Historians of medicine generally credit the hospital standardization movement of the early 20th century with establishing the record as a sign of hospital and staff quality. The medical record's role had already been the subject of intense interest at the New York Hospital several decades before, however. In the 1880s malpractice and insurance concerns caused the administration to attempt to supervise record creation, quality, and access, over the objections of physicians. Contemporary concerns about the uses of the medical record were (...) in play well before 1910. (shrink)

Medical records contain important clues about the history of medicine. These documents, which ostensibly describe the course of a patient's illness, are “unique constructions that allow us to observe the social and technical structure of contemporary healing.” As such, the 21st-century hospital medical record reflects the many components of inpatient care: medical interventions, billing, legal documentation, research, and education. It is comprised of a wide array of elements: professionals' notes; vital signs and other descriptive information; laboratory data and test results; (...) demographic information; orders, charges, diagnostic and treatment codes; and other utilization data. It is well understood that many people share and need this information. Current controversies over records involve not control, but computerization, security, and accessibility. Although health professionals offer input, decisions about hospital medical records have been considered largely an administrative responsibility. (shrink)

At the beginning of 2020, COVID-19 became a global problem. Despite all the efforts to emphasize the relevance of preventive measures, not everyone adhered to them. Thus, learning more about the characteristics determining attitudinal and behavioral responses to the pandemic is crucial to improving future interventions. In this study, we applied machine learning on the multi-national data collected by the International Collaboration on the Social and Moral Psychology of COVID-19 (N = 51,404) to test the predictive efficacy of constructs from (...) social, moral, cognitive, and personality psychology, as well as socio-demographic factors, in the attitudinal and behavioral responses to the pandemic. The results point to several valuable insights. Internalized moral identity provided the most consistent predictive contribution—individuals perceiving moral traits as central to their self-concept reported higher adherence to preventive measures. Similar was found for morality as cooperation, symbolized moral identity, self-control, open-mindedness, collective narcissism, while the inverse relationship was evident for the endorsement of conspiracy theories. However, we also found a non-negligible variability in the explained variance and predictive contributions with respect to macro-level factors such as the pandemic stage or cultural region. Overall, the results underscore the importance of morality-related and contextual factors in understanding adherence to public health recommendations during the pandemic. (shrink)

The mapping of therapeutic collaboration throughout counseling deepens our understanding of how the helping relationship fosters client change. To better understand the process of career construction counseling, we analyzed the therapeutic collaboration on six successful face-to-face cases. The participants were six Portuguese adults, five women and one man, real clients of a career counseling service, and four psychologists, three female and one male trained in the career intervention model. The participants completed demographic questions and measures of career certainty, vocational identity, (...) career indecision, and psychological functioning. The Therapeutic Collaboration Coding System was used to track collaboration throughout all interactive episodes. The clinical significance of the intervention was calculated by analyzing pre-post-test statistical differences for each case, with the Reliable Change Index and Z score. The findings evidenced a pattern of therapeutic collaboration evolution for good outcome cases. Based on this pattern, we propose a model of process-outcome evolution for the three phases of CCC. (shrink)

Nous nous référerons dans cet article à la mémoire de l’homme, incarné et historique, déterminé par les médiations spatio-temporelles et exposé aux dilemmes éthiques que doit affronter l’ipséité dans sa capacité d’accueillir l’autre telle que la définit Ricœur. Notre réflexion vise la mémoire inquiétée par des médiations propres à la condition existentielle et corporelle du soi moderne, dans un contexte d’ébullition culturelle et technologique. Un tel contexte a en effet des conséquences qui affectent aussi bien l’identité personnelle et collective, que (...) l’exercice des capacités du soi agissant et souffrant – et tout spécialement celui de sa mémoire. Nous examinerons la dimension tant réceptive que dynamique de la mémoire exposée aux fragilisations qui affectent l’identité narrative humaine, en déterminant ses pouvoirs qui laissent des traces au niveau de la conscience et du corps. Nous terminerons enfin notre réflexion par une analyse des effets volontaires et involontaires qui mettent en question la capacité même de la mémoire, en influant sur l’imagination et sur la réponse éthique du soi. (shrink)

Le dispositif des groupes multifamiliaux favorise l’expression et l’élabora-tion des conflits psychiques chez chaque participant, notamment à partir d’une approche originale dite « de confrontation intergénérationnelle ». À travers le cas de trois adolescentes enclines aux actings et aux manifestations comportementales, les auteurs montrent comment ces groupes thérapeutiques conduisent non seulement à l’élaboration de conflits réels intersubjectifs entre les adolescents et leurs parents tels qu’ils se les présentent dans la réalité, mais aussi au renforcement de leur activité fantasmatique et in (...) fine au réaménagement des liens intergénérationnels. (shrink)

À Santiago deux femmes s’affrontent. La procédure du délit d’injures nécessite, dans cette société orale de la première moitié du xviiie siècle, l’exposé de questions sensibles qui concernent, dans ce cas particulier, les identités féminines. Croisées par de multiples variables, dont l’ethnie est l’une des plus importantes, ces identités de femmes s’expriment dans des lieux sociaux plus ou moins contestés : la fragilité de ces identités s’observe dans l’expression de la violence privée et dans les discours juridiques. Réfléchir sur la (...) manière d’appréhender et de vivre les possibilités d’être femme dans une des villes de l’Amérique hispanique est un des objectifs de cette analyse. L’autre, montre comment les discours sur le métissage et les valeurs qu’ils portent s’incarnent dans les sujets au niveau des conflits mineurs, quotidiens, jusqu’à faire basculer, à travers la parole et l’opinion sur autrui, des parcours individuels. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Refusals of Treatment and Requests for DeathTom L. Beauchamp (bio)It would be hard to overestimate the importance of two decisions on physician-assisted suicide delivered recently by the Ninth and Second Circuit Courts (Compassion in Dying v. State of Washington, 79 F.3d 790 (9th Cir. 1996) (en banc), aff’g 850 F.Supp. 1454 (W.D. Wash. 1994), rev’g 49 F.3d 586 (9th Cir. 1995); Quill v. Vacco, 80 F.3d 716 (2nd Cir. (...) 1996). They are the highest courts yet to render an opinion on this subject, and their decisions have set the stage for the U.S. Supreme Court to take one of two paths: It will either say that (1) all citizens have a liberty interest in physician-assisted suicide, or that (2) each state may set its own policy on such matters. Whichever path is elected, a right to request physician-assisted suicide is a virtual certainty, at least in some states.These opinions are later segments of an evolving legal history in which courts have held that no criminal liability exists for withholding or withdrawing a life-sustaining treatment when physicians are directed to do so by a patient or an authorized surrogate (see Alan Meisel 1992). The decriminalization of suicide and the right to refuse a life-sustaining treatment now appear to be evolving into a rule that a patient has a legal right to control his or her death, or at least to obtain a lethal prescription. We are at a delicate point in this evolving history. Neither in law nor in bioethics is the justification of physician assistance in suicide the received opinion at the present time, but support for physician assistance in dying could soon become the received opinion in both disciplines.The leading edge of the wedge producing these changes has been widespread acceptance of an extensive right to refuse treatment. This right is today axiomatic in even conservative quarters of bioethics, but 20 years ago it was far from axiomatic that all patients have a right to refuse treatment. Few at that time judged that it would be both immoral and illegal for a physician not to forgo treatment in the face of a competent, authoritative refusal of any form of medical service or treatment.The justification for assistance in bringing about death in medicine is an extension of the justification for letting patients die. Letting a patient die by accepting a valid refusal to continue in life is directly analogous to helping a patient die by accepting a valid request for help. The high value we place on [End Page 371] rights of autonomy thereby spills over from the right to refuse to the underexplored right to request active assistance. 1 As the autonomy interest in this choice increases, denial of help to the patient becomes more burdensome.Those who defend the view that euthanasia and physician-assisted suicide are morally prohibited typically assume that assistance involves an act of killing, that acts of killing are impermissible, and that a defensible distinction exists between killing and letting die. However, this distinction has proved difficult to explicate, and the category of killing often seems distant from the problem at hand. For example, it is an eccentric view that a physician who prescribes a lethal medication to a patient thereby kills the patient (or, for that matter, lets the patient die) when the patient voluntarily ingests the medication and dies. So poor are the conceptual understandings of “killing” and “letting die” that conceptual confusion abounds as to which term to use in almost all morally difficult and controversial cases.A common view is that “letting die” is a matter of “ceasing useless treatments” after which patients die (Gaylin, Kass, Pellegrino, and Siegler 1988). This account is attractive, but too narrow. “Letting die” occurs in medicine under at least two circumstances: cessation of treatment because it is useless and cessation of treatment because it has been refused (which can occur even with useful treatments). Neither conceptually nor morally is “ceasing useless treatment” the proper way to state the condition under which many “letting-die” cases occur. It follows that the type of action—killing or letting... (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

In this paper we ask whether the two-factor theory of delusions is compatible with two claims, that delusions are pathological and that delusions are adaptive. We concentrate on two recent and influential models of the two-factor theory: the one proposed by Max Coltheart, Peter Menzies and John Sutton (2010) and the one developed by Ryan McKay (2012). The models converge on the nature of Factor 1 but diverge about the nature of Factor 2. The differences between the two models are (...) reflected in different accounts of the pathological and adaptive nature of delusions. We will explore such differences, considering naturalist and normativist accounts of the pathological and focusing on judgements of adaptiveness that are informed by the shear-pin hypothesis (McKay and Dennett 2009). After reaching our conclusions about the two models, we draw more general implications for the status of delusions within two-factor theories. Are there good grounds to claim that delusions are pathological? Are delusions ever adaptive? Can delusions be at the same time pathological and adaptive? (shrink)

El debate como método para mejorar la expresión y comprensión oral en Educación Primaria se está viendo reforzado por las últimas legislaciones educativas, como la LOMLOE, que da muchísima importancia al desarrollo de competencias y habilidades. En este proyecto de intervención educativa se pretende despertar el interés de los alumnos por nuevos temas de debate, incrementando su capacidad de razonamiento y análisis, habituándolos a recibir críticas y desarrollando aptitudes comunicativas. Se realizará a lo largo de un curso escolar, dividiendo tres (...) fases (acercamiento, profundización y liga de debates), que ayudará al profesorado a mejorar la competencia comunicativa de sus alumnos. (shrink)

Gustave Le Gray was one of the most technically accomplished and aesthetically enlightened of the early "artist-photographers." Trained as a painter of portraits and landscapes, Le Gray was attracted in the 1840s to the artistic potential of photographic processes. As a photographer he evolved and refined much of photography's primary aesthetic theory. By 1855 he had influenced, if not taught, every important photographer in France. Drawing on entirely new material Eugenia Parry Janis fully analyzes the life and work of (...) Le Gray and demonstrates the originality of his artistic achievement in the context of discoveries about his personal and professional history. Janis, approaching the photographs of Le Gray with the methods and sensibilities of an art historian, reveals telling connections between Le Gray's choices of subject matter and formal means of presentation and the existing pictorial practice of other media such as painting. This same approach makes her sensitive to Le Gray's departures from such traditional practice, and she skillfully illustrates how he evolved from student painter into master photographer. In doing so she gives us a glimpse of the way in which Le Gray's manipulation of the photographic process was always informed by his pictorial needs and by his developing style. (shrink)

This paper outlines a theory and computer implementation of causal meanings and reasoning. The meanings depend on possibilities, and there are four weak causal relations: A causes B, A prevents B, A allows B, and A allows not‐B, and two stronger relations of cause and prevention. Thus, A causes B corresponds to three possibilities: A and B, not‐A and B, and not‐A and not‐B, with the temporal constraint that B does not precede A; and the stronger relation conveys only the (...) first and last of these possibilities. Individuals represent these relations in mental models of what is true in the various possibilities. The theory predicts a number of phenomena, and, contrary to many accounts, it implies that the meaning of causation is not probabilistic, differs from the meaning of enabling conditions, and does not depend on causal powers or mechanisms. The theory also implies that causal deductions do not depend on schemas or rules. (shrink)

In the present paper, we substantiate the theory according to which the ailments of imagination presented by Immanuel Kant, especially in his work Anthropology from a Pragmatic Point of View, are sources of artistic creation. It is obvious that not anyone suffering from melancholia, nostalgia, hypochondria or any other ailment of the soul, which Immanuel Kant refers to, becomes a creator of culture. Genius is required for this, but instead of diminishing the creative power of the genius, it seems to (...) be enhanced by the ailments of imagination or generally, by the ailments of the soul. The hypertrophic imagination in the case of a genius plays a major role in the process of fixation in the individual and collective memory of what Immanuel Kant names. (shrink)

Among the meritorious attempts to unravel the enigma of artistic creation are the views of Immanuel Kant and Arthur Schopenhauer. In the following, we want to emphasise an aspect that is less discussed in the specialised literature, namely the relation between memory and creation. We are talking about the authentic creation that Kant and Schopenhauer consider to be the one that carries in itself the Aesthetic Ideas. With minor differences, the concept, as well as the associated linguistic expression, come together (...) in the work of both German philosophers. An authentic work of art is the work of genius and it has the role of transmitting Ideas. Thus, we will be able to observe “the secret” of a work of art – the Aesthetic Idea. (shrink)

Delusions are usually considered as harmful and dysfunctional beliefs, one of the primary symptoms of a psychiatric illness and the mark of madness in popular culture. However, in recent times a much more positive role has been advocated for delusions. More specifically, it has been argued that delusions might be an answer to a problem rather than problems in themselves. By delivering psychological and epistemic benefits, delusions would allow people who face severe biological or psychological difficulties to survive in their (...) environment - although this has obvious epistemic costs, as the delusion is fixed and irresponsive to compelling counterevidence. In other words, it has been argued that delusions are biologically adaptive. The adaptiveness of delusions has been compared by Ryan McKay and Daniel Dennett to a shear pin, a mechanism installed in the drive engine of some machines which is designed to shear whenever the machine is about to break down. By breaking, shear pins prevent the machine from collapsing and allow it to keep functioning, although in an impaired manner. Similarly, when delusions form, they would allow a cognitive or psychological system which is about to collapse to continue its functioning, although in an impaired manner. However, this optimistic picture of delusions risks being undermined by both theoretical and empirical considerations. Using Sarah Fineberg and Philip Corlett’s recent predictive coding account as a paradigmatic model of the biological adaptiveness of delusions, I develop two objections to it: principles of parsimony and simplicity suggest that maladaptive models of delusions have an upper hand over adaptive models; and the available empirical evidence suggests that at least some delusions stand good chances of being psychologically adaptive, but it is unlikely that they also qualify as biologically adaptive. (shrink)

Delusions are symptoms of psychiatric disorders such as schizophrenia and dementia. By and large, delusions are characterized by their behavioral manifestations and defined as irrational beliefs that compromise good functioning. In this overview paper, we ask whether delusions can be adaptive notwithstanding their negative features. Can they be a response to a crisis rather than the source of the crisis? Can they be the beginning of a solution rather than the problem? Some of the psychological, psychiatric, and philosophical literature has (...) recently suggested that they can. We consider different types of delusions and different ways in which they can be considered as adaptive: psychologically (e.g., by increasing wellbeing, purpose in life, intrapsychic coherence, or good functioning) and biologically (e.g., by enhancing genetic fitness). Although further research is needed to map the costs and benefits of adopting and maintaining delusional beliefs, a more nuanced picture of the role of delusions in people's lives has started to emerge. (shrink)

Bioethics, Volume 36, Issue 5, Page 486-493, June 2022.

En el contexto de cambios del proceso de globalización, la medicalización constituye una problemática central en la agenda de salud internacional. Durante la década de 1990, comenzó la expansión internacional del diagnóstico de trastorno por déficit de atención e hiperactividad (TDAH), entre otros factores, merced a la creciente relevancia de actores no médicos en el proceso y de legislaciones específicas para diferentes diagnósticos. El artículo busca contribuir a un análisis del espacio que le otorga la prensa escrita on line a (...) los procesos de medicalización del TDAH en Argentina en el siglo XXI, como aporte a una lectura panorámica de los procesos en la región y a nivel internacional, y como contribución a un área de vacancia en los estudios sociales. Para este artículo, analizamos 236 artículos on line de periódicos argentinos de alcance nacional y provincial entre 2001 y 2017. Para el relevamiento se diseñaron mecanismos de selección y filtro, con criterios y herramientas de búsqueda y procesamiento de noticias. Se efectuaron estimaciones de regularidad de tópicos emergentes y procesamientos parciales de información, incluyendo, entre otras dimensiones, año, jurisdicción, medio, fecha, sección, título, categoría, características de la nota, palabras clave, concepto o nombre del problema, fármaco/droga, tratamiento, actores sociales y recomendaciones. Con el artículo nos interesa engrosar los todavía escasos estudios que aportan a la comprensión de cómo el diagnóstico de TDAH está migrando a diferentes regiones del globo y, más específicamente, cómo está posicionándose como un problema de salud internacional. Los resultados muestran que, en los procesos de medicalización del TDAH en niños y niñas, la prensa escrita argentina (nacional y provincial) se constituye en un actor no médico relevante tanto en la institucionalización de la problemática como en la presentación de líneas terapéuticas a seguir y en acciones orientadas al impulso de legislaciones específicas. (shrink)

Resumen: En el presente ensayo nos apoyaremos en algunos escritos fundamentales de Talcott Parsons, especialmente en lo referente a su disputa epistemológica contra el empirismo, para luego mostrar sus propias inconsistencias e ir más allá de él en la propuesta de una forma novedosa de trabajo teórico para las ciencias sociales: la teorización sistemática dinámico-estructuralista, como distinta a la teoría sistémica funcional-estructural. La idea principal es trascender las posturas representacionalistas y antiteoricistas en pos de miradas teóricas abiertas a la crítica (...) y la autocrítica. Así, frente a una mirada que confunde distintas dimensiones del continuo empírico-metafísico sin otorgarles su relativa autonomía analítica, que a nivel teórico-social y de modelos de la sociedad piensa en términos funcionales y sistémicos, que considera que cada uno de sus conceptos refiere de manera cabal a dicho mundo social y que cree que es factible la construcción de teorías acabadas, nuestra mirada busca distinguir dimensiones, complementar tradiciones plurales, y mantenerse siempre abierta a la crítica externa y la autocrítica.: In this essay we will rely on some of the key writings of Talcott Parsons, especially with regards to his epistemological dispute against empiricism, to show his own inconsistencies and go beyond him in proposing a new form of theoretical work for the social sciences: systematic and dynamic-structuralist theorizing, as distinct from functional-structural systemic theory. The main idea is to transcend the representationalist and anti-theoretical positions in favour of a view of theory open to criticism and self-criticism. In this way, and against those outlooks that confuse the different dimensions of the empirical-metaphysical continuum without giving them their relative analytic autonomy, that think in terms of functions and systems when talking about models of society, that consider each concept to be a representation of the social world, and that believe theories can be closed for good, our own outlook seeks to distinguish dimensions, complement plural traditions, and stay open to external critique and self-criticism. (shrink)

Abstract. The article is devoted to the possibilities of the formation and development of engineering thinking. The paper considers the features of engineering thinking, compares various concepts that characterize engineering activities. The authors compare the concepts of technical, economic, research thinking, identifying the principles of engineering thinking. The need for a humanitarian component in engineering thinking is noted. Consistency and multidimensionality are considered by the authors as the most important concepts for the formation of engineering thinking. In conclusion, the authors (...) point out that engineering thinking universally orients the employee when solving different types of tasks and contributes to greater variability in making standard and non-standard decisions in the production process. -/- . (shrink)

The sociocultural landscape of contemporaneity can be represented as a porous inhomogeneous space consisting of border zones. These zones, understood by P. Galison as “local coordination of beliefs and actions,” can be deployed due to already existing conditions, for example, a project may arise at a university. However, such zones do not create sustainable social configurations and infrastructures associated with new areas of knowledge. In this article, we expand the concept of trading zones and call them zones requiring local ontologies (...) that arise on the border between different knowledge and imagination systems and, in turn, require their own infrastructure. This approach supports the view on humanities not as “pre-packaged” knowledge, but as special “technique” forming local ontologies. For a humanities-as-technique to emerge, it is necessary that two or more systems of knowledge coincide in time and form an intermediate zone, on the basis of which some local ontology can unfold. Thus, for example, when combining contemporary philosophy and contemporary mathematics, new images of knowledge emerge. Humanities-as-technique are considered as the basis for the establishment of trading zones, which are understood as local ontologies. We also propose a system of concepts that can be used to describe and construct these trading zones on the territory of the humanities in a techno-oriented cultural environment. (shrink)

Sem pretender esgotar o tema, este trabalho visa refletir sobre o conceito de Modernidade aqui entendida como a construção de uma perspectiva ou projeto de futuro. O ponto de partida são as reflexões teóricas de Jurgen Habermas e nesse sentido pretende ser uma contribuição para a elaboração de uma noção emancipatória de Modernidade podendo também servir como contribuição para o debate entorno dos rumos de uma reconstrução do país também emancipadora.

O objetivo deste trabalho é o de examinar processos de exclusão e expulsão que vem se ampliando nos diversos aspectos da vida sob as condições atuais do neoliberalismo e como se manifesta na ocupação/desocupação do território, no papel da informação nesse processo e como as alterações das condições tanto da ocupação da terra quanto de produção e uso da informação impostas podem resultar na expulsão de moradores e na exclusão de usuários. Este trabalho também aponta possibilidades de surgimento de condições (...) alternativas por meio da construção de contraracionalidades na constituição de uma esfera pública política e democrática. Elaborei 7 Notas. (shrink)