This study describes the results of a retrospective review of patients' charts who had an advanced directive (AD) and who were hospitalized in a tertiary, acute care teaching hospital. The purpose of the review was to understand from clinical, sociological, ethical and legal perspectives the nature and utility of ADs. Findings and implications of the review are discussed in terms of: patient demographics; diagnoses; quality of ADs; influence of ADs on clinical decisions; and legal aspects of ADs.

Drawing on my recent work using inferential role semantics and elements of speech act theory to analyze the role of derogatory terms (a.k.a. ‘hate speech’, or ‘slurs’) in the 1994 genocide of the Tutsi in Rwanda, as well as the role of certain kinds of reparative speech acts in post-genocide Rwanda, this paper highlights key pragmatist commitments that inform the methods and goals of this practical analysis of real world events. In “Genocidal Language Games”, I used conceptual tools from Wittgenstein, (...) Sellars, Lewis, and Brandom, with a nod to Searle’s concept of status-functions, to develop an analysis that helps to make sense of the view that a steady, deep, and widespread derogation of a group can at least partially constitute genocide, not only be an antecedent to it. In this paper, I sketch some of the tools and lessons of this project, with an eye to highlighting their pragmatist roots and the directions to which such real-world investigations lead. (shrink)

YOUNG L, and WHARF HIGGINS J.Nursing Inquiry2010;17: 346–358 Using participatory research to challenge the status quo for women’s cardiovascular healthCardiovascular health research has been dominated by medical and patriarchal paradigms, minimizing a broader perspective of causes of disease. Socioeconomic status as a risk for cardiovascular disease is well established by research, yet these findings have had little influence. Participatory research (PR) that frames mixed method research has potential to bring contextualized clinically relevant findings into program planning and policy‐making arenas toward (...) developing meaningful health and social policies relevant to primary prevention. In this article we provide an overview of a PR program that included two quantitative and one qualitative studies and then we discuss lessons learned. The PR process we found was empowering for lone mothers, and transformative for lone mothers and researchers. Further, PR as an approach to research opened spaces in practice and policy‐making arenas to raise upstream issues relevant to the health of low income lone mothers. We conclude that while PR is an effective approach to social determinants research, as a time‐intensive endeavor, and one that does not easily align with research tradition, researchers must consider the strengths and drawbacks of PR when planning to implement such an approach. (shrink)

The Human Tissue Act 2004 presents a radical change to the legal regulation of the use of human material in England and Wales. The Act presents a broad regulatory framework but much in the practical operation of the legislation will depend upon regulations to be enacted and a new Code of Practice. This article examines 'appropriate consent' for the use of human tissue for research purposes in the context of the living competent adult. It examines the provision of information as (...) part of the consent process for the use of human materials for research purposes, the question of when consent can be withdrawn, and the controversial exception enabling the use without consent of anonymized material for research purposes where the research has been ethically approved. The paper concludes by highlighting some of the problems which may remain after the legislation comes into force. (shrink)

What would your life be like if you committed to something larger than yourself? Find out in the newest book from global transformation thought leader Lynne Twist. How does one person make a difference in the world? People constantly seek to discover meaning in their lives, but as humans take on the challenges facing us in this decade and beyond, we're searching for it now more than ever. Living a Committed Life demonstrates the power of dedication that goes beyond (...) the self and teaches how to live a committed life that enables you to draw on resources and capacities from your most authentic self. In five parts, Lynne Twist shows how to make and keep commitments, engage in individual and collective action, and discover ways to connect and collaborate to make a difference. By sharing stories and perspectives from her life, Twist reveals her unique experience as a thought leader and activist in multiple causes, from ending world hunger and protecting the Amazon rainforest to empowering women's leadership. The book presents the guiding principles that have enabled her own success and that turn inspiration into action for everyone. (shrink)

This essay asks if a cosmopolitan—who we take to be generally supportive of freer international migration—should worry about the adverse effects on those remaining behind in poor countries.

In Poetics of Deconstruction, Lynn Turner develops an intimate attention to independent films, art, and the psychoanalyses by which they might make sense other than under continued license of the subject that calls himself man. Drawing extensively from Jacques Derrida's philosophy in precise dialogue with feminist thought, animal studies and posthumanism (Hélène Cixous, Luce Irigaray, Donna Haraway, Cary Wolfe) this book explores the vulnerability of the living as rooted in non-oppositional differences. From abjection to mourning, to the speculative and the (...) performative, it reposes concepts and buzzwords seemingly at home in feminist theory, visual culture and the humanities more broadly. Stepping away from the carno-phallogocentric legacies of the signifier and the dialectic, Poetics of Deconstruction asks you to welcome nonpower into politics, always sexual but no longer anchored in sacrifice. (shrink)

J. S. Mill's role in the Indian education controversy is well known, but scarcely well understood. That he drafted, in 1836, a despatch sharply critical of Macaulay's infamous Minute on Indian Education, is general knowledge now. That in drafting the despatch Mill drew upon the ideas of H. H. Wilson, a noted Orientalist and sharp critic of Macaulay and the Anglicists, has been adequately demonstrated. That the despatch was never sent to India, because of the objections of the President of (...) the Board of Trade, John Hobhouse, a Whig with some utilitarian connections, has been common knowledge for several decades. (shrink)

The upcoming U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization has the potential to eliminate or severely restrict access to legal abortion care in the United States. We a...

There is a growing call for greater public involvement in establishing science and technology policy, in line with democratic ideals. A variety of public participation procedures exist that aim to consult and involve the public, ranging from the public hearing to the consensus conference. Unfortunately, a general lack of empirical consideration of the quality of these methods arises from confusion as to the appropriate benchmarks for evaluation. Given that the quality of the output of any participation exercise is difficult to (...) determine, the authors suggest the need to consider which aspects of the process are desirable and then to measure the presence or quality of these process aspects. To this end, a number of theoretical evaluation criteria that are essential for effective public participation are specified. These comprise two types: acceptance criteria, which concern features of a method that make it acceptable to the wider public, and process criteria, which concern features of the process that are liable to ensure that it takes place in an effective manner. Future research needs to develop instruments to measure these criteria more precisely and identify the contextual and environmental factors that will mediate the effectiveness of the different participation methods. (shrink)

Imprecise definition of key terms in the “public participation” domain have hindered the conduct of good research and militated against the development and implementation of effective participation practices. In this article, we define key concepts in the domain: public communication, public consultation, and public participation. These concepts are differentiated according to the nature and flow of information between exercise sponsors and participants. According to such an information flow perspective, an exercise’s effectiveness may be ascertained by the efficiency with which full, (...) relevant information is elicited from all appropriate sources, transferred to all appropriate recipients, and combined to give an aggregate/consensual response. Key variables that may theoretically affect effectiveness—and on which engagement mechanisms differ—are identified and used to develop a typology of mechanisms. The resultant typology reveals four communication, six consultation, and four participation mechanism classes. Limitations to the typology are discussed, and future research needs identified. (shrink)

Scholars have proposed a number of courses and programs intended to improve the ethical behavior of scientists in an attempt to maintain the integrity of the scientific enterprise. In the present study, we conducted a quantitative meta-analysis based on 26 previous ethics program evaluation efforts, and the results showed that the overall effectiveness of ethics instruction was modest. The effects of ethics instruction, however, were related to a number of instructional program factors, such as course content and delivery methods, in (...) addition to factors of the evaluation study itself, such as the field of investigator and criterion measure utilized. An examination of the characteristics contributing to the relative effectiveness of instructional programs revealed that more successful programs were conducted as seminars separate from the standard curricula rather than being embedded in existing courses. Furthermore, more successful programs were case based and interactive, and they allowed participants to learn and practice the application of real-world ethical decision-making skills. The implications of these findings for future course development and evaluation are discussed. (shrink)

Dealing with situations where parents’ views about treatment for their child are strongly opposed to doctors’ views is one major area of ethical challenge in paediatric health care. The traditional approach focuses on the child’s best interests, but this is problematic for a number of reasons. The Harm Principle test is regarded by many ethicists as more appropriate than the best interests test. Despite this, use of the best interests test for intervening in parental decisions is still very common in (...) clinical settings and can lead to confusion. In this paper, I propose the Zone of Parental Discretion as a means of putting into practice the key ideas of the Harm Principle, in a clear, step-by-step process. The Zone of Parental Discretion provides a tool for ethical deliberation by clinicians and ethicists about all situations in which parents and doctors disagree about treatment of a child, whether parents are refusing medically recommended treatment, or requesting non-recommended treatment. (shrink)

The concept of public participation is one of growing interest in the UK and elsewhere, with a commensurate growth in mechanisms to enable this. The merits of participation, however, are difficult to ascertain, as there are relatively few cases in which the effectiveness of participation exercises have been studied in a structured manner. This seems to stem largely from uncertainty in the research community as to how to conduct evaluations. In this article, one agenda for conducting evaluation research that might (...) lead to the systematic acquisition of knowledge is presented. This agenda identifies the importance of defining effectiveness and of operationalizing one’s definition. The article includes analysis of the nature of past evaluations, discussion of potential difficulties in the enactment of the proposed agenda, and discussion of some potential solutions. (shrink)

This chapter examines the role played by derogatory terms (e.g., ‘inyenzi’ or cockroach, ‘inzoka’ or snake) in laying the social groundwork for the genocide of the Tutsi in Rwanda in 1994. The genocide was preceded by an increase in the use of anti-Tutsi derogatory terms among the Hutu. As these linguistic practices evolved, the terms became more openly and directly aimed at Tutsi. Then, during the 100 days of the genocide, derogatory terms and coded euphemisms were used to direct killers (...) to their victims. Understanding these speech acts helps to illuminate the important ways that power is enacted through discourse, how speech acts can prepare the way for physical and material acts, and how speech generates permissions for actions hitherto uncountenanced. Studying the role of speech acts and linguistic practices in laying the groundwork of the genocide illuminates how patterns of speech acts become linguistic practices that constitute permissibility conditions for non-linguistic behaviors. Further, the analysis presented here helps to make sense of the view that a steady, deep, and widespread derogation of a group can be part and parcel of genocide, not only an antecedent to it. (shrink)

Holobionts are multicellular eukaryotes with multiple species of persistent symbionts. They are not individuals in the genetic sense— composed of and regulated by the same genome—but they are anatomical, physiological, developmental, immunological, and evolutionary units, evolved from a shared relationship between different species. We argue that many of the interactions between human and microbiota symbionts and the reproductive process of a new holobiont are best understood as instances of reciprocal scaffolding of developmental processes and mutual construction of developmental, ecological, and (...) evolutionary niches. Our examples show that mother, fetus, and different symbiotic microbial communities induce or constitute conditions for the development and reproduction of one another. These include the direct induction of maternal or fetus physiological changes, the restructuring of ecological relations between communities, and evolutionary selection against undesirable competitors. The mutual scaffolding and niche constructing processes start early—prior to amniotic rupture. We are evolutionarily, physiologically, and developmentally integrated holobiont systems, strung together through mutual reliance and mutual construction. Bringing the processes of niche construction and developmental scaffolding together to interpret holobiont birth conceptually scaffolds two new directions for research: in niche construction, identifying the evolutionary implications of organisms actively constructing multiple overlapping niches and scaffolds, and in Evolutionary Developmental Biology, characterizing evolutionary and ecological processes as developmental causes. (shrink)

A longitudinal study of 308 white -collar U.S. employees revealed that feelings of hope and gratitude increase concern for corporate social responsibility. In particular, employees with stronger hope and gratitude were found to have a greater sense of responsibility toward employee and societal issues; interestingly, employee hope and gratitude did not affect sense of responsibility toward economic and safety/quality issues. These findings offer an extension of research by Giacalone, Paul, and Jurkiewicz.

. Undoubtedly, multinational corporations must play a significant role in the advancement of global ecological ethics. Our research offers a glimpse into the process of how goals of ecological sustainability in one multinational corporation can trickle down through the organization via the sustainability support behaviors of supervisors. We asked the question “How do supervisors in a multinational corporation internalize their corporation’s commitment to ecological sustainability and, in turn, behave in ways that convey this commitment to their subordinates?” In response, we (...) created a theoretical framework for supervisor sustainability support behavior based on Stern et al., Human Ecology Review 6(2), 81-97 (1999) value-belief-norm (VBN) theory. We then tested our framework by performing a survey-based field study of supervisors in a multinational pharmaceutical company that has publicly professed a goal of ecological sustainability. (shrink)

INTRODUCTION Reopening a Discussion The empiricist-derived epistemology that has directed most social and natural scientific inquiry for the last three ...

The concept of “public participation” is currently one of great interest to researchers and policy makers. In response to a perceived need for greater public involvement in decision making and policy formation processes on the part of both policymakers and the general public, a variety of novel mechanisms have been developed, such as the consensus conference and citizens jury, to complement traditional mechanisms, such as the public meeting. However, the relative effectiveness of the various mechanisms is unclear, as efforts at (...) evaluation have been sparse. In this article, the authors describe an evaluation of a two-day “deliberative conference” on the topic of radiation dose assessment. The authors detail the evaluation framework that they adopt and describe the instruments that they have developed to determine the attainment of the evaluationcriteria stipulated in that framework. They then describe the participation exercise that they have evaluated. Finally, they apply the instruments to assess the effectiveness of the exercise, and discuss the results and their implications for the conduct of evaluations and the use of this particular participation mechanism. (shrink)

This essay takes a first step in comparative ethics by looking to Aristotle and the Aztec's conceptions of the good life. It argues that the Aztec conception of a rooted life, neltiliztli, functions for ethical purposes in a way that is like Aristotle's eudaimonia. To develop this claim, it not only shows just in what their conceptions of the good consist, but also in what way the Aztecs conceived of the virtues (in qualli, in yectli).

What is a human person, and what is the relation between a person and his or her body? In her third book on the philosophy of mind, Lynne Rudder Baker investigates what she terms the person/body problem and offers a detailed account of the relation between human persons and their bodies. Baker's argument is based on the 'Constitution View' of persons and bodies, which aims to show what distinguishes persons from all other beings and to show how we can (...) be fully material beings without being identical to our bodies. The Constitution View yields answers to the questions 'What am I most fundamentally?', 'What is a person?', and 'What is the relation between human persons and their bodies'? Baker argues that the complex mental property of first-person perspective enables one to conceive of one's body and mental states as one's own. (shrink)

In “Ethics Consultation in U.S. Hospitals: Opinions of Ethics Practitioners,” Fox and colleagues note that despite efforts of the American Society for Bioethics and Humanities to impr...

There is currently a great debate about whether the holobiont, i.e. a multicellular host and its residential microorganisms, constitutes a biological individual. We propose that resident microorganisms have a general and important role in the individuality of the host organism, not the holobiont. Drawing upon the Equilibrium Model of Immunity, we argue that microorganisms are scaffolds of immune capacities and processes that determine the constituency and persistence of the host organism. A scaffolding perspective accommodates the contingency and heterogeneity of resident (...) microorganisms while accounting for their necessity and unifying contributions to host individuality. In our symbiotic view of life, holobionts may not be organisms or units of selection, but macroorganisms cannot persist nor function as individuals without their scaffolding microorganisms. (shrink)

A curious feature of Aztec philosophy is that the basic metaphysical question of the “Western” tradition cannot be formulated in their language, in Nahuatl. This did not, however, prevent the Aztecs from developing an account of 'reality', or whatever it is that might exist. The article is the first of its kind to compare the work of Aristotle on ousia (being) and the Aztecs on teotl and ometeotl. Through this analysis, it suggests that both of the Nahuatl terms are fundamental (...) for expressing the basic character of reality as process for the Aztecs. It also defends their notion as prima facia reasonable, despite its wide divergence from Aristotle's view. (shrink)

"This book is a comprehensive attack on several of the views that have been most influential in the philosophy of psychology during the last two decades. Professor Baker argues that mentalistic notions should not be eliminated, and need not be explained in terms of other notions, in cognitive science.' The book is interesting and shows an honest concern for clear argumentation. It deserves a wide readership." --Tyler Burge, University of California at Los Angeles"This book is a provocative and relentlessly argued (...) treatment of a deep and important topic: the fate of intentionality. Baker's arguments oblige those who wish to defend the current conception of cognitive science to rethink the discipline. She has put the ball squarely in the physicalists' court. ... Despite the technical character of the topic, the book is wonderfully readable."--John Heil, Visiting Fellow, University of California, BerkeleyThis stimulating book critically examines a wide range of physicalistic conceptions of mind in the works of Jerry A. Fodor, Stephen P. Stich, Paul M. Churchland, Daniel C. Dennett, and others. Part I argues that intentional concepts cannot be reduced to nonintentional (and nonsemantic) concepts; Part II argues that intentional concepts are nevertheless indispensable to our cognitive enterprises and thus need no foundation in physicalism.As a sustained challenge to the prevailing interpretation of cognitive science, this timely book fills a large gap in the philosophical literature. It is sure to spark controversy, yet its clarity makes it attractive as a text in upper-level undergraduate and graduate courses in philosophy of mind and cognitive science. Saving Belief should be read byphilosophers, psychologists, and others interested in the philosophy of language, philosophy of mind, and cognitive science. (shrink)

The discovery of the first intracellular substrate for insulin, IRS‐1, redirected the field of diabetes research and has led to many important advances in our understanding of insulin action. Detailed analysis of IRS‐1 demonstrates structure/function relationships for this modular docking molecule, including mechanisms of substrate recognition and signal propagation. Recent work has also identified other structurally similar molecules, including IRS‐2, the Drosophila protein, DOS, and the Grb2‐binding protein, Gab1, suggesting that this intracellular signalling strategy is conserved evolutionarily and is utilized (...) by an expanding number of receptor systems. In fact, IRS‐1 itself has been shown to be important in other growth factor and cytokine signalling systems, including growth hormone and several interleukins. Analysis of mice lacking IRS‐1 confirms an important physiological role for this protein in glucose metabolism and general cell growth in the intact animal. Disregulation of the signalling pathways integrated by the IRS proteins may contribute to the pathophysiology of non‐insulin‐dependent diabetes mellitus or other diseases. (shrink)

This article describes the innovative job performance strategies used by women who work as guards in men's prisons. It suggests that women guards perform the job differently from men guards not only because women face structural and discriminatory barriers on the job but also because most women bring to the job a set of prior experiences, skills, and abilities different from those of most men. One of the reasons women may fail to receive positive performance evaluations in jobs traditionally held (...) by men is that they are being evaluated on the basis of how well their work behavior matches that of men doing the same work. This article argues that there are multiple ways to perform jobs and that to expect women to perform jobs in the same manner as their male colleagues is a form of gender bias. Women should be judged by how effective they are, not by whether their approaches to work are similar to those of men. (shrink)

Derogatory terms (racist, sexist, ethnic, and homophobic epithets) are bully words with ontological force: they serve to establish and maintain a corrupt social system fuelled by distinctions designed to justify relations of dominance and subordination. No wonder they have occasioned public outcry and legal response. The inferential role analysis developed here helps move us away from thinking of the harms as being located in connotation (representing mere speaker bias) or denotation (holding that the terms fail to refer due to inaccurate (...) descriptive content). The issue is not bad attitudes or referential misfires. An inferential role semantic analysis of derogatory terms shows exactly what is at stake between those who argue that the terms should be eliminated (Absolutists) and those who claim they can be successfully rehabilitated (Reclaimers). The Reclaimer maintains, and the Absolutist denies, that certain contexts can detach the derogatory force from deeply derogatory terms. The article looks at these claims with respect to ‘nigger’ and ‘dyke,’ setting out the inferential role of each term and examining detachability potential. Explaining detachability in terms of linguistic commitments, this article also addresses the issue of whether such terms count as political discourse, and examines the implications of that issue. (shrink)

Within emotion-focused therapy, the client’s ability to express and reflect on core emotional experiences is seen as fundamental to constructing the self and to entering into a change process. For this study, we 1) examine storytelling contexts in which clients do not disclose the emotional impact of their narrative, and 2) identify the interactional practices through which EFT therapists subsequently call attention to what the client may have felt. In doing so, we examine client stories drawn from video-taped individual psychotherapy (...) sessions involving clinically depressed clients. Client stories and therapists’ responses to these stories were analysed using conversation analytic methods. Three different therapist response types were identified: eliciting, naming and illustrating the emotional impact of the client’s prior narrative. These responses also were found to differ in terms of how effectively they could display empathy and secure affiliation with clients. The implications of this work for therapeutic practice are discussed. (shrink)

My aim is twofold: first, to root out the metaphysical assumptions that generate the problem of mental causation and to show that they preclude its solution; second, to dissolve the problem of mental causation by motivating rejection of one of the metaphysical assumptions that give rise to it. There are three features of this metaphysical background picture that are important for our purposes. The first concerns the nature of reality: all reality depends on physical reality, where physical reality consists of (...) a network of events.1 The second concerns the nature of causation, and the third concerns the conception of behavior. I try to vindicate a robust idea of mental causation. (shrink)

Applying a medical conception of toxicity to speech practices, this paper calls for an epidemiology of discursive toxicity. Toxicity highlights the mechanisms by which speech acts and discursive practices can inflict harm, making sense of claims about harms arising from speech devoid of slurs, epithets, or a narrower class I call ‘deeply derogatory terms.’ Further, it highlights the role of uptake and susceptibility, and so suggests a framework for thinking about damage variation. Toxic effects vary depending on one’s epistemic position, (...) access, and authority. An inferentialist account of discursive practice plus a dynamic view of the power of language games offers tools to analyze the toxic power of speech acts. A simple account of language games helps track changes in our discursive practices. Identifying patterns contributes to an epidemiology of toxic speech, which might include tracking increasing use of derogatory terms, us/them dichotomization, terms of isolation, new essentialisms, and more. Using this framework, I analyze some examples of speech already said to be toxic, working with a rough concept of toxicity as poison. Finally, exploring discursive toxicity pushes us to find ways that certain discursive practices might “inoculate” one to absorbing toxic messages, or less metaphorically, block one’s capacity to make toxic inferences, take deontic stances that foster toxicity, etc. (shrink)

The very rules of our language games contain mechanisms of disregard. Philosophy of language tends to treat speakers as peers with equal discursive authority, but this is rare in real, lived speech situations. This paper explores the mechanisms of discursive inclusion and exclusion governing our speech practices, with a special focus on the role of gender attribution in undermining women’s authority as speakers. Taking seriously the metaphor of language games, we must ask who gets in the game and whose moves (...) can score. To do this, I develop an eclectic analysis of language games using basic inferential role theory and the concept of a semantic index, and develop the distinction between positional authority and expertise authority, which often conflict for members of oppressed groups. Introducing the concepts of master switches and sub-switches that attach to the index and change scorekeeping practices, I argue that women’s gender status conflicts with our status as authoritative speakers because sex marking in semantics functions as a master switch—“the F-switch”—on the semantic index, which, once thrown, changes the very game. An advantage of using inferentialism for understanding disregard of women’s discursive authority is that it locates the problem in the sanctioned moves, in the deontic structure of norms and practices of scorekeeping, and not primarily in the individual intentions of particular people. (shrink)

Lynne Rudder Baker presents and defends a unique account of the material world: the Constitution View. In contrast to leading metaphysical views that take everyday things to be either non-existent or reducible to micro-objects, the Constitution View construes familiar things as irreducible parts of reality. Although they are ultimately constituted by microphysical particles, everyday objects are neither identical to, nor reducible to, the aggregates of microphysical particles that constitute them. The result is genuine ontological diversity: people, bacteria, donkeys, mountains (...) and microscopes are fundamentally different kinds of things - all constituted by, but not identical to, aggregates of particles. Baker supports her account with discussions of non-reductive causation, vagueness, mereology, artefacts, three-dimensionalism, ontological novelty, ontological levels and emergence. The upshot is a unified ontological theory of the entire material world that irreducibly contains people, as well as non-human living things and inanimate objects. (shrink)

BackgroundFidelity of implementation reflects whether an intervention was implemented in clinical practice according to the originally developed manual and is a key aspect in understanding intervention effectiveness. To illustrate this process of developing a fidelity measure, this study uses the Mini-AFTERc, a brief psychological intervention aimed at managing breast cancer patients’ fear of cancer recurrence, as an example.ObjectivesTo illustrate the development of an FOI measure through applying this process to the Mini-AFTERc intervention, by including the design of a scoring system (...) and rating criteria; content validating the FOI measure using thematic framework analysis as a qualitative approach; testing consistency of the FOI measure using interrater reliability.MethodsThe FOI measure was developed, its scoring system modified and the rating criteria defined. Thematic framework analysis was conducted to content validate the FOI measure using nine intervention discussions between four specialist cancer nurses and four breast cancer patients, and one simulated breast cancer patient. Intraclass-correlation was conducted to assess interrater reliability.ResultsThe qualitative findings suggested that the Mini-AFTERc FOI measure has content validity as it was able to measure all five components of the Mini-AFTERc intervention. The interrater reliability suggested a moderate to excellent degree of reliability among three raters, rICC = 0.84, 95% CI [0.51, 0.96].ConclusionThe study has illustrated the steps that an FOI measure can be developed through a systematic approach applied to the Mini-AFTERc intervention. The FOI measure was found to have content validity and was consistently applied, independently, by three researchers familiar with the Mini-AFTERc intervention. Future studies should determine whether similar levels of interrater reliability can be obtained by distributing written and/or video instructions to researchers who are unfamiliar with the FOI measure, using a larger sample. Employing developed and validated FOI measures such as the one presented for the Mini-AFTERc would facilitate implementation of interventions in the FCR field in clinical practice as intended.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT03763825. (shrink)

This special volume of Health Care Analysis is dedicated to a consideration of the status of body parts and products and the roleof law in regulating them. We argue that such a discussion is timely giventhe conflation of technological and academic concerns posed by thecomplex legal framework within which these issues are currentlyaddressed and in the light of debates such as those regardingthe storage of children's organs addressed by inquiries atAlder Hay and Bristol, United Kingdom. The contributors addressspecific legal problems (...) which have been brought before the courts in the UK and other jurisdictions, something which wesuggest is likely to occur with increasing regularity oncethe Human Rights Act 1998 comes into force in October 2000.The issues are also considered on a more theoretical level with papers exploring the role of concepts such as property, donation, commodification and kinship in these debates.While the volume focuses principally upon the manner inwhich these issues have arisen in a UK context, though withreference to certain comparative examples, the concepts discussed here are of more general application acrossother jurisdictions. (shrink)

Toxic speech inflicts individual and group harm, damaging the social fabric upon which we all depend. To understand and combat the harms of toxic speech, philosophers can learn from epidemiology, while epidemiologists can benefit from lessons of philosophy of language. In medicine and public health, research into remedies for toxins pushes in two directions: individual protections (personal actions, avoidances, preventive or reparative tonics) and collective action (specific policies or widespread “inoculations” through which we seek herd immunity). This paper is the (...) beginning of a project of identifying potential inoculations and antidotes to toxic speech. The essay brings a social practice theory of language, with special reliance on language‐games and inferential roles, into conversation with concepts from the study of biologic toxins. Some speech harms are acute while others are chronic and insidious; they have different methods of delivery, come in variable doses, and not everyone is equally susceptible to the power to harm. I argue that of the many kinds of challenges we might issue against toxic speech, challenging its expressive commitments has the greatest potential to stop the damage. The essay explores the different sorts of protections that inoculations and antidotes might offer against discursive toxins and sketches how to imagine these in the practices that govern our speech. The paper does not make policy recommendations, but an epidemiology of discursive toxicity reveals several kinds of “more speech” that might fight against “bad speech.”. (shrink)