We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad and The (...) Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)

The problem of justifying legal punishment has been at the heart of legal and social philosophy from the very earliest recorded philosophical texts. However, despite several hundred years of debate, philosophers have not reached agreement about how legal punishment can be morally justified. That is the central issue addressed by the contributors to this volume. All of the essays collected here have been published in the highly respected journal Philosophy & Public Affairs. Taken together, they offer not only significant proposals (...) for improving established theories of punishment and compelling arguments against long-held positions, but also ori-ginal and important answers to the question, "How is punishment to be justified?"Part I of this collection, "Justifications of Punishment," examines how any practice of punishment can be morally justified. Contributors include Jeffrie G. Murphy, Alan H. Goldman, Warren Quinn, C. S. Nino, and Jean Hampton. The papers in Part II, "Problems of Punishment," address more specific issues arising in established theories. The authors are Martha C. Nussbaum, Michael Davis, and A. John Simmons. In the final section, "Capital Punishment," contributors discuss the justifiability of capital punishment, one of the most debated philosophical topics of this century. Essayists include David A. Conway, Jeffrey H. Reiman, Stephen Nathanson, and Ernest van den Haag. (shrink)

Studies on informed consent to medical research conducted in low or middle-income settings have increased, including empirical investigations of consent to genetic research. We investigated voluntary participation and comprehension of informed consent among women involved in a genetic epidemiological study on breast cancer in an urban setting of Nigeria comparing women in the case and control groups.

The notion of “cultural competency” in healthcare has gained currency in recent years. Health professionals are expected to be sensitive to the cultural backgrounds and language of their patients. Courses on cultural competency are now routinely offered to physicians, nurses, and others working in health fields. Although the rhetoric of cultural competency has been applied to clinical contexts, little attention has been given to its applicability in health research generally or, more specifically, in international health research. In this paper, I (...) briefly explore the relevance and limitations of cultural competency for informed consent to international health research, particularly in the context of low-resource settings. (shrink)

The aims of this study were to examine the effectiveness of a range of smartphone apps for managing symptoms of anxiety and depression and to assess the utility of a single-case research design for enhancing the evidence base for this mode of treatment delivery. The study was serendipitously impacted by the COVID-19 pandemic, which allowed for effectiveness to be additionally observed in the context of significant community distress. A pilot study was initially conducted using theSuperBetter app to evaluate the proposed (...) methodology, which proved successful with the four finishing participants. In the main study, 39 participants commenced, with 29 finishing the intervention phase and completing post-intervention measures. At 6-month follow-up, a further three participants could not be contacted. This study used a digitally enhanced, multiple baseline across-individuals single-case research design. Participants were randomly assigned to the following apps:SuperBetter,Smiling Mind,MoodMission,MindShift, andDestressify. Symptomatology and life functioning were measured at five different time points: pre-baseline/screening, baseline, intervention, 3-week post-intervention, and 6-month follow-up. Detailed individual perceptions and subjective ratings of the apps were also obtained from participants following the study’s completion. Data were analyzed using visual inspection, time-series analysis, and methods of statistical and clinical significance. Positive results were observed for all apps. Overall, more favorable outcomes were achieved by younger participants, those concurrently undertaking psychotherapy and/or psychotropic medication, those with anxiety and mixed anxiety and depression rather than stand-alone depression, and those with a shorter history of mental illness. Outcomes were generally maintained at 6-month follow-up. It was concluded that a diverse range of evidence-based therapies offered via apps can be effective in managing mental health and improving life functioning even during times of significant global unrest and, like all psychotherapies, are influenced by client features. Additionally, this single-case research design is a low-cost/high value means of assessing the effectiveness of mental health apps.Clinical Trial Registration: The study is registered with the Australian and New Zealand Clinical Trials Registry, which is a primary registry in the World Health Organization Registry Network, registration number ACTRN12619001302145p. (shrink)

The fourth volume in the Criminalization series, this volume explores some of the most general principles and theories of criminalization. It includes not only philosophical work, but also historical, legal, and sociological investigations into criminalization, clarifying the state of the discipline today.

The theories of inclusive fitness and multilevel selection provide alternative perspectives on social evolution. The question of whether these perspectives are of equal generality remains a divisive issue. In an analysis based on the Price equation, Queller argued (by means of a principle he called the separation condition) that the two approaches are subject to the same limitations, arising from their fundamentally quantitative-genetical character. Recently, van Veelen et al. have challenged Queller’s results, using this as the basis for a broader (...) critique of the Price equation, the separation condition, and the very notion of inclusive fitness. Here we show that the van Veelen et al. model, when analyzed in the way Queller intended, confirms rather than refutes his original conclusions. We thereby confirm (i) that Queller’s separation condition remains a legitimate theoretical principle and (ii) that the standard inclusive fitness and multilevel approaches are indeed subject to the same limitations. (shrink)

Most writing on informed consent in Africa highlights different cultural and social attributes that influence informed consent practices, especially in research settings. This review presents a composite picture of informed consent in Nigeria using empirical studies and legal and regulatory prescriptions, as well as clinical experience. It shows that Nigeria, like most other nations in Africa, is a mixture of sociocultural entities, and, notwithstanding the multitude of factors affecting it, informed consent is evolving along a purely Western model. Empirical studies (...) show that 70–95% of Nigerian patients report giving consent for their surgical treatments. Regulatory prescriptions and adjudicated cases in Nigeria follow the Western model of informed consent. However, adversarial legal proceedings, for a multiplicity of reasons, do not play significant roles in enforcing good medical practice in Nigeria. Gender prejudices are evident, but not a norm. Individual autonomy is recognized even when decisions are made within the family. Consent practices are influenced by the level of education, extended family system, urbanization, religious practices, and health care financing options available. All limitations notwithstanding, consent discussions improved with increasing level of education of the patients, suggesting that improved physician's knowledge and increasing awareness and education of patients can override other influences. Nigerian medical schools should restructure their teaching of medical ethics to improve the knowledge and practices of physicians. More research is needed on the preferences of the Nigerian people regarding informed consent so as to adequately train physicians and positively influence physicians' behaviors. (shrink)

Philsophers interested in comprehending the nature of truth and knowledge have studied reference, as have psychologists and linguists interested in uncovering the relations between thought and language, and other scholars trying to describe the role of reference in literature, culture and society.

The third book in the Criminalization series examines the constitutionalization of criminal law. It considers how the criminal law is constituted through the political processes of the state; how the agents of the criminal law can be answerable to it themselves; and finally how the criminal law can be constituted as part of the international order.

In the field of bioethics, scholars have begun to consider carefully the impact of structural issues on global population health, including socioeconomic and political factors influencing the disproportionate burden of disease throughout the world. Human rights and social justice are key considerations for both population health and biomedical research. In this paper, I will briefly explore approaches to human rights in bioethics and review guidelines for ethical conduct in international health research, focusing specifically on health research conducted in resource-poor settings. (...) I will demonstrate the potential for addressing human rights considerations in international health research with special attention to the importance of collaborative partnerships, capacity building, and respect for cultural traditions. Strengthening professional knowledge about international research ethics increases awareness of ethical concerns associated with study design and informed consent among researchers working in resource-poor settings. But this is not enough. Technological and financial resources are also necessary to build capacity for local communities to ensure that research results are integrated into existing health systems. Problematic issues surrounding the application of ethical guidelines in resource-poor settings are embedded in social history, cultural context, and the global political economy. Resolving the moral complexities requires a commitment to engaged dialogue and action among investigators, funding agencies, policy makers, governmental institutions, and private industry. (shrink)

Women are routinely subjected to penetrating surveillance during pregnancy. On the surface, this may appear to flow from a cultural commitment to protect babies – a cultural practice of “better safe than sorry” that is particularly vigilant given the vulnerability of fetuses and babies. In reality, pregnancy occasions incursions against human rights and well-being that would be anathema in other contexts. Our cultural practices concerning risk in pregnancy are infused with oppressive norms about women’s responsibility for pregnancy outcomes and the (...) demands of extreme self-sacrifice from women to protect their fetuses. Of particular concern is our culture’s willingness to enforce norms concerning risk during pregnancy using coercive measures including forced cesarean sections and criminal penalties for exposing fetuses to risk. This chapter will consider assaults on self-determination, bodily integrity and privacy inherent in such interventions, as well as the structural violence and “mangled pieties” that buttress such practices in our unjust society. (shrink)

Pain perception is influenced by several factors, and among them, affect, sex, and perception of bodily signals are assumed to play a prominent role. The aim of the present study is to explore how sex, cardiac interoceptive accuracy, and the interaction of the latter two influence the perception of experimentally induced pain. We investigated a large sample of young adults, assessing current positive and negative affective state with the Positive and Negative Affect Schedule, cardiac interoceptive accuracy with the mental heartbeat (...) tracking task, and pain sensitivity with electrical stimulation on the back of the dominant hand, applying a repeated-measures staircase protocol. Males showed a significantly higher pain threshold and tolerance level than females, whereas cardiac interoceptive accuracy was not associated with pain sensitivity. The impact of sex × cardiac interoceptive accuracy interaction was significant for pain threshold only, while pain tolerance was predicted only by sex. According to these findings, the associations between pain sensitivity, cardiac IAc, and sex might be more complicated than it was supposed in previous studies. Interactions between factors impacting pain perception appear worthy of further investigation. (shrink)

The seventeenth and eighteenth centuries are arguably the most important period in philosophy’s history, given that they set a new and broad foundation for subsequent philosophical thought. Over the last decade, however, discontent among instructors has grown with coursebooks’ unwavering focus on the era’s seven most well-known philosophers—all of them white and male—and on their exclusively metaphysical and epistemological concerns. While few dispute the centrality of these figures and the questions they raised, the modern era also included essential contributions from (...) women—like Margaret Cavendish, Elisabeth of Bohemia, Mary Wollstonecraft, and Émilie Du Châtelet—as well as important non-white thinkers, such as Anton Wilhelm Amo, Julien Raimond, and Ottobah Cugoano. At the same time, there has been increasing recognition that moral and political philosophy, philosophy of the natural world, and philosophy of race—also vibrant areas of the seventeenth and eighteenth centuries—need to be better integrated with the standard coverage of metaphysics and epistemology. -/- A New Modern Philosophy: The Inclusive Anthology of Primary Sources addresses—in one volume—these valid criticisms. Weaving together multiple voices and all of the era’s vibrant areas of debate, this volume sets a new agenda for studying modern philosophy. It includes a wide range of readings from 34 thinkers, integrating essential works from all of the canonical writers along with the previously neglected philosophers. Arranged chronologically, editors Eugene Marshall and Susanne Sreedhar provide an introduction for each author that sets the thinker in his or her time period as well as in the longer debates to which the thinker contributed. Study questions and suggestions for further reading conclude each chapter. At the end of the volume, in addition to a comprehensive subject index, the book includes 13 Syllabus Modules, which will help instructors use the book to easily set up different topically structured courses, such as "The Citizen and the State," "Mind and Matter," "Education," "Theories of Perception," or "Metaphysics of Causation." -/- And an eresource offers a wide range of supplemental online resources, including essay assignments, exams, quizzes, student handouts, reading questions, and scholarly articles on teaching the history of philosophy. (shrink)

Mammals have an XX:XY system of chromosomal sex determination in which a small heterochromatic Y controls male development. The Y contains the testis determining factor SRY, as well as several genes important in spermatogenesis. Comparative studies show that the Y was once homologous with the X, but has been progressively degraded, and now consists largely of repeated sequences as well as degraded copies of X linked genes. The small original X and Y have been enlarged by cycles of autosomal addition (...) to one partner, recombination onto the other and continuing attrition of the compound Y. This addition–attrition hypothesis predicts that the pseudoautosomal region of the human X is merely the last relic of the latest addition. Genes (including SRY) on the conserved or added region of the Y evolved functions in male sex determination and differentiation distinct from the general functions of their X‐linked partners. Although the gonadogenesis pathway is highly conserved in vertebrates, its control has probably changed radically and rapidly in vertebrate – even mammalian – evolution. (shrink)

We bring together recent discussions on data capitalism and biocapitalization by studying value flows in consumer genomics firms—an industry at the intersection between health care and technology realms. Consumer genomics companies market genomic testing services to consumers as a source of fun, altruism, belonging and knowledge. But by maintaining a multisided or platform business model, these firms also engage in digital capitalism, creating financial profit from data brokerage. This is a precarious balance to strike: If these companies’ business models consist (...) of assetizing the pool of genomic data that they assemble, then part of their work has to revolve around obscuring to consumers any uncertainties that would potentially impinge on these processes of assemblage. We reflect on the nature of these practices and the market relationships that enable them, and we relate this reflection to debates around alternative market arrangements that would potentially mitigate the extractive tendencies of these and other digital health firms. (shrink)

Most writing on informed consent in Africa highlights different cultural and social attributes that influence informed consent practices, especially in research settings. This review presents a composite picture of informed consent in Nigeria using empirical studies and legal and regulatory prescriptions, as well as clinical experience. It shows that Nigeria, like most other nations in Africa, is a mixture of sociocultural entities, and, notwithstanding the multitude of factors affecting it, informed consent is evolving along a purely Western model.Empirical studies show (...) that 70–95% of Nigerian patients report giving consent for their surgical treatments. Regulatory prescriptions and adjudicated cases in Nigeria follow the Western model of informed consent. However, adversarial legal proceedings, for a multiplicity of reasons, do not play significant roles in enforcing good medical practice in Nigeria. Gender prejudices are evident, but not a norm. Individual autonomy is recognized even when decisions are made within the family. Consent practices are influenced by the level of education, extended family system, urbanization, religious practices, and health care financing options available. All limitations notwithstanding, consent discussions improved with increasing level of education of the patients, suggesting that improved physician's knowledge and increasing awareness and education of patients can override other influences.Nigerian medical schools should restructure their teaching of medical ethics to improve the knowledge and practices of physicians. More research is needed on the preferences of the Nigerian people regarding informed consent so as to adequately train physicians and positively influence physicians’ behaviors. (shrink)

If one were to find a date for the games put on by Pompey to celebrate the opening of his theatre in 55 B.C., it would be possible to assign a more precise date to the delivery of Cicero's speech in Pisonem than seems to have been done so far. Asconius states quite firmly that the in Pisonem was delivered in the second consulship of Pompey and Crassus, a few days before the lavish games celebrating the opening of Pompey's theatre. (...) Asconius rejects a counter-view that the speech was delivered late in the following year. (shrink)

Malevolence and cruelty are commonly attributed to a failure of moral reasoning or a lack of moral imagination. We present the contrasting viewpoint – immorality as an active, creative, or resourceful act. More specifically, we develop the concept of "immoral imagination" (Jacobs, 1991) and explore how it can enter into Rest's (1986) four processes of decision making: sensitivity, judgment, intention, and implementation. The literature on revenge and workplace deviance illustrates these processes.

Taking as its starting point Miri Gur-Arye’s critical discussion of a legal duty to report crime, this paper sketches an idealising conception of a democratic republic whose citizens could be expected to recognise a civic responsibility to report crime, in order to assist the enterprise of a criminal law that is their common law. After explaining why they should recognise such a responsibility, what its scope should be, and how it should be exercised, and noting that that civic responsibility must (...) include a responsibility to report one’s own crimes; it discusses whether that civic responsibility could ground at least a limited legal duty to report certain types of crime. It then turns to the question of whether a civic responsibility to assist the criminal law’s enterprise of bringing wrongdoers to account could include a responsibility to arrest suspected or known offenders if the police cannot or will not do so—a responsibility to make a citizen’s arrest, and the legal power to discharge that responsibility: how far should citizens feel entitled, or duty-bound, thus to ‘take the law into their own hands’? (shrink)

The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a gift of life and a commodity exchange. The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We (...) argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources. (shrink)

This distinctive collection by scholars from around the world focuses upon the cultural, educational, and political significance of Richard Rorty's thought. The nine essays which comprise the collection examine a variety of related themes: Rorty's neopragmatism, his view of philosophy, his philosophy of education and culture, Rorty's comparison between Dewey and Foucault, his relation to postmodern theory, and, also his form of political liberalism.

Gordon's emphasizes that the process of prosecution is crucial to the idea of crime. One who commits a public wrong is properly called to public account for it, and the criminal trial constitutes such a public calling to account. The state is the proper prosecutor of crimes: since a crime is ‘our’ wrong, rather than only the victim's wrong, it is appropriate that we should prosecute it, collectively. The case is not simply V the victim, or P the plaintiff, against (...) D the defendant. It is brought, as the Americans properly have it, by ‘the People’, or by ‘the Commonwealth’, against the defendant. This is a useful way in which to think about crimes and criminalisation. This chapter tries to develop this conception of public wrongs a little further, which also involves complicating it more than a little. It works from a version of liberal communitarianism that rejects the metaphysical version of the individualist's ‘unencumbered self’; but the account sketched here should be compatible with all but the most radically individualist kinds of liberal theory. (shrink)