In this article, we explore the possibility of adding a new role to the clinical encounter: an illness doula. Even though research and education in medical humanities and narrative medicine have made improvements in humanizing healthcare, progress is slow and ongoing. There needs to be an intervention in the practice of healthcare now for people currently going through the system. An illness doula, like a birth doula, would facilitate and insure that attention is paid to the personal needs and desires (...) of the patient in the present system. We envision illness doulas having the ability and availability to accompany the patient throughout the healthcare process, to help communicate with clinicians, and to ensure that patient preferences are understood and respected along the way. We discuss how this idea emerged through the clinical encounters of two of our authors, the possibilities and limitations of creating a new role for illness doulas, and the logistics of how to put this new role into play. (shrink)

This book gives a descriptive analysis of specific Madhyamika texts. It compares the ideology of Kumarajiva (a translator of the four Madhyamika treatises 400 A.D.) with the ideologies of the three Chinese contemporaries - HuiYuan, Seng-Jui and Seng-Chao. It envisages an intercultural transmission of religious and philosophical ideas from India to China.

In a recent paper, Al Mele (2003) suggests that the Simple View of intentional action is “fiction” because it is “wholly unconstrained” by a widely shared (folk) concept of intentional action. The Simple View (Adams, 1986, McCann, 1986) states that an action is intentional only if intended. As evidence that the Simple View is not in accord with the folk notion of intentional action, Mele appeals to recent surveys of folk judgments by Joshua Knobe (2003, 2004a, 2004b). Knobe’s surveys appear (...) to show that the folk judge unintended but known side effects of actions to be performed intentionally. In this paper we will reject Mele’s suggestion that the Simple View is “fiction.” We will also discuss the relationship between surveys and philosophical theories, and the abilities of surveys to access folk core concepts. We will argue that considerations of both fail to support Mele’s suggestion. (shrink)

The Mental Health Literacy Scale is the most widely used and strong theory-based measurement tool to gain an understanding of mental health knowledge and ability. This study aimed to test the psychometric properties of the Chinese version of the Mental Health Literacy Scale and to document the norm and its influential factors of mental health literacy among nurses. The MHLS was translated following Brislin’s translation model and tested with a sample of 872 clinical registered nurses. The Jefferson Scale of Empathy-Health (...) Professionals, Patient Health Questionnaire-2, and Generalized Anxiety Disorder-2 were administered to assess convergent validity. The minimum average partial test, parallel analysis and confirmatory factor analysis supported 4 first-order 2 second-order structure. The 4 factors were named “knowledge of mental disorder,” “ability to seek information and help,” “recognition of mental disorder,” and “acceptance of patients with mental illness,” with factor 1-3 were summarized into MHLS-Core and factor 4 as MHLS-SA. The MHLS-C was moderately negatively correlated with the PHQ-2 and GAD-2 and highly positively correlated with JSE-HP. The Cronbach’s α was 0.85 for the overall scale and 0.89 and 0.93 for two subscales. The test-retest reliability was good, with intraclass correlation coefficients of 0.80 for the whole scale, and 0.79 and 0.94 for two subscales. As an approximately normal distribution, the 50th percentile for the MHLS-C was 99, with 50th percentiles of 74 and 20 for MHLS-Core and MHLS-SA. Higher position, higher professional credentials, higher hospital hierarchy, other specialist hospital, psychiatric hospital and unmarried status were positive predictors. The 29-item MHLS-C, with two subscales of MHLS-Core and MHLE-SA, is a stable and validated tool to measure mental health literacy. MHLS-Core could be used independently to measure the core content of mental health literacy. It may be applicable for Chinese health professionals, but need further validation among the general public. MHL curriculum and a targeted culturally appropriate program for acceptance for health professionals, especially for those in general hospitals and with less working tenure, may be recommended. (shrink)

Twenty-first-century biology rejects genetic determinism, yet an exaggerated view of the power of genes in the making of bodies and minds remains a problem. What accounts for such tenacity? This article reports an exploratory study suggesting that the common reliance on Mendelian examples and concepts at the start of teaching in basic genetics is an eliminable source of support for determinism. Undergraduate students who attended a standard ‘Mendelian approach’ university course in introductory genetics on average showed no change in their (...) determinist views about genes. By contrast, students who attended an alternative course which, inspired by the work of a critic of early Mendelism, W. F. R. Weldon, replaced an emphasis on Mendel’s peas with an emphasis on developmental contexts and their role in bringing about phenotypic variability, were less determinist about genes by the end of teaching. Improvements in both the new Weldonian curriculum and the study design are in view for the future. (shrink)

In this study, we examined the perception of actual and ideal ethical climate type among 95 nurses working in the internal medicine wards of one central hospital in the state of Israel. We also examined whether nurses’ demographic characteristics influence that perception and if a relationship between perceptions of an actual and an ideal ethical climate type influences nurses’ job satisfaction. A questionnaire composed of three subquestionnaires was administered and the responses analyzed using multiple linear regressions, analysis of variance and (...) Pearson’s correlation coefficient. The results demonstrated that demographic characteristics (such as: gender, job tenure and level of education) partially influence the perception of an ideal ethical climate. Incongruence in perceptions of ‘caring’ and ‘independence’ climate types indicated a decline in nurses’ job satisfaction, while perception of actual ‘caring’ and ‘service’ climates positively influenced all aspects of job satisfaction. We recommend constructing training programs emphasizing the ethics of nursing practice and also to help lead nurses to clarify an ethical framework and guide nursing staff in dealing with ethical dilemmas. (shrink)

Policies and position statements regarding decision-making for extremely premature babies exist in many countries and are often directive, focusing on parental choice and expected outcomes. These recommendations often state survival and handicap as reasons for optional intervention. The fact that such outcome statistics would not justify such approaches in other populations suggests that some other powerful factors are at work. The value of neonatal intensive care has been scrutinized far more than intensive care for older patients and suggests that neonatal (...) care is held to a higher standard of justification. The relative value placed on the life of newborns, in particular the preterm, is less than expected by any objective medical data or any prevailing moral frameworks about the value of individual lives. Why do we feel less obligated to treat the premature baby? Do we put newborns in a special and lesser moral category? We explore this question from a legal and ethical perspective and offer several hypotheses pertaining to personhood, reproductive choices, “precious children,” and probable evolutionary and anthropological factors. (shrink)

This paper presents an overview of the process of entanglement at the 25th International Philosophy of Nursing Conference (IPNC) at University of California at Irvine held on August 18, 2022. Representing collective work from the US, Canada, UK and Germany, our panel entitled ‘What can critical posthuman philosophies do for nursing?’ examined critical posthumanism and its operations and potential in nursing. Critical posthumanism offers an antifascist, feminist, material, affective, and ecologically entangled approach to nursing and healthcare. Rather than focusing on (...) the arguments of each of the three distinct but interrelated panel presentation pieces, this paper instead focuses on process and performance (per/formance) and performativity as relational, connected and situated, with connections to nursing philosophy. Building upon critical feminist and new materialist philosophies, we describe intra‐activity and performativity as ways to dehierarchise knowledge making practices within traditional academic conference spaces. Creating critical cartographies of thinking and being are actions of possibility for building more just and equitable futures for nursing, nurses, and those they accompany—including all humans, nonhumans, and more than human matter. (shrink)

Arguments for what consent is often appeal to its functions. For instance, some argue that because consent functions to express the consent-giver’s autonomous control over her normative boundaries, consent must consist in a mental state. In this paper, I argue that consent has an often-overlooked function and that its having this function has consequences for our views of what consent is. I argue that consent has a relationship-shaping function: acts of consent can alter and enable personal relationships. This function grounds (...) an argument for the following claim: some acts of consent cannot be morally transformative unless there is uptake, or acceptance, or cooperation, on the recipient’s part. At least some acts of consent need to be “cosigned” by both parties. This rules out what I call “unilateral” conceptions of consent, according to which consent can always be given by the giver alone and nobody else needs to enter the picture. (shrink)

This paper argues that the augmented reality gaming application for smart devices, _Pokémon GO_ shows the fate of the legal subject as a neoliberal monster subjugated to the limitations imposed by hypercapitalism. The game, derived from Nintendo’s iconic Pokémon franchise, reveals the legal subject as a frenzied, diminished and impulsive being, allowed to see, move, catch and accumulate but unable to participate in more meaningful self-narration. It is not that the game is lawless, notwithstanding, anxieties in the semiosphere about users (...) trespassing or engaging in criminal behaviour. Rather the game is over structured and highly limited, both within its game-play which is repetitive and impulsive, and in its absence of narrative. Unlike the classic Nintendo Pokémon games which are within the role-playing game genre, _Pokémon GO_ abstracts the seeing, moving, catching and accumulating features of the classic games without the overarching narrative, questing and competition. In this _Pokémon GO_ manifests the transformation of the liberal legal subject of capitalism to the neoliberal subject of a digital orientated hypercapitalism where seeing, moving, catching and accumulating is immediate and impulsive, obliterating the ‘prudent’ subject participating in their own self-narration. (shrink)

The extremely preterm infant, born before 28 weeks of gestational age, has been the focus of much ethical discussion. These infants have a significant risk of mortality and morbidity, and it is not...

David Annis is professor of philosophy at Ball State University. In this essay, Annis offers an alternative to the foundationalist-coherent controversy: "contextualism." This theory rejects both the idea of intrinsically basic beliefs in the foundational sense and the thesis that coherence is sufficient for justification. he argues that justification is relative to the varying norms of social practices.

This study describes the implementation of a curricular tool designed for students to develop civic engagement through running a social business in one fifth-grade classroom. The One Hen unit focuses on teaching elementary students the concept of social entrepreneurship through a project where students run their own social business to address a community need. This study has the potential to contribute to our understanding of how elementary students learn economics to increase civic engagement as the One Hen unit could lead (...) to students’ becoming more aware of problems in their community and to gain experience planning for civic action. (shrink)

It is common practice for social studies in the elementary school day to be integrated into other subject areas, especially language arts. Also common in an elementary school day are unstructured spaces such as snack time or recess. In this paper, we present findings from a larger study on social studies integration within various subject areas to explore how two teachers (first and fifth grade) integrated social studies into unstructured spaces. These teachers integrated social studies concepts and experiences into morning (...) work, community building, snack time, and after-lunch reading to varying degrees. This study provides an inroad for conversation among researchers, teacher educators, and practicing teachers about the ideals and reality of elementary social studies with the hope of deepening students’ experiences. (shrink)

Background: There are numerous benefits to ethics consultation services, but little is known about the reasons different professionals may or may not request an ethics consultation. Inter-professional differences in the perceived utility of ethics consultation have not previously been studied.Methods: To understand profession-specific perceived benefits of ethics consultation, we surveyed all employees at an urban tertiary children’s hospital about their use of ethics committee services (n = 842).Results: Our findings suggest that nurses and physicians find ethics consultations useful for different (...) reasons; physicians were more likely to report normative benefits, while nurses were more likely to report communicative and relational benefits.Conclusions: These findings support an open model of ethics consultation and may also help ethics committees to better understand consultation requests and remain attuned to the needs of various professional groups. (shrink)

Care as a concept has long been central to the nursing discipline, and care ethics have consequently found their place in nursing ethics discussions. This paper briefly revisits how care and care ethics have been theorized and applied in the discipline of nursing, with an emphasis on Tronto’s political view of care. Adding to the works of other nurse scholars, we consider that Tronto’s care ethics is useful to understand caring practices in a sociopolitical context. We also contend that this (...) vision can be used specifically to politicize nurses, by encouraging them to think critically about the context in which they work and how they can participate to change the status quo, notably by prompting the democratization of care in institutional settings. We illustrate this by demonstrating how moral distress that can occur with aggressive or futile treatments in the intensive care unit can be reduced if nurses are systematically included in the decision-making process. By showing some ways in which nursing political actions can begin to change the status quo as it pertains to futile treatments at the end of life, we can help empower nurses to strive to be included in political spaces and voice their concerns to have their professional needs met. (shrink)

We provide an overview of a proposal for a new metaphysical framework within which theology and science might both find a home. Our proposal draws on the triadic semiotics and threefold system of metaphysical categories of C. S. Peirce. We summarize the key features of a semiotic model of the Trinity, based on observed parallels between Peirce's categories of Firstness, Secondness, and Thirdness and Christian thinking about, respectively, the Father, Son, and Holy Spirit. We test and extend the semiotic model (...) by exploring how Peirce's taxonomy of signs offers a new approach to theological reflection on the Incarnation. This leads to a novel way of framing scientific questions about human evolution in semiotic terms and to a new approach to theological anthropology. Finally, we use the semiotic model of the Trinity as the basis of a trinitarian approach to the theology of creation according to which the semiotic processes that are fundamental to life and to human behavior and cognition may be understood as “vestiges of the Trinity in creation.”. (shrink)

A revised translation of Heidegger's most important work.

The word ought is often used to express moral judgments. It is used to express moral laws, as in “We ought to honour our parents”; and it is used to express singular moral judgments, as in “You ought not to have spoken to your mother like that”". Some singular moral judgments are clearly deductions from some moral law, as is “You ought not to have spoken to your mother like that”. Others, however, are not clearly so, e.g. “You ought not (...) to have done that”. Where both the agent and the action are indicated merely by a contextual reference, no underlying moral law is suggested by the words alone. Even when the singular judgment characterizes both the agent and the action, as “You, being a strong man, ought to have gone to his aid”, it may still be quite obscure what, if any, moral law implies this judgment. Clearly there is no moral law that “Every strong man ought always to go to everybody's aid”. (shrink)

Among philosophers, there are at least two prevalent views about the core concept of intentional action. View I (Adams 1986, 1997; McCann 1986) holds that an agent S intentionally does an action A only if S intends to do A. View II (Bratman 1987; Harman 1976; and Mele 1992) holds that there are cases where S intentionally does A without intending to do A, as long as doing A is foreseen and S is willing to accept A as a consequence (...) of S’s action. Joshua Knobe (2003a) presents intriguing data that may be taken to support the second view.1 Knobe’s data show an asymmetry in folk judgements. People are more inclined to judge that S did A intentionally, even when not intended, if A was perceived as causing a harm (e.g. harming the environment). There is an asymmetry because people are not inclined to see S’s action as intentional, when not intended, if A is perceived as causing a benefit (e.g. helping the environment). In this paper we will discuss Knobe’s results in detail. We will raise the question of whether his ordinary language surveys of folk judgments have accessed core concepts of intentional action. We suspect that instead Knobe’s surveys are tapping into pragmatic aspects of intentional language and its role in moral praise and blame. We will suggest alternative surveys that we plan to conduct to get at this difference, and we will attempt to explain the pragmatic usage of intentional language. (shrink)

Virtues are acquirable, so if intellectual humility is a virtue, it’s acquirable. But there is something deeply problematic—perhaps even paradoxical—about aiming to be intellectually humble. Drawing on Edward Slingerland’s analysis of the paradoxical virtue of wu-wei in Trying Not To Try (New York: Crown, 2014), we argue for an anti-individualistic conception of the trait, concluding that one’s intellectual humility depends upon the intellectual humility of others. Slingerland defines wu-wei as the “dynamic, effortless, and unselfconscious state of mind of a person (...) who is optimally active and effective” (Trying Not to Try, 7). Someone who embodies wu-wei inspires implicit trust, so it is beneficial to appear wu-wei. This has led to an arms race between faking wu-wei on the one hand and detecting fakery on the other. Likewise, there are many benefits to being (or seeming to be) intellectually humble. But someone who makes conscious, strategic efforts to appear intellectually humble is ipso facto not intellectually humble. Following Slingerland’s lead, we argue that there are several strategies one might pursue to acquire genuine intellectual humility, and all of these involve commitment to shared social or epistemic values, combined with receptivity to feedback from others, who must in turn have and manifest relevant intellectual virtues. In other words, other people and shared values are partial bearers of a given individual’s intellectual humility. If this is on the right track, then acquiring intellectual humility demands epistemic anti-individualism. (shrink)

Children acquiring languages with noun classes have ample statistical information available that characterizes the distribution of nouns into these classes, but their use of this information to classify novel nouns differs from the predictions made by an optimal Bayesian classifier. We use rational analysis to investigate the hypothesis that children are classifying nouns optimally with respect to a distribution that does not match the surface distribution of statistical features in their input. We propose three ways in which children's apparent statistical (...) insensitivity might arise, and find that all three provide ways to account for the difference between children's behavior and the optimal classifier. A fourth model combines two of these proposals and finds that children's insensitivity is best modeled as a bias to ignore certain features during classification, rather than an inability to encode those features during learning. These results provide insight into children's developing knowledge of noun classes and highlight the complex ways in which statistical information from the input interacts with children's learning processes. (shrink)