We agree with Faunce’s proposal that academic legitimacy is important in ensuring that whistle-blowing is included in medical curricula. We disagree, however, with the assertion that this is best achieved by means of an over-arching theoretical foundation for health care whistle-blowing of the kind suggested by Faunce. We propose that systematic theoretical justification is neither the sole nor the main determinant of academic legitimacy when it comes to matters for inclusion in medical school curricula, and outline an alternative view, together (...) with a practical example of a healthcare whistle-blowing topic. (shrink)

This interdisciplinary book examines the work of several female artists since 1960 in the areas of dance, music, installation, photography, architecture, poetry, literature, theater, film, and performance art. Each chapter is primarily devoted to an important work by a single artist, seen within its historical context, and with particular attention to how each artist incorporated gender issues or feminist thought into her respective art form. Laurie Anderson, Gwendolyn Brooks, Jane Campion, Judy Chicago, Zaha Hadid, Pauline Oliveros, Yvonne Rainer, Cindy Sherman, (...) Amy Tan, and Paula Vogel have each made groundbreaking contributions to their fields. As a group, they represent a tremendous diversity of approaches to art making: from accessible to opaque, from overtly feminist to apolitical, from emotive to cool, from controversial to mainstream. (shrink)

The Lasallian District of Medellin, Colombia requested Corporación Universitaria Lasallista to analyze the formation process received by postulants to De La Salle Brothers in Istmina, Colombia, from 2002 to 2010. Academic, religious, pedagogical, apostolic and personal formation experiences received there were analyzed in this case study –from a qualitative approach– by means of semi-structured interviews and focus groups. Personal and apostolic formations stand out among the results due to the characteristics of Istmina as a proper place for sensibilization and subjugation (...) in proof of vocation. However, the reach of integral formation is questioned because academic formation presented meaningful deficiencies. In conclusion, even though formation experiences in vulnerable contexts are appreciated –and contextualization of learning is deemed meaningful–, participants agree in the necessity of developing strong competences to face educational and apostolic practices. (shrink)

BackgroundCognitive Behavioral Therapy is delivered in most of the early intervention services for psychosis in different countries around the world. This approach has been demonstrated to be effective in decreasing or at least delaying the onset of psychosis. However, none of them directly affect the comorbidity of these types of patients that is often the main cause of distress and dysfunctionality. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders is a psychological intervention that combines cognitive-behavioral and third-generation techniques (...) that address emotional dysregulation as an underlying mechanism that these disorders have in common. The application of this intervention could improve the comorbid emotional symptoms of these patients.Materials and methodsThe study is a randomized controlled trial in which one group receives immediate UP plus standard intervention and the other is placed on a waiting list to receive UP 7 months later, in addition to standard care in one of our early psychosis programs. The sample will be 42 patients with UHR for psychosis with comorbid emotional symptoms. The assessment is performed at baseline, at the end of treatment, and at 3-months’ follow-up, and includes: general psychopathology, anxiety and depression, positive and negative emotions, emotional dysregulation, personality, functionality, quality of life, cognitive distortions, insight, and satisfaction with the UP intervention.DiscussionThis will be the first study of the efficacy, acceptability, and viability of the UP in a sample of young adults with UHR. The results of this study may have clinical implications, contributing to improving the model of care for young people who consult for underlying psychotic, anxiety, and/or depressive symptoms that can lead to high distress and dysfunctionality.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT04929938]. (shrink)

Lloyd (2009) contends that climate models are confirmed by various instances of fit between their output and observational data. The present paper argues that what these instances of fit might confirm are not climate models themselves, but rather hypotheses about the adequacy of climate models for particular purposes. This required shift in thinking—from confirming climate models to confirming their adequacy-for-purpose—may sound trivial, but it is shown to complicate the evaluation of climate models considerably, both in principle and in practice.

Wendy Brown's work commands widespread attention and respect, and there has been considerable interest as to how it would develop after "States of Injury." This book will not disappoint.

This article summarizes the April 5–6, 2002 conference on Conflict of Interest and Its Significance in Science and Medicine. Several themes are identified and addressed, including the globalization of science, the widespread presence of conflicts, the increased interest and involvement in conflict of interest by a number of organizations, the difference between academic research and research conducted by industry, and the tension between science and medicine. At the heart of the matter lies objectivity in research and the need for transparency (...) to ensure objectivity. Several future activities were discussed, including the need to share specific examples of how conflict has been managed, and the need for behavioral research to provide a sound empirical understanding of the best ways to provide informed consent for research subjects. (shrink)

Vocación es una categoría ética, que alude a la perspectiva en que ponemos nuestra vida y a las preferencias que la van orientando en la praxis cotidiana. En sentido ético, la vocación tiene cuatro notas definitorias: Las elecciones cotidianas, la prudencia, la realización efectiva del proyecto fundamental y la entrega personal y comunitaria a un quehacer, y a éstas hay que adicionarles la vertiente religiosa o trascendente. La tarea moral, consiste en llegar a ser lo que se puede ser, con (...) lo que se es, de donde resulta que el verdadero destino es nuestro ser mismo: «Llega a ser el que eres». La vocación más que un llamado es «un êthos de fidelidad a sí mismo», un programa de vida, un afán de ser responsable y «tomarse en serio la vida», buscando que sea auténtica y plena. (shrink)

Introducción: se presenta un ensayo cuyo objetivo es fijar posiciones frente al resumen del Informe de la Comisión sobre Determinantes Sociales de la Salud (CDSS) proponer las acciones políticas que los movimientos sociales en salud deben emprender. Análisis: las recomendaciones de la CDSS no enfocan el problema en toda su compleja naturaleza y en especial desconoce la influencia decisiva de la formación económica social sobre la situación crítica de la salud en el mundo. Acción: se propone la unidad de los (...) movimientos sociales que actúan en el campo de salud para luchar contra los efectos de las políticas económicas y sociales dominantes en el mundo: reducción del papel del estado, privatización de servicios, desregulación laboral, privatización de la seguridad social, políticas migratorias y otras. Denunciemos toda política neoliberal en relación con la salud, practiquemos la solidaridad con los que luchan contra esas políticas, derrotemos el monopolio mediático neoliberal, enfocar el problema de los DSS como asunto político social, no técnico y defendamos el papel protagónico del estado, único capaz de asegurar servicios de salud al alcance de todos. Conclusión: "Nuestro deber es luchar", como nos advirtió Fidel Castro. Introduction: An essay is presented in order to set positions against the Report´s summary of the Commission on social determinants of public health (CSDPH) that suggests the political actions to be undertaken by Health social movements. Analysis: The CSDPH recommendations do not focus the problem in all its complex nature and do not recognize the decisive influence of the social economic formation on the critical situation of Health in the world. Action: unity of social movements acting in the field of health to fight against the effects of the dominant economic and social policies of today´s world: reduction of the role of the State, privatization of services, labour deregulation, privatization of social security, migratory policies and others. We denounce any neo-liberal policy in relation to Health. Let´s support those who struggle against those policies; let´s defeat the neoliberal media monopoly, let´s focus on the problem of social determinants as a sociopolitical issue , not as a technical one; let´s defend the leading role of the State, the only one capable to ensure health services to everyone. Conclusion: As Fidel Castro expressed: "Our duty is to fight. (shrink)

We appreciate the opportunity to present some further thoughts on the libertarian right to test initially proposed by Loi, and hope these additional comments will further inform debate about this critical emerging technology. Loi’s important argument is that individuals possess a prima facie libertarian right to test their genomes and that regulatory intervention restricting genetic testing must be justified by those proposing regulation. Our position is that the onus of justifying regulation is reversed. The risk to others whose genomic information (...) is shared with the individual is potentially significant enough to warrant prima facie regulatory intervention, including protection against misuse of genetic information derived from those tests, not just against the individual tested but also against those who for reasons of common familial ancestry are also susceptible to misuse. Testing an individual’s genome does not merely reveal information about that individual; it reveals, or renders reasonably inferable, information about the genomes of close relatives due to the commonality of genomic DNA within families. Such commonality is not merely ‘incidentally identical’: it is instead inevitable given the shared nature of genomic DNA sequences within families. ‘Incidental identity’ may appropriately describe the statistical possibility of two unrelated individuals in the human …. (shrink)

El artículo tiene como punto de partida los cuatro discursos lacanianos: el discurso del amo, de la histérica, de la universidad y del analista. A través de los tres registros lacanianos, simbólico, imaginario y real, se alcanza el punto de llegada: tres metadiscursos jurídicos en los que se establecen tres diferentes formas de asociación (Derecho-ciencia-registro simbólico, Derecho-técnica- registro imaginario y Derecho-arte-registro real). El cuarto nudo/registro (síntoma) y la cuarta dimensión jurídica (historia) se desenvuelven en un contexto iuspsicoanalítico —caracterizado por la (...) falta— que tiene en cuenta «la impotencia de la verdad» y «el poder de los imposibles». (shrink)

Esta reflexión evidencia cómo desde los años sesenta Amílcar Osorio produce una práctica artística en procura de la desinstitucionalización de la literatura y del arte, al situar sus objetivos estéticos no solo en las letras como posibilidad narrativa y poética, sino en la utilización de lo visual, el espacio y la vida misma como recurso artístico. Con esto el autor consigue difuminar las fronteras entre literatura, artes visuales y de acción, y logra producir lo que se puede considerar hoy una (...) práctica intermedial, al tomar estrategias propias del arte conceptual que le permiten conectar la vida cotidiana, la literatura, las ideas como expresión artística, la imagen y la performance. (shrink)

ObjectiveTo provide insights on emergent ethical tensions experienced by mental health practitioners during system re-organisation, which is sufficiently grounded in empirical data at the local level to inform policy on recovery at institutional and provincial levels.MethodEthnographic methods using narrative and critical phenomenological resources over 24 months.FindingsEveryday ethical tensions emerged at the confluence of different experiences of time, for example, how a context of increasing pressure to decrease patients’ length of stay at the hospital challenged efforts to listen to and advocate (...) for what mattered to patients and maintain the integrity of interventions. In this context, practitioners drew on clinical language and that of personal recovery to strategically ‘push back’, ‘play with’ or ‘take back’ time.DiscussionExamining everyday practices through ethnographic methods can illuminate the everyday ethical tensions that arise when mental health professionals and psychiatrists grapple with, often competing, goods. Critical phenomenological resources can help expand the structural considerations in empirical ethics, excavate underground practices and raise questions about the conceptual categories undergirding normative ethics. Experiencing-with practitioners in clinical contexts as they encounter and creatively resolve ethical tensions also propose a normative ethics of possibility, to help bridge the gap between empirical and normative ethics.ConclusionFocus on the relationship between policy, temporal practices and ethics suggests a reconfiguration of time and re-imagination of ethics in institutional settings in ways that can ultimately benefit patients and professionals alike. (shrink)

Informal political representation can be a political lifeline, particularly for oppressed and marginalized groups. Such representation can give these groups some say, however mediate, partial, and imperfect, in how things go for them. Coeval with the political goods such representation offers these groups are its particular dangers to them. Mindful of these dangers, skeptics challenge the practice for being, inter alia, unaccountable, unauthorized, inegalitarian, and oppressive. These challenges provide strong pro tanto reasons to think the practice morally impermissible. This paper (...) considers the question: On what conditions is the informal political representation of oppressed and marginalized groups permissible? By responding to skeptics’ challenges, I develop a systematic account of moral constraints that, if adopted, would make such representation permissible. The account that emerges shows that informal political representatives (IPRs) must aim to fulfill two sets of sometimes conflicting duties to the represented: democracy within duties, which concern how the representative treats and relates to the represented, and justice without duties, which concern how the representative’s actions advance the aims of the representation. (shrink)

On Borders asks when are borders legitimate, and it offers a new theory to answer the question. The book challenges critical and normative theories that criticize or justify borders solely in terms of identity, and instead frames borders and border legitimacy from the perspective of place and presence. Instead of thinking of borders as the exclusionary limit of identity groups, the book develops a theory of territorial jurisdictions grounded on place-specific relations, giving central roles to urban settings and the environment. (...) Paulina Ochoa Espejo calls this the "watershed model" of territorial rights and borders. (shrink)

Whether in characterizing Catharine MacKinnon's theory of gender as itself pornographic or in identifying liberalism as unable to make good on its promises, Wendy Brown pursues a central question: how does a sense of woundedness become the basis for a sense of identity? Brown argues that efforts to outlaw hate speech and pornography powerfully legitimize the state: such apparently well-intentioned attempts harm victims further by portraying them as so helpless as to be in continuing need of governmental protection. "Whether (...) one is dealing with the state, the Mafia, parents, pimps, police, or husbands," writes Brown, "the heavy price of institutionalized protection is always a measure of dependence and agreement to abide by the protector's rules." True democracy, she insists, requires sharing power, not regulation by it; freedom, not protection.Refusing any facile identification with one political position or another, Brown applies her argument to a panoply of topics, from the basis of litigiousness in political life to the appearance on the academic Left of themes of revenge and a thwarted will to power. These and other provocations in contemporary political thought and political life provide an occasion for rethinking the value of several of the last two centuries' most compelling theoretical critiques of modern political life, including the positions of Nietzsche, Marx, Weber, and Foucault. (shrink)

Tolerance is generally regarded as an unqualified achievement of the modern West. Emerging in early modern Europe to defuse violent religious conflict and reduce persecution, tolerance today is hailed as a key to decreasing conflict across a wide range of other dividing lines-- cultural, racial, ethnic, and sexual. But, as political theorist Wendy Brown argues in Regulating Aversion, tolerance also has dark and troubling undercurrents. Dislike, disapproval, and regulation lurk at the heart of tolerance. To tolerate is not to (...) affirm but to conditionally allow what is unwanted or deviant. And, although presented as an alternative to violence, tolerance can play a part in justifying violence--dramatically so in the war in Iraq and the War on Terror. Wielded, especially since 9/11, as a way of distinguishing a civilized West from a barbaric Islam, tolerance is paradoxically underwriting Western imperialism. Brown's analysis of the history and contemporary life of tolerance reveals it in a startlingly unfamiliar guise. Heavy with norms and consolidating the dominance of the powerful, tolerance sustains the abjection of the tolerated and equates the intolerant with the barbaric. Examining the operation of tolerance in contexts as different as the War on Terror, campaigns for gay rights, and the Los Angeles Museum of Tolerance, Brown traces the operation of tolerance in contemporary struggles over identity, citizenship, and civilization. (shrink)

Wendy Rogers ist Professorin für klinische Ethik und Catriona Mackenzie ist Professorin für Philosophie. Beide lehren an der Macquarie University in Sydney, Australien. Susan Dodds ist Professorin für Philosophie an der La Trobe University in Melbourne, Australien. Alle drei befassen sich seit Jahren intensiv mit feministischer Theorie, angewandter und biomedizinischer Ethik sowie mit Moralphilosophie.

To study Earth’s climate, scientists now use a variety of computer simulation models. These models disagree in some of their assumptions about the climate system, yet they are used together as complementary resources for investigating future climatic change. This paper examines and defends this use of incompatible models. I argue that climate model pluralism results both from uncertainty concerning how to best represent the climate system and from difficulties faced in evaluating the relative merits of complex models. I describe how (...) incompatible climate models are used together in ‘multi-model ensembles’ and explain why this practice is reasonable, given scientists’ inability to identify a ‘best’ model for predicting future climate. Finally, I characterize climate model pluralism as involving both an ontic competitive pluralism and a pragmatic integrative pluralism. (shrink)

This article reviews empirical and conceptual material from two distinct research traditions: on the science-technology relation and on industrial innovation. It aims both to shed new light on an old debate—the distinction between scientific and technological knowledge—and to refine our conceptualizations of the knowledge used by companies in the course of research and development leading to innovation. On the basis of three empirical studies, a composite categorization of different types of knowledge used in innovation is proposed, as part of a (...) broader framework encompassing two further taxonomic dimensions. It is hoped that this typology and framework might provide useful research tools in furthering our understanding of the knowledge transfers and transformations that occur in the course of innovation. It could also prove useful for organizations and groups facing difficult strategic choices about technology. (shrink)

In 1946, after an eight-year debate with the New Critics, Charles Morris doggedly maintained that "an education which gave due place to semiotic would destroy at its foundations the cleavage and opposition of science and the humanities."1 This insistence on the unity of disciplines—the hallmark of the logical empiricist movement and its brainchild, The International Encyclopedia of Unified Science —effectively silenced semiotics as a force in American literary studies. For the New Critics' point of departure—and one of the few tenets (...) that they held in common—was the belief that art creates a mode of knowledge different in kind from that of practical or scientific discourse and that a criticism modeled on the latter would miss the essence of its subject matter. The quarrel, which continued unresolved during the polemics of the war years, now fuels the controversy between structuralism and post-structuralism. It lies at the very heart of the question of the relevance of semiotics to the humanities. · 1. Charles Morris, Signs, Language, and Behavior, in Writings on the General Theory of Signs , p. 327. Wendy Steiner, assistant professor of English at the University of Pennsylvania, is the author of Exact Resemblance to Exact Resemblance: The Literary Portraiture of Gertrude Stein. She has written a book on the relations between modern painting and literature and edited the proceedings of the 1978 Ann Arbor Conference on the Semiotics of Art. (shrink)

Once a term used primarily by moral philosophers, “moral distress” is increasingly used by health professionals to name experiences of frustration and failure in fulfilling moral obligations inherent to their fiduciary relationship with the public. Although such challenges have always been present, as has discord regarding the right thing to do in particular situations, there is a radical change in the degree and intensity of moral distress being expressed. Has the plight of professionals in healthcare practice changed? “Plight” encompasses not (...) only the act of pledging, but that of predicament and peril. The author claims that health professionals are increasingly put in peril by healthcare reform that undermines their efficacy and jeopardizes ethical engagement with those in their care. The re-engineering of healthcare to give precedence to corporate and commercial values and strategies of commodification, service rationing, streamlining, and measuring of “efficiency,” is literally demoralizing health professionals. Healthcare practice needs to be grounded in a capacity for compassion and empathy, as is evident in standards of practice and codes of ethics, and in the understanding of what it means to be a professional. Such grounding allows for humane response to the availability of unprecedented advances in biotechnological treatments, for genuine dialogue and the raising of difficult, necessary ethical questions, and for the mutual support of health professionals themselves. If healthcare environments are not understood as moral communities but rather as simulated marketplaces, then health professionals’ moral agency is diminished and their vulnerability to moral distress is exacerbated. Research in moral distress and relational ethics is used to support this claim. (shrink)

According to an adequacy-for-purpose view, models should be assessed with respect to their adequacy or fitness for particular purposes. Such a view has been advocated by scientists and philosophers...

Low-income women and, disproportionately low-income women of color seeking reproductive and pregnancy care are increasingly subject to what this article terms carceral care – care compromised by its’ proximity to punishment systems. This article identifies the legal and health care practice mechanisms leading to carceral care and proposes solutions designed to stop criminalization at the bedside.

In lieu of an abstract, here is a brief excerpt of the content:Duality and Non-Duality in Christian Practice:Reflections on the Benefits of Buddhist-Christian Dialogue for Constructive TheologyWendy FarleyThe question before us is the desirability of Buddhist-Christian dialogue in the work of (what Christians call) constructive theology. As a feminist theologian whose work is ever more deeply shaped by such a dialogue, my immediate answer is an unequivocal yes.1 This dialogue fits a general pattern over two thousand years in which theologians (...) have drawn from the wisdom of other traditions or cultures to better understand the mysteries of human experience. Without neo-Platonism and Aristotle there could hardly have been anything we recognize as Christian theology. Without pre-Christian Irish religion, there would be no Saint Brigit or Celtic Christianity. Without phenomenology, process, and Marxist philosophy the greatest works of twentieth-century Christian thought would not exist. Christianity, like all religions, is a moving river changed by time and culture and nearly as interiorly diverse as its members. The dialogue with Buddhism might be seen as a contemporary example of Christianity's openness to exchange with other ways of thinking that broadens and deepens its best insights. It is perhaps analogous to Origen's reliance on neo-Platonism or Thomas Aquinas's inspiration by the rediscovery of Aristotle.2The porous boundaries between Christianity and its culture open it to wisdom beyond itself but they also open it to cruelty and ignorance. Nothing protects religions from participating in the human condition and thus the prejudices and power structures that mutilate human society. Consumer culture and oppressions by class, ethnicity, and gender are seamlessly incorporated into Christian identity. The tacit synthesis of a culture's values with those of a religion neutralizes possible critique and can elevate a society's oppressions to a sacred duty. For this reason, too, dialogue with Buddhism is important to call Christianity back to its ethical moorings in the ideal of universal love and compassion.Religions are porous to the world around them, but they tend to conceal this from themselves and often imagine themselves to be not only untainted but also uniquely [End Page 135] qualified to mediate salvation. Religions provide human beings with language and practice through which dimensions of reality that cannot simply be read off of nature or experience are (in some sense) encountered. This is their great gift. The difficulty of religions is that tradition can become an end in itself. Because a tradition really does offer meaning and tools for transformation it is easy to slip into the existential posture of so idealizing a tradition that it seems in some direct and exclusive way to correlate to ultimate truth. The curvature of the ego onto itself, so attached to its own pain and pleasure that everything else seems a mere shadow, moves from the microcosm of the self to the macrocosm of religious tradition. The particular religion—or that element within it with which I identify—becomes identical with sacred reality. In the hostility to other religions characteristic of many Christians we see the illusion of egocentrism in its religious form. Paul Tillich described this tendency to absolutize itself as the demonic distortion of religion.3 Religious dialogue is a potent medicine against this overattachment to one's own tradition.These different senses in which a religion integrates into itself the wisdom and illusions of its time and place create enormous diversity within a religious tradition. Root concepts within Christianity concerning soteriology, divinity, and suffering do not have any agreed upon meaning. That is, there is no "Christian" view of salvation. Gregory of Nyssa's ideal of theosis, Luther's emphasis on salvation by grace through faith, an evangelical's experience of being born again, a liberal Protestant's commitment to social justice are so diverse that they seem to represent almost different religions.In light of the malleability and interior diversity of traditions, dialogue may not be between two self-sufficient religions but between participants who inhabit their tradition in a variety of ways.4 With this in mind, I would like to experiment with practice as a basis for some kinds of dialogue. Practice is concretely located in a religious tradition and yet reflects... (shrink)