Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or (...) it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example. (shrink)

Abstract:Brain–computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition (...) to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS. (shrink)

The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural (...) embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full. (shrink)

Purpose The purpose of this paper is to describe and explore the current state of internet regulation through content filters in Swedish public libraries. Design/methodology/approach Data was collected through an electronic survey directed to library managers of Sweden’s 290 main municipal libraries. 164 answers were returned, yielding a 57% response rate. The analysis comprises descriptive statistics for quantitative data and an activity theory approach with focus on contradictions for qualitative counterparts. Findings In total, 33% of the responding libraries report having (...) content filters; 50% have not; and a surprising 18% do not know. There is a strong correlation between internet misuse and positive attitudes towards filters, and, reversely, between lack of misuse and lack of active stances concerning filters. Rather than seeing this as weakness, the authors suggest that there is strength in a context-bound flexibility open to practical experience and weighting of values, ethics, legislation and local circumstances. More troublesome indications concern the high deferral of decision-making to local authorities (municipalities) whereby libraries are left with limited insight and influence. Research limitations/implications The situation calls for professional organisations to address political mandate questions, and educational programs to strengthen future information professionals’ knowledge of IT in general; filter issues in specific; and local authority decision-making. The study highlights the need of adequate information professional competences and mandates to decide on and oversee internet regulation. Originality/value To the best of the authors’ knowledge, this is the first internationally published study on content filters in Swedish public libraries. (shrink)

ONTOLOGY This book is a book about the world. I am concerned with ontology, not merely with language. Many ontological treatises concentrate largely on the ...

This volume is devoted to problems within analytic metaphysics. It defends an ontology and theory of categories inspired by Aristotle, but revised in such a way as to be compatible with modern science. The ontology of both natural and social reality is addressed, starting out from the view that universals exist but only in the spatiotemporal world. In attempting to bring Aristotle's ontology up-to-date, the author relies very much on the thinking of Edmund Husserl, conceiving the cement of the universe (...) as Husserlian relations of existential dependence and regarding intentionality as a non-reducible category in the ontology of mind. The work is thoroughly realistic in spirit, but large parts of it should nonetheless be of interest to conceptualists and nominalists, too. (shrink)

The doctor-patient relationship -- Consent, choice, and refusal : adults with capacity -- Treating adults who lack capacity -- Children and young people -- Confidentiality -- Health records -- Contraception, abortion, and birth -- Assisted reproduction -- Genetics -- Caring for patients at the end of life -- Euthanasia and physician assisted suicide -- Responsibilities after a patient's death -- Prescribing and administering medication -- Research and innovative treatment -- Emergency situations -- Doctors with dual obligations -- Providing treatment and (...) care in detention settings -- Education and training -- Teamwork, referral, delegation, and shared care -- Public health dimensions of medical practice -- Reducing risk, clinical error, and poor performance. (shrink)

At the outset of an ethnographic inquiry, we navigated national and international resources to search for theoretical and practical guidance on obtaining parents and children’s informed consent/assent. While much theoretical guidance debating ethical issues to children’s participation in research was found, a paucity of published papers offering practical guidance on assent processes and/or visual representations of child assent forms and information sheets was discovered. The purpose of this article is to describe our experiences, both theoretically and practically, of negotiating the (...) process of obtaining informed consent and assent with parents and children for a non-therapeutic qualitative research study. We hope this article instigates a platform for others to explicate their experience and contributes to the construction of a coherent body of knowledge which will clearly delineate important elements that must be considered when negotiating children’s agreement to participate in research. (shrink)

This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

: This paper aims to investigate whether and in what respects the conceptions of the body and of agency that Judith Butler develops in Bodies That Matter are useful contributions to feminist theory. The discussion focuses on the clarification and critical assessment of the arguments Butler presents to refute the charges of linguistic monism and determinism.

It is argued that medical science requires a classificatory system that (a) puts functions in the taxonomic center and (b) does justice ontologically to the difference between the processes which are the realizations of functions and the objects which are their bearers. We propose formulae for constructing such a system and describe some of its benefits. The arguments are general enough to be of interest to all the life sciences.

Background:Ethical competence in nursing practice helps clinical nurses to think critically, analyse issues, make ethical decisions, solve ethical problems and behave ethically in their daily work. Thus, ethical competence contributes to the promotion of high-quality care. However, studies on ethical competence in Malawi are scanty.Objectives:The aim of this study was to explore ethical competence among clinical nurses in selected hospitals in Malawi.Methodology:A cross-sectional survey was conducted in four selected hospitals in Malawi with a sample of 271 clinical nurses. Data were (...) collected using self-administered questionnaires, which included a Moral Competence Scale for Home Care Nurses. Descriptive statistics and logistic regression were computed for the dataset using STATA version 12.0.Ethical consideration:The study protocol complied with all ethical requirements and was approved by the College of Medicine Research Ethics Committee under the University of Malawi.Results:The clinical nurses in Malawi are ethically competent. However, there is a significantly high number (p 0.05). Three determinants of high ethical competence level (strong will, judgement skills and recognition of discrepancy of intention) were identified through a reduced model after stepwise logistic regression analysis. Furthermore, results show that indicators of ethical competence include caring, confidentiality and observance of nurses dressing code. The study has also confirmed that the Moral Competence Scale for Home Care Nurses is a reliable tool to assess ethical competence in low-resource settings.Conclusion:The majority of nurses who completed the survey had low ethical competence. However, clinical nurses with high ethical competence level are required to competently manage complex ethical challenges in health facilities. Strategies for enhancing ethical competence such as continuing ethics education, establishment of ethics committees and provision of supportive supervision are recommended to enable nurses in Malawi attain a high level of ethical competence. (shrink)

It is argued that medical science requires a classificatory system that (a) puts functions in the taxonomic center and (b) does justice ontologically to the difference between the processes which are the realizations of functions and the objects which are their bearers. We propose formulae for constructing such a system and describe some of its benefits. The arguments are general enough to be of interest to all the life sciences.

Body representations are known to be dynamically modulated or extended through tool use. Here, we review findings that demonstrate the importance of a user's tool experience or expertise for successful tool embodiment. Examining expert tool users, such as individuals who use tools in professional sports, people who use chopsticks at every meal, or spinal injury patients who use a wheelchair daily, offers new insights into the role of expertise in tool embodiment: Not only does tool embodiment differ between novices and (...) experts, but experts may experience enhanced changes to their body representation when interacting with their own, personal tool. The findings reviewed herein reveal the importance of assessing tool skill in future studies of tool embodiment. (shrink)

In this paper, we examine the scientific, legal, and ethical foundations for inclusion of transgender women athletes in competitive sport, drawing on IOC principles and relevant Court of Arbitration for Sport decisions. We argue that the inclusion of trans athletes in competition commensurate with their legal gender is the most consistent position with these principles of fair and equitable sport. Biological restrictions, such as endogenous testosterone limits, are not consistent with IOC and CAS principles. We explore the implications for recognizing (...) that endogenous testosterone values are a ‘natural physical trait’ and that excluding legally recognized women for high endogenous testosterone values constitutes discrimination on the basis of a natural physical trait. We suggest that the justificatory burden for such prima facie discrimination is unlikely to be met. Thus, in place of a limit on endogenous testosterone for women, we argue that ‘legally recognized gender’ is most fully in line with IOC and CAS principles. (shrink)

Nurses working in outreach capacities frequently encounter disaffiliated or ‘hard to reach’ populations, such as those experiencing homelessness, those who use substances, and those with mental health concerns. Despite best efforts, nurses regularly fail to find meaningful engagement with these populations. Mobilizing the work of Deleuze and Guattari, this paper will critically examine conventional outreach nursing practices as rooted in the royal science of psychiatry, which many ‘survivors’ of psychiatric interventions reject. The field of Mad Studies offers an understanding of (...) patient resistance to outreach nursing interventions. Delueze and Guattari's concepts of packs and sorcerers provide a framework to envision alternative nursing practices as a form of resistance and creativity, where new alliances may be formed outside the coercive confines of traditional practices. In response to patient resistance, outreach nurses themselves must assemble packs and engage in acts of sorcery. (shrink)

The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (21.3%), (...) Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision‐making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families. (shrink)

Husserlian phenomenology of time, as it is developed on theLectures on the Phenomenology of Inner Time Consciousness, shows some difficulties to explain certain temporal experiences. This is the case of the incompatibility between the rigidity of the retentional modification and the effective approach that a subject may have with his memories. On the one hand, according to the Lectures’ explanation, the darkening of the past occurs in an homogeneous way: The more distant an experience is, the lower the clarity of (...) the associated retention. However, our relation with the past is not so direct. Complementing the studies of the Lectureswith those of the Analysis concerning passive synthesiscould allow to explain this kind of temporal phenomena. (shrink)

RESUMEN Aunque las Lecciones de fenomenología de la conciencia interna del tiempo tienen pocas referencias al marco metódico, ciertos pasajes apuntan a la reducción fenomenológica, de modo que su status se diferenciaría del de las Investigaciones lógicas y se acercaría al de Ideas i. Se ha señalado que aun si la reducción es empleada en este texto, no lo sería en su "versión madura". Se busca determinar el estatus metodológico de las Lecciones a partir de una comparación entre los desarrollos (...) metódicos y las descripciones fenomenológicas que se presentan allí y aquellos consignados en Investigaciones e Ideas, teniendo como idea regulativa el esclarecimiento del papel del tiempo en la ampliación del dominio de la fenomenología como conjunto. ABSTRACT Although there are few references to the methodological framework in On the Phenomenology of the Consciousness of Internal Time, certain passages point to the phenomenological reduction. Therefore, its status would differ from that of the Logical Investigations and approach that of Ideas I. Some have argued that the reduction used in this text is not the "mature version" of the same. The article seeks to determine the methodological status of PCIT on the basis of the comparison between the methodological developments and phenomenological descriptions found in this work and those found in Investigations and Ideas. The regulative idea guiding the analysis is the clarification of the role of time in broadening the sphere of phenomenology as a whole. (shrink)

En este trabajo presentamos el proceso del ordenamiento, catalogación y curaduría de los materiales fotográficos de un antropólogo estadounidense que realizó trabajo de campo en Atlixco, Puebla, México, con indígenas de la etnia nahua en las décadas de 1970 y 1980La metodología utilizada para este trabajo se basó en una propuesta propia de catalogación mínima de materiales fotográficos.Concluimos que la catalogación mínima es adecuada para la interoperabilidad con los estándares internacionales y resulta fácil de aplicar en los contextos universitarios y (...) de archivos locales. (shrink)

many symbols. We define o, as the probability that an arbitrary machine be circular and we prove that o, is a random number that goes beyond..

Este trabajo examina diferentes perspectivas docentes para externalizar criterios de evaluación. Se presentan hallazgos de una investigación doctoral que abordan, por una parte, una metodología analítica, que cautela la claridad y transparencia en la comunicación de criterios, segmentando la meta de aprendizaje en pequeñas secuencias, transmitiendo de este modo una idea atomizada acerca del conocimiento. Por otra parte, se explora una visión más holística, sustentada en la interdependencia de los criterios de evaluación, favoreciendo la comprensión del propósito de la tarea (...) en su conjunto. Se analiza la significancia de estos enfoques para la retroalimentación y evaluación formativa. (shrink)

We contribute to feminist and gender scholarship on cultural notions of motherhood by analyzing the importance of motherhood among mothers and non-mothers. Using a national probability sample of U.S. women ages 25-45, we find a continuous distribution of scores measuring perceptions of the importance of motherhood among both groups. Employing OLS multiple regression, we examine why some women place more importance on motherhood, focusing on interests that could compete with valuing motherhood, and controlling for characteristics associated with becoming a mother. (...) Contrary to cultural schemas that view mother and worker identities as competing, we find that education level is not associated with the importance of motherhood for either group and that valuing work success is positively associated with valuing motherhood among mothers. Consistent with feminist explanations for delayed fertility, valuing leisure is negatively associated with valuing motherhood for non-mothers. (shrink)

El canon literario implica un proceso de selección sistemático y jerárquico de escritores, obras y géneros con el fin de delimitar un corpus modélico imitableligado fuertemente a la instrucción pedagógica. En el presente trabajo se analizará el particular proceso de formación y conformación del canon –así como surecepción y transformación respecto de los cánones previos– establecido por Quintiliano en el Libro 10 de la Institutio Oratoria, a fin de demostrar que los criterios de selección que guían dicho canon exceden la (...) mera función didáctica. (shrink)

Epistemological naturalists reject the demand for a priori justification of empirical knowledge; no such thing is possible. Observation reports, being the foundation of empirical knowledge, are neither justified by other sentences, nor certain; but they may be agreed upon as starting points for inductive reasoning and they function as implicit definitions of predicates used. Making inductive generalisations from observations is a basic habit among humans. We do that without justification, but we have strong intuitions that some inductive generalisations will fail, (...) while for some other we have better hopes. Why? This is the induction problem according to Goodman. He suggested that some predicates are projectible when becoming entrenched in language. This is a step forward, but not entirely correct. Inductions result in universally generalised conditionals and these contain two predicates, one in the antecedent, one in the consequent. Counterexamples to preliminary inductive generalisations can be dismissed by refining the criteria of application for these predicates. This process can be repeated until the criteria for application of the predicate in the antecedent includes the criteria for the predicate in the consequent, in which case no further counterexample is possible. If that is the case we have arrived at a law. Such laws are implicit definitions of theoretical predicates. An accidental generalisation has not this feature, its predicates are unrelated. Laws are said to be necessary, which may be interpreted as ‘“Laws” are necessarily true’. ‘Necessarily true’ is thus a semantic predicate, not a modal operator. In addition, laws, being definitions, are necessarily true in the sense of being necessary assumptions for further use of the predicates implicitly defined by such laws. Induction, when used in science, is thus our way of inventing useful scientific predicates; it is a heuristic, not an inference principle. (shrink)

Literature and Philosophical Play in Early Childhood Education explores the role of philosophy and the humanities as pedagogy in early childhood educational research and practice, arguing that research should attend to questions about education and growth that concern social structures, individual development and existential aspects of learning. It demonstrates how we can think of pedagogy and educational practices in early childhood as artistic, poetic and philosophical, and exemplifies a humanities-based approach by giving literature and artful play a place in shaping (...) the ground of practice and research. (shrink)

The article discusses a relatively obscure but significant aspect of work of the Russian and Soviet thinker Alexander Bogdanov—his science fiction novels. The author points out that, using the form...

O objetivo deste artigo é apresentar uma argumentação sobre a possibilidade de se pensar a justiça como uma experiência do i m possível. Parte-se da distinção derridiana entre justiça e direito. Essa distinção trará algumas implicações no que tradicionalmente é entendido como ética. Partindo do jogo ou da différance marcada entre a presença/ausência, pretende-se estabelecer um ponto de diálogo entre Derrida e Levinas. O ponto de aproximação é a questão do terceiro na relação do face a face. Nesse sentido, problematiza-se (...) se a desconstrução pode ser adotada como um possível modo filosófico que fundamente a compreensão da justiça. (shrink)

Offers a historical-cultural context for the ethos of service in libraries and critically examines this professional value as it intersects with gender, sexuality, race and ethnicity, class, and (dis)ability"--Provided by publisher.

It is commonly thought that that the best system account of lawhood ((Mill (1843), Ramsey (1978)[fp. 1928], Lewis (1973)) makes available a nice explanation for why laws are ‘distinctively appropriate targets of scientific inquiry’ (Hall, 2015). The explanation takes the following general form: laws are especially valuable for agents like us because they efficiently encode a lot of valuable (non-nomic) information in a tractable format. The goal of this paper is to challenge this style of explanation: I argue that the (...) general principle it presupposes is in conflict with our best account of practical rationality. After considering and rejecting a number of proposals for dissolving the tension, I conclude that BSA proponents may need to scale back the explanatory ambitions of their theory; in particular, they may need to give up the hope of non-circular explanations of the value of nomic information. I end by outlining some challenges for the humean world-view that results after this shift. (shrink)