(No abstract is available for this citation).

When patients have progressive and incurable dementia, should their advance directives always be followed? Contra Dworkin, Dresser argues that when patients remain able to enjoy and participate in their lives, directives to hasten death should sometimes be disregarded.

An innovative examination of the ways in which dance and philosophy inform each other, Dance and Philosophy brings together authorities from a variety of disciplines to expand our understanding of dance and dance scholarship. Featuring an eclectic mix of materials from exposes to dance therapy sessions to demonstrations, Dance and Philosophy addresses centuries of scholarship, dance practice, the impacts of technological and social change, politics, cultural diversity and performance. Structured thematically to draw out the connection between different perspectives, this books (...) covers: - Philosophy practice and how it corresponds to dance - Movement, embodiment and temporality - Philosophy and dance traditions in everyday life - The intersection between dance and technology - Critical reflections on dance Offering important contributions to our understanding of dance as well as expanding the study of philosophy, this book is key to sparking new conversations concerning the philosophy of dance. (shrink)

Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called (...) holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. (shrink)

The term “therapeutic misconception” was coined in 1982 by Paul Appelbaum, Loren Roth, and Charles Lidz. Appelbaum and his colleagues interviewed participants in several psychiatric studies, including a drug trial with a placebo control arm. Appelbaum's group found that many people were unaware of the differences between participating in a study and receiving treatment in the clinical setting. Rather than understanding these differences, study participants tended to believe that therapy and research were governed by the same primary goal: to advance (...) the individual patient's best interests. Appelbaum's group labeled this mistaken belief the therapeutic misconception. (shrink)

Many people are worried about developing dementia, fearing the losses and burdens that accompany the condition. Dementia‐specific advance directives are intended to address dementia's progressive effects, allowing individuals to express their treatment preferences for different stages of the condition. But enthusiasm for dementia‐specific advance directives should be tempered by recognition of the legal, ethical, and practical issues they raise. Dementia‐specific advance directives are a simplistic response to a complicated situation. Although they enable people to register their future care preferences, in (...) many cases, those preferences will not, and should not, determine their later care. (shrink)

Most patients suffering from progressive dementia have thoughts, emotions, perspectives, and perceptions of a world of experience. Decisions about life‐sustaining treatment should incorporate a principled approach to evaluating what life is like for these patients.

Off-label prescribing is an integral part of contemporary medicine. Many patients benefit when they receive drugs or devices under circumstances not specified on the label approved by the Food and Drug Administration. An off-label use may provide the best available intervention for a patient, as well as the standard of care for a particular health problem. In oncology, pediatrics, geriatrics, obstetrics, and other practice areas, patient care could not proceed without off-label prescribing. When scientific and medical evidence justify off-label uses, (...) physicians promote patients’ interests by prescribing products off label.Off-label prescribing can also harm patients, however. The potential for harm is greatest when an offlabel use lacks a solid evidentiary basis. A 2006 study examining prescribing practices for 169 commonly prescribed drugs found high rates of off-label use with little or no scientific support. Researchers examining off-label use in U.S. children’s hospitals concluded, “[W]e still have incomplete knowledge about the safety and efficacy of many medications commonly used to treat children across a range of drug classes and clinical diagnoses.”. (shrink)

In Christian books today readers can find dozens of spiritual practices. One resource of the Protestant tradition, however, that has largely been forgotten is the Puritan practice of conference. This article describes how for the English Puritans conference exemplified the importance of communal spiritual life, then considers applications for the contemporary church. Conference refers to intentional conversation among believers about spiritual matters. Conference particularly expresses the value of Christian community and the need for the body of Christ to function together (...) on the journey of faith. Understanding this practice not only illuminates the past but also offers valuable insights for the church today. (shrink)

The empirical evidence for exploration underlying the appeal of imaginary worlds is mostly absent or contradictory. Openness, and the cognitive exploration it represents, provides a better account than the overall drive to explore predicted by evolutionary theory. Furthermore, exploration cannot explain why imaginary worlds foster frequent re-engagement.

This paper will examine intertextual references between the Dialogus of Tacitus and the letters of Pliny, in particular those regarding boar hunting. It will argue that there are clues in the letters of Pliny which can help us to understand the relationship between these two writers as well as the tone and purpose of the Dialogus. By studying Pliny's letters to Tacitus on hunting , one can see the specific reference to boars as an allusion to Marcus Aper, the chief (...) spokesperson for contemporary eloquence in the dialogue, indicating a degree of humor and irony in the Dialogus that is further displayed by the similarity of Pliny's opening exhortation in Epistle 1.6, ridebis et licet rideas, to the final words of the Dialogus, cum adrisissent, discessimus. Moreover, the dialogue between Pliny and Tacitus in Pliny's letters can be seen as an indication that the Dialogus itself may have been revised throughout the years, thus problematizing the debate about the “publication date” of the Dialogus. (shrink)

With growing awareness of a crisis in pollinator health, the practice of urban hobbyist beekeeping has grown in Canada with practitioners arguing that this activity can help to foster healthier honey bees and more mindful beekeeping practices. However, urban hobbyist beekeepers have been critiqued for encouraging improper beekeeping practices and over-saturation of honey bees in cities. Drawing on a multispecies ethnography based in London, Ontario and Toronto, including participant observation with the Toronto Beekeeping Collective and the London Urban Beekeeping Collective (...) and interviews with 26 urban beekeepers, I argue that urban hobbyist beekeepers develop a sensuous and embodied relationship with honey bees that typifies playful work. By integrating participant perspectives with social reproduction theory, I demonstrate that the playful work of urban hobbyist beekeeping allows practitioners to engage with non-human nature outside of the constraints of capitalist labour regimes, enabling the expression of delight, enchantment, and curiosity. This relationship between beekeepers and honey bees encourages the development of bee-centred practices in which the preferences and physiological needs of the bees are consciously put ahead of the needs of the beekeeper. The possibility for honey bee flourishing is increased significantly when bee-centred beekeeping is coupled with integrated pest management. (shrink)

The Fundamentals of Care Framework is an evidence‐based, theory‐informed framework that conceptualises high‐quality fundamental care. The Framework places the nurse–patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse–patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse–patient relationship instruments (...) by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty‐seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring ‘focus’, ‘anticipate’ and ‘evaluate’. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse–patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework. (shrink)

It's not unusual to hear someone say, ‘I'd rather be dead than have Alzheimer's’. In ‘Alzheimer Disease and Preemptive Suicide’,1 Dena Davis explains why this is a reasonable position. People taking this position will welcome the discovery of biomarkers permitting very early AD diagnosis, Davis suggests, for this will enable more of them to end their lives while they remain motivated and able to do so. At the same time, Davis observes, people would have less reason to resort to the (...) drastic remedy of pre-emptive suicide if they had absolute authority over the medical treatment they received as patients with dementia; but the threat of pre-emptive suicide is not, in my view, a sufficient reason to grant competent individuals that authority.If preclinical diagnosis of AD becomes possible, some pre-emptive suicides will probably occur. There would be no ethical or practical way to ban such suicides, and it would be silly to try. Clinicians will undoubtedly try to discourage people seeking biomarker information in furtherance of a suicide plan, but savvy individuals will simply conceal their true motivation for having the tests. The real problem for people intent on self-destruction is that biomarkers are unlikely to deliver a clear suicide signal.First, as Davis notes, work on biomarkers remains in the research stage. No one yet knows whether biomarker tests will prove accurate enough to warrant clinical use. Second, even clinically accepted biomarker tests will generate imperfect information about future disease. Biomarkers may produce more accurate estimates of a person's risk of developing AD, but like all predictive tests, they will also yield false positive and negative results. The …. (shrink)

A reconciliation of different approaches to anger in the Christian moral tradition, with cautions and recommendations for virtuous anger formation.

In 1997, when Oregon became the first U.S. jurisdiction authorizing medical aid in dying (MAID), its law included a requirement that patients be legal residents of the state. Other U.S. jurisdictions legalizing MAID followed Oregon in adopting residency requirements. Recent litigation challenges the legality, as well as the justification, for such requirements. Facing such challenges, Oregon and Vermont eliminated their MAID residency requirements. More states could follow this move, for, in certain circumstances, the U.S. Constitution's privileges and immunities clause protects (...) citizens’ right to travel to secure medical care. Policy considerations could also motivate states to reexamine whether such requirements are justified in light of existing evidence of how MAID laws have been applied. (shrink)

It is especially from the 1970s onwards, and certainly linked to the “linguistic turn”, that the specialized research in Nietzsche begins to show a growing interest in his thesis of an intimate relationship between word and thought, sometimes emphasizing the role of rhetoric in Nietzschean reflections on science, truth and language. The present work aims, in the context of the first two chapters of Nietzsche's Beyond Good and Evil, to investigate Nietzsche's particular treatment of the problem of truth and what (...) such treatment, imbricated to the stylistic strategy of his rhetoric in the mentioned chapters, undertakes in terms of reinstating the question not only about truth, but also about the margins of philosophical discursiveness itself. (shrink)

The postmodern criticism of music analysis remains unwittingly preoccupied with a false image of ‘the Whole’, or with the construction of unity precisely through privileging its opposite. At the centre of this discourse there often emerges a split between two things—analysis/aesthetics, part/whole, subject/object—where the question then becomes one of reconciliation: how can the analytical methods be subsumed into aesthetic discussions of subjectivity to better represent the ‘thing itself’? This problem is now a cross-disciplinary one, with criticism favouring the application of (...) ‘external’ disciplines to complement the ‘internal’ act of music analysis. This article takes Žizek’s comments on the difference between modernism and postmodernism as alienation and separation as its starting point in order to reconsider the effects of the supposedly postmodern concept of interdisciplinarity for music analysis. Through a critique of existing musico-psychoanalytic literature, it demonstrates the ways in which the interdisciplinary relation currently seems to occupy the space of an objet petit a in scholarship that is therefore marked by a failure restricted to the principles of alienation. If read alongside Žižek’s phenomenology of the subject however, rather than become a fetishized unity, this relation could be seen to construct the space for a self-reflexive musical subject, able to avoid false reconciliation through critical self- awareness, and could also therefore hold greater significance for an interdisciplinary musicology. (shrink)

Access to abortion is becoming increasingly restricted for many women in the United States. Besides the longstanding financial barriers facing low-income women in most states, a newer source of scarcity has emerged. The relatively small number of physicians willing to perform the procedure is compromising the ability of women in certain parts of the country to obtain an abortion.Do physicians have a duty to respond to this situation? Do they have a professional responsibility to ensure that abortions are reasonably available (...) to the women who want to terminate their pregnancies? Or, is abortion so morally and socially controversial as to remove any professional obligation to provide reasonable access?Both law and medical ethics have traditionally protected physicians’ freedom to refuse to perform any procedure, including abortion, that conflicts with their religious or other moral beliefs. (shrink)

Rebecca Lloyd Waller defends a temporal dualist interpretation of Descartes’ account of time to directly engage and address common interpretive puzzles. Descartes' Temporal Dualism offers a significant contribution to the understanding of an important, but frequently neglected component of Descartes’ ontology.

In September 2012, news broke of a developing drug disaster in the United States. Health authorities had linked a fungal meningitis outbreak to a contaminated steroid made by a company called the New England Compounding Center. The contaminated steroid was a compounded drug that had not been approved by the Food and Drug Administration, differing from three others that had been approved in that it lacked preservatives present in those agents. Factory inspections revealed unsanitary conditions at NECC's drug production facility. (...) By the time the source of the outbreak was identified, an estimated fourteen thousand people had been injected with the drug. As of December 2012, thirty‐nine had died of meningitis, and hundreds more had been diagnosed with meningitis and other drug‐related conditions. Many factors contributed to this disaster. One was a 2002 Supreme Court decision holding that a law prohibiting providers of compounded drugs from promoting their products through advertising and other means impermissibly restricted commercial speech. (shrink)

An argument that what is usually dismissed as the “mystical shell” of Hegel's thought—the concept of absolute knowledge—is actually its most “rational kernel.” This book sets out from a counterintuitive premise: the “mystical shell” of Hegel's system proves to be its most “rational kernel.” Hegel's radicalism is located precisely at the point where his thought seems to regress most. Most current readings try to update Hegel's thought by pruning back his grandiose claims to “absolute knowing.” Comay and Ruda invert this (...) deflationary gesture by inflating what seems to be most trivial: the absolute is grasped only in the minutiae of its most mundane appearances. Reading Hegel without presupposition, without eliminating anything in advance or making any decision about what is essential and what is inessential, what is living and what is dead, they explore his presentation of the absolute to the letter. The Dash is organized around a pair of seemingly innocuous details. Hegel punctuates strangely. He ends the Phenomenology of Spirit with a dash, and he begins the Science of Logic with a dash. This distinctive punctuation reveals an ambiguity at the heart of absolute knowing. The dash combines hesitation and acceleration. Its orientation is simultaneously retrospective and prospective. It both holds back and propels. It severs and connects. It demurs and insists. It interrupts and prolongs. It generates nonsequiturs and produces explanations. It leads in all directions: continuation, deviation, meaningless termination. This challenges every cliché about the Hegelian dialectic as a machine of uninterrupted teleological progress. The dialectical movement is, rather, structured by intermittency, interruption, hesitation, blockage, abruption, and random, unpredictable change—a rhythm that displays all the vicissitudes of the Freudian drive. (shrink)

Over recent decades scholars have begun explicitly to acknowledge the importance of visual display in the formation of the fifteenth-century Burgundian “Theater State.” This remarkably apposite term, coined in the early 1980s by Wim Blockmans and Walter Prevenier, encapsulates the centrality of ceremony and ostentatious self-projection to both the political process of state building and the more personal imperative of identity construction in the Burgundian Netherlands under Duke Philip the Good . The specific sorts of display associated with the Theater (...) State in previous studies have tended to be larger-scale ceremonial events with an inherent performativity—rigorously staged entries, sharply choreographed jousts, elaborately themed dinners, joyously restrained wedding ceremonies, or grimly festive funeral processions—though the individual aspects of their makeup, that is, the texts written to accompany them, the images produced to illustrate them, or the costumes worn to celebrate them, all add to the lavish effect. But the role of these smaller-scale articulations of luxury in the shaping of a courtly identity in Burgundy has been infrequently discussed by critics; and the part played by literature and the material book in the fostering and sustaining of this spectacular culture has gone largely unacknowledged. (shrink)

This book tells the stories of seven people with a distinct perspective on cancer. Experts on medical ethics, personal experience showed them how little they knew about the real world of serious illness. In this book, they describe cancer's teachings on ethics, medicine, and the experience of illness.

Merit review of scientific projects involving laboratory animals is a central issue in the current debate over the ethics of animal experimentation. In this essay, I examine several conceptual, regulatory, and practical problems inherent in the merit review process. Contemporary challenges to the existing merit review system and suggestions for reform are also discussed. The essay concludes with comments on legal and political questions relevant to the future of merit assessment.