Political scientists have conventionally assumed that achieving democracy is a one-way ratchet. Only very recently has the question of “democratic backsliding” attracted any research attention. We argue that democratic instability is best understood with tools from complexity science. The explanatory power of complexity science arises from several features of complex systems. Their relevance in the context of democracy is discussed. Several policy recommendations are offered to help stabilize current systems of representative democracy.

Advocates for the professionalization of clinical bioethics argue that bioethics professionals play an important role in contemporary medicine and patient care, especially when addressing complex ethical questions that arise in the delivery of reproductive medicine. For bioethics consultants to serve effectively, they need adequate training in the medical and ethical issues that patients and clinicians will face, and they need skills to facilitate effective dialog among all parties. Because clinical ethics consultation is a “high‐stakes endeavor” that can acutely affect patient (...) care, efforts are under way to ensure that bioethics consultants have the competence to provide such guidance. Yet to date, no studies have examined whether the training of bioethics consultants meets the needs of health care professionals who are on the front lines of such issues. In fact, limited information is available on the reproductive health issues that bioethics training programs address or the degree to which these programs meet the needs of patients confronting reproductive health decisions and their clinicians. It is therefore important to answer this key question: What are the primary ethical issues encountered in reproductive medicine that currently affect patient care? Equally important, are bioethics training programs prepared to address those issues?To begin to answer these questions, we conducted parallel surveys of directors of graduate bioethics training programs and obstetrician‐gynecologists. The goal of this project is to lay the groundwork to establish a working partnership between bioethics educators and reproductive medicine practitioners to address the often troubling and frequently complex ethical issues in reproductive medicine. (shrink)

Political scientists have conventionally assumed that achieving democracy is a one-way ratchet. Only very recently has the question of ‘democratic backsliding’ attracted any research attention. We argue that democratic instability is best understood with tools from complexity science. The explanatory power of complexity science arises from several features of complex systems. Their relevance in the context of democracy is discussed. Several policy recommen- dations are offered to help stabilize current systems of representative democracy.

Background: Despite procedural innovations and increasing numbers of uterus transplant attempts worldwide, the perspectives of uterus transplant (UTx) trial participants are lacking. Methods: We conducted a mixed-methods study with women with absolute uterine factor infertility (AUFI). Participants included women who had previously contacted the Cleveland Clinic regarding the Uterine Transplant Trial and met the initial eligibility criteria for participation. In-depth interviews were conducted in conjunction with FertiQoL, a validated and widely used tool to measure the impact of infertility on the (...) quality of life of infertility patients. Results: All (n = 19) rated their overall health as good; some experienced grief and social isolation. AUFI is a life-framing experience that influences acceptance by family, partners, peers, and one’s self. UTx is a means to gain control of reproductive autonomy. UTx allows family-building and the ability to play an active role in prenatal health and well-being. Establishing and maintaining a supportive relationship is a key issue of AUFI and when considering UTx. Risks of UTx are perceived relative to risks to self/child/family posed by adoption/surrogacy. Participants had no overall preference regarding living or deceased donor. Conclusions: The ways in which women with AUFI conceptualize this condition in their lives and choices around UTx and participating in a study of the procedure are multifaceted and textured. These perspectives are critical to understanding its ethical, legal, and social implications. (shrink)

The idea that democracy is under threat, after being largely dormant for at least 40 years, is looming increasingly large in public discourse. Complex systems theory offers a range of powerful new tools to analyse the stability of social institutions in general, and democracy in particular. What makes a democracy stable? And which processes potentially lead to instability of a democratic system? This paper offers a complex systems perspective on this question, informed by areas of the mathematical, natural, and social (...) sciences. We explain the meaning of the term 'stability' in different disciplines and discuss how laws, rules, and regulations, but also norms, conventions, and expectations are decisive for the stability of a social institution such as democracy. (shrink)

In the wake of much previous work on Gilles Deleuze's relations to other thinkers (including Bergson, Spinoza and Leibniz), his relation to Kant is now of great and active interest and a thriving area of research. In the context of the wider debate between 'naturalism' and 'transcendental philosophy', the implicit dispute between Deleuze's 'transcendental empiricism' and Kant's 'transcendental idealism' is of prime philosophical concern. -/- Bringing together the work of international experts from both Deleuze scholarship and Kant scholarship, Thinking Between (...) Deleuze and Kant addresses explicitly the varied and various connections between these two great European philosophers, providing key material for understanding the central philosophical problems in the wider 'naturalism/ transcendental philosophy' debate. The book reflects an area of great current interest in Deleuze Studies and initiates an ongoing interest in Deleuze within Kant scholarship. The contributors are Mick Bowles, Levi R. Bryant, Patricia Farrell, Christian Kerslake, Matt Lee, Michael J. Olson, Henry Somers-Hall and Edward Willatt. (shrink)

Knowledge-first epistemology includes a knowledge norm of action: roughly, act only on what you know. This norm has been criticized, especially from the perspective of so-called standard decision theory. Mueller and Ross provide example decision problems which seem to show that acting properly cannot require knowledge. I argue that this conclusion depends on applying a particular decision theory which is ill-motivated in this context. Agents’ knowledge is often most plausibly formalized as an ambiguous epistemic state, and the theory of decision (...) under ambiguity is then the appropriate modeling tool. I show how to model agents as acting rationally on the basis of their knowledge according to such a theory. I conclude that the tension between the knowledge norm of action and formal decision theory is illusory; the knowledge-first paradigm should be used to actively select the decision-theoretical tools that can best capture the knowledge-based decisions in any given situation. (shrink)

First published in 1993. Routledge is an imprint of Taylor & Francis, an informa company.

Taking the lead from Susan Wolf's and Linda Emanuel's work on systems thinking, and developing ideas from Moberg's, Seabright's and my work on mental models and moral imagination, in this paper I shall argue that what is often missing in management decision-making is a systems approach. Systems thinking requires conceiving of management dilemmas as arising from within a system with interdependent elements, subsystems, and networks of relationships and patterns of interaction. Taking a systems approach and coupling it with moral imagination, (...) now engaged on the organizational and systemic as well as individual levels of decision-making, I shall conclude, is a methodology that encourages managers and companies to think more imaginatively and to engage in integrating moral decision-making into ordinary business decisions. More importantly this sort of thinking is a means to circumvent what often appear to be intractable problems created by systemic constraints for which no individual appears to be responsible. (shrink)

After experiments with various economic systems, we appear to have conceded, to misquote Winston Churchill that "free enterprise is the worst economic system, except all the others that have been tried." Affirming that conclusion, I shall argue that in today's expanding global economy, we need to revisit our mind-sets about corporate governance and leadership to fit what will be new kinds of free enterprise. The aim is to develop a values-based model for corporate governance in this age of globalization that (...) will be appropriate in a variety of challenging cultural and economic settings. I shall present an analysis of mental models from a social constructivist perspective. I shall then develop the notion of moral imagination as one way to revisit traditional mind-sets about values-based corporate governance and outline what I mean by systems thinking. I shall conclude with examples for modeling corporate governance in multi-cultural settings and draw tentative conclusions about globalization. (shrink)

This is part 1 of 6 of the dossier What Do We Talk about when We Talk about Queer Death?, edited by M. Petricola. The contributions collected in this article sit at the crossroads between thanatology and queer theory and tackle questions such as: how can we define queer death studies as a research field? How can queer death studies problematize and rethink the life-death binary? Which notions and hermeneutic tools could be borrowed from other disciplines in order to better (...) define queer death studies? The present article includes the following contributions: – MacCormack P., What does queer death studies mean?; – Radomska M., On queering death studies; – Lykke N., Death as vibrancy; – Hillerup Hansen I., What concreteness will do to resolve the uncertain; – Olson P., Queer objectivity as a response to denials of death; – Manganas N., The queer lack of a chthonic instinct. (shrink)

Designing for culture through intelligent tutoring systems is on the rise. The needs of military personnel to communicate and understand cultures other than their own in deployments, missions, and work-related assignments have strongly encouraged the creation of culturally aware tutoring systems (CATS) that teach about other cultures. This paper critically analyzes three systems (i.e., ELECT-BiLAT, Tactical Iraqi, and VECTOR) and the frameworks that guided the design and development process. The examination reveals that there is a need for comprehensive guidelines to (...) build CATS. Therefore, the Culture Based Model is offered as a framework to guide the design of culture-based information and communication technologies. (shrink)

The abductive stage of logical investigation benefits from direct contact with objects of thought, especially material objects in aggregates. The ubiquity of collecting activity and collections of non-utilitarian material objects in ancient as well as contemporary settings, with increasingly deliberate attention to material objects as implements of thought, demonstrates these benefits. This essay focuses on the logica utens of collecting and the role of collections in detection and discovery.

The present study aims to explore whether the symptoms associated with fibromyalgia are contextually influenced by the area of residence. Furthermore, it is analyzed whether the effect of the acceptance of the disease on the emotional, cognitive and physical symptoms is moderated by the patients’ place of residence. Using a cross-sectional design, a total of 234 women with fibromyalgia were surveyed, of which 55.13% resided in rural areas and 44.87% in urban areas. Self-reported questionnaires were used to assess pain severity, (...) anxiety and depression, functional limitation, physical and mental fatigue and acceptance of the disease. The results show significant differences in acceptance, pain, and physical and mental fatigue between patients from rural and urban areas. The rural area patients presented higher levels of acceptance and pain and lesser levels of physical and mental fatigue compared to the urban area. The moderation analysis add that, only in patients from the rural area, the variables of physical symptoms were significantly and negatively associated with acceptance. This study addresses for the first time the role of the place of residence in suffering from fibromyalgia, suggesting that the rural or urban environment plays a relevant role in the severity and/or management of symptoms in fibromyalgia women. Limitations and practical implications are also discussed. (shrink)

With the demise of Marxism and socialism, the United States is becoming a model not merely for free enterprise, but also for employment practices worldwide. I believe that free enterprise is the least worst economic system, given the alternatives, a position I shall assume, but not defend, here. However, I shall argue, a successful free enterprise political economy does not entail mimicking US employment practices. I find even today in 1998, as I shall outline in more detail, these practices, when (...) consistently carried out, by and large erode trust in the workplace, they are, on balance unfair to workers and managers, and, if Jeffrey Pfeffer is correct, they do not maximize long-term corporate earnings or growth. Getting clear on US employment practices and their weaknesses may help to shape other models for employment that neither contravene free enterprise nor are degrading to workers. (shrink)

Much current work in the social sciences seeks to understand the effects of trust and social capital on economic and political outcomes. However, the sources of trust remain unclear. In this article, the authors articulate a basic theory of the relationship between institutions and trust. The authors apply this theory to industrial districts, geographically concentrated areas of small firm production, which involve extensive cooperation in the production process. Changes in power relations affect patterns of production;the authors suggest that they also (...) have knock-on consequences for trust and cooperation among actors. (shrink)

States of the brain represent states of the world. A puzzle arises when one learns that at least some of the mind/brain’s internal representations, such as a sensation of heat or a sensation of red, do not genuinely resemble the external realities they allegedly represent: the mean kinetic energy of the molecules of the substance felt (temperature) and the mean electromagnetic reflectance profile of the seen object (color). The historical response has been to declare a distinction between objectively real properties, (...) such as shape motion and mass, and merely subjective properties, such as heat, color and smell. This hypothesis leads to trouble. A challenge for cognitive neurobiology is to characterize, in suitably general terms, the nature of the relationship between brain models and the world modeled. We favor the hypothesis that brains develop high-dimensional maps whose internal relations correspond in varying degrees of fidelity to the enduring causal structure of the world. From this perspective, the basic epistemological relation is not “single-percept to single- external-feature” but rather “background-brain-maps to causal-domain-portrayed. (shrink)

This article will defend a very simple thesis. In a diverse globalized “flat” world with expanding economic opportunities and risks, we will need to revisit and revise our mindsets about free enterprise, corporate governance, and leadership. That we can change our mindsets and world view is illustrated by studies of primate behavior, and the kind of leadership necessary in a global economy is, interestingly, exemplified by women.

La investigación en medicina tiene por objetivo generar nuevos conocimientos que ayuden al diagnóstico, el tratamiento y la prevención de enfermedades. Pero la medicina no es una ciencia exacta, sino una actividad humana heterogénea que se basa solo parcialmente en la ciencia, con varios factores no científicos que influyen en la forma de desarrollar esta actividad. El dolor, como síntoma o como enfermedad, es probablemente el trastorno que más afecta y preocupa a las personas y el que con mayor frecuencia (...) motiva una consulta médica. A pesar de la magnitud del problema, y del interés médico y social por el dolor, la atención y el tratamiento de las personas con dolor crónico es un tema infravalorado o tratado inadecuadamente. Con base en múltiples preguntas que se plantean a lo largo del desarrollo del presente documento, nuestro objetivo es, por un lado, el de señalar que los cambios que se han producido en el manejo del dolor crónico hacen de los llamados protocolos de consenso un ejercicio obsoleto en la medicina del siglo XXI. Por otro lado, en términos de bioética, responder a la pregunta ¿se ajustan los protocolos de consenso al principio de beneficencia del paciente individual? (shrink)

The essays in this book criticise the new positivism in education policy, whereby education is systematically reduced to those things that can be measured by so-called 'objective' tests. School curricula have been narrowed with an emphasis on measurable results in the 3 R’s and the ‘quality’ of university departments is now assessed by managerial exercises based on commercial audit practice. As a result, the traditional notion of liberal arts education has been replaced by utilitarian productivity indices.

Clinical next generation sequencing is a term that refers to a variety of technologies that permit rapid sequencing of large numbers of DNA segments, up to and including entire genomes. As an approach that is playing an increasingly important role in obtaining genetic information from patients, it may be viewed by public and private payers either positively, as an enabler of the promised benefits of personalized medicine, or as “the perfect storm” resulting from the confluence of high market demand, an (...) uproven technology, and an unprepared delivery system. A number of recent studies have noted that coverage and reimbursement will be critical for clinical integration of NGS, yet the evidentiary pathway for payer decision-making is unclear. Although there are multiple reasons for this uncertain reimbursement environment, the situation stems in large part from a long-standing lack of alignment between the information needs of regulators and post-regulatory decision-makers such as payers. (shrink)

Irvin Rock's hypothesis that certain stages of perceptual processing resemble problem solving in cognition is contrasted to some recent work in computer vision (Marr, Ullman) which tries to reduce intelligence in perception to computational organization. The focal example is subjective contours which Marr thought could be handled by computational modules without descending control, and which Rock thinks are the outcome of intelligent processing.

The story of Jonathan and David stands out as the Bible's lengthiest and most complex narrative reflection on friendship. Far from idealizing the mutuality of their devotion, however, this story invites readers to ponder the human freedom to accept, reject, exploit, or reciprocate the gift of a friend's loyalty.

Desde una hermenéutica ontológica política se hacen visibles y audibles prácticas singulares a partir del punto de vista de los estudios latinoamericanos, los cuales apelan por una perspectiva de afirmación como propone Arturo Escobar respecto a una mirada sobre la diversidad y singularidad de accio..

This book celebrates Professor Margaret Brazier's outstanding contribution to the field of healthcare law and bioethics. It examines key aspects developed in Professor Brazier's agenda-setting body of work, with contributions being provided by leading experts in the field from the UK, Australia, the US and continental Europe. They examine a range of current and future challenges for healthcare law and bioethics, representing state-of-the-art scholarship in the field. The book is organised into five parts. Part I discusses key principles and themes (...) in healthcare law and bioethics. Part II examines the dynamics of the patient-doctor relationship, in particular the role of patients. Part III explores legal and ethical issues relating to the human body. Part IV discusses the regulation of reproduction, and Part V examines the relationship between the criminal law and the healthcare process. Offering a collaborative review of key and innovative themes in the field, the book will be of great interest and use to academics and students working in healthcare law and bioethics, and those working in health policy, law and regulation at both national and international levels. (shrink)