The contributors featured in this work engage the reader in a stimulating exchange and dialogue about the post-modern turn in psychoanalysis. They advocate, critique, or simply observe this contemporary phenomenon.

In 2015, the predominantly visible minority immigrant community of Herongate, in Ottawa, Ontario, was slated for redevelopment by its landlord, Timbercreek Asset Management. This redevelopment involved mass eviction of the incumbent tenants, demolition of the existing affordable housing and its replacement with luxury rentals, which, by all indications, are beyond the financial reach of the former Herongage tenants. This paper seeks to problematize large-scale residential real estate redevelopment in Canada and examine its impact, using the Herongate situation as a case (...) study. Among other things, it profiles the Herongate community, its history and present redevelopment, and explores the legal framework, and the limits thereof, constraining mass evictions of this type in Ontario. The findings indicate that the selection of Herongate for redevelopment was not fortuitous; generally, racialized and immigrant communities like Herongate are disproportionately likely to be selected for large-scale redevelopment projects, and thus subjected to mass-evictions. Further results suggest that the dissolution of the Herongate community – and the attendant dislocation of its members – has exacted a pronounced social and economic toll and compounded the racial discrimination already experienced by the former Herongate residents, most of whom are visible minorities. The paper concludes with an appeal to imbue the redevelopment process with a greater regard for social justice, and a right to housing as a policy solution to address the injustice caused by real estate redevelopment. (shrink)

Modern Jewish Theology is the first comprehensive collection of Jewish theological ideas from the pathbreaking nineteenth and early twentieth centuries, featuring selections from more than thirty of the most influential modern Jewish thinkers of the era.

What motives underlie the ways humans interact socially? Are these the same for all societies? Are these part of our nature, or influenced by our environments?Over the last decade, research in experimental economics has emphatically falsified the textbook representation of Homo economicus. Literally hundreds of experiments suggest that people care not only about their own material payoffs, but also about such things as fairness, equity and reciprocity. However, this research left fundamental questions unanswered: Are such social preferences stable components of (...) human nature; or, are they modulated by economic, social and cultural environments? Until now, experimental research could not address this question because virtually all subjects had been university students, and while there are cultural differences among student populations throughout the world, these differences are small compared to the full range of human social and cultural environments. A vast amount of ethnographic and historical research suggests that people's motives are influenced by economic, social, and cultural environments, yet such methods can only yield circumstantial evidence about human motives. Combining ethnographic and experimental approaches to fill this gap, this book breaks new ground in reporting the results of a large cross-cultural study aimed at determining the sources of social preferences that underlie the diversity of human sociality. The same experiments which provided evidence for social preferences among university students were performed in fifteen small-scale societies exhibiting a wide variety of social, economic and cultural conditions by experienced field researchers who had also done long-term ethnographic field work in these societies. The findings of these experiments demonstrated that no society in which experimental behaviour is consistent with the canonical model of self-interest. Indeed, results showed that the variation in behaviour is far greater than previously thought, and that the differences between societies in market integration and the importance of cooperation explain a substantial portion of this variation, which individual-level economic and demographic variables could not. Finally, the extent to which experimental play mirrors patterns of interaction found in everyday life is traced.The book starts with a succinct but substantive introduction to the use of game theory as an analytical tool and its use in the social sciences for the rigorous testing of hypotheses about fundamental aspects of social behaviour outside artificially constructed laboratories. The results of the fifteen case studies are summarized in a suggestive chapter about the scope of the project. (shrink)

Researchers from across the social sciences have found consistent deviations from the predictions of the canonical model of self-interest in hundreds of experiments from around the world. This research, however, cannot determine whether the uniformity results from universal patterns of human behavior or from the limited cultural variation available among the university students used in virtually all prior experimental work. To address this, we undertook a cross-cultural study of behavior in ultimatum, public goods, and dictator games in a range of (...) small-scale societies exhibiting a wide variety of economic and cultural conditions. We found, first, that the canonical model – based on self-interest – fails in all of the societies studied. Second, our data reveal substantially more behavioral variability across social groups than has been found in previous research. Third, group-level differences in economic organization and the structure of social interactions explain a substantial portion of the behavioral variation across societies: the higher the degree of market integration and the higher the payoffs to cooperation in everyday life, the greater the level of prosociality expressed in experimental games. Fourth, the available individual-level economic and demographic variables do not consistently explain game behavior, either within or across groups. Fifth, in many cases experimental play appears to reflect the common interactional patterns of everyday life. Key Words: altruism; cooperation; cross-cultural research; experimental economics; game theory; ultimatum game; public goods game; self-interest. (shrink)

The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation (...) follows proportionality protocols for which LiPuma’s thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma’s contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life. (shrink)

We would like to thank the commentators for their generous comments, valuable insights and helpful suggestions. We begin this response by discussing the selfishness axiom and the importance of the preferences, beliefs, and constraints framework as a way of modeling some of the proximate influences on human behavior. Next, we broaden the discussion to ultimate-level (that is evolutionary) explanations, where we review and clarify gene-culture coevolutionary theory, and then tackle the possibility that evolutionary approaches that exclude culture might be sufficient (...) to explain the data. Finally, we consider various methodological and epistemological concerns expressed by our commentators. (shrink)

This study examines the direct and indirect effects of interpersonal fairness on employees’ willingness-to-stay and organisation-based self-esteem through affective commitment among manufacturing workers in Tema, Ghana. Using the survey design, 300 manufacturing workers in Tema were conveniently sampled for the study. The confirmatory factor analysis and structural equation modelling were used to analyse the data. Results indicated that affective commitment partially mediated the relationship between interpersonal fairness and employees' willingness-to-stay. Affective commitment also fully mediated the interpersonal fairness- organisation based self-esteem (...) relationship. Results further showed that organisation based self-esteem partially mediated the affective commitment and willingness to stay relationship, such that, an increase in organisation-based self-esteem leads to a decrease in employees’ willingness-to-stay. These findings emphasised the roles of interpersonal fairness and affective commitment in organisations, where affective commitment increases as a result of an increase in interpersonal fairness and makes employees have an intention to stay. The findings imply that employees who are very confident and have higher organisation-based self-esteem stand lower chances of staying in their current organisations. This study is the first to examine how affective commitment transfers the effects of interpersonal fairness unto employees’ intention-to-stay among manufacturing workers in Ghana. (shrink)

In 2008, researchers reported that Timothy Brown , a man with HIV infection and leukemia, received a stem-cell transplant that removed HIV from his body as far as can be detected. In 2013, an infant born with HIV infection received anti-retroviral treatment shortly after birth, but was then lost to the health care system for the next six months. When tested for HIV upon return, the child had no detectable viral load despite cessation of treatment. These remarkable clinical developments have (...) helped reinvigorate the field of ‘HIV cure’ research. (shrink)

Susan D. McCammon and Nicole M. Piemonte offer a thoughtful and thorough commentary on our manuscript entitled “Expanding the use of Continuous Sedation Until Death.” In this reply we attempt to clarify and further defend our position. We show how continuous sedation until death is not a “first resort” but rather a legitimate option among many that should available to terminally ill patients whose life expectancy is less than six months. We also attempt to show that we do not equivocate (...) the meaning of palliative care as the commentators suggested. We argue that the traditional notion of palliative care should move beyond relief of “experienced suffering” to relief of potential suffering for those whose life expectancy is less than six months. Lastly, we challenge the commentator’s position that the realm of ordinary medicine” should be the guide to care, by showing how the notion of ordinary medicine has been successfully challenged in both bioethical scholarship and the courts in a way that shows ordinary medicine to be an evolving concept rather than a static, universal guide. (shrink)

This book is a collection of reflections and empirical studies which examine the many facets of the meanings of work. The authors are significant scholars in fields of study ranging from ethics to sociology. The book is a text which aims at balancing the academic with the practical and so the chapters often reflect the tensions implicit in such a venture. The reader will find in these pages historical, philosophical, educational, religious, entrepreneurial and many other points of view which combine (...) to emerge as a text which is both encyclopedic in information yet engaging and lively in style. The reader will be able to understand how the meanings of work have changed over the centuries varying according to historical place and point of view. At the same time, the diligent reader will observe the centrality that work has in the lives of people both practically and in terms of life quests. Work has previously been defined as an activity that produces something of value for other people. This definition does not even begin to include the information about work that is presented in this book. The reader will feel a invigorating sense of worth from this book. (shrink)

This book is an important contribution to the Values literature on the meanings of work. These essays explore the philosophical, ethical, religious, and social foundations that underscore so much of the current thinking and concern about work satisfaction and the place of work in the search of meaning. Various points of view are presented and these include among others historical perspectives, empirical studies and cross-cultural explorations. The result is a compelling and critical volume which challenges many basic cultural and empirical (...) assumptions and raises many questions about values and value-based decisions. (shrink)

Originally published in 1983, _Reflections on Self Psychology_ records the development of a powerful initiative to alter psychoanalytic theory and practice, and an evaluative questioning of this initiative. It presents a dialogue that developed at the Boston Symposium of 1980 between vigorous proponents of self psychology, equally energetic critics, and many participants between these polar positions. This book attempts to capture within its pages not only the content of what was presented, explored, and evaluated in Boston, but also a sense (...) of the people, about 1,000 strong, who exchanged their ideas on and off the podium – and the remarkable spirit of open inquiry that invigorated these proceedings. The book, as was the meeting, is organized to explore four subjects: the development of the self: infant research; the implications of self psychology for psychoanalytic practice; self psychology and psychotherapy; and the implications of self psychology for psychoanalytic theory. The final section of the book is devoted to an essay by Heinz Kohut that provides an integrated response to the issues and criticisms raised in the course of the symposium. This essay while based on extemporaneous responses by Kohut during different phases of the meeting, is, in its written version, a cohesive, carefully revised, and edited statement prepared in the mellowing period following the meeting and before Kohut’s untimely death. (shrink)

Originally published in 1983 _Reflections on Self Psychology_ records the development of a powerful initiative to alter psychoanalytic theory and practice, and an evaluative questioning of this initiative. It presents a dialogue that developed at the Boston Symposium of 1980 between vigorous proponents of self psychology, equally energetic critics, and many participants between these polar positions. This book attempts to capture within its pages not only the content of what was presented, explored, and evaluated in Boston, but also a sense (...) of the people, about 1,000 strong, who exchanged their ideas on and off the podium – and the remarkable spirit of open inquiry that invigorated these proceedings. The book, as was the meeting, is organized to explore four subjects: the development of the self: infant research; the implications of self psychology for psychoanalytic practice; self psychology and psychotherapy; and the implications of self psychology for psychoanalytic theory. The final section of the book is devoted to an essay by Heinz Kohut that provides an integrated response to the issues and criticisms raised in the course of the symposium. This essay while based on extemporaneous responses by Kohut during different phases of the meeting, is, in its written version, a cohesive, carefully revised, and edited statement prepared in the mellowing period following the meeting and before Kohut’s untimely death. (shrink)

This book examines when it is morally appropriate for medical intervention to hasten the dying process. The authors’ overriding goal is to humanize the dying process by expanding patient centered autonomous control.

As currently practiced, the use of continuous sedation until death (CSD) is controlled by clinicians in a way that may deny patients a key choice in controlling their dying process. Ethical guidelines from the American Medical Association and the American Academy of Pain Medicine describe CSD as a “last resort,” and a position statement from the American Academy of Hospice and Palliative Medicine describe it as “an intervention reserved for extreme situations.” Accordingly, patients must progress to unremitting pain and suffering (...) and reach a last-resort stage before the option to pursue CSD is considered. Alternatively, we present and defend a new guideline in which decisionally capable, terminally ill patients who have a life expectancy of less than six months may request CSD before being subjected to the refractory suffering of a treatment of “last resort.”. (shrink)

Utilitarians take an uncritical attitude toward the sort of individual claims they seek to aggregate. In this way they cannot account for an individual's valid claim against a policy which actually maximizes aggregate satisfaction. We thus claim that utilitarianism properly functions only after conflicting claims have been adjudicated; consequently, Utilitarianism properly maximizes the satisfaction of claims judged to be valid. In such a program, Utilitarianism ceases to be considered a part of ethics, But is seen as maintaining a principle of (...) feasibility and efficiency. Finally, We briefly suggest the methods we believe to be most effective in the resolution of ethical conflict. (shrink)

For teachers of general semantics and leaders of study groups.

We suggest that consciousness (C) should be addressed as a multilevel concept. We can provisionally identify at least three, rather than two, levels: Gray's system should relate at least to the lowest of these three levels. Although it is unlikely to be possible to develop a behavioural test for C, it is possible to speculate as to the evolutionary advantages offered by C and how C evolved through succeeding levels. Disturbances in the relationships between the levels of C could underlie (...) mental illness, especially schizophrenia. (shrink)

As in other societies, medical professionalism in the Peoples’ Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, “Medical Professionalism in the New Millennium: A Physician Charter,” by the Chinese Medical Doctor Association (hereafter, the Charter). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians’ attitudes toward the fundamental principles and core commitments put forward in the Charter. Based (...) on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients’ autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically—recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism—a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine crosscultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. (shrink)

Recently both whole brain death (WBD) and higher brain death (HBD) have come under attack. These attacks, we argue, are successful, leaving supporters of both views without a firm foundation. This state of affairs has been described as “the death of brain death.” Returning to a cardiopulmonary definition presents problems we also find unacceptable. Instead, we attempt to revive brain death by offering a novel and more coherent standard of death based on the permanent cessation of mental processing. This approach (...) works, we claim, by being functionalist instead of being based in biology, consciousness, or personhood. We begin by explaining why an objective biological determination of death fails. We continue by similarly rejecting current arguments offered in support of HBD, which rely on consciousness and/or personhood. In the final section, we explain and defend our functionalist view of death. Our definition centers on mental processing, both conscious and preconscious or unconscious. This view provides the philosophical basis of a functional definition that most accurately reflects the original spirit of brain death when first proposed in the Harvard criteria of 1968. (shrink)

Military metaphors are pervasive in biomedicine, including HIV research. Rooted in the mind set that regards pathogens as enemies to be defeated, terms such as “shock and kill” have become widely accepted idioms within HIV cure research. Such language and symbolism must be critically examined as they may be especially problematic when used to express scientific ideas within emerging health-related fields. In this article, philosophical analysis and an interdisciplinary literature review utilizing key texts from sociology, anthropology, history, and Chinese and (...) African studies were conducted to investigate the current proliferation of military metaphors. We found the use of these metaphors to be ironic, unfortunate, and unnecessary. To overcome military metaphors we propose to give them less aggressive meanings, and/or replace them with more peaceful metaphors. Building on previous authors' work, we argue for the increased use of “journey” metaphors as meaningful, cross-culturally app... (shrink)

Trust is indispensable not only for interpersonal relationships and social life, but for good quality healthcare. As manifested in the increasing violence and tension in patient-physician relationships, China has been experiencing a widespread and profound crisis of patient–physician trust. And globally, the crisis of trust is an issue that every society, either developing or developed, has to face in one way or another. Yet, in spite of some pioneering works, the subject of patient-physician trust and mistrust – a crucial matter (...) in healthcare especially because there are numerous ethical implications – has largely been marginalized in bioethics as a global discourse. Drawing lessons as well as inspirations from China, this paper demonstrates the necessity of a trust-oriented bioethics and presents some key theoretical, methodological and philosophical elements of such a bioethics. A trust-oriented bioethics moves beyond the current dominant bioethical paradigms through putting the subject of trust and mistrust in the central agenda of the field, learning from the social sciences, and reviving indigenous moral resources. In order for global bioethics to claim its relevance to the things that truly matter in social life and healthcare, trust should be as vital as such central norms like autonomy and justice and can serve as a potent theoretical framework. (shrink)

To investigate the phenomenon of patient–physician mistrust in China, a qualitative study involving 107 physicians, nurses and health officials in Guangdong Province, southern China, was conducted through semi-structured interviews and focus groups. In this paper we report the key findings of the empirical study and argue for the essential role of medical professionalism in rebuilding patient-physician trust. Health professionals are trapped in a vicious circle of mistrust. Mistrust leads to increased levels of fear and self-protection by doctors which exacerbate difficulties (...) in communication; in turn, this increases physician workloads, adding to a strong sense of injustice and victimization. These factors produce poorer healthcare outcomes and increasingly discontented and angry patients, escalate conflicts and disputes, and result in negative media coverage, all these ultimately contributing to even greater levels of mistrust. The vicious circle indicates not only the crisis of patient-physician relationship but the crisis of medicine as a profession and institution. Underlying the circle is the inherent conflict of interest in the healthcare system by which health professionals and hospitals have become profit-driven. This institutional conflict of interest seriously compromises the fundamental principle of medical professionalism—the primacy of patient welfare—as well as the traditional Chinese ideal of “medicine as the art of humanity”. Patient trust can be restored through rectifying this institutional conflict of interest and promoting medical professionalism via a series of recommended practical measures. (shrink)

Background Community advisory boards have expanded beyond high-income countries and play an increasing role in low- and middle-income country research. Much research has examined CABs in HICs, but less is known about CABs in LMICs. The purposes of this scoping review are to examine the creation and implementation of CABs in LMICs, including identifying frequently reported challenges, and to discuss implications for research ethics. Methods We searched five databases for publications describing or evaluating CABs in LMICs. Two researchers independently reviewed (...) articles for inclusion. Data related to the following aspects of CABs were extracted from included publications: time, country, financial support, research focus, responsibilities, and challenges. Thematic analyses were used to summarize textual data describing challenges. Results Our search yielded 2005 citations, 83 of which were deemed eligible for inclusion. Most studies were published between 2010 and 2017. Upper-middle-income countries were more likely to have studies describing CABs, with South Africa, China, and Thailand having the greatest numbers. The United States National Institutes of Health was the main source of financial support for CABs. Many CABs focused on HIV research. Thirty-four studies reported how CABs influenced the informed consent process for clinical trials or other aspects of research ethics. CAB responsibilities were related to clinical trials, including reviewing study protocols, educating local communities about research activities, and promoting the ethical conduct of research. Challenges faced by CABs included the following: incomplete ethical regulations and guidance; limited knowledge of science among members of communities and CABs; unstable and unbalanced power relationships between researchers and local communities; poor CAB management, including lack of formal participation structures and absence of CAB leadership; competing demands for time that limited participation in CAB activities; and language barriers between research staff and community members. Several challenges reflected shortcomings within the research team. Conclusions Our findings examine the formation and implementation of CABs in LMICs and identify several ethical challenges. These findings suggest the need for further ethics training among CAB members and researchers in LMICs. (shrink)

HIV remission clinical researchers are increasingly seeking study participants who are diagnosed and treated during acute HIV infection—the brief period between infection and the point when the body creates detectable HIV antibodies. This earliest stage of infection is often marked by flu-like illness and may be an especially tumultuous period of confusion, guilt, anger, and uncertainty. Such experiences may present added ethical challenges for HIV research recruitment, participation, and retention. The purpose of this paper is to identify potential ethical challenges (...) associated with involving acutely diagnosed people living with HIV in remission research and considerations for how to mitigate them. We identify three domains of potential ethical concern for clinicians, researchers, and ethics committee members to consider: 1) Recruitment and informed consent; (2) Transmission risks and partner protection; and (3) Ancillary and continuing care. We discuss each of these domains with the aim of inspiring further work to advance the ethical conduct of HIV remission research. For example, experiences of confusion and uncertainty regarding illness and diagnosis during acute HIV infection may complicate informed consent procedures in studies that seek to recruit directly after diagnosis. To address this, it may be appropriate to use staged re-consent procedures or comprehension assessment. Responsible conduct of research requires a broad understanding of acute HIV infection that encompasses its biomedical, psychological, social, and behavioral dimensions. We argue that the lived experience of acute HIV infection may introduce ethical concerns that researchers and reviewers should address during study design and ethical approval. (shrink)