Background: Although attention to healthcare ethics in rural areas has increased, specific focus on rural palliative care is still largely under-studied and under-theorized. The purpose of this study was to gain a deeper understanding of the values informing good palliative care from rural individuals' perspectives. Methods: We conducted a qualitative ethnographic study in four rural communities in Western Canada. Each community had a population of 10, 000 or less and was located at least a three hour travelling distance by car (...) from a specialist palliative care treatment centre. Data were collected over a 2-year period and included 95 interviews, 51 days of field work and 74 hours of direct participant observation where the researchers accompanied rural healthcare providers. Data were analyzed inductively to identify the most prevalent thematic values, and then coded using NVivo. Results: This study illuminated the core values of knowing and being known, being present and available, and community and mutuality that provide the foundation for ethically good rural palliative care. These values were congruent across the study communities and across the stakeholders involved in rural palliative care. Although these were highly prized values, each came with a corresponding ethical tension. Being known often resulted in a loss of privacy. Being available and present created a high degree of expectation and potential caregiver strain. The values of community and mutuality created entitlement issues, presenting daunting challenges for coordinated change. Conclusions: The values identified in this study offer the opportunity to better understand common ethical tensions that arise in rural healthcare and key differences between rural and urban palliative care. In particular, these values shed light on problematic health system and health policy changes. When initiatives violate deeply held values and hard won rural capacity to address the needs of their dying members is undermined, there are long lasting negative consequences. The social fabric of rural life is frayed. These findings offer one way to re-conceptualize healthcare decision making through consideration of critical values to support ethically good palliative care in rural settings. (shrink)
Background Few empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers. Methods A phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. (...) The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities. Results Both ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance. Conclusion Our paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet. (shrink)
Evidence-based psychiatry (EBP) has arisen through the application of evidence-based medicine (EBM) to psychiatry. However, there may be aspects of psychiatric disorders and treatments that do not conform well to the assumptions of EBM. This paper reviews the ongoing debate about evidence-based psychiatry and investigates the applicability, to psychiatry, of two basic methodological features of EBM: prognostic homogeneity of clinical trial groups and quantification of trial outcomes. This paper argues that EBM may not be the best way to pursue psychiatric (...) knowledge given the particular features of psychiatric disorders and their treatments. As a result, psychiatry may have to develop its own standards for rigour and validity. This paper concludes that EBM has had a powerful influence on how psychiatry investigates and understands mental disorders. Psychiatry could influence EBM in return, reshaping it in ways that are more clinically useful and congruent with patients’ needs. (shrink)
The spotlight in the CSR discourse has traditionally been focused on multinational corporations (MNCs). This paper builds on a burgeoning stream of literature that has accorded recent attention to the relevance and importance of integrating small and medium enterprises (SMEs) in the CSR debate. The paper begins by an overview of the CSR literature and a synthesis of relevant evidence pertaining to the peculiarities and special relational attributes of SMEs in the context of CSR. Noting the thin theoretical grounding in (...) the literature on offer, the paper then presents relevant CSR theoretical perspectives that could be useful in conducting further research on SMEs. In light of this framework, the paper outlines the findings of an empirical study highlighting the peculiar CSR orientations of SMEs in a developing country context in comparison to some of their MNC counterparts. The study is qualitative in nature, capitalizing on a comparative research design to highlight differences in CSR orientations between SMEs and MNCs. The findings are presented and implications are drawn regarding the peculiar relational attributes of SMEs in the context of CSR generally, and developing countries more specifically, and how this inclination can be further nurtured and leveraged. (shrink)
Painted in 1656 by Diego Velasquez (1599-1660), Las Meninas has engendered countless philosophical commentaries. Artists, too, have explored the painting's puzzles and paradoxes. All of the responses to this masterpiece, now over 350 years old, show that Las Meninas continues to live with us on several levels. Indeed, Las Meninas is one of the most controversial paintings of our time (Brown and Garrido, 1998, p. 181); no small feat given that cutting-edge art today is often media-based and/or media-driven. The wealth (...) of controversy has generated so much material since the work's conception that James Elkins, in his book Why Are Our Pictures Puzzles, characterized Las Meninas as an artwork that has become monstrous. According to Elkins, it has effectively outgrown the discipline of art history. Like the frescos in the Brancacci Chapel, the Mona Lisa, Raphael's School of Athens and the Oath of Horatio by David, the scholarship surrounding Las Meninas is so vast that no single thinker or volume can present it fully; it is not even possible to teach these works in a yearlong seminar (Elkins, 1999). While I am among those captivated by the painting, I am also aware of how little a short essay can accomplish. Nevertheless, I do hope to convey why this immense canvas continues to inspire people creatively, intellectually, and passionately. In terms of consciousness, my comments are intended to weave the physicality of the work with epistemological interpretations and empirical investigations so that its mutability is more present in our consciousness discourse. (shrink)
David Bloor’s thought experiment is taken into consideration to suggest that the rationality of the Other cannot be inferred by way of argument for the reason that it is unavoidably contained as a hidden supposition by any argument engaged in proving it. We are able to understand a different culture only as far as we recognize in it the same kind of rationality that works in our own culture. Another kind of rationality is either impossible, or indiscernible.
Psychological essentialism is an intuitive folk belief positing that certain categories have a non-obvious inner “essence” that gives rise to observable features. Although this belief most commonly characterizes natural kind categories, I argue that psychological essentialism can also be extended in important ways to artifact concepts. Specifically, concepts of individual artifacts include the non-obvious feature of object history, which is evident when making judgments regarding authenticity and ownership. Classic examples include famous works of art (e.g., the Mona Lisa is (...) authentic because of its provenance), but ordinary artifacts likewise receive value from their history (e.g., a worn and tattered blanket may have special value if it was one’s childhood possession). Moreover, in some cases, object history may be thought to have causal effects on individual artifacts, much as an animal essence has causal effects. I review empirical support for these claims and consider the implications for both artifact concepts and essentialism. This perspective suggests that artifact concepts cannot be contained in a theoretical framework that focuses exclusively on similarity or even function. Furthermore, although there are significant differences between essentialism of natural kinds and essentialism of artifact individuals, the commonalities suggest that psychological essentialism may not derive from folk biology but instead may reflect more domain-general perspectives on the world. (shrink)
Suppose you take a tour of the Louvre, that great museum in Paris housing one of the finest art collections in the world. As you walk through the museum, you come across a painting by someone named Leonardo da Vinci -- the Mona Lisa . Suppose this is your first exposure to da Vinci -- you hadn't heard of him or seen the Mona Lisa before. What could you conclude? Certainly you could conclude that da Vinci was (...) a consummate painter. Nevertheless, just from the Mona Lisa you couldn't conclude that da Vinci was also a consummate engineer, musician, scientist, and inventor, whose ideas were centuries ahead of their time. (shrink)
Introduction: on not giving interviews -- Interview with Leonard Green, Jonathan Culler, and Richard Klein -- Interview with Anders Stephanson -- Interview with Paik Nak-Chung -- Interview with Sabry Hafez, Abbas Al-Tonsi, and Mona Abousenna -- Interview with Stuart Hall -- Interview with Michael Speaks -- Interview with Horacio Machín -- Interview with Sara Danius and Stefan Jonsson -- Interview with Xudong Zhang -- Interview with Srinivas Aravamudan and Ranjana Khanna.
Evidence-based medicine (EBM) made its first appearance in the medical lexicon in 1990 and since then has enjoyed widespread support from within the medical profession, including among psychiatrists. Proponents of evidence-based psychiatry (EBP) point to its ability to demonstrate the efficacy of various psychiatric treatments, promising improved mental health outcomes and more efficient use of healthcare resources as a result. Policymakers and insurers have embraced EBP in hopes that these goals will be realized. However, the question of whether EBM is (...) even applicable to psychiatry remains largely unaddressed, even though it is an urgent one, given the various corporate, professional, and governmental pressures .. (shrink)
Machine generated contents note: 1. Spoken, intended and problematic divorce in Hanafi Fiqh; 2. Between person and property - slavery in Qudūrī's Mukhtasar; 3. Pig, purity and permission in Mālikī slaughter; 4. Islamic and other perspectives on evil; 5. The language of love in the Qur'ān; 6. Virtue and limits in the ethics of friendship 7. Drinking and drunkenness in Ibn Rushd.
We are very grateful to Mona Gupta and Peter Zachar for their commentaries on our paper. In our view, the main challenge for both commentators is this: do they have empirical evidence to refute our rejection (on evidence-based grounds) of the primacy of the current technological paradigm in psychiatry? Although opinions may differ about our choice of the philosophical tools we use to interpret the facts, unless there is good evidence to contradict our basic premise, their arguments will fail (...) to reach the evidence-based medicine (EBM) gold standard that they support. We do not believe their commentaries present any empirical evidence that contradicts our critique. Before we respond, we wish to stress two .. (shrink)
Feminist, critical race, and postcolonial theories have established that social identities such as race and gender are mutually constitutive—i.e., that they “intersect.” I argue that “cultural appropriation” is never merely the appropriation of culture, but also of gender, sexuality, class, etc. For example, “white hipness” is the appropriation of stereotypical black masculinity by white males. Looking at recent videos from black male hip-hop artists, I develop an account of “postmillennial black hipness.” The inverse of white hipness, this practice involves the (...) appropriation, by black men, of stereotypical white gay masculinity and/or non-American, non-white femininity. I also argue that Shephard Fairey’s recent images of (mainly militant) non-Western women of color can be read as a new form of white hipness that revises the traditional logic in two ways: (1) by appropriating non-white femininity rather than masculinity, and (2) by adopting the practice of postmillennial black hipness itself. (shrink)
1. A substance is a being that is capable of action. It is either •simple, meaning that it has no parts, or •composite, meaning that it is a collection of simple substances or monads. (Monas is a Greek word meaning ‘unity’ or ‘oneness’.) Any composite thing—any body—is a multiplicity, ·a many, but simple substances are unities, ·or ones·. There must be simple substances everywhere, because without simples there would be no composites—·without ones there could not be manies·. And simple substances (...) are lives, souls, minds—·where there is a simple substance there is life·—and the world’s being full of such substances means that the whole of nature is full of life. (shrink)
1. A substance is a being that is capable of action. It is either •simple, meaning that it has no parts, or •composite, meaning that it is a collection of simple substances or monads. (Monas is a Greek word meaning ‘unity’ or ‘oneness’.) Any composite thing—any body—is a multiplicity, ·a many, but simple substances are unities, ·or ones·. There must be simple substances everywhere, because without simples there would be no composites—·without ones there could not be manies·. And simple substances (...) are lives, souls, minds—·where there is a simple substance there is life·—and the world’s being full of such substances means that the whole of nature is full of life. (shrink)
Notiones sunt Entium, aut Respectuum. Entia sunt Res aut Modi. Res sunt substantiae aut phaenomenae. Substantiae sunt vel simplices vel compositae. Substantia simplex est Monas; Monas autem est vel primitiva Deus, a quo omnia; vel derivativa. Et ha[e]c vel perceptiva tantum, vel etiam sensitiva; et haec vel sensitiva tantum vel etiam intellectiva quae et spiritus appellatur. Rursus Monas vel est Anima corporis vel est separata; haec vel creata (ut plerique volunt etsi ego an creata sint monades corporis complures dubito) vel (...) increata Deus. Substantia composita est quae Unum reale. Huc enim ponere necesse est aut statuere solas Monades esse res; composita autem esse mera phaenomena. Phaenomena sunt aggregata ex substantiis, quae de certo modo exhibent[iii] percipienti, atque ita inter substantiarum [aggregata] a nobis considerantur.[iv] Uti per nostram cogitationem phenomena ex substantiis oriuntur, ita per Divinam Cogitationem oriuntur ex substantiis simplicibus composita, posito in Deo praeter intellectum accedere voluntatem, ut fiat ex multis unum; nam si tantum multa simul consideraret, phaenomena ex iis seu aggregata faceret, uti cum deus novit iridem aut eius proprietates. At cum inde debet oriri [seu] resultare novum Ens, oportet ut accedat divina voluntas. Porro hujus novi Entis partes non sunt Monades, sed sunt ejus fundamenta, uti puncta non sunt partes lineae. Hoc novum Ens constat ex materia et forma. Materia est ortum totale ex viribus passivis omnium Monadum; et Forma est ortum totale ex entelechiis primitivis omnium Monadum. Et hoc ortum cum non sit Modus sed aliquid absolutum[,] posset conservari a Deo destructis monadibus, et vicissim ipso destructo possent conservari Monades. Atque hoc est substantia corporea, quae est in perpetuu fluxu quam . Porro modificationes sunt accidentia quae ex accidentibus Monadum oriuntur.. (shrink)
