Background: It has been widely reported that medical trainees experience situations with profound ethical implications during their clinical rotations. To address this, most U.S. medical schools include ethics curricula in their undergraduate programs. However, the contents of these curricula vary substantially. Our pilot study aimed to discover, from the students’ perspective, how ethics pedagogy prepares medical students for clerkship and what gaps might remain. Methods: This qualitative study organized focus groups of third- and fourth-year medical students. Participants recounted ethical concerns (...) encountered during clerkship rotations and reflected on how their medical school ethics curriculum informed their responses to these scenarios. Transcripts of the focus-group sessions were analyzed using a grounded theory approach to identify common themes that characterized the students’ experiences. Results: While students’ accounts demonstrated a solid grasp of ethical theory and attunement to ethical concerns presented in the clinic, they also consistently evinced an inability to act on these issues given clerks’ particular position in a complex learning hierarchy. Students felt they received too little training in the role-specific application of medical ethics as clinical trainees. We found a desire among trainees for enhanced practical ethics training in preparation for the clerkship phase of medical education. Conclusion: We recommend several strategies that can begin to address these findings. The use of roleplaying with standardized patients can enable students to practice engagement with ethical issues. Conventional ethics courses can focus more on action-based pedagogy and instruction in conflict management techniques. Finally, clear structures for reporting and seeking advice and support for addressing ethical issues can lessen students’ apprehension about acting on ethical concerns. (shrink)

Courts have determined that adaptive management does not satisfy the Endangered Species Act's requirement to use the 'best available science'. This is due, in part, to the failure to recognise the role of non-epistemic values in science. We examine the role of values in the legal controversy over the scientific reports and adaptive management plans for endangered salmon in the Columbia River Basin. To do this, we employ philosophical concepts related to risk and uncertainty that demonstrate how non-epistemic values are (...) internal to science. We describe how, because adaptive management is a method for dealing with inductive risk, by remaining flexible, responsive and adaptive in those circumstances where the costs of making a mistake are very high, it requires special attention to ensure that it remains useful. We conclude that, because non-epistemic values will inevitably influence the 'best available science', it is critical that they are clarified in any adaptive management planning so that we can ensure the salmon conservation that the ESA mandates. Fortunately, because adaptive management is iterative in nature and includes opportunities for engagement between policymakers and scientists, it enables clarification of non-epistemic values through making standards of evidence transparent, acknowledging aims and goals and dealing with uncertainty at the institutional level. (shrink)

What exactly is that quality of resilience that carries people, organizations, and communities through traumatic times? As a construct, resilience is built on the underlying assumption that an individual or organization has undergone a situation of ‘significant adversity’ and has adapted positively, returning to or increasing in performance and psychological wellbeing : 227–233, 2003; Sutcliffe and Vogus 2003). Definitions of resilience range on a continuum from survival to adaptation to competence to healing to hardiness to robustness to wellness : 205–220, (...) 1998; Luthar et al. Child Development, 71: 573–575, 2000; Coutu Harvard Business Review, 80: 46–52, 2002; Maddi 2002). Resilience is an important quality for leaders who are committed to the health of organizations. Organizational health is negatively impacted by organizational trauma; parallel to individuals’ experiences, group and organizational cultures and dynamics are wounded by trauma. While leaders cannot always protect organizations from trauma, leaders can strengthen resilience, recognize when trauma occurs, address the trauma effectively, and protect the system from spiraling into traumatization : 52–57, 2002). This paper offers recommendations for addressing organizational trauma as well as strengthening resilience, individually and collectively. Stories are shared from several organizations, demonstrating the importance of leadership and resilience in the face of trauma. (shrink)

Background: The classical symptom specificity hypothesis (Blatt, 1974) links obsessional symptoms to autonomous interpersonal behavior. Inconsistent findings from cross-sectional group studies on symptom specificity have previously been associated with several conceptual and methodological limitations intrinsic to nomothetic research. Previous empirical case research reported ambivalences between autonomous and dependent interpersonal behavior in obsessional pathology. Aim and Method: The present ‘theory-building’ case study specifically aims at further refinement of the classical symptom specificity hypothesis by testing specific operationalizations within an empirical single case (...) design. Consensual Qualitative Research for Case studies is used to quantitatively and qualitatively describe the longitudinal, clinical interplay between obsessional symptoms and interpersonal dynamics throughout the process of a psychodynamic therapy. Interpersonal functioning is assessed by means of the Core Conflictual Relationship Theme method. The classical symptom specificity hypothesis is contrasted to an alternative hypothesis of interpersonal ambivalences as determinants of obsessional symptoms. Results: Close associations between obsessions and interpersonal dynamics are observed. Findings predominantly affirm the ambivalence hypothesis rather than the classical symptom specificity hypothesis. Psychodynamic interventions focusing on interpersonal conflicts are related to symptomatic changes. Conceptual and methodological considerations, limitations and future research indications are discussed. (shrink)

This article outlines a theory of subjectivity and social consciousness that complements prevalent debates in cultural studies about marginality and subjectivity. The article suggests that we can interpret the constitution of subjectivity sociologically as between the nation-state and global market integration. More broadly, we can think about social processes in global market capitalism through returning to class formation. The article draws upon research conducted in Morocco from 1995-97 and again in 2000-02 to illustrate social transformation in market reform.

Some weeks ago, we learned that the matriarch of a family, my good friend Anna, is dying. She is 75 and has inoperable esophageal cancer, and the doctors say it will only take a few more weeks or months. Anna is dying the way I want to die–at home, surrounded and lovingly tended by her family: her devoted husband of 54 years, her three daughters, her three worshipful sons-in-law, her adoring granddaughters. All of them see her every day. All of (...) them are a part of a mutual struggle to give Anna a “good death” Anna, too, is a part of it. And, in a very small way, I am part of it, because I have been invited to be. Every few days, I walk next door and spend a few minutes talking to Anna. (shrink)

This symposium examines how various discursive frameworks inform Jewish and non-Jewish interpretations of Jewishness. Although the specific characteristics of these frameworks are context-dependent, the underlying themes remain the same: Jewish identification entails identifying “difference,” and this process of drawing distinctions between Jews and non-Jews gets developed in discursive frameworks of temporality, “race thinking,” nationalism, and genetics, among others. In the broader contexts within which Jewish identification is formulated, these frameworks serve to: delineate categories of people on the basis of socially (...) salient qualities associated with human and other bodies; evaluate these categorical “types” in regard to their determined “desirable” and “undesirable” qualities; implement institutionally sanctioned measures that facilitate the privileging of the people who apparently embody desired qualities; and enforce structural constraints within which people may choose to contest, re-inscribe, re-appropriate, and/or attempt to transform components of the other three networks mentioned above. It also emphasizes the significance of who mobilizes these discourses, with what objectives in mind, and how both factors instantiate discursive and discursively informed concretized outcomes. (shrink)

I argue that God’s holiness as conceived in Hebrew Scripture grounds human obligations to obey divine commands. To disobey the commands of a holy God would disrespect a basic good, which we have decisive reason to avoid doing. God’s holiness may be a somewhat obscure property––though I propose transcendence and perfect morality as necessary conditions––but His omniscience and perfect morality guarantee that He would not command human beings to do things that His holiness would not ground His authority to command. (...) I conclude by replying to objections. (shrink)

A mass problem is a set of Turing oracles. If P and Q are mass problems, we say that P is weakly reducible to Q if for all Y ∈ Q there exists X ∈ P such that X is Turing reducible to Y. A weak degree is an equivalence class of mass problems under mutual weak reducibility. Let [Formula: see text] be the lattice of weak degrees of mass problems associated with nonempty [Formula: see text] subsets of the Cantor (...) space. The lattice [Formula: see text] has been studied in previous publications. The purpose of this paper is to show that [Formula: see text] partakes of hyperarithmeticity. We exhibit a family of specific, natural degrees in [Formula: see text] which are indexed by the ordinal numbers less than [Formula: see text] and which correspond to the hyperarithmetical hierarchy. Namely, for each [Formula: see text], let hα be the weak degree of 0, the αth Turing jump of 0. If p is the weak degree of any mass problem P, let p* be the weak degree of the mass problem P* = {Y | ∃X ⊆ BLR )} where BLR is the set of functions which are boundedly limit recursive in X. Let 1 be the top degree in [Formula: see text]. We prove that all of the weak degrees [Formula: see text], [Formula: see text], are distinct and belong to [Formula: see text]. In addition, we prove that certain index sets associated with [Formula: see text] are [Formula: see text] complete. (shrink)

I discuss a puzzle that shows there is a need to develop a new metaphysical interpretation of mathematical theories, because all well-known interpretations conflict with important aspects of mathematical activities. The new interpretation, I argue, must authenticate the ontological commitments of mathematical theories without curtailing mathematicians' freedom and authority to creatively introduce mathematical ontology during mathematical problem-solving. Further, I argue that these two constraints are best met by a metaphysical interpretation of mathematics that takes mathematical entities to be constitutively constructed (...) by human activity in a manner similar to the constitutive construction of the US Supreme Court by certain legal and political activities. Finally, I outline some of the philosophical merits of metaphysical interpretations of mathematical theories of this type. (shrink)

During the past few years information has increasingly become a commodity. As a commodity the atypical cost structure of information goods in competitive markets result in the price of reproduction of information goods tending to zero implying that market failure is highly likely. Intellectual property rights prevent such market failure by protecting the ability of creators and/or distributors to charge for information goods and as such serve to stimulate and support the creation of information. But information also plays a vital (...) role in enabling people‘s human rights in their everyday lives and it is therefore of paramount importance that such information be accessible. Pricing of information is one of the main factors determining accessibility and pricing strategies should aim to maximise access not just profit and thereby contribute to a socially just world. This paper examines the nature and pricing of information goods and suggests differential pricing of information goods based Rawls‘ principles of social justice. (shrink)

Thomas Aquinas, one of the "founding fathers" of just war theory, offers an account of virtuous warfare in practice. The author argues that Aquinas's approach to warfare, with its emphasis on justice and charity, is helpful in providing a coherent moral account of war to which Christians can subscribe. Particular attention is given to the role of charity, since this virtue is the distinguishing characteristic of the Christian soldier. Charity compels him to soldier justly, and by fighting justly, he is (...) elevated by God to friendship with God. Notable features of this approach are its emphasis on the criteria for judging whether a war is just and its relativizing of the criteria for proper combat behavior. (shrink)

This paper analyses social practices within public health services in Morocco, suggesting that current management orientations toward models like New Public Management obscure the social relations that often make under-resourced healthcare effective. Health policy in Morocco has increasingly adopted principles that reflect neoliberal influence in international development. Citing the work of Moroccan philosopher Mohammed Abed al-Jabri and American philosopher John Searle, the paper calls for policymakers to recognise the capacity of institutions to frame social relations. Likewise, policy administration and management (...) should be guided by reflection on the social role of institutions and related social practices at the level of service delivery. (shrink)

The UK government has recently taken steps to exclude certain groups of migrants from free treatment under the National Health Service, most controversially from treatment for HIV. Whether this discrimination can have any coherent ethical basis is questioned in this paper. The exclusion of migrants of any status from any welfare system cannot be ethically justified because the distinction between citizens and migrants cannot be an ethical one.

Stephen Cole Kleene was one of the greatest logicians of the twentieth century and this book is the influential textbook he wrote to teach the subject to the next generation. It was first published in 1952, some twenty years after the publication of Godel's paper on the incompleteness of arithmetic, which marked, if not the beginning of modern logic. The 1930s was a time of creativity and ferment in the subject, when the notion of computable moved from the realm (...) of philosophical speculation to the realm of science. This was accomplished by the work of Kurt Gode1, Alan Turing, and Alonzo Church, who gave three apparently different precise definitions of computable. When they all turned out to be equivalent, there was a collective realization that this was indeed the right notion. Kleene played a key role in this process. One could say that he was there at the beginning of modern logic. He showed the equivalence of lambda calculus with Turing machines and with Godel's recursion equations, and developed the modern machinery of partial recursive functions. This textbook played an invaluable part in educating the logicians of the present. It played an important role in their own logical education.". (shrink)

This chapter talks about the war between the Formics, a seemingly malevolent species of aliens, and humans in the Ender's Game. The great tragedy of the violence that erupted from the Human/Formic war was the result of two deep misunderstandings. The Formics not only failed to grasp the capabilities of humanity, but humanity also deeply misunderstood the creatures that they would come to nickname “buggers.” These misunderstandings may have resulted from what is sometimes called “cultural incommensurability.” The chapter relates that (...) what is most important about Ender is not merely his ability to understand his “enemy,” but his ability to love them. He is able to harness the sympathies of the humans and change their minds about the buggers. Along with the Formic hive‐ queen, Ender now occupies the space in between the two conceptual schemes—a space he can never retreat from—and has begun translating their meanings. (shrink)

There are many reports about the digital divideand many discrepant interpretations of what thereports indicate. This pattern of competinganalyses, often in relation to identical datasets, has endured for a good part of the lastdecade. It is argued here that a major problemwith much of the digital divide research is afailure to include ethical concerns as anexplicit part of analyzing and interpretingdigital divide gaps. If researchers includemore recognition of ethics with their findingsabout divide gaps, it is likely that they willproduce better (...) research and findings as well asmore defensible linkages between study reportsand policy deliberations. (shrink)

This article explores how scientists adapt to a changing climate. To do this, we bring examples from a case study of salmon habitat restorationists in the Columbia River Basin into conversation with concepts from previous work on change and stability in knowledge infrastructures and scientific practice. In order to adapt, ecological restorationists are increasingly relying on predictive modeling tools, as well as initiating broader changes in the interdisciplinary nature of the field of ecological restoration itself. We explore how the field (...) of ecological restoration is shifting its conceptual gaze from restoring to past, historic baselines to anticipating a no-analog future and consider what this means in terms of understanding the adaptive capacity of knowledge infrastructures and epistemic communities more broadly. We argue that identifying how scientists themselves conceptualize drivers of change and respond to these changes is an important step in understanding what adaptive capacity in science might entail. We offer these examples as a provocation for thinking about “adaptive epistemologies” and how adaptation by scientists themselves can facilitate or hinder particular environmental or sociotechnical futures. (shrink)

In Daubert v. Merrell Dow Pharmaceuticals, Inc., the U.S. Supreme Court made its first major pronouncement on the evaluation of scientific evidence, calling on judges to act as gatekeepers for scientific knowledge and validity, despite lack of scientific training among judges. Daubert offers the science studies community a case study for examining how judges engage in boundary-work and construct scientific validity. In constructing scientific validity under Daubert, judges must evaluate the scientific method behind a particular scientific claim, and will look (...) to the parties' experts and the relevant scientific community for assistance. To combat the oft-cited problem of the battle of the experts, judges may be tempted to obtain assistance from court-appointed neutral experts, an inquisitorial system in the civil law tradition of many European countries. The judicial evaluation of scientific evidence, the resulting construction of scientific validity, and the push for a greater use of court-appointed experts reveal judges' desire to segregate "objective" scientific facts from aspects of the legal process that are infused with adversaries' values. Yet the scientific and judicial construction of validity mixes empirical results and research methods with the personal, political, and institutional values of judges and scientists. (shrink)

In the past decade, the consumption of psilocybin mushrooms has become a popular therapeutic tool for people looking to deal with mental and emotional health issues. The emerging interest in psilocybin therapy in the global north has led to the development of retreat centers in locations where psilocybin is legal or unregulated. Drawing on ethnographic research at a psilocybin retreat center in Jamaica, this article examines the emotional and somatic reactions attributed to psilocybin that influence the social interactions and the (...) mental and emotional state of the guests at this retreat center. We argue that guests go through a symbolic healing process that involves the construction of a meaning response based on internal and collective experiences of altered consciousness via psilocybin. Additionally, we emphasize how both attending the retreat and the psychedelic experience there can be considered a liminal state that leads to different modes of relation while in Jamaica. (shrink)

Vols. for 1972- include papers from the Summer Linguistics Conference, University of California, Santa Cruz.

Previous research on linguistic relativity and economic decisions hypothesized that speakers of languages with obligatory tense marking of future time reference (FTR) should value future rewards less than speakers of languages which permit present tense FTR. This was hypothesized on the basis of obligatory linguistic marking (e.g., will) causing speakers to construe future events as more temporally distal and thereby to exhibit increased “temporal discounting”: the subjective devaluation of outcomes as the delay until they will occur increases. However, several aspects (...) of this hypothesis are incomplete. First, it overlooks the role of “modal” FTR structures which encode notions about the likelihood of future outcomes (e.g., might). This may influence “probability discounting”: the subjective devaluation of outcomes as the probability of their occurrence decreases. Second, the extent to which linguistic structures are subjectively related to temporal or probability discounting differences is currently unknown. To address these, we elicited FTR language and subjective ratings of temporal distance and probability from speakers of English, which exhibits strongly grammaticized FTR, and Dutch, which does not. Several findings went against the predictions of the previous hypothesis: Framing an FTR statement in the present (“Ellie arrives later on”) versus the future tense (“…will arrive…”) did not affect ratings of temporal distance; English speakers rated future statements as relatively more temporally proximal than Dutch speakers; and English and Dutch speakers rated future tenses as encoding high certainty, which suggests that obligatory future tense marking might result in less discounting. Additionally, compared with Dutch speakers, English speakers used more low-certainty terms in general (e.g., may) and as a function of various experimental factors. We conclude that the prior cross-linguistic observations of the link between FTR and psychological discounting may be caused by the connection between low-certainty modal structures and probability discounting, rather than future tense and temporality. (shrink)

In December 2007 it was revealed that the British government is considering the exclusion of certain groups of migrants—those considered to be present “illegally”—from primary health care provided by the National Health Service. At present, practitioners have discretion to accept any individual for NHS treatment regardless of their status. A joint Home Office and Department of Health review is examining this access for foreign nationals, and the likely outcome is the restriction of access to irregular migrants, which would, according to (...) the Institute of Public Policy Research, affect around 390,000 people. In 2004 such groups were excluded from NHS secondary care, most controversially from treatment for HIV, and so the present proposal would bar them from all but emergency health treatment. (shrink)

There is an imbalance of gender roles in everyone's favorite space saga, with the vast majority of characters played by males while the female parts are minimized at nearly every turn. But the underlying problem of womanhood in Star Wars might be even more insidious than Darth Sidious himself. This chapter explains why it is difficult to embrace a strong female identity anywhere, let alone in the midst of intergalactic war. It analyzes whether the women in Star Wars have what (...) it takes to bring feminism to the Force. While Princess Leia and Queen Amidala are instantly recognizable figures in popular culture, the question arises whether they represent women positively. While Leia and Padmé are typically recognized as the feminist icons of Star Wars, they are not all the films have to offer. The women of Star Wars offer just as much as any of the individual male characters. (shrink)

Simon Blackburn’s supervenience argument—focusing on the mysterious “ban on mixed worlds”—is still subject to a variety of conflicting interpretations. In this paper, I hope to provide a defense of the argument that clarifies both the argument and the objections it must overcome. Many of the extant objections, I will argue, fail to engage the argument in its true form. And to counter the more compelling objections, it will be necessary to bring in additional argumentation that Blackburn himself does not clearly (...) provide. One important upshot of this discussion is that moral realism is not the only target of the argument: it raises trouble for a variety of metaethical views wed to realist-friendly construals of moral evaluation. Rightly understood, this argument not only survives the prominent responses, but turns out to be more powerful than his critics and Blackburn himself have recognized. (shrink)

The French writer, philosopher, and mystic Simone Weil (1909-1943) was one of the most original spiritual personalities of the 20th century. Now Coles presents a brilliant portrait of the beloved and controversial figure who was a spiritual influence on T.S. Eliot, Flannery O'Connor, Adrienne Rich, and Albert Camus.