Ute Gahlings opens up the professional field of philosophical practice with its various forms of activity such as consolation and life orientation, education and personality development as well as political and social commitment. On the basis of concrete situations in philosophical practice, she traces the complex intersubjective processes phenomenologically. She illuminates the importance of intuition, presence and atmosphere as well as the professional framing of the encounter in the field of tension between proximity and distance. In this multidimensionality, the author (...) is always concerned with core questions of an ethically based anthropology. Therefore, she also deals with professional ethical considerations and develops a code of ethics. (shrink)

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

Definition of the problem: Discussions of “holistic” medical practice confine themselves to the treatment of so-called “psychosomatic disorders”. This paper traces ways in which the patient's personal unity may become apparent to medical practitioners during three critical steps of everyday practice: physical examination, “medical history” (anamnesis) and treatment. Physical examination touches on the patient's “Leiblichkeit” (his “organ” of bodily self-awareness of being a person). Objectifying of the “Leiblichkeit” may constitute an infringement upon the patient's personal unity and is only justified (...) by strict medical indication. The patient not only is ill but he “acts” his illness (subject of and to his disease). Medical history concentrates on the development of a disease but also has to keep in mind the potential biographical meaning of being ill and the patient's biographical identity. The aim of medical treatment, finally, may touch on the patient's existential goals.Conclusion: These three steps of medical practice are not discipline-specific, but span all areas of medical practice. It is argued that medical decisions should be guided by considerations of the patient's personal unity at each of the three steps. (shrink)

A currently popular proposal for fairly distributing emission quotas is the equal shares view, which holds that that emission quotas should be distributed to all human beings globally on an equal per capita basis. In this paper I aim to show that a number of arguments in favour of equal shares are based on a misleading analysis of climate change as a global commons problem. I argue that a correct understanding of the way in which climate change results from the (...) overuse of a global commons shows those who defend equal shares using commons arguments to be harbouring more controversial commitments than might at first appear. I then discuss two options for equal shares theorists who wish to maintain the view in the face of my critique, and attempt to show that one approach holds more promise than the other. (shrink)

Cancer cells seem to exploit mechanisms that evolve as part of physiological tolerance, which is a complementary and often beneficial form of defense. The study of physiological systems of tolerance can therefore provide insights into the development of a state of host tolerance of cancer, and how to break it. Analysis of these models has the potential to improve our understanding of existing immunological therapeutic targets, and help to identify future targets and rational therapeutic combinations. The treatment of cancer with (...) immune checkpoint inhibitors aims to reverse the progression to tolerance of cancer, and achieve an immunogenic, rather than tolerogenic, homeostasis. Broadening the efficacy and durability of checkpoint inhibitors focuses on reversing tolerance and stimulating immunogenicity in the cancer, host, and environment. Two examples of important physiological states of tolerance that may inform tolerance of cancer are microbial infection and placental reproduction. These states of tolerance result from bilateral shaping of host and non‐self, akin to immunoediting in cancer, and offer reliable models to study the immune tolerance paradigm. (shrink)

Many economists, it is said, “are inclined to deny that moral philosophy has anything to do with economics” . In this paper I challenge such inclinations bydrawing an analogy between economic interventions and humansubjects research. It is undeniable that investigators engaged in thelatter should adhere to specific ethical principles. I argue that analogousfeatures of economic interventions should lead us to recognise thatsimilar ethical concerns actually arise in both activities, and thusthat economic interventions should also be conducted in accordancewith ethical principles. (...) By exploring the analogy further I formulatesome ethical guidelines for economic practice, which in turn imply thatethical responsibilities will extend to all members of the economicsprofession. (shrink)

Community-based food cultivation by and for rural Alaskans has never been stronger. Rural gardeners, many Indigenous, provide their families and communities with affordable access to high-quality fruits and vegetables and other locally grown foods. Despite these emerging trends, there is sparse examination of gardening as a complementary, diversification, or adaptation strategy in wild food-centered systems and the interchange of values and worldviews among practices. Findings from interviews and surveys in Dillingham, Alaska, and interviews with community-focused gardens throughout the state, inform (...) our research questions about the role of gardening in rural Alaska and the links between food cultivation practices and wild food traditions. In this study we find that home gardeners are essential pillars of food sovereignty and security in their communities, providing both gardened foods and high volumes and more diversity of wild foods. Gardening households increase the diversity of shared food resources in the community and serve as sinks of gardening knowledge and supplies for other community members. Traditional food practices and ethics are interwoven into gardening and have become part of annual food rounds and celebrations. Locally, cultivated foods are often described as a complement to age-old foodways that draw on histories and values connected to Indigenous agriculture and horticulture in the United States and Canada. Policies, practices, and programming of food and nutrition security and food sovereignty must consider the holistic food system and strategies that communities desire and invest in. (shrink)

Growing interest in complementary and alternative veterinary medicine (CAVM) has sparked a debate among veterinarians, who claim such therapeutic modalities fall under the purview of veterinary medicine, and non-veterinarians, who argue that several modalities do not require the rigorous training of a veterinarian to be performed safely. The veterinary profession must proactively redefine its definition of the practice of veterinary medicine in the face of increasing challenges to state practice acts. By looking to human medicine as a model for how (...) to balance conventional and alternative modalities, the profession can develop a system that provides animal caregivers access to CAVM while still safeguarding animal health. (shrink)

Enrollers play a critical yet often overlooked role in clinical research, particularly in informed consent processes. Study retention may depend in part on how complex information is conveyed to potential participants. This qualitative study aimed to assess communicative barriers during consent and enrolment in two South African TB/HIV clinical studies. In particular, we compared our own perceptions of potential challenges to consent with that of thirteen enrollers, gained via reflective journaling and focus group discussions. Some overlap of identified challenges was (...) evident, including terminology, jargon and consent document format. However there were mismatches to identified challenges. Enrollers provided further insights into potential challenges to consent, in particular, blood withdrawal, discussion of sexual issues and misunderstanding of study participation. Enrollers also reported feeling ill‐equipped to provide counselling when participants became distressed. We offer several recommendations for strengthening the inclusion of enrollers in the development of clinical research protocols and consent documents. (shrink)

Modernist Fiction and Vagueness marries the artistic and philosophical versions of vagueness, linking the development of literary modernism to changes in philosophy. This book argues that the problem of vagueness - language's unavoidable imprecision - led to transformations in both fiction and philosophy in the early twentieth century. Both twentieth-century philosophers and their literary counterparts were fascinated by the vagueness of words and the dream of creating a perfectly precise language. Building on recent interest in the connections between analytic philosophy, (...) pragmatism, and modern literature, Modernist Fiction and Vagueness demonstrates that vagueness should be read not as an artistic problem but as a defining quality of modernist fiction. (shrink)

The acceleration of technological change due to Industry 4.0 causes a need for new features of old virtues. Recent discoveries in neuroscience and in cognitive behavioral therapy complement classical virtue theory, especially that of Aristotle and Aquinas, to offer new scientific appreciation for classical virtues and more effective strategies for their acquisition. Self-mastery requires the ability to maintain focus on the task at hand in accord with one’s commitments by avoiding rumination, intrusive thoughts, and distractions. Mindfulness, positive psychology, and neuroscience (...) complement the recent philosophical study of the virtues of acknowledged dependence (MacIntyre) and offer strategies for embracing stress for personal and community growth through work within teams shaped by shared goals. The freedom to focus in accord with personal commitments can both contribute to and benefit from the shared goals of a team that is shaped by a common hope. (shrink)

As Children’s Laureate 2013–2015, Malorie Blackman raised awareness of the lack of racial diversity in children’s fiction. Underrepresentation of ethnic minorities in fiction and the publishing industry’s infrastructure is a severe problem in the world of children’s books, as illuminated by research into the publishing environment of the past 15 years, and the books populating current bestseller charts. Pierre Bourdieu’s theory of economic and symbolic capital is important to understanding how diversity is highlighted in the contemporary literary field, but his (...) polarization of the different form of capital as motivation for creating art is reductive. Storytelling is about combining voices and experiences, and publishers can, and should, combine economic and symbolic motivations in publishing diverse fiction for children. Publishing a book because it will be successful economically and because it is the right thing to do are not mutually exclusive; in publishing diverse children’s fiction, both motives can and should inspire us. (shrink)

Pihlström’s book, Pragmatist Metaphysics, offers what he feels “no previous book-length study” (viii) has accomplished: as the title suggests, he sketches how metaphysics would look when done from a pragmatic perspective. This involves rejecting two assumptions: that metaphysics is necessarily “realistic” and that pragmatism is necessarily antimetaphysical. Taking his bearings from pragmatists both classic (e.g. Peirce, James, and Dewey) and contemporary (e.g. Putnam), he argues for a “pragmatic realism” that examines the basic characteristics of our human reality. A good primer (...) for those with some background and interest in pragmatism and metaphysics, and who would like to see the latter tailored to the former .. (shrink)

Introduction: toward a theory of infrahumanity -- Bioexpansionism, 1900s-1930s -- Brief histories of time: nature, culture, and the making of modern childhood -- Ocular anthropomorphisms: eugenics and primatology at the threshold of the "almost human" -- Extraterrestriality, 1940s-1970s -- On alien ground: extraterrestrial sightings, atomic warfare, and the undoing of the human body -- Inner and outer spaces: exobiology, human genetics, and the disembodiment of corporeal difference -- Interiority, 1980s-2010s -- Of sodomy and cannibalism: disgust, dehumanization, and the rhetorics of (...) same-sex and cross-species contagion -- Everything except the squeal: porcine hybridity in the obesity epidemic and xenotransplantation research -- Conclusion. the plurality is near: techniques of symbiotic re-speciation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Beastly Vagueness in Charles Sanders Peirce and Henry JamesMegan M. QuigleyIn 1878, Charles Sanders Peirce closed the first section of "How to Make our Ideas Clear"—an article that William James later declared a "birth certificate of Pragmatism"—on a strangely anecdotal note.1 Using what would become known as the pragmatic method to demolish the notion of Grand Ideas ("Our idea of anything is our idea of its sensible effects"), Peirce (...) also included a lesson from an "old German story":Many a man has cherished for years some vague shadow of an idea, too meaningless to be positively false; he has nevertheless, passionately loved it, has made it his companion by day and by night, and has given to it his strength and his life, leaving all other occupations for its sake, and in short has lived with it and for it, until it has become, as it were, flesh of his flesh and bone of his bone; and then he has waked up some morning to find it gone, cleaned vanished away like the beautiful Melusina of the fable, and the essence of his life gone with it. I have myself known such a man.(WCSP, p. 261)The story of the fled Melusina (a half-woman, half-serpent who gives birth to monsters) acts ostensibly as a warning against the danger inherent in "vague" ideas. "A vague shadow of an idea" can sap the life-blood out of a young man and, therefore, Peirce asserted, we must strive to be clear. But Peirce's anecdote did more than further his argument; it was an autobiographical aside—so personal, in fact, that he ordered the passage to be deleted in all future printings of his essay.Melusina was not just an allusion to a mythological figure; it was also a reference to the middle name of his wife, Harriet Melusina Fay. Since his schooldays, Peirce's friend and, later, wife, whom he called [End Page 362] "Zina," had been his constant companion and even the scribe for his fervent aspirations. Under the title "Theories of C. S. Peirce, 1854" she had transcribed his ambitious declaration: "My life is built upon a theory: and if this theory turns out false, my life will turn out a failure" (Brent, p. 51). By the mid 1870s, Peirce's theory, "passionately loved... his companion by day and by night," was finally being elucidated in his articles; however, Melusina herself had "cleaned vanished away," after two decades of intimacy, leaving Peirce in Paris to what his friend Henry James described as "a very lonely and dreary existence." Peirce's inclusion of an anecdote about his own loneliness—"I have myself known such a man"—is poignant even as it reveals his anger. Melusina is both a monster and "beautiful," and with her disappearance, Peirce has lost, "the essence of his life." The personal allusion also highlights the anxiety in the young Peirce's writing. What if his theories came to nothing, remained merely vague, and he lost his whole life and his wife to a misguided dedication? And how ironic would that be given that the idea itself aimed to explode the fallacy of grand ideas? Such an irony was not lost on his main companion during the winter of 1875, Henry James.In the following pages I aim to demonstrate that Charles S. Peirce's anxiety acted as a germ for the beast of John Marcher in James's late story, "The Beast in the Jungle." "More than any of Henry James's tales," Paul Lindholdt writes, "'The Beast in the Jungle,' has prompted source studies and psychoanalytic discussions by critics striving to identify" John Marcher.2 Eager to diagnose the relationship between Marcher and May Bartram, critics have sought both autobiographical and literary sources for Marcher's character.3 Strangely, however, no one has noted the connection between Peirce and Marcher, an omission that is especially odd given the critical attention directed at the relationship between the story and pragmatism. Since Richard Hocks's Henry James and Pragmatistic Thought highlighted the pragmatic tendencies of James's story and called Marcher the "anti-pragmatist" hero, "an epitome of William's... (shrink)

We investigated the ethical decision-making processes and intentions of 151 military personnel responding to 1 of 2 ethical scenarios drawn from the deployment experiences of military commanders. For each scenario, option choice and perspective affected decision-making processes. Differences were also found between the 2 scenarios. Results add to the emerging literature concerning operational ethical conflicts and highlight the complexity and challenge that often accompanies operational ethics.

This essay argues that a renewed focus on the importance of embodied social play for people of all ages, but especially for children and teenagers, is an essential element of forming an interdisciplinary response to the mental health crises facing children and young people today. It examines the role of play from the perspective of the sciences, especially psychology and evolutionary biology, but it also draws insights from philosophy and theology to extend its arguments into the arenas of theological anthropology (...) and aesthetics. In addition to the many psychological, emotional, physical, cognitive, and social benefits of play, there is research to suggest that forms of juvenile play, especially ‘pretend play’, in children contribute to the development of capacities relevant for aesthetic experience and expression such as creativity, symbolic representation, mental flexibility, and imagination. This suggests that attention to play and, more broadly, to childhood and children, is important for developments in theological aesthetics. It suggests, at the same time, that theology has important grounds to insist on the goodness of play ‘for its own sake’, while also celebrating the downstream evolutionary benefits of play. (shrink)

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

In lieu of an abstract, here is a brief excerpt of the content:When Is Enough, Enough?Megan HomsyThis was a case that stuck with many members of our transplant team for a long time. The patient was a 44-year-old Caucasian male evaluated for a liver transplant with a diagnosis of hepatitis C virus (HCV), originally diagnosed 11 years before the transplant evaluation. The patient met the criteria for the following substance use diagnoses: alcohol use disorder moderate in sustained remission, in (...) a controlled environment, opioid use disorder, severe, in sustained remission, on maintenance therapy, in a controlled environment, stimulant use disorder, amphetamine-type, severe, in early remission, in a controlled environment and stimulant use disorder, cocaine-type, severe in early remission, in a controlled environment.The patient had been living in a sober living housing program for approximately ten months prior to his transplant evaluation with me, his social worker. He had also been diagnosed with depression and bipolar disorder. He had been intermittently linked with mental health services and had participated in numerous detox and substance abuse programs over the last ten years, with varying degrees of success. He was in dual diagnosis treatment (i.e., treatment for co-occurring substance use and mental health disorders) through his Suboxone clinic and was completing toxicology screenings on a biweekly basis.After concluding the minimum three months of drug and alcohol treatment set forth by the state's Organ Transplantation Consortium, the patient graduated from his sober living program, moved in with his sister, and was listed for a liver transplant.The patient was transplanted five months after his clinic evaluation. At the time of the surgery, the patient's Suboxone was abruptly discontinued and replaced with IV Dilaudid. Within days of his transplant, the patient frequently expressed concerns about his pain. Several medical services attempted to manage the pain medications, resulting in his pain management plan being changed repeatedly and much confusion over his current medication regimen. During his liver transplant hospitalization, the RN found the patient with a needle in his arm, and after a search of the patient's hospital room, the hospital police found drug paraphernalia and illicit substances. The patient was eventually discharged to an inpatient substance abuse program, which he left before completing the program and against medical advice.During his first year post-transplant, I attempted to arrange other various treatment programs for him (most of which he did not follow through with) and to find housing for him (as he had been forced to leave his sister's home after his relapse). Eventually, the patient was incarcerated on drug-related charges. Numerous times, the patient missed completing his labs and his post-transplant appointments. He did not refill his immunosuppressant medications, and for lengthy periods of time, he was unreachable by the transplant care team, which resulted in my team members and I calling the patient's family, other providers, and the police for safety checks.In the aftermath of these issues, my colleagues and I had to reckon with the realization that we had failed the patient. As a team, our transplant center created a task force to review this case and what to do in the future to prevent such breakdowns in patient care. We created protocols for managing patients who, at the time of their transplant, are on Medication Assisted Treatment (MAT) such as Suboxone and methadone. Staff across the multidisciplinary team attended trainings regarding addiction, pain management, and best practices for MAT services. Additionally, our transplant center collaborated with our hospital's addiction treatment program for a streamlined referral process for transplant patients to addiction services.This patient's case and its sensational nature resulted in many conversations, both professional and unprofessional. Members of the social worker department became aware that personnel within transplant, though not involved in patient care, were inappropriately discussing this patient's case and engaging in unprofessional behavior. Said actions led to the termination of a member of the transplant team. I was placed in the unenviable [End Page E3] position of having to report this behavior to hospital management and legal teams to protect a vulnerable patient.The ethical challenge behind this case really stems from the transplant team attempting to balance two... (shrink)

This article argues that Maurice Merleau-Ponty advances a queer notion of love. In particular, I argue that his notion of love as an institution, as a hollow fueled by the imaginary dimension of existence, shows that love unhinges petrified ideals of gender. I suggest that the crucial insight to be found in Merleau-Ponty's account of love is that love is a lived openness that invites us to seek out new ways of being.

Moral distress has been characterised in the nursing literature as a major problem affecting nurses in all healthcare systems. It has been portrayed as threatening the integrity of nurses and ultimately the quality of patient care. However, nursing discourse on moral distress is not without controversy. The notion itself is conceptually flawed and suffers from both theoretical and practical difficulties. Nursing research investigating moral distress is also problematic on account of being methodologically weak and disparate. Moreover, the ultimate purpose and (...) significance of the research is unclear. In light of these considerations, it is contended that the notion of moral distress ought to be abandoned and that concerted attention be given to advancing inquiries that are more conducive to improving the quality and safety of moral decision-making, moral conduct and moral outcomes in nursing and healthcare domains. (shrink)

Given that many imaging technologies in biology and medicine are non-optical and generate data that is essentially numerical, it is a striking feature of these technologies that the data generated using them are most frequently displayed in the form of semi-naturalistic, photograph-like images. In this paper, I claim that three factors underlie this: (1) historical preferences, (2) the rhetorical power of images, and (3) the cognitive accessibility of data presented in the form of images. The third of these can be (...) argued to provide an epistemic advantage to images, but I will further argue that this is often misleading and that images can in many cases be less informative than the corresponding mathematical data. (shrink)

Anthropology of Consciousness, EarlyView.

This book brings together an international collection of experts in reproductive ethics, law, disability studies, and medicine to explore the challenging future of reproduction and children. From the medical to the social and from the financial to the legal, the authors explore the expanding impact of reproductive genetics on our society. New advances in genetic technologies are revolutionizing the practice of reproductive medicine. We have expanded our ability to detect genetic changes in embryos and fetuses in ways that potentially allow (...) to identify, treat, or prevent a growing range of diseases. The development of gene-editing technologies raises questions about the possibility of removing disease-causing variants from embryos before pregnancy implantation. The growing sophistication of prenatal genomic sequencing offers us glimpses into the whole genome of the developing fetus. And, the increasingly sophisticated science of 'gene matching' allows us greater and greater foreknowledge of how the genomes of two individuals will combine in a future child. This is an indispensable book on the newest developments in bioethics caused by the sciences. Chapter 5 is available open access under a Creative Commons Attribution 4.0 International License via link.springer.com. (shrink)

In the 1830s and 1840s, the Hydrographic Office of the British Admiralty developed and oversaw one of the major state-run surveying projects of the nineteenth century. This involved a range of instruments whose circulation was increasingly regulated. Using extant museum collections and the correspondence of those involved, this article explores how such objects can be used to discuss both bureaucratic organization at a time of expanding government and the complex issues of sociability involved in hydrographic surveying. Surveying officers worked in (...) a context in which the propriety of property on public service was a pervasive question. Instruments might be given as gifts between officers, appropriated as recompense, absorbed as state property, and disputed between friends. The ownership, provision, and treatment of instruments in particular could be used to demonstrate an officer’s peculiar zeal or institutional neglect. To those outside the ship, what was understood as over-instrumentation became amusing spectacle. On board, their use was part of a deeply hierarchical order of work in regions of colonial and mercantile importance. In examining the relationships around these instruments of survey, the paper proposes a richer understanding of the material culture of hydrography in the early nineteenth century. (shrink)