When parents face the distressing news during pregnancy that their baby is affected by a serious medical condition that will likely lead to the baby’s death before or soon after birth, they experience a range of complex emotions. Perhaps paradoxically, one common response is that of hope. Navigating such hope in antenatal interactions with parents can be difficult for healthcare professionals. That can stem from a desire to accurately communicate prognostic information and a fear of conveying ‘false hope’ to families. (...) In this paper, we examine the role that hope plays when parents and healthcare professionals are grappling with a confirmed antenatal diagnosis of a life-limiting condition. We assess what it means to hope in this context and consider the different types of hopes held by both parents and healthcare professionals as well as why hopeful thinking might be helpful and not harmful. We propose ‘hope pluralism’ as a concept that might allow healthcare professionals to accommodate a multitude of parental and professional hopes, even where these conflict. Finally, we offer some practical suggestions for how professionals should evaluate and respond to hope in situations that might (from the outside) appear hopeless. (shrink)

In the past decade, the fields of machine learning and artificial intelligence (AI) have seen unprecedented developments that raise human-machine interactions (HMI) to the next level.Smart machines, i.e., machines endowed with artificially intelligent systems, have lost their character as mere instruments. This, at least, seems to be the case if one considers how humans experience their interactions with them. Smart machines are construed to serve complex functions involving increasing degrees of freedom, and they generate solutions not fully anticipated by humans. (...) Consequently, their performances show a touch of action and even autonomy. HMI is therefore often described as a sort of “cooperation” rather than as a mere application of a tool. Some authors even go as far as subsuming cooperation with smart machines under the label ofpartnership, akin to cooperation between human agents sharing a common goal. In this paper, we explore how far the notion of shared agency and partnership can take us in our understanding of human interaction with smart machines. Discussing different topoi related to partnerships in general, we suggest that different kinds of “partnership” depending on the form of interaction between agents need to be kept apart. Building upon these discussions, we propose a tentative taxonomy of different kinds of HMI distinguishing coordination, collaboration, cooperation, and social partnership. (shrink)

Legal battles continue in the UK over the Government’s plans to transport asylum seekers arriving on British shores to Rwanda in East Africa. Originally announced as a system for ‘processing’ asylum seekers, the Government has subsequently made it clear that there would not be an option for asylum seekers to return to the UK. The arrangement forms part of a deal between the UK and Rwanda, with the UK promising to invest £120 m in economic growth and development in Rwanda, (...) along with financing the cost of the ‘offshored’ asylum operation.1 The Government states that the policy is designed to break the business model of people traffickers involved in facilitating hazardous trips across the Channel in small, overcrowded and unseaworthy craft, leading to multiple drownings. Critics argue that the policy will do nothing to stop desperate people from seeking refuge in the UK, that transferring already traumatised people to Rwanda – which has been criticised for its human rights record – is inhumane and potentially outwith international law. Medical bodies, including the BMA, along with refugee organisations have expressed serious concerns about the health impact of such a system of ‘offshoring’. An equivalent system in Australia has been notorious for the devastating health impacts on those ‘offshored’ to the Pacific islands of Manus and Naura. Unusually in the UK the offshoring proposals have been greeted by unanimous condemnation by the Church of England. The lawfulness of the process is also subject to question. On the 14 July, a plane carrying a small number of asylum seekers to Rwanda was halted shortly before take-off following an intervention by the European Court of Human Rights. The ECtHR, part of the Council of Europe, of which the UK is still a member, said an Iraqi man known as KN faced ‘a real …. (shrink)

Cet article s’inscrit dans la lignée de précédents travaux visant à rapprocher l’entrepreneur schumpétérien et le surhumain nietzschéen. Les deux partagent une créativité pouvant s’interpréter comme l’extériorisation d’un surcroît de force qui, dans l’optique nietzschéenne, s’assimile à la source extra-morale de l’accroissement de la vie. Reste à savoir si le cadre dans lequel ils évoluent est le même. Au-delà d’une approche historique du cycle de la conjoncture, notre hypothèse est que l’approche philosophique d’un cycle du devenir s’avère être féconde pour (...) une interprétation enrichie du cycle de la conjoncture, complétant et prolongeant ainsi notre interprétation du surhumain et de l’entrepreneur. (shrink)

In this paper, I investigate whether phenomenological description can help in transforming an unjust or violent situation. If one can agree that describing the situation of a group of marginalised subjects is necessary in order to define what is going wrong, then the question of whether the method can help change these states, remains unanswered. With this in mind, I then suggest that phenomenological description can only serve critical causes, under the condition that it takes the transformative power of language (...) into account: by describing our experiences we already transform them. To this end, I draw on deconstructivist approaches, which focus on language as a social act of addressing oneself to others. I conclude by arguing that description can itself be a transformative tool – if we stress how it takes place under conditions of address that necessarily shape the experience to be described. (shrink)

Recent scholarship increasingly defines Islamophobia as a form of racism. The possibility that Islamophobia could also manifest itself as religious or cultural bigotry is generally overlooked. This article argues that although anti-Islam bigotry is intertwined with anti-Muslim racism, the two are conceptually distinct. Making this distinction allows us to better analyze, unmask, and critically assess Islamophobia. The article conceptually explores the similarities and differences between anti-Muslim racism and anti-Islam bigotry. It finds that although anti-Islam bigotry implies a prejudicial rejection of (...) an essentialized idea of Islam, it understands religion or culture to be an individual choice and allows for the possibility that Muslims convert or assimilate. As such, it differs from anti-Muslim racism, which implies that the Muslim identity and the negative characteristics associated with Islam are innate and unchangeable. The article argues that contemporary Islamophobic political discourse in Europe is predominantly racist, although it hides behind a cloak of anti-Islam bigotry. (shrink)

Kammerer and Frankish (this issue) challenge us to expand our conception of introspection beyond neurotypical human cases. This article describes a possible 'ancillary mind' modelled on a system envisioned in Leckie's (2013) science fiction novel Ancillary Justice. The ancillary mind constitutes a borderline case between a communicating group of individuals and a single, spatially distributed mind. It occupies a grey zone with respect to personal identity and subject individuation, neither determinately one person or subject nor determinately many persons or subjects, (...) and thus some of its processes might be neither determinately introspection within a mind nor determinately communication between minds. If ancillary minds defy discrete countability, the same might be true for some actual minds on Earth. Kammerer and Frankish's research programme can be extended to include not only the study of possible forms of introspection, but also the study of possible mental activity intermediate between introspection and communication. (shrink)

Name der Zeitschrift: Zeitschrift für kritische Sozialtheorie und Philosophie Jahrgang: 5 Heft: 2 Seiten: 338-369.

This volume deals with a variety of moments in the history of mechanics when conflicts arose within one textual tradition, between different traditions, or ...

Since the ENCODE project published its final results in a series of articles in 2012, there is no consensus on what its implications are. ENCODE’s central and most controversial claim was that there is essentially no junk DNA: most sections of the human genome believed to be «junk» are functional. This claim was met with many reservations. If researchers disagree about whether there is junk DNA, they have first to agree on a concept of function and how function, given a (...) particular definition, can be discovered. The ENCODE debate centered on a notion of function that assumes a strong dichotomy between evolutionary and non-evolutionary function and causes, prevalent in the Modern Evolutionary Synthesis. In contrast to how the debate is typically portrayed, both sides share a commitment to this distinction. This distinction is, however, much debated in alternative approaches to evolutionary theory, such as the EES. We show that because the ENCODE debate is grounded in a particular notion of function, it is unclear how it connects to broader debates about what is the correct evolutionary frame- work. Furthermore, we show how arguments brought forward in the controversy, particularly arguments from mathematical population genetics, are deeply embedded in their particular disciplinary contexts, and reflect substantive assumptions about the evolution of genomes. With this article, we aim to provide an anatomy of the ENCODE debate that offers a new perspective on the notions of function both sides employed, as well as to situate the ENCODE debate within wider debates regarding the forces operating in evolution. (shrink)

Plasminogen activator inhibitor‐1 (PAI‐1) is a physiological inhibitor of urokinase (uPA), a serine protease known to promote cell migration and invasion. Intuitively, increased levels of PAI‐1 should be beneficial in downregulating uPA activity, particularly in cancer. By contrast, in vivo, increased levels of PAI‐1 are associated with a poor prognosis in breast cancer. This phenomenon is termed the “PAI‐1 paradox”. Many factors are responsible for the upregulation of PAI‐1 in the tumor microenvironment. We hypothesize that there is a breast cancer (...) predisposition to a more aggressive stage when PAI‐1 is upregulated as a consequence of Metabolic Syndrome (MetS). MetS exerts a detrimental effect on the breast tumor microenvironment that supports cancer invasion. People with MetS have an increased risk of coronary heart disease, stroke, peripheral vascular disease and hyperinsulinemia. Recently, MetS has also been identified as a risk factor for breast cancer. We hypothesize the existence of the “PAI‐1 cycle”. Sustained by MetS, adipocytokines alter PAI‐1 expression to promote angiogenesis, tumor‐cell migration and procoagulant microparticle formation from endothelial cells, which generates thrombin and further propagates PAI‐1 synthesis. All of these factors culminate in a chemotherapy‐resistant breast tumor microenvironment. The PAI‐1 cycle may partly explain the PAI‐1 paradox. In this hypothesis paper, we will discuss further how MetS upregulates PAI‐1 and how an increased level of PAI‐1 can be linked to a poor prognosis. BioEssays 29:1029–1038, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Several researchers point to disorganized attachment as a core feature of borderline personality disorder (BPD). However, recent studies suggest that specific internal working models (IWMs) of each parent combine to account for child outcomes and that a secure relationship with one parent can protect against the deleterious effects of an insecure relationship with the other parent. It was thus hypothesized that adolescents with BPD are more likely to be disorganized with both their parents, whereas non-clinical controls are more secure with (...) at least one of their caregivers. Thirty-six adolescents with BPD and 30 control participants (aged 13-19) were included. Psychiatrist diagnosis was verified with the SIDP-IV and comorbidity was assessed using the Kiddie-SADS. Reported trauma was assessed with the Childhood Trauma Questionnaire. Attachment IWMs of each parent were assessed with the Attachment Multiple Model Interview (AMMI), which enables separate coding for each attachment figure and in which disorganization is conceptualized as conflicting attachment strategies within a specific relationship. Results of a logistic regression analysis suggested that beyond insecure attachment, being disorganized not just with one but with both parents is particularly characteristic of adolescents with BPD. Conversely, belonging to the non-clinical group was predicted by higher security scores with the father and lower deactivation with the mother. Although higher levels of childhood abuse or neglect were reported by adolescents with BPD, the retained attachment dimensions predicted group membership over and above reported trauma. These findings have important implications for clinical intervention and highlight the protective role fathers may have. (shrink)

The “Encyclopedia of DNA Elements” (ENCODE) project was launched by the US National Human Genome Research Institute in the aftermath of the Human Genome Project (HGP). It aimed to systematically map the human transcriptome, and held the promise that identifying potential regulatory regions and transcription factor binding sites would help address some of the perplexing results of the HGP. Its initial results published in 2012 produced a flurry of high-impact publications as well as criticisms. Here we put the results of (...) ENCODE and the work on epigenomics that followed in a broad theoretical and historical context, focusing on three strands of research. The first is the history of thinking about the organization of genomes, both physical and regulatory. The second is the history of ideas about gene regulation, primarily in eukaryotes. Finally, and connecting these two issues, we suggest how to think about the role of genetic material in physiology and development. (shrink)

This paper discusses ways in which empirical research investigating sexual networks can further understanding of the transmission of HIV in London, using information from a 24-month period of participant observation and 53 open-ended, in-depth interviews with eighteen men and one woman who have direct and indirect sexual links with each other. These interviews enabled the identification of a wider sexual network between 154 participants and contacts during the year August 1994-July 1995. The linked network data help to identify pathways of (...) transmission between individuals who are HIV+ and those who are HIVolderyounger’ men, and with male prostitutes. There appears to be considerable on-going transmission of HIV in London. The majority of participants reported having had unprotected anal and/or vaginal sex within a variety of relationships. The implications of these findings for policies designed to prevent the transmission of HIV are discussed. (shrink)

Girls have much lower mathematics self-efficacy than boys, a likely contributor to the underrepresentation of women in STEM. To help explain this gender confidence gap, we examined predictors of mathematics self-efficacy in a sample of 1,007 9th graders aged 13–18 years (54.2% girls). Participants completed a standardized math test, after which they rated three indices of mastery: an affective component (state self-esteem), a meta-cognitive component (self-enhancement), and their prior math grade. Despite having similar grades, girls reported lower mathematics self-efficacy and (...) state self-esteem, and were less likely than boys to self-enhance in terms of performance. Multilevel multiple-group regression analyses showed that the affective mastery component explained girls’ self-efficacy while cognitive self-enhancement explained boys’. Yet, a chi-square test showed that both constructs were equally relevant in the prediction of girls’ and boys’ self-efficacy. Measures of interpersonal sources of self-efficacy were not predictive of self-efficacy after taking the other dimensions into account. Results suggest that boys are advantaged in their development of mathematics self-efficacy beliefs, partly due to more positive feelings and more cognitive self-enhancement following test situations. (shrink)

This article examines the term “Radical Enlightenment” as a historiographical category through the lens of the philosophical work of Dorothea Christiane Erxleben (1715–1762), a keen advocate for women’s education and the first female medical doctor in Germany. The aim of the article is to develop a methodological framework that makes it possible to critically assess the radicalism of Erxleben’s philosophical position as it is presented in her highly systematic work Rigorous Investigation (1742). In the first part of the article, the (...) term “Radical Enlightenment” is briefly discussed in the German context. The second part is dedicated to articulating two methodological problems concerning the use of the term “radical” with regards to early feminist writings of the seventeenth and eighteenth centuries. The aim of this section is to develop a new approach to the classification of radical thinkers of this period. In the remaining three parts, this methodological approach is applied to the analysis of Erxleben’s views on equality and education, focusing on her call for women’s active participation in society. Finally, it is concluded that there is sufficient evidence to categorize vital parts of Erxleben’s philosophy as radical. (shrink)

At the time of writing the COVID-19 pandemic was entering its ninth month, with nearly 800 000 recorded fatalities and 22 million infections in 188 countries and territories.1 In previous ethics briefings2 we raised concerns about the possibility that demand for life-sustaining treatment would overwhelm supply, with a consequent requirement for health professionals to make challenging triage decisions. Fortunately, to date, these have largely not been realised, although there is a possibility that countries in which containment measures have been less-successful, (...) such as South Africa, may still be required to triage.3 Despite the successful ‘flattening of the curve’ in many countries, there is a wide consensus that we remain firmly within the pandemic. Enormous practical challenges remain. It is unclear whether the pandemic will ultimately take the form of two or more successive waves, or whether the patchwork of global responses will lead to a sustained slow ‘burn’ with sporadic flare-ups.4 Areas of uncertainty include whether infection confers some immunity, how long any such immunity might last, whether effective vaccines can be developed and if seasonal temperature fluctuations alter the spread of the virus. The pandemic will also be fundamentally shaped by the decisions that governments make and the extent to which their diktats are complied with by citizens. With the – possibly temporary – retreat of urgent clinical ethics issues, such as triage, opportunities have arisen to reflect on some of the ethical questions that underlie and structure the demanding policy decisions that governments are wrestling with. One of the early questions was how to balance the complex constellation of costs and benefits associated with lockdown. Countries that …. (shrink)

In December, the National Data Guardian 1 for health and care in England, Dame Fiona Caldicott, published the outcomes of a public consultation about the Caldicott Principles and the role of Caldicott Guardians.1 The Caldicott Principles are good practice guidelines which have been used by health and social care organisations in the UK since 1997 to ensure that people’s data are kept safe and used in an ethical way.2 The role of the Caldicott Guardian is well-established in the UK. Caldicott (...) Guardians are senior people which support the upholding of the Caldicott Principles within organisations. In response to views expressed during the consultation the NDG has added an eighth Caldicott Principle to the existing seven and will use her statutory powers to issue guidance about the appointment of Caldicott Guardians for health and adult social care organisations. The new eighth Caldicott Principle is: ‘Inform patients and service users about how their confidential information is used’. It provides that: > A range of steps should be taken to ensure no surprises for patients and service users, so they can have clear expectations about how and why their confidential information is used, and what choices they have about this. These steps will vary depending on the use: as a minimum, this should include providing accessible, relevant and appropriate information - in some cases, greater engagement will be required. The NDG explains that the introduction of the new principle was prompted by consideration of the role that the legal concept of ‘reasonable expectations’ should play in shaping the circumstances under which health and care data may be legitimately shared. The NDG does not envisage that this principle will establish reasonable expectations as a legal basis in its own right …. (shrink)

As the COVID-19 vaccine roll out continues apace, in the higher-income countries at least, concerns remain about the level of vaccine coverage in some health and social care settings. Although most countries have seen a relatively high uptake of vaccination against COVID-19 among staff, there continue to be some pockets of hesitancy. The risk of outbreaks in settings with potentially very vulnerable patients has led some governments across Europe to consider, or to introduce, measures compelling healthcare staff to be vaccinated. (...) The justifiability of mandating the vaccination of healthcare professionals is a longstanding question but it has come to the fore in recent months following a resurgence of cases of COVID-19 and the prevalence of the more transmissible Delta variant. In deciding whether the introduction of a mandate is appropriate, states have to balance a range of ethical and practical considerations. A voluntary approach, backed up with education, respects healthcare workers’ autonomy to make private healthcare decisions, which is valued highly in liberal democracies. However, healthcare professionals also have an obligation to ensure that they do not present a risk of harm to their patients. Similarly, healthcare providers have a responsibility to take appropriate steps to minimise the risk of infection. Alongside balancing these rights and responsibilities, governments must also consider the potential consequences and risks of enforcing vaccine uptake. For example, there are concerns that a coercive approach could deepen mistrust and resentment among people who are genuinely fearful or hesitant. Moreover, a large number of refusals and the subsequent imposition of sanctions, such as suspension or redeployment, could affect the ability of providers to staff necessary services. In the UK, Wales, Northern Ireland and Scotland have all ruled out the introduction of compulsory vaccination. However, in July, the English Parliament voted through …. (shrink)

Clinical ethics is widely recognised as an essential contribution to the quality of health and psychosocial service delivery. However, the lack of a common understanding of ethics within teams and insufficient organisational support often limits its optimal integration into the workplace. To address this problem, the clinical ethics committee of a rehabilitation centre developed a new clinical ethics framework based on a theoretical model and conducted a pre-implementation evaluation by interviewing future users. The study estimated the acceptability and initial adoption (...) of the new clinical ethics framework. The quantitative results of the study indicated a high level of acceptability for the definitions, tools and supporting strategies, with the exception of the definition of the concept of ethical issues. The qualitative results showed that the future users perceived positively the attributes of the new framework, such as its benefits and its compatibility with their professional concerns. In addition, they appreciated the fact that the framework was easy to understand and could potentially be applied in daily practice. The suggestions provided by future users also helped to improve the content of the clinical ethics framework. Finally, all the results will be useful for the planification of its eventual implementation. (shrink)

Seasonal influenza poses a significant public health risk in many countries worldwide. Lower immunity and less influenza virus circulating during the pandemic has resulted in a significant increase in cases since the lifting of COVID-19 restrictions in 2022. The seasonal influenza vaccine offers effective protection and is safe for use in large numbers of the population. This article asserts that a moral obligation to vaccinate against influenza can be understood as an Institutional Duty of Rescue. The traditional understanding of the (...) Duty of Rescue encounters issues with force and scope, making it difficult to apply to rescue cases in general, as well as being overdemanding for the individual agent. An Institutional view of the Duty of Rescue addresses these difficulties, looks at the wider context of rescue and leaves room for discussion on collective, preventative rescue measures. This makes the concept well suited to supporting a moral obligation to vaccinate against influenza as part of a collective effort on the part of institutional organisations. (shrink)

For the most part, current reflections on the social seem to overemphasize either homogeneity (society/nation-state, modernization/globalization) or heterogeneity (sociality, cosmopolitanism). Against this, here the argument is put forward that it is appropriate to think of the social as consisting of aspects of homogeneity or shared frames of reference and aspects of heterogeneity at the same time. This thought is developed particularly in contrast to normative concepts such as Bauman's sociality—republicanism nexus or Beck and Grande's ideas on European cosmopolitanism. With the (...) help of concepts such as sociation, glocalization and conflict, a basis will be developed for the elaboration of particular socials (e.g. Europe) as a general social theory. This avoids falling into normative traps, which are usually risky when starting out from a historical particularity to explain current and future structures and features of notions such as European society. (shrink)

This article discusses Dewey’s The Public and Its Problems (1927), Ethics (1932), “Theory of valuation” (1939), Art as Experience (1934) and A Common Faith (1934), for the socio-anthropological analysis of the religious, in a context of diversity and anxiety about identities. This pragmatist approach enables to consider religious in the making, experience and self-construction. The concept of ideal, taking into account intersubjectivity and context, allows treating aspirations and ideals. Finally, the idea of public and pre-political, permits to pay attention to (...) processes which are different from differentiation and where people contribute to the common good from their specific (minority) situation. (shrink)

La médiation, en tant que mode de prévention ou de résolution des litiges, a le vent en poupe. Toutefois, les imprécisions successives du législateur n’ont pas permis d’en cerner clairement les contours. De fait, cette notion se décline aujourd’hui selon des modes pluriels. À cet égard, deux pratiques médiatives nées de l’activité de la DGFiP illustrent bien la diversité des expressions de ce phénomène. Il s’agit du Médiateur du MINEF et de la cellule de médiation sociale mise en place par (...) la Direction générale des finances publiques. Dans ce contexte de flou terminologique, il convient d’interroger la qualité de ces pratiques se revendiquant de la médiation. (shrink)

Sous l’impulsion européenne, le droit de la médiation de la consommation a été profondément renouvelé avec la transposition de la directive 2013/11/UE relative au règlement extrajudiciaire des litiges de consommation par l’ordonnance n°2015-1033 du 20 août 2015. L’accès rapide, efficace et gratuit à un dispositif de médiation de la consommation a été appréhendé comme un droit pour le consommateur, dont la mise en place incombe aux professionnels dans tous les secteurs d’activités économiques. À la différence des autres modes amiables de (...) règlement des litiges, la médiation de la consommation a fait l’objet d’un encadrement strict avec l’élaboration d’un véritable statut de médiateur de la consommation et l’assujettissement du processus de médiation à des garanties d’ordre procédural. Placé sous le contrôle de la Commission d’évaluation et de contrôle de la médiation de la consommation, le dispositif de médiation de la consommation tend à s’imposer comme le mode privilégié de règlement des litiges de consommation. (shrink)

Context can determine whether a given gene acts as an oncogene or a tumor suppressor. Deubiquitinating enzymes (DUBs) regulate the stability of many components of the pathways dictating cell fate so it would be expected that alterations in the levels or activity of these enzymes may have oncogenic or tumor suppressive consequences. In the current review we survey publications reporting that genes encoding DUBs are oncogenes or tumor suppressors. For many DUBs both claims have been made. For such “double agents,” (...) the effects of gain or loss of function will depend on the overall status of a complex of molecular signaling networks subject to extensive crosstalk. As the TGF‐β paradox makes clear context is critical in cell fate decisions, and the disconnect between experimental findings and patient survival outcomes can in part be attributed to disparities between culture conditions and the microenvironment in vivo. Convincing claims for oncogene or tumor suppressor roles require the documentation of gene alterations in patient samples; survival curves are alone inadequate. (shrink)

Cet ouvrage collectif porte sur la place qu’occupent les femmes dans différentes parties de l’Empire romain d’Orient hellénophone. Il résulte de trois rencontres scientifiques organisées dans le cadre du programme GRECS d’ANIHMA entre 2012 et 2014. Comme l’explique Sophie Lalanne dans son introduction, le volume ne reflète que partiellement le contenu de ces rencontres ; l’éditrice formule d’ailleurs des réflexions intéressantes sur la place de l’histoire des femmes et du genre dans le domain...