Continence is a key moment of care that can tell us about the wider care of people living with dementia within acute hospital wards. The spotlight is currently on the quality of hospital care of older people across the UK, yet concerns persist about their poor treatment, neglect, abuse, and discrimination within this setting. Thus, within hospitals, the care of people living with dementia is both a welfare issue and a human rights issue. The challenge of continence care for (...) people living with dementia can be seen as the ‘canary in the coal mine’ for the unravelling of dignity within the acute setting. This paper draws on an ethnographic study within five hospitals in England and Wales, selected to represent a range of hospital types, geographies and socio‐economic catchments. Observational fieldwork was carried out over 154 days in acute hospitals known to admit large numbers of people living with dementia. This paper starts to fill the gap between theory and data by providing an in‐depth ethnographic analysis examining the ways in which treatment as a person is negotiated, achieved or threatened. We examine how the twin assaults on agency of a diagnosis of dementia and of incontinence threaten personhood. The acute threats to this patient group may then act to magnify perils to treatment as a person. Our findings suggest that personal dignity and the social construction of moral personhood are both threatened and maintained in such a setting. We show how empirical ethnographic data can lend weight to, and add detail to, theoretical accounts of moral personhood and dignity. (shrink)

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and (...) made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The U.S. scientific community has long led the world in research on such areas as public health, environmental science, and issues affecting quality of life. These scientists have produced landmark studies on the dangers of DDT, tobacco smoke, acid rain, and global warming. But at the same time, a small yet potent subset of this community leads the world in vehement denial of these dangers. -/- Merchants of Doubt tells the story of how a loose-knit group of high-level scientists (...) and scientific advisers, with deep connections in politics and industry, ran effective campaigns to mislead the public and deny well-established scientific knowledge over four decades. Remarkably, the same individuals surface repeatedly-some of the same figures who have claimed that the science of global warming is "not settled" denied the truth of studies linking smoking to lung cancer, coal smoke to acid rain, and CFCs to the ozone hole. "Doubt is our product," wrote one tobacco executive. These "experts" supplied it. -/- Naomi Oreskes and Erik M. Conway, historians of science, roll back the rug on this dark corner of the American scientific community, showing how ideology and corporate interests, aided by a too-compliant media, have skewed public understanding of some of the most pressing issues of our era. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Convention for Protection of Human Rights and Dignity of the Human Being with Regard to the Application of Biology and Biomedicine: Convention on Human Rights and BiomedicineCouncil of EuropePreambleThe Member States of the Council of Europe, the other States and the European Community signatories hereto,Bearing in mind the Universal Declaration of Human Rights proclaimed by the General Assembly of the United Nations on 10 December 1948;Bearing in mind the (...) Convention for the Protection of Human Rights and Fundamental Freedoms of 4 November 1950;Bearing in mind the European Social Charter of 18 October 1961;Bearing in mind the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights of 16 December 1966;Bearing in mind the Convention for the Protection of Individuals with Regard to Automatic Processing of Personal Data of 28 January 1981;Bearing also in mind the Convention on the Rights of the Child of 20 November 1989;Considering that the aim of the Council of Europe is the achievement of a greater unity between its members and that one of the methods by which that aim is to be pursued is the maintenance and further realisation of human rights and fundamental freedoms;Conscious of the accelerating developments in biology and medicine;Convinced of the need to respect the human being both as an individual and as a member of the human species and recognising the importance of ensuring the dignity of the human being; [End Page 277]Conscious that the misuse of biology and medicine may lead to acts endangering human dignity;Affirming that progress in biology and medicine should be used for the benefit of present and future generations;Stressing the need for international co-operation so that all humanity may enjoy the benefits of biology and medicine;Recognising the importance of promoting a public debate on the questions posed by the application of biology and medicine and the responses to be given thereto;Wishing to remind all members of society of their rights and responsibilities;Taking account of the work of the Parliamentary Assembly in this field, including Recommendation 1160 (1991) on the preparation of a Convention on bioethics;Resolving to take such measures as are necessary to safeguard human dignity and the fundamental rights and freedoms of the individual with regard to the application of biology and medicine;Have agreed as follows:Chapter IGeneral provisionsArticle 1. (Purpose and object)Parties to this Convention shall protect the dignity and identity of all human beings and guarantee everyone, without discrimination, respect for their integrity and other rights and fundamental freedoms with regard to the application of biology and medicine.Each Party shall take in its internal law the necessary measures to give effect to the provisions of this Convention.Article 2. (Primacy of the human being)The interests and welfare of the human being shall prevail over the sole interest of society or science.Article 3. (Equitable access to health care)Parties, taking into account health needs and available resources, shall take appropriate measures with a view to providing, within their jurisdiction, equitable access to health care of appropriate quality. [End Page 278]Article 4. (Professional standards)Any intervention in the health field, including research, must be carried out in accordance with relevant professional obligations and standards.Chapter IIConsentArticle 5. (General rule)An intervention in the health field may only be carried out after the person concerned has given free and informed consent to it.This person shall beforehand be given appropriate information as to the purpose and nature of the intervention as well as on its consequences and risks.The person concerned may freely withdraw consent at any time.Article 6. (Protection of persons not able to consent)1. Subject to Articles 17 and 20 below, an intervention may only be carried out on a person who does not have the capacity to consent, for his or her direct benefit.2. Where, according to law, a minor does not have the capacity to consent to an intervention, the intervention may only be carried out with the authorisation of his or her representative or an authority or a person or... (shrink)

Objective Apeiron was founded in 1966 and has developed into one of the oldest and most distinguished journals dedicated to the study of ancient philosophy, ancient science, and, in particular, of problems that concern both fields. Apeiron is committed to publishing high-quality research papers in these areas of ancient Greco-Roman intellectual history; it also welcomes submission of articles dealing with the reception of ancient philosophical and scientific ideas in the later western tradition. The journal appears quarterly. Articles are peer-reviewed (...) on a double-blind basis. Topics ancient philosophy ancient science reception of ancient philosophical and scientific ideas in the later western tradition Article formats Original Articles. (shrink)

Unlike some other reproductions of classic texts (1) We have not used OCR(Optical Character Recognition), as this leads to bad quality books with introduced typos. (2) In books where there are images such as portraits, maps, sketches etc We have endeavoured to keep the quality of these images, so they represent accurately the original artefact. Although occasionally there may be certain imperfections with these old texts, we feel they deserve to be made available for future generations to enjoy.

Ethics is a foundational competency in healthcare inherent in everyday nursing practice. Therefore, the promotion of qualified nurses’ and nursing students’ moral competence is essential to ensure ethically high-quality and sustainable healthcare. The aim of this integrative literature review is to identify the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence. The review has been registered in PROSPERO (CRD42023386947) and reported according to the PRISMA guideline. Focusing on qualified nurses’ and nursing students’ moral competence, (...) a literature search was undertaken in January 2023 in six scientific databases: CINAHL, Cochrane Library, PsycINFO, PubMed Medline, Scopus and Web of Science. Empirical studies written in English without time limitation were eligible for inclusion. A total of 29 full texts were retrieved and included out of 5233 citations. Quality appraisal was employed using Joanna Briggs Institute checklists and the Mixed Method Appraisal Tool. Data were analysed using inductive content analysis. Research about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence is limited and mainly explored using descriptive research designs. The contributing factors were identified as comprising two main categories: (1) human factors, consisting of four categories: individual, social, managerial and professional factors, and ten sub-categories; and (2) structural factors, consisting of four categories: educational, environmental, organisational and societal factors, and eight sub-categories. This review provides knowledge about the factors contributing to the promotion of qualified nurses’ and nursing students’ moral competence for the use of researchers, nurse educators, managers, organisations and policymakers. More research about the contributing factors is needed using complex intervention, implementation and multiple methods designs to ensure ethically sustainable healthcare. (shrink)

Air pollutants pose a threat to biodiversity throughout the world. This study was conducted to evaluate atmospheric element accumulation in Isparta city, including Gölcük Nature Park, located in the Western Mediterranean Region of Turkey. It is aimed to determine the air quality and potential pollutant sources in the region through lichen biomonitoring. Specimens of the epiphytic foliose lichen Physcia aipolia (Erh. ex Humb.) Fürnr. were sampled from 14 sites in the study area and analyzed by ICP-MS with reference material (...) in order to detect 11 trace elements; Al, As, Cd, Cr, Cu, Fe, Mn, Ni, Pb, V, and Zn. The spatial distribution of these airborne elements in the study area was mapped. The results showed that the elemental sequence in terms of average concentrations measured was as follows: Ni >Cr >V >Fe >As >Al >Zn >Cu> >Cd >Mn >Pb. The results of cluster analyses of the elemental data indicated that the 3 major contaminants in the urban area were Cr, Ni, and V, probably due to the extensive use of coal in heating facilities and gasoline in vehicles. P. aipolia specimens accumulated maximal concentrations of As, Cr, Fe, Ni, and V in the northern and the southeastern localities surrounding the city, while Cd, Pb were most abundant in the eastern edge of Gölcük Nature Park. The pollution in Isparta city with heavy metal is worse than expected, mostly due to the extensive use of coal as fossil fuel. In addition, it seems to be associated with the city's topographic and climatic characteristics, e.g. inversion effects. (shrink)

Doctoral programs at U.S. universities play a critical role in the development of human resources both in the United States and abroad. This volume reports the results of an extensive study of U.S. research-doctorate programs in five broad fields: physical sciences and mathematics, engineering, social and behavioral sciences, biological sciences, and the humanities. Research-Doctorate Programs in the United States documents changes that have taken place in the size, structure, and quality of doctoral education since the widely used 1982 editions. (...) This update provides selected information on nearly 4,000 doctoral programs in 41 subdisciplines at 274 doctorate-granting institutions. This volume also reports the results of the National Survey of Graduate Faculty, which polled a sample of faculty for their views on the scholarly quality of program faculty and the effectiveness of doctoral programs in preparing research scholars/scientists. This much-anticipated update of such an essential reference will be useful to education administrators, university faculty, and students seeking authoritative information on doctoral programs. (shrink)

This study brings together two important literatures together in the one volume. One concerns the role of quality assessments in social policy, especially health policy. The second concerns ethical and social issues raised by prenatal testing for disability. Hitherto, these two literatures have had little contact with each other: few scholars have written about both, or have compared the two domains in a systematic way, while people with disabilities and disability scholars are underrepresented in recent discussion on health policy (...) and quality of assessment. This book turns the perspectives of disability scholars on issues that have largely been the province of health methodology, policy and philosophy, while angling philosophical policy analysis on problems that have largely been the province of disability scholarship. This volume will be sought after by bioethicists, philosophers, and specialists in disability studies and healthcare economics. (shrink)

The quality of doctoral-level biochemistry (N=139), botany (N=83), cellular/molecular biology (N=89), microbiology (N=134), physiology (N=101), and zoology (N=70) programs at United States universities was assessed, using 16 measures. These measures focused on variables related to: (1) program size; (2) characteristics of graduates; (3) reputational factors (scholarly quality of faculty, effectiveness of programs in educating research scholars/scientists, improvement in program quality during the last 5 years); (4) university library size; (5) research support; and (6) publication records. Chapter I (...) discusses prior attempts to assess quality in graduate education, development of the study plans, and the selection of disciplines and programs to be evaluated. Chapter II discusses the methodology used, focusing on each of the assessment measures. Chapters III to VIII present, respectively, findings from the analyses of the biochemistry, botany, cellular/molecular biology, microbiology, physiology, and zoology programs. Chapter IX includes a summary of results, correlations among measures, several additional analyses, and suggestions for future studies. Among the findings reported are those indicating that cellular/molecular biology programs had, on the average, the largest number of faculty and that students in cellular/molecular biology, biology, biochemistry, microbiology, and physiology received a relatively high fraction of financial support. (Survey instruments and supporting documentation are included in appendices.) (JN). (shrink)

The quality of doctoral-level chemistry (N=145), computer science (N=58), geoscience (N=91), mathematics (N=115), physics (N=123), and statistics/biostatistics (N=64) programs at United States universities was assessed, using 16 measures. These measures focused on variables related to: program size; characteristics of graduates; reputational factors (scholarly quality of faculty, effectiveness of programs in educating research scholars/scientists, improvement in program quality during the last 5 years); university library size; research support; and publication records. Chapter I discusses prior attempts to assess (...) class='Hi'>quality in graduate education, development of the study plans, and the selection of disciplines and programs to be evaluated. Chapter II discusses the methodology used, focusing on each of the assessment measures. Chapters III to VIII present, respectively, findings from the analyses of the chemistry, computer science, geoscience, mathematics, physics, and statistics/biostatistics programs. Chapter IX includes a summary of results, correlations among measures, several additional analyses, and suggestions for future studies. Among the findings reported are those indicating that mathematics programs had, on the average, the largest number of faculty (N=33) in December 1980 followed closely by physics (N=28) and chemistry (N=23), and that 80 percent of computer science students had job commitments by graduation. (Survey instruments and supporting documentation are included in appendices.) (JN). (shrink)

The Quality of Thought develops and defends the thesis that thinking is a kind of experience, characterized by a sui generis (“cognitive”) phenomenology, determinates of which are thought contents—what I call the phenomenal intentionality of thought thesis. It draws out the implications of this thesis for issues in philosophy of mind, philosophy of language and metaphysics. The view defended is radically internalist and intensionalist, and thus goes against received doctrines in philosophy of mind (externalism) and language (extensionalism). It also (...) advocates for a metaphysically neutral, non-naturalistic approach to the philosophical study of mind—what I call “Analytic Phenomenology”—in combination with agnosticism about the nature of the relationship between consciousness and physical reality. -/- The book identifies persistent problems with Dretske-inspired causal-informational-teleological theories of conceptual content, and diagnoses them as due to leaving out what it’s like to think a thought—to entertain or grasp a propositional (conceptual) content. It is thus a contribution to the increasingly influential Phenomenal Intentionality Research Program. It includes refutations of classic externalism (Putnam and Burge) and arguments that standard motivations for direct reference theories of names (Kripke), indexicals and demonstratives (Kaplan) are not inevitable, and alternative accounts of their (and their conceptual equivalents’) semantics. It also addresses outstanding challenges to the phenomenal intentionalist view of thought content, including the existence of unconscious thought, the elusiveness of conceptual phenomenology, the matching content problem, phenomenal compositionality, and the determination of conceptual reference. (shrink)

Richard Kraut presents a new theory of human well-being. Kraut's principal idea, Aristotelian in spirit, is that 'external goods' have at most an indirect bearing on the quality of our lives. A good internal life - one with quality emotional, intellectual, social, and perceptual experiences - is what well-being consists in.

The odds of encountering a senior citizen selling on the street have increased. The claim that they have no choice but to work and sell on the street, despite the dangers, illnesses, and psychological issues they may face, to provide for their family’s needs is very evident. Therefore, this study explores the quality of life, lived experiences, challenges, and coping mechanisms of senior citizen street vendors in Bulacan, Philippines. The study employed Heideggerian Phenomenology and Interpretative Phenomenological Analysis (IPA). Moreover, (...) the following themes arise (1) Golden years, (2) Socially connected, and (3) Unknown journey. These themes highlighted the experiences and challenges faced by the participants. Moreover, it is highly suggested that local government agencies enhance and strictly monitor the existing program that alleviates mental and physical health concerns and senior citizens' safety and financial assistance. (shrink)

The technological advances in medicine, including prolongation of life, have constituted several dilemmas at the end of life. In the context of the Belgian debates on end-of-life care, the views of Muslim women remain understudied. The aim of this article is fourfold. First, we seek to describe the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward withholding and withdrawing life-sustaining treatments. Second, we aim to identify whether differences are observable among middle-aged and elderly women’s attitudes toward withholding (...) and withdrawing life-sustaining treatments. Third, we aim to explore the role of religion in their attitudes. Fourth, we seek to document how our results are related to normative Islamic literature. Qualitative empirical research was conducted with a sample of middle-aged and elderly Moroccan Muslim women living in Antwerp and with experts in the field. We found an unconditional belief in God’s sovereign power over the domain of life and death and in God’s almightiness. However, we also found a tolerant attitude, mainly among our middle-aged participants, toward withholding and withdrawing based on theological, eschatological, financial and quality of life arguments. Our study reveals that religious beliefs and worldviews have a great impact on the ethical attitudes toward end-of-life issues. We found divergent positions toward withholding and withdrawing life-sustaining treatments, reflecting the lines of reasoning found in normative Islamic literature. In our interviews, theological and eschatological notions emerged as well as financial and quality of life arguments. (shrink)

Quality of life is part of many different discourses and has been used in a variety of meanings ranging from purely descriptive (as in some medical contexts) to distinctly evaluative meanings (as in some social science and political contexts). The paper argues that there are good normative reasons to make the concept as descriptive as possible at least in its medical applications and, furthermore, to reconstruct it in a thoroughgoing subjectivist way, making the reflexive self-evaluation of the subject him- (...) or herself the ultimate standard. Attention is drawn to the fact that only few of the measures of quality of life applied in present-day medicine correspond to these requirements. (shrink)

In the past years, many students had problems with their finances, especially their expenses for education. Many of the students are affected by the crisis financially, emotionally, and by their wellbeing. That is why the government provides programs that will help the students with their problems with school expenses, and that is through the Tertiary Education Subsidy (TES) of the Commission on Higher Education (CHED). Further, the primary goal of this study is to explore the TES Grantees' lived experiences, challenges, (...) and coping mechanisms. Furthermore, these are the study's findings: (1) The grantees find the TES very helpful regarding finances that will tackle their academic needs, such as tuition fees and school learning materials. (2) Many students value government assistance that motivates them to maintain their grades. (shrink)

Traditionally, theories of moral responsibility feature only the minimally sufficient conditions for moral responsibility. While these theories are well-suited to account for the threshold of responsibility, it’s less clear how they can address questions about the degree to which agents are responsible. One feature that intuitively affects the degree to which agents are morally responsible is how difficult performing a given action is for them. Recently, philosophers have begun to develop accounts of scalar moral responsibility that make use of this (...) notion of difficulty (Coates and Swenson 2013; Nelkin 2016). In this paper, I argue that these accounts, although innovative, are incomplete. The degree to which agents are morally responsible is determined not only by the difficulties that agents face but also by the quality of the reasons for which they act. (shrink)

Difficulty is often treated as blame-mitigating, and even exculpating. But on some occasions difficulty seems to have little or no bearing on our assessments of moral responsibility, and can even exacerbate it. In this paper, I argue that the relevance (and irrelevance) of difficulty with regard to assessments of moral responsibility is best understood via Quality of Will accounts. I look at various ways of characterising difficulty – including via sacrifice, effort, skill and ‘trying’ – and set out to (...) demonstrate that these factors are only blame-mitigating where, and to the extent that, they complicate ascriptions of insufficient concern. Matters become more complex, however, when we turn to difficult circumstances that seem to generate such objectionable attitudes. This is arguably the case with epistemic difficulty and certain instances of moral ignorance. Here I argue that certain difficult circumstances diminish the sense in which false moral beliefs are genuinely revelatory of the agents who hold them. In particular, I draw on the distinction between difficulty that generates objectionable attitudes, and objectionable attitudes that generate difficulty. I argue that the former, but not the latter, can plausibly be viewed as blame mitigating, and that this would apply to (limited) cases of moral ignorance. (shrink)

Quality improvement mechanisms increasingly use outcome measures to evaluate health care providers. This move toward outcome measures is a radical departure from the traditional focus on process measures. More radical still is the proposal to shift from relatively simple and proximal measures of outcome, such as mortality, to complex outcomes, such as quality of life. While the practical, scientific, and ethical issues associated with the use of outcomes such as mortality and morbidity to compare health care providers have (...) been well rehearsed, the specific concerns associated with the use of quality of life measures in quality of care research have received little attention. As with much research on quality of life there is a tendency to assume that the disadvantages are outweighed by the general virtue of “listening” to patients. In this paper we disagree with this assumption and argue that quality of life is a process, not an outcome. (shrink)

This chapter explores how far one can go accounting for the moral responsibility implications of several unusual mental conditions using a parsimonious quality-of-will account that relies on the way we talk about moral responsibility in more mundane situations. By contrasting situations involving epistemic irrationality versus cognitive impairment, it becomes clear that the presence of those often (but not always) excuses actions performed by unusual agents. The discussion turns to cases of clinical depression and sketches a way for quality-of-will (...) accounts to approach them. It is also argued that of some of these mental conditions, there is no particular reason to think that they excuse. There is also an argument against regarding the concept "mental disorder" and current DSM categories as critical to agency theory. (shrink)

Political liberals refuse that there are biophysical limits to human wealth accumulation. Coal fuelled the first liberal political economy — England’s — for 800 years before coal smoke was legally regulated in London. The English also have an enduring love for the diverse and scenic quality of their island nation, and a long history of commons governance that predates the acts of land theft which accompanied the emergence of political liberalism. By contrast the United States is a (...) modern liberal polity with little collective memory of commons. American political economists therefore refuse that commons can be collectively governed, or even that atmospheric pollution may be conceived as a problem of commons governance. The historically unsituated character of North American liberals — and liberalism more generally — also explains their inability adequately to describe moral connections between past, present and future generations implicated in anthropogenic climate change. The Christian account of the spiritual communion of saints remains a more powerful intergenerational narrative than political liberalism. As interpreted by Tolstoy, Gandhi and John Howard Yoder, true spiritual communion is characterised by the Christ-shaped refusal to render evil for evil. This refusal is an essential corrective to the realist and violent frame of international relations in which the international implications of climate change is conventionally conceived. (shrink)

Philosophical work on the concept of consent in the past few decades has got to grips with it as a rich notion. We are increasingly sensitive to consent not as a momentary, atomic, transactional thing, but as a complex idea admitting of various qualities and dimensions. In this paper we note that the recognition of this complexity demands a theoretical framework quite different to those presently extant, and we suggest that the enactive approach is one which offers significant value in (...) this regard. In consonance with arguments made by Laurie Penny about how consent is a continuous and dynamic process, we outline how an enactive approach identifies consent as temporally extended (rather than momentarily transactional), and as affected by the skilfulness of the agents involved, the fitness of community provided resources to negotiate the consensual relationship over time, and the unfolding of circumstances in the situation in which the joint action is taking place. We argue that the value of an enactive perspective on consent is in highlighting these complexities, and providing resources to articulate and theorise them in ways that are not open to other current approaches. (shrink)

In this paper, I defend my book Conversation and Responsibility in response to three critics: Julia Driver, David Shoemaker, and Manuel Vargas. Driver raises questions about my account of private blame. Shoemaker finds problems with my account of quality of will. And Vargas questions the conversational nature of my account.

The aim of the present paper is to describe three different attempts, which have been made by philosophers, to define what quality of life is; and to spell out some of the difficulties that faces each definition. One, Perfectionism, focuses on the capacities that human beings possess: capacities for friendship, knowledge and creative activity, for instance. It says that the good life consists in the development and use of these capacities. Another account, the Preference Theory, urges that satisfying one's (...) preferences, or desires, is what improves one's quality of life. And a third account, Hedonism, sees life-quality as consisting in the enjoyment of pleasure and the avoidance of pain. The paper describes and evaluates objections to each of these views, thereby displaying their weaknesses and strengths. Since no view comes out as the right one there is a choice to be made. At the end of the paper it is being discussed how well each of the views cohere with different methodologies used in quality of life research. Also it is suggested that considerations about what the research is to be used for are relevant. (shrink)

This article proposes a novel strategy, one that draws on insights from antidiscrimination law, for addressing a persistent challenge in medical ethics and the philosophy of disability: whether health systems can consider quality of life without unjustly discriminating against individuals with disabilities. It argues that rather than uniformly considering or ignoring quality of life, health systems should take a more nuanced approach. Under the article's proposal, health systems should treat cases where quality of life suffers because of (...) disability-focused exclusion or injustice differently from cases where lower quality of life results from laws of nature, resource scarcity, or appropriate tradeoffs. Decisionmakers should ignore quality-of-life losses that result from injustice or exclusion when ignoring them would improve the prospects of individuals with disabilities; in contrast, they should consider quality-of-life losses that are unavoidable or stem from resource scarcity or permissible tradeoffs. On this proposal, while health systems should not amplify existing injustice against individuals with disabilities, they are not required to altogether ignore the potential effects of disability on quality of life. (shrink)

Under the Second Demographic Transition, alternative forms of living arrangement are on the rise. The aim of this article is to compare quality of life in children living in married and cohabiting families. We present the results of representative research conducted in Slovakia in 2018 (N = 1,010 respondents). We tested whether children brought up in traditional married families had better material resources and healthcare, fewer behavioural problems, better peer relations and spent more leisure time with their parents than (...) children brought up by cohabiting parents. We also investigated whether number of children in the family and net monthly household income affected the children’s quality of life. The results show that there were almost no differences in quality of life between children brought up by married and by cohabiting parents and that number of children in the family and level of net monthly household income affected only the child’s material resources. (shrink)

The Quality of Life: Aristotle Revised, by KrautRichard. Oxford: Oxford University Press, 2018. Pp. x + 249.

How an abstract immaterial being is connected to a physical thing has been viewed variously by western philosophers who considered the issue prior to their Muslim counterparts.Muslim theologians and philosophers, however, developed the related discussions which became heated following the translation of logical books and essays throughout the Translation Era.The focus of this article, besides clarifying the ideas raised by Muslim philosophers in this regard,is to shed light on Mulla Sadra's opinion and its influence on the later philosophers, Abd-ul-Razzaq Lahiji (...) in particular.To explain his opinion,Mulla Sadra primarily brings a proof to establish the unity of the soul,and to prove this,he has refuted the reasons used by the opposing philosophers through negation and affirmation.Using negation,he comments on why there can't be a unity of soul, and then refers to his opponent's inability to distinguish between specific unity and generic unity considering the latter equal to vegetable,animal and human spirits.Soul and body,Mulla Sadra reiterates,are attached to each other in two ways; in one way,soul is attached to body and yet it is contingent on itself and not on the person's being; in the other way,soul is attached to body while the person's potentialities are actualized; this second type of attachment relates to obtaining existential virtues.It must be noted that Mulla Sadra's belief in these two types of attachment results from his belief in the trans-substantial motion in which soul is also involved.Mulla Sadra works out a solution to the question of relation between soul and body and their effects on one another by proposing the mediation of a veiled spirit, since the soul which belongs to a world of pure light does not involve itself directly in the affairs of the dark body. The veiled spirit is as subtle as the non-material soul and as corporeal as it needs in connectionwith body.This view has been argued by Allameh Tabatabii who thinks corporeal qualities and ontological status must be kept separated and not be mixed.Lahiji,on the other hand, seems to have accepted Mulla Sadra's idea looking at it as a philosophical question,not a medical case. He,like Mulla Sadra, while considering unity for soul, thinks of it as having properties such as sensation imagination estimation intellection. According to Lahiji,the unity of soul and body is like the unity of matter and form; however,unlike natural forms,it does not subsist in matter and interestingly,this notion resembles Neo-Platonist views. (shrink)

Background While there are many guidelines on how to make ethical decisions at the end of life, there is little evidence regarding the quality of this sort of ethical guidelines. Objectives First, this study aims to demonstrate the conceptual transferability of the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument for the quality assessment of ethical guidelines. Second, it aims to illustrate the status quo of the quality of guidelines on end-of-life decision-making by using the AGREE (...) instrument in a first practice test. Method The transferability of the AGREE instrument on the quality assessment of ethical guidelines is demonstrated by conceptual analysis. Guidelines on end-of-life decisions in medicine are identified through a systematic search in MEDLINE (from June 1999 to June 2009). The quality of all included guidelines was assessed with a slightly modified AGREE instrument. Results Of 103 guidelines identified, 34 were included as relevant. The majority of the guidelines analysed in this study were assessed as qualitatively insufficient in five out of six AGREE quality domains. A few guidelines demonstrated, however, that a high level of quality in accordance with the AGREE requirements is possible. Conclusion This review concludes that the quality of many ethical guidelines should and can be improved in all quality domains specified by the AGREE instrument. Furthermore, conceptual analysis indicates that a slightly modified AGREE instrument is transferable to the comprehensive evaluation of the quality of ethical guidelines. Nevertheless, future research is needed to improve the assessment of the presentation of the guidelines' normative basis. (shrink)

This paper identifies four major forms of scholarship in bioethics: empirical research, the articulation of mid-level principles of bioethics, the relating of these principles to fundamental moral theories, and discussions of the bioethical implications of legal principles and health delivery policies. It develops a reflective equilibrium approach to the relation between these four forms of scholarship. It then presents, in light of this approach, criteria for quality research in each of these forms of scholarship in bioethics. Keywords: quality (...) of scholarship, reflective equilibria in bioethics, research in bioethics CiteULike Connotea Del.icio.us What's this? (shrink)

The growth of individuals and society heavily relies on education. Certain hindrances may prompt some students to halt their academic pursuits temporarily. This is known as "Balik-aral." The exploration of the quality of life, lived experiences, and challenges of grade 12 Balik-aral students was undertaken by the authors to break their silence and help them by developing recommendations that could be presented to the school's key stakeholders. A phenomenological approach was used to understand the phenomenon in a study involving (...) five grade 12 balik-aral students from different strands currently enrolled in a public school in Cebu City, Philippines. A structured interview was used to collect data, and significant themes emerged during data analysis using Colaizzi's method. The study revealed several sub-themes, including age disparities and pressure to obtain the diploma while maintaining quality of life. Additionally, key informants emphasized the sense of community and an immersive learning environment in their lived experiences as balik-aral students. Finally, competing priorities and scarcity of resources emerged as significant challenges for those involved in the study. Consequently, the investigation has determined that balik-aral students must be treated equitably to foster their engagement with their peers and enhance their self-assurance, ultimately leading to academic success. (shrink)

One of P. F. Strawson's suggestions in “Freedom and Resentment” was that there might be an elegant theory of moral responsibility that accounted for all of our responsibility responses in a way that also explained why we get off the hook from those responses. Such a theory would appeal exclusively toquality of will: when we react with any of a variety of responsibility responses to someone, we are responding to the quality of her will with respect to us, and (...) when we let her off the hook, we are doing so in virtue of her lacking the capacity for the relevant quality of will. Strawson's own attempt to put forward such a view fails, for reasons Gary Watson has given, but several other theorists have advanced their own, more developed,Pure Quality of Willtheories in recent years. Specifically, there have been three distinct interpretations of “will” defended in the literature, yielding three different possible targets of our responsibility responses: quality ofcharacter, quality ofjudgment, or quality ofregard.My first task in this essay will be to show that none of these theories individually can captureallof our responsibility responses, given our deeply ambivalent responses to several marginal cases. One reaction to this fact might be to abandon the quality of will approach altogether. Another, more plausible, reaction is to develop a pluralistic account of responsibility, one that admits three noncompeting conceptions of responsibility, each of which emphasizes one of the three different qualities of will as the target of a distinct subset of our responsibility responses. On this pluralistic approach, marginal agents might be responsible on some conceptions, but not responsible on others. In the bulk of the paper, I discuss each of the relevant subsets of responsibility responses, the different qualities of will they target, what the capacities for the three qualities of will are, and how the pluralistic qualities of will approach could account for our ambivalence in the marginal cases. (shrink)

Recent work in the psychology of happiness has led some to conclude that we are unreliable assessors of our lives and that skepticism about whether we are happy is a genuine possibility worth taking very seriously. I argue that such claims, if true, have worrisome implications for procreation. In particular, they show that skepticism about whether many if not most people are well positioned to create persons is a genuine possibility worth taking very seriously. This skeptical worry should not be (...) confused with a related but much stronger version of the argument, which says that all human lives are very bad and not worth starting. I criticize the latter stance, but take seriously the former stance and hope it can be answered in future work. (shrink)

In their article, Dylon McChesney & Mathieu Doucet argue that any viable account of the epistemic condition needs to account for the right scope of cases where an agent’s mental disorder results in exculpating ignorance. The authors then argue that this constraint on viability poses a serious problem for George Sher’s account of the epistemic condition, but not for quality of will views. In this discussion note, I do not challenge the viability constraint about mental disorder-based ignorance nor do (...) I challenge McChesney & Doucet’s argument that Sher’s account unjustly blames many cases of disorder-based ignorance. Instead, I argue against their position that quality of will views have the resources to accurately capture the scope of cases where mental disorders lead to exculpating ignorance. I argue that quality of will views fall short because they do not take into consideration the way that a non-culpably acquired difficulty, such as developing a mental disorder in childhood, can make an expectation that the agent avoid the disorder-based ignorance an unreasonably demanding expectation. This shortcoming results in quality of will views unjustly blaming agents for their disorder-based ignorance in some cases where the ignorance i) reflects a poor quality of will, but ii) it would be unreasonable to expect the agent to have avoided the ignorance. (shrink)

ContextPeople with mental disorders can acquire long-term disabilities, which could impair their functioning and quality of life (QoL), requiring permanent care and social support. Systematic data on QoL and functioning, which could support a better management of these people, were not available.ObjectiveTo analyze the QoL, level of functioning and their association with sociodemographic and clinical factors of people with mental disorders who underwent deinstitutionalization using assisted living facilities.MethodsA Cross-sectional study was conducted between July 2018 and July 2019, through interviews (...) using the World Health Organization Quality of Life (WHOQOL-BREF) to determine the QoL scores, and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to determine the level of functioning. All adults (≥18 years old) with mental disorders, who underwent deinstitutionalization, users of assisted living facilities and assisted by the Psychosocial Assistance Centers III, in a city in the state of São Paulo, Brazil, were selected. For statistical analysis of the associated factors, Student’st-test was used for dichotomous variables and ANOVA for polynomial variables. Pearson correlation coefficient was used to measure the association between QoL and functioning scores.ResultsOut of 359 people who underwent deinstitutionalization with mental disorders, 147 met the eligibility criteria. The mean total score for the WHOQOL-BREF was 66.5 ± 13.4 and the mean score for WHODAS 2.0 was 10.4 ± 7.6. An association was found between people who were studying (n= 65.8; 95%CI, 63.5–68.1vs. n= 73.9; 95%CI, 67.5–80.3;p= 0.04) and better WHOQOL-BREF QoL scores or WHODAS 2.0 levels of functioning (n= 10.9; 95%CI, 9.6–12.2vs. n= 5.1; 95%CI, 2.5–7.7;p= 0.01). A weak negative correlation (r= 0.41) emerged between higher QoL scores and functioning improvement.ConclusionThis study indicates that the QoL of the sample is associated by their functioning levels, which, in turn, may reflect on their social interactions. Public policies that favor interventions increasing socialization of this population can result in better health outcomes. The QoL and functioning scores provide valuable insights to develop public policies more suited to this population profile. (shrink)

Ayahuasca, a hallucinogen with profound consciousness- altering properties, has been increasingly utilized in recent studies (e.g., Strassman, 2001; Shanon, 2002a,b). However, other than Shanon's recent work, there has been little attempt to examine the effects of ayahuasca on perceptual, affective and cognitive experience, its relation to fringe consciousness or to pertinent personality variables. Twenty-one volunteers attending a seminar on ayahuasca were administered personality measures and a semi-structured interview about phenomenal qualities of their experience. Ayahuasca ingestion was associated with profound alterations (...) of temporal- spatial experiences including expansive space and slowed time. Ayahuasca use was also associated with positive emotional states, higher levels of fantasy proneness and psychological absorption and a greater openness to mystical experiences. Conversely, quickened time was associated with negative emotionality. The results are discussed within a multi-faceted model of fringe consciousness with a particular emphasis on Hunt's (1995) models of cross-modal translation as the basis for higher-order symbolic cognition and support James' (1890/1950) contention that fringe consciousness is essential to human cognition. (shrink)

A new word has recently entered the British medical vocabulary. What it stands for is neither a disease nor a cure. At least, it is not a cure for a disease in the medical sense. But it could, perhaps, be thought of as an intended cure for a medicosociological disease: namely that of haphazard or otherwise ethically inappropriate allocation of scarce medical resources. What I have in mind is the term ‘QALY’, which is an acronym standing for quality adjusted (...) life year. Just what this means and what it is intended to do I shall explain in due course. Let me first, however, set the scene. (shrink)