Background Policy decisions about childhood vaccination require consideration of multiple, sometimes conflicting, public health and ethical imperatives. Examples of these decisions are whether vaccination should be mandatory and, if so, whether to allow for non-medical exemptions. In this article we argue that these policy decisions go beyond typical public health mandates and therefore require democratic input.Methods We report on the design, implementation, and results of a deliberative public forum convened over four days in Ontario, Canada, on the topic of childhood (...) vaccination.Results 25 participants completed all four days of deliberation and collectively developed 20 policy recommendations on issues relating to mandatory vaccinations and exemptions, communication about vaccines and vaccination, and AEFI (adverse events following immunization) compensation and reporting. Notable recommendations include unanimous support for mandatory childhood vaccination in Ontario, the need for broad educational communication about vaccination, and the development of a no-fault compensation scheme for AEFIs. There was persistent disagreement among deliberants about the form of exemptions from vaccination (conscience, religious beliefs) that should be permissible, as well as appropriate consequences if parents do not vaccinate their children.Conclusions We conclude that conducting deliberative democratic processes on topics that are polarizing and controversial is viable and should be further developed and implemented to support democratically legitimate and trustworthy policy about childhood vaccination. (shrink)

Due to the variation, contingency and complexity of living systems, biology is often taken to be a science without fundamental theories, laws or general principles. I revisit this question in light of the quest for design principles in systems biology and show that different views can be reconciled if we distinguish between different types of generality. The philosophical literature has primarily focused on generality of specific models or explanations, or on the heuristic role of abstraction. This paper takes a different (...) approach in emphasizing a theory-constituting role of general principles. Design principles signify general dependency-relations between structures and functions, given a set of formally defined constraints. I contend that design principles increase our understanding of living systems by relating specific models to general types. The categorization of types is based on a delineation of the scope of biological possibilities, which serves to identify and define the generic features of classes of systems. To characterize the basis for general principles through generic abstraction and reasoning about possibility spaces, I coin the term constraint-based generality. I show that constraint-based generality is distinct from other types of generality in biology, and argue that general principles play a unifying role that does not entail theory reduction. (shrink)

This paper analyzes the rhetoric surrounding the profession’s presentations of auditor independence. We trace the evolution of thecharacter of the auditor from Professional Man in the early years of the twentieth century to the more public and abstract figures of Judicial Man and Economic Man. The changing character of the auditor in the profession’s narratives of legitimation reflects changes in the role of auditing, in the economic environment, and in the values of American society. Economic man is a self-interested and (...) shallow character who offered the auditing profession little protection against involvement in corporate scandals. In the wake of recent accounting scandals, the profession is calling for a return to the character of Professional Man to restore trust in audits and the financial markets.We also analyze the philosophical bases of the metaphors surrounding auditor independence. These metaphors, particularly the metaphor of independence as separation, create problems in conceptualizing independence concepts. How can you discuss appropriate relationships when your basic concept is one of separation, or no relationship? On the other hand, relational concepts of independence are also flawed if they are not based on a firm moral foundation. We suggest how the profession can act to rebuildits moral foundation through recognition of collective responsibility. (shrink)

The present paper investigates the potential benefits of a strong safety culture. Specifically, we build on the organizational support theory to explore the direct and indirect effects of SC on firm performance. Partial least squares method is used to analyze the data collected from a survey among 251 Canadian plants. The results show that SC is associated with several performance indicators all linked to sustainable development. Importantly, our findings also suggest that the relationships between SC and environmental/safety performance are mediated (...) by the actual level of implemented environmental/safety practices within plants. We conclude the paper by highlighting the study’s limitations and contributions as well as theoretical and managerial implications. (shrink)

With the emergence of systems biology the notion of organizing principles is being highlighted as a key research aim. Researchers attempt to ‘reverse engineer’ the functional organization of biological systems using methodologies from mathematics, engineering and computer science while taking advantage of data produced by new experimental techniques. While systems biology is a relatively new approach, the quest for general principles of biological organization dates back to systems theoretic approaches in early and mid-20th century. The aim of this paper is (...) to draw on this historical background in order to increase the understanding of the motivation behind the systems theoretic approach and to clarify different epistemic aims within systems biology. We pinpoint key aspects of earlier approaches that also underlie the current practice. These are i) the focus on relational and system-level properties, ii) the inherent critique of reductionism and fragmentation of knowledge resulting from overspecialization, and iii) the insight that the ideal of formulating abstract organizing principles is complementary to, rather than conflicting with, the aim of formulating detailed explanations of biological mechanisms. We argue that looking back not only helps us understand the current practice but also points to possible future directions for systems biology. (shrink)

Patient-derived xenografts are currently promoted as new translational models in precision oncology. PDXs are immunodeficient mice with human tumors that are used as surrogate models to represent specific types of cancer. By accounting for the genetic heterogeneity of cancer tumors, PDXs are hoped to provide more clinically relevant results in preclinical research. Further, in the function of so-called “mouse avatars”, PDXs are hoped to allow for patient-specific drug testing in real-time. This paper examines the circulation of knowledge and bodily material (...) across the species boundary of human and personalized mouse model, historically as well as in contemporary practices. PDXs raise interesting questions about the relation between animal model and human patient, and about the capacity of hybrid or interspecies models to close existing translational gaps. We highlight that the translational potential of PDXs not only depends on representational matching of model and target, but also on temporal alignment between model development and practical uses. Aside from the importance of ensuring temporal stability of human tumors in a murine body, the mouse avatar concept rests on the possibility of aligning the temporal horizons of the clinic and the lab. We examine strategies to address temporal challenges, including cryopreservation and biobanking, as well as attempts to speed up translation through modification and use of faster developing organisms. We discuss how featured model virtues change with precision oncology, and contend that temporality is a model feature that deserves more philosophical attention. (shrink)

This paper throws some light on the nature of argumentation, its use and advantages, within the setting of doctor–patient interaction. It claims that argumentation can be used by doctors to offer patients reasons that work as ontological conditions for enhancing the decision making process, as well as to preserve the institutional nature of their relationship with patients. In support of these claims, selected arguments from real-life interactions are presented in the second part of the paper, and analysed by means of (...) a model of argumentation borrowed from classical rhetoric, and refined according to the modern orientation of the pragma-dialectic approach. (shrink)

Proponents of the emerging field of P4 medicine argue that computational integration and analysis of patient-specific “big data” will revolutionize our health care systems, in particular primary care-based disease prevention. While many ambitions remain visionary, steps to personalize medicine are already taken via personalized genomics, mobile health technologies and pilot projects. An important aim of P4 medicine is to enable disease prevention among healthy persons through detection of risk factors. In this paper, we examine the current status of P4 medicine (...) in light of historical and current challenges to predictive and preventive medicine, including overdiagnosis and overtreatment. Moreover, we ask whether it is likely that in silico integration of patient-specific data will be able to better deal such challenges and to turn risk predictions into disease-preventive actions in a wider social context. Given the lack of evidence that P4 medicine can tip the balance between benefits and harms in preventive medicine, we raise concerns about the current promotion of P4 medicine as a solution to the current challenges in public health. (shrink)

The starting point of this paper is the acknowledgement that individual reasoning, understood as inner dialogue, and social argumentation, albeit they are two different phenomena, share some similarities. On this basis, this paper sets out to apply instruments from argumentation theory to inner dialogue in order to better explain it. Within this framework, some limitations to the study of inner dialogue are also discussed; and methodological suggestions are provided in order to grasp what could be considered data on “inner dialogue” (...) starting from social research interviews. The ultimate aim is to go beyond a mere recognition of a similarity between inner dialogue and argumentation and start analysing inner dialogue empirically using tools from argumentation theory. The findings show that the analytic overview help shed light on how inner dialogue within processes of individual decision-making develops and what it means to have an internal difference of opinion, in which one and the same person adopts opposing standpoints and argues for them. On the opposite, it is shown that the notion of strategic manoeuvring per se cannot be applied to inner dialogue. (shrink)

Novel neurotechnologies, like deep brain stimulation and brain‐computer interface, offer great hope for treating, curing, and preventing disease, but raise important questions about effects these devices may have on human identity, authenticity, and autonomy. After briefly assessing recent narrative work in these areas, we show that agency is a phenomenon key to all three goods and highlight the ways in which neural devices can help to draw attention to the relational nature of our agency. Drawing on insights from disability theory, (...) we argue that neural devices provide a kind of agential assistance, similar to that provided by caregivers, family, and others. As such, users and devices participate in a kind of co‐agency. We conclude by suggesting the need for developing relational agency‐competencies—skills for reflecting on the influence of devices on agency, for adapting to novel circumstances ushered in by devices, and for incorporating the feedback of loved ones and others about device effects on agency. (shrink)

This paper supports the need for health professionals to be trained in argumentation theory, by illustrating the challenges that they face in interacting with patients and according to the different models of consultation that patients prefer. While there is no ideal model of consultation that can be promoted universally, the ability to construct arguments in support of health professionals’ points of view, as well as the ability to engage in critical discussion with patients, translate in essential skills for reaching patients’ (...) agreement when communication develops through the interpretative model or the informed decision model or, eventually, shared decision-making. Keywords: models of consultation, argumentation skills, medical training, patient-centeredness, informed consent. (shrink)

This article reviews the relationship between managed care and public health. Managed care, with its seemingly infinite structural and organizational variation, dominates the modern American health-care system for the non-elderly U.S. population. Through its emphasis on standarhzed practice norms and performance measurement, coupled with industrial purchasing techniques, prepayment, risk downstreaming, and incentives-based compensation, managed care has the potential to exert considerable influence over the manner in which the health-care system is organized and functions. Given the degree to which the attainment (...) of the basic public health goal of protecting the public against population health threats for which there are known and effective medical interventions depends on the successful interaction between public health policy and the medical care system, the importance of a viable working relationship between public health and managed care is difficult to overstate.The potential for conflict between public health and medical care is nothing new; indeed, delineating the boundaries of public health to shape and influence medical practice has occupied the energies of policymakers and the medical industry for well over a century. (shrink)

The model of feminism as humanist in practice and postmodern in theory is inadequate. Feminist practice and theory directly inform each other to displace both humanist and postmodern conceptions of the subject. An examination of feminism's use of rights discourse suggests that feminist practice questions the humanist conception of the subject as a self-identity. Likewise, feminist theory undermines the postmodern emphasis on the constitutive instability and indeterminacy of the subject.

Perspective taking has been proposed to be impaired in persons with autism spectrum disorder, especially when implicit processing is required. In narrative texts, language perception and interpretation is fundamentally guided by taking the perspective of a narrator. We studied perspective taking in the linguistic domain of so-called Free Indirect Discourse, during which certain text segments have to be interpreted as the thoughts or utterances of a protagonist without explicitly being marked as thought or speech representations of that protagonist. Crucially, the (...) correct interpretation of text segments as FID depends on the ability to detect which of the protagonists “stands out” against the others and is therefore identifiable as implicit thinker or speaker. This so-called “prominence” status of a protagonist is based on linguistic properties, in other words, the perspective is “hidden” and has to be inferred from the text material. In order to test whether this implicit perspective taking ability that is required for the interpretation of FID is preserved in persons with ASD, we presented short texts with three sentences to adults with and without ASD. In the last sentence, the perspective was switched either to the more or the less prominent of two protagonists. Participants were asked to rate the texts regarding their naturalness. Both diagnostic groups rated sentences with FID anchored to the less prominent protagonist as less natural than sentences with FID anchored to the more prominent protagonist. Our results that the high-level perspective taking ability in written language that is required for the interpretation of FID is well preserved in persons with ASD supports the conclusion that language skills are highly elaborated in ASD so that even the challenging attribution of utterances to protagonists is possible if they are only implicitly given. We discuss the implications in the context of claims of impaired perspective taking in ASD as well as with regard to the underlying processing of FID. (shrink)

A common object found within medical museums is the developmental series: an arrangement of embryos depicting the transformation of an unremarkable blob into an anatomically organized and recognizable organism. The developmental series depicts a normative process, one where bodies emerge in reliable sequential stages to reveal anatomically perfect beings. Yet a century before the developmental series would become a visual model of embryological development, the very process of development itself was discerned through the comparative study of preserved human fetuses—specifically, those (...) deemed “monstrous” or characterized as “malformations.” This article examines how anatomically diverse fetal bodies were reformulated from singular curiosities into alternative developmental pathways whose characteristics testified to the laws of nature and to the primordial, physical relationship between humans and other species. In early nineteenth century Amsterdam, the father-son team of physicians Gerard and Willem Vrolik built up an internationally renowned anatomical museum famous especially for Willem’s collection of fetal malformations. Physical preparations of fetal malformations play a central role in Willem’s monumental handbook on developmental embryology: comparing human embryos against one another and the embryos of other species, Willem plots out a sequence of embryological development in which a body’s form marks its place within the ever-unfolding natural order. In conversation with the literature on model organisms, this article explores how the “monstrous” gets standardized and, in doing so, contributes to the scientific production of a normative physiological process. (shrink)

Volume 20, Issue 8, August 2020, Page 78-79.

Scholars from various disciplines have explored the powerful symbolic function that children occupy within public discourses of technology, but less attention has been paid to the role this plays in the social shaping of the technologies themselves. Virtual worlds present a unique site for studying how ideas about children become embedded in the artifacts adults make for them. This article argues that children’s virtual worlds are fundamentally negotiated spaces in which broader aspirations and anxieties about children’s relationships with play, technology, (...) consumer culture, and the public sphere resurface as “configurations” of an imagined, ideal child player. The article begins with a brief overview of the children's virtual worlds phenomenon, followed by a discussion of related research on children’s play and play technologies. Findings from a case study of six commercial, game-themed virtual worlds targeted specifically to children are then presented, with a focus on how these artifacts configure their child players in highly ideological and normative ways, wherein play is narrowly defined in accordance with a neoromantic, consumerist ethos. The article aims to uncover the hidden politics inscribed within a particular genre of children’s technology and to explore some of the implications for children’s digital play. (shrink)

In the last decades, new technologies have improved the survival of patients affected by chronic illnesses. Among them, left ventricular assist device has represented a viable solution for patients with advanced heart failure. Even though the LVAD prolongs life expectancy, patients’ vulnerability generally increases during follow up and patients’ request for the device withdrawal might occur. Such a request raises some ethical concerns in that it directly hastens the patient’s death. Hence, in order to assess the ethical acceptability of LVAD (...) withdrawal, we analyse and examine an ethical argument, widely adopted in the literature, that we call the “descriptive approach”, which consists in giving a definition of life-sustaining treatment to evaluate the ethical acceptability of treatment withdrawal. Focusing attention on LVAD, we show criticisms of this perspective. Finally, we assess every patient’s request of LVAD withdrawal through a prescriptive approach, which finds its roots in the criterion of proportionality. (shrink)

The aesthetic tools proposed in this article pursue the intention of articulating and reflecting on dance as a phenomenon and artistic practice both from its generative and reflective ability. For that purpose I establish analogies between the complexities that aesthetic theory and dance share, from the modal interrelationships proposed in Estética modal, which give us the access to think in terms of transitivity, movement and interrelation. Especially in this article, I intend to focus on the intermediate playing field of tension (...) and conflict of the aesthetic experience from the attractive Diamond Theory. (shrink)

The purpose of this article is to present a case for the value of argumentation as an instrument of rational persuasion in doctor-patient (and general health professional–patient) communication. By doing so, I also emphasize the value of argumentation theory—as a body of knowledge devoted to the study of argumentation—both to enrich the study of doctor-patient communication and to enhance its quality by contributing to dedicated training courses for health professionals and patient education interventions. Argumentation is used in health professional–patient interactions, (...) and its significance in this context has been acknowledged in recent literature (see the collection of articles in Rubinelli and .. (shrink)

In 2017, Medicaid faced a near-death experience, the third of its 53-year history. Its survival and resilience is a testament not just to its size but to the multiple, vital roles Medicaid plays in the health care system, and its ability to adapt to emerging population health needs. It can take an existential threat to make these indispensable qualities clear.

Proponents of the emerging field of P4 medicine argue that computational integration and analysis of patient-specific “big data” will revolutionize our health care systems, in particular primary care-based disease prevention. While many ambitions remain visionary, steps to personalize medicine are already taken via personalized genomics, mobile health technologies and pilot projects. An important aim of P4 medicine is to enable disease prevention among healthy persons through detection of risk factors. In this paper, we examine the current status of P4 medicine (...) in light of historical and current challenges to predictive and preventive medicine, including overdiagnosis and overtreatment. Moreover, we ask whether it is likely that in silico integration of patient-specific data will be able to better deal such challenges and to turn risk predictions into disease-preventive actions in a wider social context. Given the lack of evidence that P4 medicine can tip the balance between benefits and harms in preventive medicine, we raise concerns about the current promotion of P4 medicine as a solution to the current challenges in public health. (shrink)

Due to the variation, contingency and complexity of living systems, biology is often taken to be a science without fundamental theories, laws or general principles. I revisit this question in light of the quest for design principles in systems biology and show that different views can be reconciled if we distinguish between different types of generality. The philosophical literature has primarily focused on generality of specific models or explanations, or on the heuristic role of abstraction. This paper takes a different (...) approach in emphasizing a theory-constituting role of general principles. Design principles signify general dependencyrelations between structures and functions, given a set of formally defined constraints. I contend that design principles increase our understanding of living systems by relating specific models to general types. The categorization of types is based on a delineation of the scope of biological possibilities, which serves to identify and define the generic features of classes of systems. To characterize the basis for general principles through generic abstraction and reasoning about possibility spaces, I coin the term constraint-based generality. I show that constraintbased generality is distinct from other types of generality in biology, and argue that general principles play a unifying role that does not entail theory reduction. (shrink)

Lately, in educational research and debate, there have been discussions on a trend sometimes named as a ‘therapeutic turn’ in education. Mindfulness-oriented activities represent one therapeutic approach in education, aiming for virtues such as patience and trust. A large part of the critical viewpoints on therapeutic education among young students seem to concern problems of integrity, privacy and the autonomy of the student. It is therefore, I suggest, fair to say that meetings between teachers and students are of special concern (...) within the realm of therapeutic education. The aim of this study is to shed light upon two teachers' reflections upon their own work and their students' within a mindfulness-oriented approach in a Swedish secondary school. I turn to Iris Marion Young, a theorist who has dealt with questions of communicative ethics and respectful meetings, for guidance. I find Young's concepts of recognition and distance through the act of greetings interesting and possibly fruitful for discussing qualities in teacher–student relations in therapeutic education from a professional ethical point of view. The analysis shows that Life Competence Education has the potential to be an arena within youth education where traditional roles, hierarchies and relations within education may be challenged. Likewise, because of this potential, it may also function as an arena where traditional structures and hierarchies of education are reaffirmed. (shrink)

Queering Paradigms IVa: Insurgências queer ao Sul do equador, junto com o volume Queering Paradigms IV: South-North Dialogues on Queer Epistemologies, Embodiments and Activisms (Lewis et al. 2014), divulga de forma multilíngue pesquisas apresentadas no 4° Congresso Internacional Queering Paradigms (QP4), sediado no Rio de Janeiro, Brasil. Ambos os volumes compartilham o objetivo de analisar o status quo e os desafios para o futuro dos Estudos Queer a partir de uma perspectiva inter/multidisciplinar, concentrando-se sobre as relações entre os eixos Sul-Norte. (...) O presente livro oferece capítulos escritos em português e espanhol, línguas subalternas na academia global, visando a privilegiar vozes e conhecimentos do Sul. Os trabalhos reunidos neste volume insurgem contra a colonização epistemológica dos corpos que habitam o Sul global e apontam para os problemas que surgem quando a(s) Teoria(s) Queer do Norte são aplicadas sem adaptação a outros contextos. Além de violências epistemológicas, a falta de atenção ao que acontece ao sul do equador pode levar a uma paralização do debate queer. O convite que esses capítulos fazem é um desafio a olhar para onde não se costuma olhar e ouvir as vozes que não se costuma ouvir, de forma a devolver ao queer seu potencial de contestação. Queering Paradigms IVa: Insurgências queer ao Sul do equador, junto con el tomo Queering Paradigms IV: South-North Dialogues on Queer Epistemologies, Embodiments and Activisms (Lewis et al. 2014), difunde de forma multilingüe algunas de las investigaciones presentadas en el 4o Congreso Internacional Queering Paradigms (QP4), en Río de Janeiro, Brasil. Ambos tomos comparten el objetivo de analizar el estado actual y los desafíos para el futuro de los Estudios Queer desde una perspectiva inter/multidisciplinaria, concentrándose sobre las relaciones entre el eje Sur-Norte. El presente libro ofrece capítulos escritos en portugués y español, lenguas subalternas en la academia global, con la pretensión de privilegiar voces y conocimientos del Sur. Los trabajos reunidos en este tomo se insurgen contra la colonización epistemológica de los cuerpos que habitan el Sur global y apuntan a los problemas que surgen cuando la(s) Teoría(s) Queer del Norte son aplicadas sin adaptación a otros contextos. Además de las violencias epistemológicas, la falta de atención a lo que acontece al sur del Ecuador puede llevar a una paralización del debate queer. La propuesta de estos capítulos es un desafío a mirar para dónde no se suele mirar y a escuchar las voces que no se suelen escuchar, para devolverle al queer su potencial de contestación. (shrink)

There is an increasing demand for ethical and Corporate Social Responsibility practices by companies. This competence has to be introduced in students’ training in business degree programs, and a check must then be done to determine if the students have come to appreciate the importance of CSR commitments. Using the framework of Stakeholders Theory, this work aims to examine students’ perceptions of ethical and CSR practices and commitment to different stakeholders, as well as the factors that lead students to act (...) in a socially responsible way. Furthermore, we hope to identify how the perception of CSR can be improved when Web 2.0 and social media tools that have proven effective in transmitting emotions and values are used in classrooms to teach these ideas. To this end, a survey was carried out in the year 2019 with 1,030 first-year students; it was administered at the beginning of the semester and also at the end of the semester after the training activities had been carried out. The main finding of the research is that students start with the belief that ethics and CSR are developed for reasons of image and legitimacy; however, after receiving training on these topics through tools that take into account emotions and values, they start to value the importance of the company as an agent of social change. The main practical and managerial implication is that methods based on Web 2.0 and social media tools are useful to teach ethics and CSR; the theoretical contribution is that students take into account the welfare of others. This finding contributes to Stakeholder Theory in a higher education context. (shrink)

Más allá del análisis filológico e histórico de fuentes como el Kojiki y el Nihongi, se puede abordar el estudio de la mitología japonesa desde la antropología y la etnología. Es por ello que, para obtener una visión más completa de figuras mitológicas como Izanami e Izanagi, una aproximación a su presencia en algunos matsuri y danzas kagura puede ser de interés. En este trabajo se expone una relación y descripción tanto de los materiales audiovisuales como de los resultados obtenidos (...) en el trabajo de campo realizado el 5 de mayo de 2018 en el santuario Tamashiki (Kazo, Saitama), en la celebración del shunki taisai (festival de primavera), entre cuyos kagura se representaba el pasaje mítico del matrimonio entre Izanami e Izanagi, bajo el título de Izanagi Izanami no tsuremai. (shrink)

In the last fifty years a series of valuable contributions on Aristotle's Topics has helped to understand how a Topics functions in the dialectical argumentation. In contrast to this, Aristotle's topoi as set out in the Rhetoric does not seem to have received the same attention. Current opinion holds that the methodology in the Rhetoric involves two different kinds of topoi, the topoi koinoi and the ídia, considered by most scholars as idioi topoi. The problem, here, is that this distinctíon (...) of is topoir is not supported by any passage in the Rhetoric. Aristotle never speaks of. This work aims to show that the term'ídia is not intended to imply'ídioi topoi. The only distinction that Aristotle introduces in the Rhetoric is that between and which also appears in the Topica and which is the consequence of a fundamental coherente in thc thcory of argumentation presented by Aristotle in the two treatises. However, the results of such investigation has revcaled that the concept of which Aristotle introduces in Rhetaric 1358 a l0 clashes with the list of topoi which appears in Rhetoric B23. In the addenda, this work addresscs this issue and make a case for the possibility that Rhetoric B23 has been originally written independently from the previous sections of the Rhetoric. (shrink)

This article examines the recent introduction of forced ultrasound-beforeabortion measures in select U.S. states as an intervention of gendered biopower. These measures are drafted based on model legislation entitled the Woman’s Right to Know Act. Such legislation exploits a discourse of women’s health, but invests in fetal “life” by regulating the behavior of pregnant women so as to promote the carrying of pregnancies to term; the legislation also represents childbirth and motherhood as in the interest of women’s health. Ultimately, I (...) contend that Right to Know measures give the state permission to override the choices, rights, and interests of the population of pregnant women as a whole in an attempt to “protect” and optimize a supposedly vulnerable fetal population. (shrink)