This chapter contains sections titled: The Weightiest Knowledge Truth and its Incorporation Knowledge and Self‐Knowledge.

The Herald of Free Enterprise, a ferry operating in the English Channel, sank on March 6, 1987, drowning nearly two hundred people. The official inquiry found that the company running the ferry was extremely sloppy, with poor routines of checking and management. “From top to bottom the body corporate was infected with the disease of sloppiness.”1 But the courts did not penalize anyone in what might seem to be an appropriate measure, failing to identify individuals in the company or on (...) the ship itself who were seriously enough at fault. As one commentator put it, “The primary requirement of finding an individual who was liable . . . stood in the way of attaching any significance to the organizational sloppiness that had been found by the official inquiry.”2 In a case like this it can make good sense to hold that while the individuals involved may not bear a high degree of personal responsibility, together as a corporate enterprise they should carry full responsibility for what occurred. Although the members may not fully satisfy the conditions for being held personally responsible—although there are mitigating circumstances that excuse them in some mea-. (shrink)

My purpose here is to examine the question of how the law can be incorporated within morality and how the existence of the law can impinge on our moral rights and duties, a question (or questions) which is a central aspect of the broad question of the relation between law and morality. My conclusions cast doubts on the incorporation thesis, that is, the view that moral principles can become part of the law of the land by incorporation.

Increasingly there are calls for climate services to be “co-produced” with users, taking into account not only the basic information needs of users but also their value systems and decision contexts. What does this mean in practice? One way that user values can be incorporated into climate services is in the management of inductive risk. This involves understanding which errors in climate service products would have particularly negative consequences from the users’ perspective (e.g., underestimating rather than overestimating the change in (...) an impact variable) and then prioritizing the avoidance of those errors. This essay shows how inductive risk could be managed in climate services in ways that serve user values and argues that there are both ethical and practical reasons in favor of doing so. (shrink)

This essay considers the relationship between literature and film through a reading of Isabel Coixet's film My Life Without Me. The first half of the essay explores how two recent theorisations of the term incorporation allow us to read, on the one hand, the film's relationship to Nanci Kincaid's short story 'Pretending the Bed is a Raft' in particular and to literature in general and, on the other, the narrative consequences of the protagonist Ann's decision to keep her terminal (...) illness a secret. In the first instance, Jay David Bolter and Richard Grusin's definition of incorporation in Remediation helps explain how the film does not adapt the short story upon which it is supposedly based, but in fact only repurposes it. Literary aspects of the film's mise-en-scène, plot and imagery, however, signal My Life Without Me' s incorporation of literature. In the second instance, the essay explores how Jacques Derrida's theory of incorporation's role in mourning helps the viewer understand the film's plot development out of Ann's secret. In the second half of the paper, Leo Bersani's idea of impersonal intimacy is developed into a theory of literature. The conclusion posits that impersonal intimacy defines the literary in contrast to cinema's tendency to full disclosure. (shrink)

Kant held that “an incentive can determine the will [Willkür] to action only so far as the individual has incorporated it into his maxim”, a view dubbed the “Incorporation Thesis” by Henry Allison (hereafter, “IT”). Although many see IT as basic to Kant’s views on agency, it also seems irreconcilable with the possibility of a kind of weakness, the kind exhibited by a person who acts on incentives that run contrary to principles she holds dear. The problem is this: (...) According to IT, if an incentive determines the will of the weak person when she acts contrary to her principles, then it must be the case that she incorporated that incentive into her maxim. But that in turn means that she has made it her principle to act on the wayward incentive, and so is not, after all, exhibiting weakness in failing to follow her own principles, but at best simply dropping one principle in favor of another. So either the weak person does not incorporate the wayward incentive into her maxim and IT is false, or she does incorporate it and weakness is impossible. (shrink)

Although scars never disappear completely, in time most people will basically get used to them. In this paper I explore what it means to habituate to scars against the background of the phenomenological concept of incorporation. In phenomenology the body as Leib or corps vécu functions as a transcendental condition for world disclosure. Because of this transcendental reasoning, phenomenology prioritizes a form of embodied subjectivity that is virtually dis-embodied. Endowing meaning to one’s world through getting engaged in actions and (...) projects is most successful indeed when one’s body is “absent,” “transparent,” or, at least, if it is not in the center of one’s attention. This taken-for-granted nature can be disturbed by discomfort, disability, and disfigurement. Incorporation, so I explain, aims at maintaining or restoring the body’s taken-for-grantedness. My analysis of the case of a woman who successfully habituated to her mastectomy scar demonstrates, however, that habituation to a perceptible scar can only be understood partly in terms of incorporation. Next to a decrease of explicit attention for the scar and the discomfort it produces, the scar should also stop being a sign that refers to something else than itself. This is only possible, I argue, by taking the body’s materiality seriously, rather than it being wiped out as a result of transcendental reasoning. (shrink)

The Incorporated Self demonstrates that although embodiment has long been a central concern of the theoretical humanities, its potential to alter epistemology and open up new areas of dualistic inquiry has not been pursued far enough. This anthology collects the the works of scholars from a broad range of disciplines, each examining the nature of the body and the necessity of embodiment to the human experience -- for our self awareness, our sense of identity, and the workings of the mind.

The issue of the relationship between predictive processing (PP) and the free energy principle (FEP) remains a subject of debate and controversy within the research community. Many researchers have expressed doubts regarding the actual integration of PP with the FEP, questioning whether the FEP can truly contribute significantly to the mechanistic understanding of PP or even undermine such integration altogether. In this paper, I present an alternative perspective. I argue that, from the viewpoint of the constraint-based mechanisms approach, the FEP (...) imposes an important constraint, namely variational free energy, on the mechanistic architecture proposed by PP. According to the constraint-based mechanisms approach, high-level cognitive mechanisms are integral parts of extensive heterarchical networks that govern the physiology and behavior of agents. Consequently, mechanistic explanations of cognitive phenomena should incorporate constraints and flows of free energy as relevant components, given that the implemented constraints operate as long as free energy is available. Within this framework, I contend that the FEP provides a relevant constraint for explaining at least some biological cognitive mechanisms described in terms of Bayesian generative models that minimize prediction errors. (shrink)

This article presents a response to Néron and Norman’s contention that the language of citizenship is helpful in thinking about the political dimensions of corporate responsibilities. We argue that Néron and Norman’s main conclusions are valid but offer an extension of their analysis to incorporate extant streams of literature dealing with the political role of the corporation. We also propose that the perspective on citizenship adopted by Néron and Norman is rather narrow, andtherefore provide some alternative ways in which corporations (...) and citizenship might be brought together. We conclude by suggesting that, rather than simply applying the concept of citizenship to corporations, we now need to go further in exploring how corporations might play an active role in reconfiguring the whole notion of citizenship itself. (shrink)

Most current statistical natural language processing models use only local features so as to permit dynamic programming in inference, but this makes them unable to fully account for the long distance structure that is prevalent in language use. We show how to solve this dilemma with Gibbs sam- pling, a simple Monte Carlo method used to perform approximate inference in factored probabilistic models. By using simulated annealing in place of Viterbi decoding in sequence models such as HMMs, CMMs, and CRFs, (...) it is possible to incorporate non-local structure while preserving tractable inference. We use this technique to augment an existing CRF-based information extraction system with long-distance dependency models, enforcing label consistency and extraction template consistency constraints. This technique results in an error reduction of up to 9% over state-of-the-art systems on two established information extraction tasks. (shrink)

Incorporating patients' spiritual beliefs into health care decision making is essential for ethically good care. Gadow's three-level ethical framework of ethical immediacy, ethical universalism, and relational narrative is presented as a tool for enhancing nurses' ability to explore and deepen understandings of patients' spiritual beliefs, given that these and their experiences are often expressed in a language that seems foreign to nurses. The demographic and cultural shifts that lead to the necessity to understand patients who use principles and metaphors that, (...) while commonly understood within their spiritual tradition, may seem incomprehensible to outsiders, are here set in the Canadian context. A case study on palliative sedation is used to illustrate how the ethical framework can help to reveal the spiritual certainties, principles and narratives patients bring to their health care experiences. (shrink)

In this paper we discuss whether the relation between formulas in the relating model can be directly introduced into the language of relating logic, and present some stances on that problem. Other questions in the vicinity, such as what kind of functor would be the incorporated relation, or whether the direct incorporation of the relation into the language of relating logic is really needed, will also be addressed.

The design and economic realities associated with Personal Computers (PCs) was used as a model for implementing ethical issues into the core-engineering curriculum. Historically, products have not been designed to be recycled easily. By incorporating environmental ethics into our classrooms and industries, valuable materials can be recovered and harmful materials can be eliminated from our waste stream. Future engineers must consider the economic cost-benefit analysis of designing a product for easy material recovery and recycling versus the true cost of the (...) disposal and continued use of virgin materials. A three hour unit on the economic and environmental impacts of product design is proposed for inclusion in the ABET accredited engineering program. (shrink)

Part of what makes working with modals such a tricky business is that apparent modal forms are deployed in all sorts of ways in language. In this paper I explore an interesting example of an apparent modal—the Blofeld case—which was introduced by Gilles and von Fintel as part of their argument against context of assessment accounts of epistemic modals. I argue that the example is subtle, and that the apparent modal may not be an epistemic modal at all—it could be (...) a scalar modifier that merges or “incorporates” with the matrix verb, weakening the meaning of the matrix verb. If apparent modals are used as scalar modifiers and are subject to movement and incorporation, then the surface language of modality may be throwing us some crafty head fakes. Caution is advised. (shrink)

Non-epistemic values play important roles in classificatory practice, such that philosophical accounts of kinds and classification should be able to accommodate them. Available accounts fail to do so, however. Our aim is to fill this lacuna by showing how non-epistemic values feature in scientific classification, and how they can be incorporated into a philosophical theory of classification and kinds. To achieve this, we present a novel account of kinds and classification, discuss examples from biological classification where non-epistemic values play decisive (...) roles, and show how this account accommodates the role of non-epistemic values. (shrink)

In the paper we present a technique for eliminating quantifiers of arbitrary order, in particular of first-order. Such a uniform treatment of the elimination problem has been problematic up to now, since techniques for eliminating first-order quantifiers do not scale up to higher-order contexts and those for eliminating higher-order quantifiers are usually based on a form of monotonicity w.r.t implication (set inclusion) and are not applicable to the first-order case. We make a shift to arbitrary relations “ordering” the underlying universe. (...) This allows us to incorporate background theories into higher-order quantifier elimination methods which, up to now, has not been achieved. The technique we propose subsumes many other results, including the Ackermann's lemma and various forms of fixpoint approaches when the “ordering” relations are interpreted as implication and reveals the common principle behind these approaches. (shrink)

As has been noted by Alvin Goldman, there are some very interesting similarities between his Veritistic Social Epistemology (VSE) and Sandra Harding's Feminist Standpoint Theory (FST). In the present paper, it is argued that these similarities are so significant as to motivate an incorporation of FST into VSE, considering that (i) a substantial common ground can be found; (ii) the claims that go beyond this common ground are logically compatible; and (Hi) the generality of VSE not only does justice (...) to the inclusive ambition of FST, but even solves a well-discussed problem for the latter. (shrink)

In this paper, I explore the ways that phenomenological concepts like intercorporeality and mutual incorporation offer new tools in trying to make sense of human experiences via mediating systems. In particular, I think about how the COVID-19 pandemic hastened a large population into mediated interactions, and what is lost, perhaps contingently or perhaps intrinsically, when human experiences are mediated in this way. I look to research in presence, skillful interaction, and enactive social cognition to argue that there remains something (...) ineffable or at least extremely hard to pin down about intercorporeality, and embodied togetherness has not yet been replicated in the mediating systems we currently embrace. (shrink)

The Purāṇas make a major contribution to Brahmanical writing on gifting, primarily because they contain descriptions of numerous specific gifting rites that texts of other genres generally fail to discuss. Although largely unstudied, these Purāṇic gifting rites provide unique evidence of a historically significant, yet hitherto ignored, development in gifting in medieval India, namely, the incorporation of the increasingly popular ethos of bhakti into the much older practice of dāna, wherein gods traditionally played no prominent role. This article will (...) argue that Purāṇic authors strove to incorporate bhakti into dāna via two fairly distinct strategies. The first and apparently more mainstream of these is the straightforward inclusion of rather superficial Śaiva and Vaiṣṇava elements in various gifting rites. The essence of the second strategy is a belief that donors should in some way offer their gifts as a sign of respect—in other words, dedicate their gifts—to certain major Hindu deities, even if in most cases they would actually give their gifts to ordinary human beings. This strategy appears to have been less popular, but to reflect an attempt to more thoroughly integrate bhakti into dāna. (shrink)

This article presents a conceptual discussion on the phenomenon of incorporation of tools and other objects in the light of Maine de Biran’s philosophy of the relation between the body and the motor will. Drawing on Maine de Biran’s view of the body as that portion of the material world which directly obeys one’s motor will, as well as on his view (supported by studies in contemporary cognitive science) of active touch as the perceptual modality that is sensitive to (...) objects as fields of forces resisting the perceiver’s movements, we discuss the phenomena of motor incorporation and haptic incorporation, as well as the relation between them. Motor incorporation occurs when something is integrated into the motor system, i.e. when practice enables one to animate an object as directly, effortlessly and fluently as one is able to animate one’s own body. The subject then has the experience of acting there, where the object is located, not at the body–object interface. In order to better understand the phenomenon of motor incorporation, we highlight the phenomenological difference between directly and indirectly moving something. Haptic incorporation occurs when something is integrated into the haptic system, i.e. when an object is used as an instrument for the haptic perception of other objects. Finally, we seek to shed light on the phenomenon of transparency, understanding the transparency acquired by the incorporated object as both a relational property and a matter of degrees. (shrink)

Construction grammar organizes its basic elements of description, its constructions, into networks that range from concrete, lexically-filled constructions to fully schematic ones, with several levels of partially schematic constructions in between. However, only few corpus studies with a constructionist background take this multi-level nature fully into account. In this paper, we argue that understanding language variation can be advanced considerably by systematically formulating and testing hypotheses at various levels in the constructional network. To illustrate the approach, we present a corpus (...) study of the Dutch naar-alternation. It is found that this alternation primarily functions at an intermediate level in the constructional network. (shrink)

Incorporation mystique et subjectivité féminine d’après le Livre d’Angèle de Foligno. Comment qualifier, dans le cadre d’une histoire de la subjectivité, la piété compassionnelle dont témoigne Angèle de Foligno († 1309) dans le Mémorial et les Instructions? En choisissant trois motifs qui déclinent la figure de l’incorporation mystique (dévotions à l’eucharistie, aux plaies du Christ et aux instruments de la Passion), cette étude met au jour les origines monastiques d’une piété fusionnelle et affective, d’abord élaborée dans un environnement (...) spécifiquement masculin aux XIe-XIIe siècles, puis investie par la dévotion des mulieres religiosae (moniales, béguines, recluses ou tertiaires) à partir du XIIIe siècle. Placée dans une perspective de longue durée, la piété d’identification au Christ et à ses souffrances d’Angèle révèle ainsi une sensibilité religieuse aux référents mixtes, masculins et féminins, mais qui a été infléchie par la position sociale des femmes et leurs aspirations propres dans le champ de la piété. (shrink)

The population of most non-dominant ethnic groups in the USA is growing dramatically. Faculty members are challenged to develop curricula that adequately prepare our future nurses. An increased focus on clinical ethics has resulted from the use of sophisticated technology, changes in health care financing, an increasing elderly population and the shift of care from inpatient to outpatient settings. Nurses frequently face situations demanding resolution of ethical dilemmas involving cultural differences. Nursing curricula must include content on both ethics and cultural (...) sensitivity. Active student participation is an important element providing a foundation for ethical practice. A proposed educational format was introduced with graduating baccalaureate students. In a pilot study, curricular content on cultural sensitivity and ethical practice was taught in separate modules. Students were then asked to identify and problem solve an ethical dilemma involving patients and professional caregivers from vastly different cultures. Course faculty members provided discussion questions to guide the students' thinking. (shrink)

This chapter contains sections titled: Arguments for Divine Incorporeality Arguments Against Divine Incorporeality The Immanence of God Works cited.

This paper argues that Hindi incorporation is, in fact, pseudoincorporation, involving noun phrases rather than nouns. Furthermore, it shows that there is no requirement that the incorporated nominal form a morphological or even a syntactic unit with the verb. Such loosely aligned nominals can nevertheless be identified as incorporation on the basis of semantic intuitions having to do with number interpretation, anaphora, and certain properties typically associated with lexical processes. Contrary to standard assumptions, it is argued that the (...) targets of pseduo-incorporation are specified for number. Singular incorporated nominals in Hindi are shown to be semantically singular, with number neutrality arising as a consequence of interaction with aspectual specification. Taking aspectual information into account is also shown to have interesting implications for current approaches to the semantics of incorporation, one in which the incorporated nominal introduces a discourse referent, and one in which it functions as a predicate modifier. A closer look at the effect of aspect on anaphora, for example, does not unequivocally support the predicate modification view of pseudoincorporation. The paper also explores the cross-linguistic applicability of the claims made on the basis of Hindi. Most notably, a distinction between Hungarian verbs with respect to incorporation of bare singulars provides striking confirmation of the claims that number morphology is semantically visible in pseudo-incorporation. It also discusses the restrictions on the productivity of pseudo-incorporation in light of the findings for Hindi and Hungarian. (shrink)

Contrasting two standard models of corporate responsibility—the so-called “collectivist” and “individualist” model—this essay proposes a third option, namely, a discursive conception of responsibility and examines whether and how this conception can be applied to the corporate level. It does so by taking a careful look at one of the preconditions of individual discursive responsibility, i.e. discursive practical reason, and discussing how corporate agents can meet this precondition. Building on this new concept, the essay also offers a novel approach to justifying (...) corporate responsibility by referring to an argument advanced by Rainer Forst stating that a fundamental human right to justification is the normative core of any kind of responsibility and combining it, in a second step, with an argument recently proposed by Philip Pettit and Christian List showing the impossibility of forming consistent group attitudes and beliefs as a function of the attitudes and beliefs of individual group members. Finally, this essay outlines certain preliminary conclusions about the incorporation of responsibility in a corporate context. (shrink)

Businesses frequently exclude spiritual values, viewing such values as impositions that belong in business as much as a priest belongs at a bachelor party. Yet spirituality should not be viewed as impositions from without, but as inclusions from within. Spiritual values should be included in a company to the extent that these values are shared by the principals of a firm. Excluding spiritual values found in a “convergent consensus” runs contrary to freedom and liberty that Milton Friedman, among others, champions. (...) Furthermore, the exclusion of such values from a business threatens to alienate business persons from their moral integrity. By cultivating what I will call “the spiritual imagination,” businesses can facilitate fidelity between the convergent values of its principals, and the actions, policies, and culture of a company. (shrink)

California has focused on health equity in the state’s COVID-19 reopening plan. The Blueprint for a Safer Economy assigns each of California’s 58 counties into 1 of 4 tiers based on 2 metrics: test positivity rate and adjusted case rate. To advance to the next less-restrictive tier, counties must meet that tier’s test positivity and adjusted case rate thresholds. In addition, counties must have a plan for targeted investments within disadvantaged communities, and counties with more than 106 000 residents must (...) meet an equity metric. California's explicit incorporation of health equity into its reopening plan underscores the interrelated fate of its residents during the COVID-19 pandemic and creates incentives for action. This article evaluates the benefits and challenges of this novel health equity focus, and outlines recommendations for other US states to address disparities in their reopening plans. (shrink)

Volunteering, or taking part in unpaid work for the benefit of others, can be a powerful positive experience with returns to both individual well-being and community projects. Volunteering is positively associated with mental health in observational studies with community samples but has not been systematically examined as a potential part of treatment interventions with clinical adolescent samples. In this manuscript, we review the empirical evidence base connecting volunteerism to mental health and well-being, outline potential mechanisms based in the theoretical literature (...) from developmental science, and discuss the existing clinical approaches that support community volunteering as a part of treatment. Drawing on this review, we propose that including volunteering as a component of clinical treatment approaches for adolescent depression can be a powerful intervention for adolescents. (shrink)

We present a theoretical framework of individual-decision making that incorporates both moral motivations and social influence into the utility function. The main idea of the paper is that individuals face a trade-off between their material individual interests and their desire to follow moral obligation. In our model, we assume that moral motivation is weak or conditional in the sense that it may be influenced by others’ actions. Specifically, in our framework one’s moral obligation is a combination of two main components: (...) an autonomous component and a social component that captures the influence of others. Our theoretical framework is able to explain many stylized results commonly observed in the literature and suggests a different mechanism to explain economic behavior. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Incorporating Religion into Psychiatry:Evidenced–Based Practice, Not a Bioethical DilemmaMary D. MollerFor over sixteen years I was the owner and clinical director of an advanced practice nurse–managed outpatient rural psychiatric clinic staffed by APNs, a social worker, a licensed counselor and several graduate students. Many of our patients were victims of severe and often brutal trauma and abuse suffered at the hands of family, friends, and various professionals including spiritual (...) leaders. We also uncovered sources of abuse suffered from those involved in occult practices ranging from seemingly innocent white witchcraft (Wicca, Paganism, New Age) that includes such activities as astral projection and remote viewing to the darkest possible black witchcraft (perpetrating evil, incanting evil spirits, casting spells and hexes, creating dissociative identities) such as occurs in ritual abuse and satanic rites. Both types of witchcraft also typically involved family, friends, various professionals, and spiritual leaders. Recognizing the controversy surrounding the reality of witchcraft I am sharing a story that I hope will help break down the barriers that prevent many patients from receiving the treatment that would provide the most benefit to recovery.Seeking services for these patients led me on an intense personal and professional journey that included a profound Christian born–again experience at almost 50 years of age. My professional career grew in nearly indescribable terms as a result of the incorporation of prayer and deliverance ministry as part of the services we selectively provided. Today I always include assessment of spiritual experiences a patient has as well as spiritual supports that are available with every new patient intake. For patients who indicate that prayer is one of their supports, I ask if they would like prayer at the conclusion of the session. The gratitude that is expressed by individuals who appreciate being able to pray with a psychiatric provider is often profound.In the field of psychiatry there has been a long–standing and distinct taboo regarding incorporating religious and spiritual aspects of life experience into treatment unless it is to frame most of these discussions within the context of psychosis. This stems from the advent of psychoanalysis in which religion was deemed a neurosis and atheism became the goal. Some still hold to that belief and there certainly remains controversy regarding the incorporation of prayer into routine outpatient or inpatient care. The essential starting point is the determination of accurate differential diagnosis, which can often be a lengthy process. The clinician must be careful about distinguishing between religious experiences and religious delusions, and often this takes time to sort out. The determination of the etiology of hearing the voice of God or the devil or demons must be carefully parsed and framed within the context of the situation and culture the patient describes. If the clinician denies the existence of God or the devil or demons or the practice of witchcraft, the patient’s descriptions of such experiences will be quickly [End Page 206] labeled psychotic. The patient may then experience a lengthy hospitalization and treatment with psychotropic medications that can have an extremely negative effect on the possibility of recovery. Once I witnessed the level of healing that occurs with carefully administered spiritual interventions that are related to specific spiritual experiences that are based on the patient’s belief system, there was no going back to using only allopathic medication and non–spiritual psychosocial interventions, even in spite of the criticisms from others. The key is to understand and respect the patient’s belief system, if this is not congruent with the practitioner’s belief system, then practitioner must refer out.In the United States, an increasing persecution of Christianity and a devaluing of the Judeo–Christian heritage of our Constitution are creating a climate of intolerance to the expression of religious values resulting in an expectation that Christians should compromise their beliefs for the sake of political correctness. As a doctorally prepared psychiatric–mental health advanced practice nurse I experienced a profound born–again Christian experience that ultimately led to study of the Hebrew roots of Christianity and I now worship in a Messianic Jewish synagogue. It is impossible for me to not include the concept of spirituality into... (shrink)

Background Biobank participants often do not understand much of the information they are provided as part of the informed consent process, despite numerous attempts at simplifying consent forms and improving their readability. We report the first assessment of biobank enrollees’ comprehension under an "integrated consent” process, where patients were asked to enroll in a research biobank as part of their normal healthcare experience. A number of healthcare systems have implemented similar integrated consent processes for biobanking, but it is unknown how (...) much patients understand after enrolling under these conditions. Methods: We recruited patients who enrolled in a biobank while in a healthcare setting when receiving ordinary care. We assessed knowledge of consent materials using 11 true/false questions drawn from a well-known biobank knowledge test. After reviewing the results from 114 participants, we revised the consent form and repeated the knowledge assessment with 144 different participants. Results: Participants scored poorly on the knowledge test in both rounds, with no significant differences in overall scores or individual items between the rounds. In Phase 1, participants answered 53% of the questions correctly, 25% incorrectly, and 22% “I don’t know.” In Phase 2, participants answered 53% of questions correctly, 24% incorrectly, and 23% “I don’t know.” Participants scored particularly poorly on questions about data sharing and accessing medical records. Conclusions: Enrollees under an integrated consent model had significant misunderstandings that persisted despite an attempt to improve information specifically about those topics in a consent form. These results raise challenges for current approaches that attribute misunderstanding to overly complex consent forms. They also suggest that the pressures of the clinic may compound other problems with patient understanding of biobank consent. As health systems increasingly blend research and care, they may need to rethink their approach to educating patients about participation in a biobank. (shrink)

The coronavirus disease (COVID-19) crisis provoked an organizational ethics dilemma: how to develop ethical pandemic policy while upholding our organizational mission to deliver relationship- and patient-centered care. Tasked with producing a recommendation about whether healthcare workers and essential personnel should receive priority access to limited medical resources during the pandemic, the bioethics department and survey and interview methodologists at our institution implemented a deliberative approach that included the perspectives of healthcare professionals and patient stakeholders in the policy development process. Involving (...) the community more, not less, during a crisis required balancing the need to act quickly to garner stakeholder perspectives, uncertainty about the extent and duration of the pandemic, and disagreement among ethicists about the most ethically supportable way to allocate scarce resources. This article explains the process undertaken to garner stakeholder input as it relates to organizational ethics, recounts the stakeholder perspectives shared and how they informed the triage policy developed, and offers suggestions for how other organizations may integrate stakeholder involvement in ethical decision-making as well as directions for future research and public health work. (shrink)

Invested with the capacity to reinstate physiological order, medicines are at the centre of contemporary health care. Their purpose and efficacy are generally seen as predictable and concrete: disease = therapy = outcome. These culturally specific understandings shape the practices and meanings of taking medicines. This article, however, queries what actually takes place when human bodies and medical drugs converge. Is it a solely therapeutic affair, a restoration of bodily normality, or one of multiple transformations? The ambivalent meaning of the (...) original Greek word for drug, pharmakon, intimates the potential of medicines to act as ‘remedy’ as well as ‘poison’. Using pharmakon as a conceptual tool, the article explores the complex, and often paradoxical corporeal effects of HIV combination therapy, with particular focus on lipodystrophy, a peculiar change in people‘s body shape. This unintended and frequently distressing iatro-genic phenomenon challenges common notions of therapeutic efficacy and causality and foregrounds the productive dimension of medical drugs - their capacity to reconfigure bodies, diseases and identities in multiple, unpredictable ways. (shrink)

Management of the renewable natural resources in Madagascar is gradually being transferred to the local communities, particularly that of forest resources. However, these local communities are struggling to assess the consequences of management plans that they themselves must develop and implement on ecologically, economically and socially sustainable grounds. In order to highlight key aspects of different management options beforehand, we have developed MIRANA, a computer model to simulate various scenarios of management plan implementation. MIRANA differs from other simulation models by (...) not only taking into account individual practices and economic exchanges, but also by accounting for the applicable regulations. These regulations are taken into consideration by means of a multiplicity of normative structures within a spatial context. The objective of this paper is to describe the representations of institutions, norms and territories proposed by MIRANA and to discuss these representations in relation to the state of the art in the field of normative multi-agent systems. (shrink)

In this dissertation I defend the claim that Nietzsche’s middle period can be read as presenting a theory of cultural flourishing that has as its foundation the project of incorporating truth. The consciously experienced world is the product of a number of interpretive processes operating below the level of consciousness. The intentional structure of experience is universal to human beings, but the content of the resulting world is determined by inherited norms and inculcated associations. Culture in one sense refers to (...) these inherited rules, but in another to the specific worlds that individuals are presented with as a result of them. The experienced world is relative to the interpretation employing in producing it, but experience is structured such that the world is presented as mind-independent. That is, the world is perspectivally constituted, even if each perspective presents its own world as the only one. This claim is what Nietzsche means by ‘truth’ in the project of incorporating truth. To incorporate this amounts to a refusal to commit to any one perspective dogmatically, which translates into the activity of continually altering one’s experienced world. This is achieved by reordering the framework that forms culture. But this is not done because truth has absolute value that demands that it be incorporated. Rather, it is done in the name of health, which for Nietzsche amounts to realising to the greatest extent possible the inherent forces that govern all living things. Continually changing perspectives introduces diversity into one’s existence; being able to maintain an identity in the face of this diversity is a demonstration of the strength of one’s vitality. This balance of stable identity and maximum diversity is constitutive of great health at the individual level and at the cultural level. Since incorporation at the individual level employs the cultural framework, the activity involved automatically has the capacity to affect culture at large. Certain great individuals, who themselves exhibit great health, are conscious of this relation to culture and they use it both to maintain cultural diversity and to unite the community around and ideal that helps engender cultural health. That ideal is science. (shrink)