As improvements in neuroscience have enabled a better understanding of disorders of consciousness as well as methods to treat them, a hurdle that has become all too prevalent is the denial of coverage for treatment and rehabilitation services. In 2011, a settlement emerged from a Vermont District Court case, Jimmo v. Sebelius, which was brought to stop the use of an “improvement standard” that required tangible progress over an identifiable period of time for Medicare coverage of services. While the use (...) of this standard can have deleterious effects on those with many chronic conditions, it is especially burdensome for those in the minimally conscious state, where improvements are unpredictable and often not manifested through repeatable overt behaviors. Though the focus of this paper is on the challenges of brain injury and the minimally conscious state, which an estimated 100,000 to 200,000 individuals suffer from in the United States, the post-Jimmo arguments presented can and should have a broad impact as envisioned by the plaintiffs who brought the case on behalf of multiple advocacy groups representing patients with a range of chronic care conditions. (shrink)

In this essay, we suggest practical ways to shift the framing of crisis standards of care toward disability justice. We elaborate on the vision statement provided in the 2010 Institute of Medicine (National Academy of Medicine) “Summary of Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations,” which emphasizes fairness; equitable processes; community and provider engagement, education, and communication; and the rule of law. We argue that interpreting these elements through disability justice entails a commitment to both (...) distributive and recognitive justice. The disability rights movement's demand “Nothing about us, without us” requires substantive inclusion of disabled people in decision‐making related to their interests, including in crisis planning before, during, and after a pandemic like Covid‐19. (shrink)

A comprehensive study on the various benefits and traits of living with a Biblical worldview.

This research explored the feasibility of using multidimensional scaling (MDS) analysis in novel combination with other techniques to study comprehension of epistemic adverbs expressing doubt and certainty (e.g., evidently, obviously, probably ) as they relate to health communication in clinical settings. In Study 1, Australian English speakers performed a dissimilarity-rating task with sentence pairs containing the target stimuli, presented as “doctors' opinions.” Ratings were analyzed using a combination of cultural consensus analysis (factor analysis across participants), weighted-data classical-MDS, and cluster analysis. (...) Analyses revealed strong within-community consistency for a 3-dimensional semantic space solution that took into account individual differences, strong statistical acceptability of the MDS results in terms of stress and explained variance, and semantic configurations that were interpretable in terms of linguistic analyses of the target adverbs. The results confirmed the feasibility of using MDS in this context. Study 2 replicated the results with Canadian English speakers on the same task. Semantic analyses and stress decomposition analysis were performed on the Australian and Canadian data sets, revealing similarities and differences between the two groups. Overall, the results support using MDS to study comprehension of words critical for health communication, including in future studies, for example, second language speaking patients and/or practitioners. More broadly, the results indicate that the techniques described should be promising for comprehension studies in many communicative domains, in both clinical settings and beyond, and including those targeting other aspects of language and focusing on comparisons across different speech communities. (shrink)

(2004). Toward a Critical Deliberative Strategy for Addressing Ideology in Educational Policy Processes. Educational Studies: Vol. 36, No. 3, pp. null.

A defining characteristic of Alzheimer’s disease is difficulty in retrieving semantic memories, or memories encoding facts and knowledge. While it has been suggested that this impairment is caused by a degradation of the semantic store, the precise ways in which the semantic store is degraded are not well understood. Using a longitudinal corpus of semantic fluency data, we derive semantic network representations of patients with Alzheimer’s disease and of healthy controls. We contrast our network-based approach with analyzing fluency data with (...) the standard method of counting the total number of items and perseverations in fluency data. We find that the networks of Alzheimer’s patients are more connected and that those connections are more randomly distributed than the connections in networks of healthy individuals. These results suggest that the semantic memory impairment of Alzheimer’s patients can be modeled through the inclusion of spurious associations between unrelated concepts in the semantic store. We also find that information from our network analysis of fluency data improves prediction of patient diagnosis compared to traditional measures of the semantic fluency task. (shrink)

In 1981 S. W. Hawking and J. Hartle presented a quantum mechanical description of the early stages of possible cosmological evolution. Their proposal was interpreted by many authors as a pattern of cosmic creation from nothing in which no divine Creator is needed. In this approach, physically defined “nothing” was identified both with the empty set of set theory and with metaphysical nothingness. After defining philosophical presuppositions implicitly assumed in Hawking's paper, one discovers that this alleged nothingness has all properties (...) of the philosophically conceived Logos accepted by Hellenic philosophers of the Neoplatonic tradition. Consequently, Hawking's theory of creation remains consistent with Christian theism, and its only theological opponents can be found among defenders of Samuel Clark's God of scientific gaps. (shrink)

1 Department of History and Philosophy of Science, University of Cambridge, Free School Lane, Cambridge, CB2 3RH, UK.

Wuthering Heights has proved exceptionally elusive to interpretation. By foregrounding the idea of human nature, Darwinian literary theory provides a framework within which we can assimilate previous insights about Wuthering Heights , delineate the norms Brontë shares with her projected audience, analyze her divided impulses, and explain the generic forms in which those impulses manifest themselves. Brontë herself presupposes a folk understanding of human nature in her audience. Evolutionary psychology converges with that folk understanding but provides explanations that are broader (...) and deeper. In addition to its explanatory power, a Darwinian approach has a naturalistic aesthetic dimension that is particularly important for interpreting Wuthering Heights. (shrink)

In early 2017, Nevada amended its Uniform Determination of Death Act, in order to clarify the neurologic criteria for the determination of death. The amendments stipulate that a determination of death is a clinical decision that does not require familial consent and that the appropriate standard for determining neurologic death is the American Academy of Neurology’s guidelines. Once a physician makes such a determination of death, the Nevada amendments require the withdrawal of life-sustaining treatment within twenty-four hours with limited exceptions. (...) Neurologists have generally supported Nevada’s amendments for clarifying the diagnostic standard and limiting the ability of family members to challenge it. However, it is more appropriate to view the Nevada amendments with concern. Even though the primary purpose of the UDDA is to ensure that all functions of a person’s entire brain have ceased, the AAN guidelines do not accurately assess this. In addition, by characterizing the determination of death as solely a clinical decision, the Nevada legislature has improperly ignored the doctrine of informed consent, as well as the beliefs of particular faiths and cultures that reject brain death. Rather than resolving controversies regarding brain death determinations, the Nevada amendments may instead instigate numerous constitutional challenges. (shrink)

ABSTRACT Nietzsche sometimes offers the elusive suggestion that his psychology is not just original, but inaugural: a “first” in the field of philosophy. This article argues that a clue to his inaugural ambitions is discovered in his novel use of sublimation as a concept that engages in both a genealogical critique and a therapeutic reassessment of the basic prejudices of value dualism that he claims constitute the evaluative core of the Western tradition. Genealogically, sublimation provides Nietzsche with a new structure (...) of naturalistic narrative that explains how traditionally opposed values actually share a common natural origin. Therapeutically, Nietzsche's various sublimation narratives serve to qualify the effects of his own naturalistic critique by revealing how and why our animal bodies and drives can now be practically affirmed as a new source of human dignity. (shrink)

The Heythrop Journal, Volume 63, Issue 3, Page 473-479, May 2022.

That people do wrong would appear to be a moral datum: a moral realm without wrongdoing may not be coherent. Thus, an adequate philosophic theory of morality ought to allow for it. But such a theory ought also to explain wrongdoing, both axiologically and causally. This is so if we take such a theory to have practical significance. Indeed, insofar as moral philosophy and its cognate areas have practical significance, explaining wrongdoing is arguably the most pressing practical issue for theory (...) construction in this domain. For a philosophical theory of morality to have practical significance, and, further, to have influence on behavior, it must be psychologically relevant to the organisms that it ranges over. That is, the concepts that the theory purports to explain must be plausibly realized within the psychology of the creatures for which the theory is intended. Any theory satisfying this constraint would then be in a position to illuminate those psychological features that are explanatory of blameworthy behavior. The argument presented here is that moral realism and its underlying moral psychology, cognitivism, face serious difficulties allowing for and explaining, both metaphysically and psychologically, such behavior. Moral cognitivism and realism fail to adequately account for this most fundamental of moral phenomena. Hence, a comprehensive understanding of moral experience is impossible within the cognitivist/realist perspective. (shrink)

In the Phenomenology of Spirit, Hegel discusses marriage in his analysis of the first shape of Spirit, Ethical Life. Since it is analyzed in terms of a particular shape of spirit and set in Ancient Greece, it is difficult to understand both its use in the Phenomenology as well as what claims, if any, he is making about the institution of marriage as such. I aim to show that in this text, marriage functions as a fundamental context in which self‐knowing (...) occurs. (shrink)

The Soviet Union's moderate and creative policy toward Africa's wars of liberation will go far in winning allies in the conflict of capitalistic and socialistic ideologies.

Ms. Dimitriou's motivist view has a simple upshot: for at least some cases, our moral assessment of an action should depend on the motives behind it (Dimitriou, passim). This may be contrasted with the antimotivist position, the view that argues motives should not figure into our moral assessment of an action. She presents two provocative cases where an agent’s motive “infects” the concomitant action. One example involves racist thinking and the other a form of sexual self-gratification. Given that we would (...) never find the action that accompanies these motives morally acceptable once we know what the motives are, Ms. Dimitriou has argued that we ought to embrace motivism. In this brief commentary, I would like to present a few cases that seemingly show the motivist position is flawed. I want my comments to generate a discussion of how Ms. Dimitriou’s position can handle these weird cases, even though my presentation will likely come off as a direct assault of her view. (shrink)

Background Rapid ethical access to personal health information to support research is extremely important during pandemics, yet little is known regarding patient preferences for consent during such crises. This follow-up study sought to ascertain whether there were differences in consent preferences between pre-pandemic times compared to during Wave 1 of the COVID-19 global pandemic, and to better understand the reasons behind these preferences. Methods A total of 183 patients in the pandemic cohort completed the survey via email, and responses were (...) compared to the distinct pre-pandemic cohort ; all were patients of a large Canadian cancer center. The survey covered broad versus study-specific consent; opt-in versus opt-out contact approach; levels of comfort sharing with different recipients; perceptions of commercialization; and options to track use of information and be notified of results. Four focus groups were subsequently conducted to elucidate reasons motivating dominant preferences. Results Patients in the pandemic cohort were significantly more comfortable with sharing all information and biological samples, sharing information with the health care institution, sharing information with researchers at other hospitals, sharing PHI provincially, nationally and internationally compared to the pre-pandemic cohort. Discomfort with sharing information with commercial companies remained unchanged between the two cohorts. Significantly more pandemic cohort patients expressed a wish to track use of PHI, and to be notified of results. Thematic analysis uncovered that transparency was strongly desired on outside PHI use, particularly when commercialization was involved. Conclusions In pandemic times, patients were more comfortable sharing information with all parties, except with commercial entities, where levels of discomfort remained unchanged. Focus groups identified that the ability to track and receive results of studies using one’s PHI is an important way to reduce discomfort and increase trust. These findings meaningfully inform wider discussions on the use of personal health information for research during global crises. (shrink)

ABSTRACT The Pātañjalayogaśāstra (PYŚ) is typically understood to define yoga as thought-suppression. In several publications, Ian Whicher has sought to avoid the conclusion that the PYŚ endorses thought-suppression by proposing that the PYŚ’s definition of yoga refers not to thought-suppression but to liberation from the puruṣa’s misidentification with the mind. I argue that Whicher’s proposal is unsuccessful because the PYŚ portrays thought-suppression as necessary for this liberation.

Responsible innovation is gathering momentum as an academic and policy debate linking science and society. Advocates of RI in research policy argue that scientific research should be opened up at an early stage so that many actors and issues can steer innovation trajectories. If this is done, they suggest, new technologies will be more responsible in different ways, better aligned with what society wants, and mistakes of the past will be avoided. This paper analyses the dynamics of RI in policy (...) and practice and makes recommendations for future development. More specifically, we draw on the theory of ‘trading zones’ developed by Peter Galison and use it to analyse two related processes: the development and inclusion of RI in research policy at the UK’s Engineering and Physical Sciences Research Council ; the implementation of RI in relation to the Stratospheric Particle Injection for Climate Engineering project. Our analysis reveals an RI trading zone comprised of three quasi-autonomous traditions of the research domain – applied science, social science and research policy. It also shows how language and expertise are linking and coordinating these traditions in ways shaped by local conditions and the wider context of research. Building on such insights, we argue that a sensible goal for RI policy and practice at this stage is better local coordination of those involved and we suggest ways how this might be achieved. (shrink)

The distinction between the mental operations of abstraction and exclusion is recognized as playing an important role in many of Descartes’ metaphysical arguments, at least after 1640. In this paper I first show that Descartes describes the distinction between abstraction and exclusion in the early Rules for the Direction of the Mind, in substantially the same way he does in the 1640s. Second, I show that Descartes makes the test for exclusion a major component of the method proposed in the (...) Rules. Third, I argue that in Rule 14 the exclusion-abstraction distinction is connected to a theory of distinctions, which includes a notion of real distinction as essentially tied to the imagination. This sheds light on Descartes’ development in and after the Rules. (shrink)

The achievement of self-consciousness in Hegel’s Phenomenology hinges on establishing a relationship with another self-conscious being. How this is accomplished, and even that it is accomplished in Hegel’s text, are topics of dispute and misunderstanding in the literature. I show how Hegel argues for this intersubjective origin of self-consciousness, first, by comparing Hegel’s analysis of lord and bondsman to Sartre’s analysis of intimacy. Second, I focus on two in-terpretive challenges. First, I argue that the staking of life comes from an (...) other-oriented epistemological relation, and not simply from an im-mediate concern with dominating the other. Second, contrary to many interpretations which see the bondsman’s development arising out of an isolated activity merely between himself and the products of his labor, I argue that the slave’s ability to gain knowledge of himself as a self is only possible by establishing a relationship with the lord. This point is essential because, if readings of the bondsman’s development as isolated from the lord are correct, then Hegel has in fact not succeeded in showing that self-consciousness only develops out of intersubjective recognition. (shrink)