Background Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. Method We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other key (...) informants. A thematic analysis was conducted. Results Our analysis identified four interrelated themes surrounding participants’ ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. Conclusions Participant’s agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors. (shrink)

This is my response to a book, Globalize Liberation, edited by David Solnit and published in 2004. Media activists James John Bell and Patrick Reinsborough sent me a copy and asked for my thoughts about it; the result turned into an essay of some length, which got a certain amount of exposure and discussion online. Looking at the travails of progressive activism since its publication, I find very little that needs revision, except the tone of relative optimism expressed toward the (...) end. (shrink)

Although death by neurologic criteria is legally recognized throughout the United States, state laws and clinical practice vary concerning three key issues: the medical standards used to determine death by neurologic criteria, management of family objections before determination of death by neurologic criteria, and management of religious objections to declaration of death by neurologic criteria. The American Academy of Neurology and other medical stakeholder organizations involved in the determination of death by neurologic criteria have undertaken concerted action to address variation (...) in clinical practice in order to ensure the integrity of brain death determination. To complement this effort, state policymakers must revise legislation on the use of neurologic criteria to declare death. We review the legal history and current laws regarding neurologic criteria to declare death and offer proposed revisions to the Uniform Determination of Death Act and the rationale for these recommendations. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Figures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism ed. by Christopher N. Gamble and Joshua S. HananSavannah Greer DowningFigures of Entanglement: Diffractive Readings of Barad, New Materialism, and Rhetorical Theory and Criticism. Edited by Christopher N. Gamble and Joshua S. Hanan. Routledge, 2021. xvi + 122 pp. $168 (hardcover), $47.16 (electronic book). ISBN: 9780367903794.Rhetorical scholars have turned to various new materialist (...) frameworks to shift the discipline's historically anthropocentric focus and fully engage matter's rhetoricity. While all such frameworks attempt to challenge "the anthropocentric assumption that nonhuman matter is intrinsically passive or non-agential and thus external to or separable from (human) meaning," Figures of Entanglement enters this burgeoning conversation by centering the unique contributions of Karen Barad (xi, x). Readers may recognize this collection from a 2016 special issue of Review of Communication. Yet, with a new foreword by editors Christopher N. Gamble and Joshua S. Hanan and an afterword by Laurie Gries, this collection makes Barad's distinct approach to matter's rhetoricity even more apparent, underscoring its fruitful potential for new materialist rhetorics invested in ethical, political transformation.In the book's foreword Gamble and Hanan differentiate Barad's per-formative new materialism from "vital" as well as what they refer to as "negative" new materialisms to show the generative potential of Barad's framework and the notion of entanglement (x). Other new materialisms tend to be "inclusionary"—add matter and stir—and fail to complicate "the human" itself and its differences (xiv, xi). First, vital and negative new materialisms maintain a distinction between being and knowing, allowing humans to emerge with a unique capacity to "objectively observe and know the existence of something essential, determinate, and unchanging about [End Page 395] reality that precedes and remains unaffected by both its own activities and our observations of it" (xi). On the contrary, Barad's performative approach suggests that "no aspect of reality—including human thought, meaning, and observation—is in any sense external to matter or ever remains entirely unchanged by matter's ongoing performances" (x). Here, humans are not "outside" of observation, but all observation "human or otherwise" co-constitutes what is observed (xi). Second, failing to interrogate "the human" in an attempt to observe matter's vitality is an ethical flaw that makes other approaches less capable of grappling with difference: they have been charged with "erasing associations between race, gender, and matter" and (re)producing a homogenizing, "Western-colonialist notion of humanness" (xiv). In contrast, Barad's is a "thoroughly relational," performative new materialism (1).Barad's concept of "entanglement" draws attention to the indeterminacy of matter and meaning, but it is accompanied by an ethical imperative to examine how difference, human or otherwise, is produced and the implications of power imbalances that arise through these enactments. For Barad, the notion of entanglement does not dissolve difference; difference is what matters. Indeed, they give us a way of thinking about how performative intra-actions produce difference through material-discursive practices, or apparatuses—differences that may be expected but are not inevitable. Rhetorical scholars are therefore invited to interrogate the production of boundaries that cause harm and reconfigure them, rather than assume the discreteness of boundaries from the start. Gamble and Hanan thus make a convincing case for how Barad's work may contribute to important scholarship in decolonial and critical rhetorics for which vital and negative new materialisms are less equipped.Gamble and Hanan utilize the introduction to show how Barad's per-formative new materialism both "supports and affirms" rhetorical materialism, or rhetoric's materiality, and enriches it (5). Ushered in by Michael Calvin McGee, "standard" rhetorical materialism worked to challenge the centuries-old debate about rhetoric's secondary, supplementary status vis-à-vis philosophy by recognizing rhetoric as part of a "shifting and dynamic material history" (6). Building upon this view, Ronald Walter Greene utilizes Foucault's notion of the apparatus to demonstrate how even the "material history" McGee called our attention to is itself "produced by apparatuses"—history is not "outside" of meaning (6). Instead, rhetoric's materiality is a "publicity effect" produced through technologies of rhetoric and intersecting power... (shrink)

Over and above the probable peaking of worldwide oil production as a current reality, the arrival of hard limits on all energy resources is very much nearer in the future than many people realize. The public discourse on Peak Oil and the associated arrival of hard limitson energy availability has attracted more than its share of brilliant and creative minds. In addition to scientific and technical analysts, thisgroup includes a fair number of generalists who have engaged in broader forms of (...) reflection upon the likely economic, social, political, and cultural effects of Peak Oil and other hard energy limits on the structure of current world civilization. In this paper, I select for examination three such generalists who are both especially talented and widely read by those having an interest in this topic: James Howard Kunstler, John Michael Greer, and Dmitri Orlov. My intention is to survey their central ideas in turn, with a view to forming a reasonably well-developed and concrete notion as to how the impending arrival of hard limits on energy consumption will affect the structure of built space in coming decades. I focus both on the macro-infrastructural level and on what one might term the micro-infrastructural level of the built space within which the denizens of contemporary industrial civilization live their daily lives. Theprincipal focus of the discussion will be on the situation in the United States, though many of the lines of argument presented may be applied much more broadly if suitably adjusted in light of locally prevailing conditions elsewhere. (shrink)

Whole genome sequencing is quickly becoming more affordable and accessible, with the prospect of personal genome sequencing for under $1,000 now widely said to be in sight. The ethical issues raised by the use of this technology in the research context have received some significant attention, but little has been written on its use in the clinical context, and most of this analysis has been futuristic forecasting. This is problematic, given the speed with which whole genome sequencing technology is likely (...) to be incorporated into clinical care. This paper explores one particular subset of these issues: the implications of adopting this technology in the prenatal context without a good understanding of when and how it is useful. Prenatal whole genome sequencing differs from current prenatal genetic testing practice in a number of ethically relevant ways. Most notably, whole genome sequencing would radically increase the volume and scope of available prenatal genetic data. The wealth of new data could enhance reproductive decision‐making, promoting parents' freedom to make well‐informed reproductive decisions. We argue, however, that there is potential for prenatal whole genome sequencing to alter clinical practice in undesirable ways, especially in the short term. We are concerned that the technology could (1) change the norms and expectations of pregnancy in ways that complicate parental autonomy and informed decision‐making, (2) exacerbate the deleterious role that genetic determinism plays in child rearing, and (3) undermine children's future autonomy by removing the option of not knowing their genetic information without appropriate justification. (shrink)

According to the received account of guilt in the philosophical literature, one cannot feel guilt unless one takes oneself to have done something morally wrong. But ordinary people feel guilt in many cases in which they do not take themselves to have done anything morally wrong. In this paper, I focus on one kind of guilt without perceived wrongdoing, guilt about being merely causally responsible for a bad state-of-affairs. I go on to present a novel account of guilt that explains (...) guilt about mere causal responsibility, according to which guilt represents part of the self as bound up with what is bad. (shrink)

What is the relation between small-scale collaborative plans and the execution of those plans within interactive contexts? I argue here that joint attention has a key role in explaining how shared plans and shared intentions are executed in interactive contexts. Within singular action, attention plays the functional role of enabling intentional action to be guided by a prior intention. Within interactive joint action, it is joint attention, I argue, that plays a similar functional role of enabling the agents to act (...) in a collaborative way such that their actions are rationally guided by a prior shared intention. This understanding of joint attention – as having a key functional role of enabling the rational guidance of joint intentional action by a prior shared intention – allows for an alternative understanding of the kind of minimal cooperation that infants can engage in. On this understanding, infants’ capacity to engage in joint actions is already an incipient capacity to engage in rational and intentional joint actions, albeit a capacity that is necessarily scaffolded by an adult rational co-partner. (shrink)

This article unravels the complex set of financial dealings that are at the heart of the Enron story and follows the story through the highs and lows of Enron share prices. The key players are identified and their roles described. Apart from the financial and accounting issues, the Enron story also raises a wide range of ethical issues including corporate governance, organisational culture and ethical leadership and scrutiny. These are discussed in the article. It might be argued that Enron could (...) never have got away with some of its practices if it had been operating in Europe. The article concludes that this view may be naïve, particularly in the light of recent media disclosures of the UK Labour government's continuing flirtation with business donations. The Enron story raises serious considerations in a whole host of financial, economic, political and ethical areas. As the Enron story continues to unfold, an article of this type can only begin to scratch the surface of some of these issues and to lay them out for further investigation. (shrink)

Costs at the end of life disproportionately contribute to health care costs in the United States. Addressing these costs will therefore be an important component in making the U.S. health care system more financially sustainable. In this paper, we explore the moral justifications for having discussions of end-of-life costs in the doctor-patient encounter as part of an effort to control costs. As health care costs are partly shared through pooled resources, such as insurance and taxation, and partly borne by individuals (...) through out-of-pocket expenses, we separate our defense for, and approach to, discussing both pooled and individual aspects of cost. We argue that there needs to be a shift away from formulating the options as a dichotomous choice of paying attention to end-of-life costs versus ignoring such costs. The question should be how personal costs will be managed and how societal expenditures should be allocated. These are issues that we believe patients care about and need to have addressed in a manner with which they are comfortable. Conversations about how money will be spent at the end of life should begin before the end is near. We propose discussing costs from the onset of chronic illness and incorporating financial issues in advance care planning. Through these approaches one can avoid abruptly and insensitively introducing financial issues at the very conclusion of a person's life when one would prefer to address the painful and important issues of spiritual and existential loss that are appropriately the focus when a person is dying. (shrink)

The cost of health care at the end of life accounts for a high proportion of total health care costs in the United States. The percentage of Medicare payments attributable to patients in their last year of life was 28.3% in 1978 and has remained substantially the same at 25.1% in 2006. This indicates how little progress has been made in containing these costs, though doing so will be important to promote a financially sustainable health care system. These expenditures also (...) highlight the prospect that efforts to reduce health care costs overall are likely to disproportionately affect the care patients receive at the end of life. (shrink)

The fact that Gilbert Ryle and J.L. Austin seem to disagree about the ordinary use of words such as ‘voluntary’, ‘involuntary’, ‘voluntarily’, and ‘involuntarily’ has been taken to cast doubt on the methods of ordinary language philosophy. As Benson Mates puts the worry, ‘if agreement about usage cannot be reached within so restricted a sample as the class of Oxford Professors of Philosophy, what are the prospects when the sample is enlarged?’ (Mates, Inquiry 1:161–171, 1958, p. 165). In this chapter, (...) we evaluate Mates’s criticism alongside Ryle’s and Austin’s specific claims about the ordinary use of these words, assessing these claims against actual examples of ordinary use drawn from the British National Corpus (BNC). Our evaluation consists in applying a combination of methods: first aggregating judgments about a large set of samples drawn from the corpus, and then using a clustering algorithm to uncover connections between different types of use. In applying these methods, we show where and to what extent Ryle’s and Austin’s accounts of the use of the target terms are accurate as well as where they miss important aspects of ordinary use, and we demonstrate the usefulness of this new combination of methods. At the heart of our approach is a commitment to the idea that systematically looking at actual uses of expressions is an essential component of any approach to ordinary language philosophy. (shrink)

Our aim in this paper is to present the distinct ways in which Wolff, Baumgarten, and Kant understand the relationship between necessitation, constraint, and reluctant action in an effort to illustrate the subtle ways in which their conceptions of obligation differ from each another. Whereas Wolff conceives of natural or moral obligation as incompatible with constraint, Baumgarten holds that constraint and reluctant action are, in some instances, compatible with natural obligation. Kant departs from Baumgarten by conceiving of obligation as necessarily (...) involving constraint: as Kant’s reply to Schiller’s famous objection reveals, obligation must take on the character of constraint to reluctant action on account of the fact that human beings possess inclinations that always threaten to impel them in directions that oppose morality. (shrink)

Recently, there have been a number of lawsuits in the United States in which families objected to performance of apnoea testing for determination of brain death. The courts reached conflicting determinations in these cases. We discuss the medicolegal complications associated with apnoea testing that are highlighted by these cases and our position that the decision to perform apnoea testing should be made by clinicians, not families, judges, or juries.

What is the relation between joint attention and common knowledge? On the one hand, the relation seems tight: the easiest and most reliable way of knowing something in common with another is for you and that other to be attentively aware of what you are together experiencing. On the other hand, they couldn’t seem further apart: joint attention is a mere perceptual phenomena that infants are capable of engaging in from nine months of age, whereas common knowledge is a cognitive (...) phenomenon involving (so it seems) complex, overlapping metarepresentational states that require the kind of sophisticated mindreading skills that developmental psychology has shown to be beyond the capabilities of young children. In 'The Shared World: Perceptual Common Knowledge, Demonstrative Communication, and Shared Social Space', Axel Seemann attempts, inter alia, to makensense of this conundrum. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)

This a clear and concise introduction to Danish philosopher Soren Kierkegaard.ichael Watts uses Kierkegaard's own writings to introduce his theoriesbout living a truthfu; and spiritual life, while explaining the enormousnfluence of the philosopher's personal life on his work and beliefs. As theounder of 20th century existentialism, and the first philosopher to definehe idea of angst, Kierkegaard's profound influence on modern life is clearlyefined in accessible terms in this guide for students and general readers.

In the current career landscape and labor market, career transitions have become a critical aspect of career development and are significant for Human Resource Development research and practice. Our research examines the type of support used during different career transitions and who can provide that support to women in career transition. We investigated four types of social support—emotional, appraisal, informational, and instrumental—and their roles in five types of career transitions: school-to-work transition, upward mobility transition, transition to a new profession, transition (...) to entrepreneurship, career re-entry transition, and transition to retirement. We analyzed 80 journal articles using directed content analysis, cross-tabulation, and nonparametric statistical tests. Instrumental support appears to be the most commonly documented type of social support in this career transition literature. Appraisal support was consistently documented least for each type of career transition. Our results may highlight the importance of personal connections and internal resources in successful career transitions for women. Based on our findings, we offer a model of women's social support network for career transitions and advocate for expanded networks of social support for women anticipating and during career transitions. The results of our study contain insights for how women can be supported in transitioning to the next career experience. We conclude with suggestions for future research. (shrink)

A particular feature of this book is substantial "Stretch and Challenge" material throughout which allows students to develop further.

Concepts and Cases in Nursing Ethics is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an (...) added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation. (shrink)

Als Philosoph, Literat, Prediger und Pädagoge gehört Herder zu den bedeutendsten Vertretern der Weimarer Klassik. Diese aktuelle und kenntnisreiche Biografie bringt Leben und Werk Herders einem breiteren Publikum nahe.

Opponents of medically assisted dying have long appealed to ‘slippery slope’ arguments. One such slippery slope concerns palliative care: that the introduction of medically assisted dying will lead to a diminution in the quality or availability or palliative care for patients near the end of their lives. Empirical evidence from jurisdictions where assisted dying has been practiced for decades, such as Oregon and the Netherlands, indicate that such worries are largely unfounded. The failure of the palliation slope argument is nevertheless (...) instructive with respect to how slippery slope arguments can be appraised without having to await post-facto evidence regarding the effects of a proposed change in public policy. Close attention in particular to the norms operative in a given institution and how changes to policy will interact with those norms enable slippery slopes to be credibly appraised. (shrink)

I show that the common reading of Thomson, that she argues by analogy for the conclusion that abortion is permissible, is mistaken. The correct reading of Thomson is that she argues by counterexample, showing that arguments against abortion are unsound. The remainder of the paper highlights the lessons learned from Thomson once we read her aright.

Common knowledge is ubiquitous in our lives and yet there remains considerable uncertainty about how to model or understand it. Standard analyses of common knowledge end up being challenged by either regress or circularity which then give rise to well-known paradoxes of practical reasoning, such as the Two Generals’ Paradox. This paper argues that the nature and utility of common knowledge can be illuminated by appeal to Wittgenstein’s Hinge Epistemology. It is argued that those things that we standardly think of (...) as being common knowledge in our lives are the same as those that Wittgenstein identified as hinge certainties. This identification of common knowledge with hinge certainties allows us to resolve the regress problem for common knowledge and explain how the Two Generals’ Paradox arises. (shrink)

In 1982, without waiting for the findings of the National Hospice Study, Congress passed legislation enabling certified hospices to receive Medicare reimbursement. What emerged is a reimbursement program that differs substantially from the movement that spawned it. Hospices now face many dilemmas, among them shifting the burden of care to the family, determining who controls the course of patient care, and breaking even financially.

Annotation Redefines globalization as merely the framework of the current political debate on the future of world power.

The problem with authenticity—the idea of being “true to one’s self”—is that its somewhat checkered reputation garners a complete range of favorable and unfavorable reactions. In educational settings, authenticity is lauded as one of the top two traits students desire in their teachers. Yet, authenticity is criticized for its tendency towards narcissism and self-entitlement. So, is authenticity a good or a bad thing? The purpose of this article is to develop an intimate understanding of authenticity by investigating its current interpretation (...) and criticisms, its struggle with narcissism and relation to freedom. Examining authenticity as multilayered self-exploration reveals a composite of understanding, care, and acceptance. While a side current of acceptable tension shifts our understanding of authenticity from the security of self-determination to the messy interplay involved in being “true to one’s self” and being “in-the-world”. (shrink)

Drawing on work of the past decade, this volume brings together articles from the philosophy, history, and sociology of science, and many other branches of the biological sciences. The volume delves into the latest theoretical controversies as well as burning questions of contemporary social importance. The issues considered include the nature of evolutionary theory, biology and ethics, the challenge from religion, and the social implications of biology today (in particular the Human Genome Project).

While heredity is predominantly controlled by what deoxyribonucleic acid (DNA) sequences are passed from parents to their offspring, a small but growing number of traits have been shown to be regulated in part by the non‐genetic inheritance of information. Transgenerational epigenetic inheritance is defined as heritable information passed from parents to their offspring without changing the DNA sequence. Work of the past seven decades has transitioned what was previously viewed as rare phenomenology, into well‐established paradigms by which numerous traits can (...) be modulated. For the most part, studies in model organisms have correlated transgenerational epigenetic inheritance phenotypes with changes in epigenetic modifications. The next steps for this field will entail transitioning from correlative studies to causal ones. Here, we delineate the major molecules that have been implicated in transgenerational epigenetic inheritance in both mammalian and non‐mammalian models, speculate on additional molecules that could be involved, and highlight some of the tools which might help transition this field from correlation to causation. (shrink)

Ethical debates about assisted dying typically assume that only medical professionals should be able to provide patients with assisted dying. This assumption partially rests on the unstated principle that assisted dying providers may not be motivated by pecuniary considerations. Here I outline and defend a mixed provider model of assisted dying provision that contests this principle. Under this model, medically competent non-physician professionals could receive fees for providing assisted dying under the same terms and conditions as physicians can in those (...) juris- dictions where medically assisted dying is lawful. The mixed provider model blunts objections to assisted dying rooted in supposed clashes with medical values. In addition to generating a market likely to expand access to assisted dying, the mixed provider model would not create markets that are unjust because they are “noxious” in Satz’ sense or because they raise “semiotic” concerns about the value of human life. (shrink)