Spain is one of the most advanced European countries in terms of the legislative and administrative development of ADs. Article 11 of Law 41/2002, concerning Patient Autonomy, regulates ‘advance directives’ and has prompted various Autonomous Regions to develop legislation in this area. Nevertheless, whilst the variety of legislations in different territories presents advantages, the disparity of criteria also presents problems.Despite significant legislative development, only 23,000 Spanish citizens have filled in an AD. Clearly, AD use is confined to a minority. Several (...) surveys, however, show that the Spanish population views these documents in a positive light. Thus, we must analyse this discrepancy between attitude and practice. A similar situation exists amongst health professionals. Whilst they generally feel that the use of ADs is positive and necessary, they are frequently unwilling to employ them.Bioethical literature and research on ADs has significantly increased in Spain over the last six years. It is likely that this trend will continue in the foreseeable future; but more resources and effort are required if ADs are to become consolidated. (shrink)

This paper evaluates the content of the syllabi of postgraduate courses on public health ethics within accredited schools and programs of public health in the United States in order to gain an awareness of the topics addressed within these courses. Methods: Data was gathered via the analysis of syllabi of courses on PHE. In 2012, information was requested by e-mail from the 48 schools and 86 PH programs accredited by the U.S. Council on Education for Public Health for 2012. The (...) “Epidemiology and PHE Syllabi” project of the University of Miami also was consulted. A table of topics was drawn up in order to carry out content analysis of the documents. Results: Data was obtained from 25 schools and 36 accredited programs ; 36 syllabi were gathered and 75 different topics were found. Of these, 38 topics were addressed in six or more syllabi and can be grouped as follows: foundations of PHE; autonomy and its limits; infectious disease control; justice; research ethics; health education and promotion; environmental and occupational health; screening; genetics; privacy and confidentiality; and community-based practice and vulnerable populations. Conclusions: The analyzed syllabi show high variability in curricular content. The debate with regard to whether a core curriculum on PHE should be established is ongoing. The results of this work might be of interest for schools and programs of PH in other countries or regions of the world in order to develop or ameliorate their own PHE syllabi. (shrink)

The aim of this study is to assess the knowledge, attitudes and experiences of Spanish nurses in relation to euthanasia and physician-assisted suicide. In an online questionnaire completed by 390 nurses from Andalusia, 59.1% adequately identified a euthanasia situation and 64.1% a situation involving physician-assisted suicide. Around 69% were aware that both practices were illegal in Spain, while 21.4% had received requests for euthanasia and a further 7.8% for assisted suicide. A total of 22.6% believed that cases of euthanasia had (...) occurred in Spain and 11.4% believed the same for assisted suicide. There was greater support (70%) for legalisation of euthanasia than for assisted suicide (65%), combined with a greater predisposition towards carrying out euthanasia (54%), if it were to be legalised, than participating in assisted suicide (47.3%). Nurses in Andalusia should be offered more education about issues pertaining to the end of life, and extensive research into this area should be undertaken. (shrink)

Objective: To measure the stability of life-sustaining treatment preferences amongst older people and analyse the factors that influence stability. Design: Longitudinal cohort study. Setting: Primary care centres, Granada (Spain). Eighty-five persons age 65 years or older. Participants filled out a questionnaire with six contexts of illness (LSPQ-e). They had to decide whether or not to receive treatment. Participants completed the questionnaire at baseline and 18 months later. Results: 86 percent of the patients did not change preferences. Sex, age, marital status, (...) hospitalisation, and self-perception of health and pain did not affect preferences. Morbidity and the death of a relative did. Conclusion: Stability of preferences of older persons in relation to end-of-life decisions seems to be more probable than instability. Some factors, such as the death of a relative or the increase in morbidity, can change preferences. These findings have implications for advance directives (ADs) and advance care planning. (shrink)

The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of (...) patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form. (shrink)

The accuracy of proxies when they interpret advance directives or apply substituted decision-making criteria has been called into question. It therefore became important to know if the Andalusian Advance Directive Form (AADF) can help to increase the accuracy of proxies' predictions. The aim of this research was to compare the effect of the AADF on the accuracy of proxies' predictions about patients' preferences with that gained from informative and deliberative sessions about end-of-life decision making. A total of 171 pairs of (...) patients and their proxies were randomized to three groups. The control group's answers to the Life Sustaining Preferences Questionnaire (LSPQ) were compared with their proxies' answers to the same questionnaire. In one intervention group, the patients had already completed the AADF and given it to their proxies, who used it to guide their own answers to the LSPQ. In the second intervention (discussion) group, both patients and proxies attended two educative sessions guided by trained nurses and later filled in the LSPQ. Comparisons of accuracy and other variables showed a strong association with the discussion group. The findings show that promoting communication between patients and their proxies improves the accuracy of proxies' predictions much more than isolated use of the AADF form. (shrink)

Cancer is a singular cellular state, the emergence of which destabilises the homeostasis reached through the evolution to multicellularity. We present the idea that the onset of the cellular disobedience to the metazoan functional and structural architecture, known as the cancer phenotype, is triggered by changes in the cell's external environment that occur with ageing: what ensues is a breach of the social contract of multicellular life characteristic of metazoans. By integrating old ideas with new evidence, we propose that with (...) ageing the environmental information that maintains a multicellular organisation is eroded, rewiring internal processes of the cell, and resulting in an internal shift towards an ancestral condition resulting in the pseudo‐multicellular cancer phenotype. Once that phenotype emerges, a new local social contract is built, different from the homeostatic one, leading to tumour formation and the foundation of a novel local ecosystem. (shrink)

This study compares the balance of newspaper and television news coverage about migration in two countries that were differently affected by the so-called “refugee crisis” in 2015 in terms of the geopolitical involvement and numbers of migrants being admitted. Based on a broad consensus among political elites, Germany left its borders open and received about one million migrants mainly from Syria during 2015. In contrast, the conservative British government was heavily attacked by oppositional parties for closing Britain’s borders and, thus, (...) restricting immigration. These different initial situations led to remarkable differences between the news coverage in both countries. In line with news value theory, German media outlets reported much more on migration than did their British counterparts. In line with indexing theory, German news coverage consonantly reflected the consensual view of German political elites, while British news media reported along their general editorial lines. (shrink)

O dendê, símbolo peculiar e relevante da culinária nacional, tem sido objeto de investigação em diferentes vertentes, e neste trabalho será abordado pelo campo da visualidade e da cultura baiana. Buscou-se evidenciar o histórico do dendê, a tipologia e a classificação da estrutura formal, bem como a sua validação na religião de matriz africana do Candomblé. Nesse sentido, observa-se a existência do dendê na cultura material e imaterial das pessoas, sobretudo da população baiana, que interage nos modos de viver, trabalhar, (...) conceber imagens e repertórios. A metodologia adotada é a revisão de literatura que compreende a identidade cultural, a identidade baiana, a cultura e o cultivo do dendê, e seu simbolismo no âmbito sagrado, que se consolidou com pensadores centrais como Munanga (2020), Mariano (2009), Barreto e Freitas (2008), Bolini (2012), Lody (1992, 2009), Moraes e Pachêco (1985), Correa (2012), Oliveira (2009). Desse modo, conclui-se que o dendê é um elemento interdisciplinar presente em diversos contextos do cotidiano como na cultura, na arte, nas relações de fé, em produtos, as ações efêmeras e o imaginário coletivo. (shrink)

Principles of procreative beneficence (PPBs) hold that parents have good reasons to select the child with the best life prospects. Sparrow (2010) claims that PPBs imply that we should select only female children, unlesswe attach normative significance to “normal” human capacities. We argue that this claim fails on both empirical and logical grounds. Empirically, Sparrow’s argument for greater female wellbeing rests on a selective reading of the evidence and the incorrect assumption that an advantage for females would persist even when (...) a serious gender imbalance is obtained. Logically, PPBs cite only pro tanto reasons and allow that the good of an individual child could be outweighed by other morally relevant considerations, such as those which take collectively suboptimal outcomes into account. There is thus no need to attach value to the “normal.”. (shrink)

Human decisions are increasingly supported by decision support systems (DSS). Humans are required to remain “on the loop,” by monitoring and approving/rejecting machine recommendations. However, use of DSS can lead to overreliance on machines, reducing human oversight. This paper proposes “reflection machines” (RM) to increase meaningful human control. An RM provides a medical expert not with suggestions for a decision, but with questions that stimulate reflection about decisions. It can refer to data points or suggest counterarguments that are less compatible (...) with the planned decision. RMs think against the proposed decision in order to increase human resistance against automation complacency. Building on preliminary research, this paper will (1) make a case for deriving a set of design requirements for RMs from EU regulations, (2) suggest a way how RMs could support decision-making, (3) describe the possibility of how a prototype of an RM could apply to the medical domain of chronic low back pain, and (4) highlight the importance of exploring an RM’s functionality and the experiences of users working with it. (shrink)

El presente artículo aborda las connotaciones y los fundamentos de la paráfrasis cum canere vellem en Serv. Ecl. 6. 3. El análisis del sentido del verbo volo en este contexto y la confrontación del pasaje con Serv. Ecl. 6. 5 revelan que Servio interpreta la frase cum canerem reges et proelia como referencia a un temprano empeño de Virgilio en componer poesía épica, del que pronto desistió. Esta interpretación está condicionada por la idea de que la secuencia cronológica Églogas - (...) Geórgicas - Eneida tiene un correlato jerárquico, idea que se funda en noticias biográficas y en la teoría de la tripertita varietas. This paper focuses on the connotations and grounds of the paraphrase cum canere vellem in Serv. Ecl. 6. 3. The analysis of the sense of verb volo within this context, as well as the confrontation between that passage and Serv. Ecl. 6. 5, show that Servius interprets the clause cum canerem reges et proelia as a reference to Virgil's early endeavor to compose an epic poem, from which he shortly desisted. This interpretation is conditioned by the idea that the chronological sequence Eclogues - Georgics - Aeneid has a hierarchical correlate, an idea which is founded on biographical information and the theory of tripertita varietas. (shrink)

Un tipo de prolepsis, utilizado frecuentemente en Argonáuticas, es el discurso-programa en el cual un personaje anticipa la narración posterior. De esta manera funciona el relato de Fineo como guía de navegación para los Argonautas. Con el ineludible modelo de los relatos de viajes de Odisea, esta narración interna guarda una relación especular con la obra que la contiene y conlleva una cuasi-identificación entre narrador interno y narrador principal. Este artículo tiene como objetivo el análisis de los niveles narrativos en (...) este relato, para mostrar el modo en que esa técnica anticipatoria funciona en el poema en un nivel metaliterario. One type of prolepsis, frequently used in the Argonautica, is the programmatic speech in which a character anticipates the subsequent story. In this manner works the story of Phineus as navigation guidance for the Argonauts. With the inevitable model of travel stories of Odyssey, this internal narrative keeps a mirror-relationship with the work that contains it and carries a quasi-identification between internal narrator and main narrator. This article aims to analyze the narrative levels in this story, to show how this anticipatory technique works in the poem on a metaliterary level. (shrink)

En el marco de una investigación mayor acerca de la duración en el arte, el cine y la literatura en Colombia, en este trabajo realizamos un estudio de caso de un corpus conformado por la videoinstalación El caballero de la fe, de José Alejandro Restrepo (2011), y los ensayos fílmicos Pirotecnia (2019), de Federico Atehortúa, y Bicentenario, de Pablo Álvarez (2020). La hipótesis que desarrollamos afirma que estas piezas audiovisuales colombianas contemporáneas, mediante un uso de los recursos técnicos disponibles (...) puestos sobre la materialidad de lo visual, transforman, reescriben, subvierten y sublevan el sentido de las imágenes. Son obras que, por un lado, dislocan el tiempo registrado de las imágenes al intervenir en sus tiempos, en las gradaciones de su intensidad y en los movimientos de sus elementos y, a su vez, los recolocan en el tiempo proyectado como parte del proceso de sublevación de la imagen. (shrink)

El presente artículo pretende invitar al estudio del impacto que tuvo _El Evangelio en Triumpho_ de Olavide sobre el pensamiento decimonónico. Con ese fin propone, en primer lugar, leerlo captando en sus rasgos esenciales el valor alegórico de sus personajes en sus relaciones. A continuación, señala qué aspectos de esa lectura habrían influido de manera más marcada en las obras de Maistre y Saint-Simon, con las que abarca las dos tendencias post-revolucionarias de entender la historia, catecóntica y quiliástica. Finalmente, presenta (...) la unidad milenarista de la obra de Olavide, ajena a aquellas interpretaciones precisamente por su ortodoxia, apuntando, como lectura alternativa a la francesa, la que sugiere Dostoyevski en _El Gran Inquisidor_. (shrink)

This is a very short introduction to ethics. It divides into three parts: first, introducing and discussing reasons for skepticism about ethics; second introducing themes of birth, death, happiness, desire and freedom to show how deeply our lives are interwoven with ethics; third, introducing attempts to found ethics, due to Aristotle, Kant, and the contractarian tradition.

Many animals will invent new behaviour patterns, adjust established behaviours to a novel context, or respond to stresses in an appropriate and novel manner. This is the first ever book on the topic of 'animal innovation'. Bringing together leading scientific authorities on animal and human innovation, this book will put the topic of animal innovation on the map, and heighten awareness of this developing field.

It is commonly accepted that the history of Spanish anarchism started in the early nineteenth century with the economist and social reformer Ramón de la Sagra (1798–1871). In 1845, he launched the first anarchist periodical, El Porvenir, which introduced to Spain the ideas of Proudhon, Fourier, and Saint-Simon. Between 1848 and 1849, de la Sagra and Proudhon founded the Banco Popular. Despite this, the Spanish anarchist movement did not properly get underway until after the International Workingmen's Association (IWA) meeting in (...) London in 1864, when the supporters of Bakunin sent the Italian Giuseppe Fanelli to Spain. His mission was to establish the Spanish section of the First International (Sección Española de la Primera International), which occurred in 1869. The triumph of Bakunin's anarchosyndicalist theories was so great that when Pablo Lafargue arrived in Madrid in 1871 with the intention of founding a workers' political party, he was told by the Catalan statesman Francisco Pi y Margall that a Marxist political party would never succeed in Spain. (shrink)

The attempt to pursue philosophy in the name of phenomenology is one of the most significant and important developments in twentieth century thought. In this bold and innovative book, Simon Glendinning introduces some of its major figures, and demonstrates that its ongoing strength and coherence is to be explained less by what Maurice Merleau-Ponty called the 'unity' of its 'manner of thinking' and more by what he called its 'unfinished nature'. Beginning with a discussion of the nature of phenomenology, Glendinning (...) explores the changing landscape of phenomenology in key texts by Husserl, Heidegger, Sartre, Merleau-Ponty, Levinas and Derrida. Focusing on the different ways in which each philosopher has responded to and transformed the legacy of phenomenology, Glendinning shows that the richness of this legacy lies not in the formation of a distinctive movement or school but in a remarkable capacity to make fertile philosophical breakthroughs. Important topics such as the nature of phenomenological arguments, the critique of realism and idealism, ontology, existentialism, perception, ethics and the other are also closely examined. Through a re-evaluation of the development of phenomenology Glendinning traces the ruptures and dislocations of philosophy that, in an age dominated by science, strive constantly to renew our understanding of ourselves and our place in the world. Clearly and engagingly written, In the Name of Phenomenology is essential reading for students of phenomenology and contemporary philosophy. (shrink)

By examining an exemplar sample of mental health nursing educational policies and related legislation, in this article, we trace the discursive production of madness as an “othered” identity category. We engage in a critical discourse analysis of mental health nursing education in Canada, drawing on provincial and federal policies and legislation as the main sources of data. Theoretically framed by critical posthumanism and mad studies, this article outlines how the mad subjectivity becomes decontextualized out of its identity‐based understanding and recontextualized (...) as an inferior category of “the human,” circulating within discourses of pedagogy, economics, law, and psychiatry. The article maps the intertextual nexus of the discourse of mental health nursing education, making visible the complex, the arbitrary, and the sometimes‐contradictory nature of the discipline's grappling with identity‐based mental health concepts. We close with several implications for nursing policy, education, and practice. (shrink)

The notion of welfare has historically been related to the notion of satisfying individual preferences or wants. This point of view was proposed by Bentham in the eighteen century. Following Bentham, welfare is thought to depend on satisfaction of those preferences. We shall try to show how this no..

According to the Everett interpretation, branching structure and ratios of norms of branch amplitudes are the objective correlates of chance events and chances; that is, 'chance' and 'chancing', like 'red' and 'colour', pick out objective features of reality, albeit not what they seemed. Once properly identified, questions about how and in what sense chances can be observed can be treated as straightforward dynamical questions. On that basis, given the unitary dynamics of quantum theory, it follows that relative and never absolute (...) chances can be observed; that only on repetition of a large numbers of similar trials can relative probabilities be measured; and so on. The epistemology of objective chances can in this way be worked out from the dynamics. its curious features are thus explained. But one aspect of chance set-ups seems to resist this subsuming of chancing to branching: how is it that chance involves uncertainty? And if that is not possible, on Everettian lines, then the whole project is doomed. I argue that in fact there is no difficulty in making sense of uncertainty in the face of branching. Contrary to initial impressions, the unitary formalism is consistent with a well-defined notion of self-locating uncertainty. It is also consistent without: the mathematics under-determines the metaphysics in these respects. (shrink)

The Everett interpretation of quantum mechanics divides naturally into two parts: first, the interpretation of the structure of the quantum state, in terms of branching, and second, the interpretation of this branching structure in terms of probability. This is the second of two reviews of the Everett interpretation, and focuses on probability. Branching processes are identified as chance processes, and the squares of branch amplitudes are chances. Since branching is emergent, physical probability is emergent as well.

What constitutes a just war? How does race matter in America? Are the interests of corporations the same as those of the public when it comes to the environment or public health? Middle and high school history, literature, and science classes abound with important moral, social, and political questions. But under pressure to cover required materials and out of fear of raising controversy, teachers often avoid classroom discussions of questions of profound importance to students and to society. This book investigates (...) how schools can responsibly take an active role in moral education while honoring their academic mission. Using extensive observations in public, Catholic, and Jewish high schools, Katherine Simon analyzes the ways in which teachers avoid or address moral questions raised by students and implicit in course materials. She examines how morally charged issues may be taught responsibly in a diverse democracy. And in an afterword that teachers and teacher educators will find particularly useful, Simon provides practical tools and strategies for structuring discussion and designing units to help teachers explore moral issues more deeply with their middle and high school students. (shrink)

I show that frequentism, as an explanation of probability in classical statistical mechanics, can be extended in a natural way to a decoherent quantum history space, the analogue of a classical phase space. The result is a form of finite frequentism, in which Gibbs’ concept of an infinite ensemble of gases is replaced by the quantum state expressed as a superposition of a finite number of decohering microstates. It is a form of finite and actual frequentism (as opposed to hypothetical (...) frequentism) insofar as all the microstates exist, in keeping with the decoherence-based Everett interpretation, and some versions of pilot-wave theory. (shrink)

Is it possible to approach quantum theory in a 'therapeutic' vein that sees its foundational problems as arising from mistaken conceptual presuppositions? The book explores the prospects for this project and, in doing so, discusses such fascinating issues as the nature of quantum states, explanation in quantum theory, and 'quantum non-locality'.

This paper uses the example of the COVID-19 pandemic to analyse the danger associated with insufficient epistemic pluralism in evidence-based public health policy. Drawing on certain elements in Paul Feyerabend’s political philosophy of science, it discusses reasons for implementing more pluralism as well as challenges to be tackled on the way forward.

According to the Everett interpretation, branching structure and ratios of norms of branch amplitudes are the objective correlates of chance events and chances; that is, 'chance' and 'chancing', like 'red' and 'colour', pick out objective features of reality, albeit not what they seemed. Once properly identified, questions about how and in what sense chances can be observed can be treated as straightforward dynamical questions. On that basis, given the unitary dynamics of quantum theory, it follows that relative and never absolute (...) chances can be observed; that only on repetition of a large numbers of similar trials can relative probabilities be measured; and so on. The epistemology of objective chances can in this way be worked out from the dynamics. its curious features are thus explained. But one aspect of chance set-ups seems to resist this subsuming of chancing to branching: how is it that chance involves uncertainty? And if that is not possible, on Everettian lines, then the whole project is doomed. I argue that in fact there is no difficulty in making sense of uncertainty in the face of branching. Contrary to initial impressions, the unitary formalism is consistent with a well-defined notion of self-locating uncertainty. It is also consistent without: the mathematics under-determines the metaphysics in these respects. (shrink)

The Everett interpretation of quantum mechanics divides naturally into two parts: first, the interpretation of the structure of the quantum state, in terms of branching, and second, the interpretation of this branching structure in terms of probability. This is the first of two reviews of the Everett interpretation, and focuses on structure, with particular attention to the role of decoherence theory. Written in terms of the quantum histories formalism, decoherence theory just is the theory of branching structure, in Everett's sense.

A ubiquitous assumption about composite material objects is that—if they exist at all—they are single things. This chapter articulates and defends manyism, which rejects that assumption. According to manyism, each composite object is simply its many parts. Since manyism accepts the existence of composite objects, it is distinct from nihilism; since manyism denies that composite objects are each one in number in addition to being many in number, it is distinct from the view known as composition as identity (CAI). What’s (...) more, manyism is both coherent and attractive. Manyism is coherent because it can be underwritten by a defensible quasi-Quinean metaontology, and because it’s not analytic that objects are each one in number. Manyism is attractive because it shares all of the benefits of CAI without having to join CAI in objectionably positing many–one identities, and without incurring other serious costs. (shrink)

Citing the Lincoln Savings and Loan scandal, the Leo Frank murder trial, and other cases, author William Simon takes a fresh look at the ethics of lawyering.

Journal of Philosophy of Education, EarlyView.

Modernity, that amorphous and perhaps unhappy creation of periodisation, is both a mystery and a problem (in the sense of providing exis...