Current law does not adequately protect patients' privacy or their medical records. Proposals to computerize these records could further erode confidentiality unless new federal laws are enacted.

Locked-in syndrome (LIS) is a severe neurological condition that typically leaves a patient unable to move, talk and, in many cases, initiate communication. Brain Computer Interfaces (or BCIs) promise to enable individuals with conditions like LIS to re-engage with their physical and social worlds. In this paper we will use extended mind theory to offer a way of seeing the potential of BCIs when attached to, or implanted in, individuals with LIS. In particular, we will contend that functionally integrated BCIs (...) extend the minds of individuals with LIS beyond their bodies, allowing them greater autonomy than they can typically hope for in living with their condition. This raises important philosophical questions about the implications of BCI technology, particularly the potential to change selves, and ethical questions about whether society has a responsibility to aid these individuals in re-engaging with their physical and social worlds. It also raises some important questions about when these interventions should be offered to individuals with LIS and respecting the rights of these individuals to refuse intervention. By aiding willing individuals in re-engaging with their physical and social worlds, BCIs open up avenues of opportunity taken for granted by able individuals and introduce new ways in which these individuals can be harmed. These latter considerations serve to highlight our emergent social responsibilities to those individuals who will be suitable for, and receive, BCIs. (shrink)

Objective: There are benefits and risks of giving patients more granular control of their personal health information in electronic health record (EHR) systems. When designing EHR systems and policies, informaticists and system developers must balance these benefits and risks. Ethical considerations should be an explicit part of this balancing. Our objective was to develop a structured ethics framework to accomplish this. -/- Methods: We reviewed existing literature on the ethical and policy issues, developed an ethics framework called a “Points to (...) Consider” (P2C) document, and convened a national expert panel to review and critique the P2C. -/- Results: We developed the P2C to aid informaticists designing an advanced query tool for an electronic health record (EHR) system in Indianapolis. The P2C consists of six questions (“Points”) that frame important ethical issues, apply accepted principles of bioethics and Fair Information Practices, comment on how questions might be answered, and address implications for patient care. -/- Discussion: The P2C is intended to clarify whatis at stake when designers try to accommodate potentially competing ethical commitments and logistical realities. The P2C was developed to guide informaticists who were designing a query tool in an existing EHR that would permit patient granular control. While consideration of ethical issues is coming to the forefront of medical informatics design and development practices, more reflection is needed to facilitate optimal collaboration between designers and ethicists. This report contributes to that discussion. (shrink)

Computer technologies are having a profoundly transforming effect on how the United States federal government operates. As technologies become more sophisticated, Federal agencies are becoming more innovative, devising creative ways to use these technologies for program delivery. One hopes that the near-term effect of these technology applications will be more efficient operation of government, the goal that generally leads to their implementation.

We have all heard a refrain much like this one over the last decade, increasingly so, as the cost of genetic sequencing has been drastically reduced with improvements in associated techniques and technologies. Already, discoveries are being made in laboratories that can help doctors determine from which drug a particular patient will receive the most efficacious treatment. The working presumption is that, eventually, individuals’ genetic sequence information will be included in each of their personal medical records.

In recent years, two distinct trajectories of bioethical inquiry have emerged: neuroethics and nanoethics. The former deals with issues in neuroscience, whereas the latter deals with issues in nanoscience and nanotechnology. In both cases, the ethical inquiries have coalesced in response to rapidly increasing scientific and engineering developments in each field. Both also present major issues for contemplation in bioethics. However, the questions are (1) how different are the ethical issues raised, and (2) is it beneficial for neuroethics and nanoethics (...) inquiries to proceed on often-divergent trajectories by ethicists who otherwise might never interact? If, for example, ethical inquiry occurs only within the disciplinary confines of their predominant area(s) of science (which now seems to be the case) or by overlooking prior discussions in other scientific realms (like genetics), then the opportunity for a richer, more comprehensive discourse may be lost. I argue that this (1) is a disservice to bioethics, (2) is antithetical to some of the aims of bioethical inquiry, and (3) encourages the reductionism bioethicists’ claim that is counterproductive. (shrink)

Volume 20, Issue 7, July 2020, Page 1-5.

ABSTRACT The Swedish case bears out Lewin's contention, in Self-Interest and Public Interest in Western Politics, that public spiritedness is much more important than is suggested by public-choice theories positing the universal dominance of self-interestedness. However, in Sweden we find that public spiritedness on the part of the public—as evidenced, for example, in sociotropic voting—was cultivated by political institutions, policies, and rhetoric that transformed a divided, conflictual society into one in which the “public interest” was both coherent and desirable. In (...) turn, this cultivation was the result of decisions by politicians that were, in the most simplistic sense, self-interested, because they secured the politicians’ election and re-election. But the goal of election and re-election was to create a just society. In short, the politicians, too, were public spirited. (shrink)

This historical study aims to explain how the transition from student nurse service to fully qualified “graduate nurse” service in the United States in the 20th century affected assumptions about fundamental patient care in hospital wards and provide historical context for current apprenticeship programs. Through analysis of documents from 1920 when student nurse service, a nurse apprentice model, was the norm to 1960 when the nurse apprentice model was waning in favor of registered nurse service, this study found that the (...) replacement of student nurses with registered nurses led to weakened standardization of fundamental bedside care and the introduction of large numbers of unlicensed nursing assistants. While student nurses could perform all the functions of fully qualified graduate nurses, nursing assistants could not, resulting in a separation of fundamental nursing care from the professional nurse role and changes in assumptions and attitudes toward fundamental care. These changes had a negative effect on fundamental nursing care. New apprenticeship programs provide opportunities for improvement. (shrink)

Kathryn Paxton George's recent publication, Animal, Vegetable, or Woman?, is the culmination of more than a decade's work and encompasses standard and original arguments against the feminist-vegetarian connection. This paper demonstrates that George's key arguments are deeply flawed, antithetical to basic feminist commitments, and beg the question against fundamental aspects of the debate. Those who do not accept the feminist-vegetarian connection should rethink their position or offer a non-question-begging defense of it.

The growth and sustainability of the nursing profession depends on the ability to recruit and retain the upcoming generation of professionals. Understanding the career choice experiences and professional expectations of Millennial nurses (born 1980 or after) is a critical component of recruitment and retention strategies. This study utilized Polkinghorne's interpretive, narrative approach to understand how Millennial nurses explain, account for and make sense of their choice of nursing as a career. The positioning of nursing as a virtuous choice was both (...) temporally and contextually influenced. The decision to enter the profession was initially emplotted around a traditional understanding of nursing as a virtuous profession: altruistic, noble, caring and compassionate. The centricity of virtues depicts one‐dimensional understanding of the nursing profession that alone could prove dissatisfying to a generation of professionals who have many career choices available to them. The narratives reveal how participants' perceptions and expectations remain influenced by a stereotypical understanding of nursing, an image that remains prevalent in society and which holds implications for the future recruitment, socialization and retention strategies for upcoming and future generations of nurses. (shrink)

One-ing is as close a description of "What It May Be All About" that you may ever read.The awesome task that is your destiny is connecting Heaven and Earth and ...

The Swedish case bears out Lewin's contention, in Self-Interest and Public Interest in Western Politics, that public spiritedness is much more important than is suggested by public-choice theories positing the universal dominance of self-interestedness. However, in Sweden we find that public spiritedness on the part of the public—as evidenced, for example, in sociotropic voting—was cultivated by political institutions, policies, and rhetoric that transformed a divided, conflictual society into one in which the “public interest” was both coherent and desirable. In turn, (...) this cultivation was the result of decisions by politicians that were, in the most simplistic sense, self-interested, because they secured the politicians’ election and re-election. But the goal of election and re-election was to create a just society. In short, the politicians, too, were public spirited. (shrink)

: Kathryn Paxton George's recent publication, Animal, Vegetable, or Woman? (2000), is the culmination of more than a decade's work and encompasses standard and original arguments against the feminist-vegetarian connection. This paper demonstrates that George's key arguments are deeply flawed, antithetical to basic feminist commitments, and beg the question against fundamental aspects of the debate. Those who do not accept the feminist-vegetarian connection should rethink their position or offer a non-question-begging defense of it.

This historical study aims to refine understanding of the nature of nursing work. The study focuses on the 1880 crisis at Guy's Hospital in London to examine the nature and meaning of nursing work, particularly the concept of nursing work as many ‘little things.’ In this paper, an examination of Margaret Lonsdale's writing offers an original contribution to our understanding of the ways in which nursing work differs from medical practice. In this way, we use the late-nineteenth-century controversy at Guy's (...) Hospital as a prism through which to examine the contested nature of nursing work. Lonsdale's ideas are corroborated by examination of writings by nurse leaders Florence Nightingale and Eva Luckes. Luckes, in particular, elaborated what was meant by nursing as the performance of a thousand little things, which are specific to nursing work. While physicians had been performing much of what was considered to be nursing work, nurses developed some of these and other interventions into a unique body of work characterized by meticulous attention to significant details. Some implications regarding current nursing practice are discussed. (shrink)

For centuries, the British royal family has been the subject of books, articles, broadcast media, and digital communication. The addition of social media platforms has further increased the attention of the royals. Each of the family’s official social media sites have large numbers of followers around the world. The present study uses Goffman’s Presentation of Self to qualitatively examine how the current British royal family portrays itself visually via its official Instagram account. An analysis of two years of posts on (...) the social platform provides a glimpse of how the family works to maintain its image through a highly popular social media platform. Results indicated the presence of three main themes: Queen as the Head of the Monarchy, Honoring the Past, and The Working Royalty. This study offers a means of understanding the importance of visuals in conveying the royal family. (shrink)

Two related themes have dominated discussions about the Left in advanced industrial democracies in recent years. The first is that an increasingly integrated world economy is creating a fundamentally new situation for leaders and publics, imposing burdens and constraining choices. You can either opt out of the system and languish, or put on what New York Times columnist Thomas Friedman has called neoliberalism's “Golden Straightjacket”—at which point “two things tend to happen: your economy grows and your politics shrinks.” The second (...) is that traditional social democracy has played itself out as a political ideology, creating a vacuum that can and should be filled by some new progressive movement with greater contemporary relevance. For example, Ralf Dahrendorf has argued that “socialism is dead, and … none of its variants can be revived,” while Anthony Giddens has written that reformist socialism has become “defensive” and perhaps even “moribund.”. (shrink)

Robert Jackall, Street Stories: The World of Police Detectives. Cambridge, MA: Harvard University Press, 2005. 429pp.

WISDOM OF THE WILD offers a deeper appreciation of life, relationships, and experiences through the exploration of nature's spiritual offerings. This collection of life lessons focuses on aspects of the natural world and their philosophical connection to our own lives, providing insights to daily living and a deeper connection to our spiritual selves. Each entry features a phenomenon found in nature, demonstrating how readers may connect the world to their human experiences. With activities, rituals, and affirmations, this book of natural (...) wonders aligns readers' inner and outer worlds to cultivate peace, balance, and harmony. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Community and the “Absolutely Feminine”Sheri I. Hoem (bio)I’ve emphasized the importance of the moment of dissent in the process of constructing knowledge, lying at the heart of the community of thought.—Jean-François Lyotard, The Postmodern ExplainedMaurice Blanchot’s The Unavowable Community places side by side a “community” of writers who confront the very possibility of community as it comes to be inscribed in politico-philosophical and literary modes. His “little book” (...) [56], as he calls it, takes up these modes of discourse separately, in two parts. The first section of his text, “The Negative Community,” constitutes an analytical defense of Bataille’s theoretical concepts of community as they have been interpreted by Jean-Luc Nancy in The Inoperative Community. Blanchot engages the question of community, communion, and communism not simply to contest or continue Nancy’s text, but to restore Bataille to a brotherhood, or “fraternity” [26] of friends and scholars who have come to think in terms of an “unworking” [23] or “negative” community. The second section of Blanchot’s text, “The Community of Lovers,” performs a critical reading of Marguerite Duras’s fictional work The Malady of Death.In The Inoperative Community—the pretext, at least in part, for part one of Blanchot’s little book—Nancy credits Bataille as having “gone farthest into the crucial experience of the modern destiny of community” [16] in that Bataille’s thinking reveals the experience of discerning communism’s failure, followed by a fascination with fascism, and finally a “withdrawal from communitarian enterprises” [16–17] altogether. According to Nancy, at the juncture of the historical and theoretical failings of community, Bataille abandons all forms of community other than “an accursed isolation of lovers and of the artist” [24]. Admitting that he is dealing only with ‘“themes’” rather than with Bataille’s “writing” itself, Nancy nevertheless asserts that Bataille’s thinking on community has always been limited by “the theme of the sovereignty of the subject” [23], even in his community of lovers:Bataille’s lovers are also, at the limit, a subject and an object—where the subject, moreover, is always the man, and the object always the woman, due no doubt to a very classical manipulation of sexual difference in an appropriation of self by self. (However, on another register and in another reading of Bataille’s text, it is not certain that love and jouissance do not pertain essentially to the woman—and to the woman in man. To discuss this it would be necessary to consider Bataille’s writing... something I cannot do here, inasmuch as I am for the moment considering only its “themes.”).[24]Nancy’s reading of Bataille thus clears a space for Nancy’s own investigation into the possibility of community after or beyond the subject, so to speak. Instead of a subject described as an (undivided) individual, Nancy speaks of a “singular being” who is always already othered. Singular beings as such are “constituted by... sharing that makes them [End Page 49] others: other for one another... ‘“communicating’ by not ‘communing’” [25]. For Nancy, it is the very experience of the limits of communication that allows each being to discover a certain singularity in common.Blanchot too reflects on the “theme” of community in Bataille’s works without examining Bataille’s “writing” as such, but he reads Bataille differently. Blanchot demonstrates how Bataille’s thinking gives the effect of “mutation” [4], that Bataille comes to an understanding of self-difference beyond the subject, beyond the limits imposed by Nancy’s reading, beyond the classical construct of subject/object discourse. Blanchot’s “Negative Community” establishes Bataille as one who experienced stages of thought: his thought exhibited its own infidelity.Blanchot turns to certain of Bataille’s terms, particularly “sacrifice,” “ecstasy,” and “inner experience,” to present an alternative to Nancy’s reading. According to Blanchot, the “inner experience” (l’expérience intérieure) is a concept in Bataille that does the opposite of what one might expect. The “inner experience,” Blanchot explains, is amovement of contestation that, coming from the subject, devastates it, but has as a deeper origin the relationship with the other which is community itself... (shrink)

This paper examines economic arguments employers sometimes use to justify restricting or excluding from employment those workers who are Iikely to incur high costs in health care insurance. We argue that, although profit-making is a legitimate goal for businesses, hiring practices based on non-job-related criteria violate principles of self determination, autonomy, discrimination, justice, and privacy. We conclude that hiring practices based on Iiability-driven ethics are not morally justified, but that as long as health care insurance and employment are Iinked, businesses (...) will continue to have an incentive to use liability-driven arguments. (shrink)

We have long lived in a world made by global connections. Our products, our travels, our ideas--all of these have their origins in places and peoples both near and far. But when scholars narrate the history of the modern self, they ignore these connections and focus on changes in European science and philosophy. In this provocative new book, Avram Alpert argues that we need to rethink the story of the modern self as a global history. He first shows how (...) canonical European thinkers like Michel de Montaigne, René Descartes, and Immanuel Kant explicitly formed their ideas of selfhood in relation to the travel accounts flooding into Europe from colonial missionaries. He then pushes this history beyond Europe, showing how a diverse series of writers, including Ralph Waldo Emerson, W.E.B. Du Bois, Léopold Senghor, Frantz Fanon, and D.T. Suzuki, critiqued these ideas of global selfhood with their own creative responses. Spanning four continents and four centuries, the book argues that all of these writers partake of a shared global history forged in the violence of colonial rule. The resulting narrative shows that the modern self is not a European invention, but a global, evolving, and fraught attempt to make ourselves the kinds of beings who can live with the complexity of a world that is at once connected and never fully knowable. (shrink)

How an acceptance of our limitations can lead to a more fulfilling life and a more harmonious society We live in a world oriented toward greatness, one in which we feel compelled to be among the wealthiest, most powerful, and most famous. This book explains why no one truly benefits from this competitive social order, and reveals how another way of life is possible—a good-enough life for all. Avram Alpert shows how our obsession with greatness results in stress and (...) anxiety, damage to our relationships, widespread political and economic inequality, and destruction of the natural world. He describes how to move beyond greatness to create a society in which everyone flourishes. By competing less with each other, each of us can find renewed meaning and purpose, have our material and emotional needs met, and begin to lead more leisurely lives. Alpert makes no false utopian promises, however. Life can never be more than good enough because there will always be accidents and tragedies beyond our control, which is why we must stop dividing the world into winners and losers and ensure that there is a fair share of decency and sufficiency to go around. Visionary and provocative, The Good-Enough Life demonstrates how we can work together to cultivate a good-enough life for all instead of tearing ourselves apart in a race to the top of the social pyramid. (shrink)

In April 2021, longing to learn first-hand about ageing philosophically, Valery Vino reached out to the legendary Arnold Berleant (who was 89 at the time of writing), to see whether he might be interested in recording a dialogue to this theme, with a companion of his choice. Berleant selected his ideal collaborator Michael Alpert, book designer and collector, poet, senior, and treasured friend. Over the following six months, a rich tapestry of leisurely reading, contemplation and discussion unfolded, culminating in (...) an unrehearsed, free-flowing conversation about ageing, which has been recorded, lightly edited and offered here for readers to share. (shrink)

In this essay I return to the difficult relation between the ethics and politics of Emmanuel Levinas through his critique of "paganism" and "primitivism." I argue that Levinas' central philosophical claims are fundamentally constituted by his problematic conceptions of so-called primitive life. Thus unlike current scholarship which has tried to put a wedge between Levinas' ethics and his politics, I suggest that one way to make Levinas' contributions meaningful in a global world is to unhinge the philosophy from the beginning. (...) Building on the dialogue between Levinas and Derrida, as well as contemporary anthropology, I argue that we can make an orginary agnostic moment prior to his work, which might allow us to think through a plurality of ethical subjectivities. (shrink)

This commentary compares clinical aspects of ketamine with the amphetamine model of schizophrenia. Hallucinations and loss of insight, associated with amphetamine, seem more schizophrenia-like. Flat affect encountered with ketamine is closer to the clinical presentation in schizophrenia. We argue that flat affect is not a sign of schizophrenia, but rather, a risk factor for chronic schizophrenia.

The influential threat simulation theory asserts that dreaming yields adaptive advantage by providing a virtual environment in which threat-avoidance may be safely rehearsed. We have previously found the incidence of biologically threatening dreams to be around 20%, with successful threat avoidance occurring in approximately one-fifth of such dreams. TST asserts that threat avoidance is over-represented relative to other possible dream contents. To begin assessing this issue, we contrasted the incidence of ‘avoidance’ dreams with that of their opposite: ‘approach’ dreams. Because (...) TST states that the threat-avoidance function is only fully activated in ecologically valid contexts, we also performed this contrast for populations living in both high- and low-threat environments. We find that ‘approach’ dreams are significantly more prevalent across both contexts. We suggest these results are more consistent with the view that dreaming is generated by reward-seeking systems than by fear-conditioning systems, although reward-seeking is clearly not the only factor determining the content of dreams. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The African Novel of Ideas: Philosophy and Individualism in the Age of Global Writing by Jeanne-Marie JacksonAvram AlpertThe African Novel of Ideas: Philosophy and Individualism in the Age of Global Writing, by Jeanne-Marie Jackson; 232 pp. Princeton: Princeton University Press, 2021.The world of postcolonial literary studies harbors a well-earned suspicion of claims to promoting liberal ideals like civility, rationality, and individuality. The liberal worldview, after all, arose in (...) the same era as European colonial expansion. To many critics, this was not a coincidence: liberal ideals were often crafted in opposition to the peoples that Europeans were encountering around the world. Whereas these other peoples were supposedly bound to collective myths, unaware of the primacy of the individual, and condemned to violent passions, liberals claimed that Europeans used rationality to perceive the value of individual life, and, in so doing, had unlocked the key to promoting civilizational harmony. All that everyone else had to do to experience this new way of life was, in one of history's most wretched paradoxes, to succumb to colonial violence and join the empire of liberty. It is thus quite logical that anticolonial criticism would call into question the basic features of the liberal worldview.But in recent years, an interdisciplinary cohort of scholars—including Sankar Muthu in political science, Sanjay Subrahmanyam in history, Mukti Lakhi Mangharam in literary studies, and Ato Sekyi-Otu in philosophy—have come to question this consensus.1 Their challenge rests on an ironic problem of the critique of ideologies associated with colonialism: by criticizing topics like civility, rationality, and individuality as such, do we not play into the very Eurocentric idea that these ideas were invented by Europeans in the first place? As these scholars have shown across various disciplines, geographies, and time periods, this critique risks giving modern Europe too much credit. Ideals often associated with liberalism have antecedents around the world. Sometimes they are used to advance general equality and well-being; sometimes they subvert these ideals. As Jeanne-Marie Jackson argues in her trenchant new book intervening in these debates, The African Novel of Ideas, we thus need a criticism that is as much attuned to the critique of "false universalisms" as it is open to "the promise of one that is true" (p. 189).Throughout her book, Jackson argues that a reconstructed liberalism is not only fundamental to literature from Africa but that the critical neglect of this fact has distorted the general understanding of literature today. Critics—especially but not exclusively in the West—have become so accustomed to sniffing out hints of liberal, individualist ideology that they routinely cast aside the ways in which African philosophers and novelists have themselves sought to explore and transform these ideals. Jackson's argument is not that liberalism, as it stands, is a noble philosophy that has been unfairly jettisoned. Rather, she posits that African writers are developing a fundamental innovation by considering how they—who were so long exploited by European ideals—can nonetheless find [End Page 495] meaning in both alternative and emergent versions of these very same ideals. What their work emphasizes is the "process of getting from an African locality to its universal resonance" (p. 185). In other words, whereas Europeans had simply presumed that their view of the world should apply everywhere, the contemporary novelists and philosophers discussed in this book engage in thorough intellectual and conceptual labor to tease out how ideas generated in one place might speak (without force) to peoples around the world.Jackson advances this argument through an innovative mix of philosophy and literature. Rather than evoking the standard series of French philosophers summoned to explicate literature, Jackson frames her readings through the work of philosophers such as Kwasi Wiredu, Kwame Anthony Appiah, and Emmanuel Eze. This allows her to shift the focus of her readings of literature from questions of language and close reading to underanalyzed topics in philosophy and literature, especially about how African literature enacts philosophical questions. She discusses topics ranging from the nature of the self and the meaning of rationality to a meta-interrogation on the purpose of philosophizing itself (pp. 16–17). That purpose... (shrink)

The requirement by the National Science Foundation (NSF) that research proposals include plans for “broader impact” activities to foster connections between Science, Technology, Engineering, and Math (STEM) research and service to society has been controversial since it was first introduced. A chief complaint is that the requirement diverts time and resources from the focus of research and toward activities for which researchers may not be well prepared. This paper describes the theoretical framework underlying a new strategy to pair NSF-funded nano (...) research centres with science museums in order to achieve greater success in the broader impact mission, and to transform the perceived burden of the requirement into an opportunity to provide enhanced value to the constituencies of the partnering organizations, as well as to the larger community. This partnership approach is presented as a model that also can be applied to NSF-funded research centres in other STEM fields, and to non-NSF-funded STEM research centres nevertheless looking to pursue broader impacts types of activities. The model also provides an opportunity to stretch the typical spectrum of broader impacts activities to include citizen engagement in science, technology and societal concerns. (shrink)

In this article, the author argues that the works of Immanuel Kant and Henry David Thoreau can help reframe current political discussions about violence and nonviolence within revolutionary movements. For both of them, the means and ends of political change must coincide. Since they seek a nonviolent state of affairs, each argues against violent political change. However, they are also concerned to articulate a relationship between armed and unarmed struggle. After all, Kant and Thoreau worked to find what was positive (...) in violent acts: the French Revolution and John Brown’s raid on Harpers Ferry, respectively. They suggest that one of the ethical acts of revolutionary nonviolence is the sympathetic spectatorship of comrades in struggle who have chosen violent means. This opens up a theory of revolutionary nonviolence as a dual injunction to remain resolutely opposed to violence, but also to be capable of finding within violent acts a deeper desire for the end of violence. (shrink)