The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.

The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in (...) as not supportive. They also thought they were not being seen and heard in situations where they disagree with the basic values of the organization. The results are discussed in terms of Habermas’s understanding of modern society. Care settings for elderly people obviously present ethical challenges, particularly in the case of those suffering from dementia. The care provider participants in this study expressed frustration and feelings of powerlessness. It is possible to understand their experiences in terms of Habermas’s theory of modern society and the concept of the system’s colonization of the life world. (shrink)

Theories of writing and mind have proposed that the uses of literacy give rise to a distinct repertoire of cognitive skills, attitudes, and concepts. This paper reconsiders the earliest lexical lists of the Ancient Near East as one type of evidence on writing and mind. Past and present conceptions of the lists are briefly reviewed. Early views cast the lists as reflecting a Sumerian mentality or a uniquely literate mode of thought, while recent accounts suggest they may simply be routine (...) scribal exercises. A view from the philosophy of science, on which lists are considered a sub-type of ordering system, suggests a way of aligning a scribal practice account with aspects of earlier views by articulating the nature of list entries and the intentions of the list makers. On this account, the Ancient Near Eastern lists can be seen both as uniquely literate and as uniquely informative on the role of writing in mind. (shrink)

Theories of writing and mind have proposed that the uses of literacy give rise to a distinct repertoire of cognitive skills, attitudes, and concepts. This paper reconsiders the earliest lexical lists of the Ancient Near East as one type of evidence on writing and mind. Past and present conceptions of the lists are briefly reviewed. Early views cast the lists as reflecting a Sumerian mentality or a uniquely literate mode of thought, while recent accounts suggest they may simply be routine (...) scribal exercises. A view from the philosophy of science, on which lists are considered a sub-type of ordering system, suggests a way of aligning a scribal practice account with aspects of earlier views by articulating the nature of list entries and the intentions of the list makers. On this account, the Ancient Near Eastern lists can be seen both as uniquely literate and as uniquely informative on the role of writing in mind. (shrink)

Across two studies, a wide age range of participants was interviewed about the nature of death. All participants were living in rural Madagascar in a community where ancestral beliefs and practices are widespread. In Study 1, children (8–17 years) and adults (19–71 years) were asked whether bodily and mental processes continue after death. The death in question was presented in the context of a narrative that focused either on the corpse or on the ancestral practices associated with the afterlife. Participants (...) aged 8 years and older claimed that death brings an end to most bodily and mental processes. Nevertheless, particularly in the context of the religious narrative, they claimed that certain mental processes continue even after death. This assertion of an afterlife was more evident among adults than children, especially with respect to cognitive processes, such as knowing and remembering. In Study 2, 5‐ and 7‐year‐olds were asked similar questions in connection with the death of a bird and a person. Seven‐year‐olds consistently claimed that bodily and mental processes cease at death, whereas 5‐year‐olds were unsystematic in their replies. Together, the two studies replicate and extend findings obtained with Western children showing that, in the course of development, different conceptions of death are elaborated—a biological conception in which death terminates living processes and a religious conception in which death marks the beginning of a new form of spiritual existence. (shrink)

Manipulation of physical models such as tangrams and tiles is a popular approach to teaching early mathematics concepts. This pedagogical approach is extended by new computational media, where mathematical entities such as equations and vectors can be virtually manipulated. The cognitive and neural mechanisms supporting such manipulation-based learning—particularly how actions generate new internal structures that support problem-solving—are not understood. We develop a model of the way manipulations generate internal traces embedding actions, and how these action-traces recombine during problem-solving. This model (...) is based on a study of two groups of sixth-grade students solving area problems. Before problem-solving, one group manipulated a tangram, the other group answered a descriptive test. Eye-movement trajectories during problem-solving were different between the groups. A second study showed that this difference required the tangram's geometrical structure, just manipulation was not enough. We propose a theoretical model accounting for these results, and discuss its implications. (shrink)

In this timely and highly original merging of theory and practice, conflict photographer and critical theorist Rita Leistner applies Marshall McLuhan's semiotic theories of language, media, and technology to iPhone photographs taken during a military embed in Afghanistan. In a series of what Leistner calls iProbes—a portmanteau of iPhone and probe—Leistner reveals the face of war through the extensions of man. As digital photography becomes more ubiquitous, and as the phones we carry with us become more advanced, the process (...) of capturing images becomes more democratic and more spontaneous. Leistner's photos result from both access and impulse. Looking for Marshall McLuhan in Afghanistan will appeal anyone with an interest in the conflicts in the Middle East, the seminal communications theorist, or iPhone apps and photography. (shrink)

I have become curious about reciprocity within clinical practice. A vast topic that mobilizes considerations of money, knowledge, kinship, power, culture, and uses of the body, reciprocity is a strong means by which to achieve the egality required of just health care. Within health care, reciprocity might enable not only so‐called shared decision‐making and patient autonomy. It might open the door to mutual acknowledgement of the value of each participant's beliefs and habits. It might appear as a humble realization that (...) no one understands what health is and a concurrent welcoming curiosity about one another's conception of how the body and speech and mind work. From the intimate to the international levels of care, such forms of reciprocity may culminate in the radical and powerful state of reciprocal recognition.In this short essay, I will focus on one aspect of reciprocity in health care: the narrative and potentially reciprocal nature of attention in health care. A critical element in the development of therapeutic alliance, clinical accuracy, and effective practice, attention requires a donation of the self as a vessel into which can enter that which is perceived or, from the other side, a penetrating of that which is perceived so that one sees it from within its own vessel. (shrink)

If our sense of the past is inevitably shaped by the explanatory logic of narrative, then the stories that we create in turn reveal the inescapable presence and ...

Proposing that the interaction between reader and literature involves four “modes of textual engagement” — recognition, enchantment, knowledge, and shock — The Uses of Literature bridges the gap between literary theory and common-sense beliefs about why we read literature.

While the human papillomavirus vaccine is medically indicated to reduce the risk of genital warts and certain types of cancer, rates of HPV vaccination repeatedly fall short of public health goals. Individual-level factors contributing to low vaccination rates are well documented. However, system-level barriers, particularly the need for parental consent, have been less explored. To date, there is no legal or ethical consensus in the USA regarding whether adolescents might permissibly self-consent to the HPV vaccine. Consequently, there is considerable variability (...) in medical practice at the provider and state level. In this essay, we explore the ethical acceptability of vaccinating adolescents for HPV without parental consent. We argue that the same ethical considerations that justify permitting minors to consent to treatment for sexual and reproductive health care—namely, public health benefit and adolescents’ developing autonomy—similarly justify permitting minors to consent to HPV vaccination. Based on this analysis, we conclude that allowing adolescents to self-consent to the HPV vaccine is ethically justifiable and should be reflected in US state policies. (shrink)

Background The involvement of pregnant women in vaccine clinical trials presents unique challenges for the informed consent process. We explored the expectations and experiences of the pregnant women, spouses/partners, health workers and stakeholders of the consent process during a Group B Streptococcus maternal vaccine trial. Methods We interviewed 56 participants including pregnant women taking part in the trial, women not in the trial, health workers handling the trial procedures, spouses, and community stakeholders. We conducted 13 in-depth interviews and focus group (...) discussions with 23 women in the trial, in-depth interviews with 5 spouses, and 5 women not in the trial, key informant interviews with 5 health workers and 5 other stakeholders were undertaken. Results Decision-making by a pregnant woman to join a trial was done in consultation with spouse, parents, siblings, or trusted health workers. Written study information was appreciated by all but they suggested the use of audio and visual presentation to enhance understanding. Women stressed the need to ensure that their male partners received study information before their pregnant partners joined a clinical trial. Confidentiality in research was emphasised differently by individual participants; while some emphasised it for self, others were keen to protect their family members from being exposed, for allowing them to be involved in research. However, others wanted their community participation to be acknowledged. Conclusion We found that pregnant women make decisions to join a clinical trial after consulting with close family. Our findings suggest the need for an information strategy which informs not only the pregnant woman, but also her family about the research she is invited to engage in. (shrink)

The prime objective of this paper is to conduct phoneme categorization experiments for Indian languages. In this direction a major effort has been made to categorize Hindi phonemes using a time delay neural network (TDNN), and compare the recognition scores with other languages. A total of six neural nets aimed at the major coarse of phonetic classes in Hindi were trained. Evaluation of each net on 350 training tokens and 40 test tokens revealed a 99% recognition rate for vowel classes, (...) 87% for unvoiced stops, 82% for voiced stops, 94.7% for semi vowels, 98.1% for nasals and 96.4% for fricatives. A new feature vector normalisation technique has been proposed to improve the recognition scores. (shrink)

The problem of the relation and difference between things and objects is one of the most decisive issues for the conception of the real. These words are usually used interchangeably – and not only in their everyday usage. There are some contemporary philosophical positions that consider almost “everything” as an object; on the other hand, there are proponents of a strict separation of objects and things. How did it happen that the concept of thing (res) and object (obiectum) not only (...) began to theoretically “compete” with each other but also sometimes came to represent differently conceived realities, and even occasionally came to represent an identical conception of reality? This article, on the one hand, discusses the philosophical strategies that reveal the difference between objects and things and enable such a conception of reality which takes into account the Kantian distinction between Realität and Wirklichkeit. On the other, it reconstructs Giorgio Agamben’s project of modal ontology. Agamben’s take on the question What is real? is oriented toward the modus of being and could be traced back to the recognition of the difference between objects and things as well as the “restoration of the life of things themselves.”. (shrink)

In written and spoken communications, metaphors are often used as an aid to help convey abstract or less tangible concepts. However, the benefits of using visual metaphors in visualization have so far been inconclusive. In this work, we report an empirical study to evaluate hypotheses that visual metaphors may aid memorization, visual search and concept comprehension. One major departure from previous metaphor-related experiments in the literature is that we make use of a dual-task methodology in our experiment. This design offers (...) an abstraction of typical situations where viewers do not have their full attention focused on visualization (e.g., in meetings and classes). The use of the secondary task introduces “divided attention”, and makes the effects of visual metaphors more observable. In addition, it also serves as additional masking in memory-based trials. The results of this study show that visual metaphors can help participants better remember the information depicted in visualization. On the other hand, visual metaphors can have a negative impact on the speed of visual search. The results also show a complex pattern as to the benefits of visual metaphors in helping participants grasp key concepts from visualization. (shrink)

When is it permissible to move an issue out of normal politics and treat it as a security issue? How should the security measures be conducted? When and how should the securitization be reversed? Floyd offers answers to these questions by combining security studies' influential securitization theory with philosophy's long-standing just war tradition, creating a major new approach to the ethics of security: 'Just Securitization Theory'. Of interest to anyone concerned with ethics and security, Floyd's innovative approach enables scholars to (...) normatively evaluate past and present securitizations, equips practitioners to make informed judgements on what they ought to do in relevant situations, and empowers the public to hold relevant actors accountable for how they view security. (shrink)

'Manning successfully argues that theory and ethics should once again be reunited...thorough and provocative...'—THE MIDWEST BOOK REVIEW.