned treatment of children. Twenty cases concerned ethical problems related to withholding/withdrawing of treatment. In 25 cases aspects of information/communication were involved (...) in the ethical problem, either explicitly (n = 3) or implicitly (n = 22). Conclusion: Problems related to information/communication may underlie a classic ethical problem. Identification of these “hidden” problems may be important for the analysis, and hence, the solution to the ethical dilemma. (shrink)

Gilbert and colleagues point out the discrepancy between the limited empirical data illustrating changes in personality following implantation of deep brain stimulating electrodes and the vast number of conceptual neuroethics papers implying that these changes are widespread, deleterious, and clinically significant. Their findings are reminiscent of C. P. Snow’s essay on the divide between the two cultures of the humanities and the sciences. This division in the literature raises significant ethical concerns surrounding unjustified fear of personality changes in the context (...) of DBS and negative perceptions of clinician-scientists engaged in DBS. These concerns have real world implications for funding future innovative, DBS trials aimed to reduce suffering as well as hampering true interdisciplinary scholarship. We argue that the philosophical tradition of pragmatism and the value it places on empirical inquiry, experiential knowledge, and inter-disciplinary scholarship – reflecting diverse ways of knowing – provides a framework to start to address the important questions Gilbert and colleagues raise. In particular, we highlight the importance of expert clinician knowledge in contributing to the neuroethical questions raised by Gilbert and colleagues. Finally, we provide illustrative examples of some of our interdisciplinary empirical research that demonstrate the iterative cycle of inquiry characteristic of pragmatism in which conceptual neuroethics questions have led to empirical studies whose results then raise additional conceptual questions that give rise to new empirical studies in a way that highlights the contributions of the humanities and the sciences. (shrink)