Background: Spasticity following a stroke occurs in about 30% of patients. The mechanisms underlying this disorder, however, are not well understood. Method: This review aims to define spasticity, describe hypotheses explaining its development after a stroke, give an overview of related neuroimaging studies as well as a description of the most common scales used to quantify the degree of spasticity and finally explore which treatments are currently being used to treat this disorder.

Understanding loss of consciousness after brain injury poses a practical test for the field of consciousness research, with both clinical and ethical implications. We here discuss three major pathological disorders of consciousness; coma, the unresponsive wakefulness syndrome and the minimally conscious state, which together represent a lesion model for the investigation of human awareness. We review the anatomical and neurophysiological correlates of each condition, and discuss the current findings in context of several theoretical frameworks of consciousness.

Different sort of people are interested in personal identity. Philosophers frequently ask what it takes to remain oneself. Caregivers imagine their patients’ experience. But both philosophers and caregivers think from the armchair: they can only make assumptions about what it would be like to wake up with massive bodily changes. Patients with a locked-in syndrome suffer a full body paralysis without cognitive impairment. They can tell us what it is like. Forty-four chronic LIS patients and 20 age-matched healthy medical professionals (...) answered a 15-items questionnaire targeting: global evaluation of identity, body representation and experienced meaning in life. In patients, self-reported identity was correlated with B and C. Patients differed with controls in C. These results suggest that the paralyzed body remains a strong component of patients’ experienced identity, that patients can adjust to objectives changes perceived as meaningful and that caregivers fail in predicting patients’ experience. (shrink)

BackgroundWith the emergence of Brain Computer Interfaces, clinicians have been facing a new group of patients with severe acquired brain injury who are unable to show any behavioral sign of consciousness but respond to active neuroimaging or electrophysiological paradigms. However, even though well documented, there is still no consensus regarding the nomenclature for this clinical entity.ObjectivesThis systematic review aims to 1) identify the terms used to indicate the presence of this entity through the years, and 2) promote an informed discussion (...) regarding the rationale for these names and the best candidates to name this fascinating disorder.MethodsThe Disorders of Consciousness Special Interest Group of the International Brain Injury Association launched a search on Pubmed and Google scholar following PRISMA guidelines to collect peer-reviewed articles and reviews on human adults published in English between 2006 and 2021.ResultsThe search launched in January 2021 identified 4,089 potentially relevant titles. After screening, 1,126 abstracts were found relevant. Finally, 161 manuscripts were included in our analyses. Only 58% of the manuscripts used a specific name to discuss this clinical entity, among which 32% used several names interchangeably throughout the text. We found 25 different names given to this entity. The five following names were the ones the most frequently used: covert awareness, cognitive motor dissociation, functional locked-in, non-behavioral MCS and higher-order cortex motor dissociation.ConclusionSince 2006, there has been no agreement regarding the taxonomy to use for unresponsive patients who are able to respond to active neuroimaging or electrophysiological paradigms. Developing a standard taxonomy is an important goal for future research studies and clinical translation. We recommend a Delphi study in order to build such a consensus. (shrink)

Pain, suffering and positive emotions in patients in vegetative state/unresponsive wakefulness syndrome (VS/uws) and minimally conscious states (MCS) pose clinical and ethical challenges. Clinically, we evaluate behavioural responses after painful stimulation and also emotionally-contingent behaviours (e.g., smiling). Using stimuli with emotional valence, neuroimaging and electrophysiology technologies can detect subclinical remnants of preserved capacities for pain which might influence decisions about treatment limitation. To date, no data exist as to how healthcare providers think about end-of-life options (e.g., withdrawal of artificial nutrition (...) and hydration) in the presence or absence of pain in non-communicative patients. Here, we aimed to better clarify this issue by re-analyzing previously published data on pain perception (Prog Brain Res 2009 177, 329–38) and end-of-life decisions (J Neurol 2010 258, 1058–65) in patients with disorders of consciousness. In a sample of 2259 European healthcare professionals we found that, for VS/uws more respondents agreed with treatment withdrawal when they considered that VS/uws patients did not feel pain (77%) as compared to those who thought VS/uws did feel pain (59%). This interaction was influenced by religiosity and professional background. For MCS, end-of-life attitudes were not influenced by opinions on pain perception. Within a contemporary ethical context we discuss (1) the evolving scientific understandings of pain perception and their relationship to existing clinical and ethical guidelines; (2) the discrepancies of attitudes within (and between) healthcare providers and their consequences for treatment approaches, and (3) the implicit but complex relationship between pain perception and attitudes toward life-sustaining treatments. (shrink)

IntroductionA symptom cluster is very common among oncological patients: cancer-related fatigue, emotional distress, sleep difficulties, pain, and cognitive difficulties. Clinical applications of interventions based on non-ordinary states of consciousness, mostly hypnosis and meditation, are starting to be investigated in oncology settings. They revealed encouraging results in terms of improvements of these symptoms. However, these studies often focused on breast cancer patients, with methodological limitations. Another non-ordinary state of consciousness may also have therapeutic applications in oncology: self-induced cognitive trance. It seems (...) to differ from hypnosis and meditation, as it involves the body more directly. Thus, investigating its clinical applications, along with hypnosis and meditation interventions, could improve available therapeutic options in oncology. This article details the study protocol of a preference-based longitudinal controlled superiority trial aiming to assess the effectiveness of 3 group interventions to improve oncological patients’ quality of life, and more specifically CRF, emotional distress, sleep, pain, and cognitive difficulties.Methods and analysisA power analysis required a total sample of 160 patients. Main inclusion criteria are: cancer diagnosis, active treatments completed for less than a year, no practice of hypnosis, meditation, or SICT, and presence of at least one of these four symptoms: fatigue, sleep difficulties, depression, or anxiety. Each participant will choose the intervention in which they want to participate. To test the effectiveness of the interventions, data will be collected by questionnaires and neurobiological measures and directly from the medical record at four time points: before inclusion in the study ; immediately after the intervention; and at 3- and 12-month follow-up. The longitudinal data in each group will then be measured.DiscussionIn addition to standard cancer therapies, there is a growing interest from patients in complementary approaches, such as hypnosis, meditation, and SICT. The results of this study will be useful to increase knowledge about short- and long-term effectiveness of 3 group interventions for CRF, emotional distress, sleep, pain, and cognitive difficulties in patients with different cancers.Clinical Trial RegistrationClinicalTrials.gov/. Retrospectively registered on the 29th of April 2021. url: https://clinicaltrials.gov/ct2/show/NCT04873661. (shrink)

In this article, we explore the implications of a Rawlsian theory for intergenerational issues. First, we confront Rawls's way of locating his `just savings' principle in his Theory of Justice with an alternative way of doing so. We argue that both sides of his intergenerational principle, as they apply to the accumulation phase and the steady-state stage, can be dealt with on the bases, respectively, of the principle of equal liberty (and its priority) and of the difference principle. We then (...) proceed by focusing on the implications of applying maximin to his steady-state stage. One central claim is that, in principle, Rawlsians should consider not only generational dissavings, but also generational savings, as unfair. This principle suffers a series of exceptions on which we focus in the fourth section of the article. In some cases, growth can be maximin compatible. Key Words: generations • egalitarianism • maximin • sustainability • growth • difference principle • John Rawls. (shrink)

Background:Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage.Objectives:The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors.Research design:In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ Moral Courage Scale and analysed (...) statistically.Participants and research context:The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses.Ethical considerations:The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital.Findings:Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity.Discussion and conclusion:Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

The study of rare diseases has long been an area of challenge for medical researchers, with agonizingly slow movement towards improved understanding of pathophysiology and treatments compared with more common illnesses. The push towards evidence-based medicine (EBM), which prioritizes certain types of evidence over others, poses a particular issue when mapped onto rare diseases, which may not be feasibly investigated using the methodologies endorsed by EBM, due to a number of constraints. While other trial designs have been suggested to overcome (...) these limitations (with varying success), perhaps the most recent and enthusiastically adopted is the application of artificial intelligence to rare disease data. This paper critically examines the pitfalls of EBM (and its trial design offshoots) as it pertains to rare diseases, exploring the current landscape of AI as a potential solution to these challenges. This discussion is also taken a step further, providing philosophical commentary on the weaknesses and dangers of AI algorithms applied to rare disease research. While not proposing a singular solution, this article does provide a thoughtful reminder that no ‘one-size-fits-all’ approach exists in the complex world of rare diseases. We must balance cautious optimism with critical evaluation of new research paradigms and technology, while at the same time not neglecting the ever-important aspect of patient values and preferences, which may be challenging to incorporate into computer-driven models. (shrink)

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others’ emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need to be (...) humanely understood. Because we respond to others’ very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. (shrink)

Against the background of a deeply uneven package of work–family reconciliation measures and an increasing focus on engaging men in unpaid care work, in this article I discuss the extension of the Irish discrimination law framework to provide protection against family status discrimination to workers who are engaged in certain care relationships. While this development of the law to recognize a relational understanding of inequality is welcome, its confined definition of family status fails to capture the range of workers’ caring (...) relationships and networks. Adopting a contextualized assessment of 12 years of litigation generated under the ‘family status’ ground, with reference to complainants’ gender and work status, the study considers the types of experiences being litigated as ‘family status’ discrimination. The study show how much of the nature and forms of inequality presented before the tribunals are beyond the conceptual boundaries of the principle of equal treatment that depends upon a sameness of treatment model with the ‘care-less’ comparator. Despite its potential to question the neutrality of workplace structures predicated upon the division between paid work and unpaid care, the principle of indirect family status discrimination has been under utilised as a litigation strategy. The most successful dimension of family status discrimination protection has been in respect of its ability to capture the negative stereotyping of worker–carers who continue to perform as ideal workers. I suggest that this extension of a limited negative rights framework, when considered alongside the state’s extremely poor support for workcare reconciliation more broadly, places negligible obligations on employers, and that the gender neutrality implicit in its provisions have yet to impact on gender equality as regards work–care reconciliation. (shrink)

According to the sceptic Saul Kripke envisages in his celebrated book on Wittgenstein on rules and private language, there are no facts about an individual that determine what she means by any given expression. If there are no such facts, the question then is, what justifies the claim that she does use expressions meaningfully? Kripke’s answer, in a nutshell, is that she by and large uses her expressions in conformity with the linguistic standards of the community she belongs to. While (...) Kripke’s sceptical problem has gripped philosophers for over three decades, few, if any, have been satisfied by his proposed solution, and many have struggled to come up with one of their own. The purpose of this paper is to show that a more satisfactory answer to Kripke’s challenge can be developed on the basis of Donald Davidson’s writings on triangulation, the idea of two individuals interacting simultaneously with each other and the world they share. It follows from the triangulation argument that the facts that can be regarded as determining meaning are irreducible. Yet, contra Kripke, they are not mysterious, for the argument does spell out what is needed for an individual’s expressions to be meaningful. (shrink)

Adherence to professional ethics in nursing is fundamental for high-quality ethical care. However, analysis of the use and impact of nurses’ codes of ethics as a part of professional ethics is limited. To fill this gap in knowledge, the aim of our review was to describe the use and impact of the Code of Ethics for Nurses with Interpretive Statements published by the American Nurses Association as an example of one of the earliest and most extensive codes of ethics for (...) nurses with their interpretative statements and constituting a strong basis for the International Council of Nurses’ Code of Ethics for Nurses. We based our review on previous literature using a scoping review method. We included both non-scientific and scientific publications to provide an analysis of codes of ethics which can be utilized in development and revision of other nurses’ codes of ethics. In the searches, we used CINAHL and PubMed databases limiting publications to texts with a connection to the Code of Ethics for Nurses published from January 2001 to November 2022 and written in English. Searches yielded 1739 references, from which 785 non-scientific and 71 scientific publications were included for analysis of the data. Although non-scientific and scientific publications addressed different number of categories, the results indicated that in the both groups the use and impact focused on professional ethics, nursing practice, and work environment and less on education, research, or social health issues. Nurses’ ethical standards were not addressed in non-scientific publications, and clinical issues and leadership were not in focus in scientific publications. To increase evidence-based knowledge of the impact of codes of ethics additional research is needed. Good scientific conduct was followed. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

What is the cognitive role of things — sometimes but not always expressed as nouns — that appear in texts? What kind of literary affordances are the material furnishings that appear in a piece of literary writing? These questions are explored in this essay through the example of John Locke's Essay Concerning Human Understanding, a long work of literary philosophy that plays with the evolving conventions of its genre. Fusing methodologies borrowed from anthropology and linguistics, this essay reveals the extent (...) and type of work done by two of Locke's things, manna and porphyry. In doing so it tests a way of tracing the cognitive action of the Essay's contemporary readership without recourse to modern experimental methods. (shrink)

This article discusses the triage response to the COVID-19 delta variant surge of 2021. One issue that distinguishes the delta wave from earlier surges is that by the time it became the predominant strain in the USA in July 2021, safe and effective vaccines against COVID-19 had been available for all US adults for several months. We consider whether healthcare professionals and triage committees would have been justified in prioritising patients with COVID-19 who are vaccinated above those who are unvaccinated (...) in first-order or second-order triage. Given that lack of evidence for a correlation between short-term survival and vaccination, we argue that using vaccination status during first-order triage would be inconsistent with accepted triage standards. We then turn to notions of procedural fairness, equity and desert to argue that that there is also a lack of justification for using vaccination status in second-order triage. In planning for future surges, we recommend that medical institutions base their triage decisions on principles meant to save the most lives, minimise inequity and protect the public’s trust, which for the time being would not be served by the inclusion of vaccination status. (shrink)

Should the foreign debt of the world’s poorest countries be cancelled? In this essay, I am concerned with whether a generational perspective makes a difference in answering this question. I will show that it does, and that alternative accounts of repayment obligations are possible. I argue that a distributive theory of justice is not only appropriate to address the challenges to justice raised by long-term sovereign indebtedness, but that it is also superior to the solution offered by the odious debt (...) doctrine.Unlike the odious debt doctrine, a distributive view is capable of taking intoaccount the separateness of generations. More specifically, I also argue thatthe need to preserve creditors’ incentives to lend to the poor in order toensure that the latter keep having access to credit for important development purposes requires the adoption of a narrow, problem-specific view, which focuses on the distributive impact of the loan transaction, rather than a broad distributive view, which looks at the general distributive situation of the two descendent communities. (shrink)

Are there limits to what it is morally okay to imagine? More particularly, is imaginatively inhabiting morally suspect perspectives something that is off-limits for truly virtuous people? In this paper, I investigate the surprisingly fraught relation between virtue and a familiar form of imaginative perspective taking I call empathy. I draw out a puzzle about the relation between empathy and virtuousness. First, I present an argument to the effect that empathy with vicious attitudes is not, in fact, something that the (...) fully virtuous person can indulge in. At least one prominent way of thinking about the psychology of the virtuous person excludes the possibility that the virtuous could emotionally apprehend the world in a less than virtuous way, and empathizing with vicious outlooks does seem to run afoul of that restriction. Then, I develop an argument that runs in the contrary direction: virtue in fact requires empathy with vicious outlooks, at least in some situations. There is reason to think that a crucial part of being virtuous is ministering effectively to others’ needs, and there is also reason to think that other people may need to be empathized with, even if their emotional outlooks are at least minorly vicious. Finally, I outline two different solutions to this puzzle. Both solutions hold some promise, but they also bring new challenges in their train. (shrink)

This paper examines the meaningfulness of pointing in great apes. We appeal to Hannah Ginsborg’s conception of primitive normativity, which provides an adequate criterion for establishing whether a response is meaningful, and we attempt to make room for a conception according to which there is no fundamental difference between the responses of human infants and those of other great apes to pointing gestures. This conception is an alternative to Tomasello’s view that pointing gestures and reactions to them reveal a fundamental (...) difference between humans and other apes. (shrink)

A sensibility is, on a rough first pass, an emotional orientation to the world. It shapes how things appear to us, evaluatively speaking. By transfiguring things’ evaluative appearances, a change in sensibility can profoundly alter one’s overall experience of the world. I argue that some forms of sensibility change entail (1) risking one’s knowledge of what experiences imbued with one’s prior sensibility were like, and (2) surrendering one’s grasp on the intelligibility of one’s prior emotional apprehensions. These costs have consequences (...) for Laurie Paul’s ‘problem of transformative experience.’ Paul has argued that when we are poised to become someone new, our inexperience generates problems for authentic choice about our own futures. By reckoning with the epistemic losses involved in sensibility change, I show that this problem must not be confined to novel transformations. Prior experience does not guarantee the knowledge or understanding necessary for choosing authentically (in Paul’s sense). If the problem Paul highlights is indeed a problem _at all,_ then, it is a still more pervasive and intractable one than it has been taken to be. (shrink)

In Wittgenstein on Rules and Private Language, Saul Kripke articulates a form of scepticism about meaning. Even though there is considerable disagreement among critics about the reasoning in which the sceptic engages, there is little doubt that he seeks to offer constraints for an adequate account of the facts that constitute the meaningfulness of expressions. Many of the sceptic's remarks concern the nature of the guidance involved in a speaker's meaningful uses of expressions. I propose that we understand those remarks (...) as seeking to give shape to the idea that to use an expression under the guidance of one's understanding is to have a reason for that use, which one's understanding allows one to discern and act on. Any philosophical elucidation of meaning must adequately capture the rational nature of our linguistic acts. (shrink)

This study analysed teaching of nurses’ codes of ethics in basic nursing education in Finland. A total of 183 educators and 214 students responded to a structured questionnaire. The data was analysed by SPSS. Teaching of nurses’ codes was rather extensive. The nurse-patient relationship was highlighted. Educators assessed their teaching statistically significantly more extensive than what students’ perceptions were. The use of teaching and evaluation methods was conventional, but differences between the groups concerning the use of these methods were statistically (...) significant. Students’ knowledge of and their ability to apply the codes was mediocre. Most educators and students assessed educators’ knowledge of the codes as adequate for teaching. These educators also taught the codes more extensively and these students perceived the teaching as more extensive. Otherwise educators’ and students’ socio-demographic variables had little association with the teaching. Research should focus on the organization and effectiveness of ethics education, and on educators’ competence. (shrink)

In this essay Olivia Newman critically examines two opposing rights claims: the liberal claim that children have a right to become liberal choosers and the fundamentalist claim that children have a right to not become liberal choosers. These positions reflect differing views regarding the value of critically choosing, rather than simply accepting, a way of life. Given their assumptions regarding preference formation, both of these rights appear untenable in light of recent scholarship in psychology: we can neither select a (...) way of life independent of our social milieu, as liberals often imply, nor can we predict how different experiences will affect our preferences, as fundamentalists assume. Nevertheless, each position points to important concerns. Children have a substantive right of exit from constraining social milieus, as liberals purport, as well as a right to respect in public institutions, as fundamentalists insist. When liberals and fundamentalists assert these more modest rights claims, educators can and should strive to satisfy both. (shrink)

Our collective enthusiasm for empathy reflects a sense that it is deeply valuable. I show that empathy bears a complex and surprisingly problematic relation to another social epistemic phenomenon that we have reason to value, namely testimonial trust. My discussion focuses on empathy with and trust in people who are members of one or more oppressed groups. Empathy for oppressed people can be a powerful tool for engendering a certain form of testimonial trust, because there is a tight connection between (...) empathy and a approval of another's outlook. I then argue that the qualities of empathy that make it such a powerful tool for bridging differences and building trust also have a problematic upshot: they make it the case that reliance on empathy will sometimes have a distorting effect upon the ways we extend testimonial trust. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ethics & the Enviornment 6.2 (2001) 114-118 [Access article in PDF] Book Review Child versus Childmaker: Future Persons and Present Duties in Ethics and the Law Child versus Childmaker: Future Persons and Present Duties in Ethics and the Law. Melinda A. Roberts. Lanham, Md.: Rowman & Littlefield, 1998. Pp. 235. ISBN 0-8476-8901-8 (Paperback) This book will provide the reader with a systematic examination of some of the most difficult (...) philosophical issues involved in procreation, and most notably those raised by wrongful life claims and the non-identity problem. Can an action without which a given child would not even exist be simultaneously said to harm this very child? This is the key question addressed in this book. It is relevant not only to bioethicists, but also to those concerned with the possibility of harming members of future generations in general. The author proceeds with remarkable clarity in three steps. First, she unveils the core intuition and unfolds the key implications of what is standardly referred to as the person-affecting view. Second, she focuses on the now famous non-identity problem that is supposed to raise a serious challenge to the plausibility of the person-affecting view. Third, wrongful life and human cloning are taken as illustrations of the problem.The starting point is thus the person-affecting or personalist view. The author argues that what is at stake in such a view is not only a concern for [End Page 114] persons (as opposed to plants or stones), but also for definite persons. The core intuition that "what is bad must be bad for someone" (Derek Parfit) implies a comparison between two states of the same person. As she puts it, "the pairwise comparisons of worlds appealed to within personalism are always in respect of particular people" (6). This does not necessarily imply consequentialism, contrary to what Roberts claims (e.g., 1), at least if we understand the latter, for example, as Philip Pettit does. 1 Moreover, one may very well argue that what is at the heart of the person-affecting intuition is a sense that an action needs to be assessed on the basis of its effect on persons, which would not necessarily imply that such effects require a comparison between two states of the same person. Nevertheless, the extent to which a person-affecting conception--as defined by Roberts--will be in trouble depends on the extent to which comparisons between the same person's states cannot operate. This is precisely where to introduce the idea of a non-identity context, that is, a situation in which not committing an allegedly harmful act would or could also have meant the nonexistence of the allegedly harmed person. For example, had a medical doctor not committed this preconceptional diagnostic mistake (or a father taken a slower or faster means of transportation to come back home), this child would or could not have existed. Can we thus say that the practitioner harmed the child who turned out to be heavily handicapped due, for example, to a genetically transmissible disease (or that the father harmed his child by leaving him with a very polluted environment due to his use of big cars as a means of transportation)?One key feature of Roberts's approach is that she restricts the scope of the non-identity problem to cases where not committing the allegedly harmful action would have made it impossible for this child to have existed ("two-alternative" cases) (26, 319, 325). This entails that whenever this very child could still have come to existence in the allegedly harmful action's absence, whatever the likelihood of such a coming to existence, we would fall outside a non-identity context ("three-alternative" cases) (27; 94-95). What matters to Roberts is whether or not the same child could have been born better than he is, not whether he would, as a matter of fact, have been born at all. The consequence is that in cases where the same child could have been born, say, unhandicapped, the author remains... (shrink)

Although undergraduate engineering ethics courses often include the development of moral sensitivity as a learning objective and the use of active learning techniques, teaching centers on the transmission of cognitive knowledge. This article describes a complementary assignment asking students to perform an ethics “experiment” on themselves that has a potential to enhance affective learning and moral imagination. The article argues that the focus on cognitive learning may not promote, and may even impair, our efforts to foster moral sensitivity. In contrast, (...) the active learning assignments and exercises, like the ethics “experiment” discussed, offer great potential to expand the scope of instruction in engineering ethics to include ethical behavior as well as knowledge. Engineering ethics education needs to extend beyond the narrow range of human action associated with the technical work of the engineer and explore ways to draw on broader lifeworld experiences to enrich professional practice and identity. (shrink)

We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Researchers want to offer carrots to incentivise participation. We (...) are proposing that research participation be viewed as a job with the full suite of financial entitlements of fairly remunerated work, including payment for risk and labour law protections. This would be a significant shift from current practice and standards. Ambuehl, Ockenfels and Roth have grasped this basic point and have beautifully elaborated how a fair price could be arrived at using economic theory. They build on our proposal helpfully and suggest ‘ salary for time involvement that is adjusted to account for the amount of discomfort experienced during participation, insurance against ex post adverse outcomes and ex ante compensation for risks that cannot be compensated ex post.’3 This effectively addresses Fernandez Lynch and Largent’s2 concern that compensation for risk is inappropriate for harms which do not eventuate. However, because death cannot be compensated for, there must be payment for risk of death, as Ambuehl, Ockenfels and Roth convincingly argue.3 Indeed, the three-part model suggested by Ambuehl, Ockenfels and Roth makes us realise that job model would be a better title for our model than a payment for risk model. The alternative to a properly remunerated job model is the original altruistic model. However, this …. (shrink)

Streaming in secondary schools is not beneficial for improving student outcomes of education with vast amounts of educational research indicating that it does not improve academic results and increases inequity. Yet teachers often prefer working in streamed classes, and research shows that teachers mediate the effects of streaming on students. This study sought to add to the understanding of teachers’ role in student learning by investigating how teachers conceptualise the students in streamed classes. A qualitative case study approach was used, (...) where 18 teachers were interviewed in-depth to create narrative examples, three of which are presented here. These narratives summarise the research findings that teachers saw students in high and low streams as having homogenous characteristics according to five dichotomous categories: approach to learning, attitude to learning, learning style, autonomy and background. Students in mixed-ability classes were viewed along these same continua, but as more heterogeneous groups. Furthermore, these views of students had direct implications for how teachers planned for learning and the expectations that they held of their students. The discussion links streaming research with teacher expectation research, suggesting that teachers of streamed classes in this secondary school hold specific whole-class ideas that affect student learning. The article concludes with recommendations for further inquiry that links these two important fields of educational research. (shrink)

O artigo é um ensaio teórico com o propósito de discutir as implicações do conceito de trabalho, na perspectiva do filósofo húngaro György Lukács, no campo da política educacional. Em tempos em que a educação brasileira se distancia de um projeto de emancipação do indivíduo, dadas as configurações que vem assumindo as políticas educacionais nos últimos anos, particularmente as políticas curriculares para o ensino médio, parece apropriada a análise do trabalho em sua matriz ontológica, estabelecendo uma estreita correlação entre subjetividade (...) e objetividade. São tratados no decorrer do texto: o conceito de trabalho na ontologia lukacsiana e sua diferenciação entre trabalho abstrato – como mantenedor do Capital – e trabalho fundante – como definidor da natureza ontológica do ser social – em correlação com o campo da política educacional, em especial, com alguns princípios que regem a atual reforma do ensino médio elencados para tratar aspectos da política educacional brasileira que estão à serviço do trabalho abstrato. Palavras-chave: György Lukács. Trabalho fundante. Política educacional. Reforma do Ensino Médio brasileiro. (shrink)

ABSTRACTThe ways that lawyers approach mediation vary considerably and there is value in contemplating potential explanations for the adoption of particular participatory roles. This article considers how ethical orientation to legal practice might correlate with the nature of lawyers' participation in mediation, using three of Rundle's models of lawyer participation in mediation. Role choices by lawyers who approach legal practice through the professional ethical lenses described by Parker and Evans are hypothesised, uncovering a range of potential explanations for and motivations (...) behind lawyers' behaviour in mediation. The discussion provides an opportunity for critical self-reflection by legal practitioners and better interprofessional understanding between lawyers and mediators. (shrink)

Bernard Spodek, one of the most important figures in contemporary early childhood education, has been a seminal figure in early childhood education for approximately six decades. He has also been a creative contributor to contemporary thinking on the integration of theory, research, and practice on the development and education of young children. He is the author of numerous theoretical, research, and practical articles that continue to be published in scholarly journals and the author of textbooks that span the fields of (...) early childhood education and child development. This book, Bernard Spodek: Early Childhood Education Scholar, Researcher, and Teacher, offers an understanding of an eminent scholar who has made significant contributions to the field of early childhood education. It has a richly detailed and intimate picture of the construction of a knowledge base for the development and education of young children. All of the chapters show how Bernard Spodek assumes various roles to promote the field of early childhood education as he functions as a mentor, scholar, researcher, and master teacher. Bernard Spodek: Early Childhood Education Scholar, Researcher, and Teacher is a text for students who are interested in acquiring the basic knowledge about early childhood education, about the work that practitioners do with young children, and about the ideas that underlie that work. It is an appropriate text for graduate students in four-year colleges and universities. (shrink)

The House of Lords majority decision in Matthews v. Kent and Medway Towns Fire Authority overturns the narrow interpretation given to key aspects of the Part-Time Workers (Protection of Less Favourable Treatment) Regulations’ core comparator mechanism in the lower tribunals and the Court of Appeal. It is a contextually astute judgment, which recognises the reductionist implications of an overly narrow approach to establishing comparability for the purposes of a less favourable treatment claim on the grounds of part-time work. The positive (...) aspect of this decision remains overshadowed, however, by the fact that this interpretation provides little consolation to the large majority of part-time women workers whose disadvantage and inequality remains outside the scope of the Regulations’ protection. (shrink)

This paper examines Hannah Ginsborg's attempt to address the challenge raised by Saul Kripke's meaning sceptic. I start by identifying the two constraints that the sceptic claims must be met by a satisfactory answer. Then I try to show that Ginsborg's proposal faces a dilemma. In the first instance, I argue that it is able to meet the second constraint, but not the first. I then amend the proposal in order to make room for the first constraint. I go on (...) to argue that, under this new interpretation, it cannot meet the second constraint. (shrink)

Is it fair to leave the next generation a public debt? Is it defensible to impose legal rules on them through constitutional constraints? From combating climate change to ensuring proper funding for future pensions, concerns about ethics between generations are everywhere. In this volume sixteen philosophers explore intergenerational justice. Part One examines the ways in which various theories of justice look at the matter. These include libertarian, Rawlsian, sufficientarian, contractarian, communitarian, Marxian and reciprocity-based approaches. In Part Two, the authors look (...) more specifically at issues relevant to each of these theories, such as motivation to act fairly towards future generations, the population dimension, the formation of preferences through education and how they impact on our intergenerational obligations, and whether it is fair to rely on constitutional devices. (shrink)

Anna Wexler and Laura Specker Sullivan (2023) draw on their positionality as Global North early career neuroethics scholars to initiate a meaningful and timely conversation on Translational Neuroet...

In this article, it will be concluded that the major automotive racing league, Formula 1, is failing in its efforts to be a truly unisex sport. In the current Formula 1 series, there are no female drivers. Although women have never been officially prohibited from competing in Formula 1, there have been fewer than 10 female drivers since its inception. This inquiry focuses on why women drivers have been prevented from securing professional driving positions in Formula 1 and racing on (...) equal terms with men. I argue that there are five major barriers which perpetuate women’s exclusion from this league: historical and current attitudes, assumed physical and mental inferiority, sexualisation, money, and representation and visibility. In this cultural examination, I demonstrate that the situation for women in Formula 1 appears to be bleaker than in other sports that are making progress in their quest for gender equality. However, I also suggest that, despite ethical issues, W Series – a new, women-only, single-seater car racing championship – could potentially motivates positive change for women’s car racing by promoting gender equity through a new league which enables women to improve themselves in a protected category. This article also considers the impact of sex in Formula 1, which is pertinent to the discussion surrounding alleged biological differences. The discussion employs Simone de Beauvoir’s conceptualisation of ‘Otherness’, as well as Helmut Pflugfelder’s account of female embodiment in motorsport. The overall findings are that more focused research is required for gender issues in Formula 1 to be accurately addressed. (shrink)

In this article, we explore the implications of a Rawlsian theory for intergenerational issues. First, we confront Rawls's way of locating his `just savings' principle in his Theory of Justice with an alternative way of doing so. We argue that both sides of his intergenerational principle, as they apply to the accumulation phase and the steady-state stage, can be dealt with on the bases, respectively, of the principle of equal liberty and of the difference principle. We then proceed by focusing (...) on the implications of applying maximin to his steady-state stage. One central claim is that, in principle, Rawlsians should consider not only generational dissavings, but also generational savings, as unfair. This principle suffers a series of exceptions on which we focus in the fourth section of the article. In some cases, growth can be maximin compatible. (shrink)

This article reconsiders a graffitied riddle from Pompeii (CIL 4.1877). It argues that slavery is one possible dimension of the puzzle, and that acknowledging the existence of slavery in this text testifies to the potential of Pompeian graffiti as a source for overlooked social histories.