BackgroundIn this article, we address questions regarding how people consider what they do or do not consent to and the reasons why. This article presents the findings of a citizen forum study conducted by the University of Geneva in partnership with the Geneva University Hospitals to explore the opinions and concerns of members of the public regarding predictive oncology, genetic sequencing, and cancer. MethodsThis paper presents the results of a citizen forum that included 73 participants. A research tool titled "the (...) mechanics of consent" was designed for this study. This tool is a table encouraging participants to reflect on social and research actors, types of data, and desired levels of control while sharing different types of data with different actors. Participants’ discussion that led to the completion of each table were audio-recorded, transcribed, and analyzed using thematic analysis.ResultsThe results are a compilation of responses from the mechanics of consent tool divided into two sections; the first presents quantitative results of collective responses regarding attitudes to consent to donate their data. The second section present qualitative findings emerged from the discussion amongst participants.DiscussionChoice and control of personal data is crucial for the public to be able to decide who and how to trust. Key information to be disclosed to potential research participants shall include information about potential risks and benefits; who will be accessing and using their data; as well as assurances that their choice will be respected. Furthermore, researchers ought to make sure they are trustworthy, by acting in a competent, reliable, and honest manner. Governance systems ought to be better equipped to address ethical issues raise by the growing presence of non-traditional research actors, consent of exchanges of data via digital devices and online activity such as social media and fairness of data trading. Finally, informed consent is one of the various elements that contribute to conducting ethical research. More needs to be done to strengthen governance and ensure adequate protection of research participants, particularly to address issues related to predictive health analytics. (shrink)

Gratitude is both expected and problematic in live organ donation. Are there grounds to require it, and to forbid access to live donor transplantation to a recipient who fails to signal that he feels any form of gratitude? Recipient gratitude is not currently required for organ donation, but it is expected and may be a moral requirement. Despite this, we argue that making it a condition for live organ transplantation would be unjustified. It would constitute a problematic and disproportionate punishment (...) for perceived immoral behaviour on the part of the recipient. It would also bar the donor from positive aspects of organ donation that remain even in the absence of recipient gratitude. A potential recipient's lack of gratitude should be explored as a possible symptom of other morally problematic issues and integrated into the information provided to the potential donor. Recognition of the donor's gift and gratitude for it may also need to be expressed in part by others. This last aspect is relevant even in cases where the recipient feels and expresses gratitude. (shrink)

Background There has been considerable investment and strategic planning to introduce genomic testing into Australia’s public health system. As more patients’ genomic data is being held by the public health system, there will be increased requests from researchers to access this data. It is important that public policy reflects public expectations for how genomic data that is generated from clinical tests is used. To inform public policy and discussions around genomic data sharing, we sought public opinions on using genomic data (...) contained in medical records for research purposes in the Australian state of Queensland. Methods A total of 1494 participants completed an online questionnaire between February and May 2019. Participants were adults living in Australia. The questionnaire explored participant preferences for sharing genomic data or biological samples with researchers, and concerns about genomic data sharing. Results Most participants wanted to be given the choice to have their genomic data from medical records used in research. Their expectations on whether and how often they needed to be approached for permission on using their genomic data, depended on whether the data was identifiable or anonymous. Their willingness to sharing data for research purposes depended on the type of information being shared, what type of research would be undertaken and who would be doing the research. Participants were most concerned with genomics data sharing that could lead to discrimination, data being used for marketing, data security, or commercial use. Conclusions Most participants were willing to share their genomic data from medical records with researchers, as long as permission for use was sought. However, the existing policies related to this process in Queensland do not reflect participant expectations for how this is achieved, particularly with anonymous genomics data. This inconsistency may be addressed by process changes, such as inclusion of research in addition to clinical consent or general research data consent programs. (shrink)

The potential for the occurrence of multiple-role relationships is increased when professors also consult with athletic teams on their campuses. Such multiple-role relationships have potential ethical implications that are unclear and largely unexplored, and consultants may find multiple-role relationships both difficult to deal with and unavoidable. Therefore, the purpose of this study was to explore the nature of teacher-practitioner multiple-role relationships. Participants (N = 35) were recruited from Association for the Advancement of Applied Sport Psychology (AAASP) certified consultants (CCs) who (...) were also affiliated with a university (N = 68). All participants completed a 28-item survey exploring the incidence and relevant issues pertaining to multiple-role relationships. Chi-square analyses revealed that licensed mental health practitioners (i.e., psychologists and counselors) were more likely than nonlicensed AAASP CCs to believe that multiple-role relationships were never appropriate in sport psychology, 2(1, N = 30) = 12.80, p < .001, and to have never taken part in a multiple-role relationship, 2(1, N = 33) = 12.44, p < .001. Independent samples t tests revealed that mental health practitioners also reported that they would have higher levels of concern for both the practitioner, t(30) = -2.77, p = .009, and the client, t(30) = -2.50, p = .018, in such a relationship. (shrink)

This essay explores the value of oppositional, performative political action in the context of oppression, domination, and exclusionary political spheres. Rather than adopting Iris Marion Young's approach, Drexler turns to Hannah Arendt's theories of political action in order to emphasize the capacity of political action as action to intervene in and disrupt the constricting, politically devitalizing, necrophilic normalizations of proceduralism and routine, and thus to reorient the importance of contestatory action as enabling and enacting creativity, spontaneity, and resistance.

In order to develop a collaborative experience of reflexive writing, this article explores the ethnographic process through two communication devices used by the authors in their respective fieldwork: tarot readings and evolutionary astrology. Reflecting on their distinct (if not opposing) backgrounds, the authors explore and interpret how their different backgrounds and conversational devices shape their ethnographic experience as a process of revealing the unknown, following the not-knowing approach (Anderson, 1997). The dialogic exchange also reveals how the not-knowing approach affects the (...) collaborative aspect of the reflexive writing experience. (shrink)

Ionizing radiation is present in various situations in the contemporary world. Defining the quantities and units for this field is a complex scientific task, especially the quantities used in radiological protection (RP) to estimate the damage caused to individuals exposed to radiation (detriment). This article highlights the lack of consensus in the scientific RP community regarding the quantities and units employed in practice from the perspective of the philosophy of science. The basic concepts related to the system of quantities are (...) presented, followed by the problems and criticisms addressed by experts in the field. Several reasons for these problems are identified. The article discusses the scant interest on the part of philosophy of science in RP. The philosophy of science is still dominated by an analytical–conceptual perspective that pays little attention to the actual influence of certain structures better understood when considered from the institutional viewpoint, which is here exemplified by the International Commission on Radiological Protection (ICRP) and the International Atomic Energy Agency (IAEA). (shrink)

Xenotransplantation has the potential to alter the U.S. transplant system in profound ways. However, this emerging “spare parts” solution spearheaded by biotechnology companies raises concerns about its impact on the organ shortage, healthcare systems, population health, and health inequalities. We contend that xenotransplantation may have limited benefits in improving health, could prove prohibitively expensive for many, and may divert resources away from proven public health measures. Additionally, it carries the risk of perpetuating stigma. Xenotransplantation may thereby exacerbate existing healthcare inequities (...) across racial, ethnic, socio‐economic, and geographic lines. To mitigate these risks, we contend that public health expert input is integral for xenotransplant policy development and outreach and that this underscores the importance of federal government investment in transplant infrastructure. (shrink)

The potential for the occurrence of multiple-role relationships is increased when professors also consult with athletic teams on their campuses. Such multiple-role relationships have potential ethical implications that are unclear and largely unexplored, and consultants may find multiple-role relationships both difficult to deal with and unavoidable. Therefore, the purpose of this study was to explore the nature of teacher-practitioner multiple-role relationships. Participants (N=35) were recruited from Association for the Advancement of Applied Sport Psychology (AAASP) certified consultants (CCs) who were also (...) affiliated with a university (N=68). All participants completed a 28-item survey exploring the incidence and relevant issues pertaining to multiple-role relationships. Chi-square analyses revealed that licensed mental health practitioners (i.e., psychologists and counselors) were more likely than nonlicensed AAASP CCs to believe that multiple-role relationships were never appropriate in sport psychology, ?²(1,N= 30) = 12.80, p <.001, and to have never taken part in a multiple-role relationship, ?²(1, N= 33) = 12.44, p<.001. Independent samples t tests revealed that mental health practitioners also reported that they would have higher levels of concern for both the practitioner, r(30) = -2.77, p = .009, and the client, f(30) = -2.50, p = .018, in such a relationship. (PsycINFO Database Record (c) 2008 APA, all rights reserved). (shrink)

Pathogenic bacteria frequently target the endoplasmic reticulum (ER) and mitochondria in order to exploit host functions. ER‐mitochondria inter‐organelle communication is topologically sub‐compartmentalized at mitochondria‐associated ER membranes (MAMs). MAMs are specific membranous microdomains with unique regulatory functions such as lipid synthesis and trafficking, calcium homeostasis, mitochondrial morphology, inflammasome activation, autophagosome formation, and apoptosis. These important cellular processes are all modulated by pathogens to subvert host functions and promote infection, thus it is tempting to assume that pathogenic bacteria target MAMs to subvert (...) these different pathways in their hosts. First lines of evidence that support this hypothesis come from Legionella pneumophila. This intracellular bacterium secretes an effector that exhibits sphingosine‐1 phosphate lyase activity (LpSpl) that seems to target MAMs to modulate the autophagy response to infection. Here we thus propose the concept that MAMs could be targeted by pathogenic bacteria to undermine key host cellular processes. (shrink)

Next SectionBackground: Physicians face ethical difficulties daily, yet they seek ethics consultation infrequently. To date, no systematic data have been collected on the strategies they use to resolve such difficulties when they do so without the help of ethics consultation. Thus, our understanding of ethical decision making in day to day medical practice is poor. We report findings from the qualitative analysis of 310 ethically difficult situations described to us by physicians who encountered them in their practice. When facing such (...) situations, the physicians sought to avoid conflict, obtain assistance, and protect the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These goals could conflict with each other, or with ethical goals, in problematic ways. Being aware of these potentially conflicting goals may help physicians to resolve ethical difficulties more effectively. This awareness should also contribute to informing the practice of ethics consultation. Objective: To identify strategies used by physicians in dealing with ethical difficulties in their practice. Design, setting, and participants: National survey of internists, oncologists, and intensive care specialists by computer assisted telephone interviews (n = 344, response rate = 64%). As part of this survey, we asked physicians to tell us about a recent ethical dilemma they had encountered in their medical practice. Transcripts of their open-ended responses were analysed using coding and analytical elements of the grounded theory approach. Main measurements: Strategies and approaches reported by respondents as part of their account of a recent ethical difficulty they had encountered in their practice. Results: When faced with ethical difficulties, the physicians avoided conflict and looked for assistance, which contributed to protecting, or attempting to protect, the integrity of their conscience and reputation, as well as the integrity of the group of people who participated in the decisions. These efforts sometimes reinforced ethical goals, such as following patients’ wishes or their best interests, but they sometimes competed with them. The goals of avoiding conflict, obtaining assistance, and protecting the respondent’s integrity and that of the group of decision makers could also compete with each other. Conclusion: In resolving ethical difficulties in medical practice, internists entertained competing goals that they did not always successfully achieve. Additionally, the means employed were not always the most likely to achieve those aims. Understanding these aspects of ethical decision making in medical practice is important both for physicians themselves as they struggle with ethical difficulties and for the ethics consultants who wish to help them in this process. (shrink)

Theological engagement with quantum mechanics has been dominated by the Copenhagen interpretation, failing to reflect the fact that philosophers and physicists alike are increasingly moving away from the Copenhagen interpretation in favor of other approaches. One such approach, Hugh Everett's so-called Many Worlds Interpretation (MWI), is being taken increasingly seriously. As the MWI's credibility grows, it is imperative that metaphysicians, theologians, and philosophers of religion engage with its ideas and their implications. This article does just that, setting out some implications (...) of Everettian Quantum Mechanics that are particularly relevant to theism. It argues that taking seriously the radical consequences of the Everett interpretation means facing at least three major worries for theism pertaining to personal identity, the problem of evil, and salvation. The article concludes by calling on theologians and philosophers of religion to address these worries, in order that these matters of religious significance remain both coherent and credible if the MWI turns out to be correct. (shrink)

Background: Ethics support services are growing in Europe to help doctors in dealing with ethical difficulties. Currently, insufficient attention has been focused on the experiences of doctors who have faced ethical difficulties in these countries to provide an evidence base for the development of these services.Methods: A survey instrument was adapted to explore the types of ethical dilemma faced by European doctors, how they ranked the difficulty of these dilemmas, their satisfaction with the resolution of a recent ethically difficult case (...) and the types of help they would consider useful. The questionnaire was translated and given to general internists in Norway, Switzerland, Italy and the UK.Results: Survey respondents ranged in age from 28 to 82 years, and averaged 25 years in practice. Only a minority reported having access to ethics consultation in individual cases. The ethical difficulties most often reported as being encountered were uncertain or impaired decision-making capacity , disagreement among caregivers and limitation of treatment at the end of life . The frequency of most ethical difficulties varied among countries, as did the type of issue considered most difficult. The types of help most often identified as potentially useful were professional reassurance about the decision being correct , someone capable of providing specific advice , help in weighing outcomes and clarification of the issues . Few of the types of help expected to be useful varied among countries.Conclusion: Cultural differences may indeed influence how doctors perceive ethical difficulties. The type of help needed, however, did not vary markedly. The general structure of ethics support services would not have to be radically altered to suit cultural variations among the surveyed countries. (shrink)

B C Hurst; Means, Ends, Content and Objectives in Curriculum Planning: a critique of Sockett and Hirst, Journal of Philosophy of Education, Volume 18, Issue 1.

B C Hurst; Teaching, Telling and Changes in Belief, Journal of Philosophy of Education, Volume 14, Issue 2, 30 May 2006, Pages 215–224, https://doi.org/10.1111/.

Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...) (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P = 0.001), or who had had ethics courses in medical school (P = 0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensititity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available. (shrink)

Background Although methods proposed for the conduct of ethics consultation tend to be viewed as competing approaches, they may in fact function in a complementary manner. Methods We describe the experience of ethics consultation in two ethics committees at the University Hospitals of Geneva, Switzerland. Results Both committees provide case consultation by a multi-disciplinary team of committee members, but with different processes. These differences in process do not necessarily lead to differences in outcome. Discussion Different methods of ethics consultation are (...) not mutually exclusive, and can co-exist within the same institution. The practical application of one method of ethics consultation can lead to substantial variations in process between different groups of consultants. Conclusion Despite the importance of clarifying theoretical groundings, and consultation and deliberation processes, in ethics consultation, choosing between different processes may not be pressing. To assist these choices, exploration of the practical strengths and weaknesses of different methods will be necessary to assist clinical ethicists, and clinical ethics committees, in acquiring a flexible and evidence-based set of approaches to their work. (shrink)

Quantum mechanics has recently indicated that, at the fundamental level, temporal order is not fixed. This phenomenon, termed Indefinite Causal Order, is yet to receive metaphysical or theological engagement. We examine Indefinite Causal Order, particularly as it emerges in a 2018 photonic experiment. In this experiment, two operations A and B were shown to be in a superposition with regard to their causal order. Essentially, time, intuitively understood as fixed, flowing, and fundamental, becomes fuzzy. We argue that if Indefinite Causal (...) Order is true, this is good evidence in favor of a B‐theory of time, though such a B‐theory requires modification. We then turn to theology, suggesting that a B‐theoretic temporal ontology invites serious reconsideration of the doctrine of salvation. This paper concludes that the best explanation for salvation given a B‐theory is mind‐dependent salvific becoming, a type of psychological soteriological change that occurs through downward causation. (shrink)

Ethical leadership matters in the context of organizational change due to the need for followers to trust the integrity of their leaders. Yet, there have been no studies investigating ethical leadership and organizational change. To fill this gap, we introduce a model of the moderating role of involvement in change. Organizational change and involvement in change are proposed as context-level moderators in the relationships of ethical leadership and work-related attitudes and performance. We employ a sample of 199 supervisor–subordinate pairs from (...) a wide variety of organizations. Results support a three-way interaction (ethical leadership, organizational change, and involvement in change) for performance and OCBs. Our results have important implications for organizational change since ethical leadership appears to complement follower involvement when change is happening. (shrink)

En el texto se exponen algunas reflexiones sobre la importancia que tiene el rescatar los conocimientos tradicionales de las comunidades rurales, indígenas y campesinas sobre las prácticas agrícolas y alimenticias como recurso y mecanismo para favorecer la seguridad alimnetaria y de esta manera la sustentabilidad comunitaria. Se parte de una revisión bibliográfica sobre el tema, y se exponen casos específicos, como ejemplo, donde la experiencia se ha convertido en una oportunidad de algunas comunidades para hacer valer sus derechos de manejo (...) de la tierra, los procesos que se requieren para la diversidad de cultivos, de su propio sistema de producción y de esta forma mitigar los efectos de la pobreza y consolidad una propuesta alterna para el ejercicio de la soberanía y seguridad alimentaria de las comunidades. (shrink)

Despite broad agreement that the vulnerable have a claim to special protection, defining vulnerable persons or populations has proved more difficult than we would like. This is a theoretical as well as a practical problem, as it hinders both convincing justifications for this claim and the practical application of required protections. In this paper, I review consent-based, harm-based, and comprehensive definitions of vulnerability in healthcare and research with human subjects. Although current definitions are subject to critique, their underlying assumptions may (...) be complementary. I propose that we should define vulnerability in research and healthcare as an identifiably increased likelihood of incurring additional or greater wrong. In order to identify the vulnerable, as well as the type of protection that they need, this definition requires that we start from the sorts of wrongs likely to occur and from identifiable increments in the likelihood, or to the likely degree, that these wrongs will occur. It is limited but appropriately so, as it only applies to special protection, not to any protection to which we have a valid claim. Using this definition would clarify that the normative force of claims for special protection does not rest with vulnerability itself, but with pre-existing claims when these are more likely to be denied. Such a clarification could help those who carry responsibility for the protection of vulnerable populations, such as Institutional Review Boards, to define the sort of protection required in a more targeted and effective manner. (shrink)

To date, COVID-19 has spread across the world, changing our way of life and forcing us to wear face masks. This report demonstrates that face masks influence the human ability to infer emotions by observing facial configurations. Specifically, a mask obstructing a face limits the ability of people of all ages to infer emotions expressed by facial features, but the difficulties associated with the mask’s use are significantly pronounced in children aged between 3 and 5 years old. These findings are (...) of essential importance, as they suggest that we live in a time that may potentially affect the development of social and emotion reasoning, and young children’s future social abilities should be monitored to assess the true impact of the use of masks. (shrink)

Traditionally, what we are conscious of in self-consciousness is something non-corporeal. But anti-Cartesian philosophers argue that the self is as much corporeal as it is mental. Because we have the sense of proprioception, a kind of body awareness, we are immediately aware of ourselves as bodies in physical space. In this debate the case histories of patients who have lost their sense of proprioception are clearly relevant. These patients do retain an awareness of themselves as corporeal beings, although they hardly (...) feel their bodies. They can initiate movements, and with the help of visual feedback learn to control them. It is shown that the traditional view of the self as immaterial is not supported by these cases. But the argument against this view has to be amended. It relies too much on bodily sensations, and misses the importance of active self-movement. (shrink)

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)

Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria. The references of eligible papers were (...) examined to identify further eligible studies. Forty two articles were identified as eligible. Seventeen used an implicit measure, to test the biases of healthcare professionals. Twenty five articles employed a between-subjects design, using vignettes to examine the influence of patient characteristics on healthcare professionals’ attitudes, diagnoses, and treatment decisions. The second method was included although it does not isolate implicit attitudes because it is recognised by psychologists who specialise in implicit cognition as a way of detecting the possible presence of implicit bias. Twenty seven studies examined racial/ethnic biases; ten other biases were investigated, including gender, age and weight. Thirty five articles found evidence of implicit bias in healthcare professionals; all the studies that investigated correlations found a significant positive relationship between level of implicit bias and lower quality of care. The evidence indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population. The interactions between multiple patient characteristics and between healthcare professional and patient characteristics reveal the complexity of the phenomenon of implicit bias and its influence on clinician-patient interaction. The most convincing studies from our review are those that combine the IAT and a method measuring the quality of treatment in the actual world. Correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care in some circumstances and need to be further investigated. Our review also indicates that there may sometimes be a gap between the norm of impartiality and the extent to which it is embraced by healthcare professionals for some of the tested characteristics. Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. More research in actual care settings and a greater homogeneity in methods employed to test implicit biases in healthcare is needed. (shrink)

This paper is about syllogistic reasoning, i.e., reasoning from such pairs of premises as, All the chefs are musicians; some of the musicians are painters. We present a computer model that implements the latest account of syllogisms, which is based on the theory of mental models. We also report four experiments that were designed to test this account. Experiments 1 and 2 examined the strategies revealed by the participants' use of paper and pencil as aids to reasoning. Experiment 3 used (...) a new technique to externalize thinking. The participants had to refute, if possible, putative conclusions by constructing external models that were examples of the premises but counterexamples of the conclusions. Experiment 4 used the same techniques to examine the participants' strategies as they drew their own conclusions from syllogistic premises. The results of the experiments showed that individuals not trained in logic can construct counterexamples, that they use similar operations to those implemented in the computer model, but that they rely on a much greater variety of interpretations of premises and of search strategies than the computer model does. We re‐evaluates current theories of syllogistic reasoning in the light of these results. (shrink)

Representation is integral to the functioning and legitimacy of modern government. Yet political theorists have often been reluctant to engage directly with questions of representation, and empirical political scientists have closed down such questions by making representation synonymous with congruence. Conceptually unproblematic and normatively inert for some, representation has been deemed impossible to pin down analytically and to defend normatively by others. But this is changing. Political theorists are now turning to political representation as a subject worthy of theoretical investigation (...) in its own right. In their effort to rework the theory of political representation, they are also hoping to impact how representation is assessed and studied empirically. This volume gathers together chapters by key contributors to what amounts to a "representative turn" in political theory. Their approaches and emphases are diverse, but taken together they represent a compelling and original attempt at re-conceptualizing political representation and critically assessing the main theoretical and political implications following from this, namely for how we conceive and assess representative democracy. Each contributor is invited to look back and ahead on the transformations to democratic self-government introduced by the theory and practice of political representation. Representation and democracy: outright conflict, uneasy cohabitation, or reciprocal constitutiveness? For those who think democracy would be better without representation, this volume is a must-read: it will question their assumptions, while also exploring some of the reasons for their discomfort. Reclaiming Representation is essential reading for scholars and graduate researchers committed to staying on top of new developments in the field. (shrink)

The promise of genomic medicine lies in the opportunity to improve health outcomes via a personalized approach to management, grounded in genetic and genomic variation unique to an individual. However, disparities and inequities mar this remarkable landscape of genomic innovation. Prior efforts to understand these inequities have focused on populations for which genetic testing is relatively protocolized or where test utility varies greatly by ancestry groups, where equitable outcomes are more clearly defined. We therefore consider the current landscape of rare (...) disease genomics, in which diagnostic approaches vary widely and utility remains to be fully understood, and suggest a path forward: how ecosocial theory may be used to guide novel equity‐focused initiatives that incorporate illness narratives to improve population health. We present examples of narrative medicine in rare disease and reimagine the role this discipline may play in genomic sequencing studies, toward incorporation of the unique illness narrative into clinical genetics and genomics practice. Approaches that broaden the definitions of disease and of outcomes of interest will force the field to grapple with its racist history and begin to advance health equity and promote justice so that genomic medicine may truly deliver on its promise. (shrink)

Background Decisions regarding Cardio-Pulmonary Resuscitation (CPR) and Do Not Attempt Resuscitation (DNAR) orders remain demanding, as does including patients in the process. Objectives To explore physicians’ justification for CPR/DNAR orders and decisions regarding patient inclusion, as well as their reports of how they initiated discussions with patients. Methods We administered a face-to-face survey to residents in charge of 206 patients including DNAR and CPR orders, with or without patient inclusion. Results Justifications were provided for 59% of DNAR orders and included (...) severe comorbidity, patients and families’ resuscitation preferences, patients’ age, or poor prognosis or quality of life. Reasons to include patients in CPR/DNAR decisions were provided in 96% and 84% of cases, and were based on respect for autonomy, clinical assessment of the situation as not too severe, and the view that such inclusion was required. Reasons for not including patients were offered in 84% of cases for CPR and in 70% for DNAR. They included absent decision-making capacity, a clinical situation viewed as good (CPR) or offering little hope of recovery (DNAR), barriers to communication, or concern that discussions could be emotionally difficult or superfluous. Decisions made earlier in the patient's management were infrequently viewed as requiring revision. Residents reported a variety of introductions to discussions with patients. Conclusions These results provide better understanding of reasons for CPR/DNAR decisions, reasons for patient inclusion or lack thereof, and ways in which such inclusion is initiated. They also point to potential side-effects of implementing CPR/DNAR recommendations without in-depth and practical training. This should be part of a regular audit and follow-up process for such recommendations. (shrink)

We investigate the emergence of iconicity, specifically a bouba-kiki effect in miniature artificial languages under different functional constraints: when the languages are reproduced and when they are used communicatively. We ran transmission chains of participant dyads who played an interactive communicative game and individual participants who played a matched learning game. An analysis of the languages over six generations in an iterated learning experiment revealed that in the Communication condition, but not in the Reproduction condition, words for spiky shapes tend (...) to be rated by naive judges as more spiky than the words for round shapes. This suggests that iconicity may not only be the outcome of innovations introduced by individuals, but, crucially, the result of interlocutor negotiation of new communicative conventions. We interpret our results as an illustration of cultural evolution by random mutation and selection. (shrink)

There is a global consensus of ethicists, politicians, physicians, and international documents that reject any sort of market in human organs. Indeed, this issue has received much attention in the literature in the past few decades, with the majority of commentators placing a high correlation between the sale of organs and financial exploitation. While this argument may be tenable, this analysis seeks to draw out further implications of organ sale, including the idea of moralistic exploitation and the concept that providing (...) a market in a nonmarket good may crowd out certain morals that we should care about. This article will initially discuss the issue of moralistic exploitation, drawing implications from the 2005 UNESCO Declaration on Bioethics and Human Rights and will conclude with applying Michael Sandel’s concept that markets crowd out morals to the issue of organ markets. (shrink)

The results in this paper are in a context of abstract elementary classes identified by Shelah and Villaveces in which the amalgamation property is not assumed. The long-term goal is to solve Shelah’s Categoricity Conjecture in this context. Here we tackle a problem of Shelah and Villaveces by proving that in their context, the uniqueness of limit models follows from categoricity under the assumption that the subclass of amalgamation bases is closed under unions of bounded, -increasing chains.

En días pasados tuvimos como huésped de honor en nuestra universidad al filósofo francés René Schérer, uno de los más ilustres representantes del pensamiento contemporáneo en el ámbito internacional. Egresado de la célebre Escuela Normal Superior de París (rue d’Ulm), René Schérer es actualmente profesor emérito de la Universidad París 8 (Vincennes-Saint Denis). Inicialmente se dio a conocer gracias a sus trabajos sobre estética fenomenológica y fenomenología de la comunicación, así como por su traducción, del alemán al francés, de las (...) Investigaciones lógicas de Husserl y por la biografía y ensayo crítico del filósofo alemán que escribió en colaboración con su amigo el filósofo Arion Kelkel. Se consagró, luego, al estudio de problemas filosóficos vinculados con la defensa de la utopía, el sentido de la hospitalidad, la crítica de la pedagogía, el reconocimiento de la diferencia y la inclusión del otro, el cosmopolitismo y la relación entre la universidad y la política. Entre sus libros más importantes de los últimos 20 años, de una obra prolífica, cabe mencionar: El alma atómica (1986) escrito en colaboración con Guy Hocquenghem, Apuesta sobre lo imposible (1989), Zeus hospitalario (1993), Utopías nómadas (1996), Miradas sobre Deleuze (1998), La pedagogía pervertida (1999), La Ecosofía de Charles Fourier (2000), Infantiles (2003), Hospitalidades (2004) y su último libro, sobre el cineasta italiano Pier Paolo Pasolini (2005). (shrink)

Esta reflexão pretende mostrar o discurso racional cartesiano na segunda prova da existência de Deus. Para tanto, Descartes se depara com uma pergunta central: qual a causa da existência da res cogitans que é finita e possui a ideia de infinito? A resposta é encontrada na desproporcionalidade ontológica entre o finito e o infinito. Essa desproporcionalidade é elucidada mediante dois conceitos: o princípio de causalidade que determina que a causa deve ser igual ou superior a coisa causada e o princípio (...) de criação contínua em que a causa que criou o ser não é menor do que aquela que o conserva em sua existência. As objeções destacadas no texto contra os argumentos cartesianos foram escolhas deliberadas que servem para elucidar a importância da racionalidade como fundamento para a prova da existência de Deus. A relação entre o entendimento e a liberdade, apresentada no texto sucintamente, justifica a impossibilidade da res cogitans ser causa de si mesma. Palavras-chave: Infinito; finito; causalidade; criação contínuaThis essay aims to show the rational Cartesian discourse on the second proof of God’s existence. In order to do so, Descartes faces a core question: which is the cause for the existence of the res cogitans that is finite in front of the idea of the infinite? The answer is found in the ontological disproportionality between the finite and the infinite. This disproportionality is elucidated through a couple crucial concepts: the principle of causality, which determines that the cause must be equal or superior to the caused thing and the principle of continuous creation, in which the cause that created the being is not inferior than the one that preserves its existence. The objections highlighted in the text against the Cartesian arguments were deliberated choices, to elucidate the relevance of rationality as the foundation for the proof of God’s existence. The relation between the understanding and the liberty, showed on the text even if succinctly, justifies the impossibility of the res cogitans to be the cause of itself. Key words: Infinite; finite; causality; creation continuous. (shrink)

This paper analyzes the art action titled Zonas de dolor by Diamela Eltit, produced in the eighties. These video-performances were set up in marginal locations during the Chilean dictatorship. We will analyze how the marginal space and the hurt body of the protagonist produce subjectivities that exercise political resistance in the context of extreme violence and how the spectators emancipate themselves actively to create a disaggregated community which stands proudly at the margins.

Non‐Interventionist Objective Divine Action (NIODA), introduced by Robert John Russell, is a model of divine action drawing upon insights from quantum mechanics. It presents an intriguing and significant challenge to classical conceptions of divine action with far‐reaching consequences. When applying NIODA to theistic evolution, however, significant questions emerge that require attention. We identify and assess two sets of concerns. The first relates to quantum physics, particularly whether and how quantum occurrences influence mutations and evolution. We argue that the current empirical (...) evidence is ambiguous in its support of the kinds of quantum action that Russell proposes, though emerging data from quantum biology look promising. The second set of concerns is metaphysical, especially concerning the problem of evil. NIODA gives Godextensive agency over evolution and genetics, which has adverse consequences for theodicy. We propose potential solutions to the problems highlighted in our article, both metaphysical and physical, to improve the viability of NIODA's application to theistic evolution. (shrink)

This paper considers whether and how ‘vitalism’ might be considered relevant as a concept today; whether its relevance should be expressed in terms of disciplinary demarcations between the life sciences and the natural sciences; and whether there is a fundamental incompatibility between a ‘vitalism of process’ and a ‘vitalism as pathos’. I argue that the relevance of vitalism as an epistemological and ontological problem concerning the categorical distinction between living and non-living beings must be contextualized historically, and referred exclusively to (...) the epistemic horizon defined by classical physics. In contrast to this, drawing on the philosophies of Canguilhem, Whitehead, and Atlan, I propose an appreciation of the contemporary relevance of vitalism premised on the pathic and indeterminate character of nature as a whole. From this perspective vitalism expresses a politically significant ethos concerning the relationship between life, knowledge, problems and their solutions. (shrink)